Outpatient diabetes clinics and outpatient care is provided by diabetes specialists and certified diabetes educators of Japan (CDEJ) who cooperate closely with one another to provide services for individual patients. Specialized outpatient care for diabetes is available every weekday, and the “Outpatient Obesity Disease Clinic” is open on weekday mornings. In the “Diabetic Foot Outpatient Clinic”, certified nurse specialists in diabetes offer preventive care, educational support and treatment for foot and leg lesions. ”Prevention of dialysis program” is provided by doctors, registered dietitians, and nurses in an attempt to stop progression of diabetic nephropathy. At the inpatient ward, diet therapy including low-carbohydrate diets, exercise therapy and pharmacotherapy are tailored to individual patient needs, and patients are carefully examined and treated for complications. Our distinctive “self-care” support program includes self-monitoring of blood glucose and four-time daily body weight measurements. The Department also provides diabetes education for patients in which physicians and CDEJs (nurses, registered dietitians, pharmacists and clinical technologists and physical therapists) provide lectures on their specialized fields. The Best-Weight Management Seminar is also held for patients to provide information on obesity disease-associated complications, treatment options, and diet therapy.

At the first consultation, the physician collects information on the patient’s medical history and lifestyle, and performs a general physical examination, as well as blood tests, altogether to decide on courses of treatment. A more detailed examination is also performed for early detection and treatment of atherosclerotic complications, including microvascular diseases and macrovascular diseases.

Blood glucose control and lifestyle modifications for patients with type 2 diabetes; lifestyle modifications and medications for patients with other types of diabetes, dyslipidemia, obesity disease, metabolic syndrome, gout, hyperuricemia, and other metabolic disorders in general; close examination and treatment of patients with dyslipidmia, including familial hypercholesteremia. Team medical treatment for bariatric surgery through collaboration with other departments such as Stomach and Esophageal Surgery and Psychosomatic Medicine, and multi-professional collaboration with CDEJ.

Genetic diagnosis is applied to patients with suspected metabolic disorders caused by genetic abnormalities, including mitochondrial diabetes, maturity onset diabetes of the young (MODY), insulin receptor abnormality, after obtaining consent, to determine the most effective therapeutic strategy. Glucose clamp technique is used for precise estimation of insulin resistance in individual patients.

• Hemoglobin A1c (HbA1c) shows how the blood glucose level has been controlled over the last one or two months.
• Glycated albumin (GA) shows how the blood glucose level has been controlled over the last two weeks.
• Oral glucose tolerance test (OGTT) is used to diagnose diabetes and measure the early-phase insulin secretion, as well as insulin resistance.
• Continuous Glucose Monitoring (CGM) automatically records average glucose levels with a subcutaneous glucose sensor, which identifies plasma glucose fluctuations and trends over a period of 24 hours or more.

(2015)

(2015)