The effect and determinants of an educational program on glycemic control in a diabetic population from Japan.

• Project/Area Number: 15K01643
• Research Category: Grant-in-Aid for Scientific Research (C)
• Allocation Type: Multi-year Fund
• Section: 一般
• Research Field: Applied health science
• Research Institution: Hirosaki University
• Principal Investigator: MURAKAMI HIROSHI 弘前大学, 医学部附属病院, 講師 (20344608)
• Co-Investigator(Kenkyū-buntansha): 大門 眞 弘前大学, 医学研究科, 教授 (20241698)
• Project Period (FY): 2015-04-01 – 2019-03-31
• Project Status: Completed (Fiscal Year 2018)
• Budget Amount: ¥4,160,000 (Direct Cost: ¥3,200,000、Indirect Cost: ¥960,000); Fiscal Year 2017: ¥780,000 (Direct Cost: ¥600,000、Indirect Cost: ¥180,000); Fiscal Year 2016: ¥1,430,000 (Direct Cost: ¥1,100,000、Indirect Cost: ¥330,000); Fiscal Year 2015: ¥1,950,000 (Direct Cost: ¥1,500,000、Indirect Cost: ¥450,000)
• Keywords: 糖尿病 / 患者教育 / 2型糖尿病 / 心理査定 / 糖尿病教育 / 性格

Outline of Final Research Achievements

Diabetes Self Management Education (DSME) is a well-established therapy of diabetes management. Despite the benefits, the effect of DSME on glycemic control vary considerably in patients. There are few studies reporting what clinical backgrounds will affect glycemic control after DSME. The aim of the study was to assess the effectiveness and determinants of DSME based on a prospective cohort study. We implemented a 2 week-hospitalization educational program on type 2 diabetics to follow-up them for 1 year. Educational hospitalization for diabetes significantly improved glycemic control at 12 months of discharge. Better therapeutic effects were observed in cases with a shorter duration of the disease or in cases with better body weight control. Our results suggest that early intervention with educational hospitalization is therapeutically useful for the treatment of diabetics and that body weight control is a key to the persistence of the educational program effects.

Academic Significance and Societal Importance of the Research Achievements

糖尿病は生活習慣の改善を必要とする疾患である。生活習慣には各国間で相違があり、諸外国の糖尿病教育プログラムを本邦でそのまま導入することは困難であるうえに、その効果も不明である。本研究では、わが国において指針のない糖尿病教育プログラムの構築を目指し、教育効果に影響を及ぼす因子について性格・心理的側面を含め子細に検討を行った。個々の症例が持つ臨床背景に合わせ、オーダーメイドの教育プログラムを作成することは、わが国独自の糖尿病治療として有用と思われる。また患者教育を要する他疾患（気管支喘息、心疾患、膠原病、腎疾患等）への応用も期待される。

