Preserved seasonal variation in glycemic control in patients with type 2 diabetes mellitus during COVID-19: a 3-year-long retrospective cohort study in older adults in Japan

• Published in: BMC endocrine disorders Vol. 24; no. 1; p. 70
• Main Authors: Iwata, Shimpei, Ashida, Kenji, Demiya, Mutsuyuki, Nagayama, Ayako, Hasuzawa, Nao, Yoshinobu, Satoko, Sonezaki, Aya, Yasuda, Junichi, Motomura, Seiichi, Katsuki, Yoshio, Sugi, Kenzo, Nomura, Masatoshi
• Format: Journal Article
• Language: English
• Published: England BioMed Central Ltd 17.05.2024; BioMed Central; BMC
• Subjects: Aged; Aged, 80 and over; Analysis; Autumn; Blood Glucose - analysis; Blood Glucose - metabolism; Blood pressure; Body mass index; Cardiovascular disease; Care and treatment; Cohort analysis; Coronaviruses; COVID-19; COVID-19 - blood; COVID-19 - epidemiology; Diabetes; Diabetes mellitus (non-insulin dependent); Diabetes mellitus, type 2; Diabetes Mellitus, Type 2 - blood; Diabetes Mellitus, Type 2 - epidemiology; Diabetes therapy; Diabetics; Epidemics; Exercise; Female; Glycated Hemoglobin - analysis; Glycated Hemoglobin - metabolism; Glycemic Control; Glycosylated hemoglobin; Health aspects; Hemoglobin; Humans; Hypertension; Japan; Japan - epidemiology; Lifestyle; Lifestyles; Male; Medical research; Medicine, Experimental; Metabolic disorders; Middle Aged; Normal distribution; Pandemics; Patients; Physical activity; Physical fitness; Physiological aspects; Retrospective Studies; Risk factors; Sarcopenia; SARS-CoV-2; Seasonal variation; Seasonal variations; Seasonal variations (Diseases); Seasons; Standardization; State of emergency; Statistics; Type 2 diabetes; Variables; Variance analysis; Winter; Japan; COVID-19; Body mass index; Lifestyle; Diabetes mellitus, type 2; Seasonal variation
• ISSN: 1472-6823; 1472-6823
• DOI: 10.1186/s12902-024-01602-8

The coronavirus disease 2019 (COVID-19) pandemic has changed our lifestyle by imposing restrictions, such as physical distancing. The effect of COVID-19 prevalence on seasonal variations in glycemic control in patients with diabetes mellitus (DM) remains unknown. This single-center retrospective cohort study evaluated glycemic control in patients with type 2 DM who visited Sugi Cardiovascular Hospital in December 2021. We evaluated the clinical findings of all patients treated regularly between March 1, 2019, and December 31, 2021, including the periods both before and after the COVID-19 pandemic. All the standard treatments were approved. Furthermore, seasonal changes in hemoglobin A1c (HbA1c) levels were evaluated using stratified analyses based on age. This study analyzed 86 patients (mean age, 69.6 ± 9.2 years; men, 57). Median HbA1c (National Glycohemoglobin Standardization Program [Union of Clinical Chemistry]) levels in spring (March) were 7.70% (interquartile range (IQR):7.23%-8.30%) [60.6 mmol/mol (IQR:55.4-67.2 mmol/mol)], 7.35% (IQR:6.90%-7.90%) [56.8 mmol/mol (IQR:51.9-62.8 mmol/mol)], and 7.50% (IQR:7.10%-8.00%) [58.5 mmol/mol (IQR:54.1-63.9 mmol/mol)] in 2019, 2020, and 2021, respectively. During these periods, HbA1c levels and body mass index (BMI) revealed significant seasonal variations "high in spring" and "low in autumn." Median HbA1c levels in spring (March) and autumn (September) were 7.86% [61.2 mmol/mol] and 7.48% [57.4 mmol/mol] in 2019 (P < 0.001), 7.50% [57.7 mmol/mol] and 7.17% [54.2 mmol/mol] in 2020 (P < 0.001), and 7.61% [58.3 mmol/mol] and 7.19% [53.8 mmol/mol] in 2021 (P < 0.001). Seasonal variations in HbA1c levels and BMI were maintained over the past 3 years, including the pandemic period. None of the patients in this study developed COVID-19 during the study period. Seasonal variations in glycemic control in patients with DM were not influenced by lifestyle modifications associated with COVID-19. Maintenance of physical activity is necessary to prevent the development of sarcopenia. Moreover, seasonal variations in glycemic metabolism should be considered an independent factor for DM management. Additional extensive multifacility investigations are necessary to corroborate our findings.