Trends in the Management of Patients with Type 2 Diabetes Mellitus by Japanese Practitioners

In recent years, diabetes management by diabetes specialists has evolved owing to various factors such as the introduction of new glucose-lowering drugs. In Japan, many patients with diabetes mellitus are managed by general practitioners (GPs), with the quality of management provided by these GPs playing a crucial role in preventing diabetes-related complications. Despite this importance, trends in diabetes management by GPs remain unclear. This study aimed to assess changes in diabetes management by GPs, comparing data from two nationwide surveys conducted in 2006 and 2018.

We compared the characteristics and pharmacotherapy of patients with type 2 diabetes (T2DM) managed by GPs and diabetes specialists in 2006 (14,312 and 1038 patients, respectively) and 2018 (6525 and 1545, respectively). Data on age, sex, glycosylated hemoglobin (HbA1c), body mass index (BMI), treatment modalities, types and number of oral antidiabetic drugs (OADs), types of sulfonylureas (SUs), and dose of SUs were compared between the two surveys.

In 2018, patients with T2DM managed by GPs were older and had higher BMI, while exhibiting improved HbA1c levels compared to those in 2006. Dipeptidyl peptidase 4 inhibitors and biguanides were the most and second most frequently prescribed OADs, respectively, with SUs being less prescribed at lower doses. Combination OAD therapy was also more prevalent in 2018 than in 2006.

The observed trends with GPs were consistent with those observed among diabetes specialists, suggesting that many Japanese GPs are adopting current treatments strategies and may be providing appropriate diabetes management.