The natural history of diabetic-related complications in type 2 diabetes among middle-aged employees.

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1. Setup of a cohort studyThis study of the employees working for Nippon Telegraph and Telephone West Corporation is an ongoing cohort investigation designed to clarify the risk factors for major diseases, including type 2 diabetes, hypertension, and metabolic syndrome etc since 2000. And furthermore, we started a cohort study at Ohtori Health Promotion Center.2. Diagnosis of type 2 diabetes mellitusType 2 diabetes at baseline examination and follow-up was diagnosed if the fasting plasma glucose level was >126 mg/dl, (HbAlc >6.5%), or if participants were taking oral hypoglycemic medication or insulin.3. Data collection and measurementsThe clinical examination consisted of a physical examination; anthropometric measurements; and self-administered questionnaires on a medical history; measurement of the fasting plasma glucose level; and life-style characteristics, such as the duration of regular physical exercise, smoking, and daily alcohol consumption. The presence of proteinuria was co … More nfirmed by a dipstick test. Urinary albumin and creatinine were measured in a morning spot sample. Retinopathy was assessed by fundus photography.4. ResultsThis study revealed a prevalence of overt proteinuria in 23.0% of diabetic group as compared with 7.3% of non-diabetic group. The prevalence of microalbuminuria was higher in diabetic group (23.3%) than in non-diabetic group (7.0%). Multiple logistic regression model was tested to assess the risk factor on incidence of overt proteinuria followed for 4 years in 40-year-old or more male employees with type 2 diabetes. After adjusting for age, BMI, systolic blood pressure, diastolic blood pressure, number of white blood cells, HbAlc, and the presence of hypertension was associated with an increased risk of incidence of overt proteinuria.Diabetic retinopathy was observed in 3.7% and hemorrhage of the eye ground in 13.9% of diabetic group. The increased fasting plasma glucose level and HbAlc were increased multiple-adjusted odds ratio of hemorrhage of the eye ground after adjustment for age and gender. Less