Effects of Social Distancing on Diabetes Management in Older Adults during COVID-19 Pandemic

Background: On March 22, 2020, intense social distancing (SD) was implemented in Korea to prevent the spread of coronavirus disease 19 (COVID-19). This study examined the impact of SD on diabetes control in older adults with diabetes. Methods: Adults aged 60 to 90 years with type 2 diabetes mellitus who were physically and mentally independent were recruited. Participants who had complete blood chemistry data from April to July 2019 (pre-SD era) and April to July 2020 (SD era) were enrolled. Data were obtained about physical activity, nutrition, sarcopenia, and psychological and mental health from question-naires in April to July 2020. Calf circumference was measured. Results: In total, 246 people (100 men, 146 women; mean age, 73.8 +/- 5.7 years) participated in this study. The levels of glycated hemoglobin (HbA1c, 7.4% +/- 1.0% vs. 7.1% +/- 0.8%, P < 0.001), fasting glucose (142.2 +/- 16.7 mg/dL vs. 132.0 +/- 27.7 mg/dL, P < 0.001), and body weight (62.6 +/- 9.4 kg vs. 61.8 +/- 10.1 kg, P<0.01) were higher in the SD era than in the pre-SD era. Total physical activity was lower in the SD era (2,584.6 +/- 2,624.1 MET-min/week(-1) vs. 1,987.3 +/- 2,295.0 MET-min/week(-1), P< 0.001). A larger increase in HbA1c level was associated with increased body weight and decreased physical activity. Conclusion: SD had negative effects on diabetes management in older adults with diabetes. Fasting glucose and HbA1c levels and body weight increased during the SD era. Participants with reduced physical activity gained more weight and had higher blood glucose levels. Given that the COVID-19 pandemic is ongoing, health professionals and diabetes educators should monitor changes in lifestyle factors in older adults with diabetes.