{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,2]],"date-time":"2026-06-02T07:10:55Z","timestamp":1780384255709,"version":"3.54.1"},"reference-count":27,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2026,4,9]],"date-time":"2026-04-09T00:00:00Z","timestamp":1775692800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"},{"start":{"date-parts":[[2026,4,9]],"date-time":"2026-04-09T00:00:00Z","timestamp":1775692800000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/100016573","name":"Japan Association for Diabetes Education and Care","doi-asserted-by":"publisher","award":["2023\u2010MED\u2010006"],"award-info":[{"award-number":["2023\u2010MED\u2010006"]}],"id":[{"id":"10.13039\/100016573","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J of Diabetes Invest"],"published-print":{"date-parts":[[2026,6]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Aims\/Introduction<\/jats:title>\n                    <jats:p>During the coronavirus disease 2019 (COVID\u201019) pandemic, Japan imposed voluntary\u2010based restrictions under a state of emergency (SOE) from 2020 to 2021, and nationwide behavioral restrictions ended with its category 5 status in May 2023. The long\u2010term metabolic impact and their behavioral adaptations of these restrictions and relaxation remain unclear in individuals with glucose intolerance (GI). This single\u2010center observational study assessed changes in glycemic control, body composition, and lifestyle changes across the pre\u2010SOE (2019), SOE (2020\u20132021), and post\u2010SOE (2023) periods in outpatients.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Materials and Methods<\/jats:title>\n                    <jats:p>We included 221 outpatients with GI who had complete data for glycated hemoglobin (HbA1c) and body composition in all three periods. Lifestyle changes were evaluated using a questionnaire at post\u2010SOE period.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>HbA1c levels gradually increased, with a significant elevation post\u2010SOE compared to pre\u2010SOE. While body weight and BMI remained stable during the SOE, both decreased post\u2010SOE. Fat mass increased during the SOE and thereafter decreased, whereas skeletal muscle mass decreased progressively. Among 68 individuals whose HbA1c worsened during the SOE, 25 experienced further deterioration post\u2010SOE, whereas 43 showed improvements in both glycemic control and body composition. Clustering analysis of questionnaire responses in this subgroup identified two behavioral patterns. One cluster, marked by the combination of persistent reductions in physical activity and increased snacking, showed greater post\u2010SOE HbA1c increases.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>This study clarified long\u2010term metabolic effects of COVID\u201019 restrictions with glycemic deterioration in individuals with GI. In exploratory analysis of those with HbA1c worsening during SOE, behavioral patterns were associated with post\u2010SOE HbA1c changes.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/jdi.70307","type":"journal-article","created":{"date-parts":[[2026,4,9]],"date-time":"2026-04-09T14:30:11Z","timestamp":1775745011000},"page":"1063-1074","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Impact of\n                    <scp>COVID<\/scp>\n                    \u201019 restrictions and their relaxation on body composition and glycemic control in individuals with glucose intolerance in Japan: A single\u2010center observational study"],"prefix":"10.1111","volume":"17","author":[{"given":"Ami","family":"Kobayashi","sequence":"first","affiliation":[{"name":"Department of Metabolism and Clinical Nutrition Kyoto University Hospital  Kyoto Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yamato","family":"Keidai","sequence":"additional","affiliation":[{"name":"Department of Diabetes, Endocrinology, and Nutrition, Graduate School of Medicine Kyoto University  Kyoto Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3844-1138","authenticated-orcid":false,"given":"Takaaki","family":"Murakami","sequence":"additional","affiliation":[{"name":"Department of Diabetes, Endocrinology, and Nutrition, Graduate School of Medicine Kyoto University  Kyoto Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0005-3066-0442","authenticated-orcid":false,"given":"Ryo","family":"Tsukaguchi","sequence":"additional","affiliation":[{"name":"Department of Diabetes, Endocrinology, and Nutrition, Graduate School of Medicine Kyoto University  Kyoto Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Miharu","family":"Fujita","sequence":"additional","affiliation":[{"name":"Department of Metabolism and Clinical Nutrition Kyoto University Hospital  Kyoto Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Keiko","family":"Wada","sequence":"additional","affiliation":[{"name":"Department of Metabolism and Clinical Nutrition Kyoto University Hospital  Kyoto Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5334-7687","authenticated-orcid":false,"given":"Daisuke","family":"Yabe","sequence":"additional","affiliation":[{"name":"Department of Metabolism and Clinical Nutrition Kyoto University Hospital  Kyoto Japan"},{"name":"Department of Diabetes, Endocrinology, and Nutrition, Graduate School of Medicine Kyoto University  Kyoto Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,4,9]]},"reference":[{"key":"e_1_2_8_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijsu.2020.04.018"},{"key":"e_1_2_8_3_1","doi-asserted-by":"publisher","DOI":"10.3390\/ijerph17186878"},{"key":"e_1_2_8_4_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12967-020-02399-5"},{"key":"e_1_2_8_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.trip.2020.100181"},{"key":"e_1_2_8_6_1","doi-asserted-by":"publisher","DOI":"10.1177\/03000605231184036"},{"key":"e_1_2_8_7_1","unstructured":"Ministry of Health Labour and Welfare Japann.Response to COVID\u201019 after the classification change. Available from:https:\/\/www.mhlw.go.jp\/stf\/corona5rui.htmlAccessed July 22 2025. [press release]."},{"key":"e_1_2_8_8_1","unstructured":"World Health Organization.Statement on the fifteenth meeting of the IHR (2005) Emergency Committee on the COVID\u201019 pandemic. Available from:https:\/\/www.who.int\/news\/item\/05\u201005\u20102023\u2010statement\u2010on\u2010the\u2010fifteenth\u2010meeting\u2010of\u2010the\u2010international\u2010health\u2010regulations\u2010(2005)\u2010emergency\u2010committee\u2010regarding\u2010the\u2010coronavirus\u2010disease\u2010(covid\u201019)\u2010pandemic Accessed July 22 2025."},{"key":"e_1_2_8_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.diabres.2021.108840"},{"key":"e_1_2_8_10_1","doi-asserted-by":"publisher","DOI":"10.1111\/jdi.13934"},{"key":"e_1_2_8_11_1","doi-asserted-by":"publisher","DOI":"10.1111\/jdi.13758"},{"key":"e_1_2_8_12_1","doi-asserted-by":"publisher","DOI":"10.1111\/jdi.13893"},{"key":"e_1_2_8_13_1","doi-asserted-by":"publisher","DOI":"10.1111\/jdi.13526"},{"key":"e_1_2_8_14_1","doi-asserted-by":"publisher","DOI":"10.1111\/dom.14771"},{"key":"e_1_2_8_15_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00592-021-01754-2"},{"key":"e_1_2_8_16_1","doi-asserted-by":"publisher","DOI":"10.1111\/jdi.14027"},{"key":"e_1_2_8_17_1","doi-asserted-by":"publisher","DOI":"10.3390\/ijerph18084188"},{"key":"e_1_2_8_18_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.2040-1124.2010.00074.x"},{"key":"e_1_2_8_19_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.nut.2016.07.002"},{"key":"e_1_2_8_20_1","volume-title":"Guideline on Clinical Investigation of Medicinal Products in the Treatment or Prevention of Diabetes Mellitus. 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