Until recently, the frequency of Type 2 diabetes in children and teenagers, both in and outside Japan, has been considered extremely low. However, in Japan, researchers are gradually accumulating evidence that the frequency of Type 2 diabetes in this age range is, in fact, higher than that of Type 1.

Furthermore, there are many cases of patients who developed Type 2 diabetes at a young age, but later discontinued their treatment. It is becoming apparent that critical complications frequently arise for these patients when they reach their 30s and 40s, causing them to return to care. There is no doubt that having urinalysis systems in schools is very important as the only method for early detection of diabetes. Such systems prevent future increases in the number of adult Type 2 diabetics with complications from diabetes. However, it is clear that the number of cases of diabetes with complications in adults who are believed to have had diabetes already during childhood is growing every year. Therefore, this research seeks to:

1) Build a nationwide database of Type 2 diabetes cases with onset before the age of 20;
2) Track this cohort actively, and clarify the actual situation of treatment, the cumulative incidence rate of complications, and the quality of life of patients; and
3) Analyze the frequency and severity of complications, and the risk factors.

Juvenile-onset Type 2 diabetes has become easier to detect thanks to improvements in urinalysis systems in schools. However, medical care straddles the two fields of pediatrics and internal medicine. The transition from pediatrics to internal medicine is hard to manage smoothly because medical treatment is often interrupted since patients do not consider themselves seriously ill, and information is not conveyed from pediatricians to physicians. Therefore, it has traditionally been difficult to ascertain the actual situation concerning the continuity of treatment and the state of complications on a nationwide scale.

The ultimate goal of this research is thus to carry out a nationwide survey of these matters, to establish means of preventing diabetes (and its complications), and to protect young people in an era of low birthrates from the conspicuous decline in quality of life from these complications.
We have established a committee within the Japan Diabetes Society to oversee the project, and as the first step in the preliminary research for this cohort study, we have sent letters to relevant medical institutions nationwide explaining the purpose of this research.

Update: October 17, 2012