WHO Library Cataloguing in Publication Data 2003, Wilkinson,Richard Marmot,Michael Social determinants of health SDH The social gradient Stress Early life Social exclusion Work Unemployment Social support Addiction Food Transport 1

402 ( T2DM ) 1 1 1 2 3 4 5 6 7 8 9 10 11 1 2 3 4 5 6 8 9 10 11 40 MIN-IREN T2DMU40 STUDY 4 2015/05/15 ver 1.1

2 402MIN-IREN T2DMU40 Study 1 40 2 159(2): p95-104, 2016 20651 20BMI30kg/m2 BMI 30kg/m2 74.476.2 223.1 43.5 13.9 2.0mg/dl1.9 15.9 JDDM 2 Socioeconomic status and type 2 diabetes complications among young adult patients in Japan PLOS ONE https://doi.org/10.1371/journal.pone.0176087 April 24, 2017 1.912.19 1.72 2.23 2.38 3.61 2.532.602.83 4.03 3 Long working hours and skipping breakfast concomitant with late evening meals are associated with suboptimal glycemic control among young male Japanese patients with type 2 diabetes Journal of Diabetes Investigation First published: 17 April 2018 60 101 HbA1c7%

23 -HbA1c JDS)6.1%- 40 HbA1c,

BMI(Body Mass Index) BMI(kg) ( (m)(m)) 18.5 18.5 25 25 30 30 BMI 30? 175 92 160 77 160

23 1 2012 6 7 2013 6 7 2 20 402 3 /HbA1 20BMI HbA1c

(100 ) (100200 ) (200) 34.0 26.8 33.9 27.0 28.9 27.4 29.9 34.8 30.0 34.5 20 28.7 27.7

658 430 228 109 82 27 15 13 2 782 525 257 23.2 782 110 14.1 315.9 2 2 /dl 15 11.8 7.7 8.2 6.0 43.5

1 2 1 3 meta-analysis 1 2 Mika Kivimä et al : Long working hours as a risk factor for atrial fibrillation: a multicohort study European Heart Journal, 2017,ehx324, 85494 10 35 40 100012.455 100017.6 1.4 Kivimäki M et al. Long working hours, socioeconomic status, and the risk of incident type 2 diabetes: a meta-analysis of published and unpublished data from 222 120 individuals. (2015) Lancet Diabetes Endocrinol. ;3:27-34. 222120 35 40 551.29 10000 13 Ferrie JE et al: Job insecurity and risk of diabetes: a meta-analysis of individual participant data. CMAJ.2016 Dec 6;188(17-18):E447-E455. 140825 9.4 1.19 Virtanen M et al. Perceived job insecurity as a risk factor for incident coronary heart disease: systematic review and meta-analysis. 2013 8;347:f4746. 174438 9.7 1.32

12013 1 2013 6-7 13544 21782 2 2012 HbA1c I + 10reference 10 10 + 10 35 3560 60 HbA1c7%352 white collar

HbA1c7%126 352 BMI A1c 735 60 2.92 10 10 2.50

352 HbA1c(%) 35 60 60 10

( Kivimäki M et al. Long working hours, socioeconomic status, and the risk of incident type 2 diabetes: a meta-analysis of published and unpublished data from 222 120 individuals. (2015) Lancet Diabetes Endocrinol. ;3:27-34.

PLOS ONE 2017 4 24 2018 6 8 2 20402 1.31 2.231.564.03

SES DM SES DM 1 DM( ) 2 DM 2040 SES 2 DM SES DM 4 Type 2 diabetes incidence and socio-economic position: a systematic review and meta-analysis Emilie Agardh,1 * Peter Allebeck,1 Johan Hallqvist,2,3 Tahereh Moradi4 and Anna Sidorchuk1,5 International Journal of Epidemiology 2011;40:804 818 2011(1996-2010) 2 DM(incidence OR1.31OR1.41 OR1.403 4

DM SES 2004 DM 2006 DM 2010 DM 2011 DM DM SES / / / / / // 2 BMI

96 2040 2012 3 31 782525257 110672 BMI A1C (SES 3 BMI SES SES 2.5 2 1.5 1 0.5 1 1.31 1.91 1 1.44 1.56 1 2.19 1 1.72 2.23 4.5 4 3.5 3 2.5 2 1.5 1 1 1.56 2.38 1 3.61 2.53 1 2.6 1 2.83 4.03 0.5 0 0 BMI

+ SES DM SES DM2 DM 2040SES 2 DM SES DM 4 SES DM

1972 1982 1992 2002 2012 20 19932005 30 1990 1996 2008 22 2004 40 22 1994 (WHO SDH )