Informed consent was obtained from all patients for being included in the study. 2.2 Medications Seven patients enrolled in this study were treated by twice-daily injection of insulin glargine or detemir. According to the degludec dosage guide in Japan (Novo Nordisk Pharma, Ltd., Tokyo, Japan) [5], patients were started

with twice-daily injection of insulin glargine or detemir and then switched to once-daily injection of degludec Omipalisib at an initial dose that was 80–90 % of the respective dose of glargine or detemir [5]. Degludec was administered at a time of day suitable for their lifestyle. During the study period, the basal insulin doses were adjusted by the attending physician in a titration protocol as shown in Table 1. Compound C Table 1 Fasting plasma ARN-509 nmr glucose levels and basal insulin doses during the 24-week study period Fasting plasma glucose level

(mg/dL) Dose adjustment of degludec ≤80 Decreased 10–20 %/day 81–150 No adjustment 151–200 Increased 10 %/day (or 1–2 U/day) ≥201 Increased 10–20 %/day (or 2–3 U/day) U units For pre-prandial insulin supplementation, insulin aspart or lispro was administered at a dose set by the carbohydrate counting method, which remained unchanged throughout the study period. 2.3 Meals During the study period, all patients were given a test diet (1,500–1,600 kcal/day; 55–60 % carbohydrates, 15–20 % protein, 20–25 % fat) when CGM evaluation was performed before and 3 days and 24 weeks after switching to insulin degludec (Fig. 1). Fig. 1 Study design. CGM continuous glucose monitoring, HbA 1c glycated hemoglobin, W week 2.4 Continuous Glucose Monitoring (CGM) The study

design is shown Chlormezanone in Fig. 1. CGM was performed using an iPro™ 2 (Medtronic Minimed, Northridge, CA, USA) monitor before, 3 days after, and about 24 weeks after switching to insulin degludec. Evaluation of the CGM data was started while the patients were using glargine or detemir and was continued until the third day after switching to insulin degludec, when its blood concentration reached steady state [5]. The CGM data obtained before switching and at the third day after switching were then compared. Furthermore, evaluation of the glucose profile at 24 weeks was conducted on the second day. 2.5 Glycated Hemoglobin HbA1c was measured just before switching and when CGM evaluation was performed at about 24 weeks after switching to insulin degludec. 2.6 Statistical Analysis Variables are expressed as the mean ± SD. The Wilcoxon signed-ranks test was used to compare daily glucose fluctuations and the change of insulin dose before and 3 days after switching to degludec. This test was also used to compare daily glucose fluctuations and the change of HbA1c and insulin doses until about 24 weeks after switching to degludec. StatView version 5.

J Am Coll Surg 2007, 204:784–792.PubMed 91. Schein M: Planned reoperations and open management in critical intra-abdominal infections: prospective experience in 52 cases. World J Surg 1991, 15:537–545.PubMed 92. Adkins AL, Robbins J, Villalba M, Bendick P, Shanley CJ: Open abdomen management of intra-abdominal sepsis. Am Surg 2004, 70:137–140.PubMed 93. Jansen JO, Loudon MA: Damage control surgery in a non-trauma setting. Br J Surg 2007,94(7):789–90.PubMed 94. Wild T, Stortecky S, Stremitzer S, Lechner P, Humpel G, Glaser K, Fortelny R, Karner J, Sautner T: [Abdominal

dressing -- a new standard in therapy of the open abdomen following secondary peritonitis?]. Zentralbl Chir 2006,131(Suppl 1):S111–114.PubMed 95. Zügel N, Siebeck M, Geissler B, Lichtwark-Aschoff M, Gippner-Steppert Ro 61-8048 in vivo C, Witte J, Jochum M: Circulating mediators and this website organ function in patients undergoing planned relaparotomy

