AUTHOR=Landstra Cyril P. , Ruissen Merel M. , Regeer Hannah , Nijhoff Michiel F. , Ballieux Bart E. P. B. , van der Boog Paul J. M. , de Vries Aiko P. J. , Huisman Sasja D. , de Koning Eelco J. P. 

TITLE=Impact of a Public Health Emergency on Behavior, Stress, Anxiety and Glycemic Control in Patients With Pancreas or Islet Transplantation for Type 1 Diabetes

JOURNAL=Transplant International

VOLUME=Volume 37 - 2024

YEAR=2024

URL=https://www.frontierspartnerships.org/journals/transplant-international/articles/10.3389/ti.2024.12278

DOI=10.3389/ti.2024.12278

ISSN=1432-2277

ABSTRACT=A public health emergency such as the COVID-19 pandemic has behavioral, mental and physical implications in patients with type 1 diabetes (T1D). To what extent the presence of a transplant further increases this burden is not known. Therefore, we compared T1D patients with an islet or pancreas transplant (β-cell Tx;n=51) to control T1D patients (n=272). Fear of coronavirus infection was higher in those with β-cell Tx than without (Visual Analogue Scale 5.0(3.0-7.0) vs 3.0(2.0-5.0), p=0.004) and social isolation behavior was more stringent (45.8% vs 14.0% reported not leaving the house, p<0.001). A previous β-cell Tx was the most important predictor of at-home isolation. Glycemic control worsened in patients with β-cell Tx, but improved in control patients (ΔHbA1c +1.67±8.74 vs -1.72±6.15 mmol/mol, p=0.006; ΔTime-In-Range during continuous glucose monitoring -4.5%(-6.0%-1.5%) vs +3.0%(-2.0%-6.0%), p=0.038). Fewer patients with β-cell Tx reported easier glycemic control during lockdown (10.4% vs 22.6%, p=0.015). All T1D patients, regardless of transplantation status, experienced stress (33.4%), anxiety (27.9%), decreased physical activity (42.0%), weight gain (40.5%), and increased insulin requirements (29.7%). In conclusion, T1D patients with β-cell Tx are increasingly affected by a viral pandemic lockdown with higher fear of infection, more stringent social isolation behavior and deterioration of glycemic control.