Publications by authors named "So Nagai"

Aims: To compare the efficacy of adding imeglimin versus that of metformin dose escalation on glycemic control in subjects with type 2 diabetes treated with a dipeptidyl peptidase-4 inhibitor plus low-dose metformin (500-1000 mg/day).

Materials And Methods: In this multicentre, open-labelled, prospective, randomized, parallel-group comparison study, the addition of imeglimin (2000 mg/day) or metformin escalation was applied for 24 weeks in eligible subjects. The primary endpoint was the mean change in glycated haemoglobin (HbA1c) over 24 weeks.

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  • Fibrates can cause renal toxicity, which limits their use in patients with chronic kidney disease (CKD), but pemafibrate appears to be less harmful to kidney function.
  • A study analyzed the effects of pemafibrate on 520 diabetic participants, assessing changes in kidney function over 52 weeks across different treatment options (ADD-ON, SWITCH, CTRL).
  • Findings indicated that eGFR improved only in the SWITCH group, particularly in patients without severe kidney dysfunction, suggesting that switching to pemafibrate may benefit kidney function, but less so in patients with advanced renal issues.
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  • The study examined the relationship between fasting serum proinsulin levels and liver fat accumulation (hepatic steatosis) in individuals with type 2 diabetes, using a fatty liver index to gauge severity.
  • It included 268 participants categorized into three groups based on their fatty liver index: low, moderate, and high.
  • Results indicated that higher proinsulin levels correlated with increased severity of hepatic steatosis, suggesting the liver and pancreas may influence each other's functions in the context of type 2 diabetes.
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  • The study aimed to determine if switching from DPP-4 inhibitors to oral semaglutide improves blood sugar control in type 2 diabetes patients more effectively than continuing DPP-4 inhibitors.
  • Over 24 weeks, significant improvements in HbA1c levels, body weight, and other metabolic markers were observed in participants who switched to semaglutide compared to those who remained on DPP-4 inhibitors.
  • While semaglutide showed clear benefits, some participants experienced gastrointestinal issues, indicating that such side effects need to be monitored in treatment plans.
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Background: Pemafibrate has been reported to ameliorate lipid profiles and liver dysfunction. However, which patients derive benefit from the hepatoprotective effects of pemafibrate is unclear.

Methods: We conducted a sub-analysis of the PARM-T2D study where subjects with type 2 diabetes complicated by hypertriglyceridemia were prospectively treated with pemafibrate or conventional therapies for 52 weeks.

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  • Classical-like Ehlers-Danlos syndrome (clEDS) is an autosomal recessive disorder linked to the absence of tenascin-X and specific genetic variations identified in 50 patients from 43 families.
  • Detecting these genetic variants is difficult due to a related pseudogene that can interfere with analysis; researchers developed a new genetic screening system to overcome this challenge.
  • This study found biallelic variants in nine new patients and noted a higher occurrence of gastrointestinal issues compared to earlier reports, emphasizing the need for increased awareness of these complications associated with clEDS.
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  • - Non-alcoholic fatty liver disease (NAFLD) is a common issue for people with type 2 diabetes (T2DM), and while some diabetes treatments may help, the effects of semaglutide on NAFLD weren't fully known before this study.
  • - This subanalysis of the SWITCH-SEMA 1 study looked at participants with suspected NAFLD who switched to semaglutide from other treatments, finding improvements in their fatty liver index (FLI) over 24 weeks compared to those who continued their previous medications.
  • - Results showed that switching from dulaglutide to semaglutide significantly improved FLI, especially for older participants with lower initial FLI, suggesting that semag
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The Ehlers-Danlos Syndromes (EDS), a group of hereditary connective tissue disorders, were classified into 13 subtypes in the 2017 International Classification. Recently, a new subtype of EDS called classical-like EDS type 2 (clEDS2), which is caused by biallelic variants in the adipocyte enhancer binding protein 1 () gene, was identified. We describe the 11th patient (9th family) with clEDS2, who was complicated by a critical vascular event (superior mesenteric artery aneurysm and rupture).

