Low incidence of cardiovascular events in Japanese patients with Type 2 diabetes in primary care settings: a prospective cohort study (JDDM 20): Cardiovascular outcomes in Japanese Type 2 diabetes
Abstract
AIMS: To investigate whether a reduced incidence of cardiovascular disease in Type 2 diabetes can be achieved in a newly recruited cohort following the recently advanced concept of multifactorial treatment and followed in primary care settings as compared with earlier cohorts. METHODS: A prospective study was performed in primary care settings at multiple clinics nationwide in the Japan Diabetes Clinical Data Management (JDDM) study group. Subjects were 2984 patients with Type 2 diabetes without prevalent cardiovascular disease. The main outcome measure was the first event of non-fatal or fatal coronary heart disease, ischaemic stroke or peripheral artery disease, and the incidence was compared with other representative cohorts. RESULTS: There were 90 cardiovascular events over 10,827 person-years of follow-up with a dropout rate of 6%. The incidences (per 1000 person-years, 95% confidence interval) of composite, coronary heart disease, ischaemic stroke and peripheral artery disease in the JDDM study were 8.3 (6.6-10.0), 4.4 (3.2-5.6), 3.1 (2.1-4.2), and 0.7 (0.2-1.2), respectively. Each incidence was lowest in the JDDM study compared with other cohorts (P < 0.01 vs. each cohort). In the JDDM study, significant variables predictive of the occurrence of a cardiovascular event were age, duration of diabetes, HbA(1c), HDL cholesterol and urinary albumin. CONCLUSION: The novel finding of low cardiovascular disease occurrence in this study may be conferred by the feasibility at primary care settings for providing patients with Type 2 diabetes with favourable control of blood glucose, blood pressure and lipids, coupled with unique ethnicity/country factors.
Integrity signals
Registry
Cites
Statistics
Claims the paper makes
Claims other papers make about this one
Each is checked against this paper’s own text: does it say what the citing paper says it does?
In CIRCS, the incidence rate of cerebral infarction for diabetic patients was 1.9 times higher in men and 2.2 times higher in women compared with non-diabetics.
“The CIRCS study also showed that the incidence rate of cerebral infarction for diabetic patients was higher at 1.9 times in men and 2.2 times in women as compared to non-diabetics129).”
From Japan Atherosclerosis Society (JAS) guidelines for prevention of atherosclerotic cardiovascular diseases 2017 (2018) · cites this paper as [129]
Cites
Stratton, I. M. (2000) · BMJ · doi:10.1136/bmj.321.7258.405 · Cited by 9,059 · see citing works
10-year follow-up of intensive glucose control in type 2 diabetes
Holman, R. R., Paul, S. K., Bethel, M. A., Matthews, D. R., & Neil, H. A. W. (2008) · New England Journal of Medicine · doi:10.1056/nejmoa0806470 · Cited by 7,751 · see citing works
Multifactorial intervention and cardiovascular disease in patients with type 2 diabetes
Gæde, P., Vedel, P., Larsen, N., Jensen, G. V. H., Parving, H.-H., & Pedersen, O. (2003) · New England Journal of Medicine · doi:10.1056/nejmoa021778 · Cited by 4,378 · see citing works
Colhoun, H. M., Betteridge, D. J., Durrington, P. N., Hitman, G. A., W Neil, H. A., Livingstone, S. J., Thomason, M. J., Mackness, M. I., Charlton-Menys, V., & Fuller, J. H. (2004) · The Lancet · doi:10.1016/s0140-6736(04)16895-5 · Cited by 3,755 · see citing works
Effects of intensive blood-pressure control in type 2 diabetes mellitus
(2010) · New England Journal of Medicine · doi:10.1056/nejmoa1001286 · Cited by 3,598 · see citing works
Effect of a multifactorial intervention on mortality in type 2 diabetes
