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Clinical background of Japanese patients with type 1 diabetes mellitus who have received insulin therapy for 50 years or longer

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Abstract

Aims

We clarified the clinical background of Japanese patients with type 1 diabetes mellitus (T1DM) who have received insulin therapy for 50 years or longer.

Methods

Of 1,412 patients diagnosed with T1DM at an age younger than 30 years old between 1962 and 2000, 29 had a 50-year or longer history of diabetes. We investigated the mean values of HbA1c and systolic blood pressure (SBP) during follow-up, as well as diabetic retinopathy, diabetic nephropathy, and macroangiopathy.

Results

The mean age of the subjects at the time of diagnosis was 10 years and that at the completion of this survey was 66 years. The mean follow-up period was 43 years. The mean HbA1c value and SBP during the follow-up period were 8.2% and 130 mmHg, respectively. Seventeen percent of patients did not have diabetic retinopathy, 59% had proliferative retinopathy, and 66% had undergone photocoagulation. Fifty-four percent of patients did not have microalbuminuria and 11% had end-stage renal disease. Macroangiopathy was observed in 46%, cardiovascular disease (CVD) in 25%, and ischemic stroke in 18%.

Conclusions

It became possible for patients with T1DM to live more than 50 years in Japan.

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References

  1. Niimi H. The history of childhood diabetes mellitus in Japan. Diabetes J. 1992;20:120–4.

    Google Scholar 

  2. The Diabetes Control and Complications Trial Research Group. The effect of intensive treatment of diabetes on the development and progression of long-term complications in insulin-dependent diabetes mellitus. N Engl J Med. 1993;329:977–86.

    Article  Google Scholar 

  3. Sun JK, Keenan HA, Cavallerano JD, Asztalos BF, Schaefer EJ, Sell DR, et al. Protection from retinopathy and other complications in patients with type 1 diabetes of extreme duration. Diabetes Care. 2011;34:968–74.

    Article  Google Scholar 

  4. Uchigata Y, Asao K, Matsushima M, Sato A, Yokoyama H, Otani T, et al. Impact on mortality and incidence of end-stage renal disease of education and treatment at a diabetes center among patients with type 1 diabetes: comparison of two subgroups in the Japanese DERI cohort. J Diabetes Complicat. 2004;18:155–9.

    Article  Google Scholar 

  5. Seino Y, Nanjo K, Tajima N, Kadowaki T, Kashiwagi A, Araki E, The Committee of the Japan Diabetes Society on the diagnostic criteria, et al. Report of the Committee on the classification and diagnostic criteria of diabetes mellitus. Diabetol Int. 2010;1:2–20.

    Article  Google Scholar 

  6. Kashiwagi A, Kasuga M, Araki E, Oka Y, Hanafusa T, Ito H, Committee on the Standardization of Diabetes Mellitus-Related Laboratory Testing of Japan Diabetes Society (JDS), et al. International clinical harmonozation of glycated hemoglobin in Japan: from Japan Diabetes Society to National Glycohemoglobin Standardization Program values. Diabetolol Int. 2012;3:8–10.

    Article  Google Scholar 

  7. Haneda M, Utsunomiya K, Koya D, Babazono T, Moriya T, Makino H, et al. A new classification of diabetic nephropathy 2014: a report from Joint Committee on Diabeteic Nephropathy. Clin Exp Nephrol. 2015;19:1–5.

    Article  Google Scholar 

  8. Health, Labour and Welfare Statistics Association. 2015/2016 Health, labour and welfare statistics association. J Health Welf Stat. 2015;62(Suppl):454.

    Google Scholar 

  9. Diabetes Epidemiology Research International Mortality Study Group. Major cross-country differences in risk of dying for people with IDDM. Diabetes Care. 1991;14:49–54.

    Article  Google Scholar 

  10. The Diabetes Epidemiology Research International (DERI) Study. International analysis of insulin-dependent diabetes mellitus mortality: a preventable mortality perspective. Am J Epidemiol. 1995;142:612–8.

    Article  Google Scholar 

  11. Asao K, Sarti C, Forsen T, Hyttinen V, Nishimura R, Matsushima M, et al. Long-term mortality in nationwide cohorts of childhood-onset type 1 diabetes in Japan and Finland. Diabetes Care. 2003;26:2037–42.

    Article  Google Scholar 

  12. Otani T, Yokoyama H, Uchigata Y. Changes in the prognosis of Japanese patients who developed type 1 diabetes before the age of 30 years. Diabetes Res Clin Pract. 2015;109:434–9.

    Article  Google Scholar 

  13. Bain SC, Gill GV, Dyer PH, Jones AF, Murphy M, Jones KE, et al. Characteristics of type 1 diabetes of over 50 years duration (the Golden Years Cohort). Diabet Med. 2003;20:808–11.

