As of March 1, 2024, I am Professor and Chairman of the Department of Diabetes, Endocrinology and Nutrition, Kyoto University Graduate School of Medicine, duly appointed by the University Administration. I would like to offer heartfelt greetings.

In high school, I was inspired by the revolutionary discovery of the double helix molecular structure of DNA by Watson and Crick, and my passion shifted from architecture to the life sciences.  In 1992, I began my immersion in molecular biology in the laboratory of Professor Tasuku Honjo, a Nobel Prize winner in Physiology or Medicine for his discovery of cancer therapy by inhibition of negative immune regulation. After graduation from medical school in 1998, I entered the University of Texas Southwestern Graduate School of Biomedical Studies under Professors Michael S. Brown and Joseph L. Goldstein, who jointly won the Nobel Prize in Physiology or Medicine for their discoveries in the regulation of cholesterol metabolism. In 2003, I received the Ph.D. and returned to Japan as an assistant professor in the Department of Medical Chemistry, Kyoto University Graduate School of Medicine.  Four years later, I made the determination to shift to clinical research and practice, an admonition in my medical school days from Professor Hiroo Imura, our former Professor who was at that time the President of Kyoto University and a world-renown expert in endocrinology, who urged me to clinical as well as basic research to deepen my awareness of the issues still ringing in my mind. Under the guidance of my esteemed immediate predecessor, Professor Nobuya Inagaki, I started my training as a diabetes specialist under the supervision of Professor Yutaka Seino, the much-honored previous head of our department, who was at that time Director of Kansai Electric Power Hospital. Since then, I have been engaged in medical practice and research related to diabetes, obesity, and endocrine and metabolic diseases as well as nutrition therapy, including a focus on pancreatic β-cell function and incretin action under the guidance of both Professor Yutaka Seino and his late and revered brother, Professor Susumu Seino of the Division of Molecular and Metabolic Medicine, Kobe University Graduate School of Medicine. In 2016 I began as Program Specific Associate Professor at the Department of Diabetes, Endocrinology and Nutrition of Kyoto University; in 2018, I was appointed Professor at the Department of Diabetes, Endocrinology and Metabolism, Gifu University Graduate School of Medicine, where I headed the department for 5 years. I am now humbly challenged again by my alma mater in my new position.

The global population of people with diabetes was estimated by the International Diabetes Federation (IDF) in 2021 to be about 536.6 million (prevalence 10.5%) and is expected at the current rate to increase to about 783.2 million (prevalence 12.2%) by 2045.  More than 50% of the disease occurs in Asia, China (104.9 million), India (74.2 million), and Pakistan (33 million) being the three most afflicted countries, Japan (11 million) ranking ninth. Of important clinical interest, type 2 diabetes, which constitutes 90% of cases, is typically precipitated in east Asian individuals by inadequate production of insulin, while in western countries, inadequate insulin function is likely to be the proximate cause of onset. While impaired insulin secretion is associated with genetic predispositions, insulin resistance is associated with lifestyle factors such as obesity, overeating, and lack of exercise. Even so, these factors are intertwined: the lower insulin secretory capacity of east Asians can trigger onset of type 2 diabetes with a relatively slight increase in insulin resistance due to overeating or lack of exercise. On the other hand, excessive insulin requirements due to increasing insulin resistance can deplete the insulin-producing β-cell cells. Thus, research on quantification of the function and mass of pancreatic β-cells is imperative. As you know well, Kyoto University leads the world in research on incretins, the hormones that promote insulin secretion from pancreatic β-cells through stimulation of the gut upon ingestion of nutrients. Kyoto University is also a leader in innovative research on transplantation of iPS cell-derived pancreatic β-cells as well as the development of visualization technology to evaluate pancreatic β-cells in vivo. Our department also is active in research on forms of diabetes caused by single gene abnormalities to both improve therapeutic approaches and clarify the complex genetic mechanisms of impaired β-cells. Our goal is to create next-generation medicine in collaboration with domestic and international researchers in academia and industry to make diabetes a curable and not only manageable disease.

Diabetes can presently be managed with optimal clinical treatment and lifestyle guidance to prevent the onset and progression of complications and comorbidities of the disease such as nephropathy, retinopathy, and neuropathy, enabling healthy longevity. While promising anti-diabetes drugs recently have been developed that are suited to the various circumstances of patients with type 2 diabetes including the pathophysiology of the disease, complications/comorbidities, and lifestyles, approximately one in four people with diabetes in Japan is thought to receive inadequate  care for the disease, seriously impacting their quality of life by progressing nephropathy (newly required hemodialysis is required for approximately 16,000 people a year), blindness due to retinopathy, and amputations  due to neuropathy. Accordingly, various programs to prevent the onset and progression of diabetes and its complications are in place in Japan, including the diabetic nephropathy aggravation prevention program which employs public health nurses and dietitians to provide diabetes education and support to people with diabetes as well as recommending relevant diabetes treatment programs in hospitals and clinics. In addition, the Japan Council for Promotion of Countermeasures against Diabetes, led by the Japan Medical Association, the Japan Diabetes Society, and the Japan Association for Diabetes Education and Care, is active in promoting awareness of the disease, quality diabetes treatment, and strengthened communication and cooperation among diabetes specialists and general practitioners. I personally have experience in the national government committee organizing and evaluating the diabetic nephropathy aggravation prevention program as well as the local government and medical associations in Gifu to establish diabetes countermeasures. I hope to continue comprehensive anti-diabetes efforts at Kyoto University Hospital by further broadening collaboration at the local, domestic, and global level.

World-class research and medical care in the field of diabetes, obesity, endocrine and metabolic diseases, and nutrition therapy requires a strong and motivated team operating effectively; it is especially important to affirm the independence of newer members in an environment in which opinions can be shared freely. In addition to local conferences and journal clubs, full support for participation in international conferences to foster top level scientific research will be provided. In addition, eminent physicians and researchers from Japan and abroad will be invited to Kyoto to hold workshops and seminars. I am committed to cultivating an environment in which a diverse range of scientists, fellows, and students can further rewarding careers in research and clinical practice. With a renewed spirit, I will do my utmost to honor Kyoto University Faculty of Medicine and Graduate School of Medicine and Kyoto University Hospital. I sincerely seek your support, guidance, and friendship.