Gæde, P., Lund-Andersen, H., Parving, H.-H., & Pedersen, O. (2008) · New England Journal of Medicine · doi:10.1056/nejmoa0706245 · Cited by 3,489 · see citing works
Turner, R. C., Millns, H., Neil, H. A. W., Stratton, I. M., Manley, S. E., Matthews, D. R., & Holman, R. R. (1998) · BMJ · doi:10.1136/bmj.316.7134.823 · Cited by 2,014 · see citing works
Cardiovascular Disease and Risk Factors in Asia
Ueshima, H., Sekikawa, A. M., Miura, K., Turin, T. C., Takashima, N., Kita, Y., Watanabe, M., Kadota, A., Okuda, N., Kadowaki, T., et al. (2008) · Circulation · doi:10.1161/circulationaha.108.790048 · Cited by 923 · see citing works
Manson, J. E. (1991) · Archives of Internal Medicine · doi:10.1001/archinte.1991.00400060077013 · Cited by 675 · see citing works
Adler, A. I., Stevens, R. J., Neil, A., Stratton, I. M., Boulton, A. J. M., Holman, R. R., & for the U.K. Prospective Diabetes Study Group (2002) · Diabetes Care · doi:10.2337/diacare.25.5.894 · Cited by 429 · see citing works
Kothari (2002) · doi:10.1161/01.str.0000020091.07144.c7 · Cited by 420 · see citing works
Rajamani, K., Colman, P. G., Li, L. P., Best, J. D., Voysey, M., D'Emden, M. C., Laakso, M., Baker, J. R., & Keech, A. C. (2009) · The Lancet · doi:10.1016/s0140-6736(09)60698-x · Cited by 328 · see citing works
Lee, C. D., Folsom, A. R., Pankow, J. S., & Brancati, F. L. (2004) · Circulation · doi:10.1161/01.cir.0000116389.61864.de · Cited by 276 · see citing works
Reaven, P. D., MORITZ, T. E., Schwenke, D. C., Anderson, R. J., Criqui, M. H., Detrano, R., Emanuele, N., Kayshap, M., Marks, J. B., Mudaliar, S. R. D., et al. (2009) · Diabetes · doi:10.2337/db09-0618 · Cited by 182 · see citing works
Kitamura, A., Sato, S., Kiyama, M., Imano, H., Iso, H., Okada, T., Ohira, T., Tanigawa, T., Yamagishi, K., Nakamura, M., et al. (2008) · Journal of the American College of Cardiology · doi:10.1016/j.jacc.2008.02.075 · Cited by 170 · see citing works
Incidence of Coronary Heart Disease in Type 2 Diabetic Men and Women
Avogaro, A., Giorda, C. B., Maggini, M., Mannucci, E., Raschetti, R., Lombardo, F. L., Alegiani, S. S., Turco, S., Velussi, M., & Ferrannini, E. (2007) · Diabetes Care · doi:10.2337/dc06-2558 · Cited by 169 · see citing works
Kobayashi, M., Yamazaki, K., Hirao, K., Oishi, M., Kanatsuka, A., Yamauchi, M., Takagi, H., & Kawai, K. (2006) · Diabetes Research and Clinical Practice · doi:10.1016/j.diabres.2006.01.013 · Cited by 151 · see citing works
Self-citationfor the Japan Diabetes Complications Study Group, Sone, H., Tanaka, S., Iimuro, S., Tanaka, S., Oida, K., Yamasaki, Y., Oikawa, S., Ishibashi, S., Katayama, S., et al. (2010) · Diabetologia · doi:10.1007/s00125-009-1622-2 · Cited by 151 · see citing works
Self-citationKubo, M., Hata, J., Doi, Y., Tanizaki, Y., Iida, M., & Kiyohara, Y. (2008) · Circulation · doi:10.1161/circulationaha.107.743211 · Cited by 124 · see citing works
Doi, Y., Ninomiya, T., Hata, J., Fukuhara, M., Yonemoto, K., Iwase, M., Iida, M., & Kiyohara, Y. (2009) · Stroke · doi:10.1161/strokeaha.109.564708 · Cited by 110 · see citing works
Changes in Coronary Heart Disease Risk Among Japanese
Iso, H. (2008) · Circulation · doi:10.1161/circulationaha.107.750117 · Cited by 96 · see citing works
The evolution of stroke in Quebec
Mayo, N., Nadeau, L., Daskalopoulou, S., & Côté, R. (2007) · Neurology · doi:10.1212/01.wnl.0000258664.12423.4c · Cited by 61 · see citing works
Renal and Cardiovascular Protection in Type 2 Diabetes Mellitus
Deferrari, G., Ravera, M., Deferrari, L., Vettoretti, S., Ratto, E., & Parodi, D. (2002) · Journal of the American Society of Nephrology · doi:10.1097/01.asn.0000032544.37147.ae · Cited by 53 · see citing works