Research Products

• [Journal Article] Cutaneous microangiopathy in patients with type2 diabetes: Impaired vascular endothelial growth factor expression and its correlation with neuropathy, retinopathy and nephropathy (2019)
  • Author(s): Sugimoto Kazuhiro、Murakami Hiroshi、Deguchi Takahisa、Arimura Aiko、Daimon Makoto、Suzuki Susumu、Shimbo Takuro、Yagihashi Soroku
  • Journal Title: Journal of Diabetes Investigation Volume: 10 Issue: 5 Pages: 13020-13020
  • DOI: 10.1111/jdi.13020
  • Peer Reviewed / Open Access / Int'l Joint Research
• [Journal Article] Lower serum calcium levels are a risk factor for a decrease in eGFR in a general non-chronic kidney disease population (2018)
  • Author(s): Mizushiri Satoru、Daimon Makoto、Murakami Hiroshi、Kamba Aya、Osonoi Sho、Yamaichi Masato、Matsumura Koki、Tanabe Jutaro、Matsuhashi Yuki、Yanagimachi Miyuki、Tokuda Itoyo、Kurauchi Shizuka、Sawada Kaori
  • Journal Title: Scientific Reports Volume: 8 Issue: 1 Pages: 14213-14213
  • DOI: 10.1038/s41598-018-32627-4
  • Peer Reviewed / Open Access
• [Journal Article] Association between insomnia and personality traits among Japanese patients with type 2 diabetes mellitus (2018)
  • Author(s): Otaka Hideyuki、Murakami Hiroshi、Nakayama Hirofumi、Murabayashi Masaya、Mizushiri Satoru、Matsumura Koki、Tanabe Jutaro、Matsuhashi Yuki、Yanagimachi Miyuki、Yoshida Kazutaka、Sugawara Norio、Yasui-Furukori Norio、Daimon Makoto
  • Journal Title: Journal of Diabetes Investigation Volume: 10 Issue: 2 Pages: 484-490
  • DOI: 10.1111/jdi.12927
  • Peer Reviewed / Open Access
• [Journal Article] Association between insomnia and coping style in Japanese patients with type 2 diabetes mellitus (2018)
  • Author(s): Yoshida Kazutaka、Otaka Hideyuki、Murakami Hiroshi、Nakayama Hirofumi、Murabayashi Masaya、Mizushiri Satoru、Matsumura Koki、Tanabe Jutaro、Matsuhashi Yuki、Yanagimachi Miyuki、Sugawara Norio、Nakamura Kazuhiko、Daimon Makoto、Yasui-Furukori Norio
  • Journal Title: Neuropsychiatric Disease and Treatment Volume: Volume 14 Pages: 1803-1809
  • DOI: 10.2147/ndt.s168934
  • Peer Reviewed / Open Access
• [Journal Article] Dominance of the hypothalamus-pituitary-adrenal axis over the renin-angiotensin-aldosterone system is a risk factor for decreased insulin secretion. (2017)
  • Author(s): Daimon M, Kamba A, Murakami H, Mizushiri S, Osonoi S, Matsuki K, Sato E, Tanabe J, Takayasu S, Matsuhashi Y, Yanagimachi M, Terui K, Kageyama K, Tokuda I, Kurauchi S, Nakaji S.
  • Journal Title: Sci Rep. Volume: 12 Issue: 1 Pages: 11360-11360
  • DOI: 10.1038/s41598-017-10815-y
  • NAID: 120006576915
  • Peer Reviewed / Open Access
• [Journal Article] Association between serum prolactin levels and insulin resistance in non-diabetic men. (2017)
  • Author(s): Daimon M, Kamba A, Murakami H, Mizushiri S, Osonoi S, Yamaichi M, Matsuki K, Sato E, Tanabe J, Takayasu S, Matsuhashi Y, Yanagimachi M, Terui K, Kageyama K, Tokuda I, Takahashi I, Nakaji S.
  • Journal Title: PLoS One. Volume: 12 Issue: 4 Pages: e0175204-e0175204
  • DOI: 10.1371/journal.pone.0175204
  • NAID: 120006576914
  • Peer Reviewed / Open Access
• [Journal Article] Association between Higher Serum Cortisol Levels and Decreased Insulin Secretion in a General Population. (2016)
  • Author(s): Kamba A, Daimon M, Murakami H, Otaka H, Matsuki K, Sato E, Tanabe J, Takayasu S, Matsuhashi Y, Yanagimachi M, Terui K, Kageyama K, Tokuda I, Takahashi I, Nakaji S.
  • Journal Title: PLoS One. Volume: 11 Issue: 11 Pages: e0166077-e0166077
  • DOI: 10.1371/journal.pone.0166077
  • Peer Reviewed / Open Access
• [Journal Article] Clinical Significance of Determining Plasma MicroRNA33b in Type 2 Diabetic Patients with Dyslipidemia. (2016)
  • Author(s): Kimura Y, Tamasawa N, Matsumura K, Murakami H, Yamashita M, Matsuki K, Tanabe J, Murakami H, Matsui J, Daimon M.
  • Journal Title: J Atheroscler Thromb. Volume: 23 Pages: 1276-1285
  • NAID: 130005268249
  • Peer Reviewed
• [Journal Article] The Evaluation of Adrenal Function in Two Cases of Hypocortisolism Accompanied by Liver Cirrhosis (2016)
  • Author(s): Yamashita M, Kageyama K, Murakami H, Sugiyama A, Yanagimachi M, Sato E, Murasawa S, Matsui J, Tamasawa N, Daimon M.
  • Journal Title: Internal Medicine Volume: 55 Issue: 7 Pages: 765-768
