COVID-19 Lockdown and Lifestyle Changes in Saudi Adults With Types 1 and 2 Diabetes

Objective We aimed to evaluate and compare the impact of COVID-19 lockdown on lifestyle changes and other common related effects of the lockdown in Saudi adults with diabetes mellitus (DM), both type 1 (T1D) and type 2 diabetes (T2D). Methods 265 T1D and 285 T2D individuals were included in this cross-sectional survey during lockdown using an online questionnaire and compared with 297 participants without DM. Variables included demographics, treatment changes, use of supplements, change in sleeping habits and physical activity, dietary changes, social and mental health, and education and awareness during COVID-19 lockdown. Results The COVID-19 lockdown was associated with more treatment doses in people with T1D but not in those with T2D (p = 0.003). More participants with T1D and T2D than the control group reported that they felt symptoms of depression during lockdown (ORs of 1.83, p = 0.008 and 2.2, p = 0.001, respectively) and that lockdown affected them psychologically (ORs of 1.64, p = 0.019 and 1.85, p = 0.005, respectively). More participants with T1D than controls reported that their physical activity decreased during lockdown (OR of 2.70, p = 0.024). Furthermore, significantly lesser participants in both DM groups than controls agreed that the health education regarding COVID-19 covered everything (ORs of 0.41, p < 0.001 and 0.56, p < 0.001, respectively for T1D and T2D groups). Regarding dietary habits, the DM groups reported more changes in either the number of daily meals, meal content, or mealtimes than the control group. Conclusions COVID-19 lockdown-associated lifestyle changes were more prevalent in individuals with T1D and T2D compared to control. Findings may assist public health authorities in outlining their responses in pandemics and promote healthy lifestyle adaptations in this high-risk cohort to limit adverse effects in future lockdowns.

[1]  N. Osman,et al.  Association Between Mental Health Outcomes and Changes in Lifestyle Behavior Index Among Saudi Adults 16 Weeks After COVID-19 Pandemic Lockdown Release , 2022, Frontiers in Public Health.

[2]  B. Duncan,et al.  IDF diabetes Atlas: Global, regional and country-level diabetes prevalence estimates for 2021 and projections for 2045 , 2021, Diabetes Research and Clinical Practice.

[3]  N. Al-Daghri,et al.  Effects of a 2-Week 5000 IU versus 1000 IU Vitamin D3 Supplementation on Recovery of Symptoms in Patients with Mild to Moderate Covid-19: A Randomized Clinical Trial , 2021, Nutrients.

[4]  S. Toselli,et al.  Physical Activity during COVID-19 Lockdown in Italy: A Systematic Review , 2021, International journal of environmental research and public health.

[5]  N. Al-Daghri,et al.  Dietary Intake and Supplement Use Among Saudi Residents during COVID-19 Lockdown , 2021, International journal of environmental research and public health.

[6]  J. Shaw,et al.  Impact of the COVID‐19 pandemic and lockdown restrictions on psychosocial and behavioural outcomes among Australian adults with type 2 diabetes: Findings from the PREDICT cohort study , 2021, Diabetic medicine : a journal of the British Diabetic Association.

[7]  G. Mazziotti,et al.  Weight change and glycemic control in type 2 diabetes patients during COVID-19 pandemic: the lockdown effect , 2021, Endocrine.

[8]  A. Tahrani,et al.  Lifestyle changes associated with COVID-19 quarantine among young Saudi women: A prospective study , 2021, PloS one.

[9]  N. Al-Daghri,et al.  Vitamin D status of Arab Gulf residents screened for SARS-CoV-2 and its association with COVID-19 infection: a multi-centre case–control study , 2021, Journal of translational medicine.

[10]  S. Al-Fifi,et al.  Effect of COVID-19 on control of T1DM patients in Aseer region of Saudi Arabia , 2021, Journal of family medicine and primary care.

[11]  S. Alshahrani,et al.  Sleep quality and insomnia during the COVID-19 lockdown among the Saudi public , 2021, Saudi medical journal.

[12]  N. Al-Daghri,et al.  Severe vitamin D deficiency is not related to SARS-CoV-2 infection but may increase mortality risk in hospitalized adults: a retrospective case–control study in an Arab Gulf country , 2021, Aging Clinical and Experimental Research.

[13]  P. Kotanko,et al.  Effect of Statewide Lockdown in Response to COVID-19 Pandemic on Physical Activity Levels of Hemodialysis Patients , 2021, Blood Purification.

