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Am J Physiol Endocrinol Long-term efectiveness of a disease management program to prevent diabetic nephropathy: a propensity score matching analysis using administrative data in Japan Hirohito Watanabe1,2, Hisataka Anezaki3 , Kana Kazawa1 , Yuya Tamaki1 , Hideki Hashimoto3 and Michiko Moriyama1* Abstract Background: Existing reviews indicated that disease management for patients with diabetes may be efective in achieving better health outcomes with less resource utilization in the short term. However, the long-term results were inconsistent because of the heterogeneous nature of the study designs. In the present study, we evaluated the 5-year follow-up results of a local disease management program focused on diabetic nephropathy prevention under the universal public health insurance scheme in Japan. Methods: Patients diagnosed with type 2 diabetes who had stage 3 or 4 diabetic kidney disease and were aged between 20 and 75 years were invited to join a disease management program to support self-management and receive a recommended treatment protocol between 2011 and 2013. Follow-up data were collected from an electronic claims database for the public insurance scheme. Considering the non-random selection process, we prepared two control groups matched by estimated propensity scores to compare the incidence of diabetes-related complications, death, and resource utilization. Results: The treatment group was more likely to receive clinical management in accordance with the guidelinerecommended medication. After propensity score matching, the treatment group had lower incidence of