Oluwatowoju, I., Abu, E. O., Wild, S. H., & Byrne, C. D. (2009) · Diabetic Medicine · doi:10.1111/j.1464-5491.2010.02951.x · Cited by 46 · see citing works
Arai, K., Hirao, K., Matsuba, I., Takai, M., Matoba, K., Takeda, H., Kanamori, A., Yamauchi, M., Mori, H., & Terauchi, Y. (2009) · Diabetes Research and Clinical Practice · doi:10.1016/j.diabres.2008.11.036 · Cited by 44 · see citing works
Self-citationYokoyama, H., Oishi, M., Kawai, K., & Sone, H. (2008) · Diabetic Medicine · doi:10.1111/j.1464-5491.2008.02592.x · Cited by 37 · see citing works
Self-citationYokoyama, H., Kawai, K., Ohishi, M., et al. (2008) · Atherosclerosis · doi:10.1016/j.atherosclerosis.2008.02.025 · Cited by 13 · see citing works
Self-citationFenofibrate and risk of minor amputations in diabetes
Fazio, S., & Linton, M. F. (2009) · The Lancet · doi:10.1016/s0140-6736(09)60959-4 · Cited by 6 · see citing works
Flagged first, then by citations
Cited by
Sorted by citations
Kinoshita, M., Yokote, K., Arai, H., Iida, M., Ishigaki, Y., Ishibashi, S., Umemoto, S., Egusa, G., Ohmura, H., Okamura, T., et al. (2018) · Journal of Atherosclerosis and Thrombosis · doi:10.5551/jat.gl2017 · Cited by 813 · see citing works
Cardiometabolic-Based Chronic Disease, Adiposity and Dysglycemia Drivers
Mechanick, J. I., Farkouh, M. E., Newman, J. D., & Garvey, W. T. (2020) · Journal of the American College of Cardiology · doi:10.1016/j.jacc.2019.11.044 · Cited by 243 · see citing works
Evidence-based practice guideline for the treatment for diabetes in Japan 2013
Tajima, N., Noda, M., Origasa, H., Noto, H., Yabe, D., Fujita, Y., Goto, A., Fujimoto, K., Sakamoto, M., & Haneda, M. (2015) · Diabetology International · doi:10.1007/s13340-015-0206-2 · Cited by 154 · see citing works
- Authors
- Yokoyama, H., Matsushima, M., Kawai, K., Hirao, K., Oishi, M., Sugimoto, H., Takeda, H., Minami, M., Kobayashi, M., Sone, H., & on behalf of the Japan Diabetes Clinical Data Management Study Group
- Affiliations
- Jikei University School of Medicine (JP)
- Takeda (Japan) (JP)
- University of Toyama (JP)
- University of Tsukuba (JP)
- Corresponding author
- Yokoyama, H.
- Venue
- Diabetic Medicine
- Publisher
- Wiley
- Published
- 2011-09-19
- Volume
- 28
- Issue
- 10
- Pages
- 1221-1228
- ISSN
- 0742-3071 (ISSN-L)
- OpenAlex
- W2147205430
- Cited by
- 41
- References
- 29
- Citations by year
- 2025: 1 · 2023: 3 · 2021: 4 · 2020: 5 · 2019: 3 · 2018: 6 · 2017: 1 · 2016: 1 · 2015: 4 · 2014: 4 · 2013: 6 · 2012: 3
- FWCI
- 3.41
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Diabetic Medicine (publishedVersion)
- PubMed (publishedVersion)
- Funders
- Japan Society for the Promotion of Science (20300227)
- Topics
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Treatment and Management
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes, Cardiovascular Risks, and Lipoproteins
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Management and Education
- Keywords
- type 2 diabetes, cardiovascular disease incidence, multifactorial treatment, primary care, coronary artery disease, ischemic stroke, peripheral arterial disease, HbA1c, HDL cholesterol, urinary albumin, blood pressure control, lipid control, risk factors, Japanese patients
- MeSH terms
- Cardiovascular Diseases, Diabetes Mellitus, Type 2, Diabetic Angiopathies, Female, Follow-Up Studies, Glycated Hemoglobin, Humans, Japan, Male, Middle Aged, Primary Health Care, Prospective Studies, Cohort Studies, Body Mass Index, Incidence, Disease Progression, Stroke, Asian People
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
Are you an author, or do you see a problem with this page? Request a review