[14]  N. Al-Daghri,et al.  Effects of home quarantine during COVID-19 lockdown on physical activity and dietary habits of adults in Saudi Arabia , 2021, Scientific Reports.

[15]  S. Coe,et al.  The Impact of Lockdown During the COVID-19 Outbreak on Dietary Habits in Various Population Groups: A Scoping Review , 2021, Frontiers in Nutrition.

[16]  S. Yakout,et al.  Dietary Intake and Mental Health among Saudi Adults during COVID-19 Lockdown , 2021, International journal of environmental research and public health.

[17]  Hawazen A. Zarif,et al.  Managing Type 1 Diabetes among Saudi adults on insulin pump therapy during the COVID-19 lockdown , 2020, Diabetes & Metabolic Syndrome: Clinical Research & Reviews.

[18]  S. Yakout,et al.  Psychological well-being during COVID-19 lockdown: Insights from a Saudi State University’s Academic Community , 2020, Journal of King Saud University - Science.

[19]  N. Al-Daghri,et al.  Diabetes and Covid-19 among hospitalized patients in Saudi Arabia: a single-centre retrospective study , 2020, Cardiovascular Diabetology.

[20]  N. Al-Daghri,et al.  Prevalence of diabetes, management and outcomes among Covid-19 adult patients admitted in a specialized tertiary hospital in Riyadh, Saudi Arabia , 2020, Diabetes Research and Clinical Practice.

[21]  M. Kaur,et al.  Role of self-care in COVID-19 pandemic for people living with comorbidities of diabetes and hypertension , 2020, Journal of family medicine and primary care.

[22]  A. Robert,et al.  Current Status of Knowledge and Awareness of Diabetes Mellitus in Saudi Arabia. , 2020, Current diabetes reviews.

[23]  Saranya Sasidharan,et al.  Effects of COVID-19 lockdown on type 2 diabetes, lifestyle and psychosocial health: A hospital-based cross-sectional survey from South India , 2020, Diabetes & Metabolic Syndrome: Clinical Research & Reviews.

[24]  C. Khoo,et al.  Effects of hyperglycaemia on complications of COVID‐19: A meta‐analysis of observational studies , 2020, Diabetes, obesity & metabolism.

[25]  N. Nebhinani,et al.  Psychological adaptive difficulties and their management during COVID-19 pandemic in people with diabetes mellitus , 2020, Diabetes & Metabolic Syndrome: Clinical Research & Reviews.

[26]  H. Potts,et al.  Physical Activity Behavior Before, During, and After COVID-19 Restrictions: Longitudinal Smartphone-Tracking Study of Adults in the United Kingdom , 2020, Journal of medical Internet research.

[27]  A. Alzahrani,et al.  Impact of the COVID-19 lockdown on diabetes patients in Jeddah, Saudi Arabia , 2020, Diabetes & Metabolic Syndrome: Clinical Research & Reviews.

[28]  D. Groneberg,et al.  Physical activity during COVID-19 induced lockdown: recommendations , 2020, Journal of Occupational Medicine and Toxicology.

[29]  Noara Alhusseini,et al.  COVID-19 pandemic’s impact on eating habits in Saudi Arabia , 2020, Journal of public health research.

[30]  S. Nahavandi,et al.  Risk factors prediction, clinical outcomes, and mortality in COVID‐19 patients , 2020, medRxiv.

[31]  Suheda Erener Diabetes, infection risk and COVID-19 , 2020, Molecular Metabolism.

[32]  B. Capaldo,et al.  Blood Glucose Control During Lockdown for COVID-19: CGM Metrics in Italian Adults With Type 1 Diabetes , 2020, Diabetes Care.

[33]  S. Anoop,et al.  Effects of nationwide lockdown during COVID-19 epidemic on lifestyle and other medical issues of patients with type 2 diabetes in north India , 2020, Diabetes & Metabolic Syndrome: Clinical Research & Reviews.

[34]  O. Megalakaki,et al.  Insomnia during COVID-19 pandemic and lockdown: Prevalence, severity, and associated risk factors in French population , 2020, Psychiatry Research.

[35]  M. Kivipelto,et al.  The potential long-term impact of the COVID-19 outbreak on patients with non-communicable diseases in Europe: consequences for healthy ageing , 2020, Aging Clinical and Experimental Research.

[36]  S. Cuschieri,et al.  COVID-19 and diabetes: The why, the what and the how , 2020, Journal of Diabetes and its Complications.

[37]  D. Matthews,et al.  Prevention and management of COVID-19 among patients with diabetes: an appraisal of the literature , 2020, Diabetologia.

