Retrospective real-world database study to examine the prevalence and incidence of cardiovascular diseases and medication prescription in Japanese patients with type 2 diabetes

Mitsuhisa Komatsu; Hiroshi Kobayashi; Satoshi Tsuboi; Hirotaka Watada

doi:10.1007/s13340-026-00877-7

Retrospective real-world database study to examine the prevalence and incidence of cardiovascular diseases and medication prescription in Japanese patients with type 2 diabetes

Diabetol Int. 2026 Mar 17;17(2):31. doi: 10.1007/s13340-026-00877-7. eCollection 2026 Apr.

Authors

Mitsuhisa Komatsu¹, Hiroshi Kobayashi², Satoshi Tsuboi³, Hirotaka Watada⁴

Affiliations

¹ Division of Diabetes, Endocrinology and Metabolism, Department of Internal Medicine, Shinshu University School of Medicine, Asahi 3-1-1, Matsumoto, Nagano 390-8621 Japan.
² Cardiovascular and Emerging Therapy Areas, Medical Affairs Department, CMRQ Development Division, Novo Nordisk Pharma Ltd, Tokyo, Japan.
³ RWE Group, SPVD Department, CMRQ Development Division, Novo Nordisk Pharma Ltd, Tokyo, Japan.
⁴ Department of Metabolism and Endocrinology, Juntendo University Graduate School of Medicine, Tokyo, Japan.

Abstract

Introduction: In Japan, real-world characterisation of cardiovascular disease (CVD) prevalence, incidence, and medication prescription in adults with type 2 diabetes (T2D) has been limited.

Methods: This real-world study (comprising a cross-sectional and a retrospective study) in adults aged ≥ 20 years with T2D used the Medical Data Vision database to evaluate the prevalence and incidence of three-point major adverse cardiovascular events (3P-MACE) and composite CVD and to describe medication prescription patterns.

Results: The cross-sectional study included 292,383 patients in 2014 and 622,531 in 2021. Prevalence of 3P-MACE and composite CVD were 4.8% and 12.1%, respectively, in 2014; values in 2021 were 5.0% and 14.0%. In 2014, 2.1% of patients received glucagon-like peptide-1 receptor agonists (GLP-1RAs) and 0.8% received sodium-glucose cotransporter-2 inhibitors (SGLT-2is); 2021 values were 9.2% and 32.3%. The retrospective study included 314,206 patients; 19.7% had a CVD history. The overall incidence rate of 3P-MACE per 1000 person-years was 12.8 (95% confidence interval [CI] 12.6-13.0); 46.6 (45.3-48.0) in those with and 8.6 (8.4-8.8) in those without CVD history. The incidence rates (95% CI) of composite CVD were 47.9 (47.4-48.3); 179.5 (177.0-182.1) in those with and 31.5 (31.1-31.9) in those without CVD history.

Conclusions: In Japan, the prevalence of 3P-MACE and composite CVD were almost unchanged from 2014 to 2021, whereas GLP-1RA/SGLT-2i prescriptions increased. Incidence rates of 3P-MACE and composite CVD were higher in patients with a CVD history. These data provide insights into prescription patterns in T2D in Japan and could inform future treatment practices.

Supplementary information: The online version contains supplementary material available at 10.1007/s13340-026-00877-7.

Keywords: 3P-MACE; Cardiovascular disease; Diabetes medications; GLP-1RA; SGLT-2i; Type 2 diabetes.