title: Duration of diabetes and types of diabetes therapy in Japanese patients with type 2 diabetes: The Japan Diabetes Complication and its Prevention prospective study 3 (JDCP study 3).
abstract: OBJECTIVE
  To analyze the association between the duration of diabetes and selection of diabetes therapy in a large database of Japanese patients with type 2 diabetes.
  
  
  METHODS
  We used the data of 5,844 patients with type 2 diabetes to evaluate the association between the duration of diabetes and types of diabetes therapy. The logistic regression model was used to analyze the association between duration of diabetes and selection of diabetes therapy, and restricted cubic spline curves were used to represent the schematic association.
  
  
  RESULTS
  Overall, clinical characteristics of the patients were women, 39.9%; mean age, 61.4 years; median duration of diabetes, 9 years; mean glycated hemoglobin, 7.4% (57.0 mmol/mol); and mean body mass index, 24.5 kg/m2. Compared with the first quartile of diabetes duration, the multivariable-adjusted odds of any antidiabetic therapy (oral hypoglycemic agents or insulin) for the second, third and fourth quartiles were 2.17 (95% confidence interval [CI] 1.68-2.80; 3.39, 95% CI 2.53-4.54; 4.99, 95% CI 3.64-6.84), respectively (P for trend <0.001), and these associations were attenuated after adjusting possible confounders. Furthermore, those of insulin therapy were 1.48 (95% CI 1.20-1.84; 2.16, 95% CI 1.77-2.64; 4.94, 95% CI 4.04-6.04), respectively (P for trend <0.001). Schematic representation of restricted cubic spline curves analysis showed that a longer duration of diabetes was linearly associated with the odds of insulin therapy.
  
  
  CONCLUSIONS
  Obtained data showed that a longer duration of diabetes required complex diabetes drug regimens to be introduced to patients with type 2 diabetes.
authors.affiliation: The Japan Diabetes Society, Tokyo, Japan.|Tenri Hospital, Nara, Japan.
authors.forename: Yasuaki
authors.initials: Y
authors.lastname: Hayashino
authors.affiliation: The Japan Diabetes Society, Tokyo, Japan.|The National Center for Global Health and Medicine, Tokyo, Japan.
authors.forename: Kazuo
authors.initials: K
authors.lastname: Izumi
authors.affiliation: The Japan Diabetes Society, Tokyo, Japan.|Tenri Hospital, Nara, Japan.
authors.forename: Shintaro
authors.initials: S
authors.lastname: Okamura
authors.affiliation: The Japan Diabetes Society, Tokyo, Japan.|Division of Diabetes, Metabolism & Endocrinology, Department of Internal Medicine, Jikei University School of Medicine, Tokyo, Japan.
authors.forename: Rimei
authors.initials: R
authors.lastname: Nishimura
authors.affiliation: The Japan Diabetes Society, Tokyo, Japan.|Department of Biostatistics and Clinical Epidemiology, Graduate School of Medicine and Pharmaceutical Sciences, University of Toyama, Toyama, Japan.
authors.forename: Hideki
authors.initials: H
authors.lastname: Origasa
authors.affiliation: The Japan Diabetes Society, Tokyo, Japan.|Jikei University School of Medicine, Tokyo, Japan.
authors.forename: Naoko
authors.initials: N
authors.lastname: Tajima
mesh_terms: D000328:Adult; D000368:Aged; D044466:Asian People; D003924:Diabetes Mellitus, Type 2 / Q000188:drug therapy* / Q000453:epidemiology*; D005260:Female; D006801:Humans; D007004:Hypoglycemic Agents / Q000627:therapeutic use*; D007564:Japan; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D013997:Time Factors
chemical_list: D007004:Hypoglycemic Agents
keywords: Diabetes therapy; Durability; Duration of diabetes