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Understanding impacts of COVID-19 restrictions on glycemic control for patients with diabetes in Japan

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Abstract

Objective

This study evaluated the changes in the status of glycemic control and lipid management in patients with diabetes under COVID-19 containment restrictions, in order to better understand the impacts of events causing lifestyle restrictions. Patient characteristics with worsened glycemic control were also assessed.

Methods

We conducted a retrospective and observational cohort study using the electronic health records of 5,169 patients with diabetes seeking medical care in two healthcare centers. Laboratory test results including glycemic and lipid goal attainment rates were compared between pre-COVID-19 (January to December 2019) and the first wave of COVID-19 (February to June 2020). Multiple regression models were used to evaluate the association between glycated hemoglobin (HbA1c) at baseline and during the first wave with covariates such as concomitant medications and comorbidities.

Results

The HbA1c goal achievement rate improved significantly from 39.0% to 43.1% (p < 0.0001) overall, and more patients reached their glycemic target during COVID-19 restrictions. No significant changes were observed in lipid control. An indexed change in HbA1c level showed that glycemic control improved in 2,230 patients and worsened in 1,619 patients. Administration of insulin, GLP-1, and sulfonylureas were each identified as factors correlated with elevated HbA1c, during the first wave of COVID-19.

Conclusion

Although the glycemic control in patients with diabetes improved overall under COVID-19 restrictions, those on insulin, GLP-1, or sulfonylureas worsened. These findings suggest the need to better understand what drives differences in glycemic control to better support people with diabetes for future epidemiological outbreaks.

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Acknowledgements

We would like to thank the doctors at Diabetology Department in the Teikyo University Hospital and the Kyoto Medical Center for their cooperation, and Femi Morakinyo, PhD, of Edanz, for providing medical writing support.

Funding

This research was not funded through specific grants from any funding agencies in the public, commercial, or not-for-profit sectors.

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Authors and Affiliations

  1. Department of Internal Medicine, Teikyo University School of Medicine, Tokyo, Japan

    Kiyoko Uno-Eder, Kenji Uno, Takuya Uchino, Koji Morita, Toshio Ishikawa & Kazuhisa Tsukamoto

  2. Teikyo Academic Research Center, Teikyo University, Tokyo, Japan

    Kiyoko Uno-Eder, Manabu Hibiya, Tetsuji Kaneko & Tamio Teramoto

  3. Department of Endocrinology, Metabolism and Hypertension, National Hospital Organization Kyoto Medical Center, Kyoto, Japan

    Noriko Satoh-Asahara & Hajime Yamakage

  4. Medical Informatics Department, National Hospital Organization Kyoto Medical Center, Kyoto, Japan

    Yuki Kitaoka

  5. Medical Information System Research Center, Teikyo University, Tokyo, Japan

    Tomohiro Sawa

Authors
  1. Kiyoko Uno-Eder
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  2. Noriko Satoh-Asahara
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Contributions

K U-E, N S-A, KU, TK, HY, YK, TS, and KT contributed to the study design, conduct and data collection, data analysis and interpretation, and writing or reviewing of the manuscript. MH, TU, KM, TI and TT participated in the data analysis and interpretation and writing or reviewing of the manuscript. All authors read and approved the final manuscript for submission.

Corresponding author

Correspondence to Kiyoko Uno-Eder.

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Uno-Eder, K., Satoh-Asahara, N., Hibiya, M. et al. Understanding impacts of COVID-19 restrictions on glycemic control for patients with diabetes in Japan. J Diabetes Metab Disord 22, 1695–1703 (2023). https://doi.org/10.1007/s40200-023-01302-5

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  • DOI: https://doi.org/10.1007/s40200-023-01302-5

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