A statistical analysis on 156 diabetic cases were performed retrospectively and the suitable treatment also predicted by the result in oral administration of 50 gm of glucose tolerance test (GTT) at the first examination. The patients were divided into 4 groups;(1) dieted group (35 cases) controled by dietary treatment only, (2) oral drugs group (69 cases) controled by oral antidiabetic drugs, (3) insulin group (30 cases) controled by insulin, and (4) uncontroled group (18 cases) failed to any treatment. Levels of blood sugar of GTT were examined to 70 per cent of patients and, the data were given as follows: The “dieted group”, below 120 mg% at the fasting, below 200 mg% at the 1st hour, below 200 mg % at the 2nd below 120 mg % at the 3rd hour. The “oral drugs group”, 150-200 mg % at the fasting, 250-350 mg % at the 1st hour, 250-350 mg % at the 2nd hour and 150-250 mg % at the 3rd hour.Both “insulin group” and “uncontroled group” were over 250 mg % at fasting, over 400 mg % at 1st hour, over 400 mg% at the 2nd hour and over 350 mg % at the 3rd hour. Reliabilities of the above mentioned criteria for “insulin group” was increased in case of lean, juvenile and hypercholesterolemia or suffering from cataracta. The “dieted group” also gives the believable data of the patient without lean, juvenile and hypercholesterolemia. Nevertheless the insulin therapy always demonstrated in diabetitcs under condition of criteria of “insulin group.” But the steps of treatment is still very important which should be kept in mind by the order of diet, oral drugs and insulin administration.
The microangiopathy specific for diabetes mellitus, above all, diabetic retinopathy whose pathological pictures can be recognized as several stages with naked eye, was investigated from the comparative viewpoint of its occurence and development in the groups treated with sulfonylurea, an oral diabetic agent, and insulin. The effectiveness of sulfonylarea was evaluated and the influence of the normalization of body weight was studied. The results of the present investigation are as follows. 1. The frequency of diabetic retinopathy was much influenced by the severity and duration of diabetes, however, its occurence was strongly inhibited by rational treatment of diabetes. 2. The incidence of diabetic retinopathy was significantlylow and its development was slower in good control group compared with that of poor one. 3. The occurence of diabetic retinopathy in good control group was similar whether they were treated with insulin or sulfonylurea, but in case of poor control it was more remarkable in the diabetics treatea with sulfonylurea. 4. The development of diabetic retinopathy in good controlgroup by insulin was slower than that by sulfonylurea treatment. 5. The diabetics were generally well controlled when they kept their body weight less than 10% overweight of the ideal body weight, or when their body weight was decreasing even they were obese. However, in case of the obese subjects whose body weight had no tendency to decrease, the good control of diabetes was very difficult to attain and the development of retinopathy was rapid irrespective of their treatments.
There are two methods for the determination of plasma insulin by immunoassay: a single antibody And a double antibody method. The single antibody assay is theoretically more desirable than the two antibody method, however, almost all methods of the single antibody immunoassay seemed more complicated than those of double antibody assay. In this paper, a new method using ethanol precipitation is described for the assay of plasma insulin. In this procedure, labeled insulin bound with antibody is precipitated in the presence of ehtanol (terminal concentration of ehtnol: 67%) at 4°C, unbound labeled insulin remaining in solution. This method is simple and seems sufficientyl available to determine plasma insulin.
The biological activities, particularly the inhibitory action on the lipolysis, of the purified porcine proinsulin (manufactured by Eli Lilly Co.) were studied on the epididymal adipose tissue of a rat in a in vitro experiment with reference to the release of glycerol. The results obtained were as follows. 1) Proinsulin inhibited the lypolytic action of norepinephrine and glucagon. 2) Proinsulin inhibited also the action of theophylline which accelerated lypolysis by inhibiting the phosphodiesterase activity. 3) The inhibitory action on lypolysis of proinsulin was always weaker than that of insulin and, based on the molar concentration, about 100 times as much of proinsulin was necessary in order to obtain the same effect as insulin.
Thirty eight pregnant women with glycosuria (first trimester 9, second trimester 17 and last trimester 12) were infused intravenously 300ml of 10% 1-arginine for the purpose of studing the diabetogenic factor factor during pregnancy. The levels of serum HGH, blood sugar, serum IRI and NEFA were determined and the rusults were compared with those of 11 puerperal women and 10 normal nonpregnant women. The fasting serum HGH level of pregnants was higher in the second and last trimester compared with normal nonpregnant level, but it was similar to nonpregnant, if the value of cross reaction of human chorionic somatomammotropin (HCS) 3 mugml was deducted from HGH level. The HGH response in the first and last trimester was same as that of control, but in the second trimester, it wasl ower. The low response in the second trimester had no significant difference from those in another trimester and control. The HGH response in puerperal women was much lower thanthose in pregnant and control women. The level of blood sugar was similar in pregnancy and puerperium, but lower than control. Serum IRI response in the second trimester was lower than control and another group, and the fasting value of NEFA increased gradually with the advance of pregnancy. These results suggest that the secretion of HGH does not have much responsibility for the diabetogenic effects during pregnancy, and the mutual effects of HGH and HGS should be clarified.
Juvenile-onset diabetes has been assumed to be rare in this country, mainly based on clinical impression of the pediatricians who have been treating diabetes mellitus. The incidence, however, has not been surveyed extensively. The reports which can be based upon for the estimation of actual incidence have been very few. 2740 questionnaires were sent to departments of pediatrics and internal medicine of larger hopsitals and clinics, concerning the number, name, sex, present age and address of juvenile onset diabetics. Juvenile onset diabetics were reported from almost all prefectural areas without any special tendency. 310 cases were estimated to be under 15 years of age. Based on the estimation of the present number of children under 15 years of age, about 25 millions, reported incidence of juvenile onset diabetes is calculated to be 1.2 per 100, 000. Although actual incidence, which is presumed to be considerably higher than the present figure, can not be determined, the figure calculated from this survey appears to support the clinical impression that juvenile onset diabetes mellitus is actually rare in Japan compared with Western countries. In contrast to the maturity onset diabetics, among which males outnumber females like in most other Asiatic countries, there are more females among juvenile-onset diabetics. The reason for this phenomenon is not yet clear. More detailed informations were obtained concerning initial symptoms, growth and treatment from 266 patients. Almost all of them are insulin-aependent diabetics with polydipsia, polyuria and weight loss as the initial symptoms. They were not necessarily tall or obeses before the onset, and tend to remain somewhat smaller than normal boys and girls of the same age and sex. Girls tend to become obese afterpuberty. About one third of the children have experienced coma or acidosis. It is hoped that the incidence and feature of juvenile diabetics in this country is more precisely revealed, leading to the better care of this conaition in near future.