Why Treatment Matters

Diabetes is persistent high blood sugar. Even without symptoms it quietly damages blood vessels and organs, raising the risk of heart attack, stroke, kidney failure, vision loss, and foot ulcers. It can also trigger emergencies such as DKA/HHS. Early control prevents these problems.

• Even if you feel well, act early
• ・Use Continuous Glucose Monitoring (CGM) to spot hidden spikes (post-meal “glucose surges”) and adjust diet, activity, and sleep.
• ・ Want a second opinion from a specialist
• ・Managing spikes improves energy, focus, weight, fatty liver, and blood pressure while slowing atherosclerosis.

If your numbers are “borderline,” that’s the time to make a plan with a diabetes specialist—not to wait.

Diabetes Care

• Who should consider a visit
• ・ Told your glucose or HbA1c is high at a checkup or another clinic
• ・ Want a second opinion from a specialist
• ・ Family history of diabetes
• ・ Glucose seems controlled but you worry about complications or hidden metabolic risks
• ・ Concern about post-meal spikes or glucose variability
• ・ Interested in Continuous Glucose Monitoring (CGM) (FreeStyle Libre) and comprehensive wellness care (self-pay available)
• ・ Weight concerns or obesity management interest
• ・ Prefer joined medical–dental care linking oral health and systemic health

• Our approach
  (personalized & evidence-based)
• ・ Diabetes has many causes—from lifestyle to reduced insulin secretion or endocrine/liver disorders—so we tailor the standard of care to your lifestyle and glucose pattern (chronically high vs. post-meal spikes).
• ・ We coordinate related issues: obesity care, sleep apnea (SAS) home testing and CPAP when indicated, and dental collaboration because periodontal disease and dysglycemia worsen each other.
• ・ Treatment rests on three pillars: nutrition, activity, and medication—never medication-only.
• ・ We use CGM (FreeStyle Libre) to make trends visible and build practical, sustainable plans that prevent complications and improve quality of life.

Have even a small concern? Please feel free to contact us.

Intermittently Scanned CGM (isCGM) – FreeStyle Libre 2

Overview
・ Even if you don’t meet insurance criteria, you can monitor glucose with FreeStyle Libre 2 as a self-pay optional service.
・ A small sensor is worn on the skin and scanned with a smartphone app to track up to 14 days of glucose trends.
・ Insurance is available for patients on insulin therapy who meet coverage rules.

Who it’s for

・ Want to understand daily glucose patterns
・ Concerned about post-meal spikes or lifestyle effects (diet, activity, sleep)
・ Have elevated diabetes risk

Fees (self-pay, tax included)

・Libre 2 sensor ×1 (14 days): ¥8,300
Includes fitting guidance and basic use instructions
First visit fee charged separately(see Diabetes checkup page)

・ Two-sensor set (28 days): ¥16,000
May require reservation depending on stock

How it works

1. Sensor fitting (in-clinic assistance or self-apply at home)
2. 14 or 28 days of monitoring → optional data review & explanation
3. Payment & receipt
Insurance items and self-pay items are billed separately with a detailed statement

※Notes
• No returns after opening/placement.
• Please inform us of any skin issues or allergies in advance.
• If you qualify for insurance-covered CGM management, we will guide you accordingly.

Interested? Contact us to check availability or book a fitting.

How To Set Up the Libre App* and Start the Sensor
How To Apply and start sensor FreeStyle Libre 2 Plus sensor
Learn more about FreeStyle Libre 2

GIP/GLP-1 Receptor Agonist (Tirzepatide)

Overview
• Tirzepatide is a first-in-class dual agonist of GIP and GLP-1.
• It boosts glucose-dependent insulin, suppresses glucagon, slows gastric emptying, and reduces appetite, improving glycemic control and promoting weight loss.
• Mounjaro® and Zepbound® contain the same active ingredient.

Who it’s for

• Mounjaro® (insurance) Treatment of type 2 diabetes in our insured medical care.
• Zepbound® (self-pay) For obesity management when criteria are met
(handled as private care at our clinic). (Insurance for obesity is not available at general clinics.)

Obesity – basic criteria

• BMI ≥ 25 plus either:
≥1 obesity-related comorbidity, or
Evidence of visceral fat accumulation likely to cause health problems.

Common side effects

• Nausea, early satiety/indigestion, constipation or diarrhea
• Hypoglycemia (risk increases with insulin or sulfonylureas)
• Less common: pancreatitis, gallbladder issues

Do not use if

• Pregnant or breastfeeding
• Type 1 diabetes
• Personal/family history of medullary thyroid carcinoma (MTC) or MEN2

Our approach

• Screen for contraindications, review goals and alternatives, and combine with nutrition + activity.
• Gradual dose titration and regular follow-up with labs and side-effect checks.
• If severe abdominal pain or persistent vomiting occurs, stop and contact us promptly.

Endocrinology & Metabolism

• Who should consider a visit
• ・ Possible male hypogonadism / LOH (fatigue, low libido, mood changes, etc.)
• ・ Told you have thyroid hormone abnormalities (Graves’ disease, Hashimoto’s, etc.)
• ・ Neck swelling, palpitations, sweating, unintentional weight loss/gain, hand tremor
• ・ Concern about osteoporosis
• ・ Electrolyte disorders such as hyponatremia or hypercalcemia
• ・ Unexplained fatigue or headaches (possible adrenal insufficiency and others)
• ・ Metabolic disorders (dyslipidemia, hyperuricemia, etc.) needing coordinated care with diabetes and other lifestyle diseases

We provide evaluation, lab testing, and personalized treatment plans, working closely with primary care and diabetes services as needed.

Male Hypogonadism (LOH)

• Self-check (common signs)
• ・ Low energy / motivation
• ・ Poor sleep or frequent awakenings
• ・ Reduced libido / erectile difficulty
• ・ Increased body fat or reduced muscle strength
• ・ Irritability / anxiety
• ・ Sense of “loss of masculinity”

Please consult our physician to confirm suitability and discuss risks, benefits, and costs.