Seven-year Observational Study on the Association between Glycemic Control and the New Onset of Macroangiopathy in Japanese Subjects with Type 2 Diabetes

Tomohiko Kimura; Hideaki Kaneto; Yukiko Kanda-Kimura; Masashi Shimoda; Shinji Kamei; Takatoshi Anno; Fumiko Kawasaki; Mitsuru Hashiramoto; Michihiro Matsuki; Tomoatsu Mune; Kohei Kaku

doi:10.2169/internalmedicine.55.4952

ORIGINAL ARTICLES

Seven-year Observational Study on the Association between Glycemic Control and the New Onset of Macroangiopathy in Japanese Subjects with Type 2 Diabetes

Tomohiko Kimura, Hideaki Kaneto, Yukiko Kanda-Kimura, Masashi Shimoda, Shinji Kamei, Takatoshi Anno, Fumiko Kawasaki, Mitsuru Hashiramoto, Michihiro Matsuki, Tomoatsu Mune, Kohei Kaku

Author information

Tomohiko Kimura
Division of Diabetes, Endocrinology and Metabolism, Kawasaki Medical School, Japan
Hideaki Kaneto
Division of Diabetes, Endocrinology and Metabolism, Kawasaki Medical School, Japan
Yukiko Kanda-Kimura
Division of Diabetes, Endocrinology and Metabolism, Kawasaki Medical School, Japan
Masashi Shimoda
Division of Diabetes, Endocrinology and Metabolism, Kawasaki Medical School, Japan
Shinji Kamei
Division of Diabetes, Endocrinology and Metabolism, Kawasaki Medical School, Japan
Takatoshi Anno
Division of Internal Medicine, Tsuyama Chuo Hospital, Japan
Fumiko Kawasaki
Department of General Internal Medicine 1, Kawasaki Hospital, Kawasaki Medical School, Japan
Mitsuru Hashiramoto
Division of Diabetes and Endocrinology, Yodogawa Christian Hospital
Michihiro Matsuki
Division of Internal Medicine, Kurashiki Sweet Hospital, Japan
Tomoatsu Mune
Division of Diabetes, Endocrinology and Metabolism, Kawasaki Medical School, Japan
Kohei Kaku
Division of Diabetes, Endocrinology and Metabolism, Kawasaki Medical School, Japan
Department of General Internal Medicine 1, Kawasaki Hospital, Kawasaki Medical School, Japan

Keywords: meticulous glycemic control, ischemic heart disease, cerebral vascular disease

JOURNAL OPEN ACCESS

2016 Volume 55 Issue 11 Pages 1419-1424

DOI https://doi.org/10.2169/internalmedicine.55.4952

Details

Abstract

Objective To examine the association between glycemic control and the new onset of macroangiopathy in Japanese subjects with type 2 diabetes. Methods We examined seven-year follow-up data for 572 patients. We divided the subjects by the average of seven-year glycemic control based on the guidelines. First, we excluded the subjects with a past history of macroangiopathy and then examined the incidence of the new onset of macroangiopathy. Results The incidence of ischemic heart disease (IHD) was 1.0% per year, and that of cerebral vascular disease (CVD) was 1.0% per year. However, IHD events were not observed at all for five years in the most intensive glycemic control group (HbA1c<6%). Similarly, CVD events were not observed at all for seven years in the most intensive glycemic control group (HbA1c<6%). In addition, the cumulative incidence rate of IHD tended to increase as the glycemic control became poorer (HbA1c<6%, 4.5%; 6%≤HbA1c<7%, 6.0%; 7%≤HbA1c<8%, 7.2%; HbA1c≥8%, 10.7%). Furthermore, a logistic regression analysis showed that the duration of diabetes and HbA1c level were independent risk factors contributing to the onset of IHD, but not to the onset of CVD. Conclusion This seven-year observational study showed the possible association between glycemic control and the onset of macroangiopathy in a total of 572 Japanese subjects with type 2 diabetes.

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