ABSTRACT
Objective: Management of low-density lipoprotein cholesterol (LDL-C) and triglyceride (TG) is important for patients with type 2 diabetes merger hyperlipidemia. Pemafibrate (PF) has different characteristics from conventional fibrates. In this study, we retrospectively compared the efficacy and safety of PF and bezafibrate (BF) in patients with type 2 diabetes merger hypertriglyceridemia.Methods: Patients who were administered PF (0.2 mg/day) or BF (400 mg/day) for 24 weeks or longer were included. Twenty patients in each group were extracted using propensity score matching (PS). PS was calculated using the patient background (before the start of administration) of PF or BF. We investigated lipid-related parameters (TG, high density lipoprotein cholesterol [HDL-C], and LDL-C) and other laboratory test parameters pre administration and 24 weeks post administration.Results: TG decreased significantly in both groups (p<0.05). However, there were no significant differences between the two groups in the TG treatment target (<150 mg/dL) achievement rate (p =1.00), TG change rate (p=0.84), and TG change amount (p=0.77). In addition, there were no significant changes in HDL-C and LDL-C in both groups. In the PF group, alanine transaminase (ALT) (p< 0.05), alkaline phosphatase (p<0.05) decreased. In the BF group, ALT (p<0.05) and γ-GTP (p<0.05) decreased. Both groups showed improvement in liver function after 24 weeks. eGFR (p<0.05) significantly decreased only BF group. There were no significant changes in renal function, creatine kinase (CK), or hemoglobin A1c (HbA1c) in either group.Conclusion: Our study suggests that there is no difference in the TG lowering effect and safety of PF and BF in type 2 diabetic patients.
ABSTRACT
Engaru-Kosei General Hospital expanded its pharmacist duties in hospital wards in April 2018 following the nationwide switch to out-of-hospital prescriptions. The purpose of this study was to examine the effect of pharmacists’ ward duties on nursing duties. Pharmacists expanded their duties to cover drug distribution management, infusions of total parenteral nutrition (TPN) mixed with drugs, and aseptic preparation of 24-h infusions (including peripheral parenteral nutrition). The effects were compared between April 2018 before the expansion of duties and May-September 2018 after the expansion, and we compared the number of meetings set up to discuss nurses’ overtime hours and patient problems. In addition, interviews were conducted about the changes experienced on site. Drug distribution management averaged 3,150 cases/month. The number of TPN mixed infusions was 25 cases/month before expansion and this increased to 88 cases/month after expansion. The number of mixed injections of 24-h infusions was 296/month. Nurses' overtime hours did not decrease significantly, but the number of meetings increased from 47/month to 79.4/month. In the interviews, positive responses were obtained about, for example, the increased number of meetings held and more time for patient care. The pharmacist and the nurse collaborated to improve work by using their expertise, we think that the results obtained from work improvement contributed to the improvement of medical quality and medical safety.
ABSTRACT
Sodium glucose co-transporter 2 (SGLT2) inhibitors typically have various secondary effects in addition to the hypoglycemic effect. Therefore, we examined their effectiveness and other secondary effects. We targeted 86 patients with type 2 diabetes treated with SGLT2 inhibitors for the first time from June 2014 to the end of March 2017 at our hospital. Mean body mass index (BMI) was 28.69±4.91kg/m2. Body weight, BMI, and levels of hemoglobin A1c (HbA1c), aspartate aminotransferase (AST), alanine aminotransferase (ALT), γ-glutamyl transpeptidase (γ-GTP), estimated glomerular filtration rate (eGFR), triglyceride (TG) and uric acid (UA) were significantly lower,while hematocrit (HCT), blood urea nitrogen (BUN), creatinine (Cre), and high-density lipoprotein cholesterol were significantly higher 2 months after than before administration of SGLT2 inhibitors. A significant negative correlation was observed between HbA1c, body weight, AST, ALT, γ-GTP, BUN, low-density lipoprotein cholesterol (LDL-C), and change in UA before and 2 months after administration of SGLT2 inhibitors. HbA1c was lower in patients with high HbA1c before treatment, and weight loss was noted in patients with increased body weight before treatment. These results suggest that SGLT2 inhibitors may be highly effective in patients with type 2 diabetes with uncontrolled obesity. In addition, potential risk factors for cardiovascular events and deranged liver function test values were identified, and there was a possibility that long-term SGLT2 inhibitor use could induce cardiovascular events, but with possible improvement of fatty liver. However, because it was observed that HCT was elevated and renal function was impaired, it may be necessary to administer rehydration therapy in the initial stages of treatment and to continuously monitor renal function.