Journal of the Japan Diabetes Society
Online ISSN : 1881-588X
Print ISSN : 0021-437X
ISSN-L : 0021-437X
Volume 26, Issue 8
Displaying 1-9 of 9 articles from this issue
  • Tooru Funakoshi, Hideyuki Wakasugi, Toshihiko Sumii, Fumio Umeda, Hiro ...
    1983 Volume 26 Issue 8 Pages 815-821
    Published: August 30, 1983
    Released on J-STAGE: August 10, 2011
    JOURNAL FREE ACCESS
    A low recovery rate of urinary PABA in the PFD test suggesting pancreatic exocrine dysfunction has been reported in patients with primary diabetes mellitus.In order to investigate the possible mechanism of this abnormality, PABA absorption tests were performed combined with PFD tests, and changes in blood PABA levels were also observed following PFD and PABA administration with specific consideration of renal and hepatic dysfunction in patients with diabetes mellitus.
    The PFD test in 53 cases of diabetes mellitus (NIDDM) of which 5 patients had increased serum creatinine levels within 2 mg/dl, showed a significantly lower value (67.8±13.8%, M±SD) than that of healthy control subjects (82.8±4.6%), while that in patients with chronic pancreatitis was markedly decreased (66.3±11.9%).Further, it was found that the PABA absorption test results were significantly low in diabetics, similarly to the results of the PFD test.The values of [PABA-PFD] in diabetics thus remained within the normal range (12.5±6.4%) as compared with the controls (8.8±3.0%), while they were significantly high in chronic pancreatitis (20.3±5.1%). In fact, there was a positive correlation between the values of the PFD test and renal function tests such as PSP (15 min) and creatinine clearance in diabetics.Based on the serum transaminase values, the effect of liver function on the PFD test was not great in the diabetics compared with that of renal function.
    The above results suggest that abnormality of the PFD test in patients with diabetes mellitus can often be induced by a disturbed renal function rather than pancreatic exocrine hypofunction. Therefore, the PABA absorption test combined with PFD test or measurement of the serum PABA levels on the PFD test is recommended for examining the exocrine pancreatic function in primary diabetes mellitus.
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  • Studies Using a Doppler Ultrasonic Technique
    Makoto Ohashi, Junichi Seki, Toshihiko Sato, Masaki Yamamoto, Satoru F ...
    1983 Volume 26 Issue 8 Pages 823-831
    Published: August 30, 1983
    Released on J-STAGE: August 10, 2011
    JOURNAL FREE ACCESS
    The prevalence of peripheral vascular disease (PVD) was determined in 296 diabetic outpatients of Osaka City University Hospital, using a Doppler ultrasonic technique.PVD was diagnosed in 34 (11.5%) of the diabetic patients, and the male: female ratio was 2: 1.Classification into symptomatic stages was made as follows: 3 patients complained of intermittent claudication (2 males, one female); one patient had ischemic skin lesions with rest pain; and 88% of the PVD was diagnosed without any symptoms.There was a clear increase of PVD with age. The percentage of PVD in patients of the 8th decade rose sharply, and the difference between the prevalence of PVD in patients under the age of 70 and that in those aged over 70 was marked and highly statistically significant. The percentages of cases with hypertension, hypertriglyceridemia and obesity in the past were significantly higher in patients with PVD compared with those in patients without PVD.No significant differences, however, were found in the prevalence of patients with hypercholesterolemia, a low value for the HDL-cholesterol/total cholesterol ratio and smoking habits.Between patients with and without PVD, no definite differences were observed in the degree of glycemic control or mode of treatment of the diabetes.The percentages of cases with retinopathy of rather advanced stage and with persistent proteinuria were higher in the group with PVD. The frequencies of histories of cerebrovascular accident in the past and calcification of the leg arteries were higher in patients with PVD, while the frequency of ischemic ECG changes was the same in the groups with and without PVD.These findings suggest that the prevalence of PVD in Japanese diabetics is lower by one third and progression of PVD is more gradual compared to similar studies in Western countries.
