
Yoshifumi SaishoKeio University · Department of Internal Medicine
Yoshifumi Saisho
MD., PhD.
Director, Saisho Diabetes Clinic, Tokyo, Japan
About
169
Publications
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4,919
Citations
Introduction
Additional affiliations
December 2021 - present
Saisho Diabetes Clinic
Position
- Director
April 2009 - November 2021
April 2000 - March 2001
Shizuoka city Shimizu Hospital
Position
- Medical Doctor
Education
April 1992 - March 1998
Publications
Publications (169)
To investigate the association between the frequency of intermittent-scanning continuous glucose monitoring (isCGM) and diurnal variation of time in range (TIR), time above range (TAR), and time below range (TBR), we performed a post hoc analysis of the ISCHIA study, a multicenter, prospective, open-label, randomized crossover study of patients wit...
The Effect of Intermittent-Scanning Continuous Glucose Monitoring to Glycemic Control Including Hypoglycemia and Quality of Life of Patients with Type 1 Diabetes Mellitus (ISCHIA) study was a randomized, crossover trial that reported the decrease in time below range (TBR) by the use of intermittent-scanning continuous glucose monitoring (isCGM) com...
Aims/introduction:
There have been few reports about the longitudinal changes in pancreas volume (PV) or pancreatic steatosis (PS) in response to obesity. In this longitudinal analysis using health check-up data, we explored changes in PV, PS and glucose metabolic indices that occurred after weight gain in Japanese without diabetes.
Materials/met...
Hypoglycemia is one of the most significant problems in neonates born to mothers with gestational diabetes (GDM). This study aimed to identify novel predictors of hypoglycemia in neonates born to mothers with GDM. A total of 443 term singleton infants from mothers diagnosed with GDM and cared for at Keio University Hospital between January 2013 and...
Pancreas volume measured using imaging techniques has been shown to be increased in subjects with obesity and reduced in subjects with diabetes. Beta-cell mass of pancreas also was reported to be increased with obesity in autopsy samples. While, the increase in beta-cell mass of pancreas with obesity was reported to limit in Japanese autopsy studie...
A 41-year-old woman was admitted to the obstetrics department because of epigastric pain, nausea, and fatigue at 31 weeks of gestation. She was suspected of subclinical Cushing's syndrome based on high plasma cortisol and low ACTH levels along with an incidentally discovered tumor in the left adrenal gland 4 years prior to conception. 3 months befo...
The development of pancreatic cancer (PC) is associated with worsening of glucose tolerance. However, there is limited information about the effects of PC on islet morphology. The aim of this study was to elucidate changes in alpha and beta cell mass in patients with PC. We enrolled 30 autopsy cases with death due to PC (9 with diabetes; DM) and 31...
The vaccine for the coronavirus disease 2019 (COVID-19) has been reported to potentially develop or worsen diabetes. A 73-year-old Japanese woman received 2 doses of Moderna COVID-19 vaccine. Four-weeks after the second vaccination, her glycemic control began to deteriorate and 8 weeks after the second vaccination, the patient was diagnosed with ne...
Exenatide is one of the exendin-based glucagon-like peptide 1 receptor agonists (GLP-1RAs) and is currently available in two formulations, ie, exenatide twice daily (BID), a short-acting GLP-1RA, and exenatide once weekly (QW), a long-acting GLP-1RA. Clinical efficacy and safety of exenatide 2 mg QW in patients with type 2 diabetes (T2DM) has been...
Introduction
Genome-wide methylation analyses of gestational diabetes mellitus (GDM) diagnosed after 24 gestational weeks (late GDM (L-GDM)) using cord blood have been reported. However, epigenetic changes in neonates born to mothers with GDM diagnosed before 24 gestational weeks (early GDM (E-GDM)) have not been reported. We investigated DNA methy...
