• Text in Japanese

ision of personalized medicine for individual diabetic patients of varying conditions

In current treatments for diabetes, the target blood glucose value of each individual patient shoudl be determined by taking into consideration their age, duration of disease, degree of vascular complications, and presence of other severe complications. However, how to conduct precise evaluation and which medicines we should choose have not been determined. In our laboratory, we focus on the evaluation of age, disease complications and pathology, to determine best treatments for individual diabetic patients. To achieve this goal the following projects are currently in progress.

1.Study of drug selection for elderly diabetics

1)　Efficiency of basal insulin and GLP-1 (human glucagon-like peptide-1) receptor agonist combination therapy for elderly diabetic patients: In comparison to comprehensive control of blood glucose levels, it is more important to prevent hypoglycemia and choose simple treatment approaches in elderly patients. We are investigating the efficiency and limitations of such approaches while considering the individual demands of the patient.

2)　Oral hypoglycemic drugs: We are analyzing how various oral hypoglycemic agents influence treatment satisfaction distinctively for elderly and non-elderly diabetic patients. In addition, we are following the medical compliance of such treatment.

2.Optimal treatment for diabetic patients with severe complications

1)　The contorl of blood glucose level during the perioperative period of vitrectomy of patients with diabetic retinopathy: Research has indicated that the decrease of HbA1c during the 3 months before surgery is associated with a higher risk of postoperative bleeding in diabetic retinopathy patients who underwent vitrectomy. It is a common practice to lower HbA1c levels prior to surgery by the use of drugs. However, the effect of lowering blood glucose may be inappropriate for diabetic patients with diabetic retinopathy during the perioperative period of vitrectomy.

2)　Optimal treatment for diabetic patients with malignant tumor: Liver cancer is commonly associated with diabetes. We are trying to investigate how variations in glycemic control and medication affect life prognosis and recurrence rate for liver cancer. This work is in collaboration with the Department of Gastroenterology and Hepatology.

3.Delayed diagnosis of lifestyle diseases and interruption of treatments in relation to arteriosclerosis

By studying the diagnostic and therapeutic conditions of cardiovascular patients including peripheral artery disease patients, we aim to identify the factors related to the delay in diagnosis and treatment interruption for lifestyle diseases. Furthermore, by continuous follow-up on the study group, it is possible to predict how the delay in diagnosis or treatment interruption of lifestyle diseases affects the occurrence of subsequent events, i.e., overall mortality or the onset of major cardiovascular diseases, etc.

4.Search for factors that improve insulin resistance in type 2 diabetic patients associated with obesity

One of the causes of diabetes is insulin resistance. Insulin exerts its effect in adipose tissue, and when immune cells enter adipose tissue they induce an inflammation response weakening the action of insulin. We are conducting research aiming at identifying factors that suppress these immune cells invasion in adipose tissue.