2019 Fiscal Year Final Research Report
Optimization of the treatment and investigation of predictors for the glucocorticoid-induced diabetes
| Project/Area Number |
18K14956
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| Research Category |
Grant-in-Aid for Early-Career Scientists
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| Allocation Type | Multi-year Fund |
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| Review Section |
Basic Section 47060:Clinical pharmacy-related
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| Research Institution | Keio University |
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Principal Investigator |
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| Project Period (FY) |
2018-04-01 – 2020-03-31
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| Keywords | グルココルチコイド誘発性糖尿病 / ステロイド性糖尿病 |
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| Outline of Final Research Achievements |
We analyzed prescriptions for glucocorticoid (GC)-induced diabetes mellitus (GCDM) and found that drugs tended to be selected for the purpose of suppressing postprandial blood glucose elevation, which is a characteristic of GCDM. Among patients with GCDM, the percentages of patients who were not prescribed insulin was significantly higher in patients with normal blood glucose status than in patients with type 2 diabetes; thus, blood glucose status before GC administration may influence the selection of therapeutic agents.
We also examined the conditions for urinary steroid concentration measurement using LC-MS/MS to calculate 11β-HSD1 activity in GC-treated patients. We plan to investigate the relationship between changes in 11β-HSD1 activity and blood glucose levels before and after GC administration in patients with rheumatic disease who are scheduled to receive a high dose of GC.
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| Free Research Field |
医療薬学
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| Academic Significance and Societal Importance of the Research Achievements |
現在GCDMの治療ガイドラインは策定されておらず、昼から夜にかけて血糖値が上昇する特徴を持つGCDMにおける最適な薬剤選択方法は確立していない。新たな糖尿病用薬が次々と開発されている現状で、GCDMに対してより効果的な薬剤を選択するための情報を収集することは非常に重要である。また臨床現場では、GC投与患者に対し医師が自己血糖測定値等を確認し、GCDMの治療の要否を判断しているが、その対応が後手に回ることも少なくない。GCDMの予測因子が明らかになり、治療の要否を決める際の基準となれば、治療の計画・実行を主導する医師の迅速な判断の一助となり、GCによる治療を受ける患者にとって非常に有益である。
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