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Volume 31, Issue 11
Displaying 1-8 of 8 articles from this issue
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Relation to Fasting Level of Serum Ketone BodiesTakashi Ohoshi, Joji Iinuma, Susumu Nishimura, Kishio Nanjo, Kazuhiro ...1988 Volume 31 Issue 11 Pages 835-842
Published: November 30, 1988
Released on J-STAGE: August 10, 2011
JOURNAL FREE ACCESSMetabolic, hormonal and sympathetic responses to exercise (1watt/kg ideal body weight, 20 minutes) were investigated in patients with non-insulin-dependent diabetes mellitus (NIDDM) and normal subjects after overnight fasting. The NIDDM patients had no proliferative retinopathy, renal dysfunction, or decreased heart-rate variation.
In the whole NIDDM group (n=16), there was a positive correlation between serum 3-hydroxybutyrate (3-OHBA) concentrations at rest (“0 min”) and urinary catecholamine responses to exercise (ΔNA: r=0.70, p<0.01, ΔAdr: r=0.70, p<0.01). In both NIDDM subgroups (group (H): 3-OHBA≥70μM/l at 0 min, n=8, group (L): 3-OHBA<70μM/l at 0 min, n=8), plasma glucose (PG) was decreased after exercise. 3-OHBA was greatly decreased at cessation of exercise (“20 min”) in group (H). Serum IRI was decreased at 20 min in group (L) and serum HGH was increased at 20 min in both groups. Catecholamine responses were increased in group (H). In the normal subjects (group (N): n=5), there were no significant changes.
Sympathetic hypersensitivity to exercise has already been observed in NIDDM patients with fasting hyperketonemia, before metabolic and hormonal responses to exercise become exaggerated.View full abstractDownload PDF (1086K) -
Takashi Matsuura1988 Volume 31 Issue 11 Pages 843-850
Published: November 30, 1988
Released on J-STAGE: August 10, 2011
JOURNAL FREE ACCESSIn 45 patients with effort angina, cardiac catheterization was used to study the sclerotic changes in the coronary arteries, and the cardiac function were examined in relation to impaired glucose tolerance. The patients were divided into normal glucose tolerance (N), borderline (B) and diabetic (D) groups according to the types indicated by 75g glucose tolerance tests.
Wide-spread arteriosclerosis, estimated by the total involved segments in coronary arteriography, was more evident in the B and D groups, than in the N group.
There were no significant differences in resting values in the left ventricular systolic pressure (LVSP), the left ventricular end diastolic pressure (LVEDP), and the stroke index (SI) in the 3 groups. The LVSP and SI in the N group were elevated after the exercise. These elevations did not appear in the B group, and the SI in the D group was rather diminished after the exercise. The LVEDP after exercise was greatly elevated in the B group and the magnitude of the elevation was similar to the alteration in the D group. This similar change of the LVEDP was induced by ergonovine maleate and it was returned to the resting level by nitrates.
It appeared reasonable, therefore, to attribute the abnormalities of the cardiac function after the exercise in the B group to the wide-spread sclerosis of the coronary arteries.View full abstractDownload PDF (1385K) -
Junji Hirayama, Kishio Nanjo, Tokio Sanke, Hajimu Morita, Hiromichi Ta ...1988 Volume 31 Issue 11 Pages 851-856
Published: November 30, 1988
Released on J-STAGE: August 10, 2011
JOURNAL FREE ACCESSThe effect of nicardipine hydrochloride (NC), a calcium antagonist, on insulin action in peripheral tissues was examined in dogs. When NC was infused alone, it caused no significant changes in the IRI and IRG secretions. In the second experiment, an euglycemic glucose clamp test (EGCT) was performed. Sixty minutes after the beginning of EGCT, 1mg of NC was infused for 60 minutes, and the changes in the glucose disposal rate (DR) were observed. The DR was 14.5±0.31mg/kg/min before NC infusion, then it increased significantly to 17.5±0.73mg/kg/min during infusion of the NC, and significantly decreased to 13.5±0.58mg/kg/min after discontinuation of the NC infusion. The heart rate also increased with NC infusion, but remained increased even after the discontinuation of NC infusion. These findings indicate that NC increases the insulin-induced glucose utilization in the peripheral tissues.View full abstractDownload PDF (806K) -
Multivariate AnalysisKohtaro Asayama, Shin Amemiya, Kazushige Dobashi, Hidemasa Hayashibe, ...1988 Volume 31 Issue 11 Pages 857-862
Published: November 30, 1988
Released on J-STAGE: August 10, 2011
JOURNAL FREE ACCESSIt has been suggested that accelerated peroxidation of lipid and/or lipoprotein secondary to enhanced production of active oxygen species contributes to diabetic angiopathy. To determine whether such oxidative stress modifies lipid peroxidation and antioxidant enzyme defense systems in diabetes mellitus, thiobarbituric acid-reactive substance (TBARS) in plasma, superoxide dismutases (CuZnSOD and MnSOD), glutathione peroxidase (GPX) and catalase (CAT) in peripheral blood cells (i.e., erythrocytes, polymorphs, lymphocytes and monocytes) were measured. Twenty-one juvenile insulindependent diabetics and nine age-matched controls were studied. CuZnSOD and MnSOD were assayed by specific radioimmunoassays. Both CuZnSOD and MnSOD were higher in all cell types from diabetics than those from controls. On the other hand, neither plasma TBARS, erythrocyte GPX nor CAT was altered in diabetics. Both erythrocyte GPX and CAT were inversely correlated with CuZnSOD in diabetics. The latter was also inversely correlated in a multivariate manner with plasma TBARS and hemoglobin A1c, The partial correlation coefficients for GPX, TBARS, hemoglobin A1c and CAT were-0.610, 0.606, 0.527 and 0.394, respectively. These results suggest that insulin treatment suppresses the peroxidative process by induction of the SODs. Immunoreactive SOD in periphral blood cells appeared to be a useful clinical index of host defense reaction against peroxidative stress in diabetes mellitus.View full abstractDownload PDF (918K) -
Yoshiko Tokisue, Muneyoshi Yoshida1988 Volume 31 Issue 11 Pages 863-868
Published: November 30, 1988
Released on J-STAGE: August 10, 2011
JOURNAL FREE ACCESSWe report a non-ketotic, hyperosmolar diabetic coma which was preceded by the administration of L-asparaginase in a diabetic patient with acute lymphoblastic leukemia and Down's syndrome. A 19-year-old man was admitted to the hospital for the treatment of acute lymphoblastic leukemia. He had Down's syndome and hypothyroidism, and his blood glucose concentrations ranged from 110 mg/dl to 140 mg/dl.
