2018 6 23
2017 102018 10 891 63 192,858 25 8 1 13 47 181,578 25 8 1 32 53 170,200H29.12.1 83,534 86,666 2
3
WP-12
1,000 2 44 H28.3) ( 5
() () () 2015 7 10 6
7
65 2014N=22.2 2.7 74.9 34.9 65.1 70% 53% 35% - 51.8% 48.2% 65.1% 62.6% 57.7%57.8% 55.9% 42.3%42.2% 44.1% 37.4% 34.9% 140.6 4.1 18% 0% 1999 2002 2005 2008 2011 2014 26101 18 26 8
-12-12 NDB 9
074 2 3 2013 2015 ( ) 71,758 21,313 3,956,676,730 124,974 41,451 7,830,396,790 236,515 59,478 10,451,638,970 186,067 60,989 9,631,677,960 73,371 15,773 2,833,419,270 67,561 16,210 3,059,349,940 108,350 26,148 4,105,116,280 164,704 40,447 6,816,669,870 192,997 49,996 11,638,430,080 228,674 63,506 12,764,100,020 81,596 21,037 4,454,553,590 64,973 17,883 3,574,217,650 1,601,540 434,231 76,608,500,710 10
12 11
2013-201512 21.0% 20.0% 19.0% 18.9% 19.7% 20.0% 18.0% 17.0% 16.0% 15.0% 12 15.2% 12 16.0% 12 16.7% 14.0% 13.0% 12.9% 13.3% 13.6% 12.0% 0 2013 1 2014 2 2015 3 4 2000 15.2% 14.8% 16.8% 16.8% 18.9% 12.9% 13.6% 15.0% 14.0% 13.5% 15.2% 13.7% 15.2% 2014 16.1% 15.6% 17.9% 17.7% 19.7% 13.3% 14.5% 16.1% 14.9% 14.5% 16.4% 14.5% 16.0% 2015 16.6% 16.1% 18.9% 18.8% 20.0% 13.6% 15.1% 16.7% 15.7% 15.1% 17.3% 14.9% 16.7% 12
2013 8.3% 8.7% 8.8% 9.8% 10.9% 5.9% 9.0% 6.2% 9.3% 7.8% 8.4% 8.2% 8.4% 2014 8.8% 9.0% 8.9% 10.2% 10.9% 6.4% 9.4% 6.5% 8.9% 8.4% 9.3% 8.4% 8.6% 2015 9.2% 9.1% 9.2% 10.6% 11.1% 6.7% 9.7% 6.7% 9.2% 8.7% 9.8% 8.8% 9.0% 13
5.0% 2013-201512 4.0% 4.2% 3.5% 3.8% 3.0% 2.0% 12 2.6% 12 2.1% 12 2.1% 1.0% 1.4% 1.2% 1.2% 0.0% 0 2013 1 2014 2 2015 3 4 2013 3.0% 3.4% 2.3% 2.2% 1.4% 4.2% 3.4% 3.8% 3.0% 1.6% 1.4% 3.0% 2.6% 2014 2.7% 2.3% 2.0% 1.3% 1.4% 3.4% 3.5% 2.5% 2.1% 1.5% 1.2% 2.5% 2.1% 2015 2.4% 2.3% 2.0% 1.4% 1.4% 3.4% 3.8% 2.1% 2.2% 1.6% 1.2% 2.4% 2.1% 14
12 2 Ⅰ. 787 Ⅱ. 4,445 Ⅲ. 28,587 Ⅳ.HbA1c 6 2,986 36,805 HbA1c 665,724 15
1.12 2.12 3.1 4.1 1 5.12 16
40 5 12 50 17
2013-201512 11.0% 10.0% 9.7% 10.0% 10.4% 9.0% 8.0% 12 8.4% 12 8.6% 12 9.0% 7.0% 6.0% 6.1% 6.2% 6.5% 5.0% 0 2013 1 2014 2 2015 3 4 8.2% 8.6% 8.1% 9.7% 9.3% 8.0% 8.6% 6.1% 8.6% 8.5% 8.4% 8.2% 8.4% 8.5% 8.7% 8.4% 10.0% 9.5% 8.6% 8.9% 6.2% 8.5% 8.8% 9.0% 8.4% 8.6% 8.9% 8.8% 8.8% 10.4% 9.8% 9.2% 9.2% 6.5% 8.7% 9.0% 9.4% 8.9% 9.0% 18
