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Volume 30, Issue 8
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[in Japanese]1987 Volume 30 Issue 8 Pages 707-708
Published: August 30, 1987
Released on J-STAGE: August 10, 2011
JOURNAL FREE ACCESSDownload PDF (399K) -
Keiko Fujii, Yasunori Nagamine, Ichiyo Oshima, Takashi Ueda, Norihisa ...1987 Volume 30 Issue 8 Pages 709-714
Published: August 30, 1987
Released on J-STAGE: August 10, 2011
JOURNAL FREE ACCESSIn order to check whether urinary glucose can be measured quantitatively with an instrument for self-monitoring of blood glucose, Dextrostix/Dextrometer II ®, Glucostix/Glucoster ® and Diatrol/Toecho® were examined to determine the feasibility of their use for the measurement of urinary glucose. Diatrol/Toecho ® (Dia) was the only instrument that qualified for this application the values measured using Dia correlated well with those obtained with the reference instrument. Urinary glucose was quantitatively recovered when urinary samples were diluted and reproducibility of the values measured with Dia by patients or their family was good enough for its clinical use (CV=10.0%). When E. coli was added to the collected urine at 25 ° or 37°C, the urinary glucose concentration continued to decrease with time. However, when patients' urine was used without any additive, the concentration of urinary glucose did not decrease within several hours. Our data indicate that Dia can be used for self-monitoring of urinary glucose and this method can be applied to the self-management of diabetes by patients who need to measure urinary glucose.View full abstractDownload PDF (909K) -
Osamu Mokuda, Yasuo Ito, Isao Murakami, Tadasu Ikeda, Masato Tominaga, ...1987 Volume 30 Issue 8 Pages 715-721
Published: August 30, 1987
Released on J-STAGE: August 10, 2011
JOURNAL FREE ACCESSTo estimate the glucose metabolism of the myocardium in a diabetic state and to study the effect of coenzyme Q10 (CoQ10) on the myocardial metabolism of glucose, we observed glucose uptake, lactate production and glucose oxidation in the isolated perfused heart from streptozotocin (STZ)-incluceJ diabetic rats and CoQ10-treated diabetic rats.
Male Wistar rats weighing 120g were intraperitoneally administered with STZ 60mg/kg body weight, and olc-half of the rats were intraperitoneally injectd with CoQ10 10mg/kg twice a day for one week. The heart was isolated and perfused at a coronary flow rate of 2ml/min with a synthetic medium containing 1 mM glucose and [1-14C]-glucose for 30 min.
In the control rats, glucose uptake, lactate production and glucose oxidation were 9.0±0.8μrnol/30min/g wet ti ;MC weight (mean±SD), 40.5±12.4μmol/30min/g and 22.9±2.3nmol/30min/g, respectively. Glucoie uptake (4.4±2.6μmol/30min/g), lactate production (25.0±6.8μmol/30min/g) and glucose oxidation (22.0±7.8nmol/30 min/g) in diabetic rats were significantly (P<0.01) lower than those in controls. Glucose uptake (4.6±2.8μmol/3 min/g) and lactate production (23.7±4.8μmol/30 min/g) in CoQ10-treated diabetic rats were similar to those in diabetic rats, but glucose oxidation (30.7±5.2 nmol/30min/g) was significantly increased (p<0.05).View full abstractDownload PDF (1046K) -
Sumiharu Morita1987 Volume 30 Issue 8 Pages 723-728
Published: August 30, 1987
Released on J-STAGE: August 10, 2011
JOURNAL FREE ACCESSIn the present study, we examined the suppressive effect of exogenous insulin on endogenous insulin and glucagon secretion by measuring the plasma C-peptide (CPR) and glucagon (IRG) levels in NIDDM during insulin infusion using the glucose clamp technique. Moreover plasma Gut GLI levels, elevation of which has been reported in the diabetic state, were also measured to study the effect of insulin. Steady-state plasma IRI was achieved at an insulin infusion rate of 40mU/m2/min, and plasma glucose concentration was maintained at the fasting level during the two-hour glucose clamp study. The MCR of glucose in NIDDM was markedly lower at 4.9±0.4ml/kg/min than the 8.8±0.2ml/kg/min in normal subjects. Under these conditions, plasma CPR, IRG, and Gut GLI levels fell significantly from the basal levels in both normal and diabetic subjects. However, the mean maximal percentages of suppression of basal CPR, IRG and Gut GLI levels in diabetic subjects were noticeably lower Compared with those in normal subjects. These findings could also be observed in diabetic subjects with normal fasting glucose levels under good control.
