Profile of Blood Glucose in Diabetic Patient Suffered from Diabetic Foot Osteomyelitis with Effective Low Carbohydrate Diet

The case was 52-year-old female with type 2 diabetes mellitus (T2DM) for 10-years. She complained of the decreased sensation of right lower foot, and revealed diabetic foot infection (DFI) and/or diabetic foot osteomyelitis (DFO) at right 1st proximal phalanx. Various data included body mass index (BMI) 33.3 kg/m2, HbA1c 11.4%, blood glucose 430 mg/dL, WBC 12100 /μL, C-reactive Protein (CRP) 13.5 mg/dL. On admission (day 1), she was started by 4 times of injection (Aspart and Glargin) with glucose profile 200-500 mg/dL. Surgical amputation of the right toe was performed between 1st metatarsal and proximal phalanx (day 17). Then, blood glucose profile decreased moderately. After discharge of the hospital, super-Low Carbohydrate Diet (LCD) was started without Aspart (day 37). Consequently, glucose profile was normalized with HbA1c 6.3% on (day 77). Consequently, LCD was evaluated to be effective for glucose variability in this case and some related discussion was described

脳死臓器移植に関する意識調査 : 自記式質問紙調査による看護系短期大学生と両親,看護系大学生,中学生と中学教師の比較

看護系短大生とその両親,看護系大学生,中学生とその中学教師を対象に脳死臓器移植の意識調査を自記式質問紙をもちいて行った。対象者の合計は373人(男性112人,女性261人)であった。回収率は,郵送にて回答を得た父親と母親のそれぞれ36%と48%以外は100%であった。臓器移植についてはほとんどの人が認知していた。また「脳死を人の死と認めるか」記ついては36%の人が認めていた。「臓器提供の意思」は39%に提供の意思があった。基礎教育を受けた看護系短大2回生は基礎教育を受けてない看護系大学1回生と比較して臓器移植に肯定的な意見が多かった。また看護系短大生は両親と比較して,「臓器提供意思表示カード」の所有率が5倍,「臓器提供の意思」が2倍であった。家族内での臓器提供の話し合いでは父親よりも母親との話し合いが多かった。中学生の脳死臓器移植に対する関心は高く,「脳死を人の死と認める」については20%が認め,そのほとんどの中学生は「臓器提供の意思」があった。今後臓器移植を円滑に推進させるためには,今回の調査結果に示されたように18歳以上の若者に対する「臓器移植に関する教育」はもちろん必要であるが,中学生に対する「生と死」,「脳死」,「臓器移植」,「臓器提供」といった内容の教育がより必要と考えられる。The purpose of this study was to compare attitudes toward brain death and organ transplantation among nursing college students and their parents, and junior high school students and their teachers, using self-administered questionnaires. The number of respondents was 373 and the response rate was 36% for fathers and 48% for mothers respectively in a mail survey and 100% of students oh in-class survey. Most of the survey respondents recognized the necessity of organ transplantation, and 36% of respondents accepted brain death. Thirty nine percent of respondents were willing to donate organs. Sophomore nursing students with one year preparation in basic course work had a more positive attitude toward organ transplantation than had freshmen nursing students without such preparation. There were five times the number of nursing college students who had organ donation decision cards and they were twice as likely to be willing to donate organs as their parents. Nursing students discussed the issue of organ donation more often with their mothers than with their fathers. Junior high school students had great interest in organ transplantation. Twenty percent of the respondents accepted brain death and most of them were willing to donate organs. To promote organ transplantation, it is necessary to educate not only university students, but also junior high school students so that their interest and understanding in life and death, brain death, organ transplantation and organ donation can be nurtured