Identification of risk factors for discontinuing medical follow-up in Japanese patients with pharmacologically untreated type 2 diabetes mellitus

Abstract

Although strict control of blood glucose levels is thought to be essential for preventing the development of diabetes complications, the characteristics of patients who discontinue medical follow-up have not been fully examined, particularly in Japan. The present study of Japanese patients with diabetes was performed to identify factors predicting the discontinuation of medical follow-up and to characterize the clinical features of these patients. Initially, 226 patients with type 2 diabetes who had not received insulin or oral hypoglycemic drugs were enrolled. After 15–27 months, a questionnaire study of diabetes clinic attendance, self-management, and health beliefs was performed. Of the 101 patients who completed the study, 23 did not attend the clinic for over 6 months, while 78 continued follow-up. Among patients who discontinued follow-up, those with subjective symptoms had a lower self-management score compared with patients without symptoms. The final HbA1c level was lower in patients who continued clinical visits compared with those who discontinued follow-up. Regression analysis revealed that male sex, poor self-management, and patient recognition of difficulty in attending the clinic were risk factors for discontinuing follow-up. The results suggest that healthcare professionals should provide a supportive environment for patients to maintain regular clinic attendance, particularly for patients at a high risk of discontinuation.