Work-related, personal, and diabetes-related factors relevant to dropout from outpatient diabetes treatment visits among Japanese male employees with diabetes



In recent years, support for coexisting diabetes treatment and work (Ryoritsu Shien) has become increasingly important for employees with diabetes. It is important to identify factors associated with dropout from outpatient visits for diabetes treatment among employees with diabetes to determine appropriate support to prevent dropout. Therefore, we explored work-related, personal, and diabetes-related factors relevant for dropout from outpatient diabetes treatment visits among Japanese employees with diabetes.


This cross-sectional study was conducted in 2018. Participants were 140 full-time employees with type 2 diabetes aged over 40 years. Participants were classified into two groups: a dropout group and a continuation group. Work-related, personal, and diabetes-related factors were evaluated using a self-administered questionnaire and specific health checkup data.


Of the 140 employees with diabetes, 12 (8.6%) were classified in the dropout group. Multivariable logistic regression analysis revealed three factors associated with a lower risk for dropout from diabetes treatment outpatient visits. These were: high supervisor support, as measured by the Job Content Questionnaire (multivariable-adjusted odds ratio [OR] 0.71, 95% confidence interval [CI] 0.52–0.97, per 1 score); older age (multivariable-adjusted OR 0.79, 95% CI: 0.66–0.95, per 1 year); and presence of metabolic syndrome (multivariable-adjusted OR 0.04, 95% CI 0.01–0.28, presence vs. absence).


Our findings suggest that supervisor support, age, and metabolic syndrome are important factors related to dropout from outpatient diabetes treatment visits among Japanese male employees with diabetes.

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  1. 1.

    Ministry of Health, Labour and Welfare. The National Health and Nutrition Survey 2012.; (in Japanese). Accessed 1 July 2019.

  2. 2.

    Noda M, Yamazaki K, Hayashino Y, Izumi K, Goto A. Japanese practice guidance to improve patients’ adherence to appointments for diabetes care. Accessed 1 July 2019 (in Japanese).

  3. 3.

    Hammersley MS, Holland MR, Walford S, Thorn PA. What happens to defaulters from a diabetic clinic? Br Med J (Clin Res Ed). 1985;9:1330–2.

    Article  Google Scholar 

  4. 4.

    Archibald LK, Gill GV. Diabetic clinic defaulters—who are they and why do they default? Pract Diabetes. 1992;9:13–4.

    Article  Google Scholar 

  5. 5.

    Japan organization of Occupational Health and Safety. Support manual for coexistence of treatment and work for workers with diabetes. 2017. Accessed 7 July 2019 (in Japanese).

  6. 6.

    Ministry of Health, Labour and Welfare. Guidelines for supporting coexistence of treatment and work in workplace. 2019. Accessed 7 July 2019 (in Japanese).

  7. 7.

    Simmons D, Fleming C. Prevalence and characteristics of diabetic patients with no ongoing care in South Auckland. Diabetes Care. 2000;23:1791–3.

    CAS  Article  Google Scholar 

  8. 8.

    Yamaguchi S, Waki K, Tomizawa N, Waki H, Nannya Y, Nangaku M, et al. Previous dropout from diabetic care as a predictor of patients’ willingness to use mobile applications for self-management: a cross-sectional study. J Diabetes Investig. 2017;8:542–9.

    Article  Google Scholar 

  9. 9.

    Currie CJ, Peyrot M, Morgan CL, Poole CD, Jenkins-Jones S, Rubin RR, et al. The impact of treatment noncompliance on mortality in people with type 2 diabetes. Diabetes Care. 2012;35:1279–84.

    Article  Google Scholar 

  10. 10.

    Sone H, Kawai K, Takagi H, Yamada N, Kobayashi M. Outcome of one-year of specialist care of patients with type 2 diabetes: a multi-center prospective survey (JDDM 2). Intern Med. 2006;45:589–97.

    Article  Google Scholar 

  11. 11.

    Benoit SR, Ji M, Fleming R, Philis-Tsimikas A. Predictors of dropouts from a San Diego diabetes program: a case control study. Prev Chronic Dis. 2004;1:A10.

    PubMed  PubMed Central  Google Scholar 

  12. 12.

    Masuda Y, Kubo A, Kokaze A, Yoshida M, Sekiguchi K, Fukuhara N, et al. Personal features and dropout from diabetic care. Environ Health Prev Med. 2006;11:115–9.

    Article  Google Scholar 

  13. 13.

    Graber AL, Davidson P, Brown AW, Mcrae JR, Wooldridge K. Dropout and relapse during diabetes care. Diabetes Care. 1992;15:1477–83.

