Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Review
. 2018 Mar 27;9(1):1-45.
doi: 10.1007/s13340-018-0345-3. eCollection 2018 Feb.

Japanese Clinical Practice Guideline for Diabetes 2016

Masakazu Haneda  1 , Mitsuhiko Noda  2 , Hideki Origasa  3 , Hiroshi Noto  4 , Daisuke Yabe  5 , Yukihiro Fujita  1 , Atsushi Goto  6 , Tatsuya Kondo  7 , Eiichi Araki  7
Affiliations
Review

Japanese Clinical Practice Guideline for Diabetes 2016

Masakazu Haneda et al. Diabetol Int. .

Erratum in

No abstract available

Keywords: Diabetes; Diagnosis; Guideline; Treatment.

PubMed Disclaimer

Figures

Fig. 1
Fig. 1
Flow chart outlining the steps in the clinical diagnosis of diabetes mellitus. OGTT oral glucose tolerance test
Fig. 2
Fig. 2
The categories of glycemia as indicated by fasting plasma glucose levels and 75 g OGTT results
Fig. 3
Fig. 3
A schematic diagram of the relationship between the etiology (mechanism) and pathophysiological stages (states) of diabetes mellitus. Arrows pointing right represent the worsening of glucose metabolism disorders (including the onset of diabetes mellitus). Among the arrow lines, indicates the condition classified as ‘‘diabetes mellitus’’. Arrows pointing left represent improvement in the glucose metabolism disorder. The broken lines indicate events of low frequency. For example, in type 2 diabetes mellitus, infection can lead to ketoacidosis and require temporary insulin treatment for survival. Additionally, once diabetes mellitus has developed, it is treated as diabetes mellitus regardless of the improvement in the glucose metabolism; thus, the arrow lines pointing left are filled in black. In such cases, a broken line is used, because complete normalization of the glucose metabolism is rare
Fig. 4
Fig. 4
Treatment of patients in a non-insulin-dependent state. This provides a guide to the management of patients without acute metabolic disorder [i.e., those who had a casual blood glucose level of 250–300 mg/dL (13.9–16.7 mmol/L) or less than 250–300 mg/dL with a negative urinary ketone test]. The glycemic goal should be determined individually depending on the disease condition or age of the patient but is generally set at HbA1c < 7.0%. “Diet therapy” and “exercise therapy” are referred to as “medical nutrition therapy (MNT)” and “physical activity/exercise”, respectively, elsewhere in this guideline
Fig. 5
Fig. 5
Glycemic control targets
Fig. 6
Fig. 6
The treatment of hypertension complicating diabetes mellitus. Excerpt from: The Japanese Society of Hypertension, Guidelines for the Treatment of Hypertension, 2014, P.78
Fig. 7
Fig. 7
Glycemic targets (HbA1c values) for older patients with diabetes
See this image and copyright information in PMC

References

1 Guideline for the diagnosis of diabetes mellitus

    1. Kosaka K,Akanuma Y, Goto Y, et al. Report of Committee on the classification and diagnostic criteria of diabetes mellitus.J Jpn Diabetes Soc. 1982;25:859–66 (in Japanese).
    1. The Expert Committee on the Diagnosis and Classification of Diabetes Mellitus. Report of the expert committee on the diagnosis and classification of diabetes mellitus. Diabetes Care. 1997;20:1183–97. - PubMed
    1. World Health Organization. Report of a WHO consultation: definition, diagnosis and classification of diabetes mellitus and its complications. Part 1: diagnosis and classification of diabetes mellitus. Geneva: World Health Organization Department of Noncommunicable Disease Surveillance. 1999. http://www.staff.ncl.ac.uk/philip.home/who_dmc.htm.
    1. Kuzuya T, Nakagawa S, Satoh J, et al. Report of the Committee of Japan Diabetes Society on the classification and diagnostic criteria of diabetes mellitus. J Jpn Diabetes Soc. 1999;42:385–404 (in Japanese).
    1. Seino Y, Nanjo K, Tajima N. et al. Report of the Committee on the classification and diagnostic criteria of diabetes mellitus: The Committee of the Japan Diabetes Society on the diagnostic criteria of diabetes mellitus. Diabetol Int. 2010;1: 2. - PMC - PubMed

