Abstract
The Ministry of Health and Welfare Diabetes Investigation and Research Projects are going on for over ten years.
As one of those projects, three years' nation-wide net-work studies, composed of National Hospitals and National Sanatoria on newly detected type 2 diabetic patients without previously therapeutic history, continue until now. Oishi and collaborators analysed clinical features and revealed remarkable findings on those diabetic patients.
That is, on the one hand the chances of detection of total glucose intolerance (diabetes plus impaired glucose tolerance) were shown to be the most frequent in basic health examination for in-habitants (41.6%), then in therapeutic procedures of other diseases (39.1%), and in subjective symptoms (17.3%) in order. On the other hand people with new detected total glucose intolerance (TGI) were motivated to perform primary visit to National Hospitals and Sanatoria from causes of subjective symptoms (39.7%), doctors' and/or families' advices (22.7%), basic health examina-tion (20.0%), and therapeutic procedures of other diseases (17.5%) respectively.
To our regret, there was such a time lag as 1.9 years between detection of TGI by basic health examinations and primary visits to medical institutions. So, high incidences of diabetic nephropathy (23.4%) and retinopathy (14.7%) might be caused by such a time lag.
In order to confirm these results above mentioned, from 1996 we stepped in basic health exami-nation for inhabitants by Kitashigeyasu-cho health center, which was a rural community, near our Higashi-Saga National Hospital. In 1997, the first year's questionnaire was reiterated for 112 peo-ple with newly detected TGI by basic health examination. The second year's cohort study added another questionnaire to clarify whether or not there were any defferences of life style between par-ticipants with normal glucose tolerance (NGT) and those with newly detected TGI to the first year's questionnaire. Nine hundred volunteers out of 1, 200 participants aged over 40 years including people with newly detected TGI consented to filling out the second year's questionnaire.
The results showed that 80% of people with TGI were newly detected and 83.7% out of those with newly detected TGI were motivated to visit clinics, moreover 34% out of those with newly detected TGI had family histories.
Concerning with relationship between life style disorders and TGI, cigarette smokers were significantly and statistically more frequent in people with newly detected TGI than in people with NGT. There was not any significantly and statistically def f erece in average Body Mass Index (BMI) between people with newly detected TGI and people with NGT, however, BMI≥26.4 which was proportional to the excess of 20% over standard body weight, was significantly and statisti-cally frequent in people with newly detected TGI than in people with NGT.
This suggests that genetic factors may take more important part in the incidence of TGI than life style disorder in rural inhabitants aged over 40 years.
However, we need to pay close attention to young subjects, regardless of parental histories of diabetes, for primary, secondary and tertiary prevention through instructing modifiable risk factors such as over-eating, obesity, decreased physical activity, and sedentary life style.
Last not but least it is required as early as possible to detect and improve total glucose intol-erance population for the prevention of diabetic complications, which causes to curtail medical expenses and to improve quality of lives.
