{"created":"2023-06-20T15:49:26.156908+00:00","id":4027,"links":{},"metadata":{"_buckets":{"deposit":"f5e178dc-17c4-41c3-a45d-8cfaa9fd609a"},"_deposit":{"created_by":4,"id":"4027","owners":[4],"pid":{"revision_id":0,"type":"depid","value":"4027"},"status":"published"},"_oai":{"id":"oai:hama-med.repo.nii.ac.jp:00004027","sets":["1:12:83"]},"author_link":["12432","12433","12434","12435","12436","12437"],"item_3_biblio_info_5":{"attribute_name":"書誌情報","attribute_value_mlt":[{"bibliographicIssueDates":{"bibliographicIssueDate":"2022-05-30","bibliographicIssueDateType":"Issued"},"bibliographicIssueNumber":"2","bibliographicPageEnd":"6","bibliographicPageStart":"2","bibliographicVolumeNumber":"11","bibliographic_titles":[{"bibliographic_title":"静岡産科婦人科学会雑誌","bibliographic_titleLang":"ja"}]}]},"item_3_description_9":{"attribute_name":"抄録","attribute_value_mlt":[{"subitem_description":"劇症1型糖尿病は、膵β細胞の破壊による急激なインスリン分泌不全から高血糖とケトアシドーシスを呈する重篤な病態である。筆者らは、帝王切開術後に発症した劇症1型糖尿病の1例を経験した。42歳、前回の妊娠経過で血糖値異常は認めず、今回の妊娠経過でも初期と術前の随時血糖では異常を認めなかった。選択的帝王切開術後より冷汗・悪心の出現を認め、術後1日目に低血糖を認めた。術後6日目に高血糖によるケトアシドーシスを発症し、劇症1型糖尿病と診断された。劇症1型糖尿病は感染に対するストレス応答や妊娠が関与するとされる。本症例では術後6日に高血糖を確認して確定診断に至ったが、術後に低血糖を認めており、侵襲を伴う血糖の推移として異常であるという認識が必要である。また、帝王切開術後に冷汗、悪心を認める際には低血糖を鑑別診断として評価し、劇症1型糖尿病などの重篤な疾患の早期発見・治療につなげることが重要である。","subitem_description_language":"ja","subitem_description_type":"Abstract"},{"subitem_description":"Fulminant type 1 diabetes mellitus is a serious condition in which the destruction of pancreatic beta cells leads to rapid insulin deficiency, resulting in hyperglycemia and ketoacidosis. We report a case of fulminant type 1 diabetes mellitus after elective cesarean section in which the patient developed ketoacidosis due to hyperglycemia after a period of hypoglycemia. A 42-year-old female underwent elective repeat cesarean section due to previous cesarean delivery. Despite food intake, the patient had hypoglycemia for 3 days after surgery and developed ketoacidosis due to hyperglycemia after 6 days. The pathogenesis of fulminant type 1 diabetes mellitus remains unclear, but links to stress responses such as infections have been identified. Pregnancy itself may also be related to the onset of the disease because of increased insulin resistance and changes in the maternal immune system. In this case, the stress response due to cesarean section may have contributed to the onset of fulminant type 1 diabetes mellitus. When cold sweats and nausea are observed after cesarean section, glycemic abnormalities should be suspected of early diagnosis hidden serious diseases such as fulminant type 1 diabetes mellitus.","subitem_description_language":"en","subitem_description_type":"Abstract"}]},"item_3_publisher_6":{"attribute_name":"出版者","attribute_value_mlt":[{"subitem_publisher":"静岡産科婦人科学会","subitem_publisher_language":"ja"}]},"item_3_source_id_19":{"attribute_name":"ISSN","attribute_value_mlt":[{"subitem_source_identifier":"21871914","subitem_source_identifier_type":"ISSN"}]},"item_3_version_type_32":{"attribute_name":"著者版フラグ","attribute_value_mlt":[{"subitem_version_resource":"http://purl.org/coar/version/c_970fb48d4fbd8a85","subitem_version_type":"VoR"}]},"item_creator":{"attribute_name":"著者","attribute_type":"creator","attribute_value_mlt":[{"creatorNames":[{"creatorName":"竹内, 文子","creatorNameLang":"ja"}],"nameIdentifiers":[{}]},{"creatorNames":[{"creatorName":"松家, まどか","creatorNameLang":"ja"}],"nameIdentifiers":[{}]},{"creatorNames":[{"creatorName":"稲見, 勝朗","creatorNameLang":"ja"}],"nameIdentifiers":[{}]},{"creatorNames":[{"creatorName":"仲神, 宏子","creatorNameLang":"ja"}],"nameIdentifiers":[{}]},{"creatorNames":[{"creatorName":"幸村, 康弘","creatorNameLang":"ja"}],"nameIdentifiers":[{}]},{"creatorNames":[{"creatorName":"金森, 隆志","creatorNameLang":"ja"}],"nameIdentifiers":[{}]}]},"item_files":{"attribute_name":"ファイル情報","attribute_type":"file","attribute_value_mlt":[{"accessrole":"open_date","date":[{"dateType":"Available","dateValue":"2022-05-30"}],"displaytype":"detail","filename":"jsog_11_2_2.pdf","filesize":[{"value":"461.2 kB"}],"format":"application/pdf","licensetype":"license_note","mimetype":"application/pdf","url":{"label":"jsog_11_2_2","url":"https://hama-med.repo.nii.ac.jp/record/4027/files/jsog_11_2_2.pdf"},"version_id":"d6d71a1c-5abf-4189-88f7-8847934ea1d9"}]},"item_keyword":{"attribute_name":"キーワード","attribute_value_mlt":[{"subitem_subject":"劇症1型糖尿病","subitem_subject_language":"ja","subitem_subject_scheme":"Other"},{"subitem_subject":"妊娠","subitem_subject_language":"ja","subitem_subject_scheme":"Other"},{"subitem_subject":"産褥発症","subitem_subject_language":"ja","subitem_subject_scheme":"Other"},{"subitem_subject":"糖尿病性ケトアシドーシス","subitem_subject_language":"ja","subitem_subject_scheme":"Other"},{"subitem_subject":"低血糖","subitem_subject_language":"ja","subitem_subject_scheme":"Other"}]},"item_language":{"attribute_name":"言語","attribute_value_mlt":[{"subitem_language":"jpn"}]},"item_resource_type":{"attribute_name":"資源タイプ","attribute_value_mlt":[{"resourcetype":"journal article","resourceuri":"http://purl.org/coar/resource_type/c_6501"}]},"item_title":"選択的帝王切開術後に発症した劇症1型糖尿病の一例","item_titles":{"attribute_name":"タイトル","attribute_value_mlt":[{"subitem_title":"選択的帝王切開術後に発症した劇症1型糖尿病の一例","subitem_title_language":"ja"},{"subitem_title":"A case of fulminant type 1 Diabetes mellitus after an elective Caesarean section","subitem_title_language":"en"}]},"item_type_id":"3","owner":"4","path":["83"],"pubdate":{"attribute_name":"PubDate","attribute_value":"2022-05-30"},"publish_date":"2022-05-30","publish_status":"0","recid":"4027","relation_version_is_last":true,"title":["選択的帝王切開術後に発症した劇症1型糖尿病の一例"],"weko_creator_id":"4","weko_shared_id":-1},"updated":"2023-08-01T07:01:02.520623+00:00"}