2 Goals and strategies for diabetes management

    1. United Kingdom Prospective Diabetes Study (UKPDS) Group. Intensive blood-glucose control with sulphonylureas or insulin compared with conventional treatment and risk of complications in patients with type 2 diabetes (UKPDS33). Lancet 1998;352:837–53 (level 1+). - PubMed
    1. Schauer PR, Bhatt DL, Kirwan JP, et al. Bariatric surgery versus intensive medical therapy for diabetes—3-year outcome. N Engl J Med. 2014;370:2002–13 (level. 1). - PMC - PubMed
    1. Sone H, Tanaka S, Tanaka S, et al. Serum level of triglycerides is a potent risk factor comparable to LDL cholesterol for coronary heart disease in Japanese patients with type 2 diabetes: subanalysis of the Japan Diabetes Complications Study (JDCS). J Clin Endocrinol Metab. 2011;96:3448–3456 (level 2). - PubMed

3 Medical nutrition therapy (MNT)

    1. Nakagawa Y, Ishikawa Y, Watanabe K, et al. Impact of the duration of diabetes and frequency of counseling on the effectiveness of dietitian-led medical nutrition therapy in patients with type 2 diabetes. J Jpn Diabetes Soc. 2014;57:813–9 (in Japanese) (level 3).
    1. Pastors JG, Warshaw H, Daly A et al. The evidence for the effectiveness of medical nutrition therapy in diabetes management. Diabetes Care 2002;25:608–13 (level 3). - PubMed

4 Physical activity/exercise

    1. American Diabetes Association. Foundations of care and comprehensive medical evaluation. Sec. 3. In: Standards of Medical Care in Diabetes-2016. Diabetes Care 2016;39(Suppl 1):S23–35. - PubMed
    1. Marwick TH, Hordern MD, Miller T, et al. Exercise training for type 2 diabetes mellitus: impact on cardiovascular risk: a scientific statement from the American Heart Association. Circulation. 2009;119:3244–62. - PubMed
    1. Umpierre D, Ribeiro PA, Kramer CK et al: Physical activity advice only or structured exercise training and association with HbA1c levels in type 2 diabetes: a systematic review and meta-analysis. JAMA. 2011;305:1790–9 (level 1). - PubMed
    1. Boulé NG, Kenny GP, Haddad E, et al. Meta-analysis of the effect of structured exercise training on cardiorespiratory fitness in type 2 diabetes mellitus. Diabetologia. 2003;46:1071–81 (level 1). - PubMed
    1. Kelley GA, Kelley KS: Effects of aerobic exercise on lipids and lipoproteins in adults with type 2 diabetes: a meta-analysis of randomized-controlled trials. Public Health. 2007;121:643–55 (level 1). - PMC - PubMed

5 Treatment with glucose-lowering agents (excluding insulin)

    1. United Kingdom Prospective Diabetes Study (UKPDS) 13. Relative efficacy of randomly allocated diet, sulphonylurea, insulin, or metformin in patients with newly diagnosed non-insulin dependent diabetes followed for three years. BMJ. 1995;310:83–8 (level 1+). - PMC - PubMed
    1. Stratton IM, Adler AI, Neil HA, et al. Association of glycaemia with macrovascular and microvascular complications of type 2 diabetes (UKPDS 35): prospective observational study. BMJ. 2000;321:405–12 (level 2). - PMC - PubMed
    1. UK Prospective Diabetes Study (UKPDS) Group. Intensive blood-glucose control with sulphonylureas or insulin compared with conventional treatment and risk of complications in patients with type 2 diabetes (UKPDS 33). Lancet. 1998;352:837–53 (level 1+). - PubMed
    1. Inzucchi SE, Bergenstal RM, Buse JB, et al. Management of hyperglycemia in type 2 diabetes, 2015: a patient-centered approach: update to a position statement of the American Diabetes Association and the European Association for the Study of Diabetes. Diabetes Care. 2015;381:140–9. - PubMed
    1. UK Prospective Diabetes Study (UKPDS) Group. Effect of intensive blood-glucose control with metformin on complications in overweight patients with type 2 diabetes (UKPDS 34). Lancet. 1998;352:854–65 (level 1+). - PubMed

