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Volume 53, Issue 5
Displaying 1-10 of 10 articles from this issue
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Mini Review
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H. Yokoyama2010 Volume 53 Issue 5 Pages 325-330
Published: 2010
Released on J-STAGE: June 09, 2010
JOURNAL FREE ACCESSDownload PDF (404K)
Original Articles
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Ryuzo Kawamori, Hitoshi Ishida, Atsunori Kashiwagi, Hideki Kishikawa2010 Volume 53 Issue 5 Pages 331-340
Published: 2010
Released on J-STAGE: June 09, 2010
JOURNAL FREE ACCESSThis randomized, placebo-controlled, double-blind comparative study investigated α-glycosidase inhibitor voglibose efficacy in preventing diabetic complication onset or progression-diabetic retinopathy and nephropathy-in 573 subjects with type 2 diabetes mellitus treated with dietary and exercise and sulfonylurea if necessary-voglibose group n=279 and placebo group n=280. Voglibose group subjects took a 0.2 mg tablet three times daily for 8 weeks, then a 0.3 mg tablet three times daily for 136 more weeks (144 weeks total) . Statistically significant improvement on postprandial blood glucose, HbA1C, and fasting blood glucose by voglibose was seen over placebo (p<0.05 or p<0.01) . No statistically significant improvement in the diabetic retinopathy and nephropathy onset or progression by voglibose was seen (p=0.968) . No safety issues arose. One plausible reason why sustained improved long-term glycemic control did not significantly affect diabetic complication progression is that more time is needed to evaluate such effects.
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Yutaka Umayahara, Takahiro Ohkusu, Fumiyo Kubo, Yoko Yoshima, Fumie Sa ...2010 Volume 53 Issue 5 Pages 341-350
Published: 2010
Released on J-STAGE: June 09, 2010
JOURNAL FREE ACCESSTo clarify GAD antibody (GADab) prevalence in Japanese noninsulin-dependent diabetes (NID) and to characterize the clinical GADab-positive NID features, we examined 2,110 NID cases in Osaka Police Hospital from August 2007 to May 2008. Of these, GADab was detected in 39 (1.85% [95%CI 1.27-2.42%]) . Those with high GADab titers (GAD>10 U/ml) (HT-NID) had more typical type 1 diabetes than those with low GADab titers (GAD<10 U/ml) (LT-NID) . No statistically significant difference was seen in fasting serum C-peptide and BMI between LT-NID and typical type 2 diabetes subjects, more LT-NID subjects required insulin therapy (p<0.001) . Pancreatic β-cell function evaluated by SUIT index was significantly lower in LT-NID subjects (p<0.01) . Taken overall, results suggest differences in LT-NID and typical type 2 diabetes pathology.
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Case Reports
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K. Nagasawa, A. Nishimura, M. Okubo, Y. Oka, S. Kon, C. Koga, A. Takeb ...2010 Volume 53 Issue 5 Pages 351-356
Published: 2010
Released on J-STAGE: June 09, 2010
JOURNAL FREE ACCESS -
Yoshiyuki Kimbara, Atsushi Araki, Junichiro Adachi, Yoshiaki Tamura, Y ...2010 Volume 53 Issue 5 Pages 357-362
Published: 2010
Released on J-STAGE: June 09, 2010
JOURNAL FREE ACCESSWe report a rare case of slowly progressive insulin-dependent diabetes mellitus acutely exacerbated by excessive soft-drink consumption providing novel insights into differential diabetic ketoacidosis diagnosis. A healthy 62-year-old woman with no diabetes, obesity, or infection history admitted for severe hyperglycemia-plasma glucose: 998 mg/dl; hemoglobin A1c [HbA1c]: 13.9%, and ketoacidosis-reported drinking 1 l of tangerine juice daily for 3 weeks before admission. She lacked insulin secretion and tested positive for antiglutamic acid decarboxylase antibody (titer: 8.1 U/ml) , yielding an initial diagnosis of acute type-1 diabetes mellitus onset. Diabetic retinopathy was also detected, suggesting prolonged hyperglycemia. Intravenous fluid repletion and continuous insulin infusion attenuated the hyperglycemia and ketoacidosis, restoring insulin secretion and obviating the need for insulin. Oral α-glucosidase inhibitor and metformin therapy was initiated and the woman discharged. She maintained good glycemic control and adequate insulin secretion in the next 2 years.
