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3005 北関東医学会 >
330501 The Kitakanto medical journal >
Vol.64 (2014) >

Please use this identifier to cite or link to this item: http://hdl.handle.net/10087/8530

Title: 糖質制限を周術期の輸液管理に応用し,糖尿病を改善せしめたS状結腸癌の1切除例
Other Titles: A Low Carbohydrate Diet During the Perioperative Period for Sigmoidectomy : Improvement in the Body Weight and Glycemic Control for Patients with Colon Cancer
Authors: 門脇, 晋
Kadowaki, Susumu
Keywords: 糖質制限
周術期管理
大腸癌
糖尿病
肥満症
low carbohydrate diet
perioperative period
colon cancer
diabete
obesity
Issue Date: 1-May-2014
Publisher: 北関東医学会
Citation: The Kitakanto medical journal = 北関東医学. 2014, 64(2), p.177-182
Abstract: 86歳男性. 糖尿病, 慢性心不全のため近医通院していた. 貧血進行, 腫瘍マーカー上昇のため精査したところ高度の狭窄を伴うS状結腸癌と診断され当科入院した. 入院時は身長155cm, 体重57kg (BMI 23.7), 腹囲89cm,空腹時血糖値302mg/dl,HbA1c 8.4% (NGSP)と肥満及びコントロール不良の糖尿病を認めた.血糖コントロールのため術前より江部らが提唱する糖質制限を応用し, S状結腸切除術を施行した.術後経過は良好で術後15日目に退院した. 糖質制限を自宅でも継続し術後37病日には体重50kg (BMI 20.8), 腹囲78cm, 空腹時血糖値100mg/dl, HbA1c 6.1% (NGSP) まで改善した. 術前より糖質制限を食事療法だけでなく輸液管理にも応用し, 2ヶ月という短期間で糖尿病を改善せしめた貴重な症例と考え報告する.(Kitakanto Med J 2014;64:177~182)
Description: A 86-year-old male was admitted to our hospital due to anemia and elevation of tumor marker. Computed tomography(CT)and colonoscopy showed sigmoid colon cancer. He complained of poorly controlled diabetes and obesity. Elective sigmoidectomy was planned, and a low carbohydrate diet during the perioperative period was recommended. His hemoglobin A1c(HbA1c)was improved from 8.4% (NGSP)to 6.1% and his bodyweight was decreased from 57 kg to 50 kg during the 2 month interval. We were able to perform sigmoidectomy safely. A low carbohydrate diet seems to be safe and effective for improving the condition of patients prior to surgery. Physicians should advise obese patients with diabetes to follow a low carbohydrate diet during the perioperative period,because it can have dramatic effects on the body weight and glycemic control.(Kitakanto Med J 2014;64:177~182)
URI: http://hdl.handle.net/10087/8530
ISSN: 1343-2826
Appears in Collections:Vol.64 (2014)

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