title: Trends in prevalence and management of diabetes and related vascular risks in Japanese adults: Japan National Health and Nutrition Surveys 2003-2012.
abstract: OBJECTIVE
  To examine temporal changes in health system performance for the control of diabetes and related risks for vascular complications in Japan over a decade.
  
  
  METHODS
  Data of 51,128 individuals aged ≥20years were obtained from the National Health and Nutrition Surveys in 2003-2012. Diabetes was defined as currently being treated by insulin or oral hypoglycaemic agents or having a glycated haemoglobin (HbA1c) level ≥6.5% (≥48mmol/mol). We estimated the prevalence and proportions of people with diabetes being treated and achieving target goals of HbA1c <7.0% (<53mmol/mol), blood pressure <130/80mmHg, and non-high-density lipoprotein cholesterol <130mg/dL. All estimates were age-standardized using the Japanese population in 2010.
  
  
  RESULTS
  The age-standardized prevalence of diabetes remained constant at approximately 8% and was significantly higher in men (P<0.001) and in individuals age ≥65years (P<0.001) throughout the study period. The proportion of people with diabetes being treated significantly increased from 41.8% (95% confidence interval, 37.2-46.5%) in 2003 to 54.9% (51.9-57.8%) in 2012, and the proportion of those having controlled HbA1c significantly increased from 13.4% (10.3-17.3%) in 2003 to 28.8% (26.3-31.5%) in 2012. These two rates were significantly higher in age ≥65years compared with younger adults in most of the survey years (P<0.05). The control rates of blood pressure and non-high-density lipoprotein cholesterol remained around 20% and 30-40%, respectively.
  
  
  CONCLUSIONS
  Diabetes management in Japan has improved over the past decade but is still inadequate for prevention of vascular complications.
authors.affiliation: Center for International Collaboration and Partnership, National Institute of Health and Nutrition, National Institutes of Biomedical Innovation, Health and Nutrition, 1-23-1 Toyama, Shinjuku-ku, Tokyo 162-8636, Japan. Electronic address: ikedan@nibiohn.go.jp.
authors.forename: Nayu
authors.initials: N
authors.lastname: Ikeda
authors.affiliation: Center for International Collaboration and Partnership, National Institute of Health and Nutrition, National Institutes of Biomedical Innovation, Health and Nutrition, 1-23-1 Toyama, Shinjuku-ku, Tokyo 162-8636, Japan.
authors.forename: Nobuo
authors.initials: N
authors.lastname: Nishi
authors.affiliation: Department of Public Health, Osaka University Graduate School of Medicine, 2-2 Yamadaoka, Suita-shi, Osaka 565-0871, Japan.
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Noda
authors.affiliation: Department of Endocrinology and Diabetes, Saitama Medical University, 38 Morohongo, Moroyama-machi, Iruma-gun, Saitama 350-0495, Japan.
authors.forename: Mitsuhiko
authors.initials: M
authors.lastname: Noda
mesh_terms: D000328:Adult; D002318:Cardiovascular Diseases / Q000453:epidemiology*; D003920:Diabetes Mellitus / Q000453:epidemiology*; D005260:Female; D006801:Humans; D007564:Japan / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D009749:Nutrition Surveys; D015995:Prevalence; D012306:Risk; D055815:Young Adult
keywords: Blood pressure; Cholesterol; Diabetes; Epidemiology; Japan