Background
We investigated the changes in blood glucose fluctuation, gastric emptying, and vascular endothelial function by switching from an exenatide twice-daily formulation (BID) to a once-weekly formulation (QW) since the evaluation of postprandial glucose excursion and glycemic variability (GV) by continuous glucose monitoring (CGM) after swit...
During the coronavirus disease 2019 pandemic, the Japanese Society of Diabetes and Pregnancy (JSDP) proposed the use of random plasma glucose and HbA1c measured 1 month after delivery combined with pre‐pregnancy body mass index to detect postpartum glucose intolerance instead of performing oral glucose tolerance test (OGTT) in women with gestationa...
Type 2 diabetes (T2DM) is characterized by insulin resistance and β-cell dysfunction. Since patients with T2DM have inadequate beta cell mass (BCM), and β-cell dysfunction worsens glycemic control and makes treatment difficult, therapeutic strategies to preserve and restore BCM are needed.In rodent models, obesity increases BCM about 3-fold, but th...
The detection of epigenetic changes associated with neonatal hypoglycaemia may reveal the pathophysiology and predict the onset of future diseases in offspring. We hypothesized that neonatal hypoglycaemia reflects the in utero environment associated with maternal gestational diabetes mellitus. The aim of this study was to identify epigenetic change...
Aims/Introduction
Long-term glycemic variability is important to predict diabetic complications, but evaluation in a Japanese population is lacking. The aim of this study was to explore the relationship between visit-to-visit glycemic variability (VVV) and cardiovascular diseases (CV) in Japanese patients with type 2 diabetes (T2DM), using the pros...
Interventions for gestational diabetes mellitus (GDM), diagnosed in early pregnancy, have been a topic of controversy. This study aimed to elucidate factors that predict patients with GDM diagnosed before 24 gestational weeks (early GDM: E-GDM) who require insulin therapy later during pregnancy. Furthermore, we identified patients whose impaired gl...
The Japanese abnormal glucose tolerance before 24 gestational weeks diagnostic strategy in the evolving coronavirus disease 2019 pandemic published by the Japanese Society of Diabetes and Pregnancy.
Aims/hypothesis
Type 2 diabetes is characterised by reduced beta cell mass (BCM). However, it remains uncertain whether the reduction in BCM in type 2 diabetes is due to a decrease in size or number of beta cells. Our aim was to examine the impact of beta cell size and number on islet morphology in humans with and without type 2 diabetes.
Methods...
Objective
The presence of more than one atherosclerotic macrovascular disease (cerebrovascular, cardiovascular, and peripheral arterial diseases) in the same patient is called polyvascular disease, which carries a very high cerebro- and cardiovascular morbidity and mortality. Recently, hypobilirubinemia is recognized as a possible risk factor for t...
Type 2 diabetes (T2DM) is characterized by insulin resistance and beta-cell dysfunction. Although insulin resistance is assumed to be a main pathophysiological feature of the development of T2DM, recent studies have revealed that a deficit of functional beta-cell mass is an essential factor for the pathophysiology of T2DM. Pancreatic fat contents i...
Background: No reports have focused on the clinical and metabolic characteristics of gestational diabetes (GDM) in underweight women. The aim of this study is to investigate the clinical and metabolic features of underweight GDM (pregravid BMI, <18.5 kg/m²: U-GDM).
Materials and methods: Women diagnosed with GDM were categorized based on their pre-...
Introduction
Recent advances in anti-diabetic medications and glucose monitoring have led to a paradigm shift in diabetes care. Newer anti-diabetic medications such as DPP-4 inhibitors, GLP-1 receptor agonists (GLP-1RAs), and SGLT2 inhibitors have enabled optimal glycemic control to be achieved without increasing the risk of hypoglycemia and weight...
Aims/hypothesisLow birthweight is associated with a high risk of diabetes, but there are no reports discussing birthweight and pancreatic tissues in humans. The purpose of this study was to examine the correlation between birthweight and beta and alpha cell mass in humans.Methods
Sixty-four Japanese adults with and without diabetes who underwent pa...