  • DOI: 10.2169/internalmedicine.55.5604
  • NAID: 130005141959
  • ISSN: 0918-2918, 1349-7235
  • Peer Reviewed / Open Access / Int'l Joint Research
• [Journal Article] Association Between Pituitary-Adrenal Axis Dominance Over the Renin-Angiotensin-Aldosterone System and Hypertension. (2016)
  • Author(s): Daimon M, Kamba A, Murakami H, Takahashi K, Otaka H, Makita K, Yanagimachi M, Terui K, Kageyama K, Nigawara T, Sawada K, Takahashi I, Nakaji S.
  • Journal Title: J Clin Endocrinol Metab. Volume: 101 Issue: 3 Pages: 889-897
  • DOI: 10.1210/jc.2015-3568
  • Peer Reviewed / Int'l Joint Research
• [Journal Article] Association of Treatment for Hyperlipidemia with Decreased Total Mortality in Japanese Individuals: the Yamagata (Takahata) Study (2015)
  • Author(s): Daimon M, Oizumi T, Kameda W, Matsui J, Murakami H, Ueno Y, Kubota I, Yamashita H, Kayama T, Kato T.
  • Journal Title: Journal of Atherosclerosis and Thrombosis Volume: 22 Issue: 10 Pages: 1030-1039
  • DOI: 10.5551/jat.29181
  • NAID: 130005101338
  • ISSN: 1340-3478, 1880-3873
  • Peer Reviewed / Open Access / Int'l Joint Research
• [Presentation] Adherence And Associated Follow-ups For Diabetic Eye Examinations In Japan (2018)
  • Author(s): Murakami H, Daimon M, Mizushiri S, Otaka H
  • Organizer: AMERIKAN DIABETES ASSOCIATION - 78TH SCIENTIFIC SESSION
• [Presentation] The Postprandial C-peptide To Glucose Ratio Correlated with Beta-cell Function in Japanese Patients with Type2 Diabetes Mellitus (2018)
  • Author(s): Matsuhashi Y, Chikazawa S, Nakayama H, Murabayashi M, Mizushiri S, Osonoi S, Takahashi K, Otaka H, Yanagimachi M, Murakami H, Daimon M
  • Organizer: AMERIKAN DIABETES ASSOCIATION - 78TH SCIENTIFIC SESSIONS
• [Presentation] Nutrient Dependent Association Of Cdk5 Regulatory Associated Protein1-like1 Gene With Insulin Secretion (2018)
  • Author(s): Mizushiri S, Daimon M, Murakami H, Kamba A
  • Organizer: AMERIKAN DIABETES ASSOCIATION - 78TH SCIENTIFIC SESSIONS
• [Presentation] Association Of Urinary Normetanephrine Levels With Increased Insulin Resistance In A General Population (2018)
  • Author(s): Murabayashi M, Daimon M, Murakami H, Kamba A, Mizushiri S
  • Organizer: AMERIKAN DIABETES ASSOCIATION - 78TH SCIENTIFIC SESSIONS
• [Presentation] 糖尿病外来通院患者の眼科受診状況と眼科未受診症例の臨床背景の検討 (2018)
  • Author(s): 村上 宏, 村林 公哉, 中山 弘文, 水尻 諭, 大高 英之, 松村 功貴, 田辺 壽太郎, 松橋 有紀, 柳町 幸, 大門 眞
  • Organizer: 第61回日本糖尿病学会学術総会
• [Presentation] 睡眠障害を持つ2型糖尿病患者の臨床的特徴について (2017)
  • Author(s): 大高英之、村上宏、中山弘文、村林公哉、水尻諭、松村功貴、田辺壽太郎、松橋有紀、柳町幸、大門眞
  • Organizer: 第61回日本糖尿病学会年次学術集会
• [Presentation] 糖尿病外来通院患者の眼科受診状況と眼科未受診症例の臨床背景の検討 (2017)
  • Author(s): 村上宏、村林公哉、中山弘文、水尻諭、大高英之、松村功貴、田辺寿太郎、松橋有紀、柳町幸、大門眞
  • Organizer: 第61回日本糖尿病学会年次学術集会
• [Presentation] Adherence and associated follow-ups for diabetic examinations in Japan. (2017)
  • Author(s): Hiroshi Murakami, Makoto Daimon, Satoru Mizushiri, Hideyuki Otaka.
  • Organizer: 77th Scientific Sessions of American Diabetes Association
  • Int'l Joint Research
• [Presentation] Association with sleep disorders and patients with type 2 diabetes mellitus. (2017)
  • Author(s): Hideyuki Otaka, Hiroshi Murakami, Makoto Daimon
  • Organizer: 77th Scientific Sessions of American Diabetes Association
  • Int'l Joint Research
• [Presentation] Axial length is associated with discordance between the severities of retinopathy and nephropathy in type 2 diabetes. (2016)
  • Author(s): Hiroshi Murakami, Hideyuki Otaka, Aya Kamba, Yuki Kimura, Hiroshi Murakami, Kota Matsuki, Makoto Daimon.
  • Organizer: 3.76th Scientific Sessions of American Diabetes Association
  • Place of Presentation: ニューオリンズ（米国）
  • Year and Date: 2016-06-10
  • Int'l Joint Research
• [Presentation] 2型糖尿病患者における味覚障害の検討 (2016)
  • Author(s): 大高 英之, 神庭 文, 木村 祐輝, 松村 功貴, 村上 洋, 松木 恒太, 松橋 有紀, 柳町 幸, 村上 宏, 大門 眞
  • Organizer: 第59回日本糖尿病学会年次学術集会
  • Place of Presentation: 国立京都国際会館（京都府・京都市）
  • Year and Date: 2016-05-19
• [Presentation] 2型糖尿病患者における潜在性甲状腺機能低下症の頻度と糖尿病合併症との関連について (2016)
  • Author(s): 村上 宏, 大高 英之, 高橋 和久, 神庭 文, 木村 裕輝, 松村 功貴, 村上 洋, 山下 真紀, 松木 恒太, 松橋 有紀, 柳町 幸, 高橋 一平, 中路 重之, 大門 眞
  • Organizer: 第59回日本糖尿病学会年次学術集会
  • Place of Presentation: 国立京都国際会館（京都府・京都市）
  • Year and Date: 2016-05-19