Psychological perspectives on COVID-19 and diabetes

More than six months into the global pandemic, we summarise emerging publications about the psychological impact of, and diabetes care during, COVID-19

By Jennifer Halliday

Several months into the global COVID-19 pandemic, we are seeing an influx of publications related to COVID-19 and diabetes in academic journals, including commentaries, reviews, and surveys. So, this month, we aim to highlight some of these emerging publications related to psychological impacts and support. All the articles included below are open access, which means you can read them without paying an access fee, by clicking the links provided.

In May 2020, the United Nations published a policy brief about COVID-19 and the Need for Action on Mental Health. This important document emphasised the significant immediate and potential long-term impacts of the virus on physical and mental health for people worldwide, and highlighted groups who may be at higher risk of COVID-19-related psychological distress, including people with pre-existing conditions and frontline healthcare workers. The UN made a number of recommendations to national decision makers to help minimise and address the consequences of COVID-19 upon mental health, including: 1) apply a whole-of-society approach to promote, protect, and care for mental health, 2) ensure widespread availability of emergency mental health and psychosocial support, and 3) support recovery from COVID-19 by building mental health services for the future. The World Health Organization had previously, in March 2020, made recommendations about psychosocial considerations during COVID-19 for the general population, healthcare workers, team leaders/managers in health facilities, carers of children, older adults, people with underlying health conditions, and people in isolation.

Kyle Rose and Renza Scibilia have published a commentary in Diabetes Research and Clinical Practice about the impacts that lockdown and quarantine can have for diabetes management (e.g. access to food, activity, medical care and supplies) and social and emotional wellbeing. Based on their own experiences living with diabetes, they make several recommendations for living well with diabetes in the current environment: 1) keep at least one month’s supply (if possible), of diabetes supplies and medications, but avoid stockpiling, 2) stay connected to social networks via telephone, social media, and virtual meetings 3) do the best with the situation around you, 4) be safe (frequent hand washing, maintain physical distance, wear personal protective equipment such as masks, avoid large gatherings etc.), and 5) take a break from the news (social media, internet, TV, radio etc.) if the constant stream of communication about COVID-19 is overwhelming or distressing you.

Dr Rose Stewart has published a commentary in Diabetic Medicine about the psychological risks of COVID-19, for people with diabetes and healthcare professionals. She makes a number of recommendations for managing these risks. First, she suggests that diabetes care teams need to remain mindful that the proportion of people with diabetes with significant psychological needs is likely to increase over the coming weeks and months. She recommends awareness of psychological issues, an empathetic approach to care, and linking with mental health and social care services within routine diabetes care. Further, she suggests proactively identifying those at highest risk of psychological issues (e.g. those from vulnerable or marginalised communities, and those diagnosed with COVID-19) to link them with appropriate psychological care. With regard to healthcare professionals, she recommends that managers need to stay alert for signs that their staff may be struggling and give their staff time to safely ‘decompress’ from what they have been through. Dr Stewart also highlights the role that psychology professionals can play in supporting both of these groups during, and after, the pandemic. She calls for additional funding to fill new and pre-existing gaps in psychological care, to ensure equitable access to psychology services for both COVID-19 and non-COVID-19 related issues.

Dr Rowan Hillson (former National Clinical Director for Diabetes, Department of Health, UK) has also published a commentary on COVID-19 psychological issues for people with diabetes and healthcare professionals, in Practical Diabetes. This included a salient point about the importance of how governments and healthcare professionals communicate about COVID-19, to ensure accuracy, empathy, and promotion of advice about psychological wellbeing.

Lauren Quinn and colleagues have published a viewpoint in JMIR about the benefits and challenges of navigating digital consultations during COVID-19, including handy guides for health professionals about how to conduct a virtual clinic (Figure 2) and for people with diabetes about making the most of virtual diabetes clinics (Figure 3).

We have previously reported on other related research, including a rapid review about the psychological impacts of quarantine led by Dr Samantha Brooks and a commentary about minimising the psychological impacts of COVID-19 media coverage led by Dr Dana Rose Garfin. Additionally, Lene Joensen led a study of COVID‐19‐specific worries experienced by Danish adults with diabetes, and Professor Tim Skinner and Professor Jane Speight wrote a related invited commentary, which we summarised here.

Finally, we have worked with the National Diabetes Services Scheme to develop two factsheets for people with diabetes, which are now freely available: Managing worry about COVID-19 and diabetes and Diabetes care and COVID-19.