Diabetes or Diabetes Melitus (DM) is metabolic disorder characterized by hyperglycemia and abnormalities in carbohydrate, fat, and protein metabolism (Dipiro et.al., 2015). It occurs when the pancreas does not produce enough insulin or the body cannot effectively use the insulin it produces (World Health Organization, 2016). Diabetes needs seriously and consistent therapy for get optimal clinical outcome. The starting point for living well with diabetes is an early diagnosis. People with diabetes are defined as those having a fasting plasma glucose value of greater than or equal to 7.0 mmol/L, but each country has a different number to diagnosed it. The types diabetes are type 1 diabetes, type 2 diabetes, and gestational diabetes.


Type 1 diabetes develops in childhood or early adulthood. 5-10% cases of diabetes are type 1 diabetes. Type 1 diabetes is characterized by deficient insulin production in the body. It results from autoimmune-mediated destruction of pancreatic β-cells (Dipiro et.al., 2015). People with type 1 diabetes require daily administration of insulin to regulate the amount of glucose in their blood. If they do not have access to insulin, they cannot survive. The cause of type 1 diabetes is not known and it is currently not preventable. Effective approaches are available to prevent type 2 diabetes and to prevent the complications and premature death that can result from all types of diabetes. Symptoms include excessive urination and thirst, constant hunger, weight loss, vision changes and fatigue (World Health Organization, 2016).


Type 2 diabetes was seen only in adults but it has begun to occur in children. 90% cases of diabetes are type 2 diabetes. Type 2 diabetes is characterized by a combination of some degree of insulin resistance and relative insulin deficiency (Dipiro et.al., 2015), and then the body cannot effectively to use it (World Health Organization, 2016). The risk of type 2 diabetes is determined by an interplay of genetic and metabolic factors. Ethnicity, family history of diabetes, and previous gestational diabetes combine with older age, overweight and obesity, unhealthy diet, physical inactivity and smoking to increase risk.  Taking a life-course perspective is essential for preventing type 2 diabetes, as it is for many health conditions. Early in life, when eating and physical activity habits are formed and when the long-term regulation of energy balance may be programmed, there is a critical window for intervention to mitigate the risk of obesity and type 2 diabetes later in life. Symptoms may be similar to those of type 1 diabetes, but are often less marked or absent (World Health Organization, 2016).


Gestational diabetes (GDM) is a temporary condition that occurs in pregnancy and carries long-term risk of type 2 diabetes. The condition is present when blood glucose values are above normal but still below those diagnostic of diabetes. Women with gestational diabetes are at increased risk of some complications during pregnancy and delivery, as are their infants. Gestational diabetes is diagnosed through prenatal screening, rather than reported symptoms (World Health Organization, 2016).


Diabetes is an important public health problem because has higher premature death. According WHO, diabetes caused 1,5 million deaths in 2012 and 43% of all deaths due to high blood glucose occur before the age of 70. The prevalence of diabetes is steadly increasing everywhere. Globally, 422 million adults were living with diabetes in 2014 and it includes Japan.


Diabetes happened in Japan, everywhere and everytime with prevalence 11,2% patients (15,5% in man, and 9,8% in woman). Higher patients aged about 40~59 years old (APS, 2016). Japan has eighth ranked with 8,9 millions people with highest number of estimated diabetes cases for 2030 (W.Michael., and Smith,MD., 2004). The causing problems identified are nephritis, high blood, loss of vision. It can because high blood glucose make body system is damage, especially in central nerve system and blood vessel (APS, 2016).
Each country have their policy and intervention to reduce diabetes cases. Attempts have been done to reduce the current condition by the government and private sectors. The government in Japan advice japanese to go to a hospitai for a health checkup and prevention of the severity of lifestyle-related diseases by solidarity among patients and family physicians. With event about diabetes, assosiation in Japan (APS) attempt many walking person to let them  pay attention to diabetes (APS, 2016).


Note: If you are interested to know more about the current condition, you can contact rpo@apro.ipsf.org