Behavioral Problems among Type 1 Diabetes Mellitus Children with Good and Poor Metabolic Control During COVID-19 Pandemic

Background: Children with type-1 diabetes mellitus (T1DM) often experience emotional and behavioral problems such as anxiety and depression. Social restrictions during the COVID-19 pandemic caused social restrictions and limited access to healthcare facilities, which may have worsened the metabolic control. Objectives: This study aimed to analyze the behavioral problems among type 1 diabetes mellitus children with good and poor metabolic control during COVID-19 pandemic. Methods: This cross-sectional study was conducted in January - August 2021 in the Endocrine Outpatient Clinic of General Hospital Dr. Soetomo Surabaya. Type-1-DM children who fulfilled the inclusion criteria were divided into two groups based on metabolic control, including good (HbA1C ≤ 8) and poor (HbA1C > 8). The Pediatric Symptom Checklist-17 (PSC-17) was used as a screening tool with the domain internalizing problems (IP), externalizing problems (EP), and attention problems (AP). The data were analyzed using Pearson or Spearman test with Statistical Product and Service Solution (SPSS) version 18.0. Results: In this study, 27 subjects (17 boys and 10 girls, aged 12.63 ± 3.39 years) were investigated. Of all subjects, only 8 subjects had good metabolic control during the COVID-19 pandemic. Furthermore, 33.3% of the participants had behavioral problems (14.8% IP; 18.5% EP). The frequencies of IP, EP, and AP in the good metabolic control group were 12.5%, 37.5%, and 0%, respectively; while those in the poor metabolic group were 15.8%, 10.5%, and 0%, respectively. There was no significant difference between the good and poor metabolic control groups in terms of behavior problems (P = 1.00, IP; P = 0.14, EP). Conclusions: No significant difference was found between good and poor metabolic control groups (P = 1.00, IP; P = 0.14, EP). However, the frequency of EP was higher in good metabolic control, and the frequency of IP was higher in poor metabolic control.