糖尿病透析患者でのインスリンからａｃａｒｂｏｓｅ（グルコバイ）への切り替え成功例と失敗例

• 大野 敦

  東京医科大学八王子医療センター内分泌代謝内科

• 旭 暢照

  東京医科大学八王子医療センター内分泌代謝内科

• 佐藤 知也

  東京医科大学八王子医療センター内分泌代謝内科

• 植木 彬夫

  東京医科大学八王子医療センター内分泌代謝内科

• 横関 一雄

  三愛記念クリニック

• 林 春幸

  三愛記念クリニック

• 入江 康文

  三愛記念クリニック

• 林 徹

  東京医科大学第3内科

書誌事項

タイトル別名

• Response and resistance to acarbose replacing insulin in diabetic patients on dialysis.

抄録

The ability of acarbose (Glucobay^®) to replace low-dose (4-8IU/day) insulin therapy was assessed in 4 patients (mean age: 56.5±2.1 year-old; mean diabetes estimated duration: 17.5±7.3 years; mean duration of dialysis: 21.5±6.5 months; mean insulin dose prior to acarbose: 6.5±1.9IU/day) who exhibited diabetic nephropathy and were maintained on dialysis. Good control of HbA_1c (7-8%) was achieved but patients presented with hypoglycemia during dialysis. On the day following insulin withdrawal, acarbose therapy at a daily dose of 300mg (150mg for patient 3 only) was initiated. HbA_1c and fructosamine (FRA) levels, as well as abdominal symptoms starting at 12 to 15 months after replacement were compared to those observed at 9 months prior to replacement. Patient 1 was a 54-year-old woman. Following replacement of insulin, her HbA_1c and FRA values were significantly reduced along with a transient improvement in bowel movement. Patient 2 was a 59-year-old man. Fifty days after the replacement of insulin anorexia developed, and insulin therapy was resumed. Subsequently he regained his appetite, but HbA_1c and FRA values increased, requiring a higher insulin dose (monotard insulin: 8IU/day→12IU/day). Patient 3 was a 57-year-old woman. Her HbA_1c and FRA were maintained at similar levels, but a pre-existing alternate stool abnormality was exacerbated. Patient 4 was a 59-year-old man. His HbA_1c and FRA were maintained at similar levels, but transient tarry stool required acarbose therapy suspension. Acarbose, which replaced insulin, continued to achieve good control of blood glucose as evidenced by HbA_1c and FRA values that remained steady or lowered. However, acarbose did cause abdominal symptoms severe enough to require drug suspension or discontinuation in some patients.

収録刊行物

• 日本透析医学会雑誌

  日本透析医学会雑誌 29 (2), 141-147, 1996

  一般社団法人 日本透析医学会

キーワード

• 糖尿病透析患者
• インスリン療法
• 血糖コントロール
• 腹部症状

詳細情報

• CRID: 1390001204676970496
• NII論文ID: 10005562139
• NII書誌ID: AN10432053
• DOI: 10.4009/jsdt.29.141
• ISSN: 1883082X
• ISSN: 13403451
• Web Site: https://search.jamas.or.jp/link/ui/1996203441
• 本文言語コード: ja
• データソース種別:
  • JaLC
  • Crossref
  • CiNii Articles
• 抄録ライセンスフラグ: 使用不可