Yoshiki Kusunoki

Publications (5)5.42 Total impact

• Article: Effect of additional administration of acarbose on blood glucose fluctuations and postprandial hyperglycemia in patients with type 2 diabetes mellitus under treatment with alogliptin.

  Yoshiki Kusunoki, Tomoyuki Katsuno, Makiko Myojin, Kana Miyakoshi, Takashi Ikawa, Toshihiro Matsuo, Fumihiro Ochi, Masaru Tokuda, Kazuki Murai, Masayuki Miuchi, Tomoya Hamaguchi, Jun-Ichiro Miyagawa, Mitsuyoshi Namba
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  ABSTRACT: Acarbose was administered at 300 mg/day to patients with type 2 diabetes mellitus (T2DM) who had been taking 25 mg/day of alogliptin, and levels of blood glucose were analyzed by continuous glucose monitoring (CGM) for 3 days. The mean blood glucose level with acarbose (136.4 ± 30.7 mg/dL) did not differ significantly from that without acarbose (141.7 ± 28.3 mg/dL). However, in the condition of the combination therapy, there were significant decreases in the standard deviation of the mean blood glucose levels for the 24-hour period (27.6 ± 9.1 vs. 16.2 ± 6.9 mg/dL, p<0.001) and mean amplitude of glycemic excursions (MAGE) (65.8 ± 26.1 vs. 38.8 ± 19.2 mg/dL, p=0.010). In addition, a meal tolerance test was conducted to monitor changes in insulin secretion and active GLP-1 and total GIP values. Ten subjects (5 males, 5 females) of 54.9 ± 6.9 years with BMI 25.9 ± 5.2 kg/m(2) and HbAlc 9.2 ± 1.2% were enrolled. In the meal tolerance test, active GLP-1 values before and after acarbose administration were 17.0 ± 5.8 and 24.1 ± 9.3 pmol·hr/mL (p=0.054), respectively, showing an increasing tendency, and total GIP(AUC0-180) values were 685.9 ± 209.7 and 404.4 ± 173.7 pmol·hr/mL, respectively, showing a significant decrease (p=0.010). The results indicate that the combined administration of both inhibitors is effective not only in decreasing blood glucose fluctuations and preventing postprandial insulin secretion. The beneficial effects may also protect the endocrine pancreas and inhibit body weight gain.
  Endocrine Journal 12/2012; · 2.03 Impact Factor
• Article: New strategy for the treatment of type 2 diabetes mellitus with incretin-based therapy.

  Mitsuyoshi Namba, Tomoyuki Katsuno, Yoshiki Kusunoki, Toshihiro Matsuo, Masayuki Miuchi, Jun-Ichiro Miyagawa
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  ABSTRACT: Incretin-based therapy was first made available for the treatment of type 2 diabetes mellitus (T2DM) in the US in 2006 and in Japan in 2009. Four DPP-4 inhibitors and two GLP-1 analog/receptor agonists are currently available. The effects of incretin-based therapy are assumed to be exerted mainly through the hormonal and neuronal actions of one of the incretins, GLP-1, which is secreted from L cells localized in the small intestine. The benefits of this therapy over conventional sulfonylureas or insulin injections, such as fewer hypoglycemic events and reduced body weight gain, derive from the glucose-dependent insulinotropic effect. The protective effects of this therapy on vulnerable pancreatic β-cells and against micro/macroangiopathy in T2DM are also most welcome. Indications and/or contraindications for incretin-based therapy should be clarified by prospectively studying the experiences of Japanese T2DM patients undergoing this therapy in the clinical setting.
  Clinical and Experimental Nephrology 11/2012; · 1.37 Impact Factor
• Article: [Case report: A case of deep coma with early diagnosed myxedema].

  Noriko Kitamura, Masaru Tokuda, Fumihiro Ochi, Yoshiki Kusunoki, Kazuki Murai, Masayuki Miuchi, Tomoyuki Katsuno, Tomoya Hamaguchi, Jun-ichiro Miyagawa, Mitsuyoshi Namba
  Nihon Naika Gakkai Zasshi 04/2012; 101(4):1066-8.
• Article: Effects of miglitol in combination with intensive insulin therapy on blood glucose control with special reference to incretin responses in type 1 diabetes mellitus.

