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Volume 22, Issue 9
Displaying 1-9 of 9 articles from this issue
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Hiroshi Maruyama, Osamu Mizuno, Akira Suzuki, Susumu Ishizawa, Masayuk ...1979 Volume 22 Issue 9 Pages 953-962
Published: September 30, 1979
Released on J-STAGE: August 10, 2011
JOURNAL FREE ACCESSHigh serum C-peptide inu-nunoreactivity (CPR) due to the presence of proinsulin-like component (PLC)-insulin antibody complex which cross-reacts with human C-peptide antiserum, is often observed in insulin-treated diabetics. The CPR extracted from the serum using polyethylene glycol (the so-coiled free-CPR) is considered to express more accurately the C-peptide concentration in the serum of insulintreated diabetics with insulin antibody.
Serum CPR and free-CPR levels were measured during 50 g oral glucose tolerance tests (OGTT) in 10 adult-onset diabetics nerver on insulin, 8 insulin-treated diabetics without insulin antibody, and 19 insulin-treated diabetics with insulin antibody.
A significant correlation was noted between the CPR and free-CPR levels in the adult-onset diabetics and insulin-treated diabetics without insulin antibody (r=0.97, p<0.005). No significant difference was observed between the CPR and free-CPR levels during OGTT in these two groups. In the insulin-treated diabetics with insulin antibody, the average levels of CPR during OGTT were 3.1±0.5 ng/ml (M±SE)(at fasting) and 4.1±0.6ng/ml (at peak, 120 min after glucose), while the average levels of free-CPR were 1.1±0.1 ng/ml, 1.8±0.3 ng/ml, respectively. Moreover, the fasting free-CPR level in these patients was significantly lower than the fasting CPR level in 9 normal subjects (2.0±0.1ng/ml, p<0.005). The free-CPR response during OGTT in these diabetics with insulin antibody was markedly lower and more delayed than the CPR response in normal subjects, and was also lower than that in adult-onset diabetics.
These results suggest that determinations of the serum free-CPR are more meaningful in assessing the endogenous insulin secretory capacity to various stimuli of insulin-treated diabetics with high serum CPR.View full abstractDownload PDF (1417K) -
Yoshikuni Fujita, Miyuki Nakazawa, Ichitaro Takada, Yoshitada Yajima, ...1979 Volume 22 Issue 9 Pages 963-975
Published: September 30, 1979
Released on J-STAGE: August 10, 2011
JOURNAL FREE ACCESSThe effects of continuous i. v. infusion and repeated i. m. injection of small amounts of insulin were compared retrospectively in 18 patients with severe diabetes mellitus. Half of them, including 4 with ketoacidosis, 3 with ketosis and 2 with nonketotic hyperosmolar diabetic coma, were treated with continuous low dose insulin. The other 9 patients, including 5 with ketoacidosis and 4 with ketosis, were treated with repeated i. m. injections of small doses of insulin.
The results obtained were as follows.
1) The rate of blood glucose decline in the first 4 hr of continuous i. v. infusion and repeated i. m. injections was 104 mg/dl/hr and 110 mg/dl/hr, respectively.
2) The blood glucose levels fell below 250 mg/dl when 33 u of insulin was given in 6.9 hr by continuous i. v. infusion and when 55 U of insulin was given in 9 hr by repeated i. m. injections.
3) The amount of insulin used in the present study, i. e. 2-7.2 U/hr for continuous i. v. infusion and 6-20 U as initial dose in repeated i.m. injections, was sufficient to increase the plasma I. R. I. levels to 20-200 μU /ml within 1 hr.
4) Serum ketones became negative when 22 U of insulin was given in 11 hr by continuous i. v. infusion and when 33 U of insulin was given in 6 hr by repeated i. m. injections (p: n. s.).
