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Volume 32, Issue 11
Displaying 1-11 of 11 articles from this issue
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Its Structure and FunctionMasato Kasuga1989 Volume 32 Issue 11 Pages 783-786
Published: November 30, 1989
Released on J-STAGE: August 10, 2011
JOURNAL FREE ACCESSDownload PDF (713K) -
Nigishi Hotta, Nobuo Sakamoto, Yasuo Akanuma, Kenpei Matsuoka, Yoshio ...1989 Volume 32 Issue 11 Pages 787-795
Published: November 30, 1989
Released on J-STAGE: August 10, 2011
JOURNAL FREE ACCESSWe performed a double-blind trial to investigate the effect of a new aldose reductase inhibitor, ponalrestat, on red blood cell (RBC) sorbitol level in 48 non-insulin dependent diabetics who were orally administered the drug (150 mg, 300 mg, or 600 mg) once daily.
Ponalrestat reduced, in a dose-dependent manner, the increased RBC sorbitol level due to high blood glucose level. The rates of reduction against the predose levels were 16.5% in the 150 mg dose group, 28.8 % in the 300 mg dose group and 43.1 % in the 600 mg dose group. A significant correlation was observed between plasma drug concentration and rate of RBC sorbitol level reduction (r= 0.704).
Although ponalrestat did not affect blood glucose levels, it significantly inhibited the increase in RBC sor itol level in response to the postprandial increase in blood glucose levels. Significant reduction of the RBC sorbitol level remained for 24 hours in the 600 mg dose group. Further, none of the subjects in this study manifested any symptoms or hematobiochemical abnormalities of clinical significance.
Thus, ponalrestat was well tolerated, significantly reduced RBC sorbitol level, and remained effective for 24 hours in the 600 mg dose group.View full abstractDownload PDF (1530K) -
Toshika Otani, Hiroki Yokoyama, Yasuko Uchigata, Yuko Higami, Tadasu K ...1989 Volume 32 Issue 11 Pages 797-800
Published: November 30, 1989
Released on J-STAGE: August 10, 2011
JOURNAL FREE ACCESSThe development of retinopathy was examined over an 8-year period in 56 patients with insulin-dependent diabetes (IDDM) who were under the age of 25 when they were diagnosed as having diabetes and who had simple retinopathy in 1980 (mean duration of diabetes, 20.5 years [1988]; mean level of HbA1 11.4%[1980-1988]). The duration of diabetes among the 12 patients who had developed proliferative retinopathy after 8 years was 22.2 years, compared with 20.7 years in the 33 patients with simple retinopathy and 17.8 years in the 11 patients without retinopathy. Life-table analysis was performed to determine the duration of diabetes until the retinal lesions became proliferative. Proliferative retinopathy occurred in those with over a 10-year history of diabetes. The interval from diagnosis of IDDM to 25% risk for developing proliferative retinopathy was 18.9 years, and that to 50% risk was 27.6 years.View full abstractDownload PDF (789K) -
Keisuke Kosugi, Hideki Hidaka, Takahiko Aoki, Hideto Kojima, Yuzuru Na ...1989 Volume 32 Issue 11 Pages 801-805
Published: November 30, 1989
Released on J-STAGE: August 10, 2011
JOURNAL FREE ACCESSSelf-measurements of blood ketone body and 3-hydroxybutyrate levels were performed at home by 12 IDDM and 2 insulin-treated NIDDM patients using a newly developed film-test method.
A good correlation was observed between the self-monitored blood 3-hydroxybutyrate levels and quantitatively determined serum concentrations (n=52, r =0.97). In 12 IDDM patients, blood 3-hydroxybutyrate levels at home ranged widely from 20 to 1440 μM before breakfast and from 20 to 2230 μM before dinner. On the other hand, blood 3-hydroxybutyrate levels in 2 NIDDM patients were generally less than 200 μM.
This study suggests that self-measurement of blood 3-hydroxybutyrate and glucose at home is useful to detect ketoacidosis early and to obtain good metabolic control in IDDM patients.View full abstractDownload PDF (663K) -
Yoshihiko Suzuki, Kempei Matsuoka, Akira Horiuchi1989 Volume 32 Issue 11 Pages 807-812
Published: November 30, 1989
Released on J-STAGE: August 10, 2011
JOURNAL FREE ACCESSIt is useful to clarify insulin secretion by the 75g oral GTT. Discriminant analysis of 673 subjects who underwent the 75g OGTT indicated that the relationship of ΔIRI/(Δ BG) 2 is discriminant to the impairment of glucose metabolism.
