Publications by authors named "Yuko Okada"
Association of metformin treatment with changes in metal dynamics in individuals with type 2 diabetes.
BMJ Open Diabetes Res Care
August 2025
Introduction: The metal-chelating activity of metformin, which has long been known but of unclear clinical relevance, has recently been implicated in the pleiotropic effects, including antitumorigenic and anti-inflammatory actions, of the drug. However, whether metformin actually influences metal dynamics in humans has remained unknown. We here investigate whether metformin influences serum metal levels in individuals with type 2 diabetes.
View Article and Find Full Text PDFManagement of pediatric Peutz-Jeghers syndrome: Highlighting the efficacy and safety of endoscopic ischemic polypectomy.
J Pediatr Gastroenterol Nutr
March 2025
Objectives: Patients with Peutz-Jeghers syndrome (PJS) require continuous medical management throughout their lives. However, few case series regarding the clinical course, polyp surveillance, and treatment, including endoscopic ischemic polypectomy (EIP) for pediatric patients with PJS, were reported. We analyzed the current status and clinical course of pediatric patients with PJS under the management of our institute, including those treated with EIP.
View Article and Find Full Text PDFContext: Sodium-glucose cotransporter 2 (SGLT2) inhibitors lower blood glucose levels by promoting urinary glucose excretion, but their overall effects on hormonal and metabolic status remain unclear.
Objective: We here investigated the roles of insulin and glucagon in the regulation of glycemia in individuals treated with an SGLT2 inhibitor using mathematical model analysis.
Methods: Hyperinsulinemic-euglycemic clamp and oral glucose tolerance tests were performed in 68 individuals with type 2 diabetes treated with the SGLT2 inhibitor dapagliflozin.
Although transamidation of amides generally requires metals, additives, or harsh conditions, we present here a facile transamidation of -cyano amides with various amines at ambient temperature without any additive. -cyano amides preferred the trans conformation and have a reduced double bond character revealed by crystal analysis. The DFT study indicates that the transamidation reaction proceeds through the direct attack of amine on the amide carbonyl since the LUMO (or LUMO+1) is located at the carbonyl moiety.
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- Multiple endocrinopathies, particularly the rare combination of hypophysitis and type 1 diabetes mellitus (T1DM), can occur as adverse events from immune checkpoint inhibitors (ICIs) like anti-PD-1 antibodies.
- In a study analyzing three cases along with existing reports, it was found that all patients had specific human leukocyte antigen (HLA) haplotypes linked to hypophysitis, and these cases predominantly affected men in their 60s.
- The onset of endocrine disorders occurred similarly in both combined and single endocrinopathy cases, indicating no significant difference in the time frame from ICI treatment initiation to disease manifestation, suggesting the need for more research on this condition.
Article Synopsis
- - The study investigates how different subtypes of type 1 diabetes mellitus (slowly progressive, acute-onset, and fulminant) affect bone mineral density (BMD), particularly at the lumbar spine and femoral neck.
- - Results show that acute-onset diabetes has lower lumbar spine BMD compared to slowly progressive diabetes, while femoral neck BMD is generally higher in the slowly progressive subtype.
- - The findings suggest that BMD changes over time are linked to insulin secretion levels, indicating that longer exposure to low insulin might contribute to greater declines in bone mineral density in certain subtypes.
Article Synopsis
- Diabetic ketoacidosis (DKA) is a critical and life-threatening condition in both type 1 and type 2 diabetes, with varying causes and treatment necessities based on the diabetes type.
- This study compared clinical characteristics of 24 type 1 and 13 type 2 diabetes patients diagnosed with DKA, revealing different primary causes and symptoms for each group.
- Key conclusions emphasize the need for targeted social and lifestyle support to prevent DKA, highlighting symptoms and lab results as crucial for determining the appropriate emergency treatment.
Patients with diabetes mellitus having insulin antibodies (InsAb) with properties of high binding capacity and low affinity, which are observed in insulin autoimmune syndrome (IAS), are known to have greater plasma glucose fluctuations. Glycated albumin (GA) and the GA/HbA1c ratio have been demonstrated to reflect plasma glucose fluctuations. Hence, we hypothesized that GA or the GA/HbA1c ratio in diabetic patients having InsAb with properties of high binding capacity and low affinity may be higher than those in InsAb-negative diabetic patients, and we verified this hypothesis.
