Impact of the COVID-19 pandemic and lockdown restrictions on psychosocial and behavioural outcomes among Australian adults with type 2 diabetes: Findings from the PREDICT cohort study

Julian W Sacre; Elizabeth Holmes-Truscott; Agus Salim; Kaarin J Anstey; Grant R Drummond; Rachel R Huxley; Dianna J Magliano; Peter van Wijngaarden; Paul Z Zimmet; Jane Speight; Jonathan E Shaw

doi:10.1111/dme.14611

Impact of the COVID-19 pandemic and lockdown restrictions on psychosocial and behavioural outcomes among Australian adults with type 2 diabetes: Findings from the PREDICT cohort study

Diabet Med. 2021 Sep;38(9):e14611. doi: 10.1111/dme.14611. Epub 2021 Jun 18.

Authors

Julian W Sacre¹, Elizabeth Holmes-Truscott^{2

3}, Agus Salim^{1

4

5}, Kaarin J Anstey^{6

7}, Grant R Drummond^{1

8}, Rachel R Huxley⁹, Dianna J Magliano^{1

10}, Peter van Wijngaarden^{11

12}, Paul Z Zimmet¹³, Jane Speight^{2

3}, Jonathan E Shaw^{1

14}

Affiliations

¹ Baker Heart and Diabetes Institute, Melbourne, Vic., Australia.
² School of Psychology, Deakin University, Geelong, Vic., Australia.
³ The Australian Centre for Behavioural Research in Diabetes, Melbourne, Vic., Australia.
⁴ Department of Mathematics and Statistics, La Trobe University, Melbourne, Vic., Australia.
⁵ Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, Vic., Australia.
⁶ UNSW Ageing Futures Institute, University of New South Wales, Sydney, NSW, Australia.
⁷ Neuroscience Research Australia, Sydney, NSW, Australia.
⁸ Centre for Cardiovascular Biology and Disease Research, Department of Physiology, Anatomy and Microbiology, School of Life Sciences, La Trobe University, Melbourne, Vic., Australia.
⁹ Faculty of Health, Deakin University, Melbourne, Vic., Australia.
¹⁰ School of Public Health and Preventive Medicine, Monash University, Melbourne, Vic., Australia.
¹¹ Centre for Eye Research Australia, Royal Victorian Eye and Ear Hospital, Melbourne, Vic., Australia.
¹² Ophthalmology, Department of Surgery, University of Melbourne, Melbourne, Vic., Australia.
¹³ Department of Diabetes, Central Clinical School, Monash University, Melbourne, Vic., Australia.
¹⁴ School of Life Sciences, La Trobe University, Melbourne, Vic., Australia.

Abstract

Aim: To examine psychosocial and behavioural impacts of the novel coronavirus disease 2019 (COVID-19) pandemic and lockdown restrictions among adults with type 2 diabetes.

Methods: Participants enrolled in the PRogrEssion of DIabetic ComplicaTions (PREDICT) cohort study in Melbourne, Australia (n = 489 with a baseline assessment pre-2020) were invited to complete a phone/online follow-up assessment in mid-2020 (i.e., amidst COVID-19 lockdown restrictions). Repeated assessments that were compared with pre-COVID-19 baseline levels included anxiety symptoms (7-item Generalised Anxiety Disorder scale [GAD-7]), depressive symptoms (8-item Patient Health Questionnaire [PHQ-8]), diabetes distress (Problem Areas in Diabetes scale [PAID]), physical activity/sedentary behaviour, alcohol consumption and diabetes self-management behaviours. Additional once-off measures at follow-up included COVID-19-specific worry, quality of life (QoL), and healthcare appointment changes (telehealth engagement and appointment cancellations/avoidance).

Results: Among 470 respondents (96%; aged 66 ± 9 years, 69% men), at least 'moderate' worry about COVID-19 infection was reported by 31%, and 29%-73% reported negative impacts on QoL dimensions (greatest for: leisure activities, feelings about the future, emotional well-being). Younger participants reported more negative impacts (p < 0.05). Overall, anxiety/depressive symptoms were similar at follow-up compared with pre-COVID-19, but diabetes distress reduced (p < 0.001). Worse trajectories of anxiety/depressive symptoms were observed among those who reported COVID-19-specific worry or negative QoL impacts (p < 0.05). Physical activity trended lower (~10%), but sitting time, alcohol consumption and glucose-monitoring frequency remained unchanged. 73% of participants used telehealth, but 43% cancelled a healthcare appointment and 39% avoided new appointments despite perceived need.

Conclusions: COVID-19 lockdown restrictions negatively impacted QoL, some behavioural risk factors and healthcare utilisation in adults with type 2 diabetes. However, generalised anxiety and depressive symptoms remained relatively stable.

Keywords: anxiety; delivery of health care; depression; diabetes complications; exercise; quality of life; telemedicine.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Aged
Anxiety / epidemiology
Australia / epidemiology
COVID-19 / epidemiology
COVID-19 / prevention & control*
COVID-19 / psychology*
Cohort Studies
Communicable Disease Control / methods*
Depression / epidemiology
Diabetes Mellitus, Type 2 / epidemiology
Diabetes Mellitus, Type 2 / psychology*
Exercise / psychology
Female
Health Behavior*
Humans
Male
Mental Health / statistics & numerical data
Middle Aged
Pandemics
Patient Isolation / psychology
Psychology / statistics & numerical data*
Quality of Life / psychology
SARS-CoV-2
Social Isolation / psychology

Abstract

Publication types

MeSH terms

Grants and funding