The Effect of COVID-19 Pandemic on Quality of Life in Children with Type 1 Diabetes Mellitus and Their Families Using Insulin Infusion Pumps

Year 2024, Volume: 16 Issue: 3, 249 - 256, 29.10.2024

Nurcan Ünal , İlknur Arslanoğlu , Seda Erişen Karaca , Pınar Yıldız Gülhan

https://doi.org/10.18521/ktd.1389913

Abstract

Objective: This study aimed to assess the impact of the coronavirus disease (COVID-19) pandemic on the quality of life (QOL) of children with type 1 Diabetes Mellitus (T1DM) and their families, specifically focusing on the effects of insulin infusion pumps. We also aimed to identify changes in both children's and parents' QOL during the pandemic period.
Methods: This study utilized the KINDL (KINDer Lebensqualitätsfragebogen: Children’s QOL) questionnaire for the children, and the World Health Organization Quality of Life (WHOQOL)-BREF Turkish Version (TR) (WHO-QOL-BREF-TR) scale for their parents. Data were collected using Google Forms, with assessments performed before and during the pandemic.
Results: The study included 61 participants, 38 of whom were female (62.3%), with a mean age of 12.7±2.9 years and a mean diabetes duration of 6.4±2.5 years. Pre-pandemic KINDL scores for "emotional health" and "school" were significantly higher than those during the pandemic (p=0.022 and p=0.002, respectively). Surprisingly, HbA1c levels improved during the pandemic compared to the pre-pandemic values (p<0.001). There were strong correlations between children's and parents' QOL before and during the pandemic (p<0.001). Parents' physical health scores on the WHOQOL-BREF decreased significantly during the pandemic (p=0.012).
Conclusion: Improvement in HbA1c levels during the pandemic warrants further investigation. Additionally, the pandemic negatively affected the emotional well-being of children and the physical health of parents, highlighting the need for more support in these areas during times of crisis.

Keywords

COVID-19 Pandemic, Type 1 Diabetes Mellitus, Infusion Pumps, Quality of Life

COVID-19 Pandemisinin Tip 1 Diyabetes Mellitus Tanılı Çocuklar ve Ailelerinin Yaşam Kalitesi Üzerindeki Etkisi: İnsülin İnfüzyon Pompası Kullanan Hastalar

Abstract

Amaç: Bu çalışma, COVID-19 pandemisinin Tip 1 Diyabetes Mellitus (T1DM) tanılı çocuklar ve ailelerinin yaşam kalitesi (QOL) üzerindeki etkisini, özellikle insülin infüzyon pompalarının etkisine odaklanarak incelemeyi amaçlamaktadır. Ayrıca, pandemi süresince hem çocukların hem de ebeveynlerin QOL’undaki değişiklikler tespit edilmeye çalışılmıştır.
Gereç ve Yöntem: Çocuklar için KINDL (KINDer Lebensqualitätsfragebogen: Çocuk Yaşam Kalitesi Anketi) ve ebeveynler için Dünya Sağlık Örgütü Yaşam Kalitesi Ölçeği (WHOQOL)-BREF Türkçe Versiyonu (TR) (WHO-QOL-BREF-TR) kullanılmıştır. Veriler Google Forms üzerinden toplanmış, değerlendirmeler pandemi öncesi ve pandemi sırasında yapılmıştır.
Bulgular: Çalışmaya katılan 61 katılımcının 38’i (%62,3) kadındı ve katılımcıların yaş ortalaması 12,7±2,9 yıl, diyabet süresi ortalaması ise 6,4±2,5 yıldı. Pandemi öncesinde KINDL’nin “duygusal sağlık” ve “okul” alt boyutlarının puanları, pandemi süresindekilerden anlamlı derecede daha yüksekti (sırasıyla p=0,022 ve p=0,002). Şaşırtıcı bir şekilde, pandemi sırasında HbA1c seviyeleri pandemi öncesine göre iyileşmiştir (p<0,001). Pandemi öncesi ve sırasında çocukların ve ebeveynlerin QOL’ları arasında güçlü korelasyonlar bulunmuştur (p<0,001). Ebeveynlerin WHOQOL-BREF üzerindeki fiziksel sağlık puanları pandemi sırasında anlamlı şekilde düşmüştür (p=0,012).
Sonuç: Pandemi süresince HbA1c seviyelerindeki iyileşme dikkate değer olup, daha fazla araştırma gerektirmektedir. Ayrıca, pandemi çocukların duygusal sağlıklarını ve ebeveynlerin fiziksel sağlıklarını olumsuz etkilemiş, bu tür kriz dönemlerinde bu alanlarda daha fazla desteğin gerekliliğine işaret etmiştir.

