Impact of the first announced state of emergency owing to coronavirus disease 2019 on stress and blood pressure levels among patients with type 2 diabetes mellitus in Japan

J Diabetes Investig. 2022 Sep;13(9):1607-1616. doi: 10.1111/jdi.13813. Epub 2022 May 6.

Abstract

Aims/introduction: After the first coronavirus disease 2019 state of emergency announcement, there was an increase in stress that might have affected the self-management of patients with type 2 diabetes mellitus. This study identified the changes in clinical findings and stress among patients with type 2 diabetes mellitus, and investigated the characteristics of patients who experienced an increase in blood pressure (BP) after the announcement.

Materials and methods: Retrospectively, we scrutinized 310 patients with type 2 diabetes mellitus who were treated by the Sagamihara Physicians Association. After the announcement, 164 and 146 patients showed an increase (ΔBP >0 group) and decrease in BP (ΔBP ≤0 group), respectively. The propensity score matching method was used to compare the differences in clinical findings and stress-related questionnaire responses between the two groups.

Results: After the announcement, 47% of patients experienced an increase in daily stress. Furthermore, 17% and 36% reported worsening dietary intake and a decrease in exercise, respectively. More patients reported that their dietary and salt intake had worsened in the ΔBP >0 group than in the ΔBP ≤0 group (9% vs 20%, P = 0.02, and 3% vs 10%, P = 0.04, respectively). Additionally, both systolic and diastolic BP measured in the office were significantly increased (P = 0.02 and P = 0.03, respectively); however, systolic BP measured at home significantly decreased (P = 0.01). The total stress scores were higher in the ΔBP >0 group than in the ΔBP ≤0 group (0.05 ± 2.61 and 0.93 ± 2.70, respectively, P = 0.03).

Conclusions: An increase in stress and, particularly, worsening dietary and salt intake were noted among patients with type 2 diabetes mellitus who experienced an increase in BP after the state of emergency announcement.

Keywords: Blood pressure; Coronavirus disease 2019; Diabetes mellitus.

MeSH terms

  • Blood Pressure / physiology
  • COVID-19* / complications
  • COVID-19* / epidemiology
  • Diabetes Mellitus, Type 2* / drug therapy
  • Humans
  • Hypertension* / complications
  • Japan / epidemiology
  • Retrospective Studies
  • Sodium Chloride, Dietary / therapeutic use

Substances

  • Sodium Chloride, Dietary