Shinichi Umezawa's scientific contributions

Publications (26)

Article
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Aim/introduction: Following the first coronavirus disease-2019 state-of-emergency announcement, there was an increase in stress that may have affected the self-management of patients with type 2 diabetes mellitus (T2DM). This study identified the changes in clinical findings and stress among patients with T2DM and investigated the characteristics...
Article
Aims This study aimed to clarify the differences in how sodium glucose co-transporter 2 inhibitors (SGLT2i) and glucagon-like peptide 1 receptor agonists (GLP1Ra) influence kidney function in Japanese patients with type 2 diabetes mellitus (T2DM). Methods We retrospectively built two databases of patients with T2DM who visited the clinics of membe...
Article
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Introduction: MOSAIc was a multinational, non-interventional, prospective, observational cohort study designed to provide an understanding of the specific challenges associated with intensification of initial insulin therapy in patients with type 2 diabetes mellitus (T2DM). We present a sub-analysis of Japanese patients from MOSAIc, with data anal...
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To prevent further spread of coronavirus disease 2019 (COVID-19), the Japanese government announced a state of emergency, resulting in major stress for the population. The aim of this study was to investigate a possible association between changes in daily stress and blood pressure (BP) in Japanese patients. We retrospectively investigated 748 pati...
Article
Aim: Long-term changes in body composition associated with SGLT2 inhibitors have not been characterized. Materials and methods: In this multicenter, single-arm, open-label study, 107 subjects with type 2 diabetes were treated, as add-on therapy, with canagliflozin at 100 mg for 12 months. Body composition was measured with a body composition ana...
Article
Aim: Sodium-glucose co-transporter 2 inhibitors (SGLT2is) provide renal protection in patients with type 2 diabetes mellitus (T2DM). The aim of this study was to elucidate the renal effects of long-term use of six types of SGLT2i in Japanese patients with T2DM and chronic kidney disease (CKD). Materials and methods: The Kanagawa Physicians Assoc...
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Backgrounds and objects Sodium‐glucose cotransporter 2 inhibitors (SGLT2i) improve renal outcome in patients with type 2 diabetes mellitus, but the mechanism isn’t fully understood. The aim of this retrospective study is to assess the association of achieved blood pressure with renal outcomes in Japanese type 2 diabetes mellitus patients with chron...
Article
Background: There are several reports of seasonal variation in hemoglobin A1c (HbA1c) in patients with type 2 diabetes (T2DM), but no reports of seasonal variation in the effect of add-on drugs on blood glucose control in insulin-treated patients. Methods: Using data collected from 630 patients in a multicenter study, we compared the amount of c...
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Background: Sodium/glucose cotransporter-2 (SGLT2) inhibitors improve glycemic control and reduce body weight by increasing glycosuria. Although a compensatory increase of food intake has been reported, the long-term effect of SGLT2 inhibitors on food intake remains unclear. This study investigated the influence of canagliflozin on calorie and nutr...
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Aim: The renoprotective effect of sodium-glucose cotransporter 2 inhibitors is thought to be due, at least in part, to a decrease in blood pressure. The aim of this study was to determine the renal effects of these inhibitors in low blood pressure patients and the dependence of such effect on blood pressure management status. Methods: The subjec...
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Background Sitagliptin, the first dipeptidyl peptidase-4 inhibitor, has demonstrated efficacy and safety as monotherapy and as add-on therapy to oral antidiabetic agents or insulin. However, there have been few reports about sitagliptin in elderly patients. The ASSIST-K observational study was performed in patients with type 2 diabetes mellitus (T2...
Article
Decrease in blood pressure contributes to the reno-protective effects of sodium-glucose cotransporter 2 inhibitors; however, its relationship with home monitoring of blood pressure is unclear. We retrospectively analyzed 101 visiting members of the Kanagawa Physicians Association with type 2 diabetes mellitus and chronic kidney disease who were tak...
Article
Aim: The aim of this study was to assess the renal effects of the glucose-lowering SGLT2 inhibitors in Japanese type 2 diabetes mellitus patients with chronic kidney disease. Methods: The Kanagawa Physicians Association maintains a registry of patients who visit their 31 clinics. Clinical data of type 2 diabetes mellitus patients with chronic ki...
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Background Ipragliflozin is a selective sodium glucose co-transporter 2 inhibitor. The ASSIGN-K study is investigating the efficacy and safety of ipragliflozin for type 2 diabetes mellitus (T2DM) in the real-world clinical setting. Methods Japanese T2DM patients with inadequate glycemic control despite diet and exercise with/without pharmacotherap...
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Background Ipragliflozin, a sodium-glucose transporter 2 inhibitor, was administered to patients with type 2 diabetes mellitus for 24 weeks to evaluate its effect on glycemic control and body composition. Methods This was an investigator-initiated multicenter prospective intervention study in which ipragliflozin (50 mg) was administered once daily...
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IntroductionGuidelines recommend insulin progression for patients with type 2 diabetes (T2D) with inadequate glycemic control. The Multinational Observational Study Assessing Insulin use (MOSAIc [ClinicalTrials.gov identifier, NCT01400971]) study is a 2-year observational study, investigating factors that influence insulin progression in T2D patien...
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Background Sitagliptin, a dipeptidyl peptidase-4 inhibitor, is an effective oral antidiabetic agent as both monotherapy and when combined with insulin. Data from three observational studies performed in patients with type 2 diabetes receiving sitagliptin therapy in the routine clinical setting were integrated to conduct factor analysis of the chang...
Article
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Background: Ipragliflozin is a selective sodium glucose co-transporter 2 (SGLT2) inhibitor that blocks glucose reabsorption in the proximal tubules. SGLT2 inhibitors are expected to be effective in patients with insulin resistance and obesity, but it is important to select treatment according to patient background factors that minimizes the risk o...
Article
Full-text available
Background: Ipragliflozin is a sodium-glucose co-transporter 2 inhibitor that can improve glycemic control and reduce body weight and blood pressure in patients with type 2 diabetes mellitus (T2DM). We evaluated the efficacy and safety of ipragliflozin in the real-world clinical setting, with a focus on the changes of body composition up to 3 mont...
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It is unclear whether dipeptidyl peptidase-4 inhibitors decrease hemoglobin A1c (HbA1c) in a glucose-dependent manner in patients on insulin therapy who have impaired insulin secretion. This study investigated factors influencing the efficacy of sitagliptin when used concomitantly with insulin to treat type 2 diabetes mellitus (T2DM) in the real-wo...
Article
Full-text available
There have only been a few reports about use of dipeptidyl peptidase 4 (DPP-4) inhibitors in elderly patients with type 2 diabetes mellitus (T2DM), suggesting that the safety of these agents has not been sufficiently demonstrated. We performed a comparative review of the efficacy and safety of sitagliptin for Japanese patients with T2DM managed in...
Article
We retrospectively studied more than 1000 patients with type 2 diabetes attending 36 Japanese clinics to investigate the efficacy and safety of adding sitagliptin to various insulin regimens. We found that the treatment with add-on sitagliptin for 6-months was effective, irrespective of the type or dose of concomitant insulin.

