Japan Diabetes Optimal Integrated Treatment study for 3 major risk factors of cardiovascular diseases


Takashi Kadowaki

I would like to thank all the diabetic patients who have visited this website, as well as their families and healthcare professionals, for taking an interest in Japan Diabetes Optimal Integrated Treatment study for 3 major risk factors of cardiovascular diseases, or J-DOIT3.

Japan has become the world's No.1 country for longevity in both men and women, according to the 2006 edition of the World Health Report published by World Health Organization. At the same time, however, we are on the way to the super-aging society at a rate no other country has ever experienced before. Now it is imperative to enable as many people as possible to lead healthy lives even later in life, which is also necessary for keeping the Japanese society ein shapef as a whole. In order to build a bright and vigorous society, as well as to extend people's healthy lifespans, the Ministry of Health, Labour and Welfare of Japan has launched, as a part of the Health Frontier Strategic Plan, large-scale clinical trials aiming at prevention and improvement in treatment of eight diseases including diabetes, from 2005 to 2014. Among them are gJapan Diabetes Outcome Intervention Trial 1 (J-DOIT1): Intervention study to prevent or delay type 2 diabetes mellitus,h gJapan Diabetes Outcome Intervention Trial 2 (J-DOIT2): The large trial to improve the medical care of the family doctors for type 2 diabetes patients and to decrease dropout rate of these patientsh and J-DOIT3, all of which are planned to elucidate how to prevent onset of diabetes as well as its complications.

Why should we struggle against diabetes now? Actually the number of patients suffering from diabetes in Japan has continued to grow in recent years. It was approximately 7.4 million in 2002, and is predicted to reach approximately 14 million in 2020. If left unattended, incidence of microcvaslular complications, including neuropathy, retinopathy and nephropathy, is expected to be elevated. It will surely impair quality of life (QOL) of diabetic patients, due to vision loss (diabetes is the leading cause of acquired blindness), dialysis (diabetes is the leading causative disease of dialysis), and amputation. There is also a concern for increased national disadvantages such as shorter healthy lifespans, rising medical expense and increased economic losses due to short of workforce, caused by macrovascular diseases, including myocardial infarction and stroke. Unfortunately, it has not been established how to prevent these complications effectively, both nationally and internationally.

This trial is, therefore, designed in order to show a new treatment strategy for diabetes treatment in advanced stage. With the goal to reduce its complications by 30% in seven years, J-DOIT3 is carried out at 81 leading facilities in treatment for diabetes throughout Japan, including university hospitals, public hospitals, and private hospitals. Actually approximately 2,500 participants of type 2 diabetes patients were registered and randomly allocated into two groups: the conventional therapy group to undergo the current standardized treatment, and the intensive therapy group to undergo treatment for stricter control targets, with enhanced diet therapy, exercise theapy and medication. They are now making regular visits to facilities and being followed up. For more details of the protocol, see gWhat is J-DOIT3?h

Lastly, I would like to express my heartfelt appreciation again for your cooperation in this trial. We are looking forward to unveiling a new direction in treatment for diabetes on this website after the follow-up period. To break up with complications of diabetes, "Let's DO IT!"

Takashi Kadowaki
Research Leader, J-DOIT3
Professor, Department of Diabetes and Metabolic Diseases,
Graduate School of Medicine, the University of Tokyo

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