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Volume 35, Issue 5
Displaying 1-12 of 12 articles from this issue
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Mamoru Kudoh1992 Volume 35 Issue 5 Pages 375-379
Published: May 30, 1992
Released on J-STAGE: March 02, 2011
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Syoh-ichi Yamagishi, Hisatsugu Miyakoshi, Yasuyuki Nishimura, Rie Take ...1992 Volume 35 Issue 5 Pages 381-384
Published: May 30, 1992
Released on J-STAGE: March 02, 2011
JOURNAL FREE ACCESSIn order to clarify the effects of impaired liver function on 1, 5-anhydroglucitol (AG) metabolism, we measured serum AG concentrations in 15 patients with compensated liver cirrhosis who had a negligible amounts of glucose in their 24-hr urine samples.Serum AG concentrations were significantly lower in cirrhotics than in normal controls (20.0±2.2 vs 26.1±1.7μg/m, p<0.05). Moreover, cirrhotics with low serum albumin (<3.5g/dl) or serum cholinesterase (<3.0 IU/l) levels had significanly lower serum AG concentrations than patients with normal values (14.3±1.0 vs 23.6±3.5μg/m/, p<0.05; 13.7±1.0 vs 24.0±3.3μg/m/, p<0.05). Mean fasting blood glucose, HbA1, fructosamine and AG clearance in cirrhotics were unaffected by their albumin or cholinesterase levels. A significant positive correlation was found between serum AG and cholinesterase levels (r=0.74, p<0.01). These findings suggest that the low serum AG concentrations of patients with cirrhosis may be the result of altered liver metabolism of AG.View full abstractDownload PDF (662K) -
Ichiro Komiya, Nobuyuki Takasu, Yoshitaka Nagasawa, Toru Aizawa, Takes ...1992 Volume 35 Issue 5 Pages 385-389
Published: May 30, 1992
Released on J-STAGE: March 02, 2011
JOURNAL FREE ACCESSIt is well known that the serum concentration of 1, 5-anhydroglucitiol (AG) decreases in diabetic patients. In this study, we evaluated the usefulness of AG measurement as a marker of glycemic control in diabetic patients with “near-normal” hyperglycemia (“near-normal” patients)(5.5≤HbA1c≤6.5%). We also examined the serum AG concentration in newly diagnosed diabetic patients (HbA1c>9.0%), patients with fair glycemic control (6.5<HbA1c<7.5%), patients with impaired glucose tolerane (IGT) and normal subjects.
The mean serum AG concentration in “near-normal” patients was 15.2±6.9μg/ml (mean±SD), which was significantly higher than in newly diagnosed patients (2.0±1.6) and patients with fair glycemic control (5.9±1.9), and definitely lower than in IGT (22.0±6.9) and normal subjects (24.3±7.9). However, the range of AG concentration in “near-normal” patients was wider (4.1-27μg/ml) than in the other 4 groups.
We divided “near-normal” patients into two groups according to AG concentration (AG<10μg/ml, AG≥10μg/ml). There were no differences in the levels of HbA1c or postprandial blood glucose (2-hour) in the two groups.When the oral glucose tolerance test was performed in some of “near-normal” patients, while 10 of the 14 patients with high AG concentrations had IGT, no patients with low AG concentrations had IGT. We concluded that AG concentrations in “near-normal” patients may reflect finer glycemic control or immediate changes in blood glucose as a result of daily diet, in which there is no change in HbA1c.View full abstractDownload PDF (681K) -
Nobuyo Kasuga, Naoko Tajima, Masato Matsushima, Teruo Kitagawa, Ronald ...1992 Volume 35 Issue 5 Pages 391-396
Published: May 30, 1992
Released on J-STAGE: March 02, 2011
JOURNAL FREE ACCESSThe present study evaluated how regional characteristics were related to the mortality status of children with IDDM. Of 1217 subjects diagnosed between 1965-1979 with age of onset less than 18 years, 83patients had died as of 1-1-1990, and the 78 whose place of residence was known were matched with 78randomly selected living controls by sex and year of diagnosis. Urban-rural indices and income indiceswere compared in patients (cases) and controls, and the date were analyzed by the Wilcoxon 2-sample test.