He received intravenous injections of L-asparaginase (500 KU each) on October 16 and 18. On October 19, he was found unconscious when his blood glucose rose to 1100 mg/dl. Urinalysis, however, yielded a negative result for ketone bodies. We immediately started intrvenous administration of insulin and saline. Plasma osmotic pressure was 329 mosm/L, although it was determined after he received about 800 ml of saline infusion.
He responded well to insulin treatment and regained consciousness on October 23. On Novemer 6, we stopped insulin administration because of an improved blood glucose level. Binding of 125I. insulin to his erythrocytes was within normal limits, suggesting that the number of insulin receptors on his red blood cells was normal.View full abstractDownload PDF (752K) -
Akio Ikeda, Shoichiro Ikuyama, Sadato Fujii, Yoichi Setoguchi, Iwata O ...1988 Volume 31 Issue 11 Pages 869-874
Published: November 30, 1988
Released on J-STAGE: August 10, 2011
JOURNAL FREE ACCESSA 61 year-old woman, who had been treated for liver cirrhosis for five years, was admitted to our hospital because of insulin allergy and poor control of blood glucose. She had been treated with an oral hypoglycemia agent for a year after she was diagnosed as having diabetes mellitus. She had started human insulin therapy three months before admission, but shortly after that she had developed itchy skin wheals at the insulin-injected sites. On admission, intradermal injection of several types of human, porcine and bovine insulin give highly positive reactions. Her sera bound 95.2% of 125I-human insulin added in vitro. The wheals, disappeared gradually with the combined injection of 0.06mg of dexamethasone with human insulin and her blood glucose was well controlled with 62U/day of insulin. As she was diagnosed as having idiopathic hemochromatosis by histological examination of a liver specimen and by other laboratory tests, repetitive phlebotomy and desferioxamine were administered. With these treatments, the insulin requirement decrease to 44U/day. These results show that insulin allergy occurs even with human insulin, and that in this patient the insulin requirement was affected by the idiopathic hemochromatosis itself as well as by the insulin allergy.View full abstractDownload PDF (829K) -
Investigation with the Euglycemic Glucose Clamp TechniqueAkira Sekikawa, Makoto Tominaga, Katsunobu Shinohara, Mitsuo Matsumoto ...1988 Volume 31 Issue 11 Pages 875-879
Published: November 30, 1988
Released on J-STAGE: August 10, 2011
JOURNAL FREE ACCESSA 55-year-Old male palient was admitted for diabetic control and examination for acromegaly.
He was diagnosed as having acromegaly based on his clinical features and basal plasma growth hormone (GH) levels of 42-196ng/ml. To measure his insulin requirement, an artificial pancreas was operated for 24 hours. His insulin requirement was 150 units a day.
After we removed a acidophilic tumor from the pituitary by Hardy's operation, the blood glucose level was well controlled by only diet therapy.
To quantify the insulin resistance, a euglycemic glucose clamp study was performed before the operation, and it was repeated 2 and 6 months after the operation.
The M values which represents insulin sensitivity were 2.4mg/kg/min before the operation, 5.3 mg/kg/min 2 months after the operation and 8.5mg/kg/min 6 months after the operation The last value is just compatible with the normal value of 8.4±0.4 mg/kg/min (n=7, mean±S.D.). The insulin resistance 2 months after the operation may have been caused by long-term hyperinsulinemia and/or hyperglycemia. The insulin resistance caused by excess GH could be restored by normalization of the GH level.View full abstractDownload PDF (668K) -
Tadashi Okabe, Hajime Tei, Kohtaro Iwamoto, Toshihiro Ohuchi, Masahiro ...1988 Volume 31 Issue 11 Pages 881-884
Published: November 30, 1988
Released on J-STAGE: August 10, 2011
JOURNAL FREE ACCESSWe have used 31P nuclear magnetic resonance spectroscopy to study noninvasively the metabolic state of skeletal muscle in vivo in diabetic patients under poor and good control. The concentrations of phosphocreatine (PCr), inorganic phosphate (Pi) and ATP in hamstring muscles were measured during rest, aerobic exercise and recovery from exercise. Under poor control, diabetic patients (with both IDDM and NIDDM) show evidence of a reduced muscle energy state with the following abnormalities compared with a normal subject. First, PCr concentrations are lower than normal and continue to decline during exercise. Second, Pi concentrations are higher than normal during exercise. Third, PCr resynthesis in post exercise recovery is abnormally prolonged. Under good control, these abnormalities are improved to almost near normal.
These findings demonstrate the impaired energy metabolism which is due to inhibited glycolysis and/or mitochondrial oxidative activity in skeletal muscles of diabetic patients under poor control. 31P nuclear magnetic resonance spectroscopy may have potential clinical application in defining the biochemical basis of energy metabolism in diabetic patients.View full abstractDownload PDF (449K)
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