Skip to main content
SpringerLink
Log in

Questionnaire surveillance of cardiovascular risk factor awareness in community pharmacy patients with diabetes in an urban area of Japan

  • Original Article
  • Published:
Diabetology International Aims and scope Submit manuscript

Abstract

A questionnaire survey was conducted at local pharmacies in an urban area to investigate awareness and management of cardiovascular risk factors in patients with diabetes. Among respondents, 51, 86, and 94 % stated that they knew their low density lipoprotein (LDL) cholesterol, hemoglobin A1c (HbA1c), and systolic blood pressure levels, respectively. Among patients aware of their risk factor levels, 49 % achieved HbA1c <7 %, 45 % achieved systolic blood pressure <130 mmHg, and 32 % achieved LDL <120 mg/dL. Only 10 % of patients met all three criteria recommended by the current guidelines. When the achievement of less stringent criteria was examined, 79 % of the patients achieved HbA1c <8 %, 75 % achieved systolic blood pressure <140 mmHg, 73 % achieved LDL <140 mg/dL, and 48 % achieved all three criteria. Significantly smaller proportions of patients in the youngest age category (<62 years), and those with the longest disease duration (>15 years) met all three of these less stringent criteria. Awareness of HbA1c was significantly associated with achievement of systolic blood pressure <140 mmHg, independently of age, gender, or duration of diabetes treatment. In conclusion, risk factor management in patients with diabetes is not sufficient according to the current standards. Therefore, effective measures against inadequate control of modifiable risk factors in diabetes especially early in life are recommended.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3
Fig. 4

Similar content being viewed by others

References

  1. International Diabetes Federation. Diabetes Atlas 5th edn 2012 update (http://www.idf.org/sites/default/files/5E_IDFAtlasPoster_2012_EN.pdf).

  2. Barr CC. Retinopathy and nephropathy in patients with type 1 diabetes four years after a trial of intensive therapy, by The Diabetes Control and Complications Trial/Epidemiology of Diabetes Interventions and Complications Research Group. N Engl J Med. 2000;342:381–9.

    Article  Google Scholar 

  3. 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.

    Article  Google Scholar 

  4. Ohkubo Y, Kishikawa H, Araki E, Miyata T, Isami S, Motoyoshi S, Kojima Y, Furuyoshi N, Shichiri M. 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.

    Article  CAS  PubMed  Google Scholar 

  5. Cholesterol Treatment Trialists’ (CTT) Collaborators., Kearney PM, Blackwell L, Collins R, Keech A, Simes J, Peto R, Armitage J, Baigent C. Efficacy of cholesterol-lowering therapy in 18,686 people with diabetes in 14 randomised trials of statins: a meta-analysis. Lancet. 2008;371:117–25.

    Article  Google Scholar 

  6. Chobanian AV, Bakris GL, Black HR, Cushman WC, Green LA, Izzo JL Jr, Jones DW, Materson BJ, Oparil S, Wright JT Jr, Roccella EJ, National Heart, Lung, and Blood Institute Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure; National High Blood Pressure Education Program Coordinating Committee; National Heart, Lung, and Blood Institute Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure; National High Blood Pressure Education Program Coordinating Committee. The Seventh Report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure: the JNC 7 report. JAMA. 2003;289:2560–72.

    Article  CAS  PubMed  Google Scholar 

  7. Gaede P, Lund-Andersen H, Parving HH, Pedersen O. Effect of a multifactorial intervention on mortality in type 2 diabetes. N Engl J Med. 2008;358:580–91.

    Article  CAS  PubMed  Google Scholar 

  8. American Diabetes Association. Standards of medical care in diabetes—2013. Diabetes Care. 2013;36(Suppl 1):S11–66.

    Article  PubMed Central  Google Scholar 

  9. IDF Clinical Guidelines Task Force. Global Guideline for type 2 Diabetes. 2012 (http://www.idf.org/global-guideline-type-2-diabetes-2012).

  10. National Institutes of Health and Centers for Disease Control and Prevention. National Diabetes Education Program. Bethesda, US. Department of Health and Human Services, 2010.

  11. Casagrande SS, Burrows NR, Geiss LS, Bainbridge K, Fradkin JE, Cowie CC. Diabetes knowledge and its relationship with achieving treatment recommendations in a national sample of people with type 2 diabetes. Diabetes Care. 2012;35:1556–65.

    Article  Google Scholar 

  12. Kashiwagi A, Kasuga M, Araki E, Oka Y, Hanafusa T, Ito H, Tominaga M, Oikawa S, Noda M, Kawamura T, Sanke T, Namba M, Hashiramoto M, Sasahara T, Nishio Y, Kuwa K, Ueki K, Takei I, Umemoto M, Murakami M, Yamakado M, Yatomi Y, Ohashi H, Committee on the Standardization of Diabetes Mellitus-Related Laboratory Testing of Japan Diabetes Society. International clinical harmonization of glycated hemoglobin in Japan: from Japan Diabetes Society to National Glycohemoglobin Standardization Program values. Diabetol Int. 2012;3(1):8–10.

    Article  Google Scholar 

  13. Japan Diabetes Society. Treatment Guide for Diabetes 2012–2013. (http://www.jds.or.jp/common/fckeditor/editor/filemanager/connectors/php/transfer.php?file=/uid000025_54726561746D656E745F47756964655F666F725F44696162657465735F323031322D323031332E706466).

