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 day, 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 through lifestyle modification. At the inpatient ward, In addition to hospitalization for diabetes education, medical care is provided for those who require close examination and treatment of complications and pre-surgical blood glucose management. Ddiet therapy, exercise therapy and pharmacotherapy are tailored to individual patient needs. If medically indicated, patients are introduced to a low carbohydrate diet. Our distinctive “self-care” support program includes selfmonitoring of blood glucose and four-time daily body weight measurements. Furthermore, insulin secretion capacity is evaluated through a meal tolerance test (MTT), and continuous glucose monitoring (CGM) is performed for those with unstable blood glucose levels. In the “Diabetes Education Seminar” and “Best-Weight Management Seminar” for inpatients, physicians and CDEJs (nurses, registered dietitians, pharmacists and clinical technologists and physical therapists) provide lectures on diabetes- and obesity-associated complications, treatment options, and diet therapy on their specialized fields.

At the first consultation, the physician will collect information on the patient’s medical history and lifestyle, and perform a general physical examination, as well as blood tests, 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 management and individual lifestyle modifications for patients with diabetes; individual lifestyle modifications and medications for patients with other metabolic disorders in general; close examination and treatment for patients with particular types of dyslipidemia. 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. We have also been incorporating SAP (Sensor Augmented Pump) therapy, which combines continuous glucose monitoring (CGM) and insulin pump therapy.

• 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 early-phase insulin secretion, as well as insulin resistance.
• Continuous Glucose Monitoring (CGM) is used to monitor detailed blood glucose fluctuations over a 24-hour period with a subcutaneous sensor.

(2015)

(2015)