Twenty-year trend of increasing obesity in young patients with poorly controlled type 2 diabetes at first diagnosis in urban Japan.
OBJECTIVE
To investigate trends over the past 20 years for the prevalence of obesity and glycemic control in association with a patient's first hospital visit for type 2 diabetes mellitus.


METHODS
This was a historical, cross-sectional, time-series, single-center study carried out at Marunouchi Hospital. Data from type 2 diabetic patients who were never treated until their first hospital visit were analyzed for the following periods: 1986-1987 (group A, n = 453), 1996-1997 (group B, n = 547) and 2006-2008 (group C, n = 443). Data on each patient's body mass index (BMI), age, untreated duration and glycated hemoglobin levels were also collected.


RESULTS
Obesity in younger patients (below age 40 years and ages 40-49 years in group C) with poor glycemic control increased over time. Patients with a BMI of <21.0 kg/m(2) or ≥23.0 kg/m(2) showed worse glycemic control than those with a BMI of 21.0-23.0 kg/m(2) in group C. Younger patients had worse glycemic control and shorter untreated durations in group C. A BMI ≥23.0 kg/m(2) was an independent risk factor for glycated hemoglobin levels ≥8.4% in group C, even after correction for sex, age, untreated duration and symptoms.


CONCLUSIONS
In recent years, glycemic control has worsened in young, obese patients in urban Japan. Obesity is rapidly increasing in younger patients, and patients with a BMI ≥23.0 kg/m(2) might be candidates for diabetes screening. This trial was registered with the University Medical Information Network Clinical Trials Registry (no. UMIN000005725).
The Institute for Adult Diseases Asahi Life Foundation Tokyo Japan.
Akifumi
A
Kushiyama
The Institute for Adult Diseases Asahi Life Foundation Tokyo Japan.
Yoko
Y
Yoshida
The Institute for Adult Diseases Asahi Life Foundation Tokyo Japan.
Takako
T
Kikuchi
The Institute for Adult Diseases Asahi Life Foundation Tokyo Japan.
Naoki
N
Suzawa
The Institute for Adult Diseases Asahi Life Foundation Tokyo Japan.
Mayumi
M
Yamamoto
The Institute for Adult Diseases Asahi Life Foundation Tokyo Japan.
Kentaro
K
Tanaka
The Institute for Adult Diseases Asahi Life Foundation Tokyo Japan.
Mineko
M
Okayasu
The Institute for Adult Diseases Asahi Life Foundation Tokyo Japan.
Tazu
T
Tahara
The Institute for Adult Diseases Asahi Life Foundation Tokyo Japan.
Toshiko
T
Takao
The Institute for Adult Diseases Asahi Life Foundation Tokyo Japan.
Yukiko
Y
Onishi
The Institute for Adult Diseases Asahi Life Foundation Tokyo Japan.
Shoji
S
Kawazu
Body mass index; Glycated hemoglobin; Screening criteria