6 Insulin therapy

    1. The Diabetes Control and Complications Trial (DCCT) Research Group. Early worsening of diabetic retinopathy in the diabetes control and complications trial. Arch Ophthalmol. 1998;116:874–86 (level 1+). - PubMed
    1. Takahashi Y, Takayama S, Ito T, et al. Clinical features of eighty-six diabetic patients with post-treatment painful neuropathy. J Jpn Diabetes Soc. 1998;41:165–70 (in Japanese, level 4).
    1. United Kingdom Prospective Diabetes Study (UKPDS) Group. United Kingdom Prospective Diabetes Study 24: a 6-year, randomized, controlled trial comparing sulfonylurea, insulin, and metformin therapy in patients with newly diagnosed type 2 diabetes that could not be controlled with diet therapy. Ann Intern Med. 1998;128:165–75 (level 1). - PubMed
    1. The Diabetes Control and Complications Trial (DCCT) Research Group. The effect of intensive treatment of diabetes on the development and progression of long-term complications in insulin-dependent diabetes mellitus. N Engl J Med. 1993;329:977–86 (level 1+). - PubMed
    1. The Diabetes Control and Complications Trial (DCCT) Research Group. The effect of intensive diabetes therapy on measures of autonomic nervous system function in the Diabetes Control and Complications Trial (DCCT). Diabetologia. 1998;41:416–23 (level 1+). - PMC - PubMed

7 Diabetes Self-management education and support and education for the self-management of diabetes

    1. Tshiananga JK, Kocher S, Weber C, et al. The effect of nurse-led diabetes self-management education on glycosylated hemoglobin and cardiovascular risk factors: a meta-analysis. Diabetes Educ. 2012;38:108–23 (level 1). - PubMed
    1. Minet L, Moller S, Vach W, et al. Mediating the effect of self-care management intervention in type 2 diabetes: a meta-analysis of 47 randomised controlled trials. Patient Educ Couns. 2010;80:29–41 (level 1). - PubMed
    1. Deakin T, McShane CE, Cade JE. Group based training for self-management strategies in people with type 2 diabetes mellitus. Cochrane Database Syst Rev. 2005:CD003417 (level 1). - PubMed
    1. Duke SA, Colagiuri S, Colagiuri R. Individual patient education for people with type 2 diabetes mellitus. Cochrane Database Syst Rev. 2009:CD005268 (level 1). - PMC - PubMed
    1. The Diabetes Control and Complications Trial Research Group. The effect of intensive treatment of diabetes on the development and progression of long-term complications in insulin-dependent diabetes mellitus. N Engl J Med. 1993;329:977–86 (level 1). - PubMed

8 Diabetic retinopathy

    1. Klein R, Klein BE, Moss SE, et al. The Wisconsin Epidemiologic Study of Diabetic Retinopathy: IX. Fouryear incidence and progression of diabetic retinopathy when age at diagnosis is less than 30 years. Arch Ophthalmol. 1989;107:237–43 (level 2). - PubMed
    1. Klein R, Klein BE, Moss SE, et al. The Wisconsin Epidemiologic Study of Diabetic Retinopathy: X. Fouryear incidence and progression of diabetic retinopathy when age at diagnosis is 30 years or more. Arch Ophthalmol. 1989;107:244–9 (level 2). - PubMed
    1. Younis N, Broadbent DM, Vora JP, et al. Incidence of sight-threatening retinopathy in patients with type 2 diabetes in the Liverpool Diabetic Eye Study: a cohort study. Lancet. 2003;361:195–200 (level 2). - PubMed
    1. Misra A, Bachmann MO, Greenwood RH, et al. Trends in yield and effects of screening intervals during 17 years of a large UK community-based diabetic retinopathy screening programme. Diabet Med. 2009;26:1040–7 (level 2). - PubMed
    1. Diabetes Control and Complications Trial Research Group. The effect of intensive treatment of diabetes on the development and progression of long-term complications in insulin-dependent diabetes mellitus. N Engl J Med. 1993;329:977–86 (level 1+). - PubMed