View Article and Find Full Text PDFPredictive factors for postpartum glucose intolerance in women with gestational diabetes mellitus.
J Obstet Gynaecol Res
March 2022
Aim: The aim of this prospective cohort study was to evaluate the risk factors for postpartum glucose intolerance (GI) in women with gestational diabetes mellitus (GDM).
Method: A total of 140 women with GDM were enrolled. Of these, 115 underwent a 75-g oral glucose tolerance test (OGTT) at 12 weeks after delivery.
Reduction of acute gastric volvulus in a 3-year-old using a balloon-attached endoscope combined with gel immersion endoscopy.
Clin J Gastroenterol
February 2022
Article Synopsis
- When treating gastric volvulus through endoscopy, it's crucial to keep intragastric pressure low and stabilize the endoscope in the duodenum.
- A new method called gel immersion endoscopy helps maintain a clear visual field by injecting gel, making it easier to use a balloon-equipped endoscope without harming the stomach lining.
- A case involving a 3-year-old boy displayed the successful use of this technique, providing a safe alternative to surgical intervention for reducing gastric volvulus, especially in non-emergency situations.
Type 1 diabetes mellitus is characterized by the destruction of pancreatic β-cells and requires the regeneration of these destroyed pancreatic β-cells for radical treatment. The degeneration of organelles in stem cells compromises stem cell quality; however, organelles in the mesenchymal stem cells of patients with type 1 diabetes mellitus have not been characterized previously. In this study, we use transmission electron microscopy to evaluate the degeneration of organelles in adipose-derived stem cells of patients with type 1 diabetes mellitus (T1DM ADSCs).
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- - The study investigates how insulin resistance affects heart function in people with type 2 diabetes, comparing a well-known measure (HOMA-IR) to a more accurate method (hyperinsulinemic-euglycemic clamp analysis).
- - 34 individuals with type 2 diabetes were analyzed, finding that insulin sensitivity (ISI) was significantly connected to heart function measures, while HOMA-IR showed no correlation.
- - Results suggest that high insulin sensitivity is an important predictor of better heart function (measured by E/A ratio and LVEF), indicating a potential link between insulin resistance and heart problems in type 2 diabetes patients.
Sodium-glucose cotransporter 2 (SGLT2) inhibitors often increase the hematocrit. It remains unclear whether this increase would be observed in all patients administered SGLT2 inhibitors, however. We therefore used the data from the previous study and investigated time-dependent alterations of various outcomes related to erythrocytes, erythropoiesis, and clinical outcome in type 2 diabetes subjects ( = 89) treated with ipragliflozin for 16 weeks.
View Article and Find Full Text PDFJuvenile polyposis syndrome-hereditary hemorrhagic telangiectasia associated with a SMAD4 mutation in a girl.
Clin J Gastroenterol
December 2020
Article Synopsis
- Juvenile polyposis syndrome (JPS) and hereditary hemorrhagic telangiectasia (HHT) are rare inherited disorders, and some individuals with a mutation in the SMAD4 gene may develop both conditions, known as JPS-HHT.
- A case study is presented of a 9-year-old patient who, after initial suspicion of Crohn's disease and subsequent colonoscopy, was found to have multiple polyps but no mutations linked to other syndromes.
- Further evaluation revealed symptoms like nosebleeds and abnormal blood vessel formations, leading to the discovery of a specific SMAD4 gene mutation, and the patient is now under regular monitoring for related vascular issues and gastrointestinal cancer.
Patients with pheochromocytoma exhibit low aldosterone renin ratio-preliminary reports.
BMC Endocr Disord
September 2020
Article Synopsis
- The study investigates plasma renin activity (PRA), plasma aldosterone concentration (PAC), and aldosterone renin ratio (ARR) in patients with pheochromocytoma (PCC) compared to those with subclinical Cushing's syndrome (SCS) and non-functioning adrenal adenoma (NFA).
