Relationship Between COVID-19-related Factors and Self-management Behaviors in People with Type-2 Diabetes: A Cross-sectional Study

Background: Coronavirus disease 2019 (COVID-19) is a risk factor for long-term complications and mortality in people with diabetes. Diabetes self-management can prevent the adverse effects of COVID-19. Objectives: This study aimed to investigate the association between COVID-19-related personal, familial, and psychological factors and diabetes self-management. Methods: The research was conducted using the simple non-probability sampling method at the Institute of Endocrinology and Metabolism of Iran University of Medical Sciences. A total of 102 people with type-2 diabetes participated in the study. Their inclusion criteria were a diagnosis of type-2 diabetes for at least one year, an age of 30 to 65 years, literacy, and no personal or family history of COVID-19 for the past two months. The Diabetes Self-management Questionnaire assessed the participants' self-management behaviors. Their personal and family data were recorded in a personal information form. The Diabetes Distress Scale and the Patient Health Questionnaire measured diabetes distress and depressive symptoms, respectively. COVID-19-related psychological factors were evaluated using the COVID-19-related Psychological Distress Scale, the Coronavirus Anxiety Scale, and the Fear of COVID-19 Scale. Results: The Pearson correlation test showed that the number of times one or their family members were infected or hospitalized due to COVID-19, diabetes distress, and depressive symptoms were negatively related to diabetes self-management. Doses of COVID-19 vaccine injection were also positively related to self-management and negatively correlated with depressive symptoms and diabetes distress (P < 0.05). Multivariate linear regression analysis revealed diabetes regimen and interpersonal distress, COVID-19-related psychological distress, and the number of one's family members with chronic disease as the predictors of diabetes self-management (adjusted R2 = 96%, P < 0.001). Conclusions: People with diabetes can improve their participation in self-management activities by taking care of themselves and their families against COVID-19 and controlling negative emotions. COVID-19 vaccination can reduce the depressive symptoms and diabetes distress in people with type-2 diabetes and facilitate their participation in self-management.