Diabetes Research and Clinical Practice
Volume 72, Issue 3 , Pages 277-283, June 2006

Actual usage and clinical effectiveness of insulin preparations in patients with Type 1 diabetes mellitus in Japan: CoDiC®-based analysis of clinical data obtained at multiple institutions (JDDM 3)☆

  • Azuma Kanatsuka

      Affiliations

    • Diabetes Center, Chiba Central Medical Center, 1835-1 Kasori, Wakaba-ku, Chiba 264-0017, Japan
    • Corresponding Author InformationCorresponding author.
    • ,
  • Koichi Kawai

      Affiliations

    • Kawai Clinic, Tsukuba, Japan
    • ,
  • Koichi Hirao

      Affiliations

    • H.E.C. Science Clinic, Yokohama, Japan
    • ,
  • Mariko Oishi

      Affiliations

    • Oishi Internal Medicine Clinic, Kyoto, Japan
    • ,
  • Hirofumi Takagi

      Affiliations

    • School of Health Sciences, Faculty of Medicine, Niigata University, Niigata, Japan
    • ,
  • Masashi Kobayashi

      Affiliations

    • The First Department of Internal Medicine, Toyama Medical and Pharmaceutical University, Toyama, Japan
    • ,
  • Japan Diabetes Clinical Data Management Study Group

Received 5 November 2004; received in revised form 15 February 2005; accepted 29 March 2005. published online 17 April 2006.

Abstract 

To clarify the actual usage of insulin preparations and their effectiveness on glycaemic control in patients with Type 1 diabetes mellitus in Japan, we analyzed clinical data collected via CoDiC®, an electronic system for diabetes data collection and management, at 28 institutes. Of 18,470 diabetic patients registered with CoDiC® in June, 2003, 12,279 patients were being treated with insulin preparations and/or oral hypoglycemic agents, with 861 of these patients having Type 1 diabetes mellitus and 11,418 patients having Type 2 diabetes. Three analytical surveys were carried out with the Type 1 diabetes patients. Study I: Cross-sectional survey on the treatment in 2002. Six hundred and thirteen patients received intensive conventional insulin treatment (ICT). The number of patients receiving rapid-acting insulin analogue (RA) was greater than that of patients receiving regular insulin (R). Serum CPR was lower in the patients with ICT than in the patients with conventional insulin treatment (CT). Study II: Survey on the changes in the actual usage and clinical effectiveness of insulin preparations, based on the data input in 2001 and 2002. The number of patients with ICT using RA insulin markedly increased. Study III: Analysis of the participants’ clinical course over the 18-month period of the study from the time of first consultation. The dose of insulin increased during the term. The average HbA1c level fell drastically and reached to 7.5% over the first 9 months of the study and then remained between a range of 7.5% and 8% for the rest of the study period. In conclusion, ICT is actively performed and the RA insulin analogues are widely used in Type 1 diabetic patients in Japan. Basal-bolus therapy should be used to treat Type 1 diabetic patients with postprandial serum CPR of less than 0.5ng/ml. It is difficult to obtain the ideal glycaemic control in Type 1 diabetic patients with the currently available insulin preparations.

Keywords: Outcome research, Type 1 diabetes mellitus, Insulin treatment, Insulin preparation, Glycaemic control

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☆ A part of the manuscript has been presented at the Annual Meeting of the Japan Diabetes Society, 22–24 May 2003, Toyama, Japan: A. Kanatsuka, M. Kobayashi, H. Takagi, Actual Using Status of Insulin Preparations and Oral Hypoglycemic Agents —CoDiC-based Analysis of Clinical Data Obtained at Multiple Institutions, Journal of the Japan Diabetes Society 46 Supplement 1, 2003 (in Japanese) and at the 18th Congress of the Internal Diabetes Federation, 24–29 August 2003, Paris, France: A. Kanatsuka, M. Kobayashi, H. Takagi, Actual Using Status of Insulin Preparations and Oral Hypoglycemic Agents in Japan —CoDiC-based Analysis of Clinical Data Obtained at Multiple Institutions, Diabetologia 46 Supplement 2, 2003.

PII: S0168-8227(06)00035-0

doi:10.1016/j.diabres.2005.03.040

Diabetes Research and Clinical Practice
Volume 72, Issue 3 , Pages 277-283, June 2006

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