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  • The study aimed to assess how body fat mass and serum adiponectin levels affect glucose variability (GV) in individuals with type 2 diabetes, focusing on different insulin secretion levels.
  • It involved 193 participants who underwent glucose monitoring and analysis to determine their insulin secretion status based on fasting C-peptide levels.
  • Findings indicated that in those with preserved insulin secretion, body fat area did not affect GV, while in those with impaired secretion, lower fat area was linked to higher GV, indicating a more complex relationship between body fat and glucose stability.
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Aim: To investigate the effects of switching from liraglutide or dulaglutide to once-weekly semaglutide on glycaemic control and treatment satisfaction in patients with type 2 diabetes.

Materials And Methods: In this multicentre, open-labelled, prospective, randomized, parallel-group comparison study, patients treated with liraglutide 0.9-1.

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  • Imeglimin is a new anti-hyperglycemic drug that helps improve insulin resistance and secretion, and its effects are being studied in patients with type 2 diabetes (T2D) compared to metformin in a clinical trial.
  • The trial involves 70 participants currently on a DPP-4 inhibitor and low-dose metformin, who will be randomized to receive either imeglimin or an increased dose of metformin for 24 weeks, with primary focus on changes in HbA1c levels.
  • The study aims to provide insights on how imeglimin can be integrated into diabetes treatment plans and will be the first to compare its effectiveness against metformin dose adjustments in a controlled setting.
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Aims: Pemafibrate, a novel selective peroxisome proliferator-activated receptor modulator, was shown to ameliorate lipid abnormalities in a phase III clinical trial of patients with type 2 diabetes mellitus (T2DM). However, its efficacy has not been demonstrated in real-world clinical practice in patients with T2DM.

Methods: We performed a multi-center prospective observational study of the use of pemafibrate in patients with T2DM and hypertriglyceridemia versus conventional therapy, with or without a fibrate.

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Aim: To investigate the achievement of individualized target HbA1c based on the Japanese guideline after geriatric assessment with the Dementia Assessment Sheet for Community-based Integrated Care System 8-items (DASC-8) and to evaluate patient characteristics acting as barriers to achieving the target HbA1c in elderly outpatients with diabetes.

Methods: This cross-sectional study enrolled 303 Japanese outpatients aged ≥65 years with diabetes. Their health status was measured using the DASC-8.

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An 85-year-old man was being treated with anti-cancer drugs for adenocarcinoma of the lung and was on a tapering dose of prednisolone for interstitial pneumonia. He attended our hospital complaining of fatigue, thirst, and polyuria in September 2020. His postprandial plasma glucose concentration was 976 mg/dL, his glycated hemoglobin was 8.

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Introduction: Incretin-based therapies exert antihyperglycaemic effects in patients with type 2 diabetes (T2D) in a blood glucose concentration-dependent fashion. The first-in-class oral glucagon-like peptide-1 receptor agonist semaglutide has potent effects on glycaemic and weight control, but little evidence has been published for the superiority of semaglutide for glycaemic control in patients after switching from a dipeptidyl peptidase-4 (DPP-4) inhibitor. Therefore, we aim to verify the efficacy of oral semaglutide in patients with T2D being treated with a DPP-4 inhibitor.

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Aims: Sodium-glucose cotransporter-2 inhibitor (SGLT2i) reduces clinic blood pressure (BP), but the effects on BP circadian rhythm remain unclear. The present study aimed to determine the nighttime antihypertensive effect of SGLT2i compared with dipeptidyl peptidase-4 inhibitor (DPP-4i) in patients with type 2 diabetes and hypertension.

Materials And Methods: In this randomized, open-label, parallel-group trial, patients treated with DPP-4i were either switched to luseogliflozin 2.

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  • Thyroid storm is a rare but life-threatening condition that can occur after surgery, as shown in a case involving a 76-year-old man after radical nephrectomy for kidney cancer.
  • Post-surgery, the patient exhibited severe symptoms including fever, rapid heartbeat, and confusion, leading to the diagnosis of perioperative hyperthyroidism.
  • Timely treatment with corticosteroids and iodide successfully improved his condition, highlighting the importance of recognizing and managing thyroid storm to prevent fatal outcomes.
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Objective Glucose-dependent insulinotropic polypeptide (GIP) is speculated to worsen growth hormone (GH) hypersecretion in acromegaly and to be a cause of paradoxical increases in GH (PI-GH) during 75-g oral glucose tolerance testing (75-g OGTT). Dipeptidyl peptidase-4 inhibitors (DPP4is), which increase the circulating concentration of active GIP, are frequently administered to diabetic patients, including those with acromegaly. We aimed to determine whether or not the administration of a DPP4i increases GH concentration, especially in patients demonstrating PI-GH during a DPP4i-OGTT, in which a DPP4i was administered immediately before 75-g OGTT.

