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Akihiko TAKAHASHI4, 5), Toshio NAITO2), Ryohei KUWATSURU4, 6), Hirotaka WATADA1)5)4DIN Ltd., Tokyo, Japan3)Clinical Research and Trial Center, Juntendo University, Tokyo, Japan6)Department of Radiology, Juntendo University Graduate School of Medicine, Tokyo, Japan2)Department of General Medicine, Juntendo University Graduate School of Medicine, Tokyo, Japan4)Center for Promotion of Data Science, Juntendo University Graduate School of Medicine, Tokyo, Japan1)Department of Metabolism & Endocrinology, Juntendo University Graduate School of Medicine, Tokyo, JapanToshiki KOGAI1), Kazutoshi FUJIBAYASHI2, 3), Naotake YANAGISAWA3), Nobuyuki FUKUI4, 5), Corresponding author: Kazutoshi FujibayashiDepartment of General Medicine, Juntendo University Graduate School of Medicine3-1-3 Hongo, Bunkyo-Ku, Tokyo 113-8421, JapanTEL/FAX: +81-3-5802-1190　E-mail: kfujiba@juntendo.ac.jp〔Received　Mar. 15, 2021〕〔Accepted　Apr. 12, 2021〕J-STAGE Advance published date: Jun. 7, 2021Copyright © 2021 The Juntendo Medical Society. This is an open access article distributed under the terms of Creative Commons Attribution License (CC BY), which permits unrestricted use, distribution, and reproduction in any medium, provided the original source is properly credited. doi: 10.14789/jmj.JMJ21-OA14Objective: To elucidate the impact of activity restrictions associated with the pandemic on diabetes management.Materials: This study evaluated all patients visiting our facility who were determined to have diabetes during the observation periods. To determine the impacts of the emergency declared on April 7, 2020, we examined 345, 1109, and 752 patients whose hemoglobin A1c (HbA1c) levels were measured in March and April, May, or in June, respectively. Patients were compared to data from other subjects evaluated in 2019 under the same conditions. The 2019 subjects included 469, 1315, and 783 patients whose HbA1c levels were measured in March and April, May, or June, respectively.Methods: Comparison of the HbA1c levels in April, May, and June minus the HbA1c levels in March of both 2019 and 2020 were used to assess the impact of pandemic-related activity restrictions on diabetes management. HbA1c levels greater than 0 were defined as patients who “worsened”, while differences in HbA1c levels ≤0 were defined as patients who conditions were “not worsened”. Comparisons of the deterioration/improvement rates for the HbA1c levels in 2019 and 2020 were then performed.Results: Compared to 2019, the number of patients exhibiting a worsened diabetes management increased from March to April 2020 [122 (26.0%) vs. 137 (39.7%), p<0.01], while the number of patients with worsened diabetes management decreased from March to June 2020 [305 (39.0%) vs. 240 (31.9%), p<0.01].Conclusions: When compared to 2019, there was no sustained increase in patients with worsening diabetes management during the 2020 observation period.Key words: coronavirus disease 2019, diabetes management, activity limitations, social participation restrictionsJuntendo Medical Journal2021. 67(4), 333-337Original ArticlesImpact on Diabetes Management Due to Social Participation Restrictions 1. IntroductionIn order to ensure good diabetes management, it has been reported that proper exercise is beneficial in these patients1). Due to the worldwide spread of coronavirus disease 2019 (COVID-19), many coun‑tries have put into place lockdowns and quaran‑tines of both cities and regional locations. Japan first declared a state of emergency from April 7, 2020 to May 25, 2020, during which time stricter restrictions on activities were placed. During this state of emergency, there was a decrease in the mobility of the Japanese population, which caused many patients with lifestyle-related diseases having to subsequently change their lifestyles2). However, the impact of these nationwide activity 333Associated with the COVID-19 Pandemic