1 19
1 30,000 401 22,500 15,000 7,500 0 40 44 50 54 60 64 70 74 20
1 550,000 500,000 450,000 400,000 350,000 300,000 250,000 55-59 60-64 65-69 70-74 200,000 21
1 22
DPP4 2013-2015 a.sglt2 0.0% 2.6% 6.1% b.dpp4 62.7% 67.9% 71.3% c.glp-1 d. e. 0.8% 0.9% 1.2% 4.8% 5.0% 5.0% 47.3% 47.3% 47.4% 2013N=28,795) 2014N=30,817) 2015N=31,735) f.α- 25.0% 23.0% 21.2% g. 46.6% 42.3% 38.6% h. 4.2% 4.6% 6.4% 0.0% 20.0% 40.0% 60.0% 80.0% 23
DPP4 15 17 2013 57.0% 54.9% 64.3% 56.0% 62.5% 65.1% 67.3% 62.7% 64.4% 63.6% 69.9% 56.9% 62.7% 2014 60.5% 57.0% 69.0% 62.7% 69.3% 70.3% 72.2% 68.0% 69.0% 68.9% 73.8% 63.0% 67.9% 2015 64.8% 60.6% 71.8% 67.3% 72.6% 72.7% 73.7% 74.1% 72.2% 71.9% 77.4% 67.1% 71.3% 24
20 2013 49.5% 57.9% 40.3% 56.6% 48.1% 44.1% 41.6% 41.0% 50.7% 50.5% 44.8% 47.3% 47.3% 2014 50.9% 58.2% 39.5% 55.2% 48.3% 45.6% 42.8% 41.5% 52.0% 49.7% 43.7% 44.7% 47.3% 2015 53.4% 57.1% 40.1% 56.9% 48.2% 45.3% 45.0% 42.0% 51.5% 48.5% 42.4% 45.9% 47.4% 25
1 DPP4 DPP4 26
12 DPP4 DPP4 27
1 28
12 29
J-DOME Japan medical association Diabetes database O clinical MEdicine 65 2 2203500(6 11 30
J-DOME 40 J-DOME J-DREAMS 31
HbA1c HDLALT DPP-4 32
J-DREAMS J-DOME J-DOME 20 50100 12 33
/ / 5. 9 6. 1 5. 4 4. 1 1 9. 5 1 5. 4 HbA1c NGSP 6. 0 6. 06. 5 6. 57. 0 7. 07. 5 7. 58. 0 8. 09. 0 9. 0 2 1. 5 2 4. 5 2 6. 0 2 7. 7 2 8. 4 2 2. 4 2 0. 5 2 0. 1 2 0. 4 1 9. 9 1 4. 9 % 1 2. 3 1 1. 2 1 8. 4 9. 4 8. 3 4. 7 1 1. 8 5. 1 6. 0 6. 14. 1 egfr 9 0 m L / m i n / 1. 7 3 6 0 m L / m i n / 1. 7 39 0 m L / m i n / 1. 7 3 3 0 m L / m i n / 1. 7 36 0 m L / m i n / 1. 7 3 1 5 m L / m i n / 1. 7 33 0 m L / m i n / 1. 7 3 1 5 m L / m i n / 1. 7 3 % 1 4. 9 1 4. 9 1 5. 0 5 5. 6 5 5. 0 5 7. 0 2 7. 0 2 7. 9 2 5. 0 2. 0 1. 7 2. 5 0. 5 0. 5 0. 4 1 0. 2 5 7. 1 3 2. 7 0. 0 0. 0 n=2,396 n=1,643 n=753 n=49 34
9 2 35
36
37
30 1 26 38
39
H25 8 6 30 30 30 3 40
30 30 3 41
30 30 3 42
43