9 Diabetic nephropathy

    1. Katayama S, Moriya T, Tanaka S, et al. Low transition rate from normo- and low microalbuminuria to proteinuria in Japanese type 2 diabetic individuals: the Japan Diabetes Complications Study (JDCS). Diabetologia. 2011;54:1025–31 (level 2). - PMC - PubMed
    1. Ohkubo Y, Kishikawa H, Araki E, et al. Intensive insulin therapy prevents the progression of diabetic microvascular complications in Japanese patients with non-insulin-dependent diabetes mellitus: a randomized prospective 6-year study. Diabetes Res Clin Pract. 1995;28:103–17 (level 1). - PubMed
    1. Patel A, MacMahon S, Chalmers J, et al. Intensive blood glucose control and vascular outcomes in patients with type 2 diabetes. N Engl J Med. 2008;358:2560–72 (level 1+). - PubMed
    1. Shurraw S, Hemmelgarn B, Lin M, et al. Association between glycemic control and adverse outcomes in people with diabetes mellitus and chronic kidney disease: a population-based cohort study. Arch Intern Med. 2011;171:1920–7 (level 3). - PubMed
    1. UK Prospective Diabetes Study Group. Tight blood pressure control and risk of macrovascular and microvascular complications in type 2 diabetes: UKPDS 38. BMJ. 1998;317:703–13 (level 1+). - PMC - PubMed

10 Diabetic neuropathy

    1. Hotta N, Toyoda R, et al. Diabetic neuropathy. Kanehara, Tokyo ;1996. p. 145–54 (in Japanese).
    1. Boulton AJ, Vinik AI, Arezzo JC, et al. Diabetic neuropathies: a statement by the American Diabetes Association. Diabetes Care. 2005;28:956–62. - PubMed
    1. Tesfaye S, Chaturvedi N, Eaton SE, et al. Vascular risk factors and diabetic neuropathy. N Engl J Med 2005;352:341–50 (level 2). - PubMed
    1. The Diabetes Control and Complications Trial (DCCT) Research Group. The effect of intensive treatment of diabetes on the development and progression of long-term complications in insulin-dependent diabetes mellitus. N Engl J Med. 1993;329:977–86 (level 1+). - PubMed
    1. Ohkubo Y, Kishikawa H, Araki E, et al. Intensive insulin therapy prevents the progression of diabetic microvascular complications in Japanese patients with non-insulin-dependent diabetes mellitus: a randomized prospective 6-year study. Diabetes Res Clin Pract. 1995;28:103–17 (level 1). - PubMed

11 Diabetic foot

    1. International Working Group on the Diabetic Foot (IWGDF). Guidance 2015. http://iwgdf.org/guidelines-2/.
    1. Frykberg RG, Zgonis T, Armstrong DG, et al. Diabetic foot disorders: a clinical practice guideline (2006 revision). J Foot Ankle Surg. 2006;45:S1–66. - PubMed
    1. Resnick HE, Carter EA, Lindsay R, et al. Relation of lower-extremity amputation to all-cause and cardiovascular disease mortality in American Indians: the Strong Heart Study. Diabetes Care. 2004;27:1286–93 (level 2). - PubMed
    1. Krishinan S, Nash F, Baker N, et al. Reduction in diabetic amputations over 11 years in a defined UK population benefits of multidisciplinary team work and continuous prospective audit. Diabetes Care. 2008;31:99–101 (level 2). - PubMed
    1. Malone JM, Snyder M, Anderson G, et al. Prevention of amputation by diabetic education. Am J Surg. 1989;1508:520–4 (level 1). - PubMed

12 Diabetic macroangiopathy

    1. Gaede P, Vedel P, Larsen N, et al. Multifactorial intervention and cardiovascular disease in patients with type 2 diabetes. N Engl J Med. 2003;348:383–93 (level 1). - PubMed
    1. Miller ME, Williamson JD, Gerstein HC, et al, ACCORD Investigators. Effects of randomization to intensive glucose control on adverse events, cardiovascular disease, and mortality in older versus younger adults in the ACCORD Trial. Diabetes Care. 2014;37:634–43 (level 3). - PMC - PubMed
    1. Wing RR, Look AHEAD Research Group. Long-term effects of a lifestyle intervention on weight and cardiovascular risk factors in individuals with type 2 diabetes mellitus: four-year results of the Look AHEAD trial. Arch Intern Med. 2010;170:1566–75 (level 1). - PMC - PubMed
    1. Stratton IM, Adler AI, Neil HA, et al. Association of glycaemia with macrovascular and microvascular complications of type 2 diabetes (UKPDS 35): prospective observational study. BMJ. 2000;321:405–12 (level 2). - PMC - PubMed
    1. Adler AI, Stratton IM, Neil HA, et al. Association of systolic blood pressure with macrovascular and microvascular complications of type 2 diabetes (UKPDS 36): prospective observational study. BMJ. 2000;321:412–9 (level 2). - PMC - PubMed

