Impact of COVID-19 and Partial Lockdown on Access to Care,
Self-Management and Psychological Well-being among People with Diabetes:
A Cross-sectional Study
Background The impact of lockdown measures can be widespread, affecting
both clinical and psychosocial aspects of health. This study aims to
assess changes in health services access, diabetes self-care, behavioral
and psychological impact of COVID-19 and partial lockdown in Singapore.
Methods We conducted a cross-sectional online survey amongst people with
diabetes with the Diabetes Health Profile-18 (DHP-18). Hierarchical
regression analyses were performed for each DHP-18 subscale
(Psychological Distress, Disinhibited Eating and Barriers to Activity)
as dependent variables in separate models. Results Among 301
respondents, 45.2% were women, majority were ethnic Chinese (67.1%),
aged 40 to 49 years (24.2%), have Type 2 diabetes (68.4%) and on oral
medications (42.2%). During the lockdown, nearly all respondents were
able to obtain their medications, supplies (94%) and contact their
doctors (97%) when needed. Respondents reported less physical activity
(38%), checking of blood pressure (29%) and blood glucose (22%).
Previous diagnosis of mental health conditions (β=11.44, p= 0.017),
diabetes-related comorbidities (β= 3.98, p= 0.001) and Indian ethnicity
(β= 7.73, p= 0.018) were significantly associated with higher
psychological distress. Comorbidities were associated with higher
disinhibited eating (β= 2.71, p= 0.007) while mental health condition
was associated with greater barriers to activities (β= 9.63, p= 0.033).
Conclusion Health services access were minimally affected but COVID-19
and lockdown had mixed impact on self-care and management behaviors.
Greater clinical care and attention should be provided to people with
diabetes with greater number of comorbidities and previous mental health
disorders during the pandemic and lockdown.