• Endocrinology and Metabolism
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• v.37 no.2
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• pp.221-232
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• 2022

Background Obesity, the prevalence of which is increasing due to the lack of exercise and increased consumption of Westernized diets, induces various complications, including ophthalmic diseases. For example, obesity is involved in the onset of cataracts. Methods To clarify the effects and mechanisms of midodrine, an α1-adrenergic receptor agonist, in cataracts induced by obesity, we conducted various analytic experiments in Otsuka Long-Evans Tokushima Fatty (OLETF) rats, a rat model of obesity. Results Midodrine prevented cataract occurrence and improved lens clearance in OLETF rats. In the lenses of OLETF rats treated with midodrine, we observed lower levels of aldose reductase, tumor necrosis factor-α, and sorbitol, but higher levels of hexokinase, 5'-adenosine monophosphate-activated protein kinase-alpha, adenosine 5'-triphosphate, peroxisome proliferator-activated receptor-delta, peroxisome proliferator-activated receptor gamma coactivator 1-alpha, superoxide dismutase, and catalase. Conclusion The ameliorating effects of midodrine on cataracts in the OLETF obesity rat model are exerted via the following three mechanisms: direct inhibition of the biosynthesis of sorbitol, which causes cataracts; reduction of reactive oxygen species and inflammation; and (3) stimulation of normal aerobic glycolysis.

• Clinical Pain
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• v.19 no.1
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• pp.32-35
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• 2020

Treatment-induced neuropathy in diabetes (TIND) is a reversible neuropathy that occurs in patients with diabetes, usually after a fast improvement in glycemic control. TIND is defined as the sudden onset of neuropathic pain or autonomic dysfunction with a large improvement in glycemic control (glycated hemoglobin [HbA1c] level of ≥ 2% over 3 months). We report the first case of a 24-year-old woman with type 1 diabetes mellitus who developed TIND in Korea. Her HbA1c level had decreased from 16.7% to 7.3% within a 3-month period. She developed acute-onset, severe, and continuous burning pain affecting her back and lower extremities. She was administered tapentadol (50 mg), pregabalin (75 mg), and vitamin B with minerals twice daily for neuropathic pain. She complained of orthostatic hypotension; thus, midodrine (2.5 mg) and anti-embolic stockings were prescribed. She almost completely recovered 6 months after the onset. A physician should be aware of TIND and gradually reduce HbA1c levels to prevent the occurrence of TIDN. They must also try to provide relief from severe pain or autonomic dysfunction and emphasize on an almost complete recovery.