{ "abstract": "Objectives To describe the prevalence, coexistence patterns and associated clinical factors of diabetic microvascular complications—neuropathy (N), retinopathy (R) and nephropathy (K)—in a large Japanese cohort with type 2 diabetes.Design Cross-sectional analysis of baseline data from a multicentre, prospective cohort study (Japan Diabetes Complication and its Prevention prospective study (JDCP)).Setting Diabetes clinics in Japan, with baseline data collected between June 2007 and November 2009.Participants A total of 4585 adults with type 2 diabetes enrolled in the JDCP study.Outcome measures The prevalence of individual and coexisting microvascular complications, stratified by diabetes duration (≤5, 6–9, 10–15 and ≥16 years) and clinical characteristics associated with multiple microvascular complications.Results Participants had a mean age of 61.4 years, a mean diabetes duration of 10.7 years, a mean body mass index (BMI) of 24.5 kg/m², a mean haemoglobin A1C (HbA1c) of 7.4% and a mean estimated glomerular filtration rate of 77.5 mL/min/1.73 m². The prevalence of microvascular complications was 36.4% for neuropathy, 27.7% for retinopathy and 30.5% for nephropathy. Coexisting complications were observed in 25.9% of participants, including all three complications in 6.8%. The prevalence of nephropathy and neuropathy increased markedly among individuals with ≥16 years of diabetes duration, whereas retinopathy increased progressively across all duration categories (p<0.001 for trends). Isolated retinopathy increased with longer diabetes duration, whereas isolated nephropathy was more common in those with ≤5 years of diabetes duration (both p<0.001). Participants with all three complications had a higher prevalence of hypertension and a higher proportion receiving insulin therapy as well as longer diabetes duration, HbA1c levels and systolic blood pressure, compared with those with two complications (all p<0.05). In multivariable logistic regression analysis, age (per 10-year increase; OR 1.29, 95% CI 1.169 to 1.433, p<0.001), diabetes duration (per 5 year-increase; OR 1.24, 95% CI 1.189 to 1.302, p<0.001), HbA1c (per 1% increase; OR 1.19, 95% CI 1.121 to 1.251, p<0.001), BMI (per 5 kg/m² increase; OR 1.28, 95% CI 1.168 to 1.412, p<0.001), hypertension (OR 1.54, 95% CI 1.324 to 1.782, p<0.001) and insulin therapy (OR 1.87, 95% CI 1.592 to 2.190, p<0.001) were independently associated with the presence of multiple microvascular complications.Conclusions Microvascular complications frequently coexist in type 2 diabetes, with nephropathy commonly overlapping with other complications, while a distinct subgroup with neuropathy and retinopathy without nephropathy increases with longer diabetes duration. Clinical factors reflecting disease severity were associated with the coexistence of multiple complications.", "abstract_shown": true, "affiliations": [ "Division of Diabetes, Metabolism and Endocrinology, Department of Internal Medicine, The Jikei University School of Medicine, Minato-ku, Tokyo, Japan", "Department of Endocrinology, Diabetes, and Metabolism/Center for Clinical Sciences, National Center for Global Health and Medicine, Shinjuku-ku, Tokyo, Japan", "Department of Endocrinology, Tenri Hospital, Tenri, Nara, Japan", "The Institute of Statistical Mathematics, Tachikawa, Tokyo, Japan", "Shiga University, Hikone, Shiga, Japan" ], "article_type": "research article", "arxiv": null, "author_total": 6, "authors": [ { "affs": [ 0 ], "name": "Mizuki Ishiguro", "orcid": "0009-0006-4738-1965" }, { "affs": [ 0 ], "name": "Takayuki Ohno", "orcid": "0009-0002-9947-7687" }, { "affs": [ 1 ], "name": "Kazuo Izumi", "orcid": "0000-0001-9705-7588" }, { "affs": [ 2 ], "name": "Yasuaki Hayashino", "orcid": "0000-0002-2932-8478" }, { "affs": [ 3, 4 ], "name": "Hideki Origasa", "orcid": "0000-0002-9618-7361" }, { "affs": [ 0 ], "name": "Rimei Nishimura", "orcid": "0000-0001-6222-119X" } ], "bibtex": "https://research.draconitic.com/paper/3gsa8jkkxwmsw.bib", "cited_by": 0, "doi": "10.1136/bmjopen-2026-119882", "fulltext_url": "https://bmjopen.bmj.com/content/16/10/e119882.full", "id": "3gsa8jkkxwmsw", "issns": [ "2044-6055", "2044-6055" ], "landing_url": "https://bmjopen.bmj.com/lookup/doi/10.1136/bmjopen-2026-119882", "language": "en", "licence": "CC-BY-NC-4.0", "licence_label": "CC BY-NC 4.0", "licence_source": "article", "licence_url": "https://creativecommons.org/licenses/by-nc/4.0/", "metadata_licence": null, "native_subjects": [ [ "heading", "1506" ], [ "heading", "1843" ], [ "heading", "Diabetes and Endocrinology" ], [ "heading", "Original Research" ], [ "lcc", "R" ] ], "openalex": null, "pdf_url": null, "pmcid": "PMC13723833", "pmid": "42963091", "published": "2026-10-30", "publisher": "BMJ", "ris": "https://research.draconitic.com/paper/3gsa8jkkxwmsw.ris", "sources": [ { "first_seen": "2026-10-31T00:21:03Z", "native_id": "10.1136/bmjopen-2026-119882", "source": "crossref", "url": "https://bmjopen.bmj.com/lookup/doi/10.1136/bmjopen-2026-119882" }, { "first_seen": "2026-10-31T14:22:55Z", "native_id": "d578127e0a5a4f12af496c6d95cf56c6", "source": "doaj", "url": "https://doi.org/10.1136/bmjopen-2026-119882" }, { "first_seen": "2026-11-04T12:22:24Z", "native_id": "PMC13723833", "source": "pmc", "url": "https://doi.org/10.1136/bmjopen-2026-119882" } ], "subjects": [ { "field": "medicine", "origin": "lcc:R", "subfield": "general" } ], "title": "Coexistence of microvascular complications in type 2 diabetes: a baseline cross-sectional analysis of the Japan Diabetes Complication and its Prevention prospective study (JDCP study 13)", "title_text": "Coexistence of microvascular complications in type 2 diabetes: a baseline cross-sectional analysis of the Japan Diabetes Complication and its Prevention prospective study (JDCP study 13)", "type": "peer-reviewed", "updated_at": "2026-11-05T12:20:34Z", "url": "https://research.draconitic.com/paper/3gsa8jkkxwmsw", "venue": "BMJ Open", "versions": [] }