skip to Main Content

Healthy lifestyle behaviors took a hit during shelter-in-place in people with prediabetes

Kaiser Permanente study found less exercise, more stress, and less motivation to maintain healthy habits that help ward off diabetes

The shelter-in-place orders cities and states put into place to contain the COVID-19 pandemic affected all aspects of people’s lives. For adults in the U.S. with prediabetes, these mandates made it more difficult to maintain the healthy behaviors necessary to keep diabetes at bay, new Kaiser Permanente research shows.

The study, published in Preventive Medicine Reports, included 259 people who were enrolled in a study launched in 2018 at Kaiser Permanente Northern California (KPNC) and Michigan Medicine examining the role peer support can play in helping people with prediabetes initiate and maintain healthy behaviors.

Tainayah Thomas, PhD

“We had started our peer intervention study because we know how important it is to prevent people with prediabetes from progressing to diabetes — but we still don’t know the best way to do it,” said lead author Tainayah Thomas, PhD, MPH, an adjunct investigator at the Division of Research and an assistant professor at Stanford University. “The pandemic gave us the opportunity to look at how the stress and restrictions related to the pandemic affected people at risk of developing a chronic illness in real time.”

Participants in the study completed surveys every 6 months about physical activity and eating habits. From June 2020 to June 2021, the participants were asked 7 additional questions about how COVID-19 affected their ability to adopt healthy behaviors. About 75% of participants reported changes in physical activity levels, 70% in eating habits, 75% in stress and anxiety, and 60% in their motivation to adopt or maintain healthy habits — and for most, the changes were not for the better. Instead, participants reported they were now eating less healthy foods, doing less physical activity, experiencing more stress, and having more difficultly managing their health.

“During the pandemic we learned that people with diabetes were at higher risk of contracting the virus that causes COVID-19 and had worse COVID infection,” said Thomas. “We were concerned that our study participants who were at home, possibly more isolated, and experiencing other pandemic-related stresses would be at higher risk of transitioning from prediabetes to diabetes.”


We will need to continue to find ways to help people at high risk for chronic diseases adopt or re-adopt healthy behaviors.

— Julie Schmittdiel, PhD


There are currently about 37.3 million people in the U.S. with diabetes and about 96 million American adults — more than 1 in 3 — have prediabetes. People with prediabetes have blood sugar levels that are higher than normal but not high enough yet to be diagnosed with type 2 diabetes; they are also at increased risk for heart disease and stroke.

This is one of the first studies to look at how the pandemic and shelter-in-place specifically affected the health behaviors at high risk for developing a chronic disease, such as diabetes. The researchers say what they learned can be used to help shape ongoing efforts to implement programs to help people with prediabetes or other chronic illnesses.

Julie Schmittdiel, PhD

“In California, as in other parts of the country, the pandemic emergency has now officially ended,” said senior author Julie Schmittdiel, PhD, a research scientist at the Division of Research. “It’s true that infection rates and hospitalization rates are down. But how the pandemic affected people’s lives has not ended. Our paper is a timely and important reminder that we will need to continue to find ways to help people at high risk for chronic diseases adopt or re-adopt healthy behaviors.”

The study was funded by the  National Institute of Diabetes and Digestive and Kidney Diseases, the Department of Veterans Affairs, The Permanente Medical Group Delivery Science Fellowship Program and the National Institute of Diabetes and Digestive and Kidney Diseases.

Co-authors include Maher Yassin, MPH, and Luis A. Rodriguez, PhD, MPH, RD, at the Division of Research, and Rebecca Lindsey, PhD, and Michele Heisler, MD, MPA, at the University of Michigan.

# # #

About the Kaiser Permanente Division of Research

The Kaiser Permanente Division of Research conducts, publishes and disseminates epidemiologic and health services research to improve the health and medical care of Kaiser Permanente members and society at large. It seeks to understand the determinants of illness and well-being, and to improve the quality and cost-effectiveness of health care. Currently, DOR’s 600-plus staff is working on more than 450 epidemiological and health services research projects. For more information, visit or follow us @KPDOR.

This Post Has 0 Comments

Leave a Reply

Your email address will not be published. Required fields are marked *

Back To Top