急激な血糖上昇で発見され,膵体尾部切除後経口血糖降下剤で良好な経過を示した膵癌・膵性糖尿病の1例

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An 81-year-old woman visited our clinic with backache in June 2005. Laboratory data revealed elevation of the HbA_<1c> (6.8%) with no abnormal findings on abdominal ultrasonography. She was diagnosed as having diabetes mellitus and advised to perform therapeutic diet and exercise. In January 2006, she complained of polydipsia and psychogeusic disturbances. She lost 5kg of weight during the last 2 months. Her plasma glucose was 715mg/dl and the HbAic was 14.9%. She was hospitalized and treated with intravenous insulin infusion at first, and by subcutaneous insulin infusion 4 times a day from the third day after admission. On admission her serum CA 19-9 was elevated to 923U/ml. Further examination by abdominal ultrasonography, CT, MRI, and angiography led to the diagnosis of pancreatic carcinoma, stage IVa. In spite of increased risk due to higher age pancreatectomy was performed in accordance with the patient's wish. The pathological diagnosis was invasive ductal carcinoma of the pancreas. Her blood glucose level decreased after the surgery, and her diabetes was well controlled by only oral medication thereafter. She has been well even now, 180 days postoperatively, and her latest HbAic was 6.8%.
東京女子医科大学の論文