    CAS  Article  Google Scholar 

  14. 14.

    Fullerton B, Erler A, Pöhlmann B, Gerlach FM. Predictors of dropout in the German disease management program for type 2 diabetes. BMC Health Serv Res. 2012;12:8.

    Article  Google Scholar 

  15. 15.

    Kawakami N, Fujigaki Y. Reliability and validity of the Japanese version of Job Content Questionnaire: replication and extension in computer company employees. Ind Health. 1996;34:295–306.

    CAS  Article  Google Scholar 

  16. 16.

    Kawakami N, Kobayashi F, Araki S, Haratani T, Furui H. Assessment of job stress dimensions based on the Job Demands-Control model of employees of telecommunication and electric power companies in Japan: reliability and validity of the Japanese version of Job Content Questionnaire. Int J Behav Med. 1995;2:358–75.

    CAS  Article  Google Scholar 

  17. 17.

    Chuang LL, Lin KC, Hsu AL, Wu CY, Chang KC, Li YC, et al. Reliability and validity of a vertical numerical rating scale supplemented with a faces rating scale in measuring fatigue after stroke. Health Qual Life Outcomes. 2015;13:91.

    Article  Google Scholar 

  18. 18.

    Soejima Y, Munemoto T, Masuda A, Uwatoko Y, Miyata M, Tei C. Effects of waon therapy on chronic fatigue syndrome: a pilot study. Intern Med. 2015;54:333–8.

    Article  Google Scholar 

  19. 19.

    Mendoza TR, Wang XS, Cleeland CS, Morrissey M, Johnson BA, Wendt JK, et al. The rapid assessment of fatigue severity in cancer patients: use of the brief fatigue inventory. Cancer. 1999;88:1186–96.

    Article  Google Scholar 

  20. 20.

    Antonovsky A. Unraveling the mystery of health: how people manage stress and stay well. San Francisco: Jossey-Bass; 1987.

    Google Scholar 

  21. 21.

    Togari T, Yamazaki Y, Nakayama K, Shimizu J. Development of a short version of the sense of coherence scale for population survey. J Epidemiol Community Health. 2007;61:921–2.

    Article  Google Scholar 

  22. 22.

    The Examination Committee for Criteria of Metabolic Syndrome. Definition and criteria of metabolic syndrome. J Jpn Soc Int Med. 2005;94:794–809 (in Japanese).

    Article  Google Scholar 

  23. 23.

    Ministry of Health, Labor and Welfare. An overview of the national health and nutrition usurvey 2016 Results, Accessed 18 June 2019. (in Japanese)

  24. 24.

    Trief PM, Aquilino C, Paradies K, Weinstock RS. Impact of the work environment on glycemic control and adaptation to diabetes. Diabetes Care. 1999;22:569–74.

    CAS  Article  Google Scholar 

  25. 25.

    Badley EH,Yoshida K, Webster G, Stephens M. Disablement and chronic health problem in Ontario. Ontario health survey 1990. Working paper No.5. 1993. Ministry of health Ontario. Accessed 12 July 2019.

  26. 26.

    Naderi S, Johnson CE, Rodriguez F, Wang Y, Pollin I, Foody JM. Characteristics of women lost to follow-up in cardiovascular community health interventions: findings from the Sister to Sister campaign. J Community Health. 2013;38:458–62.

    Article  Google Scholar 

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This work was supported by a Grant-in-Aid for Scientific Research (B) from the Japan Society for the Promotion of Science (Grant number: 18H03118). We thank Audrey Holmes, MA, from Edanz Group for editing a draft of this manuscript.

Author information




NS designed this study, acquired data, performed the analyses, and wrote the manuscript. SW and YO designed this study, acquired data, performed data interpretation, and contributed to editing the manuscript. KG acquired data, performed data interpretation, and contributed to editing the manuscript. CH, YS, SO, and MS performed data interpretation and contributed to editing the manuscript. AM designed this study, acquired data, performed data interpretation, and contributed to editing the manuscript. All authors approved the final version of the manuscript.

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Correspondence to Nao Sonoda.

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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 versions.

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All Informed consent or substitute for it was obtained from all patients for being included in this study.

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Sonoda, N., Watanabe, S., Ohno, Y. et al. Work-related, personal, and diabetes-related factors relevant to dropout from outpatient diabetes treatment visits among Japanese male employees with diabetes. Diabetol Int 11, 261–268 (2020).

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  • Employees with diabetes
  • Dropout
  • Work-related factors
  • Supervisor support