Therefore, we made a new index, insulinogenic index 2 (II 2;ΔIRI/Δ BG2×100), and compared it statistically with the insulinogenic index (II;Δ IRI/Δ BG by Seltzer, 1967). II 2 did not show a great difference in nosological sensitivity, but an improvement of about 10-20% in nosological specificity was noted. There was almost no difference in diagnostic specificity. Therefore, II 2 could be an another good simple parameter, improving the low nosological specificity of I I.
II=ΔIRI/ΔBG II2=-ΔIRI (ΔBG) 2×100 conf.ΔIRI=IRI 30 min-IRI 0 min ΔBG=BG 30 min-BG 0 minView full abstractDownload PDF (777K) -
Yuji Nagasaka, Kohei Kaku, Yumiko Harada, Kenichi Mori, Ken Yaga, Shin ...1989 Volume 32 Issue 11 Pages 813-817
Published: November 30, 1989
Released on J-STAGE: August 10, 2011
JOURNAL FREE ACCESSIn order to further assess the pathophysiology of non-insulin dependent diabetes mellitus (NIDDM), the relationship between insulin resistance and insulin secretory ability was analyzed in individual NIDDM patients using the glucose clamp technique and 75g oral glucose tolerance test (OGTT). NIDDM patients were divided into two groups according to insulin sensitivity as evaluated by the metabolic clearance rate of glucose (MCR) during the glucose clamp (resistant group:<5.8 ml/kg/min; non-resistant group: 5.8 ml/kg/min). Insulin secretory ability as assessed by the insulinogenic index and insulin area on 75g OGTT was markedly reduced in the non-resistant group, whereas it was relatively preserved in the insulin resistant group. MCR was significantly correlated with body mass index, but not with duration of disease or HbA1. These findings suggested two categories in the pathophysiology of NIDDM, that due mainly to insulin secretory defect and that due mainly to insulin resistance.View full abstractDownload PDF (830K) -
Masahisa Kitada, Keigo Yasuda, Noriyuki Takeda, Tomiko Horiya, Yasufum ...1989 Volume 32 Issue 11 Pages 819-824
Published: November 30, 1989
Released on J-STAGE: August 10, 2011
JOURNAL FREE ACCESSIn a total of 74 patients with NIDDM, the effects of i. v. administration of TRH (500 μ) and LHRH (100 μg) on paradoxical GH release were investigated. TRH and LHRH tests were performed in 71 patients (46 male, 25 female) and 58 patients (38 male, 20 female), respectively. In 55 out of the 74 patients, both tests were performed. Paradoxical ΔGH response was defined as the response of AGH (the difference between basal and peak values) above 3 ng/ml. None of the 44 normal subjects had a response greater than this level.
Among the patients with NIDDM studied, the mean ΔGH during TRH and LHRH tests was 3.4±4.4 ng/ml and 3.5±4.8 ng/ml, respectively, the levels of which were significantly higher than those in normal subjects (p<0.01). In TRH testing, GH in 27 of 71 patients (38%) responded paradoxically. The same pattern was observed in LHRH testing in 24 of 58 patients (41%). In 55 patients who underwent both tests, ΔGH to TRH positively correlated with ΔGH to LHRH (r=0.75, p<0.001). Fasting plasma glucose and HbA1c also positively correlated with ΔGH in both TRH and in LHRH tests (both, p<0.001).
These results suggest the possibility that an unknown but related mechanism to the derangement of glycemic control is involved in the paradoxical GH responses to TRH and LHRH observed in NIDDM.View full abstractDownload PDF (1174K) -
Tsutomu Kanda, Ichiro Uematsu, Nobuko Oka, Koji Miyoshi, Mitsuo Azukiz ...1989 Volume 32 Issue 11 Pages 825-830
Published: November 30, 1989
Released on J-STAGE: August 10, 2011
JOURNAL FREE ACCESSOrganic germanium compounds have recently been reported to have antihypertensive action and antitumor and immunomodulative effects, and are habitually taken for health.
