Division of Diabetology and Metabolism, Department of Internal Medicine, Tokyo Women's Medical University School of Medicine, Japan.
Intern Med. 2024 May 1;63(9):1197-1205. doi: 10.2169/internalmedicine.2703-23. Epub 2024 Feb 19.
Objective To examine the impact of lifestyle changes caused by the first emergency declaration issued in 2020 on glycemic control and body weight changes in Japanese individuals with type 1 diabetes mellitus. Methods This study included Japanese individuals with type 1 diabetes mellitus who visited Tokyo Women's Medical University Hospital between January 2019 and September 2020 (n=278). Seasonal changes in glycated hemoglobin (HbA1c) levels and the body mass index (BMI) were compared. A self-administered questionnaire regarding changes in treatment, diet, exercise, sleep, and telecommuting was used to assess lifestyle changes. Results Although HbA1c levels decreased from winter to summer in 2019 and 2020, the annual change was slightly but significantly greater in 2020 than in 2019. Seasonal changes in the BMI between 2019 and 2020 were also significantly different. An increase in the daily insulin dose, overall blood glucose level, diurnal change in blood glucose level, and food intake were significantly associated with increased HbA1c levels. Furthermore, HbA1c levels decreased with increasing moderate physical activity and sleep duration. The change in the BMI increased with increasing insulin dose, overall high blood glucose levels, and food intake. However, an increase in moderate physical activity was associated with a decrease in the BMI. HbA1c levels were significantly lower after the first emergency declaration in individuals with type 1 diabetes mellitus than that before the emergency declaration, even after accounting for seasonal variations. Conclusion Decreased HbA1c levels were associated with a decreased food intake, increased moderate exercise, and increased sleep duration during the state of emergency. The BMI remained relatively unchanged.
探讨 2020 年首次发布的紧急状态对日本 1 型糖尿病患者血糖控制和体重变化的生活方式改变的影响。
本研究纳入了 2019 年 1 月至 2020 年 9 月期间在东京女子医科大学医院就诊的日本 1 型糖尿病患者(n=278)。比较了糖化血红蛋白(HbA1c)水平和体重指数(BMI)的季节性变化。采用自行设计的问卷评估了治疗、饮食、运动、睡眠和远程办公等生活方式的变化。
尽管 2019 年和 2020 年 HbA1c 水平从冬季降至夏季,但 2020 年的年度变化略高于 2019 年。2019 年和 2020 年 BMI 的季节性变化也有显著差异。每日胰岛素剂量、总血糖水平、日间血糖变化和食物摄入量的增加与 HbA1c 水平的升高显著相关。此外,中度体力活动和睡眠时间的增加与 HbA1c 水平的降低相关。BMI 的变化与胰岛素剂量、总高血糖水平和食物摄入量的增加相关。然而,中度体力活动的增加与 BMI 的降低相关。即使考虑到季节性变化,1 型糖尿病患者在紧急状态下的 HbA1c 水平也明显低于紧急状态前。
HbA1c 水平的降低与紧急状态下食物摄入量的减少、中度运动的增加和睡眠时间的增加有关。BMI 保持相对不变。