Keywords

COVID-19 Pandemisi, Tip 1 Diyabetes Mellitus, İnfüzyon pompaları, Yaşam kalitesi

References

• 1. Dabelea D, Mayer-Davis EJ, Saydah S, Imperatore G, Linder B, Divers J, et al. Prevalence of type 1 and type 2 diabetes in children and adolescents from 2001 to 2009. JAMA. 2014;311(17):1778–86.
• 2. Mobasseri M, Shirmohammadi M, Amiri T, Vahed N, Hosseini Fard H, Ghojazadeh M. Prevalence and incidence of type 1 diabetes in the world: a systematic review and meta-analysis. Heal Promot Perspect. 2020;10(2):98–115.
• 3. Yeşilkaya E, Cinaz P, Andıran N, Bideci A, Hatun Ş, Sarı E, et al. First report on the nationwide incidence and prevalence of Type 1 diabetes among children in Turkey. Diabet Med. 2017; 34(3):405–10.
• 4. Svoren BM, Jospe N. Diabetes mellitus in children. Nelson textbook of pediatrics. Philadelphia: Saunders Elsevier; 2016.
• 5. Alvarado-Martel D, Velasco R, Sánchez-Hernández RM, Carrillo A, Nóvoa FJ, Wägner AM. QOL and type 1 diabetes: a study assessing patients’ perceptions and self-management needs. Patient Prefer Adherence. 2015;9:1315–23.
• 6. World Health Organization (WHO). World Health Organization (2020) Novel coronavirus (2019-nCoV). Situation Report [https://iris.who.int/handle/10665/330760] Available from: https://www.who.int/emergencies/diseases/novel-coronavirus-2019/situation-reports
• 7. Ferreira LN, Pereira LN, da Fé Brás M, Ilchuk K. QOL under the COVID-19 quarantine. Qual Life Res. 2021;30(5):1389–405.
• 8. Delamater AM, de Wit M, McDarby V, Malik J, Acerini CL. ISPAD Clinical Practice Consensus Guidelines 2014. Psychological care of children and adolescents with type 1 diabetes. Pediatr Diabetes. 2014 ; Suppl 2:232–44.
• 9. Mukhtar S, Mukhtar S. Letter to the Editor: Mental Health and Psychological Distress in People with Diabetes during COVID-19. Vol. 108, Metabolism: clinical and experimental. 2020; 154248
• 10. Von Elm E, Altman DG, Egger M, Pocock SJ, Gøtzsche PC, Vandenbroucke JP, et al. The Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) statement: guidelines for reporting observational studies. J Clin Epidemiol. 2008;61(4):344–9.
• 11. Gunes S, Aldemir R, Gunes A, Ekinci O. Parent-reported sleep problems in children and adolescents with sickle cell disease: relationship to health-related quality of life. Arch Med Sci. 2021; 26;18(3):659-65.
• 12. Guven SG, Gorgulu Y. The impact of preoperative psychological characteristics on postoperative satisfaction and QOL in patients undergoing septoplasty and inferior turbinate ablation surgery. Eur Arch Oto-Rhino-Laryngology. 2022;279:4007–15
• 13. Er M. Child, illness, parent siblings. Çocuk Sağlığı ve Hast Derg. 2006;49(2):155–68.
• 14. Turkel S, Pao M. Late consequences of chronic pediatric illness. Psychiatr Clin North Am. 2007;30(4):819–35.
• 15. Fakhri M, Abdan M, Ramezanpour M, Dehkordi AH, Sarikhani D. Systematic Review and Meta-Analysis on QOL in Diabetic Patients in Iran. Int J Prev Med. 2021;12:41.
• 16. Duras E, Bezen D, Özkaya O, Dursun H. Evaluation of the quality of life of patients followed up with diagnosis of type 1 diabetes mellitus. Güncel Pediatr. 2018;16(2):72–85.
• 17. Memik NÇ, Ağaoğlu B, Coşkun A, Hatun Ş, Ayaz M, Karakaya I. Evaluation of quality of life in children and adolescents with type 1 diabetes mellitus. Turk J Child Adolesc Ment Heal. 2007;14(3):133–8.
