Introduction Diabetes poses a significant threat to quality of life due to serious complications including cardiovascular diseases, and as such, many discussions have focused on screening for diabetes. In Japan, the special health examination (“Tokutei Kenshin”) launched in 2008 for all people aged 40–74 includes screening for diabetes. However, some individuals do not make follow-up visits to see a doctor even if they are deemed to be hyperglycaemic at a health check-up.

Objectives To investigate proportions and characteristics of those deemed to be hyperglycaemic through screening but who did not make a follow-up visit.

Design A retrospective cohort study.

Setting and Participants The Japan Medical Data Center's database includes data from health insurance claims and health checkups for 109 212 insured individuals.

Main outcome measures Prevalence of follow-up visits after health checkups.

Results We identified 4869 individuals deemed to be hyperglycaemic at health checkups (prevalence, 7.1%). Of these, 2432 (49.9%) did not make follow-up visits after health checkups (men=49.1%, women=64.6%). Elderly participants were more likely to follow-up after a health check-up where they were told to be hyperglycaemic (OR for NOT making follow-up clinical visit [95% CI]: 10 years older, 0.70 [0.65 to 0.75] for men, 0.77 [0.59 to 1.01] for women).

Conclusions In the present study, almost half of individuals did not follow-up after a health check-up where they were deemed to be hyperglycaemic. Older individuals were more likely to follow-up than younger individuals. Participant characteristics should be taken into account as improvements are made to health check-up services.