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Clinical practice of diabetic foot, nephropathy, and retinopathy in Japan: cross-sectional study using local and nationwide questionnaire surveys

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Abstract

Aims/introduction

It is a reality that there are still many diabetic subjects who suffer from serious complications, but there are few statistics of severe eye complications such as vitrectomy or blindness and diabetic foot including amputations in Japan.

Materials and methods

To determine the status of medical examination, consultation, and the actual practice for diabetic foot, retinopathy, and nephropathy, we conducted two surveys on diabetic subjects under treatment by the local physicians in Asahikawa area or in the nationwide diabetes-specialized facilities, respectively.

Results

A total of 3649 diabetic subjects responded to the questionnaire from 35 clinics/hospitals in Asahikawa area. Sixty-five percent of the subjects had a routine eye examination at least once a year, but 29% of them interrupted or never attended eye examination. Besides, only 37.2% of subjects had received ankle–brachial index (ABI) test as a useful screening for diabetic foot. The nationwide survey found that 1,273,103 diabetic subjects were undergoing treatment in 472 diabetes-specialized facilities. There, lower extremity amputations accounted for 0.23% and revascularization accounted for 0.64% of the subjects. However, outpatient foot care and dialysis preventive outpatient services were offered only in 77.3% and 66.5% of the facilities, respectively. Furthermore, we found a lower availability of ophthalmologic treatments even in some of the specialized facilities.

Conclusion

We considered that interruption and non-attendance of eye examinations were a barrier to prevent severe retinopathy. Our results also suggested that some of the specialized facilities may be inadequate in their efforts to detect and prevent these complications.

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Acknowledgements

This work was supported by Grants-in-Aid Research Scientific Research of Japan’s Ministry of Health, and Welfare ‘Development of comprehensive severity assessment of diabetic retinopathy and diabetic foot, and approaches to management for diabetic complications (201608012, 201709007, 201809004). We really appreciate the facility members of in the Asahikawa Diabetes Linkage Path for supporting the local survey of clinical practice of diabetic foot, nephropathy, and retinopathy among the diabetic subjects in Asahikawa area. We would like to acknowledge Dr. Kohjiro Ueki (National Center for Global Health and Medicine, Chair of the JDS Board of Directors), Dr. Yuichiro Ogura (Nagoya City University, Chair of the JSOD Board of Directors), Dr. Jiro Nakamura (Aichi Medical University, Chair of the SDC Board of Directors) and appreciate Drs. Atsuko Abiko, Akihiro Ishibazawa, Taiji Nagaoka, Yasuaki Saijo, and Akitoshi Yoshida (Asahikawa Medical University), Dr. Tatsumi Moriya (Kitasato University), Dr. Tetsuya Babazono (Tokyo Women’s Medical University), Dr. Hiroki Yokoyama (Jiyugaoka Medical Clinic), Dr. Shin-ichi Araki (Shiga University of Medical Science), Dr. Yoshimitsu Takahara (Osaka University), Dr. Osamu Iida (Kansai Rosai Hospital) as members of this project of Grants-in-Aid Research Scientific Research for insightful suggestions. We also thank Dr. Shinsuke Kikuchi (Asahikawa Medical University), Drs. Takehiro Sugiyama, and Mitsuru Ohsugi (National Center for Global Health and Medicine) for suggestive discussions.

Funding

Grants-in-aid Research Scientific Research of Japan’s Ministry of Health, 201608012 Masakaza Haneda, 201709007 Masakaza Haneda, 201809004 Masakaza Haneda

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Authors and Affiliations

  1. Division of Metabolism and Biosystemic Science, Department of Internal Medicine, Asahikawa Medical University, Asahikawa, 078-8510, Japan

    Yukihiro Fujita & Masakazu Haneda

  2. Division of Diabetology, Endocrinology, and Nephrology, Department of Medicine, Shiga University of Medical Science, Seta Tsukinowa-Cho, Otsu, 520-2192, Japan

    Yukihiro Fujita

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Correspondence to Yukihiro Fujita.

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MH received honoraria as lecture fees from Astellas, Eli Lilly, Boehringer Ingelheim and Novo Nordisk.

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Fujita, Y., Haneda, M. Clinical practice of diabetic foot, nephropathy, and retinopathy in Japan: cross-sectional study using local and nationwide questionnaire surveys. Diabetol Int 13, 493–502 (2022). https://doi.org/10.1007/s13340-021-00559-6

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