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Figure3.Change in HbA1c (ANCOVA). Data presented as the least square mean ± standard error. ||p<0.05 ANCOVA. Covariates: Pre-declaration HbA1c, gender, age, stress level (before), anxiety level (before), family stress, changes in frequency of eating out, changes in frequency of going out. "Commuting" was not included in the covariates due to the small number of responses. Regarding stress and anxiety data, there were significant differences in these values between the two groups both before and after the declaration, but the value before the declaration was adopted as the covariate.
Source publication
Objective The stress brought on by changes in social conditions due to COVID-19 is diverse. However, there have been no studies examining the relationship between the type of stress felt by an individual due to such changes in social conditions and the degree of change in HbA1c, prompting us to conduct this study.
Methods We conducted a collaborati...
Citations
... Therefore, the stress caused by the COVID-19 pandemic and the subsequent state of emergency was likely a major concern among patients with diabetes mellitus. Several retrospective studies reported the relationship between the stress caused by the COVID-19 pandemic and the level of hemoglobin A 1c (HbA 1c ) or bodyweight (BW) in Japanese patients with diabetes mellitus [11][12][13][14][15][16][17][18] . Appropriate BP control is also important in the management of patients with diabetes mellitus; however, only one study carried out by Endo et al. 19 reported the relationship between stress, dietary intake or exercise and systolic BP and HbA 1c in Japanese patients with diabetes mellitus under the state of emergency. ...
... Several retrospective studies reported that increased physical stress or inappropriate dietary intake caused by the COVID-19 pandemic induced the worsening of HbA 1c levels and BW in Japanese patients with diabetes mellitus [11][12][13][14][15][16][17][18] . Tanaka et al. 13 reported the different processes for the increase in BW and the reduced glycemic control depending on age under the state of emergency. ...
... With respect to prevention against the worsening of glycemic control, improving inappropriate dietary behavior 12 or seeking telemedicine or regular clinic visits during the state of emergency was suspected 26 . In contrast, significant worsening of glycemic control was not observed in patients with diabetes mellitus after the announcement of the COVID-19 pandemic 18,27,28 . Among these studies, Masuda et al. 18 reported that HbA 1c levels significantly decreased in the unstressed group, whereas Terakawa et al. 28 suggested a relationship between the worsening of glycemic control and living and working environments. ...
Aim/introduction:
Following the first coronavirus disease-2019 state-of-emergency announcement, there was an increase in stress that may have affected the self-management of patients with type 2 diabetes mellitus (T2DM). This study identified the changes in clinical findings and stress among patients with T2DM and investigated the characteristics of patients who experienced an increase in blood pressure (BP) following the announcement.
Materials and methods:
Retrospectively, we scrutinized 310 patients with T2DM who were treated by the Sagamihara Physicians Association. Following the announcement, 164 and 146 patients showed an increase (ΔBP>0 group) and decrease in BP (ΔBP≤0 group), respectively. The propensity score matching method was used to compare the differences in clinical findings and stress-related questionnaire responses between the two groups.
Results:
Following the announcement, 47% of patients experienced an increase in daily stress. Further, 17% and 36% reported worsening dietary intake and a decrease in exercise, respectively. More patients reported that their dietary and salt intake had worsened in the ΔBP>0 group than in the ΔBP≤0 group (9% vs. 20%, p=0.02, and 3% vs. 10%, p=0.04, respectively). Additionally, both systolic and diastolic BP measured in the office were significantly increased (p=0.02 and p=0.03, respectively); however, systolic BP measured at home significantly decreased (p=0.01). The total stress scores were higher in the ΔBP>0 group than in the ΔBP≤0 group (0.05±2.61 and 0.93±2.70, respectively, p=0.03).
Conclusions:
An increase in stress and, particularly, worsening dietary and salt intake were noted among patients with T2DM who experienced an increase in BP following the state-of-emergency announcement.