13 Diabetes and periodontitis

    1. Takahashi K, Nishimura F, Kurihara M, et al. Subgingival microflora and antibody responses against periodontal bacteria of young Japanese patients with type 1 diabetes mellitus. J Int Acad Periodontol. 2001;3:104–11 (level 3). - PubMed
    1. Morita I, Inagaki K, Nakamura F, et al. Relationship between periodontal status and levels of glycated hemoglobin. J Dent Res. 2012;91:161–6 (level 3). - PubMed
    1. Borgnakke WS, Ylöstalo PV, Taylor GW, et al. Effect of periodontal disease on diabetes: systematic review of epidemiologic observational evidence. J Periodontol. 2013;84:S135–52 (level 2). - PubMed
    1. Katagiri S, Nitta H, Nagasawa T, et al. Effect of glycemic control on periodontitis in type 2 diabetic patients with periodontal disease. J Diabetes Investig. 2013;4:320–5 (level 3). - PMC - PubMed
    1. Demmer RT, Jacobs DR, Desvarieux M. Periodontal disease and incident type 2 diabetes: results from the First National Health and Nutrition Examination Survey and its epidemiologic follow-up study. Diabetes Care. 2008;31:1373–9 (level 2). - PMC - PubMed

14 Diabetes complicated by obesity (including metabolic syndrome)

    1. Matsuzawa Y, Sakata T, Ikeda Y, et al: Guidelines for the management of obesity disease 2006. 2006:1–91 (in Japanese).
    1. Saito Y, Shirai A, Nakamura M, et al: Diagnostic criteria for obesity disease 2011. 2011:1–78 (in Japanese).
    1. Van Gaal L, Scheen A. Weight management in type 2 diabetes: current and emerging approaches to treatment. Diabetes Care. 2015;38:1161–72. - PubMed
    1. Madigan CD, Aveyard P, Jolly K, et al. Regular self-weighing to promote weight maintenance after intentional weight loss: a quasi-randomized controlled trail. J Public Health (Oxf). 2014;36:259–67 (level 2). - PubMed
    1. Ribaric G, Buchwald JN, McGlennon TW. Diabetes and weight in comparative studies of bariatric surgery vs conventional medical therapy: a systematic review and meta-analysis. Obes Surg. 2014;24:437–55 (level 2). - PMC - PubMed

15 Hypertension associated with diabetes

    1. Kengne AP, Patel A, Barzi F, et al, Asia Pacific Cohort Studies Collaboration. Systolic blood pressure, diabetes and the risk of cardiovascular diseases in the Asia-Pacific region. J Hypertens. 2007;25:205–13 (level 2). - PubMed
    1. Patel A, MacMahon S, Chalmers J, et al. Effects of a fixed combination of perindopril and indapamide on macrovascular and microvascular outcomes in patients with type 2 diabetes mellitus (the ADVANCE trial): a randomised controlled trial. Lancet. 2007;370:829–40 (level 1+). - PubMed
    1. American Diabetes Association. Microvascular complications and foot care: standards of medical care in diabetes 2016. Diabetes Care. 2016;39:S72–80. - PubMed
    1. American Diabetes Association. Standards of medical care in diabetes 2010. Diabetes Care. 2010;30:S4–10.
    1. Bangalore S, Kumar S, Lobach I, et al. Blood pressure targets in subjects with type 2 diabetes mellitus/impaired fasting glucose: observations from traditional and bayesian random-effects meta analyses of randomized trials. Circulation. 2011;123:2799–810 (level 1). - PubMed

