O7 Evaluation of the Degree of Anxiety and Stress in People with Type 1 and 2 Diabetes (T1D and T2D) during quarantine due to COVID-19 pandemic in Argentina

Abstract

Introduction: the COVID-19 pandemic has generated the indication of isolation in many countries, in order to avoid the spread of the virus. This situation has meant that people with diabetes must remain at home, and alterations in their mood and psychological state may appear.

Objectives: evaluate the psychological impact of quarantine by determining the degree of anxiety and stress measured by questionnaires, in people with DM1 and DM2 over 18 years of age. Analyze the possible association of the scores obtained with various independent covariates.

Materials and methods: multicenter, cross-sectional observational study, data collection through online questionnaires, sent randomly by electronic means from April 1 to May 3, 2020. The degree of stress was evaluated using the Perceived Stress Scale. (PSS), and the degree of anxiety using the Beck Anxiety Inventory (BAI). Statistical analysis: descriptive statistics and hypothesis confrontation test, multiple linear regression, chi2 and Spearman correlation coefficient. Any value of p<0.05 was considered statistically significant (SE).

Results: 2,273 patients were included, 1,057 (46.5%) with DM1 and 1,216 (53.4%) with DM2. Female sex 52.5%, male sex 47.5%. Average age 41 years (±14) in DM1 and 57 years (±11) in DM2. Years of diabetes: 17 years in DM1 and 11 years in DM2. Hb A1c 7.8% (±1.4) in DM1 vs 7.4% (±1.6) in DM2. Complications due to diabetes 9.2% diabetic foot, 12.8 retinopathy, 4.7% kidney disease and 9.3% cardiovascular disease. 96.9% of the population was quarantined. 62.4% received the flu vaccine in 2019 (higher in DM1 vs DM2, p 0.027). Qualitative variables: 3.6% had a severe BAI score, 8% moderate BAI, with a lower score in DM2 (p 0.0213), 22.4% mild BAI and 63.8% minimal BAI, with a higher score in DM2 (p 0.0042). Good Spearman correlation between both scales (0.57, p<0.0001). In the univariate analysis, not having complications was correlated with lower BAI (p <0.0001) and PSS. (p<0.0001), the younger the age, the greater the BAI (p<0.0001) and PSS (p<0.0001), the greater the Hb A1c, the greater the BAI (p.00001) and PSS (p0.0001). Female sex and having DM1 were correlated with higher scores in both questionnaires in ES form. The PPS was higher in people served in the public system. Multivariate analysis: younger age, higher Hb A1c, female sex and presence of complications had statistical significance with higher scores in both questionnaires. When the type of diabetes was adjusted for confounders, there was an ES change in the direction of the correlation, with a higher score in DM2 being found in both questionnaires.

Conclusions: in the present study, younger age, worse metabolic control, female sex, the presence of complications and having DM2 were correlated with a greater emotional impact of isolation due to COVID in people with diabetes in Argentina.