Impact of sex differences on lifestyle and glycemic control in Japanese patients with diabetes during COVID-19 lockdowns

Background Pneumonia of unknown pathogenesis detected in Wuhan, Hubei Province, China, in December 2019 was later found to be a new coronavirus infection that causes the now-named coronavirus disease 2019 (COVID-19). The onset of the pandemic has drastically changed global lifestyles. Some reports about lifestyle changes in patients with diabetes during COVID-19 pandemic have been published. However, these studies have not assessed sex differences. Thus, we analyzed three lifestyle changes during the COVID-19 pandemic to determine any sex differences. Methods We analyzed physical activity, snacking habits, and drinking habits in 323 patients with diabetes. Sex differences in the changes in these three lifestyle habits were analyzed using the 𝜒2 test, and the factors that influenced the deterioration of HbA1c were analyzed by paired t-test. The factors that influenced the deterioration of HbA1c were determined by univariate and multivariate logistic regression analyses. Results Of the 323 diabetic, 212 were male (65.6%) and 111 were female (34.4%). HbA1c values were higher in 2020 compared with those in 2019. Increased physical activity was higher in men, whereas decreased physical activity was higher in women. The factors that affected the deterioration in HbA1c were snacking habits for the overall population and in the male sex. No factors significantly affected HbA1c in the female population. Conclusions Our study confirmed that lifestyle changes differed between the sexs during the COVID-19 pandemic. Snacks influenced the deterioration of HbA1c in the overall study population and in the male population. A balanced diet and regular exercise are important for all patients with diabetes during this pandemic. This study demonstrates that more attention should be given on men’s diet, whereas physical inactivity should be emphasized for women.