Evidence mapPaperPMID 42423356Full record

ArticleGeriatrics & gerontology international2026

Prefecture-Level Prehospital Glucose Administration for Hypoglycemia and Diabetologist Density Among Older Adults in Japan: A Nationwide Ecological Study.

Tomoya Saika, Yuki Kado, Michiko Yamazaki, Tohru Takebe, Masaya Sakamoto, Atsushi Nakagomi

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Article in Geriatrics & gerontology international, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

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1citing papers in PubMed
field-weighted citation impact
1 · What the graph read from it

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3 · Its place in the literature

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1 citing paper in PubMed.

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4 · The record

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5 · Who and what money

Authors and funding

6 authors.

Tomoya SaikaPatient Engagement Frontier Medical Science, KAKEHASHI Inc., Tokyo, Japan.ORCID https://orcid.org/0000-0001-9690-3244
Yuki KadoPatient Engagement Frontier Medical Science, KAKEHASHI Inc., Tokyo, Japan.ORCID https://orcid.org/0009-0008-9511-0435
Michiko YamazakiPatient Engagement Frontier Medical Science, KAKEHASHI Inc., Tokyo, Japan.ORCID https://orcid.org/0009-0001-2866-9553
Tohru TakebePatient Engagement Frontier Medical Science, KAKEHASHI Inc., Tokyo, Japan.ORCID https://orcid.org/0000-0001-5945-5139
Masaya SakamotoDepartment of Diabetes, Metabolism & Endocrinology, International University of Health and Welfare Mita Hospital, Tokyo, Japan.ORCID https://orcid.org/0009-0009-7239-0988
Atsushi NakagomiDepartment of Social Preventive Medical Sciences, Center for Preventive Medical Sciences, Chiba University, Chiba, Japan.ORCID https://orcid.org/0000-0002-3908-696X

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

aimsTo assess prefecture-level disparities in prehospital glucose administration for hypoglycemia among older adults, diabetologist density, and insulin prescribing, and to examine the association between diabetologist density and prehospital glucose administration in Japan.

methodsWe conducted a nationwide ecological cross-sectional study across all 47 prefectures. Prehospital glucose administration for hypoglycemia was identified from national Emergency Medical Service statistics (2022). Diabetologist density (certified diabetologists per 100 000 population) was obtained from the Japan Diabetes Society specialist list. Prescribing patterns were derived from the Musubi electronic medication history database (January 2019 to June 2025) and summarized as the proportion of insulin prescriptions among glucose-lowering drugs. Pearson correlation coefficients were calculated.

resultsRates of prehospital glucose administration for hypoglycemia varied substantially across prefectures (approximately 10-fold between the highest and lowest). Diabetologist density was inversely correlated with prehospital glucose administration per 100 000 population (r = -0.331, p < 0.05) and per 1000 EMS patients (r = -0.425, p < 0.05); the inverse correlation per 1000 patients with diabetes was not statistically significant (r = -0.274, p = 0.062). Although diabetologist density was positively correlated with insulin prescribing proportion (r = 0.326, p < 0.05), it was inversely correlated with prehospital glucose administration.

conclusionsMarked geographic disparities in prehospital glucose administration for hypoglycemia were observed in Japan. Higher diabetologist density was associated with lower rates of prehospital glucose administration, despite a higher proportion of insulin prescribing, supporting efforts to improve access to certified diabetologists and strengthen diabetologist-primary care collaboration.

Indexed as

Emergency Medical ServicesGlucoseHypoglycemiaHypoglycemic AgentsPractice Patterns, Physicians'AgedCross-Sectional StudiesFemaleHumansInsulinJapanMaleGlucoseHypoglycemic AgentsInsulindiabetologist densityecological studyEmergency Medical Servicesgeographic disparitieshypoglycemia

Identifiers

PMID42423356
PMCPMC13348015

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.