title: Present status of sulfonylurea treatment for type 2 diabetes in Japan: second report of a cross-sectional survey of 15,652 patients.
abstract: Sulfonylureas are commonly used for the treatment of patients with type 2 diabetes mellitus (T2DM). However, some clinical concerns regarding their use have grown over the past decade. Thus, results of a previous Japan-wide cross-sectional survey of patients with type 2 diabetes mellitus (T2DM) were analyzed to determine the present status and problems associated with the use of sulfonylureas in the treatment of T2DM by general practitioners (GPs) and diabetes specialists. Of 15,652 patients across 721 clinics and hospitals from the previous survey, 15,350 were diagnosed as T2DM (14,312 by GPs and 1,038 by specialists). For each patient, data were collected for HbA1c levels, age, height, body weight, and treatment modality. Of T2DM patients being treated by GPs, 35.4% and 60.0% received sulfonylureas in entire oral drugs or as monotherapy, respectively, compared with 29.2% and 61.2% of patients, respectively, treated by specialists. Of the patients treated with sulfonylurea monotherapy, 1335 patients (35.2%) achieved HbA1c <6.5%, whereas HbA1c was >or=8.0% in 531 patients (14.0%). Patients with HbA1c levels >or=8.0% had a higher body mass index, used glibenclamide more frequently, and used higher doses of sulfonylureas than patients in whom HbA1c levels were <6.5%. In conclusion, the present study shows that sulfonylureas are central in the treatment of T2DM in Japan. However, careful consideration of suitable patients, agents, and doses is necessary to achieve appropriate glycemic control.
authors.affiliation: The Japanese Medical and Dental Practitioners for the Improvement of Medical Care, Tokyo, Japan. arai-cl@n04.itscom.net
authors.forename: Keiko
authors.initials: K
authors.lastname: Arai
authors.forename: Kiyokazu
authors.initials: K
authors.lastname: Matoba
authors.forename: Koich
authors.initials: K
authors.lastname: Hirao
authors.forename: Ikuro
authors.initials: I
authors.lastname: Matsuba
authors.forename: Masahiko
authors.initials: M
authors.lastname: Takai
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Takeda
authors.forename: Akira
authors.initials: A
authors.lastname: Kanamori
authors.forename: Mikio
authors.initials: M
authors.lastname: Yamauchi
authors.forename: Hisao
authors.initials: H
authors.lastname: Mori
authors.forename: Yasuo
authors.initials: Y
authors.lastname: Terauchi
mesh_terms: D000368:Aged; D001786:Blood Glucose; D003430:Cross-Sectional Studies; D003924:Diabetes Mellitus, Type 2 / Q000188:drug therapy*; D005194:Family Practice; D005907:Gliclazide / Q000627:therapeutic use; D005905:Glyburide / Q000627:therapeutic use; D006442:Glycated Hemoglobin / Q000378:metabolism; D006801:Humans; D007004:Hypoglycemic Agents / Q000627:therapeutic use*; D007564:Japan; D008875:Middle Aged; D010818:Practice Patterns, Physicians'; D013453:Sulfonylurea Compounds / Q000627:therapeutic use*; D016896:Treatment Outcome
chemical_list: D001786:Blood Glucose; D005907:Gliclazide; D005905:Glyburide; D006442:Glycated Hemoglobin; D007004:Hypoglycemic Agents; D013453:Sulfonylurea Compounds; C057619:glimepiride