Large-scale survey of rates of achieving targets for blood glucose, blood pressure, and lipids and prevalence of complications in type 2 diabetes (JDDM 40)

Abstract

ObjectiveThe fact that population with type 2 diabetes mellitus and bodyweight of patients are increasing but diabetes care is improving makes it important to explore the up-to-date rates of achieving treatment targets and prevalence of complications. We investigated the prevalence of microvascular/macrovascular complications and rates of achieving treatment targets through a large-scale multicenter-based cohort.Research design and methodsA cross-sectional nationwide survey was performed on 9956 subjects with type 2 diabetes mellitus who consecutively attended primary care clinics. The prevalence of nephropathy, retinopathy, neuropathy, and macrovascular complications and rates of achieving targets of glycated hemoglobin (HbA1c) <7.0%, blood pressure <130/80 mm Hg, and lipids of low-density/high-density lipoprotein cholesterol <3.1/≥1.0 mmol/L and non-high-density lipoprotein cholesterol <3.8 mmol/L were investigated.ResultsThe rates of achieving targets for HbA1c, blood pressure, and lipids were 52.9%, 46.8% and 65.5%, respectively. The prevalence of microvascular complications was ∼28% each, 6.4% of which had all microvascular complications, while that of macrovascular complications was 12.6%. With an increasing duration of diabetes, the rate of achieving target HbA1c decreased and the prevalence of each complication increased despite increased use of diabetes medication. The prevalence of each complication decreased according to the number achieving the 3 treatment targets and was lower in subjects without macrovascular complications than those with. Adjustments for considerable covariates exhibited that each complication was closely inter-related, and the achievement of each target was significantly associated with being free of each complication.ConclusionsAlmost half of the subjects examined did not meet the recommended targets. The risk of each complication was significantly affected by 1 on-target treatment (inversely) and the concomitance of another complication (directly). Total diabetes care including one-by-one management of modifiable risk factors and complications may be important for high-quality care. The future studies including more subjects and clinics with precise complication status are needed.

Twelve-year trends of increasing overweight and obesity in patients with diabetes: the Shiga Diabetes Clinical Survey

“…It should be recognized that obese patients may have albuminuria or proteinuria regardless of age or duration of diabetes. Previous reports from the JDDM showed a similar prevalence of microalbuminuria and macroalbuminuria [25] and the same tendency that nephropathy defined by ACR ≥30 mg/gCre increased with higher BMI levels [26]. This suggests our findings are reasonable.…”

Impact of obesity on annual medical expenditures and diabetes care in Japanese patients with type 2 diabetes mellitus

“…In particular, Japanese patients are relatively lean in comparison with Caucasian patients. In the present study, the mean BMI was 24.7 kg/m 2 and just 8.7% had a BMI ≥ 30 kg/m 2 , similar to a recent report on a large‐scale survey of Japanese patients with type 2 diabetes. Thus, the findings of the present study require confirmation in other ethnic groups, particularly other Asian ethnic populations that are as lean as the Japanese population.…”

Factors associated with diabetic polyneuropathy‐related sensory symptoms and signs in patients with polyneuropathy: A cross‐sectional Japanese study (JDDM 52) using a non‐linear model

“…DPN‐related symptoms can cause considerable morbidity and diminished quality of life for patients with diabetes, and it is, therefore, important to determine the factors associated with DPN‐related symptoms. In the present cross‐sectional Japanese study using a large survey database, the factors associated with DPN‐related sensory symptoms/signs within a population of patients with DPN were analyzed. Diabetes mellitus duration, age, smoking status (current and former), alcohol consumption (former), sex and SBP were all identified as candidate factors potentially associated with the development of DPN‐related sensory symptoms/signs in patients with DPN.…”