Diabetes Care. 2022 Jan 1;45(1):42-58. doi: 10.2337/dc21-0769.
To compare the mental health experiences associated with coronavirus disease 2019 (COVID-19) in adults with and without diabetes.
Between 29 May 2020 and 30 June 2020, 2,176 U.S. adults completed an online survey including demographics, COVID-19 experiences, depression (eight-item Patient Health Questionnaire) and anxiety (seven-item Generalized Anxiety Disorder) symptoms, perceived stress (10-item Perceived Stress Scale), resilience (Brief Resilience Scale), and diabetes-related distress (in participants with diabetes) (17-item Diabetes Distress Scale).
Mean age was 49.6 years (SD 16.9); participants were primarily women (80.0%) and White (88.3%), with an annual household income of ≥$60,000 (57.6%). One hundred reported a diagnosis of type 1 diabetes (4.6%), 304 type 2 diabetes (13.9%), and 145 prediabetes (6.6%). Nearly one-third (29.7%) indicated decreases in income attributable to the pandemic. Participants with type 1 diabetes had higher levels of diabetes distress than participants with type 2 diabetes (P < 0.05), with moderate severity in both groups. Participants with type 2 diabetes had significantly more comorbidities and COVID-19 risk factors than all other groups (all P < 0.01). After controlling for covariates, participants with type 2 diabetes reported significantly more depressive symptoms than those without diabetes (P < 0.05) and lower levels of resilience (P < 0.05). Subgroup analyses by sex and age indicated that women and younger adults, particularly those age 18-34 years, reported significantly more depression and anxiety symptoms, stress, and diabetes-related distress and lower levels of resilience than men and adults age ≥51 years.
In this naturalistic observational study, participants with type 2 diabetes reported more depression, lower resilience, and significantly more COVID-19 risk factors and medical comorbidities than participants without diabetes. Overall, our participants demonstrated worse depression and anxiety symptoms during compared with before the pandemic.
比较患有和不患有糖尿病的成年人与 2019 年冠状病毒病（COVID-19）相关的心理健康体验。
在 2020 年 5 月 29 日至 6 月 30 日期间，2176 名美国成年人完成了一项在线调查，内容包括人口统计学、COVID-19 经历、抑郁（8 项患者健康问卷）和焦虑（7 项广泛性焦虑症）症状、感知压力（10 项感知压力量表）、韧性（简要韧性量表）以及糖尿病相关困扰（在患有糖尿病的参与者中）（17 项糖尿病困扰量表）。
平均年龄为 49.6 岁（标准差 16.9）；参与者主要为女性（80.0%）和白人（88.3%），年收入≥$60,000（57.6%）。有 100 人报告诊断为 1 型糖尿病（4.6%），304 人报告诊断为 2 型糖尿病（13.9%），145 人报告诊断为前期糖尿病（6.6%）。近三分之一（29.7%）的人表示收入因大流行而减少。与 2 型糖尿病患者相比，1 型糖尿病患者的糖尿病困扰程度更高（P < 0.05），两组均为中度严重程度。与所有其他组相比，2 型糖尿病患者的合并症和 COVID-19 风险因素明显更多（均 P < 0.01）。在控制了协变量后，与无糖尿病患者相比，2 型糖尿病患者报告的抑郁症状明显更多（P < 0.05），韧性水平明显更低（P < 0.05）。按性别和年龄进行的亚组分析表明，女性和年轻成年人，尤其是 18-34 岁的成年人，与男性和≥51 岁的成年人相比，报告的抑郁、焦虑症状、压力和糖尿病相关困扰更多，韧性水平更低。
在这项自然观察研究中，与无糖尿病患者相比，2 型糖尿病患者报告的抑郁症状更多，韧性更低，COVID-19 风险因素和合并症更多。总体而言，与大流行前相比，我们的参与者在大流行期间表现出更严重的抑郁和焦虑症状。
