Abstract
Aims
We examined whether diet and/or physical activity contribute to seasonal variation of hemaglobin A1c (HbA1c) in Japanese diabetic patients.
Materials and methods
We studied 207 patients from 2009 to 2010. HbA1c measurements, clinical parameters, and practices of diet and physical activities were assessed. For the time-series analysis, each patient was classified as complete, incomplete, or no fluctuation.
Results
Patients showed a clear seasonal fluctuation of HbA1c levels (P < 0.01), with the highest levels being in March (7.19 %) and the lowest in October (6.87 %). The time-series analysis showed that 123 patients had complete or incomplete fluctuation. Of them, 107 exhibited normal fluctuation and only 16 had reverse fluctuation. In the former, both HbA1c levels and body weight were higher in winter/spring than in summer/autumn (7.3 vs. 6.9 %, P < 0.01; 59.8 vs. 59.2 kg, P < 0.01). In the latter, both HbA1c and body weight were lower in winter/spring than in summer/autumn (7.2 vs. 7.5 %, P < 0.01; 59.8 vs. 60.1 kg, P < 0.01). In patients with normal fluctuation, dietary practice remained steady across seasons, but physical activity was less in winter/spring than in summer/autumn (22 vs. 35 %, P < 0.05).
Conclusions
Seasonal fluctuations in HbA1c levels are observed in most Japanese diabetic patients. Our questionnaire may indicate that reduced self-reported physical activity is a potential factor affecting seasonal fluctuations in HbA1c levels.
This is a preview of subscription content, log in via an institution to check access.
Similar content being viewed by others
Abbreviations
- BMI:
-
Body mass index
- HbA1c :
-
Hemoglobin A1c
- ANOVA:
-
One-way analysis of variance
- OHAs:
-
Oral hypoglycemic agents
- SAF:
-
Seasonal adjustment factor
References
International Expert Committee. International Expert Committee report on the role of the A1C assay in the diagnosis of diabetes. Diabetes Care. 2009;32:1327–34.
American Diabetes Association. Diagnosis and classification of diabetes mellitus. Diabetes Care. 2012;35:S64–71.
Selvin E, Marinopoulos S, Berkenblit G, Rami T, Brancati FL, Powe NR, Golden SH. Meta-analysis: glycosylated hemoglobin and cardiovascular disease in diabetes mellitus. Ann Intern Med. 2004;141:421–31.
Ishii H, Suzuki H, Baba T, Nakamura K, Watanabe T. Seasonal variation of glycemic control in type 2 diabetic patients. Diabetes Care. 2001;24:1503.
Sohmiya M, Kanazawa I, Kato Y. Seasonal changes in body composition and blood HbA1c levels without weight change in male patients with type 2 diabetes treated with insulin. Diabetes Care. 2004;27:1238–9.
Sakura H, Tanaka Y, Iwamoto Y. Seasonal fluctuations of glycated hemoglobin levels in Japanese diabetic patients. Diabetes Res Clin Pract. 2010;88:65–70.
Iwata K, Iwasa M, Nakatani T, Yano Y, Mifuji-Moroka R, Hara N, Akamatsu M, Ishidome M, Takei Y. Seasonal variation in visceral fat and blood HbA1c in people with type 2 diabetes. Diabetes Res Clin Pract. 2012;96:e53–4.
Seino Y, Nanjo K, Tajima N, Kadowaki T, Kashiwagi A, Araki E, Ito C, Inagaki N, Iwamoto Y, Kasuga M, Hanafusa T, Haneda M, Ueki K. Report of the Committee on the classification and diagnostic criteria of diabetes mellitus (revision for international harmonization of HbA1c in Japan). J Jpn Diabetes Soc. 2012;55:485–504.
Walker BR, Best R, Noon JP, Watt GC, Webb DJ. Seasonal variation in glucocorticoid activity in healthy men. J Clin Endocrinol Metab. 1997;82:4015–9.
Kuroshima A, Doi K, Ohno T. Seasonal variation of plasma glucagon concentrations in men. Jpn J Physiol. 1979;29:661–8.
Woodhouse PR, Khaw KT, Plummer M. Seasonal variation of blood pressure and its relationship to ambient temperature in an elderly population. J Hypertens. 1993;11:1267–74.
Woodhouse PR, Khaw KT, Plummer M. Seasonal variation of serum lipids in an elderly population. Age Ageing. 1993;22:273–8.
Baynes KC, Boucher BJ, Feskens EJ, Kromhout D. Vitamin D, glucose tolerance and insulinaemia in elderly men. Diabetologia. 1997;40:344–7.
Yeh CJ, Chan P, Pan WH. Values of blood coagulating factors vary with ambient temperature: the Cardiovascular Disease Risk Factor Two-Township Study in Taiwan. Chin J Physiol. 1996;39:111–6.
Plasqui G, Kester AD, Westerterp KR. Seasonal variation in sleeping metabolic rate, thyroid activity, and leptin. Am J Physiol Endocrinol Metab. 2003;285:E338–43.
Kristal-Boneh E, Froom P, Harari G, Malik M, Ribak J. Summer-winter differences in 24 h variability of heart rate. J Cardiovasc Risk. 2000;7:141–6.
Kristal-Boneh E, Harari G, Green MS, Ribak J. Summer-winter variation in 24 h ambulatory blood pressure. Blood Press Monit. 1996;1:87–94.
Campbell IT, Jarrett RJ, Keen H. Diurnal and seasonal variation in oral glucose tolerance: studies in the Antarctic. Diabetologia. 1975;11:139–45.
Rosenstock J, Fonseca V. Missing the point: substituting exenatide for nonoptimized insulin: going from bad to worse!. Diabetes Care. 2007;30:2972–3.
Conflict of interest
None
Author information
Authors and Affiliations
Corresponding author
About this article
Cite this article
Iwao, T., Sakai, K. & Ando, E. Seasonal fluctuations of glycated hemoglobin levels in Japanese diabetic patients: effect of diet and physical activity. Diabetol Int 4, 173–178 (2013). https://doi.org/10.1007/s13340-013-0112-4
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s13340-013-0112-4