Differential impact of COVID-19 on change in body composition in young and older individuals with diabetes in the post-COVID-19 Era.

No significant changes in HbA1c were observed across the pre-SE, SE, and post-SE periods in any subgroup.

• HbA1c was measured in three periods: pre-SE (April 2019–March 2020), SE (April 2020–September 2021), and post-SE (October 2021–September 2022).
• This finding held across all subgroups divided by age and gender.
• A total of 673 subjects with diabetes aged 20 years or older were analyzed.
• Hospitalized individuals were excluded from the analysis.

Body weight remained constant during the state of emergency period but decreased in the post-SE period.

• The pattern of body weight stability during SE followed by post-SE decrease was observed in the total analysis.
• The study period spanned from April 2019 to September 2022.
• Japan's intermittent states of emergency ran from April 2020 to September 2021 without strict lockdowns.
• 673 subjects with diabetes were included in the retrospective analysis.

Skeletal muscle mass continuously decreased across all groups throughout the observation periods.

• Continuous decreases in skeletal muscle mass were noted in all subgroups regardless of age or gender.
• Subgroups were divided by age (young: <65 years, older: ≥65 years) and gender.
• The decline occurred across pre-SE, SE, and post-SE periods without reversal.
• Body composition was measured at each of the three time periods for all 673 participants.

In the total analysis, body fat mass initially increased during SE but decreased post-SE, yet overall body fat percentage rose due to accompanying weight loss.

• Body fat mass increased during the SE period compared to pre-SE.
• Body fat mass then decreased in the post-SE period.
• Despite the decrease in fat mass post-SE, body fat percentage continued to rise because body weight also declined.
• This pattern reflects a disproportionate loss of lean mass relative to fat mass in the post-SE period.

Older males showed a distinct pattern in which body fat mass increased during SE and remained unchanged post-SE, resulting in a continuous increase in body fat percentage throughout the entire observation period.

• This pattern differed from younger individuals and from older females.
• In older males, the body fat mass increase during SE was not followed by a post-SE decrease as seen in the total group.
• The continuous rise in body fat percentage in older males persisted across all three time periods.
• The authors characterized the impact as 'most significant in older males,' underscoring the need for targeted health interventions.

The study design was a retrospective analysis of individuals with diabetes attending an outpatient setting in Japan during intermittent COVID-19 states of emergency.

• 673 subjects with diabetes aged 20 years or older were included.
• Participants required HbA1c and body composition measurements in all three defined periods.
• Hospitalized individuals were excluded.
• Japan's containment measures involved intermittent states of emergency without strict lockdowns from April 2020 to September 2021.
• Subgroup analyses were conducted by age (<65 years vs. ≥65 years) and gender.