Table 3.

Univariable and multivariable associations of COVID-19-related diabetes-specific challenges and sociodemographic factors with diabetes distress (T1-DDS) in Iranians with T1D before and during the COVID-19 pandemic

Challenge/Sociodemographic factor	Before COVID-19			During COVID-19
	P	OR*	CI 95%	P	OR*	CI 95%
Univariable analysis
Difficulty accessing diabetes care	0.7814	1.142	0.447-2.924	<0.0001	4.856	2.672-8.824
Difficulty accessing diabetes supplies or medication	<0.0001	3.909	2.194-6.966	<0.0001	3.953	2.154-7.255
Difficulty accessing healthy food	0.0910	2.315	0.874-6.135	<0.0001	5.177	2.866-9.352
Difficulty accessing safe places for physical exercise	0.3488	1.362	0.713-2.747	0.4193	1.333	0.664-2.675
Difficulty paying for basic necessities	<0.0001	5.318	2.932-9.647	<0.0001	4.479	2.451-8.185
Job loss worries	<0.0001	5.737	2.378-13.841	<0.0001	6.500	2.869-14.726
Housing loss worries	<0.0001	8.826	4.002-19.466	<0.0001	4.666	2.319-9.388
Health insurance loss worries	<0.0001	13.393	4.479-40.046	<0.0001	8.743	3.233-23.643
Diabetes-related hospitalizations/ED visits				<0.0001	6.103	2.886-12.909
Gender (ref=female)				0.1885	1.550	0.806-2.985
Age				0.5076	0.988	0.954-1.023
Education (ref=graduate degree)
High school				0.0283	2.330	1.094-4.960
Associate degree					2.200	0.625-7.742
Bachelor degree					1.260	0.572-2.778
Marital status (ref=married)				0.8550	1.056	0.590-1.888
Residential area (ref=urban)				0.0069	7.777	1.756-34.442
Following recommended COVID-19 precautions				0.0762	3.229	0.884-11.801
Being tested for COVID-19				0.0021	3.956	1.650-9.485
Multivariable analysis
Difficulty accessing diabetes supplies/medications (ref=no)	0.0006	4.288	1.874-9.813
Health insurance loss worries (ref=no)	<0.0001	7.165	2.653-19.352
Difficulty paying for basic necessities (ref=no)				0.0012	4.249	1.771-10.196
Diabetes-related hospitalization/ED visits (ref=no)				0.0029	5.459	1.787-16.674

*Odds ratio for high diabetes distress