In conclusion, insulin inhibits the secretion of not only insulin and glucagon but also enteroglucagon. However, in NIDDM, as well as the decrement in the MCR of glucose during insulin infusion, the suppressive effect of insulin on the secretion of these hormones diminished in comparison with that in normal subjects.View full abstractDownload PDF (1116K) -
Comparison between Goshajinkigan and Mecobalamin TreatmentNobuo Sakamoto, Yuzo Sato, Yoshio Goto, Yoshio Ikeda, Akira Takahashi, ...1987 Volume 30 Issue 8 Pages 729-737
Published: August 30, 1987
Released on J-STAGE: August 10, 2011
JOURNAL FREE ACCESSA well-controlled comparative study was performed in order to compare the clinical effects of Goshajinkigan (G) and mecobalamin (M) on diabetic neuropathy.
The improvement rates of numbness of the extremities (69.8%; p<0.05), and sexual hypofunction and impotence (29.6%; p<0.10) in the G group were higher than those (37.1% and 13.3%, respectively) in the M group.
These results suggest that the traditional form of oriental medicine, Goshajinkigan, might be a useful approach for amelioration of the numbness and autonomic dysfunction associated with diabetic neuropathy.View full abstractDownload PDF (1203K) -
Toshika Otani, Kenshi Yao, Asako Sato, Naoko Iwasaki, Yuko Higami, Tad ...1987 Volume 30 Issue 8 Pages 739-746
Published: August 30, 1987
Released on J-STAGE: August 10, 2011
JOURNAL FREE ACCESSThe relationship between the inheritance of diabetes, microangiopathies and obesity was examined in 97 patients with NIDDM who had been diagnosed as diabetes before the age of 25 years and referred to the Diabetes Center of the Tokyo Women's Medical College from 1980 to 1984 (51 males and 46 femeles; the age at diabetes, diagnosis of 18.4±4.2 years [mean±SD]; the duration of diabetes 7.1±6.4 years). At the same time 127 patients diagnosed as having IDDM before the age of 25 years (60 males and 67 females; the age at diabetes, diagnosis of 11.8±5.9 years; the duration of diabetes 10.5±7.2 years) during hospital visits were used as the control group.
The percentage of probands with diabetic first degree relatives was 49.0% for NIDDM, and 11.9% for IDDM (p<0.005). For NIDDM, MODY was defined as follows:(1) every affected person had an affected parent, (2) there was direct vertical transmission through three generations, (3) the ratio of affected: unaffected children of diabetic parents was 1: 1. All other cases of NIDDM except MODY were defined as NIDDY. 11.5% of the NIDDM were designated as MODY. Incidences of MODY detected before the age of 20 years and between 20 and 24 years were 19.2% and 2.3%, respectively (p<0.025).
Patients with past histories of obesity amounted to 30.9% for NIDDM and 3.9% for IDDM (p<0.005). None of the MODY patients had past histories of obesity, whereas 35.3% of NIDDY patients did.
Among NIDDM patients the rates of those with simple and with proliferative retinopathy were 22.1% and 14.7% respectively, although these rates in IDDM patients were 43.7% and 9.5% respectively. Retinopathy was found in 41.7%(simple, 25.0%; proliferative, 16.7%) of the patients with MODY, and 36.1%(simple, ≥21.7%; proliferative, 14.5%) of those with NIDDY. The rate of patients with nephropathy was 14.7% for NIDDM and 10.3% for IDDM. Nephropathy was indicated in 16.7% of the patients with MODY, and 14.5% of those with NIDDY. These findings suggest that severe microagniopathies occur in patients with NIDDM to the same degree as in patients with IDDM, and that there were various heterogeneities with or without microangiopathies in MODY.View full abstractDownload PDF (1218K) -
Hidehiro Ishii, Tomoki Suehiro, Kazunori Miyazaki, Akihiro Funakoshi, ...1987 Volume 30 Issue 8 Pages 747-751
Published: August 30, 1987
Released on J-STAGE: August 10, 2011
JOURNAL FREE ACCESSA case of MEN type I with multiple insulinoma and parathyroid adenoma is described. A 25-year-old woman was admitted because of unconsciousness. The diagnosis of multihormone-producing insulinoma was made by a fasting test, angiography and venous sampling through percutaneous transhepatic catheterization. Her symptoms were ameliorated after the removal of six pancreatic tumors. Two years later, she was readmitted because of hypercalcemia. A parathyroid tumor was detected and the hypercalcemia disappeared after removal of the tumor.