16 Dyslipidemia associated with diabetes

    1. Wang Y, Lammi-Keefe CJ, Hou L, et al. Impact of low-density lipoprotein cholesterol on cardiovascular outcomes in people with type 2 diabetes: a meta-analysis of prospective cohort studies. Diabetes Res Clin Pract. 2013;102:65–75 (level 2). - PMC - PubMed
    1. Turner RC, Millns H, Neil HA, et al. Risk factors for coronary artery disease in non-insulin dependent diabetes mellitus: United Kingdom Prospective Diabetes Study (UKPDS 23). BMJ. 1998;316:823–8 (level 3). - PMC - PubMed
    1. Sacks FM, Hermans MP, Fioretto P, et al. Association between plasma triglycerides and high-density lipoprotein cholesterol and microvascular kidney disease and retinopathy in type 2 diabetes mellitus: a global case-control study in 13 countries. Circulation. 2014;129:999–1008 (level 3). - PubMed
    1. Toth PP, Simko RJ, Palli SR, et al. The impact of serum lipids on risk for microangiopathy in patients with type 2 diabetes mellitus. Cardiovasc Diabetol. 2012;11:109–9 (level 3). - PMC - PubMed
    1. Heilbronn LK, Noakes M, Clifton PM. Effect of energy restriction, weight loss, and diet composition on plasma lipids and glucose in patients with type 2 diabetes. Diabetes Care. 1999;22:889–95 (level 1). - PubMed

17 Impaired glucose metabolism in pregnancy

    1. Ray JG, O’Brien TE, Chan WS. Preconception care and the risk of congenital anomalies in the offspring of women with diabetes mellitus: a meta-analysis. QJM. 2001;94:435–44 (level 2). - PubMed
    1. Falavigna M, Schmidt MI, Trujillo J, et al. Effectiveness of gestational diabetes treatment: a systematic review with quality of evidence assessment. Diabetes Res Clin Pract. 2012;98:396–405 (level 2). - PubMed
    1. Ekbom P, Damm P, Feldt-Rasmussen B, et al. Pregnancy outcome in type 1 diabetic women with microalbuminuria. Diabetes Care. 2001;24:1739–44 (level 2). - PubMed
    1. Metzger BE, Lowe LP, Dyer AR, HAPO Study Cooperative Research Group, et al. Hyperglycemia and adverse pregnancy outcomes. N Engl J Med. 2008;358:1991–2002 (level 2). - PubMed
    1. Chew EY, Mills JL, Metzger BE, et al. Metabolic control and progression of retinopathy. The Diabetes in Early Pregnancy Study. National Institute of Child Health and Human Development Diabetes in Early Pregnancy Study. Diabetes Care. 1995;18:631–7 (level 2). - PubMed

18 Pediatric/adolescent diabetes

    1. ISPAD Clinical Practice Consensus Guidelines for Pediatric and Adolescent Diabetes 2014. Nankodo, Tokyo. 2015.
    1. Ascerini C, Craig ME, de Beaufort C, et al. ISPAD clinical practice consensus guidelines 2014 compendium. Introduction. Pediatr Diabetes. 2014;15(Suppl 20):1–3. - PubMed
    1. Craig ME, Jefferies C, Dabelea D, et al. ISPAD clinical practice consensus guidelines 2014 compendium. Definition, epidemiology, and classification of diabetes in children and adlescents. Pediatr Diabetes 2014;15(Suppl 20):4–17. - PubMed
    1. Ly TT, Maahs DM, Rewers A, et al. ISPAD clinical practice consensus guidelines 2014 compendium. Assessment and management of hypoglycemia in children and adolescents with diabetes. Pediatr Diabetes. 2014;15(Suppl 20):180–92. - PubMed
    1. Zeitler P, Fu J, Tandon N, et al. ISPAD clinical practice consensus guidelines 2014 compendium. Type 2 diabetes in the child and adolescent. Pediatr Diabetes. 2014;15(Suppl 20):26–46. - PubMed