vs conventional surgical therapy in severe secondary peritonitis. Arch Surg 2002,137(5):590–599.PubMed 96. Lamme B, Boermeester MA, Belt EJ, van Till JW, Gouma DJ, Obertop H: Mortality and morbidity of planned relaparotomy versus relaparotomy on demand for secondary peritonitis. Br J Surg 2004, 91:1046–1054.PubMed 97. Hau T, Ohmann C, Wolmershauser A, Lichtwark-Aschoff M, Gippner-Steppert C, Witte J, Jochum M: Planned relaparotomy vs relaparotomy on demand in the treatment of intraabdominal infections. The selleck chemicals Peritonitis Study Group of the Surgical Org 27569 Infection Society-Europe. Arch Surg 1995, 130:1193.PubMed 98. Van Ruler O, Mahler CW, Boer KR, Reuland EA, Gooszen HG, Opmeer BC, de Graaf PW, Lamme B, Gerhards MF, Steller EP, van Till JW, de Borgie CJ, Gouma DJ, Reitsma JB, Boermeester MA: Comparison of on-demand vs planned relaparotomy strategy in patients with severe peritonitis: A randomized trial. JAMA 2007, 298:865–872.PubMed 99. Robledo FA, Luque-de-León E, Suárez R, Sánchez P, de-la-Fuente M, Vargas A, Mier J: Open versus closed management of the abdomen in the surgical treatment of severe secondary

peritonitis: a randomized clinical trial. Surg Infect (Larchmt) 2007, 8:63–72. 100. Gladman MA, Knowles CH, Gladman LJ, Payne JG: Intra-operative culture in appendicitis: Traditional practice challenged. Ann R Coll Surg Engl 2004,86(3):196–201.PubMed 101. Solomkin JS, Mazuski JE, Baron EJ, Sawyer RG, Nathens AB, DiPiro JT, Buchman T, Dellinger EP, Jernigan J, Gorbach S, Chow AW, Bartlett J, Infectious Diseases Society of America: Infectious Diseases Society of America: Guidelines for the selection of anti-infective agents for complicated intra-abdominal infections. Clin Infect Dis 2003,15,37(8):997–1005. 102. Weigelt JA: Empiric treatment options in the management of complicated intra-abdominal infections. Cleve Clin J Med 2007,74(Suppl 4):S29–37.PubMed 103.

Fifth, a candidate gene encoding a potential acetate uptake system for M. acetivorans was identified (Figure 6). This gene exhibits the same expression patterns as the ack and pta genes needed for activation of the methanogenic substrate following its entry into Milciclib the cell. Expression of aceP was suppressed by the energetically favorable substrate, methanol (Figure 6B). The AceP protein is predicted to have six transmembrane-spanning alpha-helical regions (Additional file 1, Figure S1). Noteworthy, aceP homologs are present in other methanogens including M. mazei, M. barkeri, M. maripaludis, and M. hungatei, and they constitute

a distinct class of archaea transporters. Related genes are also present in many bacterial species (Additional file 3, Figure S3), suggesting the possibility of a lateral gene transfer event from a bacterium into the Methanosarcina sp. as was proposed as one explanation for their large genome sizes [23]. Experiments are in progress to characterize the AZD1480 membrane function of the M. acetivorans Luminespib protein since no archaeal or bacterial homologs shown in Additional file 3, Figure S3 have been examined to date. Carbon control in the Archaea Considerable

information is available concerning carbon control of gene expression in bacterial and eukaryal systems, but little is yet known about related carbon control in the Archaea. Few studies have been reported for any archaeal species but include microarray studies in Pyrococcus furiosus [28], M. mazei [29, 30], and M. acetivorans [6]. The present experiments extend these studies to address a larger set of genes needed for carbon flow and electron transfer leading to methane formation from two key methanogenic substrates (Figure 8).

It provides a foundation of RNA transcript abundance and 5′ end data to begin exploring regulatory controls in this organism at the level of regulated mRNA synthesis and turnover. Little is known Meloxicam about the relative contributions of archaea transcription factors, translation factors, and/or small RNA’s in gene regulation in the Methanosarcina species to provide the distinct patterns of gene expression observed here. M. acetivorans clearly maintains a cellular commitment to dynamically control transcript levels in response to methanogenic substrate type where two major gene families are further defined by this study. Conclusion Of the twenty M. acetivorans gene clusters examined in this study, all but four were differentially expressed by 2 to 200-fold during acetate versus methanol cell growth (Figures 1, 2, 3, 4, 5, 6). The majority of these queried genes are present all sequenced Methanosarcina genomes that include M. acetivorans, M. mazei and M. barkeri (Table 1) and include the genes for multiple heterodisulfide reductase and hydrogenase-like enzymes. Exceptions are the echABCDEF, vhoGAC, rnfXCDGEABY, and mrpABCDEFG genes that encode known or predicted electron transfer complexes for ion movement and/or electron transfer.

