Disrupted Self-Management and Adaption to New Diabetes Routines: A Qualitative Study of How People with Diabetes Managed Their Illness during the COVID-19 Lockdown
Abstract
:1. Introduction
2. Methods
2.1. Data Collection
2.2. Qualitative Analysis
3. Results
3.1. The Changes in and Challenges of Self-Management Caused by the Lockdown
3.1.1. Disruption of Self-Management Practices
“I have many ups and downs during a day, and not one day passes without having either too high or too low blood glucose.”(Female, 27 years, T1D)
“We’re in a situation now where we barely move, like when you’re working from home like I am. Then you need much more insulin, and that just happened from one day to another… but you don’t know how much [insulin you need], it’s not something you can calculate, so you just have to guess”(female, 26 years, T1D)
“I became aware, that even though I biked five kilometers or did something else to work out, then I was still short on my daily exercise. Normally, I would go grocery shopping, go for more walks with my dog, or do something else that I don’t consider exercise, but that matters for my diabetes—physical activity throughout the day that isn’t there now.”(Female, 27 years, T1D)
“When COVID-19 came into our lives, I’ve had difficulties managing it [diabetes], because of my very reduced activity level. I think insulin-to-carb ratio, how much to eat, and how many units [of insulin] to take is a bit more difficult now.”(Male, 20 years, T1D)
“I’m comfort eating a bit. I drink a glass of wine on weekdays and that sort of stuff, that I normally don’t do.”(Male, 60 years, T2D)
“You could say that I snack more [during lockdown], because I’m just walking around the house being bored and that affects my diabetes.”(Female, 24 years, T1D)
3.1.2. Unaffected Diabetes Routines
and they were able to:“the [diabetes management] routines are continuing on the same path as they did before the Corona crisis”(male, 54 years, T2D)
“take the pills I normally take, eat what I normally eat—exactly like I’m used to”(male, 69 years, T2D)
3.2. Different Ways of Adapting Diabetes Routines to Life During Lockdown
3.2.1. Modifications and Adaptions in Everyday Life
“Then I think to myself: Okay, I have to reach 10,000 steps a day. I’ll do it [go for a walk] one time, then I get it all over with at once! (…) Then I can stay at home the rest of the day, because I have walked the steps I need.”(Female, 24 years, T1D)
“I was running up there [in the summer house], so that way I increased my activity level by staying at the summer house, because I had more free space and wasn’t so nervous about meeting other people.”(Male, 20 years, T1D)
“We have this chat conversation where you can get guidance on different topics. I’ve asked how they are handling it, and they’ve answered in different ways and we’ve had some discussions about how to act in relation to Corona.”(Female, 26 years, T1D)
3.2.2. Corona Holiday
“I have a somewhat more liberated approach to everything [now]. If things are going the wrong way for a while, then you must pull yourself together in the next period, and so on. The most important thing at the moment is to survive this period.”(Female, 71 years, T2D)
“This morning I went to the bakery, and they had this pastry that I thought we [himself and his wife] should share. Something that I would not normally do.”(Male, 60 years, T2D)
3.2.3. Positive Side Effects of Changed Conditions for Everyday Life
“Currently, my diabetes, diet, and physical activity have my full and absolute attention! I don’t have anything else to do, I’m not going anywhere, I’m not talking to anyone, so I have plenty of time to care for my diabetes! It’s my top priority right now, because I struggle to lose weight and change my HbA1c [indicator of glycemic control], so it’s really getting more focus that it usually does.”(Female, 44 years, T1D)
“It [lockdown] has been a sort of gift for me—it’s SO wonderful to putter around with myself (…) Wow, have I had a good time!”(Female, 70 years, T2D)
3.3. Worries Related to Self-Management during Lockdown
3.3.1. Fear of Infection with COVID-19
“I’ve had difficulties managing my blood glucose levels. I have the feeling, that the more unstable you are, the worse your immune system is. So that way I think that the virus may more easily gain a foothold in people [with diabetes] who have poor or suboptimal diabetes control.”(Male, 20 years, T1D)
“I know from other times I’ve been sick that diabetes is a hell to manage. I think that’s why I’m a bit frightened of it [COVID-19], because I know it’s going to be really unpleasant [if I get infected]. It’s one thing to be sick, but then there’s also the damn diabetes that you have to care for, right?”(Female, 23 years, T1D)
3.3.2. Worrying How Lockdown Lifestyle Affects Diabetes Management
“What worries me is this, I wouldn’t call it laziness, but the lack of exercise and too much bad food and that sort of stuff.”(Male, 60 years, T2D)
“I wouldn’t do it [go for a run] in the middle of the day because I don’t feel like going outside and exercising when there’re people in the streets. (…) I see myself as being in the risk group, so if I cross a lot of people on the street while running, then I definitely feel like I’m more exposed than if I didn’t do it. I have that worry about being physically active.”(Male, 20 years, T1D)
3.3.3. Can We Still Get Our Insulin?
“Can we still get our insulin and our cannulas and the stuff we need?”(female, 71 years, T1D)
“Some people say that as a diabetic you should make sure you have enough supplies and Libre systems [continuous glucose monitor] for a month, but no one says why. Are there suddenly no more Libre systems left in the world?”(Female, 27 years, T1D)
“I’ve bought more insulin because I didn’t know which direction it [the pandemic] would go, so I’ve felt a bit insecure about what would happen.”(Male, 20 years, T1D)
4. Discussion
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Conflicts of Interest
References
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Gender | Age | Type | |
---|---|---|---|
1 | Female | 70 | Type 2 |
2 | Female | 26 | Type 1 |
3 | Male | 58 | Type 2 |
4 | Female | 71 | Type 2 |
5 | Male | 69 | LADA |
6 | Female | 27 | Type 1 |
7 | Male | 20 | Type 1 |
8 | Male | 73 | Type 2 |
9 | Female | 50 | Type 1 |
10 | Male | 69 | Type 2 |
11 | Female | 71 | Type 2 |
12 | Male | 60 | Type 2 |
13 | Male | 75 | Type 2 |
14 | Female | 24 | Type 1 |
15 | Female | 23 | Type 1 |
16 | Male | 68 | Type 2 |
17 | Male | 22 | Type 1 |
18 | Female | 44 | Type 1 |
19 | Male | 54 | Type 2 |
20 | Female | 70 | Type 2 |
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Share and Cite
Grabowski, D.; Overgaard, M.; Meldgaard, J.; Johansen, L.B.; Willaing, I. Disrupted Self-Management and Adaption to New Diabetes Routines: A Qualitative Study of How People with Diabetes Managed Their Illness during the COVID-19 Lockdown. Diabetology 2021, 2, 1-15. https://doi.org/10.3390/diabetology2010001
Grabowski D, Overgaard M, Meldgaard J, Johansen LB, Willaing I. Disrupted Self-Management and Adaption to New Diabetes Routines: A Qualitative Study of How People with Diabetes Managed Their Illness during the COVID-19 Lockdown. Diabetology. 2021; 2(1):1-15. https://doi.org/10.3390/diabetology2010001
Chicago/Turabian StyleGrabowski, Dan, Mathilde Overgaard, Julie Meldgaard, Lise Bro Johansen, and Ingrid Willaing. 2021. "Disrupted Self-Management and Adaption to New Diabetes Routines: A Qualitative Study of How People with Diabetes Managed Their Illness during the COVID-19 Lockdown" Diabetology 2, no. 1: 1-15. https://doi.org/10.3390/diabetology2010001