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Trends in medical performance in diabetic patients in primary care clinics compared with those in hospitals: Shiga Diabetes Clinical Survey, Japan, 2000–2012

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Abstract

Aims

This study aimed to clarify trends in clinical performance in diabetic patients over a 12-year period in primary care clinics and hospitals in Japan.

Materials and methods

The Shiga Diabetes Clinical Survey records medical performance in diabetic patients in primary care clinics and hospitals in Shiga Prefecture, Japan. In this study, laboratory data, modality of treatment for diabetes, and status of examination for diabetic complications were examined using results of surveys in 2000, 2006, and 2012. The study included 17,870, 18,398, and 24,219 patients for those years, respectively.

Results

Mean glycated hemoglobin (HbA1c) level significantly improved over 12 years and was significantly lower in the primary care clinics group than the hospitals group (7.3 ± 1.5 vs. 7.4 ± 1.4 % in 2000, 7.2 ± 1.2 vs. 7.4 ± 1.3 % in 2006, and 6.9 ± 1.0 vs. 7.1 ± 1.1 % in 2012). With regard to diabetic treatment modality, patients treated in hospitals used insulin more frequently than those in primary care clinics. The proportion of patients examined for diabetic complications increased but did not reach 50 % in 2012. Mean blood pressure and low-density lipoprotein cholesterol levels were lowered, but blood pressure control was worse than that of low-density lipoprotein cholesterol.

Conclusions

This study shows that glycemic control in both primary care clinics and hospitals has improved and was almost acceptable. However, examinations for diabetic complications and the control of blood pressure were still insufficient.

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Acknowledgments

We thank all the members of the Shiga Medical Association for their participation in this study. Members of the Shiga Diabetes Clinical Survey Group: Atsunori Kashiwagi (Department of Medicine, Shiga University of Medical Science), Masayuki Shigenaga (Shigenaga Clinic), Yuichi Orita (Orita Clinic), Tsuyoshi Otaka (Otaka Clinic), Nobuisa Mizuno, Hirohumi Hukumoto (Department of Medicine, Shiga Medical Center for Adults), Takamasa Miura (Miura Clinic), Yasuhiro Nishida (Department of Ophthalmology, Shiga University of Medical Science), Naoyuki Takashima, Hirotsugu Ueshima (Department of Health Science, Shiga University of Medical Science), Katsuhito Yoshitoku (Yoshitoku Clinic), Hideki Yano (Department of Medicine, Hikone Municipal Hospital), Makoto Konishi (Konishi Clinic), Hideki Noda, Masataka Nishimura (Department of Medicine, Nagahama City Hospital), Kenji Kamiuchi (Department of Medicine, Otsu Municipal Hospital), Masanori Iwanishi (Department of Medicine, Kusatsu General Hospital), Hideo Kawamura (Kawamura Clinic), Naoya Ochiai (Miyaji Clinic), Yukimasa Shimosaka (Shimosaka Clinic), Jun Morita (Morita Dental Clinic). Writing committee: Itsuko Miyazawa, Hiroshi Maegawa (Department of Medicine, Shiga University of Medical Science), Aya Kadota, Katsuyuki Miura (Department of Public Health, Center for Epidemiologic Research in Asia, Shiga University of Medical Science), Motozumi Okamoto (Japanese Red Cross Otsu Hospital), Atsuo Ohnishi (Ohnishi Clinic).

Author information

Authors and Affiliations

  1. Department of Medicine, Shiga University of Medical Science, Seta, Otsu, Shiga, 520-2192, Japan

    Itsuko Miyazawa & Hiroshi Maegawa

  2. Department of Public Health, Shiga University of Medical Science, Otsu, Shiga, Japan

    Aya Kadota & Katsuyuki Miura

  3. Center for Epidemiologic Research in Asia, Shiga University of Medical Science, Otsu, Shiga, Japan

    Aya Kadota & Katsuyuki Miura

  4. Japanese Red Cross Otsu Hospital, Otsu, Shiga, Japan

    Motozumi Okamoto

  5. Ohnishi Clinic, Kusatsu, Shiga, Japan

    Atsuo Ohnishi

  6. The Shiga Medical Association, Ritto, Shiga, Japan

    Atsuo Ohnishi

Authors
  1. Itsuko Miyazawa
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  2. Aya Kadota
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  3. Motozumi Okamoto
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  4. Katsuyuki Miura
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  5. Hiroshi Maegawa
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  6. Atsuo Ohnishi
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Consortia

For the Shiga Diabetes Clinical Survey Group

  • Atsunori Kashiwagi
  • , Masayuki Shigenaga
  • , Yuichi Orita
  • , Tsuyoshi Otaka
  • , Nobuisa Mizuno
  • , Hirohumi Hukumoto
  • , Takamasa Miura
  • , Yasuhiro Nishida
  • , Naoyuki Takashima
  • , Hirotsugu Ueshima
  • , Katsuhito Yoshitoku
  • , Hideki Yano
  • , Makoto Konishi
  • , Hideki Noda
  • , Masataka Nishimura
  • , Kenji Kamiuchi
  • , Masanori Iwanishi
  • , Hideo Kawamura
  • , Naoya Ochiai
  • , Yukimasa Shimosaka
  •  & Jun Morita

Corresponding author

Correspondence to Itsuko Miyazawa.

Ethics declarations

Conflict of interest

The authors declare no conflicts of interest.

Human rights

This study was conducted in accordance with the Declaration of Helsinki, “Personal Information Protection Law” of Japan, “Ethical Guidelines in Epidemiological Research” compiled the Ministry of Education, Culture, Sports, Science and Technology and the Ministry of Health, Labor and Welfare of Japan.

Ethical approval

The study was approved by a committee including experts in ethical matters and the board of the Shiga Medical Association and by the ethical standards of the responsible committee on human experimentation (Shiga University of Medical Science).

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Cite this article

Miyazawa, I., Kadota, A., Okamoto, M. et al. Trends in medical performance in diabetic patients in primary care clinics compared with those in hospitals: Shiga Diabetes Clinical Survey, Japan, 2000–2012. Diabetol Int 8, 59–68 (2017). https://doi.org/10.1007/s13340-016-0280-0

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  • DOI: https://doi.org/10.1007/s13340-016-0280-0

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