Prevalence of diabetes mellitus and dialysis risk based on annual health checkup frequency among National Health Insurance citizens in Japan.

BACKGROUND

In Japan, type 2 diabetes mellitus (T2DM) is a major health concern due to its increasing prevalence and associated complications, including diabetic nephropathy and dialysis. Although the positive relationship between annual health checkups and health outcomes is well-documented, the impact of skipping health checkups on T2DM and its progression to dialysis remains unclear. This study aimed to explore the association between the frequency of annual health checkups and DM-related indices and the potential impact of early intervention in preventing dialysis.

METHODS

The study included citizens aged ≥ 40 years from Nobeoka City, Japan (n = 22,094). Health checkup data from 2021 were analyzed, and participants were categorized into four groups based on their health checkup attendance between 2018 and 2020. Logistic regression analyses evaluated the association between health checkup frequency and DM-related indices, such as hemoglobin A1c and estimated glomerular filtration rate. These indices are used to diagnose DM and evaluate its severity. The time to dialysis for citizens without health checkups was estimated under untreated and treated scenarios using a previously published model.

RESULTS

Among the 3,472 participants who underwent health checkups in 2021, 2,098 (60.4%) were women, and 1,374 (39.6%) were men. Citizens who missed health checkups for 3 consecutive years had a higher risk of T2DM than those who had annual checkups (odds ratio = 4.69, 95% confidence interval: 2.78-7.94). No significant difference was observed in T2DM rates between those who attended once or twice and those who attended annually. Simulations for high-risk citizens showed that 32 of 39 individuals may require dialysis during their lifetime; however, early intervention could prevent dialysis in 31 of them.

CONCLUSIONS

Citizens who skipped health checkups for 3 consecutive years or longer had a higher risk of T2DM, highlighting the need for targeted public interventions to prevent DM in this population.