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)
5 affiliations
- 1Division of Diabetes, Metabolism and Endocrinology, Department of Internal Medicine, The Jikei University School of Medicine, Minato-ku, Tokyo, Japan
- 2Department of Endocrinology, Diabetes, and Metabolism/Center for Clinical Sciences, National Center for Global Health and Medicine, Shinjuku-ku, Tokyo, Japan
- 3Department of Endocrinology, Tenri Hospital, Tenri, Nara, Japan
- 4The Institute of Statistical Mathematics, Tachikawa, Tokyo, Japan
- 5Shiga University, Hikone, Shiga, Japan
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.
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BibTeX
@article{ishiguro2026coexistence,
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)}},
author = {Mizuki Ishiguro and Takayuki Ohno and Kazuo Izumi and Yasuaki Hayashino and Hideki Origasa and Rimei Nishimura},
journal = {BMJ Open},
year = {2026},
month = oct,
doi = {10.1136/bmjopen-2026-119882},
url = {https://bmjopen.bmj.com/lookup/doi/10.1136/bmjopen-2026-119882},
note = {CC BY-NC 4.0},
}
RIS
TY - JOUR
TI - 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)
AU - Mizuki Ishiguro
AU - Takayuki Ohno
AU - Kazuo Izumi
AU - Yasuaki Hayashino
AU - Hideki Origasa
AU - Rimei Nishimura
PY - 2026
DA - 2026/10/30
JO - BMJ Open
DO - 10.1136/bmjopen-2026-119882
UR - https://bmjopen.bmj.com/lookup/doi/10.1136/bmjopen-2026-119882
AB - 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.
SN - 2044-6055
SN - 2044-6055
ER -