The incidence of diabetes as well as obesity among the relatives of diabetics and, as control, their mates was investigated. The incidence of known diabetes among the parents and the siblings of diabetics was7.8 and 7.0% respectively, and that of obesity among them was 27.2 and 28.9%. In contrast, among theparents and the siblings of the mates, the incidence was 1.8 and 2.6% for diabetes, and 13.4 and 18.6% for obesity respectively. From these results the possible interrelationship of diabetes and obesity was discussed, and it was suggested that the obesity in diabetes is closely related to the genetic disorder of diabetics rather than accidental.
Fifty eight cases with gastrectomy were subjected toa glucose tolerance test and some other tests.The results were as follows. 1) Twelve cases of them (20.7%) wererecognized as diabetes mellitus: the value of their blood sugar in the glucose tolerance test amounted to over 170 mg/dl at maximum and over 140 mg/dl at 2 and 3 hours after the glucose load. 2) Nine cases of them (15.5%) were diagnosed as probable diabetes mellitus: the value of their blood sugar indicated over 170 mg/dl at maximum and over 140 mg/dl at 2 hours. 3) Eight cases of probable diabetics were examined with a tolubutamide test.Three of them showed abnormal blood sugar level. 4) The insulin-like activity in serum was measured during a glucose tolerance test.Its value showed remarkable increase after taking glucose. 5) On the serum electrolyte value during glucose test, Na value showed indefinitive tendency but K value seemed to be decreased 30 minutes after taking glucose. 6) ECG showed the tendency of T wave flat 30 minutes after taking glucose. The results described above suggest that cases with gastrectomy should continuously undergo the glucose tolerance test.
Xylitol was infused to male rabbits of about 3 kg. The fate of xylitol and the effects on the carbohydrate metabolism were studied. 1) Infused xylitol disappeared from the circulation rapidly. The half life time was estimated as 14 minutes after a single intravenous dose of 10 ml of xylitol solution (10%). 2) No significant increase of reducing sugar in circulation was found after administration of xylitol. 3) After 60-minute infusion of 10% solution of sugar alcohols at a rate of 0.2 ml per minute, xylitol and sorbitol diappeared from the circulation with half life times of 18 and 35 minutes. Mannitol disappeared more slowly with a half life time of 66 minutes. 4) During and after the infusion of xylitol, little change of blood glucose level was noticed in healthy animals. In alloxan diabetic animals, however, blood glucose concentration increased during and for some time after the infusion. Little or no change in blood glucose level was observed with sorbitol or mannitol infusion. 5) Blood lactate level increased after infusion ofxylitol in healthy animals, but the pyruvate concentration in blood remained unchanged. In diabetic animals, the blood lactate increased corresponding to the blood glucose level. The blood pyruvate concentration increasedfor one hour after the infusion, then decreased.
Eight or 12g of xylitol or glucose was given intravaenously to several diabetic patients and healthy subjects. Effects of these treatments on the carbohydrate and lipid metabolism, and the insulin secretion were studied. 1) After injection of xylitol, the blood glucose level incresed temporarily in both groups. In diabetic patients, the increase in blood glucose was greater and lasted longer. 2) The administered glucose remained in the circulation much longer in diabetic patients than in healthy subjects. As for xylitol, no such difference was found between diabetics and healthy subiects, suggesting that xylitol can be metabolized in diabetics rapidly as in healthy subjects. 3) In diabetic patients, the distribution space of xylitol was larger than that of glucose. Xylitol seems to be incorporated into tissues better than glucose. 4) In healthy controls, xylitol administration stimulated the insulin secretion less than glucose administration. In diabetic patients, both treatments affected on the insulin secretion to a similar extent. 5) Blood laclate concentration increased in parallel with the blood glucose concentration after xylitol injection. Xylitol seems to be utilized by peripheral tissues. 6) Decreases of the serum nonesterified fatty acid (NEFA) following glucose administration were almost the same in both diabetic and healthy subjects. However, the decrease of NEFA followiag xylitol administration was much greter in diabetic patients than in healthy controls.
Marked difference between immuno reactive insulin in blood and insulin-like activity by adipose tissue method was investigated. ILA (insulin-like activity) and IRI (immuno reactive insulin) were compared for the thoracic duct lymph of dog and human body fluids of various origin. The results were as follows: 1) The ILA/IRI of the thoracic duct lymph of dog was about 6.5. After gel filtration of the lymph with Sephadex G 50, the ILA/IRI ratio of Fr. A with high protein concentration was about 6.5, while that of Fr. B with very little protein was less than 3.1. 2) The changes in IRI in the thoracic duct lymph after intravenous injection of glucose reflected the changes in IRI in blood with a delay of about 10minutes. 3) The IRI in human body fluid was fairly similar with that of serum. ILA was low in the fluid with low protein concentration and a correlation was observed between ILA and protein concentration. From these results, it was suggested that IRI may pass through the capillary wall fairly freely and reach the peripheral tissues, while there was only little ILA in the dog lymph and human body fluids as assayed by the fat pad method.
Elucidation of the effect of diabetic agents on thlipid metabolism would appear important io considering the prophylactics against vascular complications which are the main causes of daeth in diabetics. Accordingly, the author investigated the effects of an oral diabetic agent, butyl-biguanide (BBG) on lipid metabolism in diabetics and rats with diabetes. The following results were obtained: 1) BBG caused no significant changes in the levels of blood sugar and plasma free fatty acid (FFA) for three hours after the administration of the agent. 2) Chronic administration of BBG, however, decreased plasma FFA and normalized the composition of fatty acids and alsp ameliorated the disturbed pictures of plasma triglycericie and cholesterol. 3) Adipose tissue uptake of FFA in vitro was not affected by addition of usual dosage of BBG both normal and alloxari diabetic rats, while it was restored to normal in adipose tissue of diabetic rat treated with BBG chronically. These findings suggest that the attainment of BBG effect on lipid metabolism requires a certain period of time and its effect is exerted through the process of enzyme synthesis, etc.