Fig. 2

Flow diagram of this study. Among 2,571,418 individuals registered in the Shizuoka Kokuho Database (SKDB) between April 1, 2012, and September 30, 2021, a total of 1,898,936 were excluded because they did not undergo a medical checkup or lacked a 1-year baseline period. Of the remaining 672,482 participants, those with pre-existing diabetes or antidiabetic prescriptions during the baseline period (n = 58,642), low estimated glomerular filtration rate (eGFR) (n = 32,347), or a history of cancer other than nonmelanoma skin cancer (n = 118,245) were excluded. The final analysis dataset included 463,248 individuals, which were randomly divided into a derivation dataset (n = 308,832) and a validation dataset (n = 154,416) in a 2:1 ratio. SKDB, Shizuoka Kokuho Database, eGFR: estimated glomerular filtration rate.