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Kumi Suzuki, Takahiro Takeda, Akiko Ishii, Satoko Maruyama, Junnosuke ...2010 Volume 53 Issue 5 Pages 363-368
Published: 2010
Released on J-STAGE: June 09, 2010
JOURNAL FREE ACCESSA 43-year-old woman with a 33-year type 1 diabetes history admitted for glycemic control and memory disturbance had suffered severe hypoglycemic attack without evidence of global circulatory disturbance at age 22, and manifested short-term memory disturbance and episodic memory impairment as hypoglycemic encephalopathy fallouts. On admission, HbA1c was 11.0%, a minimental state examination score of 27/30 suggested slightly mild cognitive impairment, and Wechsler Memory Scale Revised (WMS-R) showed apparent delayed recall disturbance (<50) with mildly impaired general memory verbal (77) and visual memory (71) function. Coronal brain magnetic resonance imaging (MRI) showed severe hippocampal atrophy accompanied by mild cerebral atrophy. Single photon emission computed tomography (SPECT) of the brain showed decreased HMPAO uptake in the medial temporal and frontal regions. Short-term memory disturbance, e.g, forgetting her last insulin injection, was seen on admission. Hypoglycemic status is recognized as causing selective neuronal degeneration from aspartate stress, especially in the dentate gyrus, cerebral cortex, and basal ganglia. Severe hippocampal atrophy with concomitant minor involvement of other cerebral regions after hypoglycemic attack may be responsible for amnesic memory deficit.
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Yoshihiko Yamaguchi, Kenichi Chin, Tsuyoshi Ideguchi2010 Volume 53 Issue 5 Pages 369-373
Published: 2010
Released on J-STAGE: June 09, 2010
JOURNAL FREE ACCESSWe report the cases of a diagnosis changed from type 2 to type 1 diabetes mellitus. In checking GAD antibody and C-peptide levels in those over 65 years old at diabetes diagnosis treated with insulin, we found GAD antibody in 3 subjects with antibody titers of 30377.9±46570.8 (U/ml) (titer range: 53.8-84,000) . Subjects were aged 80.3±11.2 years 72.3±5.0 years at onset, for a mean 8.0±8.2 years (mean±SD) disease duration. HbA1c was 8.0±1.9 (%) , serum C-peptide 0.38±0.48 (ng/ml) (not detected in one subject) , and daily insulin dose 0.44±0.17 (U/kg/day) . One subject had brittle diabetes and very difficult plasma glucose control despite insulin treatment. Two patients are currently alive, and one died of pneumonia. These findings suggest that type 1 diabetes prevalence among the insulin-treated elderly may be higher than currently thought.
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Yui Yamashita, Yugo Kanai, Shin Yonemitsu, Ken Masatsugu, Seiji Muro, ...2010 Volume 53 Issue 5 Pages 374-378
Published: 2010
Released on J-STAGE: June 09, 2010
JOURNAL FREE ACCESSWhile conditions associated with reversible posterior leukoencephalopathy syndrome (RPLS) are reported to have underlying biological features similar to T-cell activation and inflammatory cytokine production, it is also reported that diabetic ketoacidosis (DKA) or its treatment increase inflammatory cytokines and could develop systemic inflammatory responce syndrome (SIRS). A 63-year-old woman admitted for appetite loss, a 3-day headache, and consciousness disturbance of Japan coma scale II-10 showed no neurological deficit. She had diabetes mellitus since the age of 39 and poor glycemic control with oral hypoglycemic agents. On admission, laboratory tests showed elevated plasma glucose of 543 mg/dl and metabolic acidosis. Diagnosed as having DKA, she was administered saline drip infusion and continuous intravenous insulin. Her consciousness disturbance remained despite improved laboratory results. Head magnetic resonance imaging (MRI) showed hyperintensive bilateral posterior lobes and left thalamus on fluid-attenuated inversion recovery imaging and an apparent diffusion coefficient map. Corresponding diffusion weighted imaging showed isointensive signals in these regions, suggesting vasogenic brain edema. Her condition became normal on hospitalization day 3, and lesion improvement on MRI. In our case, SIRS accompanied with DKA and its treatment may have caused RPLS.
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Report
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Working Group Committee of the Japanese Society of Experimental Diabe ...2010 Volume 53 Issue 5 Pages 379-384
Published: 2010
Released on J-STAGE: June 09, 2010
JOURNAL FREE ACCESS
Co-medicals; Original Article
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Minoru Ueyama, Yoshimi Isogai, Mariko Yukawa, Tomohisa Nishio, Kazuo N ...2010 Volume 53 Issue 5 Pages 385-389
Published: 2010
Released on J-STAGE: June 09, 2010
JOURNAL FREE ACCESSThe usefulness of enzymatic HbA1c measurement was studied in view of international HbA1c standardization. Norudia N HbA1c (Sekisui Medical Co. Ltd.) was used for enzymatic method and the resulting value was compared to that by the International Federation of Clinical Chemistry and Laboratory Medicine (IFCC) , HPLC, and immunological method. Results showed that: (1) raw data before correction by the Japan Diabetes Society (JDS) Lot 3 calibrator obtained by the enzymatic method were almost the same as that by the IFCC method, (2) When HbA1c values corrected by JDS Lot 3 were compared enzymatically and HPLC or immunologically, 0% obtained enzymatically corresponded to 0.2 to 0.3% by HPLC, unlike immunologically, which was almost 0%, (3) regression line analysis of raw data compared enzymatically and by HPLC showed the two to differ slightly. Enzymatic HbA1c measurement is therefore useful in the international standardization of HbA1c measurement.
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