TY - JOUR
T1 - Type 1 diabetes patient experiences and management practices during the COVID-19 pandemic in rural Uganda
AU - Sseguya, Wenceslaus
AU - James, Steven
AU - Bwambale, Manfred
AU - L Klatman, Emma
AU - D Ogle, Graham
AU - Munyagwa, Mary
AU - Maniam, Jayanthi
AU - Wesonga, Ronald
AU - Bahendeka, Silver
N1 - © The Author(s), under exclusive licence to Tehran University of Medical Sciences 2023, Springer Nature or its licensor (e.g. a society or other partner) holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law.
PY - 2023/12
Y1 - 2023/12
N2 - BACKGROUND: The COVID-19 pandemic has impacted various aspects of the lives of persons with chronic diseases, including type 1 diabetes (T1D). However, the diabetes care experiences and practices adopted by persons living with T1D after the declaration of the COVID-19 pandemic in Uganda have not been well documented.OBJECTIVES: We investigated diabetes management practices and experiences of persons with T1D during the COVID-19 pandemic lockdown in a rural district of southwestern Uganda.METHODS: Using interactive sequential explanatory mixed methods, we conducted a cross-sectional study of persons with T1D aged 18-25 years, their caregivers and health workers. Quantitative data was exclusively collected from patients with T1D using Kobo Toolbox™ and analysed with SPSS™ version 26; qualitative interviews were used to elicit responses from purposively selected patients with T1D, plus caregivers and health workers that were analysed using a thematic framework approach.RESULTS: The study enrolled 51 (24 males) patients with T1D; diabetes duration (mean ± SD) 6.6 ± 5 years. Access to insulin syringes significantly worsened in 19.6% of participants (
p = 0.03). Insulin injection frequency (p
= 0.01), blood glucose monitoring (
p = 0.001) and meal frequency (
p = 0.0001) significantly decreased. Qualitative interviews highlighted COVID-19 restriction measures had reduced household income, frequency of clinic visits, and access to food, diabetes support and social services.
CONCLUSIONS: Experiences and practices were consistent with decisions to prioritise survival, even with known risks around metabolic control.SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1007/s40200-023-01222-4.
AB - BACKGROUND: The COVID-19 pandemic has impacted various aspects of the lives of persons with chronic diseases, including type 1 diabetes (T1D). However, the diabetes care experiences and practices adopted by persons living with T1D after the declaration of the COVID-19 pandemic in Uganda have not been well documented.OBJECTIVES: We investigated diabetes management practices and experiences of persons with T1D during the COVID-19 pandemic lockdown in a rural district of southwestern Uganda.METHODS: Using interactive sequential explanatory mixed methods, we conducted a cross-sectional study of persons with T1D aged 18-25 years, their caregivers and health workers. Quantitative data was exclusively collected from patients with T1D using Kobo Toolbox™ and analysed with SPSS™ version 26; qualitative interviews were used to elicit responses from purposively selected patients with T1D, plus caregivers and health workers that were analysed using a thematic framework approach.RESULTS: The study enrolled 51 (24 males) patients with T1D; diabetes duration (mean ± SD) 6.6 ± 5 years. Access to insulin syringes significantly worsened in 19.6% of participants (
p = 0.03). Insulin injection frequency (p
= 0.01), blood glucose monitoring (
p = 0.001) and meal frequency (
p = 0.0001) significantly decreased. Qualitative interviews highlighted COVID-19 restriction measures had reduced household income, frequency of clinic visits, and access to food, diabetes support and social services.
CONCLUSIONS: Experiences and practices were consistent with decisions to prioritise survival, even with known risks around metabolic control.SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1007/s40200-023-01222-4.
KW - COVID-19
KW - Diabetes self-management
KW - Self-monitoring of blood glucose
KW - Type 1 diabetes
KW - Uganda
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UR - https://www.mendeley.com/catalogue/cad3365c-a8f0-35de-8eb3-8d1f4b42be27/
U2 - 10.1007/s40200-023-01222-4
DO - 10.1007/s40200-023-01222-4
M3 - Article
C2 - 37363199
AN - SCOPUS:85160098925
SN - 2251-6581
VL - 22
SP - 1
EP - 9
JO - Journal of Diabetes and Metabolic Disorders
JF - Journal of Diabetes and Metabolic Disorders
IS - 2
ER -
