A web-based survey assessing perceived changes in diet, physical activity and sleeping behaviours in adults with type 1 and type 2 diabetes during the COVID-19 pandemic in the UK

Background: The COVID-19 pandemic may have contributed to poorer self-management (ie, diet, physical activity and sleep) of diabetes mellitus (DM), which might predispose individuals to more severe COVID-19 outcomes. Objective: The first objective was to capture perceived changes in diet, physical activity and sleeping during the COVID-19 pandemic in adults with type 1 (T1DM) and type 2 diabetes mellitus (T2DM) in the UK. A second objective was to explore differences between individuals with DM compared with no' or other' health conditions. Methods: Participants aged >18 years were selected by convenience. Individuals subscribed to the Diabetes.co.uk community were sent a web-based survey including questions about demographics and health, followed by 5-point Likert-type scale questions relating to lifestyle-related behaviours during the COVID-19 pandemic. Individuals were grouped by diagnosis of DM, other' or no' health condition and responses were compared. Results: 4764 individuals responded, with 2434 (51.3%) being female and 1550 (32.6%) aged 55-64 years. T2DM (2974; 62.7%), hypertension (2147; 45.2%) and T1DM (1299; 27.4%) were most frequently reported. Compared with T1DM, no' or other' health conditions, respondents with T2DM reported making a less conscious effort to get outside and exercise daily (p<0.001) and spending no time outdoors (p=0.001). Weight loss was more frequently reported in respondents with T2DM (p=0.005). More individuals with T2DM reported consuming convenience foods (p=0.012) and sugary foods (p=0.021), yet eating more fresh foods (p=0.001) and drinking less alcohol than normal (p<0.001). More individuals with T1DM and T2DM reported worse sleep quality (p=0.004). Conclusions: Our study highlighted important differences in lifestyle by individuals with T1DM, T2DM, other and no health conditions in relation to the COVID-19 pandemic. Establishing surveillance systems and conducting repeated assessments are required to analyse how the situation shifted over time and whether adverse collateral effects of the pandemic were sustained in those with chronic health conditions.