抄録
There are two major guidelines in the field of diabetes created under the supervision of the Japan Diabetes Society: “Treatment Guide for Diabetes” and “Evidence-based Practice Guideline for the Treatment of Diabetes in Japan”. Both are commonly used in various clinical settings related to diabetes in the country. Since the revision of diagnostic criteria of diabetes in 2010 and the global standardization of HbA1c in 2012, the aggressive use of glycated hemoglobin (HbA1c) is recommended in the diagnostic screening of diabetes in Japan, because much clinical and epidemiological data showed that the early identification and treatment of diabetes is beneficial in preventing diabetic complications and mortality. In particular, the guideline recommends the simultaneous measurement of glucose as well as HbA1c, to avoid delays or misclassifying people. Moreover, a patient-centered approach is strongly recommended. The guidelines do not include a specific regime of medications, but recommend the individualized selection of medicine based on pathophysiology and living conditions such as age, hypoglycemia, and comorbidity. Based on these considerations, three levels of HbA1c (<6, 7, and 8%) are adopted and HbA1c <7% is now widely known as a new treatment target with respect to diabetic complications. As introduced, the treatment guidelines have been updated repeatedly according to the progress of diagnosis and treatment of diabetes. However, the objectives of treatment for diabetes are consistent, which are to maintain a quality of life similar to that of healthy people, and to ensure a normal life expectancy in people living with diabetes.
