{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,20]],"date-time":"2025-10-20T17:51:00Z","timestamp":1760982660272,"version":"build-2065373602"},"reference-count":10,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[1991,3,1]],"date-time":"1991-03-01T00:00:00Z","timestamp":667785600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["J Parenter Enteral Nutr"],"published-print":{"date-parts":[[1991,3]]},"abstract":"<jats:p>Little is known about effective treatment for severe diarrhea in the insulin\u2010dependent diabetic patient. A 41\u2010year\u2010old woman was admitted to our hospital because of hyperglycemia and dysuria. She had stopped insulin self\u2010injection therapy for 2 years and diarrhea had become worse, resulting in malnutrition. Following enteral alimentation by elemental diet (ED) with continuous subcutaneous insulin infusion (CSII), frequency of diarrhea remarkably decreased and general nutritional condition was improved. At the first step, the patient was given 600 kcal\/d ED through the tube sustained in the jejunum. Total calorie intake for 24 hours was gradually increased to the level of 2400 kcal\/d and this therapy continued for 5 months. During this period, blood glucose level was kept in almost normal range (between 100 and 200 mg\/dL) through the continuous insulin infusion of regular insulin (1.0\u20131.5 U\/h). Thereafter, general conditions were improved and frequency of diarrhea gradually decreased. When this treatment was stopped, watery diarrhea, steatorrhea, and hypoalbuminemia completely disappeared and she gained 12 kg of body weight. Furthermore, spontaneous urination appeared following this treatment. This case suggests that the enteral hyperalimentation combined with strict control of blood glucose, using the CSII, may be an effective therapy for such severe diarrhea with malnutrition in diabetes. <jats:italic>(Journal of Parenteral and Enteral Nutrition<\/jats:italic> <jats:bold>15:<\/jats:bold>181\u2013183, 1991)<\/jats:p>","DOI":"10.1177\/0148607191015002181","type":"journal-article","created":{"date-parts":[[2008,5,14]],"date-time":"2008-05-14T19:51:26Z","timestamp":1210794686000},"page":"181-183","source":"Crossref","is-referenced-by-count":4,"title":["Enteral Hyperalimentation with Continuous Subcutaneous Insulin Infusion Improved Severe Diarrhea in Poorly Controlled Diabetic Patient"],"prefix":"10.1002","volume":"15","author":[{"given":"Hiroyuki","family":"Shimizu","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yohnosuke","family":"Shimomura","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Masaki","family":"Takahashi","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Isao","family":"Kobayashi","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Takashi","family":"Tomizawa","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Setsuo","family":"Kobayashi","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[1991,3]]},"reference":[{"key":"e_1_2_1_2_1","first-page":"737","article-title":"The diarrhea of diabetes and steatorrhea of pancreatic insufficiency","volume":"11","author":"Bargen JA","year":"1936","journal-title":"Proc Mayo Clin"},{"key":"e_1_2_1_3_1","doi-asserted-by":"crossref","first-page":"1021","DOI":"10.1016\/S0016-5085(69)80003-X","article-title":"Diabetic diarrhea: A clinical and pathological study","volume":"56","author":"Whalen GE","year":"1969","journal-title":"Gastroenterology"},{"key":"e_1_2_1_4_1","doi-asserted-by":"publisher","DOI":"10.7326\/0003-4819-72-2-215"},{"key":"e_1_2_1_5_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.2.6150.1462"},{"key":"e_1_2_1_6_1","first-page":"467","article-title":"Diabetic diarrhea","volume":"26","author":"Malins JM","year":"1957","journal-title":"Q J Med"},{"key":"e_1_2_1_7_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.4.5889.423"},{"key":"e_1_2_1_8_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1476-5381.1973.tb08339.x"},{"key":"e_1_2_1_9_1","first-page":"26","article-title":"On a new product of the elemental diet","volume":"106","author":"Kogoshi S.","year":"1978","journal-title":"Igaku Ayumi"},{"key":"e_1_2_1_10_1","doi-asserted-by":"publisher","DOI":"10.1016\/0003-9861(57)90216-3"},{"key":"e_1_2_1_11_1","first-page":"817","volume-title":"Joslin's Diabetes Mellitus","author":"Falchuk KR","year":"1985"}],"container-title":["Journal of Parenteral and Enteral Nutrition"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/aspenjournals.onlinelibrary.wiley.com\/doi\/pdf\/10.1177\/0148607191015002181","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,16]],"date-time":"2025-10-16T15:40:55Z","timestamp":1760629255000},"score":1,"resource":{"primary":{"URL":"https:\/\/aspenjournals.onlinelibrary.wiley.com\/doi\/10.1177\/0148607191015002181"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[1991,3]]},"references-count":10,"journal-issue":{"issue":"2","published-print":{"date-parts":[[1991,3]]}},"alternative-id":["10.1177\/0148607191015002181"],"URL":"https:\/\/doi.org\/10.1177\/0148607191015002181","archive":["Portico"],"relation":{},"ISSN":["0148-6071","1941-2444"],"issn-type":[{"type":"print","value":"0148-6071"},{"type":"electronic","value":"1941-2444"}],"subject":[],"published":{"date-parts":[[1991,3]]}}}