Japan Diabetes Complications Study: Revisiting one of the first large‐scale clinical studies in East Asians with diabetes

Abstract This review highlights the significance of the Japan Diabetes Complications Study (JDCS), one of the earliest large‐scale studies of people with type 2 diabetes outside Europe and the United States, in understanding type 2 diabetes mellitus among East Asian populations, particularly in Japa...

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Main Authors: Hirohito Sone, Chika Horikawa, Sachiko Tanaka‐Mizuno, Ryo Kawasaki, Kazuya Fujihara, Tatsumi Moriya, Atsushi Araki, Shiro Tanaka, Yasuo Akanuma
Format: Article
Language:English
Published: Wiley 2025-03-01
Series:Journal of Diabetes Investigation
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Online Access:https://doi.org/10.1111/jdi.14394
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author Hirohito Sone
Chika Horikawa
Sachiko Tanaka‐Mizuno
Ryo Kawasaki
Kazuya Fujihara
Tatsumi Moriya
Atsushi Araki
Shiro Tanaka
Yasuo Akanuma
author_facet Hirohito Sone
Chika Horikawa
Sachiko Tanaka‐Mizuno
Ryo Kawasaki
Kazuya Fujihara
Tatsumi Moriya
Atsushi Araki
Shiro Tanaka
Yasuo Akanuma
author_sort Hirohito Sone
collection DOAJ
description Abstract This review highlights the significance of the Japan Diabetes Complications Study (JDCS), one of the earliest large‐scale studies of people with type 2 diabetes outside Europe and the United States, in understanding type 2 diabetes mellitus among East Asian populations, particularly in Japan. Historically, large‐scale clinical studies on type 2 diabetes mellitus have predominantly focused on Western populations, despite East Asians comprising the largest proportion of diabetic patients globally. The JDCS, which was initiated in 1996, enrolled 2,033 Japanese type 2 diabetes mellitus patients. It aimed to evaluate the effects of intensive lifestyle interventions on diabetic complications. The study demonstrated that lifestyle‐focused interventions significantly reduced the risk of stroke and other complications compared to conventional treatment. Key findings of its sub‐analyses include the unique characteristics of Japanese patients with type 2 diabetes mellitus, such as their lower body mass index (BMI) compared to Western counterparts and a stronger association between even modest BMI increases and beta cell dysfunction. Additionally, the JDCS provided insights into the risk factors for nephropathy, retinopathy, and macrovascular complications, emphasizing the importance of controlling blood pressure, glycemia, and lifestyle factors. The study also explored the impact of diet, exercise, and mental health on diabetic outcomes, revealing the protective effects of physical activity and a balanced diet, while highlighting the risks associated with high salt intake and depression. A risk prediction model tailored to Japanese patients was also developed. Overall, this study made a significant contribution to the evidence‐based management of type 2 diabetes mellitus in East Asia.
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spelling doaj-art-59f2ef9248ff49a6a1f69be3f30372dc2025-08-20T02:11:17ZengWileyJournal of Diabetes Investigation2040-11162040-11242025-03-0116336036910.1111/jdi.14394Japan Diabetes Complications Study: Revisiting one of the first large‐scale clinical studies in East Asians with diabetesHirohito Sone0Chika Horikawa1Sachiko Tanaka‐Mizuno2Ryo Kawasaki3Kazuya Fujihara4Tatsumi Moriya5Atsushi Araki6Shiro Tanaka7Yasuo Akanuma8Department of Hematology, Endocrinology and Metabolism Niigata University Faculty of Medicine Niigata JapanDepartment of Health and Nutrition University of Niigata Prefecture Faculty of Human Life Studies Niigata JapanLaboratory of Epidemiology and Prevention Kobe Pharmeceutical University Kobe JapanDivision of Public Health, Department of Social Medicine, Graduate School of Medicine Osaka University Osaka JapanDepartment of Hematology, Endocrinology and Metabolism Niigata University Faculty of Medicine Niigata JapanHealth Care Center Kitasato University Sagamihara JapanDepartment of Diabetes, Metabolism, and Endocrinology Tokyo Metropolitan Institute for Geriatrics and Gerontology Tokyo JapanDepartment of Clinical Biostatistics, Graduate School of Medicine Kyoto University Kyoto JapanThe Institute of Medical Science Asahi Life Foundation Tokyo JapanAbstract This review highlights the significance of the Japan Diabetes Complications Study (JDCS), one of the earliest large‐scale studies of people with type 2 diabetes outside Europe and the United States, in understanding type 2 diabetes mellitus among East Asian populations, particularly in Japan. Historically, large‐scale clinical studies on type 2 diabetes mellitus have predominantly focused on Western populations, despite East Asians comprising the largest proportion of diabetic patients globally. The JDCS, which was initiated in 1996, enrolled 2,033 Japanese type 2 diabetes mellitus patients. It aimed to evaluate the effects of intensive lifestyle interventions on diabetic complications. The study demonstrated that lifestyle‐focused interventions significantly reduced the risk of stroke and other complications compared to conventional treatment. Key findings of its sub‐analyses include the unique characteristics of Japanese patients with type 2 diabetes mellitus, such as their lower body mass index (BMI) compared to Western counterparts and a stronger association between even modest BMI increases and beta cell dysfunction. Additionally, the JDCS provided insights into the risk factors for nephropathy, retinopathy, and macrovascular complications, emphasizing the importance of controlling blood pressure, glycemia, and lifestyle factors. The study also explored the impact of diet, exercise, and mental health on diabetic outcomes, revealing the protective effects of physical activity and a balanced diet, while highlighting the risks associated with high salt intake and depression. A risk prediction model tailored to Japanese patients was also developed. Overall, this study made a significant contribution to the evidence‐based management of type 2 diabetes mellitus in East Asia.https://doi.org/10.1111/jdi.14394East Asialarge‐scale clinical studyLifestyle
spellingShingle Hirohito Sone
Chika Horikawa
Sachiko Tanaka‐Mizuno
Ryo Kawasaki
Kazuya Fujihara
Tatsumi Moriya
Atsushi Araki
Shiro Tanaka
Yasuo Akanuma
Japan Diabetes Complications Study: Revisiting one of the first large‐scale clinical studies in East Asians with diabetes
Journal of Diabetes Investigation
East Asia
large‐scale clinical study
Lifestyle
title Japan Diabetes Complications Study: Revisiting one of the first large‐scale clinical studies in East Asians with diabetes
title_full Japan Diabetes Complications Study: Revisiting one of the first large‐scale clinical studies in East Asians with diabetes
title_fullStr Japan Diabetes Complications Study: Revisiting one of the first large‐scale clinical studies in East Asians with diabetes
title_full_unstemmed Japan Diabetes Complications Study: Revisiting one of the first large‐scale clinical studies in East Asians with diabetes
title_short Japan Diabetes Complications Study: Revisiting one of the first large‐scale clinical studies in East Asians with diabetes
title_sort japan diabetes complications study revisiting one of the first large scale clinical studies in east asians with diabetes
topic East Asia
large‐scale clinical study
Lifestyle
url https://doi.org/10.1111/jdi.14394
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