We experienced a patient who had taken an inorganic germanium compound as a popular cure without the permission of her doctor. The total intake of germanium was probably 30 to 70 gram, and chronic renal failure developed. The patient, a 55-year-old woman, was diagnosed as having non-insulin dependent diabetes mellitus in November 1979. She had no diabetic retinopathy and creatinine clearance (Ccr) was 103.1ml/minute at that time.
After she began to take the germanium compound on her friend1s advice in September 1985, Ccr decreased from 80.6 ml/minute to 20.9 ml/minute and she was admitted to our hospital in February 1988. Diabetic simple retinopathy, proteinuria and hypertension were not advanced during the period, and she was under relatively good control by an oral hypoglycemic agent. We noticed she had a history of ingestion of germanium compound and carried out a renal biopsy under suspicion of germanium intoxication. Renal biopsy revealed almost normal glomeruli and tubulointerstitial nephritis which were not specific for diabetic nephropathy. The level of germanium in the renal tissue was 279 μg/gram, a very high level.
These facts suggest that chronic renal failure in this case was based not on diabetic nephropathy but on germanium intoxication.View full abstractDownload PDF (5047K) -
Masatoshi Ichihara, Tetsuro Kobayashi, Koji Nakanishi, Tadao Sugimoto, ...1989 Volume 32 Issue 11 Pages 831-836
Published: November 30, 1989
Released on J-STAGE: August 10, 2011
JOURNAL FREE ACCESSA 78-year-old man was admitted to the Toranomon Hospital because of acute myocardial infarction. An episode of premature ventricular contraction (PVC) was successfully treated with disopyramide (DPM). However, the plasma glucose level decreased gradually to a low of 28 mg/dl 67 hours after the initiation of DPM. In contrast, plasma insulin (IRI) and C-peptide immunoreactivity (CPR) levels increased progressively to reach peak values of 50 μU/ml and 8.3 ng/ml, respectively, despite severe hypoglycemia (34 mg/dl). Hypoglycemia was improved by decreasing the dose of DPM and by glucose infusion. Glucose tolerance test revealed a diabetic pattern with Kg-value of 0.0075. Adrenocortical function was preserved in this case. Plasma levels of IRI and CPR were slightly increased in response to rechallenge with DPM, while the plasma glucose level showed normoglycemia during the rest period.
This is the first report describing progressive increases in plasma CPR and IRI during DPM-induced hypoglycemia.View full abstractDownload PDF (1117K) -
Keiichiro Tanigawa, Shinichi Tsuchiyama, Setsuji Kato, Kazuhiko Yamamo ...1989 Volume 32 Issue 11 Pages 837-842
Published: November 30, 1989
Released on J-STAGE: August 10, 2011
JOURNAL FREE ACCESSWe report the clinical course of an aged diabetic primigravida who delivered an infant with skeletal malformation and showed an increase in plasma growth hormone (GH) level during gestation with wellcontrolled blood glucose levels. A 38-year-old primipara was found to have glucosuria when she was 4 months pregnancy. A glucose tolerance test showed a diabetic pattern, and HbAi level was 12.7%. Blood glucose levels were controlled by insulin therapy after admission. The levels of HbAi and fructosamine before delivery were improved to 6.7% and 2.3 mmol/l, respectively, by insulin administration of 70 unit per day. The basal value of plasma GH was increased as much as 15 ng/ml at admission, and the high concentrations continued until labor. Plasma somatomedin-C (SMC) levels gradually increased throughout gestation. Both plasma GH and SMC levels rapidly decreassed after caesarian section, which was perfomed at 38 weeks of gestation. The baby was healthy except for her low birth weight of 2460 g and defects of the distal phalanx of the middle finger and nail of the third finger. These findings suggest that the advanced age of the primigravida and hyperglycemia during organogenesis acted in an additive way to induce skeletal malformation in this infant.View full abstractDownload PDF (2952K) -
1989 Volume 32 Issue 11 Pages 843-848
Published: November 30, 1989
Released on J-STAGE: August 10, 2011
JOURNAL FREE ACCESSDownload PDF (1404K)
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