Lifestyle changes and their impact on glycemic control and weight control in patients with diabetes during the coronavirus disease 2019 pandemic in Japan

Abstract

Aims/Introduction: This study aimed to reveal lifestyle changes and their impact on glycemic control and weight control in patients with diabetes during the coronavirus disease 2019 (COVID-19) pandemic in Japan. Materials and Methods: We retrospectively analyzed 1,402 outpatients with diabetes at a clinic in Osaka, Japan, who responded to an interview sheet regarding lifestyle changes during the COVID-19 pandemic between 28 March and 30 May 2020. The association of lifestyle changes with hemoglobin A1c (HbA1c) and weight changes from February to May 2020 was investigated using the linear regression model. We also investigated the association with clinically important change of HbA1c (by ≥0.3%) and bodyweight (by ≥3%), using the cumulative link model. Results: Leisure time and other outside physical activities were decreased in one-quarter of patients during the COVID-19 pandemic, whereas the amount of meals and snacks was decreased and increased in approximately 10%, respectively. The change in leisure time physical activities was inversely associated with HbA1c and weight changes, whereas the quantitative change of meals with the decline in eating out and that of snacks were positively associated with HbA1c and weight changes (all P < 0.05). The quantitative change of meals without the decline in eating out was also positively associated with weight change (P = 0.012). The cumulative link model for clinically important HbA1c and weight change showed broadly similar associations, except for that between snacks and bodyweight (P = 0.15). Conclusions: A considerable number of outpatients with diabetes experienced lifestyle changes during the COVID-19 pandemic. The lifestyle changes were associated with HbA1c and weight changes.

Impact of the COVID-19 Pandemic on Glycemic Control and Blood Pressure Control in Patients with Diabetes in Japan

“…These differences in results may be due in part to the fact that the amount of food eaten and the amount of exercise during the lockdown varied among the target patients. As expected, an increased overall dietary intake and increased consumption of snacks were associated with worse HbA1c values, although the results varied slightly between studies ( 28 , 29 ). It was also found that, as expected, the amount of physical activity was associated with glycemic control during the COVID-19 pandemic ( 7 , 29 ).…”

“…As expected, an increased overall dietary intake and increased consumption of snacks were associated with worse HbA1c values, although the results varied slightly between studies (28,29). It was also found that, as expected, the amount of physical activity was associated with glycemic control during the COVID-19 pandemic (7,29). Indeed, in our study, there was no notable worsening of the HbA1c value in patients who responded in the questionnaire that they had eaten less or exercised more during the state of emergency (Table 2).…”

The Effects of COVID-19 Lockdown on Glycaemic Control and Lipid Profile in Patients with Type 2 Diabetes: A Systematic Review and Meta-Analysis

“…Other lockdown strategies involved declaration of states of emergencies by governments and reduced outings by individuals and person to person contacts, while persons were requested to avoid settings with poor ventilation [11]. There were also cancellations, postponement and scaling down of large-scale events, and closure of primary, secondary and tertiary institutions [12].…”

“…It is well established that the management of blood glucose and other metabolic parameters are quite challenging for patients with diabetes and this can be exacerbated by changes in lifestyle and daily routines, such as diet, exercise, insulin adjustments, emotions, stress, social relations and working activities [13]. Changes in lifestyle, such as lack of physical activities and increased intake of diet may promote weight gain, which has implications for insulin sensitivity and glycaemic control [12].…”

Medium-term Influence of the Coronavirus Disease 2019 Pandemic on Patients with Diabetes: A Single-center Cross-sectional Study

“…For patients with diabetes, dietary habits, activities of daily living, and mental health are particularly important in disease management, and any disruptive change is likely to adversely affect patients' glycemic and body weight control (5,6). Indeed, recent studies have evaluated the impact of the COVID-19 pandemic on the changes in lifestyles and/ or mental health and their impact on glycemic and body weight control (7)(8)(9)(10)(11)(12)(13)(14). However, these reports evaluated the early phase, approximately two months after the beginning of the COVID-19 pandemic.…”