635-P: Health Disparities among People With and Without Diabetes during 24 Months of the COVID-19 Pandemic

This study describes the mental health of US adults with (PWD) and without (ND) diabetes during the COVID-19 pandemic. A 24-month web-based survey was administered from May 2020 (baseline, n=2,176) to June 2022 (24MO; n=1,172; 5 time points). Demographics, pandemic experiences, diabetes distress (DDS-17), depression (PHQ-8) and anxiety (GAD-7) symptoms, perceived stress (PSS-10), and resilience (BRS) were collected. On average, 24MO completers (53.1%) were 53 years (SD=16.4), primarily female (80.9%) and White (91.3%), highly educated (45.0% post-master’s degree), homeowners (72.7%), with an annual household income of ≥ $60,000 (62.2%). They were less likely to have a diagnosis of depression compared to non-completers (all p<0.05). Mental health score means (SD) were DDS= 2.2 (1.0; moderate), PHQ=4.9 (5.0; mild), GAD=4.0 (4.7), PSS=13.3 (8.0). At 24MO, type 2 diabetes (TD2) prevalence was 14% (167), prediabetes 7% (82), and type 1 4% (52; T1D). PWD showed higher levels of financial worry/distress compared to ND (all p<0.05). Similarly, PWD reported COVID as a greater personal health threat (range of means= 4.3-4.8) compared to ND (M=3.7, SD=1.8; p< 0.001). Greatest pandemic burnout was reported by T1D (M=2.9, SD=2.0) and lowest among T2D (M=2.0, SD=2.1; p<0.05). Across the 5 time points, measures of depression, anxiety, perceived stress and diabetes distress improved (all p<0.001). At 24MO, rates of personal COVID infection (33.0%), knowing someone with (93.7%) or who died from COVID (41.4%) increased compared to 12MO (first time point queried; 10.2%, 81.3%, and 34.1%, respectively; all p<0.001). However, financial concerns worsened. Difficulty paying bills increased (11.8% at 24MO v. 6.1% at baseline; p<0.001) and worsening financial appraisal increased (25.4% at 24MO vs. 17.1% at baseline; p<0.05). These data show that, despite improvements in mental health from the height of the pandemic to summer 2022, financial concerns persisted, particularly in those with diabetes.