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Compared with insulin glargine, insulin degludec narrows the day-to-day variability in the glucose-lowering effect rather than lowering blood glucose levels

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Journal of Diabetes Mellitus 2013年第4期3卷 244-251页

作者： Susumu Ogawa Kazuhiro Nako masashi okamura Miho Senda Takuya Sakamoto Sadayoshi Ito Division of Nephrology Endocrinology and Vascular Medicine Tohoku University Hospital Sendai Japan

Background: Changes in the day-to-day variability in the glucose-lowering effect of insulin [fluctuations of blood glucose levels (BG) seen during the same time period] that occur when insulin glargine (glargine) is replaced with insulin degludec (degludec) have not been sufficiently evaluated. Subjects: Five diabetics with unstable BG undergoing basal-bolus treatment using insulin glargine as basal insulin. Methods: Basal insulin was changed from glargine to same-dose degludec. The subjects’ HbA1c, glycoalbumin, and 1.5-anhydro-D-glucitol were measured before and after the switchover. Fasting blood glucose concentration (FBG) and predinner blood glucose concentration (PDBG) were measured continuously for 28 days immediately before the switchover, and 28 days immediately thereafter, to compare and evaluate 1) the changes in their mean values and standard deviations (SDs) before and after the switchover, and 2) the frequency of appearance of BG of over 180 mg/dL (BG ≥ 180) and under 70 mg/dL (BG Results: The levels of HbA1c, glycoalbumin, FBG’s mean value, SDs, BG ≥ 180 and BG Conclusion: The possibility was shown that degludec, to a greater extent than glargine, suppressed daily fluctuations of FBG and PDBG, suppressed the occurrence frequency of hyperglycemia and hypoglycemia, and exerted more steady hypoglycemic actions.

关键词： Degludec Glargine Hyperglycemia Hypoglycemia The Day-to-Day Variability in the Glucose-Lowering Effect of Insulin

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Urinary type IV collagen excretion predicts an increased urinary albumin-to-creatinine ratio in normoalbuminuric patients with diabetes

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Journal of Diabetes Mellitus 2012年第4期2卷 413-426页

作者： Susumu Ogawa Masato Matsushima masashi okamura Miho Senda Takuya Sakamoto Kazuhiro Nako Sadayoshi Ito Division of Clinical Epidemiology Jikei University School of Medicine Tokyo Japan Division of Nephrology Endocrinology and Vascular Medicine Tohoku University Hospital Sendai Japan

Aims: We evaluated whether urinary excretion of type IV collagen (U-COL) may predict an increase in the urinary albumin-to-creatinine ratio (ACR) and what factors regulate U-COL in 145 normoalbuminuric patients with type 2 diabetes. Methods: We measured HbA1c, systolic blood pressure (SBP), urinary 8-hydroxydeoxyguanosine (8-OHdG) and monocyte chemoattractant protein (MCP)-1 at start of this study (Baseline), ACR and U-COL in addition to these measurements at one year later (Evaluation-1), and ACR and SBP after two years of the Evaluation-1 (Evaluation-2). The relationships were investigated between the increase of ACR and the U-COL. The effect of angiotensin receptor blockers (ARB) treatment on the correlations between U-COL and ACR at Evaluation-2 on one hand, and between U-COL and percent change of ACR on the other, was also analyzed. Furthermore, we investigated whether the increase in 8-OHdG and in MCP-1 in a year prior to the Evaluation-1 were risk factors of the rise in U-COL levels. Results: Both U-COL and SBP at Evaluation-1, but not ARB treatment, were independent risk factors for an increased ACR after 2 years. ARB treatment significantly suppressed the increase in ACR after 2 years in patients with higher U-COL excretion. The percentage changes in 8-OHdG (%8-OHdG) and MCP-1 (%MCP-1) in one year prior to Evaluation-1 measurements are independent risk factors for U-COL. HbA1c and SBP values one year prior to Evaluation-1 are independent risk factors not only for %8-OHdG but also, for baseline U-COL. The %8-OHdG is an independent risk factor for %MCP-1. Conclusions: U-COL may predict an increase in the ACR. The U-COL seems to be increased with oxidative stress and inflammation induced by past hyperglycemia.

关键词： Type IV Collagen Diabetic Nephropathy Oxidative Stress Monocyte Chemoattractant Protein-1

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Late-onset non-islet cell tumor hypoglycemia: A case report

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World Journal of Clinical Cases 2021年第1期9卷 163-169页

作者： Shunichi Matsumoto Eijiro Yamada Yasuyo Nakajima Naoki Yamaguchi Takashi okamura Toshiki Yajima Satoshi Yoshino Kazuhiko Horiguchi Emi Ishida masashi Yoshikawa Jun Nagaoka Sho Sekiguchi Mai Sue Shuichi Okada Izumi Fukuda Ken Shirabe Masanobu Yamada Department of Medicine and Molecular Science Gunma University Graduate School of MedicineMaebashi 371-8511GunmaJapan Division of General Thoracic Surgery Integrative Center of General SurgeryGunma University HospitalMaebashi 371-8511GunmaJapan Department of Endocrinology Diabetes and MetabolismGraduate School of Medicine Nippon Medical SchoolTokyo 1138602Japan

BACKGROUND Hypoglycemia due to non-insulin-producing tumors is referred to as non-islet cell tumor hypoglycemia(NICTH).As NICTH is a rare lesion,the natural course of NICTH is not well understood.We report a case of NICTH that was observed 30 years before the onset of hypoglycemia.CASE SUMMARY A 50-year-old man was diagnosed with an abnormal right chest shadow during a routine X-ray examination,but no further examination was undertaken because the lesion appeared benign.Thirty years after the tumor discovery,the patient was admitted to the hospital with symptoms of severe hypoglycemia,which was diagnosed as NICTH based on a complete examination.The tumor was resected and found to be a solitary fibrous mass(15.6 cm×13.7 cm×10.4 cm);thereafter,the patient’s blood glucose levels normalized and he completely recovered.CONCLUSION NICTH can have an acute onset,even if the tumor has been present and asymptomatic over a long time period.

关键词： Hypoglycemia Non-islet cell tumor hypoglycemia Blood glucose Solitary tumor Late onset Case report Insulin-like growth factor II

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