A parent was interviewed if the patient was under 15 years of age and if the patients were between 15 and 18 years of age they could be interviewed – subject to parental approval. This study was reported GDC-0449 research buy to The Danish Data Protection Agency and has been approved by the regional scientific ethical committee of Copenhagen and Frederiksberg Municipality (KEF 01-031/01). Selection of strains Faecal strains of S. Typhimurium were chosen based on the previously described patient interviews. Strains from patients over the age of 65 years and strains from patients with known underlying diseases were not included in this study. The patients

were sorted according to hospitalization data and fever. Two groups were then established: a severe infection group with patients who were hospitalized due to their S. Typhimurium infection and also had a fever; and a mild infection group with patients who were not hospitalized and did not have a fever. From each of these groups nine strains were selected, Cell Cycle inhibitor aiming to represent the same phagetypes Selleckchem C59 wnt in each group (Table 1). The phagetype distribution observed within all strains from the interviewed patients, not including the patients with known underlying disease, correlated to the overall distribution of all human S. Typhimurium strains in Denmark in 2001 and 2002. A pattern of specific phagetypes relating to specific symptoms was not observed

within the entire interview material (data not shown). Of the nine hospitalized patients, four had bloody stools. Furthermore, three outbreak strains were included in the study, representing strains with known high virulence potential. All faecal samples received at SSI in Denmark are screened for double infection with frequently occurring intestinal pathogens such as Campylobacter, Shigella,

Yersinia and others. All strains used in this study were confirmed as originating from a single-organism infection. Table 1 Isolate information and degree of disease symptoms. Isolate nr Phage type Patient age Year of isolation Disease symptoms 0210F37188 Casein kinase 1 3 39 2002 Mild 0110H11581 10 38 2001 Mild 0202F44678 12 30 2002 Mild 0205R4381 12 41 2002 Mild 0111H24126 104 62 2001 Mild 0210H31581 104 14 2002 Mild 0110F7002 120 63 2001 Mild 0209H16582 120 0 2002 Mild 0211F40143 RDNC 1 2002 Mild 0201H32554 10 3 2002 Severe 0112F33212 12 47 2001 Severe 0207T9764 12 11 2002 Severe 0112F28702 104 20 2001 Severe 0110R3988 104a 36 2001 Severe 0210M16322 170 19 2002 Severe 0208F10996 193 9 2002 Severe 0111M12249 RDNC 12 2001 Severe 0207M72344 RDNC 16 2002 Severe 0506H32341 12 53 2005 Outbreak 0509R6852 104 58 2005 Outbreak 0511R7026 104 2 2005 Outbreak Serotyping All strains were previously serotyped at SSI according to the White-Kauffmann-Le Minor scheme [31] by agglutination with O- and H-antigen specific sera (SSI Diagnostika, Hillerød, Denmark).

CrossRefPubMed 83. Stutz EW, Defago G, Kern H: Naturally occurring fluorescent pseudomonads involved in suppression of black root rot of tobacco. Phytopathology 1986, 76:181–185.CrossRef 84. Gardener BBM, Schroeder KL, Kalloger SE, Raaijmakers

JM, Thomashow LS, Weller DM: Genotypic and phenotypic diversity of phlD -containing Pseudomonas strains isolated from the rhizosphere of wheat. Appl Environ Microbiol 2000, 66:1939–1946.CrossRef 85. Mavrodi OV, Gardener BBM, Mavrodi DV, Bonsall RF, Weller DM, Thomashow LS: Genetic diversity of phlD from 2,4-diacetylphloroglucinol-producing fluorescent Pseudomonas spp. Phytopathology 2001, 91:228–228.CrossRef 86. Landa BB, Mavrodi OV, Raaijmakers JM, Gardener BBM, Thomashow LS, Weller DM: Differential ability of genotypes of 2,4-diacetylphloroglucinol-producing Pseudomonas learn more fluorescens strains to colonize the roots of pea plants. Appl Environ Microbiol 2002, 68:3226–3237.CrossRefPubMed 87. Smirnov V, Kiprianova E: Bacteria of Pseudomonas genus. Kiev: Naukova Dumka 1990, 264. 88. Shanahan P, O’sullivan DJ, Simpson P, Glennon JD, O’Gara F: Isolation of 2,4-diacetylphloroglucinol from a fluorescent pseudomonad and investigation of physiological parameters

influencing its Entospletinib production. Appl Environ Microbiol 1992, 58:353–358.PubMed 89. Cornelis P, Anjaiah V, Koedam N, Delfosse P, Jacques P, Thonart P, Neirinckx L: Stability, frequency and multipliCity of transposon insertions in the pyoverdine region in the chromosomes of different fluorescent pseudomonads. J

