Diabetes self‐management during the COVID‐19 pandemic and its associations with COVID‐19 anxiety syndrome, depression and health anxiety

INTRODUCTION: The effects of the COVID‐19 pandemic on mental health have been profound. Mental health and diabetes self‐care are inter‐related. We examined whether COVID‐19 anxiety, depressive symptoms and health anxiety were associated with domains of diabetes self‐management and investigated whether greater COVID‐19 anxiety syndrome would independently contribute to suboptimal diabetes self‐care. RESEARCH DESIGN AND METHODS: Surveys were sent to people attending diabetes clinics of three London hospitals. Participants completed the Diabetes Self‐Management Questionnaire (DSMQ), the COVID‐19 Anxiety Syndrome Scale (C‐19 ASS), which measures perseveration and avoidant maladaptive coping behaviour, assessed with measures of co‐existent depressive symptoms and anxiety, controlling for age, gender and social deprivation. Clinical data, including pre‐ and post‐lockdown HbA(1c) measures, were obtained from hospital records for 369 respondents, a response rate of 12.8%. RESULTS: Depressive symptom scores were high. Both pre‐existing health anxiety and depressive symptoms were independently linked to improvable measures of diabetes care, as was lower socio‐economic rank. However, avoidant COVID‐19 anxiety responses were independently associated with higher diabetes self‐care scores. HbA(1c) levels improved modestly over the year of UK lockdown in this cohort. CONCLUSION: During the height of lockdown, avoidant coping behaviours characteristic of the COVID‐19 anxiety syndrome may in fact work to improve diabetes self‐care, at least in the short term. We recommend screening for depressive symptoms and being aware of the significant minority of people with COVID‐19 anxiety syndrome who may now find it difficult to re‐engage with face‐to‐face clinic opportunities.