Mood Changes in People With Type 2 Diabetes During the COVID-19 Pandemic

Type 2 Diabetes
Type 2 Diabetes
People aged ˃65 years with type 2 diabetes (T2D) were more vulnerable to increased complications at the height of the COVID-19 pandemic. Researchers sought to explore psychological changes in this group as well.

Depressive symptoms and loneliness rose during the COVID-19 pandemic in people with type 2 diabetes (T2D) aged ˃65 years, but many showed a level of resiliency. The results were published in Diabetes Care.

Investigators collected data from 2829 adults mean aged 75.6 with T2D who participated in the Look AHEAD (Action for Health in Diabetes) study. They used the Patient Health Questionnaire-8 (PHQ-8) to measure depressive symptoms, the UCLA Brief Loneliness Scale to measure loneliness, and the Women’s Health Initiative Insomnia Rating Scale to measure insomnia.

Questionnaires were given during 3 visits to study enrollees. Two visits occurred pre-COVID-19 pandemic, with the first visit between April 2016 and June 2018 and the second between February 2018 and February 2020. The third took place virtually during the COVID-19 pandemic either by phone or mail between July 2020 and December 2020.

Mild or greater depressive symptoms were 1.6 times higher compared to prepandemic levels (19.3% prepandemic to 30.4% during the pandemic) among study participants, and reports of loneliness rose 1.8 times (12.3% prepandemic to 22.1% during the pandemic). Rates of these 2 conditions had been stable 3 years prior to the pandemic. Insomnia remained stable (31.5% prepandemic to 33.3% during the pandemic).

There was a higher predisposition for mild or greater depressive symptoms during the pandemic among White women with obesity and T2D. Heterosexual women expressed higher rates of loneliness, which investigators speculated may have been due to an increased likelihood of being widowed. Loneliness and depression among this group may have also increased because “[they] may not have been able to visit their social networks who lived outside of their households, such as friends or family, due to physical distancing,” the investigators wrote.

However, the study group seemed to show some resiliency during the height of the pandemic.

“Many older adults have shown resilience to potential adverse mental health consequences of the pandemic, even with the heightened risks they faced,” the investigators wrote. “The psychological resiliency of some older adults may be related to internal factors [such as personality traits and physical health] as well as external resources [such as social and family support and financial stability].”

One study limitation was the lack of generalizability to the larger population of older adults with T2D because participants were exclusively from the Look AHEAD trial. Additionally, “findings related to sex and race/ethnicity may signal differences in some social, cultural, and economic factors that were not explicitly measured in the study,” the investigators wrote.

“Our longitudinal study demonstrated that reports of mild or greater depressive symptoms, as well as loneliness, increased during the COVID-19 pandemic, yet over half of participants remained free of clinically significant levels of adverse mental health conditions,” the investigators concluded, adding that “many older adults have demonstrated psychological resiliency amid the pandemic.”

Disclosure: Some study authors declared affiliations with biotech, pharmaceutical, and/or device companies. Please see the original reference for a full list of authors’ disclosures.


Chao AM, Wadden TA, Clark JM, et al. Changes in the prevalence of symptoms of depression, loneliness, and insomnia in US older adults with type 2 diabetes during the COVID -19 pandemic: the Look AHEAD study. Diabetes Care. Published online November 9, 2021. doi:10.2337/dc21-1179