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Volume 34, Issue 11
Displaying 1-12 of 12 articles from this issue
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[in Japanese]1991 Volume 34 Issue 11 Pages 933-938
Published: November 30, 1991
Released on J-STAGE: August 10, 2011
JOURNAL FREE ACCESSDownload PDF (820K) -
[in Japanese]1991 Volume 34 Issue 11 Pages 939-941
Published: November 30, 1991
Released on J-STAGE: August 10, 2011
JOURNAL FREE ACCESSDownload PDF (445K) -
[in Japanese]1991 Volume 34 Issue 11 Pages 943-945
Published: November 30, 1991
Released on J-STAGE: August 10, 2011
JOURNAL FREE ACCESSDownload PDF (411K) -
S. Okada, Y. Miyai, Y. Masaki, K. Ichiki, S. Tanokuchi, K. Ishii, M. M ...1991 Volume 34 Issue 11 Pages 947-950
Published: November 30, 1991
Released on J-STAGE: August 10, 2011
JOURNAL FREE ACCESSThe medium-term effect of a diabetes education program on metabolic improvement (blood HbA1 levels) was evaluated in a total of 50 outpatients with non-insulin dependent diabetes mellitus who received no drug therapy. Diabetes education was provided by means of a diabetes educational textbook in a dialogue-oriented class. Compared to baseline, HbA1 levels were significantly lower 2, 4 and 6 months after the diabetes educational program (p<0.00003, Wilcoxon test). This metabolic effect was noted in both the higher annual income (Stratum A) and lower annual income (Stratum B) groups in the short-and medium-term. At 2, 4 and 6 months after the educational program, HbA1 levels in Stratum A were significantly lower than in Stratum B (p=0.0094, p=0.0038, p=0.0233, Mann-Whitney U-test).
These results indicate that this diabetes educational program leads to medium-term, metabolic improvement which is greater in the higher income group.View full abstractDownload PDF (722K) -
Tomio Nakayama, Kazumasa Chikamori, Toshinao Yamano, Fumitoshi Ohno1991 Volume 34 Issue 11 Pages 951-957
Published: November 30, 1991
Released on J-STAGE: August 10, 2011
JOURNAL FREE ACCESSWe performed an ultrasound scan on 12 IDDM patients, 120 NIDDM patients, 100 healthy controls and 30 necropstied cadavers in order to evaluate the relationship between pancreatic function and morphology.
As an index of the pancreatic size, the area of the head, body, and tail of the pancreas (P value) was measured in the transverse or oblique plane parallel to the splenic vein. A Q value was calculated as equal to P value/body surface area. The Q value in NIDDM (urinary CPR<80μg/day), healthy controls, NIDDM (urinary CPR<80μg/day), and IDDM were 9.2±1.4, 8.9±1.5, 6.3±1.7, and 4.7±1.2 cm2/m2 (mean±SD), respectively. The following results were obtained:(1) A positive correlation was found between P value, pancreatic weight and volume in necropsied cadavers. (p<0.01)(2) A positive correlation was found between Q value, urinary c-peptide secretion dose and serum immunoreactive trypsin in NIDDM. (3) No significant correlation was found between Q value, age and stage of nephropathy. The data suggest that the pancreas becomes hypertrophic in association with accelerated endocrine pancreatic function in NIDDM, but that pancreatic atrophy and pancreatic exocrine dysfunction gradually ensue with progression of endocrine pancreatic dysfunction.View full abstractDownload PDF (2337K) -
S. Inomata, N. Tsurui, M. Inoue, O. Masamune1991 Volume 34 Issue 11 Pages 959-964
Published: November 30, 1991
Released on J-STAGE: August 10, 2011
JOURNAL FREE ACCESSThe aim of the present study was to clarify the relationship between serum levels of type IV collagen 7S (IV 7S) and diabetic or non-diabetic renal disease in patients with non-insulin dependent diabetes mellitus (NIDDM). 1) IV 7S was measured by RIA in 15 healthy subjects [group H: age 55±5 (SD) yr] and 22 patients with normoalbuminuria (group A:<20μg/min, age 56±10yr, diabetes duration 14±5yr, HbA1c 6.8±1.2%, Ccr 85±18ml/min), 17 with microalbuminuria (group B: 20-200, 55±10, 16±5, 6.9v0.7, 87±15), 14 with macroalbuminuria (group C:<200, 56v9, 15± 5, 6.7±0.7, 64±23), and in another 11 patients (54±11, 9±6, 6.1±0.8, 77±22) primarily affected by non-diabetic renal disease (NDRD: IgA nephropathy 4, membranous nephropathy 2, nephrosclerosis 4, minor abnormality 1).2) IV 7S values were compared with the grade of glomerular diffuse lesions (Gellman's classification) in 14 patients. Results obtained were as follows. 1) IV 7S levels were 4.2±0.5, 4.9±0.7, 6.1±1.0, 6.4±1.2 and 4.3±0.7ng/ml in groups H, A, B, C and D, respectively (A vs H, p<0.01; B vs H and A, p<0.001; C vs H and A, p<0.001; D vs A, p<0.05; D vs B and C, p<0.001). 2) IV 7S values were significantly higher in the 9 patients with grade III or more diffuse lesions than in the 5 with grade II or less (6.2±0.9 vs 4.6±0.4ng/ml, p<0.01).