Gen Microbiol 1992, 138:1337–1343.PubMed 90. Thompson IP, Bailey MJ, Fenlon Baricitinib JS, Fermor TR, Lilley AK, Lynch JM, Mccormack PJ, Mcquilken MP, Purdy KJ, Rainey PB, Whipps JM: Quantitative and qualitative seasonal changes in the microbial community from the phyllosphere of sugar beet ( Beta vulgaris ). Plant and Soil 1993, 150:177–191.CrossRef Authors’ contributions DVM was responsible for conception of the study, experimental design, data collection, and analysis. LST, ITP and JEL participated in data P5091 in vitro analysis and preparation of the manuscript.”
“Background Neisseria meningitidis, or the meningococcus (Mc), exclusively colonizes the oro- and nasopharynx of humans. It resides as a commensal in approximately 10% of healthy individuals [1], but may become virulent, disseminating into the bloodstream and crossing the blood-brain barrier [2]. Mc septicaemia and meningitis are the cause of significant morbidity and mortality worldwide [2]. On the mucosal surface of the upper respiratory tract, Mc is exposed to reactive oxygen species (ROS) produced by the immune system through the oxidative burst and by endogenous aerobic metabolism, causing damage to many cellular components, including DNA [3]. Oxidative DNA lesions comprise single- and double strand breaks, abasic (apurinic/apyrimidinic, or AP) sites, and base damages, among which one of the most common is the oxidation product of guanine, 7,8-dihydro-8-oxo-2′-deoxyguanosine (8oxoG).

From Bedside to Bench. Maria Karlou 1 , Jun Yang2, Sankar Maity2, Nora M. Navone2, Jing-Fang Lu2, Xinhai Wan2, Anh Hoang1, Christopher J. Logothetis2, Eleni Efstathiou1 1 Department of Genitourinary Medical Oncology, David H. Koch Center for Applied Research of Genitourinary Cancers, The Stanford Alexander Tissue Derivatives Laboratory, The University of Texas MD Anderson Cancer Center, Houston, TX, Akt signaling pathway USA, 2 Department

of Genitourinary Medical Oncology, David H. Koch Center for Applied Research of Genitourinary Cancers, The University of Texas MD Anderson Cancer Center, Houston, TX, USA Background: In the tumor microenvironment, activation of tumor-stromal interactions is considered to play a critical role in Prostate Cancer (PCa) progression. LY3039478 mouse hedgehog signaling, a developmental pathway implicated in cancer, has been associated with resistance to cytotoxic treatment in human samples. Thus hedgehog signaling inhibition is a candidate therapeutic Salubrinal clinical trial target for combination with maximal androgen ablation. Selection of preclinical models of PCa relevant

to the human disease is imperative for development of applicable therapeutic strategies. Materials and methods: Xenografts generated by our research team from castrate-resistant PCa specimens were used to screen gene expression of key components in hedgehog signaling. Tumors were examined for the RNA and protein expression Tideglusib of Shh, Gli1, Gli2, Smo, Ptch1 and Sufu by Real Time RT-PCR and IHC in both (human) prostate cancer cells and in host (mouse) derived stromal cells. Results-Conclusions:

118b is an androgen independent xenograft, not expressing AR, inducing bone formation in the surrounding stroma. This xenograft has a striking overexpression of hedgehog signaling including nuclear expression of Gli1 and Gli2. Xenografts A10, 137, 117, 115 and 79 are expressing AR and some extent of hedgehog signaling. All studied models showed differential gene expression of hedgehog signaling components in stromal compartment compared to tumor cells. Notably, A10 when grown in castrate host has increased expression of the transcription factors Gli1 and Gli2 and the ligand Shh, in the stromal compartment as compared to growth in non-castrate (vide infra). This experiment recapitulates the human condition based on our translational results and therefore might be the most well suited model to test the effect of hedgehog signaling inhibition on blocking androgen-resistant growth. Poster No.