Citations

... Changes in diet and weight gain during lockdown have been reported in other countries [8][9][10][11][12]. However, the results regarding the effects of the restrictions due to the pandemic on BP have been inconsistent [13][14][15][16][17][18]. A recent study from the United States revealed a mild increase in systolic BP during the COVID-19 pandemic, although only sex, age, and weight gain were considered confounding factors [16]. ...
... Recently, it was reported that the degree of interstitial volume reduction was not associated with patient prognosis [24], suggesting that the intravascular volume is more a driver of clinical outcomes than even large changes in the interstitial volume [14,25]. In this study, canagliflozin treatment of patients with CHF and T2D decreased the eEV as well as the ePV, without a rebound increase over a long period of time, a finding already shown with SGLT2 inhibitors, including canagliflozin [7,8,26,27]. Consistent results support a class effect of SGLT2 inhibitors on reducing the intravascular volume. ...
... This study is a subanalysis of our previous study, and the details of the entire study population have been described previously. 8 In brief, the study included 797 registered patients with T2DM who visited the clinics of the members of the Kanagawa Physicians Association between October and December 2018, with the following inclusion criteria: (i) first-time treatment with an SGLT2i more than 1 year before the enrollment; (ii) CKD, as defined by the Kidney Disease Outcomes Quality Initiative clinical practice guidelines 9 ; and (iii) age greater than 20 years. Thirty-four patients were excluded based on the following exclusion criteria: (i) type 1 diabetes mellitus; (ii) required chronic dialysis; (iii) severe liver dysfunction, such as liver cirrhosis or severe infection; (iv) terminal-stage cancer; (v) pregnancy; (vi) irregular use of an SGLT2i as evidenced by poor adherence; and (vii) an intention to opt out during the study. ...
... [17][18][19][20] However, the appropriate end points are not completely agreed upon and should be chosen depending on the study design or participants. According to our previous study, 5,6 we defined the renal composite outcome as ACR progression, a greater than 15% annual decrease in the eGFR, or both. ...
... There is a report that blood glucose levels fluctuate with the season and HbA1c levels are high in the winter and low in the summer [33][34][35][36][37]. The same has been described in reports on drug effectiveness [38,39]. It is still possible that the season from April to July has an effect. ...
... Together with an observed increased appetite and carbohydrate intake, this could contribute to less weight loss than expected based on urinary calorie excretion. Other studies also suggested a specific increase in (craving for) high calorie/sweet foods with SGLT2i treatment (4)(5)(6). ...
... The study reported that ipragliflozin is more effective in Japanese T2DM patients with hypertension with kidney dysfunction and obesity. [190] The efficacy and safety of empagliflozin and linagliptin, a fixed dosage combination once a day was assessed in T2DM patients. ...
... In a multicenter prospective Japanese study, patients received ipragliflozin (50 mg/daily) as monotherapy or combined with other glucose-lowering drugs for up to 104 weeks shown a significant reduction in SMM (−0.9 kg) [83]. ...
... In mice, greater plasma DPPIV activity is observed in models of genetic obesity (ob/ob) and diet-induced obesity (DIO) 20 ; meanwhile, mice that lack one or both Dpp4 alleles in adipocytes and/or hepatocytes exhibit reduced plasma DPPIV activity and are protected from DIO 21 . DPPIV has also been extensively studied in the context of T2DM and insulin signaling, and DPPIV inhibitors such as sitagliptin are effective, United States Food and Drug Administration (FDA)-approved second-line treatments for T2DM [22][23][24][25][26][27] . In line with the hypothesis that DPPIV is an active player in obesity progression, results from clinical trials indicate that DPPIV inhibitors can improve weight control [28][29][30][31][32][33][34] , systemic metabolism [22][23][24][25][26][27] , and inflammatory responses [35][36][37][38][39][40][41][42][43] all critical processes that become progressively dysregulated in the context of obesity. ...
... However, a report by Sakura et al is the only study that verified seasonal variation in the effect of antidiabetic drugs throughout the year [7], and there has been no study that verified seasonal variation in the effect of antidiabetic drugs used concomitantly with insulin. Therefore, we used data collected in the multicenter AS-SIST-K study [11][12][13][14] to verify seasonal variation in the effect of add-on sitagliptin on blood glucose control in patients on insulin therapy. ...