Background & Aims
Improvement of fatty liver may be required for remission of type-2 diabetes. However, there is no longitudinal evidence on whether fatty liver reduces the chances for remission of type-2 diabetes. We investigated the association between fatty liver and remission of type-2 diabetes (the primary analysis), and also the association b...
Sodium-glucose cotransporter 2 (SGLT2) inhibitors are a novel class of oral hypoglycemic agents which increase urinary glucose excretion by suppressing glucose reabsorption at the proximal tubule in the kidney. SGLT2 inhibitors lower glycated hemoglobin (HbA1c) by 0.6–0.8% (6–8 mmol/mol) without increasing the risk of hypoglycemia and induce weight...
The aim of the study was to explore the relationship between daily glycemic variability (GV) and visit-to-visit glycemic variability (VVV) in patients with type 2 diabetes (T2DM). A total of 156 outpatients with T2DM who had undergone continuous glucose monitoring (CGM) for 5 days were included in this study. Indices of GV, i.e., standard deviation...
Background
Only a few studies have longitudinally evaluated whether fatty pancreas increases the risk of type-2 diabetes (T2D), and their results were inconsistent. Fatty pancreas is closely linked to overweight and obesity, but previous studies did not exclude overweight or obese individuals. Therefore, in this cohort study, we investigated the as...
Aims/introduction:
Changes in histologically quantified beta and alpha cell mass during the development of glucose intolerance have not been fully elucidated. The aim of the present study was to explore differences in beta and alpha cell mass according to the glucose tolerance status.
Materials and methods:
Autopsy samples from a total of 103 su...
Hypoglycemia is the major symptom of insulinoma. Chronic and recurrent hypoglycemia leads to the disappearance of autonomic symptoms and persistence of non-specific symptoms alone, possibly contributing to the delayed diagnosis of insulinoma and accounting for several undiagnosed cases. We previously reported the usefulness of hemoglobin A1c (HbA1c...
AIM: To establish pancreatic alpha-cell mass in lean non-diabetic humans over the adult lifespan, performed as a follow up study to beta cell mass across the adult human lifespan.
METHODS: We examined human pancreatic autopsy tissue from 66 lean non-diabetic individuals aged from 30–102 years, grouped into deciles: 3rd(30-39 years), 4th(40-49 years...
Aims:
To evaluate the efficacy and safety of once-weekly (QW) extended-release exenatide after switching from twice-daily (BID) exenatide in patients with type 2 diabetes (T2DM).
Methods:
This was an investigator-initiated, prospective, single-arm, multicenter study. Subjects with T2DM who had been treated with exenatide BID for at least 3 month...
Recent large clinical trials on sodium-glucose cotransporter 2 (SGLT2)
inhibitors and glucagon-like peptide-1 (GLP-1) receptor agonists, with the aim of
verifying cardiovascular safety, have revealed that these medications have a
preventative advantage on adverse cardiovascular outcomes, including worsening of
heart failure and deterioration of nep...
Table S2 ¦ Linear regression analysis between four single‐nucleotide polymorphisms and postpartum metabolic features.
Table S1 ¦ Primers designed by Assay Design Suite in the present study.
A number of data on gestational diabetes mellitus (GDM) in singleton pregnancy is available, however, little is known about the glycemic characteristics of twin pregnancy with GDM. The aim of this study was to compare the severity of dysglycemia between twin and singleton pregnancies with GDM (T-GDM and S-GDM). We retrospectively analyzed pregnanci...
Abstract Background Insulinoma represents hypoglycemia as a predominant symptom; the autonomic symptoms may be resolved by chronically recurrent hypoglycemia resulting in the persistence of non-specific symptoms alone. Therefore, it has been estimated that there are many patients in whom the disease takes longer to diagnose and has remained undiagn...