Meanwhile, the increase of CCR7 chemokine receptor expression promotes tumor growth and metastasis. When the latter effect is prominent, the Danusertib molecular weight tumor disseminates. Under normal conditions, CCR7 is expressed on T cells. When malignancy occurs, the neoplastic T cell may enhance the expression of CCR7. The differential expression of CCL21 by endothelial cells might explain at least one part of this process. Our results support the chemotaxis theory that CCL21 expression co-mediates the dissemination of primary tumors to different organs [19]. Epacadostat mw Hasegawa [20] found that adult T cell leukemia/lymphoma (ATLL) cells with high CCR7 expression have increased directional migration capability toward CCL21, which

suggests that CCR7 expression may facilitate ATLL cell movement to the high endothelial vein of lymph nodes with abundant

CCL21, and then to metastasis. The influence of CCL21 on lymphatic dissemination (compared ACP-196 datasheet with hematogenous) has not been investigated thus far, but CCL21 is also highly expressed in lymph nodes, and CCR7 inhibition results in suppression of breast cancer lymph node metastases, which implies similar pathways for lymphatic and hematogenous dissemination [10]. PI3K/Akt, an intracellular signal pathway, plays a role in the invasion of many malignant tumors. Whether PI3K/Akt participates in the invasion and metastasis of T cell lymphomas induced by CCR7 and if a relationship exists between them remains unclear. The PI3K/Akt signal pathway was first found in the 1990′s. The catalysate of PI3K can participate in cellular proliferation, living, differentiation, and migration [21]. Receptor protein tyrosine kinase (RPTK) activation results in PI(3,4,5)P(3) and PI(3,4)P(2) production by PI3K at the inner side of the plasma membrane. Akt interacts with these phospholipids, causing its translocation to the inner membrane, where it is phosphorylated and activated by PDK1 and PDK2. The activated Akt

modulates the function of numerous substrates which are involved in the regulation of cell survival, cell cycle progression, and cellular growth. Several studies have proven that Akt expression is excessively upregulated in also many malignant tumors, such as thyroid carcinomas, gliomas, breast carcinomas, pulmonary carcinomas, and so on [22–26]. As a protein kinase, Akt is activated through phosphorylation. The upregulation of Akt protein may promote oncogenesis and tumor growth. The expression level of phosphorylated-Akt is the indicator of the kinase activity. In our experiment, the expression levels of PI3K mRNA, Akt mRNA, and p-Akt protein in Hut 78 cells were higher than that in Jurkat cells. The Hut 78 cells were more invasive than the Jurkat cells. The invasiveness of T-NHL is associated with the CCR7 expression. CCR7 is a transmembrane receptor of GTP-protein. CCR7 may activate Akt and the PI3K/Akt signal pathway to promote cell proliferation and spread.

In the next section we consider other limitations of anthropomorphism as a tool for conservation. Potential negative Aurora Kinase inhibitor outcomes of anthropomorphism as a conservation tool Here we discuss three kinds of negative outcomes of anthropomorphizing non-human species. In the first kind, an apparently positive outcome conflicts with conservation goals. In the second kind, animals violate the social expectations raised by their anthropomorphization, creating conflict with humans. Finally, non-human species can take on pejorative social stereotypes, with negative effects on their conservation. A main goal of

using empathetic anthropomorphism as a conservation tool is to promote care and protection of individuals of a species. But producing SBE-��-CD in vivo a caring attitude towards individual non-humans can negatively affect conservation goals. Research to promote humans caring for other humans shows that willingness to contribute to humans in need is greatest when the information given with the request for help is focused on a single individual identified with a picture (Kogut and Ritov 2005). Slovic (2007) claims that most people will exert great effort to help alleviate individual suffering.

These same people, however, can become “numbly indifferent to the plight of individuals who are ‘one of many’ in a much greater problem” (p. 79). Slovic (2007) provides cattle and canine examples of how this phenomenon also functions with human perceptions of nonhuman animals. The feeling of indifference and associated lack of action begins at two individuals (Slovic 2007). Because anthropomorphism can draw people’s attention to individuals, it is equipped to heighten medroxyprogesterone care. Further research is needed, however, to determine whether anthropomorphism is effective or destructive

in teaching caring actions for complex concepts, such as ecosystems and biodiversity. As Chan (2012) notes, a caring attitude directed at individuals rather than systems can act as a limitation to conservation. Chan (2012) cites a hypothetical example whereby anthropomorphizing one species heightens care for that species and leads to public support for the killing of a competitor or predator species. Another possibility is that a caring attitude would conflict with conservation actions such as control of zoo populations in breeding programs, culling, trapping or tagging. As a case in point, breeding programs for threatened species in zoos are divided about whether it is better to prevent unwanted crosses entering the gene pool through the use of contraceptives (more efficient), or by allowing animals with unplanned pregnancies to experience natural Selleckchem Autophagy Compound Library offspring-raising behaviors, followed by euthanizing these offspring when they reach adulthood (argued to be more caring) (Kaufman 2012).