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  • Ken Sawada
    1983 Volume 26 Issue 8 Pages 833-843
    Published: August 30, 1983
    Released on J-STAGE: August 10, 2011
    JOURNAL FREE ACCESS
    Recent reports have indicated that prostaglandins (PGs) play an important role in the secretion of insulin and other hormones.From this viewpoint, changes in PGs, insulin, and counter-regulatory hormones were investigated in 6 cases of IDDM, 8 cases of NIDDM, and 7 normal subjects.They underwent 3 stages of graded muscular exercise with a bicycle ergometer.Blood samples were taken 5 times from the cubital vein (the before, at 15 min, 30 min, 45 min, 60 min), and plasma immunoreactive PGE-like material (iPGE), immunoreactive 6-keto-PGF1-like material (i-6-keto-PGF), blood sugar, IRI, IRG, HGH, and cortisol levels were measured.PGs were assayed by RIA, The results obtained were as follows.1) The plasma iPGE levels were significantly decreased with muscular exercise in the normal subjects and IDDM patients.2) The plasma i-6-keto-PGF, levels were significantly decreased with muscular exercise in the normal subjects and NIDDM patients. 3) The blood sugar values were significantly depressed in all groups with muscular exercise.The IRI levels were significantly decreased in the normal subjects with muscular exercise.The IRG levels were significantyl decreased in the NIDDM patients with muscular exercise.The cortisol levels were significantly decreased in NIDDM with muscular exercise.The HGH levels were significantly elevated with muscular exercise only in the NIDDM patients.
    These results suggested PGs metabolic abnormalities in diabetics, and that the abnormalities might be related to some of the counter-regulatory hormones.
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  • Determination of Glycosylation Rates of Serum Protein, Hemoglobin and Lens Protein
    Tsutomu Nakamura
    1983 Volume 26 Issue 8 Pages 845-852
    Published: August 30, 1983
    Released on J-STAGE: August 10, 2011
    JOURNAL FREE ACCESS
    The non-enzymatic glycosylation rates of serum proteins, hemoglobin and lens proteins were determined. In addition, in vitro studies on the non-enzymatic glycosylation of serum proteins and lens proteins were performed with various concentrations of D-glucose.
    1) The glycosylated serum protein (GSP) levels were determined by thiobarbituric acid assay after removing free glucose by pretreatment with trichloroacetic acid.The GSP levels in 93 diabetics were 1.00±0.19 5-hydroxymethylfurfural (5-HMF) nmolcs/mg protein (mean±SD).This value was significantly higher (p<0.001) than that in normals (0.75±0.085-HMF nmoles/mg protein).The glycosylated hemoglobin A1 (HbA1) levels were also determincd with a Corning HbA1 kit.
    2) The correlation between the GSP or HbA1 level and blood sugar control was examined.The highest correlation was obtained between the GSP level and mean fasting blood sugar (FBS) level from 1 to 3 weeks previously (r=0.641, p<0.001) and also between the HbAi level and mean FBS level from 1 to 3 months previously (r=0.0.748, p<0.001).
    3) The glycosylation rates of soluble lens proteins (6, 500×gsupernatant in0.05M sodium phosphate buffer, pH 7.2) were determined using cataractous lenses extracted from senile and diabetic subjects.The glycosylated lens protein (GLP) levels were 0.79±0.23 and 1.64±0.43 5-HMF nmoles/mg protein in senile and diabetic cataracts, respectively.The latter value was significantly higher (p×0.001) than the former, while the mean age of diabetics (66.3 y) was significantly lower than the senile one (75.4 y).
    4) The in vitro non-enzymatic glycosylation of serum proteins and lens proteins was dependent on glucose concentration and incubation time.
    5) Based on the present results, it is suggested that a hyperglycemic state in diabetics can accelerate the non-enzymatic glycosylation of various body proteins, and that measurement of the glycosylation rates of body proteins may represent a valuable means of assessing blood sugar control and investigating some aspects of the pathophysiology of diabetic complications.
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  • Yoshinori Goto
    1983 Volume 26 Issue 8 Pages 853-860
    Published: August 30, 1983
    Released on J-STAGE: August 10, 2011
    JOURNAL FREE ACCESS
    It has been widely accepted that deterioration of metabolism in IDDM results from an absolutedecrease in insulin secretion of the pancreas.There have, however, been only a few studies on the insulin sensitivity of peripheral tissues in IDDM.The present study was undertaken to investigate the insulin sensitivity of the peripheral tissues of children with IDDM employing the insulin receptor level of monocytes as a parameter of insulin sensitivity.
    Six children with untreated IDDM, 10 children with IDDM under treatment, and 10 healthy control children participated in the study.The insulin receptor of circulating monocytes was assayed by the method of Gavin et al.modified for use of a small amount of blood sample.The insulin receptor levels were 1.43pg/106 cells in the children with untreated IDDM, 1.56pg/106 cells in those with IDDM under treatment, and 1.91pg/106 cells in the controls.The difference in value between the controls and untreated diabetic children was statistically significant (p<0.05) while that between the controls and treated diabetic children was not.These data indicate that a decrease of insulin action in human IDDM might be attributable, in part, to a defect of adaptive regulation of insulin receptor, namely release of down regulation, which is demonstrated in streptozotocin-induced or genetic IDDM animals.
