College of Nursing, University of Tennessee, Knoxville, Tennesse.
Department of Public Health, The University of Tennessee, Knoxville, Tennessee.
Sci Diabetes Self Manag Care. 2022 Aug;48(4):213-234. doi: 10.1177/26350106221102863. Epub 2022 May 31.
The purpose of this study was to compare diabetes psychosocial comorbidities among adults with type 1 diabetes (T1D) across the United States during the onset of COVID-19 pandemic.
Adults with T1D from 4 main US geographic regions including South (n = 367), West (n = 234), Northeast (n = 250), and Midwest (n = 247) completed a cross-sectional online survey between April and June 2020. Data collection was done on psychosocial measures, glycemic variability, sociodemographic characteristics, and various challenges related to the COVID-19 pandemic. Chi-square, Fisher's exact, Kruskal-Wallis tests, ordinary least squares, proportional odds, and ordinal logistic regression methods were used for data analysis.
In the South, 51.2% of participants had moderate to high levels of diabetes distress, and this was significantly ( = .03) higher than other regions. Northeast region had the lowest prevalence of moderate to severe diabetes burnout (19.8%), but this was not significantly different compared to the other regions. Participants in the South had also the highest mean score on the 8-item Patient Health Questionnaire, with 30.3% of them reporting moderate to severe depressive symptoms. However, there were no significant differences in depressive symptoms among the regions. Glycemic control, demographic characteristics, and COVID-19-related challenges were associated with different psychosocial comorbidities in different regions.
When providing information and support to individuals with diabetes in time of crisis like the COVID pandemic, providers should consider psychosocial aspects of diabetes care. Diabetes disparities and contextual factors vary geographically in the United States; these factors may impact the psychosocial comorbidities of diabetes in each region.
本研究旨在比较美国 COVID-19 大流行期间，1 型糖尿病（T1D）患者的糖尿病心理共病。
来自美国 4 个主要地理区域（南部，n=367；西部，n=234；东北部，n=250；中西部，n=247）的 T1D 成年人在 2020 年 4 月至 6 月期间完成了一项横断面在线调查。数据收集涉及心理社会措施、血糖变异性、社会人口统计学特征以及与 COVID-19 大流行相关的各种挑战。使用卡方检验、Fisher 精确检验、Kruskal-Wallis 检验、最小二乘法、比例优势和有序逻辑回归方法进行数据分析。
在南部，51.2%的参与者存在中度至高度糖尿病困扰，这明显高于其他地区（ = .03）。东北部地区的中度至重度糖尿病倦怠发生率最低（19.8%），但与其他地区相比无显著差异。南部参与者的 8 项患者健康问卷平均得分也最高，其中 30.3%的人报告存在中度至重度抑郁症状。然而，各地区之间的抑郁症状无显著差异。血糖控制、人口统计学特征和与 COVID-19 相关的挑战与不同地区的不同心理社会共病有关。
在 COVID 大流行等危机时期为糖尿病患者提供信息和支持时，医务人员应考虑到糖尿病心理护理的各个方面。美国各地的糖尿病差异和背景因素存在地域差异，这些因素可能会影响每个地区的糖尿病心理共病。