• 18. Tornese G, Ceconi V, Monasta L, Carletti C, Faleschini E, Barbi E. Glycemic Control in Type 1 Diabetes Mellitus During COVID-19 Quarantine and the Role of In-Home Physical Activity. Diabetes Technol Ther. 2020;22(6):462–7.
• 19. Christoforidis A, Kavoura E, Nemtsa A, Pappa K, Dimitriadou M. Coronavirus lockdown effect on type 1 diabetes management οn children wearing insulin pump equipped with continuous glucose monitoring system. Diabetes Res Clin Pract. 2020 ;166:108307.
• 20. Turan H, Güneş Kaya D, Tarçın G, Evliyaoğlu SO. Effect of the COVID-19 quarantine on metabolic control in children and adolescents with type 1 diabetes. Endocrinol diabetes y Nutr. 2022;69(3):201–8.
• 21. Arslanoglu I, Akcali F, Yavuzyilmaz F, Sungur MA. Short Time Effect of COVID 19 Pandemic on HbA1c and Acute Metabolic Complications in Children with Type 1 Diabetes. SAS J Med, 2021;7(8):336-34.
• 22. Cohn LN, Pechlivanoglou P, Lee Y, Mahant S, Orkin J, Marson A, et al. Health Outcomes of Parents of Children with Chronic Illness: A Systematic Review and Meta-Analysis. J Pediatr. 2020 ;218:166-177.e2.
• 23. Cousino MK, Hazen RA. Parenting stress among caregivers of children with chronic illness: a systematic review. J Pediatr Psychol. 2013;38(8):809–28.
• 24. Khalid R, Van Zwieten A, Kim S, Didsbury M, Francis A, Mctaggart S, et al. Association between socioeconomic status and academic performance in children and adolescents with chronic kidney disease. Pediatr Nephrol. 2022;37(12):3195-204.
• 25. Jones EAK, Mitra AK, Bhuiyan AR. Impact of COVID-19 on Mental Health in Adolescents: A Systematic Review. Int J Environ Res Public Health. 2021 ;18(5):2470.
• 26. Passavanti M, Argentieri A, Barbieri DM, Lou B, Wijayaratna K, Foroutan Mirhosseini AS, et al. The psychological impact of COVID-19 and restrictive measures in the world. J Affect Disord. 2021;283:36–51.
• 27. Ma Z, Idris S, Zhang Y, Zewen L, Wali A, Ji Y, et al. The impact of COVID-19 pandemic outbreak on education and mental health of Chinese children aged 7–15 years: an online survey. BMC Pediatr. 2021;21(1):1–8.
• 28. Wakui N, Abe S, Shirozu S, Yamamoto Y, Yamamura M, Abe Y, et al. Causes of anxiety among teachers giving face-to-face lessons after the reopening of schools during the COVID-19 pandemic: a cross-sectional study. BMC Public Health [Internet]. 2021;21(1):1050.
• 29. Van Lancker W, Parolin Z. COVID-19, school closures, and child poverty: a social crisis in the making. Lancet Public Heal. 2020;5(5):e243–4.
• 30. Guio A-C, Gordon D, Marlier E, Najera H, Pomati M. Towards an EU measure of child deprivation. Child Indic Res. 2018;11(3):835–60.
• 31. Algahtani FD, Hassan S-N, Alsaif B, Zrieq R. Assessment of the quality of life during COVID-19 pandemic: a cross-sectional survey from the Kingdom of Saudi Arabia. Int J Environ Res Public Health. 2021;18(3):847.
• 31. Hosany ARS, Hosany S, He H. Children sustainable behaviour: A review and research agenda. J Bus Res. 2022;147:236–57.
• 32. Jia F, Yu H. Action, communication, and engagement: How parents “ACE” Children’s pro-environmental behaviors. J Environ Psychol . 2021;74:101575.
• 33. Shakeel A, Khan S, Shamama-tus-Sabah S. Home Chaos and Self-Regulation: Moderating Role of Gender between Home Chaos and Effortful Control. J Rawalpindi Med Coll. 2021;25(3):376–81.