  14. Ogihara T, Kikuchi K, Matsuoka H, Fujita T, Higaki J, Horiuchi M, Imai Y, Imaizumi T, Ito S, Iwao H, Kario K, Kawano Y, Kim-Mitsuyama S, Kimura G, Matsubara H, Matsuura H, Naruse M, Saito I, Shimada K, Shimamoto K, Suzuki H, Takishita S, Tanahashi N, Tsuchihashi T, Uchiyama M, Ueda S, Ueshima H, Umemura S, Ishimitsu T, Rakugi H, Japanese Society of Hypertension Committee. The Japanese Society of Hypertension Guidelines for the Management of Hypertension (JSH 2009). Hypertens Res. 2009;32(1):3–107.

    CAS  PubMed  Google Scholar 

  15. Teramoto T, Sasaki J, Ishibashi S, Birou S, Daida H, Dohi S, Egusa G, Hiro T, Hirobe K, Iida M, Kihara S, Kinoshita M, Maruyama C, Ohta T, Okamura T, Yamashita S, Yokode M, Yokote K, Japan Atherosclerosis Society. Executive summary of the Japan Atherosclerosis Society (JAS) guidelines for the diagnosis and prevention of atherosclerotic cardiovascular diseases in Japan -2012 version. J Atheroscler Thromb. 2013;20(6):517–23.

    Article  PubMed  Google Scholar 

  16. Stark CS, Fradkin JE, Saydah SH, Rust KF, Cowie CC. The prevalence of meeting A1C, blood pressure, and LDL criteria among people with diabetes, 1988–2010. Diabetes Care. 2013;36:2271–9.

    Article  Google Scholar 

  17. Iwao T, Sakai K, Ando E. Seasonal fluctuations of glycated hemoglobin levels in Japanese diabetic patients: effect of diet and physical activity. Diabetol Int. 2013;4:173–8.

    Article  Google Scholar 

  18. Kloner RA, Poole WK, Perritt RL. When throughout the year is coronary death most likely to occur? A 12-year population-based analysis of more than 220 000 cases. Circulation. 1999;100:1630–4.

    Article  CAS  PubMed  Google Scholar 

  19. Kelly-Hayes M, Wolf PA, Kase CS, Brand FN, McGuirk JM, D’Agostino RB. Temporal patterns of stroke onset. The Framingham Study. Stroke. 1995;26:1343–7.

    Article  CAS  PubMed  Google Scholar 

Download references

Acknowledgments

We would like to express our sincere gratitude for the survey participants; the members of the pharmacist associations of Suita, Toyonaka, Mino, and Ikeda Cities, who collected the questionnaires; and the members of the review meeting for the Regional Diabetes Clinical Pathway in the Toyono Medical District. The study was partly supported by a grant for Cardiovascular Research and Development (24-4-1) from the National Cerebral and Cardiovascular Center.

Conflict of interest

The authors declare no conflicts of interest.

Author information

Authors and Affiliations

  1. Department of Endocrinology and Metabolism, National Cerebral and Cardiovascular Center, 5-7-1 Fujishiro-dai, Suita City, Osaka, 565-8565, Japan

    Ichiro Kishimoto, Hisashi Makino, Yoko Ohata, Tamiko Tamanaha & Mayu Tochiya

  2. Toyono Division of Japan Pharmaceutical Association, Osaka, Japan

    Yasuhiro Ashida, Yoko Omori, Hirotoshi Nishi, Yasuko Hagiwara & Toshiaki Fujimoto

  3. Ikeda Public Health Center of Osaka Prefecture, Ikeda, Japan

    Masayo Yamamoto, Keiko Iinuma, Kazue Maeda & Masaya Miyazono

Authors
  1. Ichiro Kishimoto
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Yasuhiro Ashida
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Yoko Omori
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Hirotoshi Nishi
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Yasuko Hagiwara
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Toshiaki Fujimoto
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Hisashi Makino
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. Yoko Ohata
    View author publications

    You can also search for this author in PubMed Google Scholar

  9. Tamiko Tamanaha
    View author publications

    You can also search for this author in PubMed Google Scholar

  10. Mayu Tochiya
    View author publications

    You can also search for this author in PubMed Google Scholar

  11. Masayo Yamamoto
    View author publications

    You can also search for this author in PubMed Google Scholar

  12. Keiko Iinuma
    View author publications

    You can also search for this author in PubMed Google Scholar

  13. Kazue Maeda
    View author publications

    You can also search for this author in PubMed Google Scholar

  14. Masaya Miyazono
    View author publications

    You can also search for this author in PubMed Google Scholar

Consortia

Review Meeting for Regional Diabetes Clinical Pathway in Toyono Medical District

Corresponding author

Correspondence to Ichiro Kishimoto.

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Kishimoto, I., Ashida, Y., Omori, Y. et al. Questionnaire surveillance of cardiovascular risk factor awareness in community pharmacy patients with diabetes in an urban area of Japan. Diabetol Int 6, 117–124 (2015). https://doi.org/10.1007/s13340-014-0183-x

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s13340-014-0183-x

Keywords

Search

Navigation