  Etsuko Nagai, Tomoyuki Katsuno, Jun-Ichiro Miyagawa, Kosuke Konishi, Masayuki Miuchi, Fumihiro Ochi, Yoshiki Kusunoki, Masaru Tokuda, Kazuki Murai, Tomoya Hamaguchi, Mitsuyoshi Namba
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  ABSTRACT: To determine whether miglitol administration improves glycemic control and reduces the frequency of hypoglycemia in type 1 diabetes mellitus (T1DM) patients treated with intensive insulin therapy, we analyzed the effect of miglitol on daily insulin doses, body weight, hypoglycemia, and incretin hormone responses during meal tolerance tests (MTT). Eleven T1DM subjects (21-77 years) undergoing intensive insulin therapy, took 25 mg (weeks 0-4) and 50 mg miglitol (weeks 4-12) thrice daily, immediately before meals. At weeks 0 and 12, 9 of 11 subjects underwent MTT. In present study, mean HbA1c, glycoalbumin, and 1,5-anhydroglucitol levels were significantly improved. The blood glucose level 1 h after dinner was significantly lower at week 12 than at week 0 (p = 0.008). From week 0 to 12, there was a significant decrease in the body mass index (BMI; p = 0.0051), frequency of preprandial hypoglycemic events (p = 0.012), and daily bolus insulin dosage (p = 0.018). The change in active glucagon-like peptide-1 (GLP-1) at 120 min significantly increased at week 12 (p = 0.015). The change in total glucose-dependent insulinotropic peptide (GIP) significantly decreased in the MTT at week 12. These results demonstrate that addition of miglitol on intensive insulin therapy in T1DM patients has beneficial effects on reducing BMI, bolus and total insulin dosage, and frequency of preprandial hypoglycemic events. MTT findings suggest that this combination therapy improves blood glucose control by delaying carbohydrate absorption and modifying the responses of incretins, GIP, and GLP-1.
  Endocrine Journal 08/2011; 58(10):869-77. · 2.03 Impact Factor
• Source

  Available from: PubMed Central

  Article: Incretin responses to oral glucose load in Japanese non-obese healthy subjects.

  Etsuko Nagai, Tomoyuki Katsuno, Jun-Ichiro Miyagawa, Kosuke Konishi, Masayuki Miuchi, Fumihiro Ochi, Yoshiki Kusunoki, Masaru Tokuda, Kazuki Murai, Tomoya Hamaguchi, Mitsuyoshi Namba
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  ABSTRACT: Recently, incretin-related therapy has been developed for the new treatment of diabetes mellitus; however, incretin response to glucose ingestion in normal glucose tolerant (NGT) subjects has not been clarified in detail with special reference to the role of incretin hormones, glucagon, and a family history of diabetes. We conducted a 75 g oral glucose tolerance test in 30 NGT subjects. The total glucose-dependent insulinotropic peptide (GIP)-AUC(0-120) (area under the curve over a period of 0-120 minutes) was correlated with immunoreactive insulin (IRI)-AUC(0-120) (P<0.05), insulinogenic index (II; P<0.05), ΔIRI between 0 and 120 minutes (P<0.05). Active glucagon-like peptide-1 (GLP-1) AUC(0-120) was correlated inversely both with Δ glucose between 0 and 30 minutes (P<0.01) and with Δ immunoreactive glucagon between 0 and 30 minutes (P<0.05). Δ Total GIP between 0 and 15 minutes (P<0.01), Δ total GIP between 0 and 30 minutes (P<0.05), and the total GIP-AUC(0-120) (P<0.05) in the subjects with a family history of type 2 diabetes were significantly higher than those in the subjects without a family history. These results suggest that GIP possibly facilitates insulin secretion in response to oral glucose load directly and active GLP-1 may exert the glucoregulatory action via the suppression of glucagon secretion in NGT subjects. Notably, the subjects with a family history of diabetes exert significantly higher GIP response in the early phase of glucose load compared with those without a family history.
  Diabetes Therapy 03/2011; 2(1):20-8.