Measurement of the pancreatic hormone content and histological studies of the pancreatic tumors showed that the tumors contained insulin, glucagon, somatostatin and human pancreatic polypeptide. The concentrations of these components were different in each tumor. Insulin extracted from the tumor analyzed by HPLC revealed no structural abnormalities.View full abstractDownload PDF (882K) -
Mutsumi Hakamata, Mitsuyasu Ito, Hiroyuki Ohashi, Noriyuki Nihei1987 Volume 30 Issue 8 Pages 753-759
Published: August 30, 1987
Released on J-STAGE: August 10, 2011
JOURNAL FREE ACCESSThe pathogenesis of painless thyroiditis remains unknown, but recent reports have suggested that immunological abnormalities might play some roles in this condition. No case of painless thyroiditis complicated with diabetes mellitus has been reported, although the incidence of autoimmune thyroiditis has been reported to be high among diabetic patients. We describe a patient who developed diabetes mellitus following painless thyroiditis. A 51-year-old woman was admitted to our hospital because of hyperglycemia and signs of hyperthyroidism. Two months before admission she complained of thirst, polydipsia, polyuria and palpitation. She had lost 5 kg in body weight within 20 days. A diffusely enlarged thyroid was palpable without tenderness. Serum levels of T4, T3and free T4were elevated but thyroid 131I uptake was low in thyroid tissue. The titers of microsome hemagglutination (MCHA) and thyroglobulin hemagglutination (TGHA) were elevated. indenolol had been administered for 6 weeks resulting in a decrease in the scrum levels of thyroid hormones. On admission, the fasting plasma glucose level was 181 mg/dland HbA1c was 13.5%. Islet cell surface antibody was negative and the circulating immune complex level was high. The fasting plasma glucose value declined to 100 mg/dland HbA1c fell to 8% after treatment with glibenclamide. Fasting plasma glucose value and the level of HbA1c remained normal after discontinuation of glibenclamide. Thyroid function was also kept within the normal range after discontinuation of indenolol, but the level of TSH transiently increased in parallel with the increased titer of MCHA. A 75-g oral glucose tolerance test revealed an impaired glucose tolerance with low responses of immuno-reactive insulin (IRI). However, responses of IRI to oral glucose loading became normal after thyroid functions had normalized. A transient increase in plasma thyroid hormone might have caused or resulted in clinically manifest diabetes mellitus in this case. However, the contribution of immunological abnormalities observed in painless thyroiditis could not be ruled out in the onset of diabetes mellitus.View full abstractDownload PDF (1911K) -
Naotake Hashimoto, Hideichi Makino, Azuma Kanatsuka, Toshimasa Fujiwar ...1987 Volume 30 Issue 8 Pages 761-765
Published: August 30, 1987
Released on J-STAGE: August 10, 2011
JOURNAL FREE ACCESSCoxsackie B3virus infection, as well as that of Coxsackie B4or B5 virus, has been suggested to be one of the pathogenic factors in insulin-dependent diabetes mellitus (IDDM). However, there are few reported cases of Coxsackie B3virus infection followed by IDDM. In this communication, a case of IDDM with Coxsackie B3 virus infection following DDS syndrome is reported. A 60-year-old female patient suffering from DDS syndrome was treated with predonine. Three weeks later, she suddenly complained of thirst and polyuria with accompanying hyperglycemia and ketouria. IDDM was diagnosed from such examinations as insulin release and HLA typing. Coxsackie B3neutralizing antibody titer quadrupled immediately after the onset of IDDM, rose by as much as 128 times after three weeks and then fell to four times after two months. Other viral neutralizing antibody titers did not change significantly. Therefore considering the time course of IDDM and changes in Coxsackie B3virus neutralizing titers, it seems probable that Coxsackie B3virus infection was pathogenic for the onset of IDDM in this patient.View full abstractDownload PDF (2234K) -
Yuuichiro Sudoh, Mitsuyasu Itoh1987 Volume 30 Issue 8 Pages 767-772
Published: August 30, 1987
Released on J-STAGE: August 10, 2011
JOURNAL FREE ACCESSDiabetic patients often have a complicating depression or neurosis which is sometimes indistinguishable from autonomic neuropathy or diabetic central neuropathy. We report a 33-year-old female office worker who responded to antidepressants against recurrent nausea and vomiting. She was admitted this hospital for the fourth time because of nausea and vomiting since the onset insulin-dependent diabets in 1971. Physical examination revealed proliferative diabetic retinopathy, diminished ankle jerk reflexes and a vibratory sensation. Laboratory findings on admission are summarize as follows: fasting plasma gluccose 430 mg/dl, urinary ketone bodies (2+), HbA1c 9.3%, base excess of arterial blood -6.6mEq/l. It took three months until the vomiting was cured with improvement of diabetic control. She was repeatedly admitted to this hospital in spite of good diabetic control and no evidence of diabetic ketoacidosis. No abnormality was found by EEG, brain scan, or spinal fluid examination.
The coexistence of autonomic neuropathy was demonstrated by a decreased coefficient of variation of the R-R interval on EEG (0.07%) and orthostatic hypotension. An upper GI series did not reveal any sign of gastric dilatation, diminished peristalsis or prolonged retention of barium. The patient was started on antidepressants, which alleviated her symptoms for the next 12 months. The present case suggests that depression might contribute to hyperemesis of unknown origin in some cases of diabetes.View full abstractDownload PDF (2851K) -
1987 Volume 30 Issue 8 Pages 773-792
Published: August 30, 1987
Released on J-STAGE: August 10, 2011
JOURNAL FREE ACCESSDownload PDF (3667K)
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