The psychosocial impact of type 1 diabetes mellitus in children and adolescents during the covid-19 pandemic

Background: Type 1 Diabetes Mellitus (T1DM) is the most common chronic endocrine disorder of childhood. [1] It can exert a large psychosocial impact on children and their families, as the treatment is often complex requiring a multidisciplinary approach. [1] The significance of the psychosocial impact can become more pronounced during the COVID-19 pandemic. [2] Aim: The primary aim of this study was to investigate whether the COVID-19 pandemic might impact the psychosocial impact of T1DM and glycaemic control. Methods: During the lockdown to restrict the spread of COVID-19, residents of New South Wales (NSW) were not allowed to leave home except for essential activities. [3] Three months later (July to August 2020) children with T1DM and their parents were invited to complete online questionnaires consisted of 10-14 questions with the use of Likert scale from 1 to 5 (1 being strongly disagreed and 5 being strongly agreed), addressing psychosocial aspects of T1DM in relation to the COVID-19 pandemic. Data on glycaemic control pre-and post-COVID pandemic were extracted from the patient's clinical records for those who chose to give their identities. Descriptive and comparative statistics were used to analyse the responses. Results: Out of 149 families, 99 responses were received, with 92 participants identified. 72% of parents felt anxious about diabetes due to added health risks, whereas 45% of children felt worried about getting severe COVID-illness due to diabetes. The responses from parents and children were closely correlated (p < 0.05) except for having clear and concrete goals for diabetes care (p = 0.80). The was no consistent effect of COVID-19 on HbA1C levels, but there was a significant inverse correlation between HbA1C levels during the pandemic and children's prepandemic regular exercise activities. Conclusion: This study found that parents were more anxious generally about diabetes due to added health risks. There were significantly correlated responses between parents and children in most psychosocial aspects except for having clear and concrete goals for diabetes care. The HbA1C levels did not change significantly with the lockdown. Higher pre-pandemic organised physical activity correlated with better pandemic diabetes control. The findings are consistent with the results of a Denmark study that concluded people with diabetes were associated with poorer psychosocial health during the pandemic. [4] Additional studies on psychosocial assessment and intervention are recommended to offer support to parents and children with T1DM.