Disease oriented registries are essential not only for evaluating and analyzing current practice but also for making comparisons over time. In previous database studies such as JDDM, barriers such as the time and effort required for data entry have been overcome through the tireless efforts of researchers. Therefore, a database study was planned to reduce the time and effort required for data entry and to facilitate the increase in the number of registered patients, collection items, and data points by automatically capturing medication, test results, and other data, thereby enabling a real-time understanding of the situation. This is the Japan Diabete compREhensive dabase project based on an Advaced electronic Medical record System: J-DREAMS, which is being conducted by the National Center for Global Health and Medicine (NCGM) in collaboration with the Japan Diabetes Society. In J-DREAMS, patient background information and daily clinical conditions are entered using a standard diabetes care template, stored using a standard data storage system called SS-MIX2, and then extracted and transmitted using a multipurpose clinical data registration system (MCDRS). This system currently operates a database linking approximately 70 hospitals.More than seven years have passed since the construction and data entry of J-DREAMS, and an exploratory cross-sectional survey of patients as well as longitudinal analyses focusing on some of the diabetic complications are underway. For diabetic nephropathy and diabetic kidney disease, we have seen sufficient registration of laboratory data and are conducting multifaceted analyses of risk factors and other factors. The current status of diabetes care and its complications, as well as future issues for disease databases including J-DREAMS, will be outlined.