The status of diabetes control and antidiabetic drug therapy in Japan—A cross-sectional survey of 17,000 patients with diabetes mellitus (JDDM 1)

Present status of sulfonylurea treatment for type 2 diabetes in Japan: Second report of a cross-sectional survey of 15,652 patients

“…Compared with other countries, the high proportion of T2DM patients being treated with sulfonylureas in Japan may be due to the fact that the insulin secretory capacity of most Japanese patients with T2DM is less than that of Caucasian T2DM patients [12]. However, the percentage of patients in Japan being treated with sulfonylureas alone decreased over the period 2000-2002 from 42.9% to 37.1%, respectively [8]. A combination of factors, such as reports on the adverse effects of sulfonylureas, the recent development of new drugs (e.g.…”

“…However, the proportion of sulfonylureas used as monotherapy by specialists and GPs did not differ significantly. The use of sulfonylureas as monotherapy by diabetes specialists has reportedly decreased recently in Japan [8], with sulfonylurea monotherapy for T2DM accounting for 37.1% of entire OHA therapy in 2002. In the present study, sulfonylurea monotherapy was found to account for 29.2% and 35.4% of all OHA therapy administered by diabetes specialists and GPs, lurea used was significantly higher in patients with HbA1c levels ≥8.0% compared with patients in whom HbA1c levels were <6.5% (p<0.0001; Table 1).…”

“…A survey of diabetes care specialists in Japan in 2002 found that approximately 40% of the entire patients with T2DM, that is 78% of patients on oral hypoglycemic agents (OHAs) were being treated with sulfonylureas alone or in combination with other OHAs [8]. In contrast, 26.1% and 20.6% of the entire patients with T2DM were being treated with sulfonylureas alone and or in combination with other OHAs in USA in 2000 [9].…”

Comment on: Nathan DM, Buse JB, Davidson MB et al (2006) Management of hyperglycaemia in type 2 diabetes: a consensus algorithm for the initiation and adjustment of therapy. A consensus statement from the American Diabetes Association and the European Association for the Study of Diabetes. Diabetologia 49:1711–1721

“…I and many of my European colleagues have used sulfonylurea as first drug in scores of patients with success, as we have metformin. Furthermore, a recent study in a very large patient population in Japan reported that ∼40% of patients were treated with sulfonylurea as single drug with excellent effect, with these patients achieving a mean HbA 1c of 7.1 [3]. The risk of severe hypoglycaemia is very small with modern sulfonylureas, and there appears to be no evidence to justify the fear of cardiovascular events related to sulfonylurea treatment [4,5].…”

Short duration of diabetes and disuse of sulfonylurea have any association with insulin cessation of the patients with type 2 diabetes in a clinical setting in Japan (JDDM 30)

“…The timing of initiation and stopping insulin therapy were depended on the decision of each physician. The clinical data obtained from the patients were standardized and saved using CoDiC software, as described previously [12]. Data were collected at the central analytical facility, where the information was treated anonymously.…”