ObjectiveTo assess the relationship between socioeconomic status (SES) and complications of type 2 diabetes among young adults in Japan.DesignA cross-sectional study.SettingOutpatient wards of 96 member hospitals and clinics of the Japan Federation of Democratic Medical Institutions.ParticipantsA total of 782 outpatients with type 2 diabetes (525 males, 257 females), aged 20–40 years as of March 31, 2012. After excluding 110 participants whose retinopathy diagnosis was in question, 672 participants were analyzed.MeasurementsWe examined the relations between SES (educational level, income, type of public healthcare insurance, and employment status) and diabetes complications (retinopathy and nephropathy) using a multivariate logistic regression analysis.ResultsThe prevalence of type 2 diabetic retinopathy was 23.2%, while that of nephropathy was 8.9%. The odds of having retinopathy were higher among junior high school graduates (OR 1.91, 95% CI 1.09–3.34), patients receiving public assistance (OR 2.19, 95% CI 1.20–3.95), and patients with irregular (OR 1.72, 95% CI 1.03–2.86) or no employment (OR 2.23, 95% CI 1.36–3.68), compared to those with a higher SES, even after covariate adjustment (e.g., age, gender, body mass index). Similarly, the odds of having nephropathy were higher among patients with middle (OR 3.61, 95% CI 1.69–8.27) or low income levels (OR 2.53, 95% CI 1.11–6.07), even after covariate adjustment.ConclusionsLow SES was associated with a greater likelihood of type 2 diabetes complications in young adults. These findings suggest the necessity of health policies that mitigate socioeconomic disparity and thereby reduce the prevalence of diabetic complications.

Aims/Introduction: To assess the associations of working conditions, eating habits and glycemic control among young Japanese workers with type 2 diabetes. Materials and Methods: This hospital-and clinic-based prospective study included 352 male and 126 female working patients with diabetes aged 20-40 years. Data were obtained from June to July 2012 and June to July 2013. Logistic regression analysis was used to estimate multivariable-adjusted odds ratios (ORs) and 95% confidence intervals (CIs) for suboptimal glycemic control (glycosylated hemoglobin level of ≥7%) obtained from June to July 2013. Results: Multivariable logistic regression analysis showed that disease duration of ≥10 years (OR 2.43, 95% CI 1.02-5.80), glycosylated hemoglobin level of ≥7% in 2012 (OR 8.50, 95% CI 4.90-14.80), skipping breakfast and late evening meals (OR 2.50, 95% CI 1.25-5.00) and working ≥60 h/week (OR 2.92, 95% CI 1.16-7.40) were predictive of suboptimal glycemic control in male workers, whereas a glycosylated hemoglobin level of ≥7% in 2012 (OR 17.96,, oral hyperglycemic agent therapy (OR 12.49,) and insulin therapy (OR 11.60,) were predictive of suboptimal glycemic control in female workers. Conclusions: Working ≥60 h/week and habitual skipping breakfast concomitant with late evening meals might affect the ability of young male workers with type 2 diabetes to achieve and maintain glycemic control.

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Weobserved two patients with diabetes whowere suffering from nausea, vomiting and epigastralgia after meals. These symptoms subsided when lying on their left side. Since the 2 patients had autonomic neuropathy, at first, the symptoms seemed to be attributable to diabetic gastroparesis. However, they were diagnosed as having superior mesen-teric artery syndrome by hypotonic duodenography. These finding suggest that in diabetic patients whohave a history of excessive weight loss superior mesenteric artery syndrome should be ruled out even though they have autonomic neuropathy. (Internal Medicine 40: 736-739, 2001)