Impacts of the Kumamoto Earthquake 2016 on Glycemic Control in Diabetic Patients

In April 14th and 16th, 2016, Kumamoto area was severely damaged by massive M7 class earthquakes. To examine the effects of these earthquakes on glycemic control and stress factors in diabetic outpatients regularly cared in diabetic clinic of Kumamoto University Hospital, sequential HbA1c, glycated albumin, other biochemical parameters, life style associated questionnaire and Impact of Event Scale-Revised (IES-R) scores were analyzed. A total of 557 patients were enrolled and data were collected from 13 months before to 13 months after the earthquakes. In patients with type 1 diabetes (T1D) or specific types of diabetes due to other causes, glycemic control was not altered during the observational period. This glycemic stability in T1D may result from self-management of insulin doses (increase in 7% and decrease in 20% of patients). In patients with type 2 diabetes (T2D), HbA1c was decreased by 0.11% (from 7.33% to 7.22%) at 1-2 months after the earthquakes compared to that before the earthquakes, and increased at 3-4, 6-7 and 12-13 months after the earthquakes. The reduction of HbA1c at after 1-2 months in T2D was associated with “quick restoration of life-lines” and “sufficiency of sleep.” The glycemic deterioration at after 3-4 months was related to “shortage of antidiabetic agents” and “insufficient amount of food”, and at after 12-13 months that was connected to “large-scale partial destruction of houses” and “changes in working environments.” IES-R, representing disaster associated stress levels were positively correlated with “age”, “delayed restoration of life-lines”, “self-managements of antidiabetic agents” and “increased amount of activity”, and negatively associated with “early restoration of life-lines” and “sufficiency of sleep.” Thus, the glycemic control, associated factors and stress levels are altered in chronological order. Post-disaster diabetic medical care must consider these corresponding points in accordance with the time period. Disclosure T. Kondo: None. N. Miyakawa: None. H. Motoshima: None. N. Ishii: None. M. Igata: None. K. Yoshinaga: None. D. Kukidome: None. T. Senokuchi: None. J. Kawashima: None. T. Matsumura: None. E. Araki: Speaker's Bureau; Self; Astellas Pharma US, Inc., MSD K.K., Kowa Pharmaceuticals America, Inc., Sanofi, Novo Nordisk Inc.. Research Support; Self; Astellas Pharma US, Inc., MSD K.K., Ono Pharmaceutical Co., Ltd., Shionogi & Co., Ltd., Takeda Pharmaceuticals U.S.A., Inc., Daiichi Sankyo Company, Limited, Nippon Boehringer Ingelheim Co. Ltd., Novartis Pharma K.K., Novo Nordisk Inc., Sanofi, Mitsubishi Tanabe Pharma Corporation, Sumitomo Dainippon Pharma Co., Ltd., Taisho Toyama Pharmaceutical Co..