Evaluation of Glycemic Control Using Continuous Glucose Monitoring in a Case of Insulin Antibody-positive Type 2 Diabetes Treated With Steroid

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  • インスリン抗体陽性2型糖尿病患者のステロイド投与による血糖改善を持続血糖モニターで評価しえた1例

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Abstract

<p>A 76-year-old man was diagnosed with type 2 diabetes at 41 years of age and treated with oral hypoglycemic agents. Insulin therapy was started at 63 years of age. Because his glycemic control was worsened by insulin antibodies (binding rate 53.1 %, serum level >5000 nU/mL), his insulin formulation was replaced at 70 years of age. His glycemic control improved only temporarily, so prednisolone (20 mg/day) was started, and this dramatically improved his glycemic control. The dosage of prednisolone was gradually reduced, and it was discontinued entirely at 76 years of age. However, his glycemic control worsened again after stopping steroid therapy. We admitted him to our hospital and evaluated his daily blood glucose profile via continuous glucose monitoring (CGM). CGM showed gradual reductions in both the fasting and postprandial blood glucose from the day after he began prednisolone (20 mg/day). We therefore reduced his insulin dose (total daily dose: 95 units on admission, 48 units at discharge). We also evaluated the glycemic variability using the following indicators: M value, MAGE and CONGA-1. We observed that these indicators decreased with steroid therapy.</p>

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