ABSTRACT Objective To identify predictors of mental health disorders and self-care worsening in patients with diabetes through 15 months of COVID-19 pandemic. Subjects and methods Prospective study following patients with type 1 and type 2 diabetes during the COVID-19 pandemic in Southern Brazil. Participants were evaluated through phone calls in two moments: first three months of the outbreak, and 15 months later. The outcomes were the assessment of worsening in mental health disorders (increase ≥ 10% in the total score of the Self-Report Questionnaire), the assessment of emotional distress related to diabetes (increase ≥ 10% in the total score of the Brazilian version of the Problem Areas in Diabetes), and worsening in self-care parameters (reduction ≥ 3 points in the Self-Care Inventory-Revised). Logistic regression models were used to determine the odds ratio (OR) and their respective confidence intervals. Point-biserial correlation coefficients (rpb) were used to measure the relationship between the variation in scores and patient characteristics. Results In total, 150 adults were enrolled (54.6 ± 13.9 years old, 58.7% female, 85.9% white), out of which 118 remained during follow up. After 18 months, 34,7% of them (52.2 ± 14.8 years old, 53.7% female, 87.5% white) worsened mental health scores. An increase in mental health disorders was experienced by patients with lower middle-income [OR 4.2 (1.2-15.0)], and those who reported greater difficulty managing diabetes [OR 3.2 (1.4-7.1); rpb 0.32, P < 0.01]. In contrast, those who perceived an improvement in diabetes control showed a reduction in their mental health scores [OR 0.3 (0.1-0.8)]. For self-care, there was a score worsening in patients with longer duration of diabetes [OR 1.1 (1.0-1.1)] and in those using insulin [OR 8.3 (1.7-41.4); rpb 0.23, P = 0.01]. Conversely, those who followed the social distancing guidance had an improvement in self-care [OR 0.4 (0.1-0.9); rpb 0.18, P = 0.05]. Conclusion Some clinical and socioeconomic characteristics may be suitable for identifying patients at higher risk of mental health and self-care worsening, signaling who needs to be monitored more closely during crisis situations. selfcare self care COVID19 COVID 19 COVID-1 Brazil moments outbreak later 10 SelfReport Self Report Questionnaire, Questionnaire , Questionnaire) Diabetes, Diabetes Diabetes) SelfCare Care InventoryRevised. InventoryRevised Inventory Revised . Inventory-Revised) OR (OR intervals Pointbiserial Point biserial (rpb 54.6 546 54 6 (54. 139 13 9 13. old 587 58 7 58.7 female 859 85 85.9 white, white 11 up 347 34 34,7 52.2 522 52 (52. 148 14 8 14. 537 53 53.7 875 87 5 87.5 middleincome middle income 42 4 4. 1.215.0, 12150 1.2 15.0 0 (1.2-15.0)] 32 3. 1.47.1 1471 1.4 7.1 (1.4-7.1) 032 0.32 0.01. 001 0.01 01 0.01] contrast 03 0. 0.10.8. 0108 0.1 0.8 (0.1-0.8)] selfcare, care, 1. 1.01.1 1011 1.0 (1.0-1.1) 83 8. 1.741.4 17414 1.7 41.4 41 (1.7-41.4) 023 23 0.23 Conversely 04 0.10.9 0109 0.9 (0.1-0.9) 018 0.18 0.05. 005 0.05 05 0.05] situations COVID1 COVID- Inventory-Revised 54. (54 58. 85. 34, 52. (52 53. 87. 215 1.215.0 1215 12 15. (1.2-15.0) 47 1.47. 147 71 7. (1.4-7.1 00 0.0 0.10.8 010 08 (0.1-0.8) 1.01. 101 (1.0-1.1 741 1.741. 1741 17 414 41. (1.7-41.4 02 0.2 0.10. 09 (0.1-0.9 (5 21 1.215. 121 (1.2-15.0 1.47 (1.4-7. (0.1-0.8 1.01 (1.0-1. 74 1.741 174 (1.7-41. 0.10 (0.1-0. ( 1.215 (1.2-15. (1.4-7 (1.0-1 1.74 (1.7-41 (0.1-0 1.21 (1.2-15 (1.4- (1.0- (1.7-4 (0.1- (1.2-1 (1.4 (1.0 (1.7- (0.1 (1.2- (1. (1.7 (0. (1.2 (1 (0

ABSTRACT Objective: To assess caregivers’ perception about the changes in the daily habits of children and adolescents with type 1 diabetes during the COVID-19 pandemic. Subjects and methods: Primary caregivers of youth aged ≤18 with or without type 1 diabetes were selected for the diabetes and the control groups. Caregivers estimated the youth's time (hours) of physical activity and screen time before and during the pandemic, and rated the quality of eating habits and medication adherence from 0 to 10. The primary outcome was the change in physical activity time, screen time, and eating habits scores during isolation. Between-group analyses and within-group comparisons were conducted. A post hoc analysis was performed using logistic regression to correct for confounding factors. Results: In total, 764 participants were included (381 diabetes group vs. 383 control group). Before the pandemic, the diabetes group presented a reduced median of physical activity (P < 0.001) and screen time (P < 0.001). During the pandemic, the difference between both groups remained similar (P = 0.58). Scores of quality of eating habits were similar in both groups before the pandemic [8.0 (7.0-9.0) vs. 8.0 (7.0-9.0), P = 0.31] but decreased during the pandemic [7.0 (5.1-8.1) vs. 8.0 (6.0-9.0), P < 0.001]. The diabetes group had a significantly worse change in eating habits scores (P < 0.01). Conclusion: During the pandemic, eating habits were significantly worse in youth with diabetes than in those without diabetes. Objective COVID19 COVID 19 COVID-1 methods 18 ≤1 youths s hours (hours 10 isolation Betweengroup Between withingroup within conducted factors Results total 76 381 (38 vs 38 group. . group) 0.001 0001 001 0.001. 0.58. 058 0.58 58 0.58) 80 8 [8. 7.09.0 7090 7.0 9.0 7 9 (7.0-9.0 8. 7.09.0, , 0.31 031 31 70 [7. 5.18.1 5181 5.1 8.1 5 (5.1-8.1 6.09.0, 6090 6.0 6 (6.0-9.0) 0.001] 0.01. 0.01 01 0.01) Conclusion COVID1 COVID- ≤ (3 3 0.00 000 00 05 0.5 [8 09 7.09. 709 7. 90 9. (7.0-9. 0.3 03 [7 5.18. 518 51 5. 81 (5.1-8. 6.09.0 609 60 6. (6.0-9.0 0.0 ( 0. [ 7.09 (7.0-9 5.18 (5.1-8 6.09. (6.0-9. (7.0- (5.1- 6.09 (6.0-9 (7.0 (5.1 (6.0- (7. (5. (6.0 (7 (5 (6. (6