Aims
To evaluate the efficacy and safety of switching to insulin glargine 300 U/mL (Gla-300) from insulin glargine 100 U/mL (Gla-100) in Japanese patients with type 2 diabetes (T2DM).
Methods
This was a 12-month retrospective study comprising 109 patients. Primary endpoint was glycated hemoglobin (HbA1c) level at month 12. Secondary endpoints were...
Although the current guidelines recommend the use of "individualized" HbA1c goals for patient-centered diabetes care, information regarding the satisfaction of patients with their glycemic control is insufficient. In this study, we aimed to clarify the satisfaction of patients with their glycemic control and to determine the related factors. Outpat...
Diabetes is defined as chronic hyperglycaemia due to insufficient insulin action. Over the last few decades, various different types of antidiabetic medications have been developed and the management of patients with Type 2 diabetes mellitus (T2DM) has been substantially improved. While we can now successfully control hyperglycaemia in patients wit...
Aims/Introduction
Risk factors of type 2 diabetes mellitus in Japanese women with recent gestational diabetes mellitus are unknown. Our objective was to investigate the clinical and genetic characteristics associated with postpartum abnormal glucose tolerance in Japanese women with gestational diabetes mellitus.
Materials and Methods
A total of 21...
We aimed to clarify the pathophysiological significance of total bilirubin (TB) in gestational diabetes mellitus (GDM). This was a cross-sectional study that included 616 pregnant Japanese women (368 normal glucose tolerance [NGT] and 248 GDM). Serum TB concentration, homeostasis model assessment of insulin resistance (HOMA-IR), and other clinical...
Background
Glycated albumin reflects 2–3-week glycaemic controls, and in addition to glycated haemoglobin, it has been used as a glycaemic control indicator. We presumed that glycated albumin also has seasonal variations and is related to temperature, similar to glycated haemoglobin.
Methods
The subjects were diabetic outpatients from April 2007 t...
Background:
Despite a number of innovations in anti-diabetic drugs and substantial improvement in diabetes care, the number of people with diabetes continues to increase, suggesting further need to explore novel approaches to prevent diabetes. Type 2 diabetes (T2DM) is characterized by beta cell dysfunction and insulin resistance. However, insulin...
Dyslipidemia is a major risk factor for cardiovascular disease (CVD), which is the leading cause of morbidity and mortality in type 2 diabetes (T2DM). Statins have played a crucial role in its management, but residual risk remains since many patients cannot achieve their desired low-density lipoprotein cholesterol (LDL-C) level and up to 20% of pat...
The efficacy of diabetes treatment should not be evaluated solely by HbA1c levels as they should also focus on patient-reported outcomes (PROs), such as patient satisfaction, wellbeing and quality of life. The Diabetes Treatment Satisfaction Questionnaire (DTSQ) has been developed to assess patient satisfaction with diabetes treatment. DTSQ has bee...
Chronic low-grade inflammation in the pancreatic islets is observed in individuals with type 2 diabetes, and macrophage levels are elevated in the islets of these individuals. However, the molecular mechanisms underlying the interactions between the pancreatic β-cells and macrophages and their involvement in inflammation are not fully understood. H...
Objective:
The aim of this study was to clarify the association of maternal factors with perinatal complications in pregnancies complicated with type 1 (T1D) or type 2 diabetes (T2D).
Methods:
We conducted a retrospective chart review and enrolled 26 Japanese pregnant women with diabetes who received perinatal care at our hospital between 2008 a...
Recent evidence has revealed that a change of functional beta cell mass is an essential factor of the pathophysiology of type 2 diabetes (T2DM). Since beta cell dysfunction is not only present in T2DM but also progressively worsens with disease duration, to preserve or recover functional beta cell mass is important in both prevention of the develop...
Aim of this study was to examine the association between the severity of obstructive sleep apnea (OSA) and dysglycemia in Japanese individuals with and without type 2 diabetes (T2DM). We enrolled 115 individuals diagnosed with OSA with an apnea hypopnea-index (AHI) ≥ 20 in whom continuous positive airway pressure (CPAP) therapy was introduced (N =...
