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Prevalence of diabetes mellitus in Japan was estimated from fructosamine and hemoglobin A1c measurement data obtained from the National Survey of Circulatory Disorders 1990, using a previously reported method which used the results of a screening test for estimating true prevalence. The prevalence for males was higher than that for females. The prevalences were less than 10% for those 49 years or younger and approximately 20% for those 50 years or older. The estimated values derived from fructosamine or hemoglobin A1c did not vary considerably.

A method for estimating the prevalence interval of diabetes mellitus from fructosamine data is presented, which is based on the previously reported method for estimating prevalence from results of screening tests and on the results of 75 gram glucose tolerance test and fructosamine test in 1,359 examinees. Where true prevalences are 1-20% and population size is 100-10,000, the estimates for prevalence of diabetes mellitus are generally minimum when a screening level of 310 mumol/l of fructosamine is utilized. In our method, a screening level for fructosamine of 310 mumol/l was specified. Standard error ratios of estimated prevalence of diabetes mellitus to true prevalence in a population with an actual prevalence of 10% were about 40% for a population of 200 persons, and about 20% for 2,000 persons or more.

To evaluate the efficacy of hemoglobin-Alc, fructosamine, and 1,5-anhydroglucitol tests in screening for diabetes mellitus in communities, the sensitivity and the specificity of these tests were observed on the island of Ojika, Goto islands, Nagasaki prefecture Japan. A 75 gram glucose tolerance test was performed simultaneously on every participant, and WHO diabetes mellitus criteria were used to classify individuals. A total of 554 males and 820 females, older than 34 years, participated in the examination, representing a response rate of 42% and 52% respectively, and 86 were classified as diabetic. The sensitivity and the specificity of several screening levels were determined for each test. Each of the tests attained greater than 70% sensitivity and specificity simultaneously, but could not achieve greater than an 80% level simultaneously. If screening levels are selected for a sensitivity of as low as 50%, it is possible to produce a high specificity of 97-98%. These results provide valuable information for the planning of efficient diabetes mellitus detection programs in communities.

A mass health examination was performed to assess the glucose tolerance of inhabitants of the island of Ojika, in the Goto islands, Nagasaki prefecture Japan. There were 554 males and 820 females older than 34 years who participated in the mass health examination, a response rates of 42 percent and 52 percent for males and females respectively. Serum glucose levels after overnight fasting and at 2 hours after a 75 gram oral glucose tolerance were used with WHO criteria to classify individuals. Among these subjects, the prevalence of diabetes mellitus increased with age, with a prevalence of diabetes mellitus of around 10 percent in the older subjects. The prevalence for males was higher than that for females. Prevalences of impaired glucose tolerance were roughly in the 15-25 percent range and did not show clear differences among different age groups and sexes. From a questionnaire survey of all island inhabitants, it was considered that the degree of bias of the results was small, if any. The true prevalence for all the inhabitants may be a little larger than the observed prevalence of these subjects.