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  • Nagayasu Toyoda
    1983 Volume 26 Issue 8 Pages 861-868
    Published: August 30, 1983
    Released on J-STAGE: August 10, 2011
    JOURNAL FREE ACCESS
    Increased insulin resistance is one of the characteristics of metabolism during pregnancy.We studied the action of insulin on glucose oxidation and the insulin receptors using isolated adipocytes prepared from late pregnant rats in order to clarify the mechanism of the insulin resistance.The insulin action on glucose oxidation was estimated by measuring the amount of 14CO2 converted by adipocytes from (1-14C) glucose during 60 min at 37°C. The insulin receptors were assessed by measuring the 125I-insulin bound to the adipocytes during 60 min at 37°C or during 90 min at 24°C. The glucose oxidation was significantly decreased in the pregnant rat adipocytes with or without insulin.The amount of 14CO2 converted from (1-14C) glucose by adipocytes from pregnant and nonpregnant rats was 2.81±0.49 and 4.62±0.54 without insulin, and 16.04±2.10 and 26.1±3.43 (n=7, mean±SEM) with 25ng/ml insulin, respectively.There was no significant difference in the 125I-insulin binding at each insulin concentration between the pregnant and nonpregnant rats.There was also no significant difference in the degradation of 125I-insulin during the incubation time.
    These results suggest that isolated adipocytes from late pregnant rats are resistant to insulin on glucose oxidation and that this insulin resistance is due to certain changes at the postreceptor sites.
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  • Observations over a 20-Year Period
    Akira Sasaki, Masuko Uehara
    1983 Volume 26 Issue 8 Pages 869-877
    Published: August 30, 1983
    Released on J-STAGE: August 10, 2011
    JOURNAL FREE ACCESS
    A further study was made on the causes of death in diabetic patients during the 5-year period between 1975-1979 in Osaka, Japan, and the data were analyzed with reference to the previous results for the 15-year period between 1960-1974, as consecutive observations for a 20-year period.
    1) The aging of diabetic patients dying during the past 20 years was remarkable: The ratios of those aged 65 years or over was 61% for males and 72% for females.The mean ages at death, which were on a steadily increasing trend as a whole, were exceptionally very low for those who died from tuberculosis and liver cirrhosis and for those who had coma, ketoacidosis or diabetic nephropathy as contributing conditions.
    2) Analysis of the underlying causes of death indicated a continuous increase in diseases of the circulatory system, accounting for 50% of the total deaths excluding “diabetes” as the underlying cause. Among the causes, cerebrovascular disease was the greatest in number, but with a gradually declining trend during the latest 5 years.On the other hand, diseases of the heart, which took second place, revealed a rapidly increasing trend, leaving only a small difference from the cerebrovascular disease.An increase in liver cirrhosis was also noted.
    3) Diabetic nephropathy, which was described as a contributory condition, also showed an increase, accounting for 18% during the recent 10 years, including renal diseases not defined as diabetic.
    It was demonstrated, therefore, that the causes of death among Japanese diabetics had changed considerably during the past 20 years.However, it was also recognized that there was still not a small difference in the distribution from that in Western countries, suggesting some peculiarity in Japanese diabetics as regards their complications and natural history.
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  • The Incidence of I.C.A.
    Shinya Note, Kazumi Notsu, Masana Hirata, Akira Yaita, Terushisa Nakam ...
    1983 Volume 26 Issue 8 Pages 879-884
    Published: August 30, 1983
    Released on J-STAGE: August 10, 2011
    JOURNAL FREE ACCESS
    We examined the pancreatic islet cell antibodies (I.C.A.) in one population in Japan. The incidence of I.C.A.was 6 cases out of 1, 125 subjects, or 0.5%.The incidence of I.C.A.in males was 0.6% and that in feamles was 0.5%.All the cases with I.C.A.suffered from neither type 1 nor type 2 diabetes.However, one case had diffuse goiter and antithyroid antibodies, and another case had antinuclear antibodies.The case with diffuse goiter and circulating thyroid antibodies was suspected to suffer from Hashimoto's thyroiditis.The other 5 cases with I.C.A.had no autoimmune endocrinopathies.
    There were 13 cases with overt diabetes in the population, 2 of whom were of the insulin dependent type and 11 were of non-insulin dependent types.However, none of them had I.C.A.
    The titers of I.C.A. ranged from 1: 5 dilutions to 1: 10 dilutions.The titer in the case with Hashimoto's thyroiditis was the highest of all.The I.C.A.in 6 cases showed diffuse cytoplasmic fluorescence over the pancreatic islet cells, and these were so-called “classical” patterns.
    Identical tests for I.C.A.were performed on childhood diabetics as type 1 diabetics.The incidence of I.C.A.in 80 cases with type 1 diabetes was 36.3%.
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  • 1983 Volume 26 Issue 8 Pages 885-902
    Published: August 30, 1983
    Released on J-STAGE: August 10, 2011
    JOURNAL FREE ACCESS
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