disappeared, with standardized diferences below 0.1. Te number of physician visits and annual medical cost were higher in control group 2 (benefciaries meeting clinical criteria) compared with the treatment group and control group 1 (screened candidates for program). Table 3 shows the cumulative incidence of targeted events during the 5-year follow-up. Control group 2 had higher incidence of diabetes-related complications of any kind (20.4% vs. 12.9%), nephropathy requiring hemodialysis (4.3% vs. 0.7%), and emergency care use (25.5% vs. 15.1%) than the treatment group. Tere were no marked diferences in incidence between the treatment group and control group 1. Table 1 Baseline characteristics of the treatment group and the subpopulations for the two control groups Characteristics Treatment Control group 1 Screened candidate Control group 2 Benefciary within inclusion criteria n= 153 n= 2,635 n= 11,806 Age (mean (SD)) (years) 68.0 (3.9) 67.2 (5.7) 67.1 (6.6) Sex (male %) 90 (58.8) 1,174 (44.6) 5,284 (44.8) Diabetes treatment medication (n, %) Oral 114 (74.5) 2,062 (78.3) 10,080 (85.4) Insulin 39 (25.5) 573 (21.7) 1,726 (14.6) Medication for cardiovascular risk control (n, %) Anti-platelet 43 (28.1) 631 (23.9) 2,657 (22.5) Anti-hyperlipidemic 92 (60.1) 1,500 (56.9) 6,370 (54.0) Anti-hypertensives 111 (72.5) 1,769 (67.1) 7,450 (62.3) Cardiorenal protective agents (n, %) 95 (62.1) 1,397 (53.0) 5,669 (48.0) Charlson Risk Index (n, %) 1 119 (77.8) 1,976 (75.0) 8,614 (73.0) 2 30 (19.6) 563 (21.4) 2,682 (22.7) 3 or more 4 (2.6) 96 (3.6) 510 (4.3) Utilization patterns (annual) (mean (SD)) Medical cost (USD) 5,695 (4,855) 5,869 (7,651) 5,286 (7,710) Number of Physician visits 33.4 (37.0) 31.1 (34.7) 29.3 (34.1) Hospitalization days 3.7 (12.8) 3.9 (14.3) 3.8 (14.8) Watanabe et al. BMC Endocrine Disorders (2022) 22:135 Page 6 of 9 Table 4 presents the results of the Cox proportional hazard model analyses on event incidence during the 5-year follow-up, adjusted for age, sex, diabetes medication, and Charlson comorbidity index. None of the estimated hazard ratios reached conventional signifcance levels between the treatment group and control group 1 (screened candidates for program). However, the treatment group had lower hazard ratios for diabetes-related complication of any kind and emergency care use than control group 2 (benefciaries meeting inclusion criteria). Finally, we compared the medical and long-term care cost among the groups for the 5-year follow-up period. Te mean medical and long-term care cost for the treatment group was 34,836 USD (90% confdence interval [CI]: 29,865–39,807 USD), compared with 37,758 USD (90% CI: 34,354–41,161) in control group 1 (screened Table 2 Characteristics of the treatment group and the control groups after propensity score matching Characteristics Treatment Control group 1 Screened candidate Control group 2 Benefciary within inclusion criteria Standardized diference treatment— control group1 Standardized diference treatment— control N= 139 N= 412 N= 416 group2 Age (mean (SD)) (years) 68.1 (3.8) 67.9 (4.0) 68.5 (4.1) 0. (10.6) 2.0 (8.0) 0.039 0.044 Table 3 Cumulative incidence of targeted events during the 5-year follow-up * PMetab 2011; 300: E134-44. [Crossref]ernandez, N.; Jacobs-Cachá, C.; Mora-Gutiérrez, J.M.; VergAdverse Outcomes Associated with DKD Diabetes is a common and complex disorder associated with multiple comorbid conditions and higher risk for mortality. The 2015 overall underlying-cause mortality rate attributable to diabetes was 24.7 per 100,000.1 A collaborative meta-analysis suggested that a 50-year-old with diabetes died on average approximately 6 years earlier than an individual without diabetes.2 Multiple complications are associated with diabetes, including retinopathy and neuropathy. Diabetes is a major risk factor for cardiovascular disease (CVD) and diabetic kidney disease (DKD) or diabetic nephropathy.3, 4, 5, 6 Diabetes is the leading cause of chronic kidney disease (CKD) and accounts for 44% of new cases of end stage kidney disease (ESKD).1 All-cause mortality in patients with DKD is reportedly higher than in diabetes patients without kidney disease.7,8 Management of DKD Overview Type 2 diabetes treatment generally involves multiple interventional strategies, including glycemic control and management of other CVD-related risk factors, many of which are also risk factors for CKD. Additional measures to help preserve kidney function can also include avoidance of nonsteroidal anti-inflammatory drugs (NSAIDs) and caution with the use of certain contrast dyes with imaging tests. Drugs that interact with the renin–angiotensin–aldosterone system (RAAS), such as angiotensin-converting-enzyme inhibitors (ACEIs) and angiotensin II receptor blockers (ARBs), can be applied to both blood pressure management and slowing kidney disease progression.5,6,8 RAAS blockade agents have been shown to reduce blood pressure, decrease albuminuria, and help slow the progression of kidney disease in patients with DKD.9,