In order to investigate the relationship between the characteristic triphasic blood sugar response and plasma insulin in the initial period of alloxan diabetes, the levels of blood sugar, plasma immunoreactive insulin and non-esterified fatty acid (NEFA) were measured frequently for two to seven days following the intravenous administration of alloxan (100 mg/kg) in dogs. 1) During the initial phase of hyperglycemia, plasma insulin did not change significantly while NEFA increased. 2) In the hypoglycemic phase, plasma insulin increased markedly about two to ten times as high as the control level. The change in plasma insulin was inversely related to the blood sugar level. Despite the rise in plasma insulin, NEFA did not decrease but tended to rise. 3) When the persistent hyperglycemia developed, plasma insulin level fell significantly below the control level and remained unchanged after 48 hours. NEFA continued to rise. These results seem to suggest that there is some inhibition of extra-secretion of insulin despite hyperglycemia during the initial phase, and provide support for the view of uncontroled release of insulin during the hypoglycemic phase. Persistent hyperglycemia is apparently due to the deficiency of circulating insulin although the deficiency seems to be incomplete.
The oral glucose tolerance test (GTT) and intravenous tolbutamide test were performed in 68 subjects with history of gastrectomy and serum immunoreactive insulin (IRI) response curve as well as blood glucose level were determined during these tests. Besides, the same examinations were also carried out both before and after gastrectomy in another 26 subjects. The shift of these results by surgery or the duration after that were investigated in special reference to the pathogenic effect of gastrectomy on diabetogenesis. 1) of 68 subjects with history of gastrectomy 61.8% exhibited oxyhyperglycemia, 10.8% probable diabetes, and 10.3% diabetes in GTT, and these percentages were quite independent on the duration after gastrectomy. The frequency of probable diabetics or diabetics was not only high in the subjects more than 40 years of age, but increased gradually with aging. 2) The glucose tolerance was impaired by gastrectomy in the cases whose glucose tolerance had been found to be diabetic prior to surgery, however, of 23 subjects diagnosed as nondiabetic, oxyhyperglycemic, or probable diabetic before surgery 18 cases exhibited oxyhyperglycemia after gastrectomy, and no cases could be observed to have shifted to the probable diabetics or diabetics. 3) Observing 11 cases with oxyhyperglycemia during 1-4 years, no cases could be found to have shifted to probable diabetics or diabetics. 4) Many cases of nondiabetes or oxyhyperglycemia showed high IRI response after glucose load, namely, serum IRI. was remarkably elevated more than 100μU/ml at 30-60 minutes and restored at 120-180 minutes, however the most interesting point was that the similar IRI response was also observed in the normal students when glucose was loaded into the jejunum through the tube, whereas, the initial rise of IRI at 30 minutes after glucose loading was diminished (35-60μU/ml) in the cases with probable diabetes. 5) Both serum IRI response during GTT and glucose tolerance curve were found to have shifted to be parallel before and after gastrectomy. 6) No particular correlation could be observed between serum IRI response and the duration after gastrectomy in each group with different glucose tolerance. 7) Although the initial fall of blood glucose level after tolbutamide infusion remained within normal range, the time required for reaching to minimum and that necessary for restoring were tended to have delayed in all cases with oxyhyperglycemia, besides, these results were independent on the duration after gastrectomy. 8) The results described above considered to suggest little possibility that the subjects with oxyhyperglycemia after gastrectomy proceed to diabetes in the cases without diabetic disposition.
In Japan it has been generally believed that vaccination is not available for diabetic patients. However, rehabilitation of diabetics is a goal of treatment of diabetes, therefore diabetics should be vaccinated to prevent infectious diseases. In this study 121 diabetics were subjected for vaccination of Japanese encephalitis or influenza. Only slight side effects caused by vaccination were shown in these diabetics, and there was no significant difference between nondiabetics and diabetics conceerning side effects of vaccination. It was also proved in this study that the antibody titer in diabetics became as high as in non-diabetics after vaccination. As a conclusion it should be pointed out that diabetic patients are able to receive vaccination without any dangerous side effects and that the proper effect of vactination is enough satisfactory in diabetics.
Effect of xylitol and insulin on acetate metabolism was observed using alloxan diabetic rat liver slices. Incorporation of acetate-2-14C into total lipid, total fatty acid, phospholipid and triglyceride fraction was decreased in alloxan diabetic rat liver slices, and was recovered by insulin administration in vivo. Addition of insulin in vitro to liver slices of normal rat or diabetic rat administered with insulin in vivo caused decrease in acetate-2-14C incorporation into fatty acid fraction (and no effect on incorporation into phospholipid and triglyceride). By the addition of xylitol in vitro, acetate-2-14C incorporation into total lipid, total fatty acid, phospholipid, triglyceride and sterol fractions was decreased to about half level. Xylitol-U-14C incorporation into total fatty acid was almost same level as acetate incorporation and also decreased to about half level by the addition of acetate. From these results, it would be considered that insulin administration to alloxan diabetic rat have induced enzyme activities concerning with fatty acid synthesis in the liver, and that the addition of xylitol caused regulation in these metabolic flow in substrate level.
Standard glucose tolerance test (SGTT) and HGTT were carried out in normal young adult persons consisting of 17 males and 9 females. Before glucose loading in the HGTT the examinees were kept in fasting condition for 21±1 hours, whereas in the SGTT they were kept in the same condition for 15±1 hours. The changes of blood glucose, plasma NEFA and plasma insulin (IRI) of the male and the female groups in the HGTT were compared with those in the SGTT. The results were as follows: 1) In the SGTT there was no significant difference in the blood glucose, plasma insulin and NEFA between the males and the females. 2) In the HGTT the blood glucose levels after the glucose ingestion were much higher in the females than those in the males. Also in the HGTT the changes of plasma insulin and NEFA after the glucose ingestion showed significant differences between the males and the females.