Since advanced microangiopathy in diabetes severely impairs activities of daily living and quality of life and is life-threatening regardless of severity, treatment of diabetes requires appropriate risk management to avoid ALL of those severe complications. A simultaneous assessment of the risk of complications rather than individual assessments is essential to developing optimal treatment strategies. Thus, we examined the association between CSDC and the number of achieved treatment targets. CSDC were defined as follows: vision-threatening retinopathy, initiation of dialysis, amputation of lower extremity, and cardiovascular disease including heart failure. Studied were 86,633 patients with no history of CSDC. Achieved targets as analyzed by multivariate Cox model for treatment were HbA1c <7%, SBP <130, LDL-C <120, and non-smoking. During a median follow up of 4.6 years, 4,542 cases of CSDC (12.9/1,000 person-years) occurred. Risk of CSDC decreased as the number of achieved targets increased. The risk of CSDC was extremely reduced in patients who achieved all targets compared with patients who did not achieve any of the 4 targets (Figure). The risk of CSDC decreased as the number of achieved targets for atherosclerotic risk factors increased, suggesting that multifactorial interventions are necessary to prevent these conditions.
T. Nanako: None. K. Fujihara: None. Y. Yaguchi: None. M.H. Yamada: None. M. Yamamoto: None. M. Kitazawa: None. Y. Matsubayashi: None. T. Yamada: None. S. Kodama: None. H. Sone: Research Support; Novo Nordisk, Astellas Pharma Inc., Kowa Company, Ltd., Kyowa Kirin Co., Ltd., Eisai Inc., Sumitomo Dainippon Pharma Co., Ltd.
