The impact of the COVID-19 pandemic on people with diabetes and diabetes services: A pan-European survey of diabetes specialist nurses undertaken by the Foundation of European Nurses in Diabetes survey consortium

Diabet Med. 2021 May;38(5):e14498. doi: 10.1111/dme.14498. Epub 2020 Dec 30.


Aim: To describe diabetes nurses' perspectives on the impact of the COVID-19 pandemic on people with diabetes and diabetes services across Europe.

Methods: An online survey developed using a rapid Delphi method. The survey was translated into 17 different languages and disseminated electronically in 27 countries via national diabetes nurse networks.

Results: Survey responses from 1829 diabetes nurses were included in the analysis. The responses indicated that 28% (n = 504) and 48% (n = 873) of diabetes nurses felt the COVID-19 pandemic had impacted 'a lot' on the physical and psychological risks of people with diabetes, respectively. The following clinical problems were identified as having increased 'a lot': anxiety 82% (n = 1486); diabetes distress 65% (n = 1189); depression 49% (n = 893); acute hyperglycaemia 39% (n = 710) and foot complications 18% (n = 323). Forty-seven percent (n = 771) of respondents identified that the level of care provided to people with diabetes had declined either extremely or quite severely. Self-management support, diabetes education and psychological support were rated by diabetes nurse respondents as having declined extremely or quite severely during the COVID-19 pandemic by 31% (n = 499), 63% (n = 1,027) and 34% (n = 551), respectively.

Conclusion: The findings show that diabetes nurses across Europe have seen significant increases in both physical and psychological problems in their patient populations during COVID-19. The data also show that clinical diabetes services have been significantly disrupted. As the COVID-19 situation continues, we need to adapt care systems with some urgency to minimise the impact of the pandemic on the diabetes population.

Keywords: COVID-19; diabetes care provision; physical and psychological health.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Anxiety / psychology
  • Attitude of Health Personnel
  • COVID-19*
  • Delivery of Health Care*
  • Depression / psychology
  • Diabetes Mellitus / metabolism
  • Diabetes Mellitus / nursing
  • Diabetes Mellitus / physiopathology*
  • Diabetes Mellitus / psychology
  • Diabetes Mellitus, Type 1 / metabolism
  • Diabetes Mellitus, Type 1 / nursing
  • Diabetes Mellitus, Type 1 / physiopathology
  • Diabetes Mellitus, Type 1 / psychology
  • Diabetes Mellitus, Type 2 / metabolism
  • Diabetes Mellitus, Type 2 / nursing
  • Diabetes Mellitus, Type 2 / physiopathology
  • Diabetes Mellitus, Type 2 / psychology
  • Diabetic Foot / physiopathology
  • Europe
  • Humans
  • Hyperglycemia / metabolism
  • Nurse Specialists*
  • Psychological Distress*
  • SARS-CoV-2
  • Self-Management
  • Surveys and Questionnaires