Etiologies and treatments of chronic intestinal failure-short bowel syndrome (SBS) in Japanese adults: a real-world observational study

Mizushima, Tsunekazu; Udagawa, Eri; Hasegawa, Miyuki; Tazuke, Yuko; Okuyama, Hiroomi; Fernandez, Jovelle; Nakamura, Shirô

doi:10.1007/s00595-022-02469-9

Cited by 9 publications

(7 citation statements)

References 22 publications

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“…In our case, massive small intestine resection resulted in short bowel syndrome as evidenced by a lack of postprandial hyperglycemia even in the absence of endogenous and bolus insulin. Therefore, life-long parenteral nutrition is necessary for a survival in short bowel syndrome (4)(5)(6)(7)(8). However, type 1 diabetes leads to life-threatening hyperglycemia unless insulin administration is appropriately matched with glucose infusion.…”

Section: Discussionmentioning

confidence: 99%

“…Short bowel syndrome due to massive resection of the intestine is common ( 4 - 6 ); however, short bowel syndrome complicated with type 1 diabetes is extremely rare ( 7 ). In our case, massive small intestine resection resulted in short bowel syndrome as evidenced by a lack of postprandial hyperglycemia even in the absence of endogenous and bolus insulin.…”

Section: Discussionmentioning

confidence: 99%

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Glycemic Excursion and Insulin Action Revealed in a Rare Case of Type 1 Diabetes Complicated with Short Bowel Syndrome

et al. 2023

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We herein report a 52-year-old woman with a rare combination of short bowel syndrome due to massive resection of the small intestine and complete loss of endogenous insulin due to type 1 diabetes. To provide nutritional support, she was treated with total parenteral nutrition with co-administration of insulin, requiring careful matching of insulin and glucose levels. This case report provides insights on glycemic excursion and insulin action in type 1 diabetes, even when both insulin and glucose are administered directly into circulation, and the usual obstacles caused by subcutaneous injection of insulin and oral intake of nutrients are eliminated.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Glycemic Excursion and Insulin Action Revealed in a Rare Case of Type 1 Diabetes Complicated with Short Bowel Syndrome

et al. 2023

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“…In addition, advances in postoperative care have improved outcome for patients with short bowel syndrome [ 14 , 15 ]. Both in-hospital care and further bowel rehabilitation lead to increase survival and better long-term outcome with acceptable quality of life [ 16 , 17 ].…”

Section: Introductionmentioning

confidence: 99%

Acute mesenteric ischemia: updated guidelines of the World Society of Emergency Surgery

et al. 2022

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Acute mesenteric ischemia (AMI) is a group of diseases characterized by an interruption of the blood supply to varying portions of the intestine, leading to ischemia and secondary inflammatory changes. If untreated, this process may progress to life-threatening intestinal necrosis. The incidence is low, estimated at 0.09–0.2% of all acute surgical admissions, but increases with age. Although the entity is an uncommon cause of abdominal pain, diligence is required because if untreated, mortality remains in the range of 50%. Early diagnosis and timely surgical intervention are the cornerstones of modern treatment to reduce the high mortality associated with this entity. The advent of endovascular approaches in parallel with modern imaging techniques is evolving and provides new treatment options. Lastly, a focused multidisciplinary approach based on early diagnosis and individualized treatment is essential. Thus, we believe that updated guidelines from World Society of Emergency Surgery are warranted, in order to provide the most recent and practical recommendations for diagnosis and treatment of AMI.

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To the Editor, Mizushima et al recently published remarkable explorative data on the causes, treatment patterns and outcomes of short bowel syndrome with intestinal failure (SBS-IF) in Japanese adult patients [1]. The observed outcomes demonstrate the critical remaining medical and therapeutic needs for these patients.Overall, the characteristics of these Japanese adults with SBS-IF are very similar to what is observed elsewhere in the world but they notably differ from those of the small population included in a contemporary clinical trial (CT) evaluating the efficacy and safety of a glucagon-like-peptide-2 analog [2], in that the mean age in the CT was 40.9 ± years versus 61.4 ± 17.3 years in Mizushima's real-world (RW) study.

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mentioning

confidence: 99%

“…To the Editor, Mizushima et al recently published remarkable explorative data on the causes, treatment patterns and outcomes of short bowel syndrome with intestinal failure (SBS-IF) in Japanese adult patients [1]. The observed outcomes demonstrate the critical remaining medical and therapeutic needs for these patients.…”

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confidence: 99%

Crohn’s disease and short bowel syndrome

Pinton

2022

Surg Today

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To the Editor, Mizushima et al. recently published remarkable explorative data on the causes, treatment patterns and outcomes of short bowel syndrome with intestinal failure (SBS-IF) in Japanese adult patients [1]. The observed outcomes demonstrate the critical remaining medical and therapeutic needs for these patients.Overall, the characteristics of these Japanese adults with SBS-IF are very similar to what is observed elsewhere in the world but they notably differ from those of the small population included in a contemporary clinical trial (CT) evaluating the efficacy and safety of a glucagon-like-peptide-2 analog [2], in that the mean age in the CT was 40.9 ± years versus 61.4 ± 17.3 years in Mizushima's real-world (RW) study. Weaning from parenteral nutrition (PN) declines with age. Crohn's disease (CD) was the cause of SBS-IF in 72.7% of the patients in the CT in comparison to 20.1% of the patients in the RW study. In Japan, biologics are recommended to treat moderate-to-severe CD. A mirror image study using an insurance database showed that 51% of patients with CD are on biologics [3]. Observed differences in patients' characteristics support the discussion raised by Mizushima et al. (1) CD is typically diagnosed in early adulthood; (2) CD surgeries are usually performed in late age and after a long disease duration; and (3) biologics reduce the rate of surgery, preserve the residual bowel and facilitate earlier weaning from PN. SBS is the most common cause of chronic intestinal failure (IF) in CD [4]. Risk factors for and characteristics of IF in Japanese patients with CD have been previously identified [4-6]. These include cumulative initial inflammation, short residual small intestinal length, and non-use of anti-tumor necrosis factor-alpha therapy.Detailed data about the features of CD and administered treatments (e.g., fluids, biologics, or teduglutide) would help to provide a better picture of SBS-IF in Japan.These differences between RW and CT data in Japanese adult patients with SBS also perfectly illustrate how realworld data and randomized control trial data can be mutually complementary and how the first can improve the conclusions of clinical trial by better tackling the variety and heterogeneity of populations.

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Etiologies and treatments of chronic intestinal failure-short bowel syndrome (SBS) in Japanese adults: a real-world observational study

Cited by 9 publications

References 22 publications

Glycemic Excursion and Insulin Action Revealed in a Rare Case of Type 1 Diabetes Complicated with Short Bowel Syndrome

Glycemic Excursion and Insulin Action Revealed in a Rare Case of Type 1 Diabetes Complicated with Short Bowel Syndrome

Acute mesenteric ischemia: updated guidelines of the World Society of Emergency Surgery

Crohn’s disease and short bowel syndrome

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