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Aims: We aimed to identify patients who would benefit from basal insulin-supported oral therapy (BOT) with a glinide and an α-glucosidase inhibitor (a fixed-dose combination tablet of mitiglinide 10 mg and voglibose 0.2 mg) in Japanese type 2 diabetic patients., Methods: Patients who were hospitalized to improve hyperglycemia received basal-bolus insulin therapy. After the reduction of glucose toxicity, a 75 g oral glucose tolerance test and a glucagon test were performed. Thereafter, the basal-bolus insulin therapy was switched to BOT with mitiglinide, followed by further addition of voglibose. Interstitial glucose levels were continuously monitored throughout the study period. Diurnal glucose profile was recorded and analyzed. Patients were divided into two groups according to whether their percentage of time in range (TIR, 70-180 mg/dL) under BOT with mitiglinide/voglibose was higher than 70% or not, and the differences in clinical characteristics between the groups were analyzed., Results: Twenty patients were enrolled, and 19 of them completed the study. BOT with mitiglinide/voglibose achieved ≥ 70% of TIR in thirteen patients. The area under the curve of serum C-peptide levels during the oral glucose tolerance test was significantly higher in the patients with ≥ 70% of TIR. The daily insulin dosages and blood glucose profiles were comparable between the two groups., Conclusions: The efficacy of BOT with mitiglinide/voglibose depended on residual insulin secretory abilities. This therapy would be a useful therapeutic option for patients with type 2 diabetes., Competing Interests: Conflict of interestHideki Kamiya: lecture fees: Novo Nordisk Pharma, Sanofi, Sumitomo Pharma, Nippon Boehringer Ingelheim, Eli Lilly Japan, Daiichi Sankyo, Ono Pharmaceutical, Kissei Pharmaceutical, Mitsubishi Tanabe Pharma, Kowa, Novartis Pharma, MSD, Sanwa Kagaku Kenkyusho, Otsuka Pharmaceutical, Ltd., Terumo, Taisho Pharmaceutical. Research funding: Ono Pharmaceutical, Eli Lilly Japan, Kissei Pharmaceutical. Subsidies or donations: Ono Pharmaceutical, Taisho Pharmaceutical, Sumitomo Pharma, Takeda Pharmaceutical, Mitsubishi Tanabe Pharma, Japan Tobacco, Novo Nordisk Pharma. Endowed departments by commercial entities: Ono Pharmaceutical, Abbott Japan, Sanwa Kagaku Kenkyusho, Kowa, Terumo. Jiro Nakamura: lecture fees: Novo Nordisk Pharma, Sanofi, Daiichi Sankyo, Ono Pharmaceutical, Novartis Pharma, MSD, Taisho Pharmaceutical, Takeda Pharmaceutical, Terumo. Research funding: Eli Lilly Japan, Ono Pharmaceutical, Kissei Pharmaceutical. Subsidies or donations: MSD, Ono Pharmaceutical, Sumitomo Pharma, Takeda Pharmaceutical, Mitsubishi Tanabe Pharma, Japan Tobacco, Novo Nordisk Pharma, Taisho Pharmaceutical. Endowed departments by commercial entities: Ono Pharmaceutical, Abbott Japan, Sanwa Kagaku Kenkyusho, Kowa, Terumo. The other authors declare no conflict of interest., (© The Japan Diabetes Society 2023. Springer Nature or its licensor (e.g. a society or other partner) holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law.)

Aims/introduction: Diabetic polyneuropathy (DPN) develops in the early stage of diabetes. However, no common diagnostic protocol has yet been established. Here, to verify that the flicker electroretinogram using a hand-held device can detect the early dysfunction of the peripheral nervous system in patients with diabetes, we investigated the correlation between the progression of DPN and neuroretinal dysfunction., Materials and Methods: In total, 184 participants with type 1 or 2 diabetes underwent a flicker electroretinogram (ERG) using a hand-held device RETeval™ and nerve conduction study. Participants were also evaluated for intima-media thickness, ankle-brachial index, toe brachial index and brachial-ankle pulse wave velocity. Parameters of the nerve conduction study were used to diagnose the severity according to Baba's classification. A multiple regression analysis was used to examine the associations of ERG parameters with the severity of DPN categorized by Baba's classification. Diagnostic properties of the device in DPN were evaluated using a receiver operating characteristic curve., Results: A multiple regression model to predict the severity of DPN was generated using ERG. In the model, moderate-to-severe DPN was effectively diagnosed (area under the receiver operating characteristic curve 0.692, sensitivity 56.5%, specificity 78.3%, positive predictive value 70.6%, negative predictive value 66.1%, positive likelihood ratio 2.60, negative likelihood ratio 0.56). In the patients without diabetic retinopathy, the implicit time and amplitude in ERG significantly correlated with the parameters of the nerve conduction study, brachial-ankle pulse wave velocity and intima-media thickness., Conclusions: Electroretinogram parameters obtained by the hand-held device successfully predict the severity of DPN. The device might be useful to evaluate DPN., (© 2020 The Authors. Journal of Diabetes Investigation published by Asian Association for the Study of Diabetes (AASD) and John Wiley & Sons Australia, Ltd.)

Aims/introduction: Although nerve conduction study (NCS) using a standard electromyography system (EMGS) is considered to be the gold standard in evaluating diabetic polyneuropathy, this examination requires expensive equipment and well-trained technicians. We aimed to validate a point-of-care device, NC-stat/DPNCheck™, that has been developed for widespread use of NCS in diabetic polyneuropathy., Materials and Methods: Diabetes patients underwent two kinds of NCS: DPNCheck™ and electromyography system. Inter-/intrarater reliability of DPNCheck™ were also determined by the intraclass correlation coefficient., Results: A total of 57 patients were evaluated. The parameters of NCS between the two methods correlated well (r = 0.7734 for the sural nerve conduction velocity, r = 0.6155 for the amplitude of sural nerve action potential). The intraclass correlation coefficients were excellent (intrarater: the velocity 0.767, the amplitude 0.811; interrater: the velocity 0.974, the amplitude 0.834)., Conclusions: The point-of-care device has excellent reproducibility and good agreement with standard electromyography system. The device might be useful to evaluate diabetic polyneuropathy., (© 2019 The Authors. Journal of Diabetes Investigation published by Asian Association for the Study of Diabetes (AASD) and John Wiley & Sons Australia, Ltd.)