Glycemic Control in Diabetic Patients With Impaired Endogenous Insulin Secretory Capacity Is Vulnerable After a Natural Disaster: Study of Great East Japan Earthquake

In March 2011, the Tohoku district of Japan experienced the Great East Japan Earthquake. When treating numerous diabetic outpatients affected by this earthquake, we noticed that postdisaster glycemic control alterations varied among patients. Therefore, we speculated that predicting which diabetic patients have glycemic control that is vulnerable to an extreme situation such as a huge natural disaster is important for allocating limited medical resources effectively in times of great need. Furthermore, predicting who these patients are may enable us to provide them with guidance for postdisaster management in advance, thereby minimizing exacerbation of the diabetic condition. However, at present, there are no available markers predicting postdisaster diabetic vulnerability. Therefore, to identify potentially useful markers, we collected data on several metabolic parameters from 497 diabetic patients who had been followed up at hospitals located in the devastated areas prospectively at 1 and 3 months after the earthquake, and retrospectively using medical records from pre-earthquake time points. First, we divided the 497 diabetic outpatients into two groups (i.e., the …