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

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 (Delta BP >0 group) and decrease in BP (Delta BP <= 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 Delta BP >0 group than in the Delta BP <= 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 Delta BP >0 group than in the Delta BP <= 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.