[38]  F. Visioli,et al.  Covid-19 and the Subsequent Lockdown Modified Dietary Habits of Almost Half the Population in an Italian Sample , 2020, Foods.

[39]  L. Sanford,et al.  Insomnia and psychological reactions during the COVID-19 outbreak in China. , 2020, Journal of clinical sleep medicine : JCSM : official publication of the American Academy of Sleep Medicine.

[40]  B. Dunn Faculty Opinions recommendation of Multidisciplinary research priorities for the COVID-19 pandemic: a call for action for mental health science. , 2020, Faculty Opinions – Post-Publication Peer Review of the Biomedical Literature.

[41]  Andrew K. Przybylski,et al.  Multidisciplinary research priorities for the COVID-19 pandemic: a call for action for mental health science , 2020, The Lancet Psychiatry.

[42]  T. Yuan,et al.  Mental wellness system for COVID-19 , 2020, Brain, Behavior, and Immunity.

[43]  Yeen Huang,et al.  Generalized anxiety disorder, depressive symptoms and sleep quality during COVID-19 outbreak in China: a web-based cross-sectional survey , 2020, Psychiatry Research.

[44]  C. Espie,et al.  Dealing with sleep problems during home confinement due to the COVID‐19 outbreak: Practical recommendations from a task force of the European CBT‐I Academy , 2020, Journal of sleep research.

[45]  Heng Fan,et al.  Diabetes is a risk factor for the progression and prognosis of COVID‐19 , 2020, Diabetes/metabolism research and reviews.

[46]  David W Smith,et al.  COVID-19: a novel zoonotic disease caused by a coronavirus from China: what we know and what we don’t , 2020, Microbiology Australia.

[47]  E. Holmes,et al.  A new coronavirus associated with human respiratory disease in China , 2020, Nature.

[48]  Y. Hu,et al.  Clinical features of patients infected with 2019 novel coronavirus in Wuhan, China , 2020, The Lancet.

[49]  M. Delano,et al.  Obesity and type 2 diabetes mellitus drive immune dysfunction, infection development, and sepsis mortality , 2018, Journal of leukocyte biology.

[50]  Nadeem Shafique Butt,et al.  Effect of diet on type 2 diabetes mellitus: A review , 2017, International journal of health sciences.

[51]  G. Gao,et al.  Bat-to-human: spike features determining ‘host jump’ of coronaviruses SARS-CoV, MERS-CoV, and beyond , 2015, Trends in Microbiology.

[52]  Victor M Corman,et al.  Middle East respiratory syndrome coronavirus neutralising serum antibodies in dromedary camels: a comparative serological study , 2013, The Lancet Infectious Diseases.

[53]  L. Burke,et al.  Effect of Poor Sleep Quality and Excessive Daytime Sleepiness on Factors Associated With Diabetes Self-Management , 2013, The Diabetes educator.

[54]  A. Osterhaus,et al.  Isolation of a novel coronavirus from a man with pneumonia in Saudi Arabia. , 2012, The New England journal of medicine.

[55]  E. Mohammadi,et al.  Barriers and facilitators related to the implementation of a physiological track and trigger system: A systematic review of the qualitative evidence , 2017, International journal for quality in health care : journal of the International Society for Quality in Health Care.

[56]  Natalie Pearson,et al.  Sedentary behavior and dietary intake in children, adolescents, and adults. A systematic review. , 2011, American journal of preventive medicine.

[57]  S. Janson,et al.  Barriers to diabetes management: patient and provider factors. , 2011, Diabetes research and clinical practice.

[58]  Pedagógia,et al.  Cross Sectional Study , 2019 .

[59]  J. Kahn,et al.  History and Recent Advances in Coronavirus Discovery , 2005, The Pediatric infectious disease journal.

[60]  W. Kröger,et al.  Recommendations , 1915, Nature.

[61]  Stephen H. Bell,et al.  A ?scoping review. , 2018, Sexual health.

[62]  Akira Matsushita,et al.  A web-based cross-sectional survey of selective medical school admissions for medically underserved areas , 2015 .

[63]  Russell Sandberg The what, the why and the how , 2014 .

[64]  Cme Diabetes Diabetes and exercise , 2014 .

[65]  J. Manson,et al.  Prospective Study of , 2007 .

[66]  A. Cassidy,et al.  A multi-centre case-control study of occupational exposure to crystalline silica and lung cancer risk. , 2006 .

[67]  Robert C. Wolpert,et al.  A Review of the , 1985 .

[68]  E. Glaser The randomized clinical trial. , 1972, The New England journal of medicine.