- Results showed that PRA was significantly higher in PCC patients, while ARR was lower compared to SCS and NFA patients, suggesting ARR may be a more sensitive indicator for detecting PCC.
- The study concludes that the reduced ARR in PCC patients could help differentiate them from those with other adrenal conditions, indicating a need for further research on its diagnostic value.
Article Synopsis
- The study aimed to compare the effects of two insulin types, insulin degludec (IDeg) and insulin glargine U300 (IGlarU300), on blood sugar stability in people with type 1 diabetes.
- In a crossover trial with 46 participants, each insulin was given for four weeks, and various glycaemic measurements were taken to evaluate their effectiveness.
- The results showed that both insulins had similar effects on blood sugar variability, but IDeg led to lower average blood sugar levels and better control compared to IGlarU300.
Objective: Positron emission tomography (PET)-computed tomography has revealed that metformin promotes the intestinal accumulation of [F]fluorodeoxyglucose (FDG), a nonmetabolizable glucose derivative. It has remained unknown, however, whether this accumulation occurs in the wall or intraluminal space of the intestine. We here addressed this question with the use of [F]FDG PET-MRI, a recently developed imaging method with increased accuracy of registration and high soft-tissue contrast.
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- The study aimed to evaluate if the homeostasis model assessment of insulin resistance (HOMA-IR) accurately reflects insulin sensitivity in patients with type 2 diabetes undergoing treatment with a sodium-glucose cotransporter 2 inhibitor (SGLT2i) like dapagliflozin.
- Researchers used hyperinsulinemic-euglycemic clamp analysis on 22 diabetic patients taking the medication and compared them with a matched control group of 44 patients not on SGLT2i, identifying 17 pairs for analysis.
- Results showed a negative correlation between natural log-transformed HOMA-IR and insulin sensitivity index (ISI) in both groups, but HOMA-IR values were lower for the SGLT
A boy with Alagille syndrome coexisting with mid-aortic syndrome and renovascular hypertension.
J Cardiol Cases
January 2020
Article Synopsis
- Alagille syndrome (ALGS) features cholestasis from a lack of bile ducts, along with various anomalies affecting the heart, eyes, skeleton, and facial structure; Mid-aortic syndrome (MAS) is a rare condition involving narrowing of the abdominal aorta and its major branches.
- A four-year-old boy with ALGS was found to have elevated blood pressure and severe renal artery stenosis due to MAS, which was confirmed through 3D-CT angiography.
- Although vascular issues are seen in some ALGS patients, the co-occurrence of ALGS and MAS is very rare, highlighting the need for careful screening of blood vessels in these patients to prevent complications.
Relationship between metformin use and vitamin B status in patients with type 2 diabetes in Japan.
J Diabetes Investig
July 2020
Article Synopsis
- Metformin therapy may lead to vitamin B12 deficiency, but research on this in Asian populations is limited, prompting a study on Japanese type 2 diabetes patients.
- The study compared 122 patients treated with metformin to 63 control patients, measuring serum homocysteine levels and other parameters related to VB12 status.
- Results indicated no significant differences in VB12 levels between groups, though higher metformin doses correlated with lower VB12; elderly patients on metformin showed lower hemoglobin levels, suggesting a risk of anemia.
Aims/introduction: Sulfonylurea-related hypoglycemia increases the risk of cardiovascular sequela, such as cardiac arrhythmia. This study aimed to clarify the relationship between the level of glycated hemoglobin (HbA ) and the duration of hypoglycemia in type 2 diabetes patients treated with sulfonylureas.
Materials And Methods: Glucose levels in the enrolled patients (n = 300) were investigated with a professional continuous glucose monitoring device in the outpatient setting at six diabetes centers in Japan.
Article Synopsis
- * A specific peptide derived from tenascin-C, TNIIIA2, has been shown to activate β1-integrin, promote cancer cell invasion, and is found in early dysplastic lesions in a mouse model of CAC.
- * The FNIII14 peptide, which can deactivate β1-integrin, demonstrated the potential to reduce tumor formation in the same model, suggesting it could be a promising preventive treatment for CAC.