Ebe, Koji Takao Hospital|Japan Low Carbohydrate Diet Promotion Association
Muneta, Tetsuo Japan Low Carbohydrate Diet Promotion Association|Muneta Maternity Clinic
Bando, Masahiro Tokushima University
Yonei, Yoshikazu Doshisha University
Sodium–glucose cotransporter 2 inhibitors
Continuous glucose monitoring
Freestyle libre pro
Low carbohydrate diet
Authors have continued clinical research of Calorie Restriction (CR) and Low Carbohydrate Diet (LCD) and present a case with precise observation of continuous glucose monitoring (CGM). The patient is 38 years-old females with type 2 diabetes mellitus (T2DM), who showed BMI 19.6, postprandial blood glucose 277 mg/dL. HbA1c 12.6%, glycoalbumin 31.8% (11.6-16.4), HOMA-R 2.8, HOMA-β 8.5, urinary excretion of C-peptide 67 μg/day, and normal range of liver, renal, lipid exams. She was given three stage intervention. The protocol was
• Day 1-2; CR meal with 60% carbohydrate,
• Day 3-5; LCD meal with 12% carbohydrate,
• Day 6-13; LCD+Sodium–glucose cotransporter 2(SGLT2) inhibitors (Suglat 50 mg, Ipragliflozin L-Proline).
The glucose variability was monitored using FreeStyle Libre Pro (Abbott) for 14 days. Blood glucose was decreased as
• More than 350 mg/dL,
• 180-200 mg/dL,
• 100-150 mg/dL in day 7-9, and 90-120 mg/dL in day 10-13.
Acute decrease of blood glucose was found 3 hours after giving Suglat, which was remarkable finding. These results suggest the improving glucose variability of LCD in short term, the acute and strong efficacy of SGLT2 inhibitors for glucose metabolism, and clinical usefulness of simultaneous observation of glucose fluctuation.
Diabetes Case Reports
© 2019 Ebe K, et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License(https://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
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