Association of Daily Home-Based Hot Water Bathing and Glycemic Control in Ambulatory Japanese Patients with Type 2 Diabetes Mellitus During the COVID-19 Pandemic: A Multicenter Cross-Sectional Study

Hiroharu Kamioka; Yasunori Mori; Takahiko Horiuchi; Takahito Hayashi; Koichiro Ohmura; Satoru Yamaguchi; Mitsutoshi Kato

doi:10.2147/DMSO.S279270

Association of Daily Home-Based Hot Water Bathing and Glycemic Control in Ambulatory Japanese Patients with Type 2 Diabetes Mellitus During the COVID-19 Pandemic: A Multicenter Cross-Sectional Study

Diabetes Metab Syndr Obes. 2020 Dec 22:13:5059-5069. doi: 10.2147/DMSO.S279270. eCollection 2020.

Authors

Hiroharu Kamioka¹, Yasunori Mori², Takahiko Horiuchi³, Takahito Hayashi⁴, Koichiro Ohmura⁵, Satoru Yamaguchi⁶, Mitsutoshi Kato⁷

Affiliations

¹ Faculty of Regional Environment Science, Tokyo University of Agriculture, Tokyo, Japan.
² Mie Prefecture Health and Environment Research Institute, Yokkaichi, Mie, Japan.
³ Department of Internal Medicine, Kyushu University Beppu Hospital, Beppu, Oita, Japan.
⁴ Department of Legal Medicine, Graduate School of Medical and Dental Sciences, Kagoshima University, Kagoshima, Japan.
⁵ Department of Rheumatology and Clinical Immunology, Kyoto University Graduate School of Medicine, Kyoto, Japan.
⁶ Department of Oriental Medicine, Saitama Medical University, Saitama, Japan.
⁷ Kato Clinic of Internal Medicine, Tokyo, Japan.

Abstract

Purpose: To clarify the relationship between daily hot water bathing (HWB) at home and glycemic control in middle-aged and elderly ambulatory patients with type 2 diabetes mellitus (T2DM).

Methods: We defined hemoglobin A1c (HbA1c) as the main outcome. We set 7.0% based on the mean value of the dependent variable as the cut-off point for analysis. Frequency of HWB was an explanatory variable. A two-sample t-test was used to compare between groups with continuous variables. Multiple logistic regression analysis was performed for frequency, adjusted age, sex, BMI, T2DM duration (Model 1), and other confounding factors (Model 2). Odds ratio (OR) and 95% confidence interval (95% CI) were calculated.

Results: Among 838 patients, there was a significant difference (p<0.001) in age between males (n=528, 62.8±8.7 years) and females (n=310, 65.0±8.1 years). In Model 1, compared with participants who used HWB more than seven times a week, those with poorly controlled HbA1c were significantly associated with low frequency of HWB: four to six times a week (OR 1.32, 95% CI 0.87-1.99) and less than three times a week (OR 1.43, 95% CI 0.98-2.10); p-value for overall trend was 0.041. In Model 2, p-value for overall trend was 0.138.

Conclusion: A higher frequency of HWB was moderately associated with a decreased risk of poor glycemic control in middle-aged and elderly ambulatory patients with T2DM.

Keywords: hemoglobin A1c; hot water bathing; middle-aged and elderly ambulatory patients; type 2 diabetes.

Grants and funding

This study was supported by the Japanese Society of Balneology, Climatology and Physical Medicine (President: Prof. Kazuhisa Miyashita) in 2019–2020. We would like to express our appreciation for their support.