Effect of diabetes self-management on quality of life during the COVID-19 pandemic in patients with diabetes mellitus admitting Cukurova University Faculty of Medicine Balcali Hospital Endocrinology and Metabolism Outpatient Clinic

Aim: The major changes in usual life, restrictions, lockdowns, quarantines and other measures taken during the COVID-19 Pandemic adversely affected the self-management in patients with diabetes mellitus. The aim of this study was to assess the relationship between diabetes self-management and quality of life during the COVID-19 pandemic period in patients with diabetes mellitus admitting to Cukurova University Faculty of Medicine Balcali Hospital Endocrinology and Metabolism Outpatient Clinic. Materials and Methods: One hundred and eighty six patients with type 2 diabetes mellitus diagnosis for at least six months admitting to Cukurova University Faculty of Medicine Balcali Hospital Endocrinology and Metabolism Outpatient Clinic between 04.12.2021 and 20.07.2022 and the ones who had given informed consent were included in the study. Our study is a cross-sectional descriptive study. Sociodemographic Data Collection Questionnaire (24 questions), Diabetes Self-Management Questionnaire (DSMQ) (16 questions), General Quality of Life Scale (EQ-5D) (5 questions) and Visual Analog Scale (VAS) were used. Data was analyzed using SPSS (Statistical Package for the Social Sciences) 25.0 pocket program. Results: Of 186 patients, 100 (53,8%) were female and 86 (46,2%) were male. Mean age was 56,3±8,8 years (min: 35, max: 80), mean height was 166,4±11,4 cm (min: 88, max:192), mean body weight was 84,4±16,2 kg (min:42, max:160), mean Body Mass Index (BMI) was 30,2±5,6 (min:16,9, max:53,3), and mean waist circumference was 92,2±20,8 cm (min:50, max:140). The mean score for Diabetes Self-Management Questionnaire was 5,67±1,47, mean score for the General Quality of Life Scale was 0,27±0,23, and mean VAS score was 63,98±20 (min:0, max:100). The mean scores for the Diabetes Self-Management Questionnaire subscales were as follows: The glucose management score was 5,68±1,88, the diet control score was 5,03±1,96, the physical activity score was 5,40±2,75, the health care utilization score was 6,55±2,01. There was a significant relationship between the Diabetes Self-Management Scale score and admitting to the outpatient clinic every 3-6 months for diabetes control (p<0.001). There was significant relationship between the General Quality of Life Scale scores and age, educational and economical status, duration of diabetes, and performing regular physical activity (p<0.001, p<0.001, p=0.03, p<0.001, p<0.001, respectively). There was a negative weak correlation between the General Quality of Life Scale (EQ-5D) life index score and the use of health care services and DSMQ scale scores (r=-0,247; r=-0,240, respectively); a negative moderately significant correlation between physical activity and VAS score (r=-0,305; r=-0,541, respectively) (p=0.001, p=0.001, p<0.001, p<0.001, respectively). There was a positive weak correlation between VAS score and Diet control, the use of health care services and Diabetes Self-Management Questionnaire scale scores (r=0,157; r=0,185; r=0,298, respectively). It was found that there was a positive moderately significant correlation with the physical activity scale score (r=0,336) (p=0.032, p=0.011, p<0.011, p<0.001, respectively). Conclusion: During the COVID-19 pandemic, routine examinations of diabetic patients were disrupted and due to the regulation about obtaining regularly used drugs without a prescription outpatient clinic admissions were no longer obligatory leading to diabetic patients being unfollowed and uncontrolled due to both the pandemic restrictions and the anxiety and fear of catching COVID. Pandemic restrictions caused changes in the dietary and physical activity behaviors and health care service use in these patients and therefore affected self-management of diabetic patients. Diabetes is a very important clinical condition requiring holistic care and biopsychosocial, cultural and existential approach by family physicians. This approach differs for each patient and includes patient education, counseling and medical treatment as well as the improving self-management skills in patients with diabetes by dynamic process including new plans. However, studies showed that outpatient follow-ups and self-management in patients with diabetes were adversely affected during the pandemic. The impaired self-management in our study may be associated with future complications and low quality of life. Uncontrolled diabetes mellitus may cause complications and adversely affect the quality of life in patients with diabetes resulting in high health care costs. Family medicine specialists can make a significant contribution to overcoming this problem by using their core competencies.