We conclude that serum levels of IV 7S can reflect the development of diabetic glomerulosclerosis, and therefore serve as useful index for differentiating diabetic renal disease from NDRD in NIDDM.View full abstractDownload PDF (986K) -
Koji Yarimizu, Masahiro Maruo, Junko Ono, Keisuke Ina, Toshimitu Okeda ...1991 Volume 34 Issue 11 Pages 965-971
Published: November 30, 1991
Released on J-STAGE: August 10, 2011
JOURNAL FREE ACCESSIt has been recognized that the exposure of β-cells to sustained hyperglycemia results in the impaired secretion of insulin to acute glucose challenge in both non-insulin dependent diabetic patients and experimental animals. To clarify the mechanisms of glucose induced “desensitization” of β-cells, we tried to establish an in vitro system using cultured islets. A time course study revealed that desensitization occurred when the islets were cultured for 48 hr in 3mg/ml glucose. In perfusion experiments, islets previously cultured in 3mg/ml glucose for 5 days were stimulated for 1 hr by 3 mg/ml glucose, 10mM theophylline, 10mM arginine, 150 /dem/ tolbutamide, 1 μM A 23187 or 200ng/ml phorbol 12-myristate 13-acetate. The amount of insulin released in response to 3mg/ml glucose showed a marked decrease in both the first (1-20 min) and the second (21-60 min) phases, however, these desensitized islets preserved their secretory response to secretagogues other than high glucose. The reversibility of impaired insulin secretion by high glucose was confirmed functionally and morphologically, when the desensitized islets were subsequently cultured for 2 days in 1mg/ml glucose. Our system is of use in pursuing the mechanisms of glucose induced desensitization of insulin secretion from β-cells.View full abstractDownload PDF (3807K) -
Tatsuhiko Urakami, Yukinobu Miyamoto, Hidehiro Fujita, Teruo Kitagawa, ...1991 Volume 34 Issue 11 Pages 973-977
Published: November 30, 1991
Released on J-STAGE: August 10, 2011
JOURNAL FREE ACCESSEarly retinal changes evaluated by ophthalmoscopy and fluorescein angiography (FAG) were studied in two groups of juvenile onset insulin-dependent diabetes mellitus (IDDM) patients. Twenty one patients representing abrupt onset with clinical symptoms at diagnosis (Group A) and 19 patients with slow onset detected by chance during urine glucose screening at school (Group B) were examined. The aim of the study was to investigate the relationship between the prevalence of incipient retinopathy during 10 years of diabetes and the mode of onset of IDDM.
There was no statistical differences in age at diagnosis and annual average HbA1 values between the two groups. Group B patients maintained higher serum C-peptide (S-CPR) levels than Group A patients during the study. Despite higher S-CPR values, the progression of retinal abnormalities detected by both ophthalmoscopy and FAG was more rapid in Group B than Group A. Long-term glycemic control, since the rapid onset of diabetes seemed to affect the development of retinal abnormalities seen in Group A, which were not seen in Group B. There was no statistical difference in HLA phenotypes between the patients with and without retinal abnormalities. From these findings, it is concluded that the mode of onset of diabetes as well as the duration and the metabolic control may affect the development of early retinopathy in juvenile onset IDDM.View full abstractDownload PDF (911K) -
Evaluation of Diabetic Pancreatic Exocrine Function by Biochemical Analysis of Pure Pancreatic JuiceShigenobu Ishida1991 Volume 34 Issue 11 Pages 979-988
Published: November 30, 1991
Released on J-STAGE: August 10, 2011
JOURNAL FREE ACCESSTo evaluate the exocrine pancreatic function seen in diabetes mellitus, the biochemical changes in pure pancreatic juice aspirated by endoscopy were investigated. There was no significant diffrences in the flow rate and the maximal bicarbonate concentration of pancreatic juice from diabetic patients and normal subjects. On the contrary, in diabetic patients the amylase activity per mg protein was significantly lower than that in normal subjects. After strict glycemic control, the amylase activity per mg protein increased significantly, but remained at a lower level than that of normal subjects. The lipase activity per mg protein in diabetic patients was not different from that in normal subjects. The abnormality of acinar cell function under poot glycemic control was accompanied by a significant decrease in the 6-keto-PGF1 α/TXB2 ratio compared with normal subjects. After strict glycemic control, this ratio was normalized. In summary, the diabetic exocrine pancreatic abnormality is characterized by a decreased amylase activity per mg protein resulting from decreased insulin secretion and/or insulin resistance. The altered prostaglandin balance, leading to cytotoxicity and vasoconstriction in the pancreas of diabetic patients, is considered to be the consequence of hyperglycemia.View full abstractDownload PDF (1631K) -