19 Diabetes in older adults

    1. Ito H. Study to establish a treatment guideline for the elderly patients with diabetes mellitus. In: Research reports of the longevity sciences volume 3. The Ministry of Health and Welfare of Japan. 1996. p. 309–11 (in Japanese, level 3).
    1. Kuusisto J, Mykkänen L, Pyörälä K, et al. NIDDM and its metabolic control predict coronary heart disease in elderly subjects. Diabetes 1994;43:960–7 (level 2). - PubMed
    1. Cukierman T, Gerstein HC, Williamson JD. Cognitive decline and dementia in diabetes-systematic overview of prospective observational studies. Diabetologia. 2005;48:2460–9 (level 2). - PubMed
    1. Whitmer RA, Karter AJ, Yaffe K, et al. Hypoglycemic episodes and risk of dementia in older patients with type 2 diabetes mellitus. JAMA. 2009;301:1565–72 (level 2). - PMC - PubMed
    1. Kalyani RR, Tian J, Xue QL, et al. Hyperglycemia and incidence of frailty and lower extremity mobility limitations in older women. J Am Geriatr Soc. 2012;60:1701–7 (level 2). - PMC - PubMed

20 Acute metabolic complications of diabetes, sick days, and infectious diseases

    1. Nyenwe EA, Kitabchi AE: Evidence-based management of hyperglycemic emergencies in diabetes mellitus. Diabetes Res Clin Pract. 2011;94:340–51. - PubMed
    1. Kitabchi AE, Umpierrez GE, Miles JM, et al. Hyperglycemic crises in adult patients with diabetes. Diabetes Care. 2009;32:1335–43. - PMC - PubMed
    1. Wolfsdorf J, Glaser N, Sperling MA. Diabetic ketoacidosis in infants, children, and adolescents. Diabetes Care. 2006;29:1150–9. - PubMed
    1. Jeffrey A, Kraut MD, Nicolaos E, et al. Lactic acidosis. N Engl J Med. 2014;371:2309–19. - PubMed
    1. Eppenga WL, Lalmohamed A, Geerts AF, et al. Risk of lactic acidosis or elevated lactate concentrations in metformin users with renal impairment: a population-based cohort study. Diabetes Care. 2014;37:2218–24 (level 2). - PubMed

21 Prevention of type 2 diabetes

    1. Heianza Y, Arase Y, Hsieh SD, et al. Development of a new scoring system for predicting the 5 year incidence of type 2 diabetes in Japan: the Toranomon Hospital Health Management Center Study 6 (TOPICS 6). Diabetologia 2012;55:3213–23 (level 3). - PubMed
    1. Sasai H, Sairenchi T, Irie F, et al. Development of a diabetes risk prediction sheet for specific health guidance. Nippon Koshu Eisei Zasshi. 2008;55:287–94 (in Japanese, level 3). - PubMed
    1. Doi Y, Ninomiya T, Hata J et al. Two risk score models for predicting incident type 2 diabetes in Japan. Diabet Med. 2012;29:107–114 (level 2). - PubMed
    1. Kodama S, Horikawa C, Fujihara K, et al. Comparisons of the strength of associations with future type 2 diabetes risk among anthropometric obesity indicators, including waist-to-height ratio: a meta-analysis. Am J Epidemiol. 2012;176:959–69 (level 2). - PubMed
    1. Kodama S, Horikawa C, Yoshizawa S, et al. Body weight change and type 2 diabetes. Epidemiology. 2013;24:778–9 (level 2). - PubMed

Appendix

    1. Bonovas S, Filioussi K, Tsantes A. Diabetes mellitus and risk of prostate cancer: a meta-analysis. Diabetologia. 2004;47:1071–1078. - PubMed
    1. Friberg E, Orsini N, Mantzoros CS et al. Diabetes mellitus and risk of endometrial cancer: a meta-analysis. Diabetologia. 2007;50:1365–1374. - PubMed
    1. Huxley R, Ansary-Moghaddam A, de Gonzalez AB et al. Type-II diabetes and pancreatic cancer: a meta-analysis of 36 studies. Br J Cancer. 2005;92:2076–2083. - PMC - PubMed
    1. Kasper JS, Giovannucci E. A meta-analysis of diabetes mellitus and the risk of prostate cancer. Cancer Epidemiol Biomarkers Prev. 2006;15:2056–2062. - PubMed
    1. Larsson SC, Orsini N, Wolk A. Diabetes mellitus and risk of colorectal cancer: a meta-analysis. J Natl Cancer Inst. 2005;97:1679–1687. - PubMed

LinkOut - more resources