The Japanese version of the insulin delivery system questionnaire (IDSQ-J) is a scale rating insulin injection devices. We retrospectively subanalyed the data used to develop the IDSQ-J. We found that lifestyle impact is an important factor in the user's view of quality of life (QOL) relating to insulin delivery devices. The IDSQ-J is useful for evaluating the insulin delivery of users in daily social activities. The IDSQ-J is a reliable, valid rating scale in addition to being clinically useful in evaluating insulin delivery from the user's viewpoint.

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We have reported that, among treatment groups, glycemic control is poorest in those with Type 2 diabetes mellitus (T2DM) treated with insulin combined with an oral hypoglycemic agent (OHA). We analyzed data from 55 institutes using CoDiC^®, an electronic diabetes data collection and management system, to determine the actual status of subjects treated with combination therapy. Of 43,574 T2DM cases registered in 2008, 4,684 were treated with combination therapy. Compared to T2DM subjects treated with either diet and/or OHA, onset age was younger and diabetes duration longer in those treated using combination therapy and their body mass index (BMI), HbA1c, and postprandial glycemia highest. The most commonly prescribed insulin was premixed and OHA was metformin. To determine the relationship between clinical aspects and glycemic control in these subjects, we analyzed factors affecting glycemic control stratified by HbA1c level. In those with HbA1c ≥8.0%, age and onset age were markedly lower and BMI, systolic blood pressure, and LDL-cholesterol higher than in those with HbA1c <8.0%. In Japan, T2DM subjects treated with combination therapy had the poorest glycemic control, particularly those who were younger, had earlier disease onset, and were obese.

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[in Japanese]

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[in Japanese]

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[in Japanese]

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A 33-year-old woman with type 1 diabetes had been under treatment with of CSII, and successfuly became pregnant by IVF (in vitro fertilization). She kept good glycemic control during pregnancy, perinatal period, and lactation. Basal insulin infusion increased after 20 weeks' gestation, reached maximum insulin requirement at 30 weeks' gestation, decreased just before delivery, increased a little just after delivery, and decreased markedly during lactation. Bolus insulin infusion increased after 20 weeks' gestation, reached maximum insulin requirement just before delivery (double the amount of prepregnancy amount), decreased markedly just after delivery, and reverted to the prepregnancy level during lactation. After the end of lactation, both basal and bolus insulin infusion reverted to the prepregnancy state. We have to take notice of these features of insulin requirement in cases of pregnancy with diabetes.

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[in Japanese]

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[in Japanese]

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