Citation: Saisho Y and Murakami R. (2017). Pancreas Fat and Diabetes. M J Diab. 2(2): 008. Citation: Saisho Y and Murakami R. (2017). Pancreas Fat and Diabetes. M J Diab. 2(2): 008. Obesity is an important factor for the development of diabetes. When excess of calorie intake continues for a long time, fat supply exceeds the capacity of subcutaneous...
Context
The mechanisms by which beta cell mass is reduced in patients with type 2 diabetes (T2DM) remain unclear. It has been postulated that ectopic fat deposits in the pancreas induce beta cell apoptosis, leading to the development of diabetes.
Objective
The aim of this study was to clarify the effects of intra-pancreatic fat on beta and alpha c...
Gestational diabetes (GDM) and type 2 diabetes (T2DM) share part of pathomechanism and several T2DM susceptibility genes are demonstrated to be associated with GDM. No information on the genetics of GDM, however, was available in Japanese women. In this study, T2DM risk variants (45 single nucleotide polymorphisms [SNPs] from 36 genes) identified i...
Objective: The aim of this study was to clarify the impact of individualized HbA1c targets on the rate of HbA1c goal achievement. Methods: Individualized HbA1c target values were set for 389 randomly selected outpatients with type 2 diabetes and the relationship to the clinical parameters was examined. Results: Individualized HbA1c target values of...
The prevalence of type 2 diabetes (T2DM) is markedly increasing, the incidence of diabetic complications and the cost of treatment remain major issues throughout the world. Recent studies showed that β-cell deficit is a core feature of T2DM [1]. Even in the obese subjects with T2DM, beta cell function and mass are reduced [2]. Preservation or recov...
Objective:
This cross-sectional study was conducted to assess the association between serum albumin concentration (SAC) and microvascular complications in hypertensive patients complicated by type 2 diabetes mellitus (T2DM).
Design and method:
Four hundred and ninety five hypertensive patients (331 men) with T2DM were investigated. SAC was compa...
The pancreas is comprised of exocrine and endocrine components. Despite the fact that they are derived from a common origin in utero, these two compartments are often studied individually because of the different roles and functions of the exocrine and endocrine pancreas. Recent studies have shown that not only type 1 diabetes (T1D), but also type...
C-peptide is secreted from pancreatic β cells at an equimolar ratio to insulin. Since, in contrast to insulin, C-peptide is not extracted by the liver and other organs, C-peptide reflects endogenous insulin secretion more accurately than insulin. C-peptide is therefore used as a marker of β cell function. C-peptide has been mainly used to assess th...
Context:
The ethnic difference in beta cell regenerative capacity in response to obesity may be attributable to different phenotypes of type 2 diabetes among ethnicities.
Objective:
This study aimed to clarify the effects of diabetes and obesity on beta (BCM) and alpha cell mass (ACM) in the Japanese population.
Design, setting and participants...
Objective: This retrospective study was undertaken to compare hemoglobin A1c and glycoalbumin levels as glycemic control indicators during linagliptin treatment in diabetic patients with or without nephropathy. The efficacy and safety of linagliptin were also examined. Methods: The subjects were 127 outpatients with type 2 diabetes, including 69 pa...
Objective This retrospective study evaluated the long-term efficacy of sitagliptin and the factors contributing to its glucose-lowering effect. Methods Six hundred and sixteen dipeptidyl peptidase-4 inhibitor-naïve outpatients with type 2 diabetes who began sitagliptin treatment between December 1, 2009 and December 31, 2011 were included in this s...
Though recommended for pregnant women at risk of preterm birth to improve perinatal outcomes, antenatal corticosteroid (ACS) treatment can cause maternal hyperglycemia, especially in cases of glucose intolerance. A standardized protocol for preventing hyperglycemia during ACS treatment remains to be established. We herein retrospectively investigat...