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Dipeptidyl peptidase-4 (DPP-4), namely CD26, is expressed on the surface of immune cells, suggesting that inhibition of DPP-4 might affect the immune system. The current multicenter observational case-control study was carried out to investigate the effects of DPP-4 inhibitor (DPP-4i) administration on Graves' disease (GD) activity. This study comprised patients with GD and type 2 diabetes, who were administered an oral hypoglycemic agent including DPP-4i.

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The contribution of endogenous insulin secretion to glycemic variability (GV) may differ between patients with impaired insulin secretion and those with preserved secretion. Our objective was to determine the linearity of the relationship between fasting C-peptide (CPR) as a marker of endogenous insulin secretion and GV in type 2 diabetes (T2DM), regardless of the type of antidiabetic treatment. We conducted a prospective observational study using continuous glucose monitoring obtained from 284 Japanese outpatients with T2DM with various HbA1c values and antidiabetic treatment.

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Background: This study aimed to explore predictive factors of time below target glucose range (TBR) ≥ 1% among patients' characteristics and glycemic variability (GV) indices using continuous glucose monitoring data in elderly patients with type 2 diabetes.

Methods: We conducted a prospective observational study on 179 (71 female) Japanese outpatients with type 2 diabetes aged ≥ 65 years. The characteristics of the participants with TBR ≥ 1% were evaluated by multivariate logistic regression analysis.

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The prevalence of Gaucher disease (GD) in Japan is much lower than that in Western countries; therefore, data on Japanese pediatric patients with GD type 1 are currently limited. The present study reports on the case of a Japanese pediatric patient with GD type 1 who was diagnosed when she presented with hepatosplenomegaly, thrombocytopenia and slight anemia at the age of 2 years. Serology tests revealed high levels of acid phosphatase (ACP) and angiotensin-converting enzyme (ACE).

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Introduction: Glucagon-like peptide (GLP)-1 receptor agonists exert potent hypoglycemic effects in patients with type 2 diabetes (T2D) in a blood glucose concentration-dependent manner. Once-weekly subcutaneous administration of the GLP-1 receptor agonist semaglutide has beneficial effects on glycemic and body weight control, but it is currently unclear if semaglutide provides superior glycemic control compared to conventional GLP-1 receptor agonists in the Japanese population. We aim to compare the effects of once-weekly subcutaneous semaglutide with those of liraglutide or dulaglutide administration in Japanese patients with T2D.

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Aims/introduction: We recently reported the beneficial effect of the combination of sodium-glucose cotransporter 2 inhibitor and dipeptidyl peptidase-4 inhibitor on daily glycemic variability in patients with type 2 diabetes mellitus. Additional favorable effects of combination therapy were explored in this secondary analysis.

Materials And Methods: The CALMER study was a multicenter, open-label, prospective, randomized, parallel-group comparison trial for type 2 diabetes mellitus involving continuous glucose monitoring under meal tolerance tests.

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Aims/introduction: To identify the effect of combination therapy with a dipeptidyl peptidase-4 inhibitor and a sodium-glucose cotransporter 2 inhibitor compared with switching from a dipeptidyl peptidase-4 inhibitor to a sodium-glucose cotransporter 2 inhibitor on improving the glucose variability in patients with or without impaired endogenous insulin secretion.

Materials And Methods: A secondary analysis regarding the relationship between endogenous insulin secretion and the change in mean amplitude of glycemic excursions (ΔMAGE) was carried out in a multicenter, prospective, randomized, parallel-group comparison trial that enrolled patients with type 2 diabetes who had been taking teneligliptin and were treated by switching to canagliflozin (SWITCH) or adding canagliflozin (COMB). Participants were categorized into the following four subgroups: SWITCH or COMB and high or low fasting C-peptide (CPR) divided at baseline by the median.

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