5) Serum potassium fell with each therapeutic regimen within 1 hr following insulin administration. The mean rate of serum potassium decline was about the same in both therapeutic regimens.It was concluded that both the continuous i. v. infusion and repeated i. m. injections of small amounts of insulin were effective and safe in the management of severe diabetes mellitus. However, it should be pointed out that in continuous i. v. infusion, complete recovery from derangement of fat metabolism was to some extent sluggish in spite of prompt recovery of carbohydrate metabolism.View full abstractDownload PDF (1976K) -
With Specia1 Referonce to the P1atelet Adhesiveness IndexMasahiko Nakayama, Iwao Fukui, Eiichi Kakumoto, Kiyotaka Masaki, Susum ...1979 Volume 22 Issue 9 Pages 977-988
Published: September 30, 1979
Released on J-STAGE: August 10, 2011
JOURNAL FREE ACCESSRecently, it has been emphasized that accelerated thrombogenesis is one of the risk factors for diabetic angiopathies. Gliclazide, a newly developed oral hypoglycemic sulfonylurea, has been reported to prevent the progress of the vascular complications through its inhibitory action on platelet adhesiveness in addition to its hypoglycemic action.
The present authors undertook clinical observations to determine the possible clinical effects of gliclazide in 30 adult onset diabetic patients who could not be controlled well by diet alone. The periods of observation ranged from 12 to 30 months (average 22.2) and the administered dose of gliclazide was 20-240 mg/day. The results obtained were as follows.
1) Throughout the observation period, assessment of the blood glucose levels revealed 19 cases (63%) of good control, 6 (20%) of fair control, and 5 (17%) of poor control. Good control was observed in 73% of the group whose body weight was normalized after administration.
2) The platelet adhesiveness was maintained at a medium to low level in 69% of the diabetics receiving gliclazide, and a high level of platelet adhesiveness was found in fewer cases on gliclazide than those on insulin and other available sulfonylurea agents as control (p<0.10).
3) The inhibitory action of gliclazide on platelet adhesiveness was loosely correlated with the dosage of this agent but not with the blood glucose levels. It was presumed that gliclazide may exert a direct action on platelet function.
4) In relation to the diabetic angiopathies, the progress of retinopathy, proteinuria and ECG findings was studied. Most remained unchanged and no severe aggravation was observed.
5) No adverse effects were seen in hematological examinations or liver and kidney function tests.View full abstractDownload PDF (1962K) -
Michio Seki1979 Volume 22 Issue 9 Pages 989-999
Published: September 30, 1979
Released on J-STAGE: August 10, 2011
JOURNAL FREE ACCESSGlucose is a major physiological stimulator of insulin secretion in the islets of the pancreas. However, the islets of fetal and perinatal animals have been shown to be poorly responsive to glucose stimulation in insulin release compared to adult islets. The present investigation was thus undertaken to determine whether the adrenergic mechanism participated in the poor insulin responsiveness of neonatal islets.
Islets isolated by the collagenase method from rats of the 1st, 3rd and 7th day after birth and from adult rats were incubated in a standard medium of Krebs-Henseleit bicarbonate buffer containing various concentrations of glucose, epinephrine and/or phentolamine for 60 min subsequent to a 20-min preincubation at 37°C under a gas phase of 95% O2: 5% CO2. The insulin released into the medium was estimated by radioimmunoassay.
The insulin responsiveness to glucose of the islets from rats of the 1st day after birth was lower than that of adult rats. However, the responsiveness of rats on the 3rd and 7th post-natal days was similar to that of adult rats. The suppressive effect of epinephrine on insulin release from the islets of the 1st post-natal day was poor compared to that the that of adult rats. Phentolamine at a concentration of 0.01 to 0.1 mM increased the insulin responsiveness to glucose, but the enhancement declined with age. At 1 mM, phentolamine suppressed the insulin responsiveness in adult rats, but it was increased in neonates.
These observations suggest that the endogenous a-adrenergic mechanism may be functioning during the neonatal periods and be involved in the poor insulin responsiveness of rats immediately after birth.View full abstractDownload PDF (4632K) -
Shoichi Nakagawa, Hidetaka Nakayama, Shiro Ozaki, Kazuaki Oda1979 Volume 22 Issue 9 Pages 1001-1007
Published: September 30, 1979
Released on J-STAGE: August 10, 2011
JOURNAL FREE ACCESSMethodological problems of an enzyme-immunoassay kit employing the sandwich method were studied.
