2023年 新着論文 53 糖尿病診療分野から論文が発表されました

Impact of COVID-19 pandemic on behavioral changes and glycemic control and a survey of telemedicine in patients with diabetes: A multicenter retrospective observational study

J Diabetes Investig. 2023 Aug;14(8):994-1004. doi: 10.1111/jdi.14027. Epub 2023 May 15.

Authors

Ryotaro Bouchi  1   2 Takehiro Sugiyama  2   3 Atsushi Goto  4 Mitsuru Ohsugi  1   2 Narihito Yoshioka  5 Hideki Katagiri  6 Tomoya Mita  7 Yushi Hirota  8 Hiroshi Ikegami  9 Munehide Matsuhisa  10 Eiichi Araki  11 Hiroki Yokoyama  12 Masae Minami  13 Katsuya Yamazaki  14 Hideaki Jinnouchi  15 Hiroki Ikeda  16 Hitomi Fujii  17 Miyuki Nogawa  18 Masahiro Kaneshige  19 Kengo Miyo  20 Kohjiro Ueki  1   21

Affiliations

  • 1 Department of Diabetes, Endocrinology and Metabolism, Center Hospital, National Center for Global Health and Medicine, Tokyo, Japan.
  • 2 Diabetes and Metabolism Information Center, Research Institute, National Center for Global Health and Medicine, Tokyo, Japan.
  • 3 Department of Public Health/Health Policy, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan.
  • 4 Department of Health Data Science, Graduate School of Data Science, Yokohama City University, Yokohama, Japan.
  • 5 NTT Medical Center Sapporo, Sapporo, Japan.
  • 6 Department of Metabolism and Diabetes, Tohoku University Graduate School of Medicine, Sendai, Japan.
  • 7 Department of Metabolism & Endocrinology, Graduate School of Medicine, Juntendo University, Tokyo, Japan.
  • 8 Division of Diabetes and Endocrinology, Department of Internal Medicine, Kobe University Graduate School of Medicine, Kobe, Japan.
  • 9 Department of Endocrinology, Metabolism and Diabetes, Kindai University Faculty of Medicine, Osaka, Japan.
  • 10 Diabetes Therapeutics and Research Center, Institute of Advanced Medical Sciences, Tokushima University, Tokushima, Japan.
  • 11 Department of Metabolic Medicine, Faculty of Life Sciences, Kumamoto University, Kumamoto, Japan.
  • 12 Jiyugaoka Medical Clinic, Internal Medicine, Obihiro, Japan.
  • 13 Minami Diabetes Clinical Research Center, Fukuoka, Japan.
  • 14 Kawai Clinic, Tsukuba, Japan.
  • 15 Jinnouchi Hospital Diabetes Care Center, Kumamoto, Japan.
  • 16 Ikeda Hospital, Amagasaki, Japan.
  • 17 Tama-Center Mirai Clinic, Tokyo, Japan.
  • 18 Clinic Mirai Kunitachi, Tokyo, Japan.
  • 19 Clinic Mirai Tachikawa, Tokyo, Japan.
  • 20 Center for Medical Informatics Intelligence, National Center for Global Health and Medicine, Tokyo, Japan.
  • 21 Diabetes Research Center, National Center for Global Health and Medicine, Tokyo, Japan.

Free PMC article

Abstract

Aims/introduction: To investigate whether the COVID-19 pandemic affected behavioral changes and glycemic control in patients with diabetes and to conduct a survey of telemedicine during the pandemic.

Materials and methods: In this retrospective study, a total of 2,348 patients were included from 15 medical facilities. Patients were surveyed about their lifestyle changes and attitudes toward telemedicine. Hemoglobin A1c (HbA1c) levels were compared among before (from June 1 to August 31, 2019) and in the first (from June 1 to August 31, 2020) and in the second (from June 1 to August 31, 2021) year of the pandemic. A survey of physician attitudes toward telemedicine was also conducted.

Results: The HbA1c levels were comparable between 2019 (7.27 ± 0.97%), 2020 (7.28 ± 0.92%), and 2021 (7.25 ± 0.94%) without statistical difference between each of those 3 years. Prescriptions for diabetes medications increased during the period. The frequency of eating out was drastically reduced (51.7% in 2019; 30.1% in 2020), and physical activity decreased during the pandemic (48.1% in 2019; 41.4% in 2020; 43.3% in 2021). Both patients and physicians cited increased convenience and reduced risk of infection as their expectations for telemedicine, while the lack of physician-patient interaction and the impossibility of consultation and examination were cited as sources of concern.

Conclusions: Our data suggest that glycemic control did not deteriorate during the COVID-19 pandemic with appropriate intensification of diabetes treatment in patients with diabetes who continued to attend specialized diabetes care facilities, and that patients and physicians shared the same expectations and concerns about telemedicine.

Keywords: COVID-19; glycemic control; lifestyle changes.

Conflict of interest statement

The authors declare no conflict of interest.

Approval of the research protocol: This study was approved by the Institutional Review Board for Clinical Research of the National Center for Global Health and Medicine (approval number, NCGM‐S‐004287‐03; approval date, November 05, 2021).

Informed consent: Written informed consent was obtained from all patients.

Registry and the registration no. of the study/trial: N/A.

Animal studies: N/A.

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