COVID-19 pandemic-related healthcare interruptions and diabetes distress: A national study of US adults with diabetes Open Access

Saseetharran, Ankeeta (Spring 2023)

Permanent URL: https://etd.library.emory.edu/concern/etds/7s75dd80q?locale=en%5D
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Abstract

Objective: Diabetes distress is an emotional state characterized by worry, conflict, frustration, and discouragement due to living with diabetes. This analysis aimed to determine the association between COVID-19 pandemic-related healthcare interruptions and diabetes distress in 2021 among adults with Type 1 and Type 2 diabetes in the United States.

Method: A representative sample of adults aged 20 years and older with Type 1 (n=228) and Type 2 (n=2534) diabetes from the National Health Interview Survey in 2021 were analyzed with survey adjusted methods. Participants reported pandemic-related healthcare delays and deferrals, as well as the experience of diabetes-related distress through a single item regarding frequency of diabetes distress in the past month. Diabetes distress was dichotomized as never or ever having experienced diabetes distress in the past month. Logistic regression was used to determine the associations of experiencing delayed medical care and being unable to get medical care (exposures) with diabetes distress (outcome).

Results: 60.3% of individuals with Type 1 diabetes and 50.8% of individuals with Type 2 diabetes experienced diabetes distress. 23.2% of individuals with Type 1 diabetes experienced delayed medical care and 18.0% did not get medical care. 21.1% of individuals with Type 2 diabetes experienced delayed medical care and 15.1% did not get medical care. In individuals with Type 1 diabetes, people who delayed medical care, compared to those who did not delay care, were more likely to experience diabetes distress (adjusted odds ratio [aOR]= 4.14; 95% CI: 1.89-9.11). Similarly, not receiving medical care was associated with aOR= 3.37 (95% CI: 1.35-8.45) for diabetes distress in people with Type 1 diabetes. In individuals with Type 2 diabetes, the adjusted odds ratio of diabetes distress for delayed medical care was 1.72 (95% CI: 1.35-2.20) and the adjusted odds ratio of diabetes distress for not receiving medical care was 1.50 (95% CI: 1.13-1.98).

Conclusion: Over half of adults with diabetes reported diabetes distress in 2021. Experience of pandemic-related healthcare disruptions was associated with higher reports of diabetes distress.

Table of Contents

Chapter 1: Introduction and Extended Literature Review 1

Chapter 2: Manuscript 5

Abstract 6

Introduction 7

Materials and methods 8

Results 11

Discussion 13

References 16

Tables and Figures 19

Chapter 3. Summary and Conclusions 23

References 25

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