These latter are defined microsatellite unstable tumors (MSI), represent about 15% of all the gastric tumors and are associated with a more favorable prognosis, larger size, female gender, advanced age, less lymph node involvement, intestinal histotype and antral location [2]. Common alterations found associated with MSI include promoter methylation of MLH1 [3] and mutations

of TGFBR2, IGFR2 and BAX [4]. Microsatellite stable (MSS) gastric neoplasms show a different set of alterations: drug discovery several proto-oncogenes, including MET, FGFR2 and ERBB2, are frequently amplified [5] while inactivation of both alleles of TP53 by loss of heterozygosity and mutation is the most frequent genetic event associated with MSS phenotype [6]. Moreover, loss of TP73, APC, DCC, FHIT and TFF1 are also frequently detected [5, 7]. PIK3CA is a gene that encodes for the p110-alpha subunit of phosphoinositide-3-kinase (PI3K). Recently, a key role as oncogene is emerging for PIK3CA, as it is one of the genes most frequently hit by somatic mutations in several types of human cancer [8, 9]. PI3K is part of a family of ser-thr-kinases that interacts with phosphatidylinositol bisphosphate (4,5-PIP2) to produce the

phosphatidylinositol trisphosphate (3,4,5-PIP3), a second messenger with several functions. PIP3 mainly binds the plekstrine homology (PH) domain of a number www.selleckchem.com/products/ca3.html of target CX-5461 purchase molecules and leads to their activation through cell membrane targeting or modulation of their activity. One of the best characterized targets of PI3K lipid products is the protein kinase Akt. PI3K/Akt activation was

demonstrated to be involved in the regulation of several cellular functions like cell survival, cell growth and angiogenesis stimulation, inhibition of apoptosis, translation of several proteins and hence, in the development of cancer [10, 11]. Of the twenty exons that compose the PIK3CA gene, more than 75% of the mutations are found in two hot-spots located in exons 9 and 20, which encode for the helical and kinase domains, respectively [8]. Expression Ribonucleotide reductase of the most common variants (E542K, E545K and H1047R) is associated with an increased lipid kinase activity and is oncogenic both in cell coltures and in vivo [12, 13]. Mutations affecting the two hot-spots have recently been demonstrated to be functionally different [14] and their respective rates of mutation have been often reported as associated to specific cancer types or particular patient features [15, 16]. In this study, we analysed 264 gastric cancers for the presence of mutations in the exons 9 and 20, by means of direct sequencing, and correlated the presence of mutations with clinical-pathological features, including MSI phenotype.

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Oudkerk M, Witteman JC, Hofman A, van Gijn J, et al. Hypertension and cerebral white matter lesions in a prospective cohort study. Brain J Neurol. 2002;125(Pt 4):765–72.CrossRef 35. Warsch JR, Wright CB. Stroke: hyperlipidemia and cerebral small-vessel disease. Nat Rev Neurol. 2010;6(6):307–8.PubMedCrossRef 36. Swartz RH, Sahlas DJ, Black SE. Strategic involvement of cholinergic pathways and executive dysfunction: Does location of white matter signal hyperintensities matter? J Stroke Cerebrovasc Dis. Entinostat 2003;12(1):29–36.PubMedCrossRef 37. Bohnen NI, Muller ML, Kuwabara H, Constantine

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“Key Points Switching α-glucosidase inhibitors to miglitol reduced glucose fluctuations and circulating cardiovascular disease (CVD) risk factors in type 2 diabetic Japanese patients Reducing glucose fluctuations may reduce the development of CVD in type 2 diabetic patients 1 Introduction Large-scale cohort studies such as Diabetes Epidemiology: Collaborative else analysis of Diagnostic criteria in Europe (DECODE) and FUNAGATA have shown that impaired glucose tolerance (IGT) is strongly associated with subsequent incidence of cardiovascular disease (CVD) [1–3]. The Study TO Prevent Non-insulin-dependent diabetes mellitus (STOP-NIDDM) and Meta-analysis of Risk Improvement under Acarbose (MeRIA7) trials have demonstrated that inhibition of postprandial hyperglycemia by the α-glucosidase inhibitor (α-GI) acarbose reduces pronounced CVD events in subjects with IGT and type 2 diabetes [4, 5]. These results suggest that inhibition of postprandial hyperglycemia, rather than the total rise of glucose throughout the day, in type 2 diabetic patients is important for preventing CVD development.