Behavioral changes in patients with diabetes during the COVID-19 pandemic

Amid the coronavirus disease (COVID-19) pandemic, the Japanese government declared a state of emergency and urged people to stay at home to prevent disease transmission. Herein, we investigated this emergency situation's effect on diabetes patients' lifestyle and glycemic control.

Diabetes patients who visited our hospital between April 1 and June 13, 2020, for a regular consultation were asked about changes in their physical activities and dietary habits during the state of emergency period.

Among 168 patients, 26 (15.5%) gained > 2 kg; HbA1c levels were elevated or decreased by > 0.2% compared to that at the last visit in 57 and 51 patients (Groups D and I), respectively. Group D patients were affected to a larger extent by changes in commuting (transition to teleworking) and closures of sport gyms than Group I patients. Increased snacks, sweets, total diet, and alcohol intake could have contributed to worsening of glucose control in Group D, whereas a healthy diet and less alcohol intake could have led to better glucose control in Group I.

During the state of emergency period, decreased physical activity levels negatively affected glycemic control. However, despite changes in physical activity level, maintaining or improving dietary habits could lead to better glycemic control in diabetes patients. During this COVID-19 pandemic, more diabetes patients are likely to shift to teleworking and stay home for longer periods. Therefore, we should develop effective and feasible measures to promote exercise and dietary therapy, especially for those who engage in teleworking.