Akinori Urae, Takeshi Kuzuya, Yasuo Akanuma, Kazutoshi Kikuchi, Toshio ...1991 Volume 34 Issue 11 Pages 989-999
Published: November 30, 1991
Released on J-STAGE: August 10, 2011
JOURNAL FREE ACCESSThe safety and pharmacokinetics of a rapid acting insulin analogue (NN-X10), in which the histidine at the B-10 position has been replaced by aspartic acid, were assessed by administering it to 20 normal healthy males in a single subcutaneous dose. Regular human insulin was used as a control with a dose of, 0.05 IU/kg, the maximum plasma insulin concentration was significantly higher after injection of NN-X10 (Mean±SE, 27.3±1.9μU/ml) as compared to regular human insulin (16.8±1.1μU/ml, p<0.01). The time to achieve maximum plasma insulin concentration was significantly shorter with NN-X 10 (0.4±0.04 hr) than with regular human insulin (0.8±0.1hr, p<0.01). The change of blood glucose from the base line is defined as the actual BG value-the base line BG value. There was no significant difference between the maximum ABG with NN-X10 and with regular human insulin. The time required to reach the maximum ABG was observed to be significantly shorter after NN-X10 injection than after regular human insulin. With a dose of 0.1 IU/kg, the differences between the effects of NN-X10 and regular human insulin were greater than with the 0.05IU/kg dose, and the maximum ABG after NN-X10 was also significantly greater than after regular human insulin.View full abstractDownload PDF (1842K) -
Hiroko Yoshino, Harumi Yonemitsu, Sumiko Hasumi, Teiko Amemiya, Yukima ...1991 Volume 34 Issue 11 Pages 1001-1006
Published: November 30, 1991
Released on J-STAGE: August 10, 2011
JOURNAL FREE ACCESSA case of hyperosmolar hyperglycemic nonketotic coma (HHNC) caused by severe dehydration as a result of fasting during Ramadan for religious reasons is reported. A 50-year-old Indonesian man was admitted because of a consciousness disorder which occurred on the 11th day of Ramadan. He had no history of diabetes. His skin and tongue were extremely dry on admission. Laboratory data revealed a serum glucose level of 734mg/dl, sodium of 151mg/dl, and serum osmolality of 363m0sm/kg. Arterial blood gas analysis revealed a pH of 7.321 and HCO-3 of 20.9mEq/l. A small dose of short-acting insulin and 0.45% saline were infused immediately, and 19 hours after the start of treatment, the patient recovered from his HHNC. It is a well known fact that HHNC is sometimes caused by iatrogenic factors, certain drugs or postoperative hyperalimentation. Fasting may also be a precipitating factor for HHNC in diabetic patients, so such patients must pay adequate attention to dehydration.View full abstractDownload PDF (960K) -
Jun Wada, Kozo Hashimoto, Kenji Takahashi, Akira Kubota, Toru Kusumoto ...1991 Volume 34 Issue 11 Pages 1007-1012
Published: November 30, 1991
Released on J-STAGE: August 10, 2011
JOURNAL FREE ACCESSA 53-year-old female was admitted in November 1987 for polyuria (up to 5 liters daily) and polydipsia. Her blood glucose levels, however, were within the normal range. In June 1989 she lost her appetite and drank almost 10 liters of a cooling beverage. She was readmitted in July 1989 because of nausea and vomiting. Her urine volume was 8 to 10 liters/day, her blood glucose level was 624mg/dl, and HbA1c 15.9%. The patient was severely dehydrated. The fluid and electrolyte deficit was replaced, she was treated with insulin infusion, and her blood glucose level normalized. Two months later the patient's urine C-peptide level had gradually improved, and a glucose tolerance test showed impaired glucose tolerance. Insulin administration was discontinued after six weeks, and the patient's diabetes mellitus was under good control on diet therapy. Polyuria and polydipsia nevertheless persisted, and a diagnosis of central diabetes insipidus was made on the basis of a water restriction test. After nasal inhalation of DDAVP (1-deamino-8-arginine vasopressin), the polyuria and polydipsia were ameliorated.
The glucose intolerance and excess of glucose intake resulted in hyperglycemia, and we suppose that the transient failure of insulin secretion which caused severe hyperglycemia was attributable to stress and severe dehydration due to the osmotic diuresis and water diuresis of diabetes insipidus.View full abstractDownload PDF (1009K)
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