    Article  CAS  Google Scholar 

  14. Gill GV, Daousi C, Barnett AH, Bain SC. Chronic kidney disease in long duration type 1 diabetes lasting more than 50 years. Curr Med Res Opin. 2009;25:395–400.

    Article  CAS  Google Scholar 

  15. Klein R, Knudtson MD, Lee KE, Gangnon R, Klein BE. The Wisconsin epidemiologic study of diabetic retinopathy: XXII the twenty-five-year progression of retinopathy in persons with type 1 diabetes. Ophthalmology. 2008;115:1859–68.

    Article  Google Scholar 

  16. Turner RC, Millns H, Neil HA, Stratton IM, Manley SE, Matthews DR, et al. Risk factors for coronary artery disease in non-insulin dependent diabetes mellitus: United Kingdom Prospective Diabetes Study (UKPDS: 23). BMJ. 1998;14:823–8.

    Article  Google Scholar 

  17. Davis TM, Millns H, Stratton IM, Holman RR, Turner RC. Risk factors for stroke in type 2 diabetes mellitus: United Kingdom Prospective Diabetes Study (UKPDS) 29. Arch Intern Med. 1999;24:1097–103.

    Article  Google Scholar 

  18. Sone H, Mizuno S, Fujii H, Yoshimura Y, Yamasaki Y, Ishibashi S, et al. Is the diagnosis of metabolic syndrome useful for predicting cardiovascular disease in Asian diabetic patients? Analysis from the Japan Diabetes Complications Study. Diabetes Care. 2005;28:1463–71.

    Article  Google Scholar 

  19. Diabetes Control and Complications Trial/Epidemiology of Diabetes Interventions and Complications (DCCT/EDIC) Research Group, Nathan DM, Zinman B, Cleary PA, Backlund JY, Genuth S, Miller R, et al. Modern-day clinical course of type 1 diabetes mellitus after 30 years’ duration: the diabetes control and complications trial/epidemiology of diabetes interventions and complications and Pittsburgh epidemiology of diabetes complications experience (1983–2005). Arch Intern Med. 2009;169:1307–16.

    Article  Google Scholar 

  20. Diabetes Control and Complications Trial (DCCT)/Epidemiology of Diabetes interventions and Complications (EDIC) Study Research Group. Intensive diabetes treatment and cardiovascular outcomes in type 1 diabetes: the DCCT/EDIC study 30-year follow-up. Diabetes Care. 2016;39:686–93.

    Article  Google Scholar 

  21. Diabetes Control and Complications Trial (DCCT)/Epidemiology of Diabetes Interventions and Complications (EDIC) Study Research Group. Mortality in type 1 diabetes in the DCCT/EDIC versus the general population. Diabetes Care. 2016;39:1378–83.

    Google Scholar 

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Acknowledgements

We thank Drs. Maruyama, Nakayama, Hashimoto, and Ohashi for their cooperation.

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Authors and Affiliations

  1. Diabetes Center, Tokyo Women’s Medical University School of Medicine, 8-1 Kawada-cho, Shinjuku-ku, Tokyo, 162-0054, Japan

    Toshika Otani, Junnosuke Miura, Yasuko Uchigata & Tetsuya Babazono

  2. Omiya Kyoritsu Hospital, 1550 Katayanagi, Minuma-ku, Saitama-City, Saitama, 337-0024, Japan

    Toshika Otani

  3. Johsai Hospital, 2-42-11 Kamiogi, Suginami-ku, Tokyo, 167-0043, Japan

    Tadasu Kasahara

  4. Tokyo Women’s Medical University Medical Center East, 2-1-10 Nishioku, Arakawa-ku, Tokyo, 116-8567, Japan

    Yasuko Uchigata

Authors
  1. Toshika Otani
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  2. Tadasu Kasahara
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  3. Junnosuke Miura
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  4. Yasuko Uchigata
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  5. Tetsuya Babazono
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Corresponding author

Correspondence to Toshika Otani.

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Conflict of interest

The authors declare that they have no conflict of interest.

Ethical policy

All procedures followed were in accordance with the ethical standards of the responsible committee on human experimentation (institutional and national) and with the Helsinki Declaration of 1964 and later version. Informed consent or a substitute for it was obtained from all patients included in the study. This study obtained the approval of the Tokyo Women’s Medical College Ethical Review Board (Approval date: Jan 16, 2017, No. 4,233).

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Otani, T., Kasahara, T., Miura, J. et al. Clinical background of Japanese patients with type 1 diabetes mellitus who have received insulin therapy for 50 years or longer. Diabetol Int 10, 288–294 (2019). https://doi.org/10.1007/s13340-019-00393-x

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  • DOI: https://doi.org/10.1007/s13340-019-00393-x

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