**Background:** COVID-19 disrupted health services globally, including care for people with diabetes (PWD). While the toll on frontline COVID-19 healthcare workers is well documented, the impact on professionals addressing behavioral and psychosocial needs of PWD had not been investigated. This study aimed to explore the nature and severity of those impacts in an international sample.
**Methods:** English-language email invitations were sent to members of five organizations addressing psychosocial aspects of diabetes (~735 invitations). Data were collected via anonymous online survey (REDCap) over 6 months (April–October 2021). Participants reported demographics, workplace characteristics, and rated COVID-related problems on a 1 (no problem) to 5 (serious problem) scale across four domains: healthcare system, workplace, technology, and concerns about PWD. Descriptive statistics were computed using SPSS v27. The study was approved by UConn Health IRB (IRB# 21X-219-1) and deemed exempt.
**Key Results:** Of 735 invited, 149 accessed consent (20%), and 123 completed the survey (17% completion rate). Respondents were from 27 countries; 45.5% from Europe (19.5% Slovenia), 32.8% from North America (29.3% US). Most were from high-income countries (81.4%), female (74.8%), aged 31–40 years (38.2%), worked in urban settings (77.2%) in hospitals (35.2%), and were from medicine (47.5%) or psychology/psychotherapy (32.8%). Over half (56.4%) reported moderate-to-serious personal stress/burnout/mental health issues. Only 1% reported COVID was not a problem for their work with PWD.
HEALTHCARE SYSTEM PROBLEMS
Lack of clear public health guidelines was the top problem (56.4% moderate-to-serious). Other issues included delay/lack of COVID testing for PWD (32.0%), reimbursement issues (30.7%), and disagreements with government bodies (28.3%), organization administration (23.8%), and research funders (22.6%).
WORKPLACE PROBLEMS
Over half reported moderate-to-serious problems with COVID safety for PWD (69.0%), changing flow of people (69.3%), safety of self/staff (62.4%), decisions to close/reopen (59.3%), and possible family exposure (50.9%). Nearly half reported isolation from colleagues (48.5%) and disruption to the PWD relationship (44.3%).
TECHNOLOGY PROBLEMS
PWD lacking access/knowledge to use diabetes technology (54.5%) and telemedicine (59.1%) were top concerns. Other issues included too much screen time (46.7%) and legal/licensure/reimbursement issues with telemedicine (35.3%).
CONCERNS ABOUT PWD
Top behavioral concerns were physical activity (90%), weight gain (89%), eating problems (79%), diet (75%), and sleep (72%). Top psychosocial concerns were anxiety (90%), loneliness (87%), depression and diabetes distress (both 83%), family conflict (74%), and suicidality (52%).
**Clinical Implications:** The findings reveal a high level of detrimental impact on professionals addressing psychosocial needs of PWD. Over half reported stress/burnout/mental health issues, threatening an already under-resourced workforce. Safety concerns were compounded by limited patient access to telemedicine. Disruption to the PWD-professional relationship may partly explain perceived reductions in patient health behaviors and emotional wellbeing. The authors recommend: (1) clear, timely public health guidelines; (2) organizational training on COVID-19 evidence dissemination; (3) investment in telemedicine infrastructure and training; (4) flexible insurance and licensing policies; (5) equitable access to internet, diabetes technologies, and PPE; (6) expanding the workforce through peer counselors and community health workers; (7) psychological care for professionals themselves; and (8) direct patient outreach to rebuild the PWD-professional relationship. Limitations include low response rate (20%), small sample (n=123), potential self-selection bias, predominance of high-income country respondents, English-only survey, and retrospective self-report.