1.A Case of Type 2 Diabetes with Ipragliflozin Administration Developing Euglycemic Diabetic Ketoacidosis Due to Reduced Food Intake Following Colonoscopy
Takamasa OSAKI ; Shusaku TOMITA ; Takahiro HARADA ; Shoko MATSUMOTO ; Hiroyuki SAITO
An Official Journal of the Japan Primary Care Association 2024;47(1):12-16
The patient was an 80-year-old woman with type 2 diabetes mellitus taking ipragliflozin. She underwent a colonoscopy one week prior to admission. After the colonoscopy, she felt exhausted and lost her appetite. On the day of admission, she was admitted to the emergency department because of abdominal pain and repeated vomiting. Physical examination and chest and abdominal CT were performed; however, no cause was identified for the abdominal pain or vomiting. Blood gas analysis showed high anion gap metabolic acidosis. Serum ketones were elevated to 6,045/μL and plasma glucose concentration was 182 mg/dL. We diagnosed ipragliflozin-induced euglycemic diabetic ketoacidosis (euDKA) and discontinued the drug. Ketoacidosis improved with administration of intravenous fluids and insulin injections. Her abdominal pain and vomiting improved. It is important to recognise that patients taking SGLT2 inhibitors may develop euDKA, as in this case, due to fasting after colonoscopy or reduced food intake after the procedure, and to discontinue SGLT2 inhibitors at least 2 days before the procedure.
2.An Integrated High School-University Lecture Program in Basic Medical Science
Yoji NAGASHIMA ; Yukio KATOUNO ; Takamasa SAITO ; Hideki KANEKO ; Ichiro AOKI ; Hitoshi KITAMURA ; Rieko IJIRI ; Eiji GOTO
Medical Education 2005;36(2):101-106
Integrated lecture programs for high school students involving university teaching staff have recently become popular. Here, we report on such a program involving lectures on tumor pathology attended by 110 high school students at the Yokohama City University School of Medicine. Two weeks before the lectures at our university, the students were given a 45-minute introductory lecture by a teacher at their school. The 1-day course at our university comprised an overview lecture by the author (40 minutes), light-microscopic observation of histologic specimens of normal and tumor tissues (50 minutes), and a summary with an introduction to diagnostic pathology (20 minutes). During light-microscopic observation, medical students served as teaching assistants. The high school students were given handouts of microscopic