The insulin-antibody-coupled bead and the enzyme-coupled insulin antibody display sufficient capacities and high affinities for performing serum insulin determinations. The first reaction (antibodycoupled bead and serum insulin) was interfered with slightly by the presence of protein but the I. R. I. value obtained was corrected by the addition of a suitable concentration of serum protein to the standard insulin solution. The I. R. I. value obtained with this kit correlated well with that by radioimmunoassay in usual sera and was practically interchangeable. However, extra attention should be paid in the case of sera with markedly different concentrations of proteins and extracted insulin solutions. The I. R. I. obtained with this kit is nevertheless considered to be reliable and practically useful for routine I. R. I. determinations in clinical laboratories where the use of isotopes is restricted.View full abstractDownload PDF (1033K) -
Mayumi Sanaka, Tomoko Yokosuka, Masashi Honda, Yasue Omori, Masatoshi ...1979 Volume 22 Issue 9 Pages 1009-1017
Published: September 30, 1979
Released on J-STAGE: August 10, 2011
JOURNAL FREE ACCESSA 35-yr-old diabetic woman with diabetic retinopathy (Scott Ib) was referred to our Diabetes Center in May 1976, when she was in the 16th week of her seventh pregnancy.
She was diagnosed originally as having diabetes mellitus in the fifth month of her first pregnancy at the age of 27. Insulin therapy was begun from the eighth month, and she delivered a normal male infant weighing 3, 300 g. Her second and third pregnancies terminated in spontaneous abortion and the fourth resulted in stillbirth, although the diabetic control was poor during the gestational period. In her fifth pregnancy, an artificial premature delivery was performed but the baby died of pulmonary hemorrhage. An artificial premature delivery was also performed in her sixth pregnancy because of anencephalia.
Due to the patient's strong desire to have another child, we decided to continue with her seventh pregnancy. Her control became good through dietary therapy and an increased insulin dosage. Photocoagulation was carried out for her retinopathy. A cesarean section was made at 39 weeks of gestation, but the male baby died of respiratory distress syndrome. The patient's retinopathy did not worsen.
The clinical course of the present patient indicates to us the importance of planned pregnancy.View full abstractDownload PDF (8029K) -
Yasuteru Hamasaki, Yasuko Kono, Takemasa Matsuda, Koichi Nomoto, Shige ...1979 Volume 22 Issue 9 Pages 1019-1022
Published: September 30, 1979
Released on J-STAGE: August 10, 2011
JOURNAL FREE ACCESSTiters of CH5O were assayed in 30 JOD (juvenile-onset diabetics with insulin-dependency) and 4 MODY (maturity-onset diabetics among young people).
In patients with a JOD history of less than 3 years, the CH5O titer was significantly lower than that in patients with a history of more than 5 years. The CH5O titer in JOD patients with a duration of from 5 to 10 years did not differ significantly from that in JOD patients with a history of more than 10 years. The CH5O titer in patients with a JOD history of less than 5 years was significantly lower than that in MODY patients, who had an almost identical duration.
These results suggest involvement of the complement system in the earlier phase of JOD.View full abstractDownload PDF (1742K) -
Atsuko Tenku, Keiji Kakita, Hiromichi Matsuki, Shigeichi Matsumura, Se ...1979 Volume 22 Issue 9 Pages 1023-1026
Published: September 30, 1979
Released on J-STAGE: August 10, 2011
JOURNAL FREE ACCESSThe contaminating Proinsulin-Like Immunoreactivity (PLI) in a monospecies porcine NPH insulin preparation (lot. IS1) was determined directly and after gel filtration by proinsulin-specific radioimmunoassay (porcine). Although eluate of 500 ng of monospecies insulin did not reveal Proinsulin-Like Component (PLC), apparent PLC was detected after gel filtration of 5, 000 ng of this insulin preparation by the specific radioimmunoassay.
The monospecies insulin preparation contained 0.04% of porcine PLI by weight as estimated directly utilizing the specific radioimmunoassay for porcine PLI.
In 6 diabetics treated with monospecies porcine NPH insulin preparation from the beginning of insulin treatment, porcine or bovine proinsulin-specific antibodies were not detectable throughout the insulin treatment for 3 to 12 months. One case out of 6 insulin treated diabetics developed porcine insulin antibodies after 2 months of the treatment. Porcine or bovine insulin antibodies were not detectable after 3 to 12 months of insulin treatment in 5 out of 6 diabetics.View full abstractDownload PDF (2876K) -
1979 Volume 22 Issue 9 Pages 1027-1041
Published: September 30, 1979
Released on J-STAGE: August 10, 2011
JOURNAL FREE ACCESSDownload PDF (3603K)
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