The results showed that population density and income ratio to national and prefectural means were higher in the controls than in the cases (p<0.01). The proportion of agricultural households, on the other hand, was lower (p<0.01). A similar pattern was seen in both sexes. The effect was most evident among patients diagnosed in 1965-69. Mortality appeared to be highest in rural and low SES areas.
Further study is necessary to clarify possible different environmental factors in urban andrural areas and high and low SES areas which might affect prognosis of children with IDDM.View full abstractDownload PDF (845K) -
Time-Course of Albuminuria and Serum Laminin P1 in an 8-year Follow up StudyShoji Kawazu, Shoichi Tomono, Norihiro Kato, Mitsuo Shimizu, Mayumi Fu ...1992 Volume 35 Issue 5 Pages 397-402
Published: May 30, 1992
Released on J-STAGE: March 02, 2011
JOURNAL FREE ACCESSThe relationship between albuminuria and the control of plasma glucose was chronologically followed up for 8 years in NIDDM patients without hypertension. In patients with normoalbuminuria in the second spotted urine in the morning (urinary albumin index: UAI<15mg/g·creatinine), 5 of 11 patients (45%) whose glycemic control was good (HbA1<9.0% and FPG<140mg/dlthroughout the observation period) and 13 out of 22 patients (59%) with poor control became microalbuminuric (15≤UAI≤200) after 8 years, respectively. Among patients already suffering from microabluminuria, 5 out of 10 patients (50%) with poor control became macroalbuminuric (UAI≥200), excreting more than twice the amount of urinary albumin, though no significant change was observed in the good-control group. The serum levels of laminin P1 in patients with poor control also significantly increased simultaneously. Thus, the development or acceleration of albuminuria in NIDDM resulted from poor glycemic control, independent of hypertension, which indicates the importance of good glycemic control.View full abstractDownload PDF (966K) -
Tadao Sugimoto, Kouji Nakanishi, Minoru Ookubo, Tetsuro Kobayashi, Tos ...1992 Volume 35 Issue 5 Pages 403-408
Published: May 30, 1992
Released on J-STAGE: March 02, 2011
JOURNAL FREE ACCESSWe studied the clinical characteristics and management of diabetes mellitus secondary to total pancreatectomy for the treatment of pancreatic or gastric cancer. With successful management, the patients have survived for 12-89 months (mean: 48.5) after surgery.
The diabetes secondary to total pancreatectomy is unique in that the patient is completely and abruptly deprived of both the endocrine and exocrine functions of the pancreas. Because of the loss of exocrine function, all patients lost their appetite and showed marked loss of body weight. Dyspepsia affected most of the patients, and they required pancreatic enzyme replacement to treat it. Because of the removal of the endocrine pancreas, diabetes developed immediately after surgery. The patients required insulin replacement therapy, however, the dose of insulin was small at the beginning, but thereafter gradually increased to the dose of insulin used to treat insulin-dependent-diabetic patients in our hospital.
One patient had frequent and prolonged hypoglycemic comas, which may have been caused by pancreatic glucagon deficiency and inadequate catecholamine secretion. The possible contribution of the latter mechanism was demonstrated by impaired catecholamine secretion in response to insulin-induced hypoglycemia in this patient (Case 1 in Fig. 2).
The present study yielded findings concerning the clinical features and special clinical management of diabetes secondary to total pancreatectomy.View full abstractDownload PDF (951K) -
The Effect of Hypoglycemia on Battery Tests of Intellectual and Cognitive Performance and Event-Related Potentials (ERPs)Tohru Kawabata, Hitoshi Yasuda, Masahiko Terada, Takashi Hisanaga, Ken ...1992 Volume 35 Issue 5 Pages 409-416
Published: May 30, 1992
Released on J-STAGE: March 02, 2011
JOURNAL FREE ACCESSThe possibility that hypoglycemia causes abnormal of neuropsychological function in diabetic patients was examined. A veriety of battery tests of intellectual and cognitive performance were performed and the P300 latency of event-related potentials (ERPs) was measured with reference to hypoglycemic episodes, glycemic control and daily fluctuations in plasma glucose levels in 46 diabetic patients without cerebrovascular disease.
Latency was significantly prolonged in patients with hypoglycemic episodes than in those without. Among diabetic patients with hypoglycemic episodes, those under poor (HbA1>10) of labile glycemic control had a lower attention (story recall) score. Patients having the 3 conditions of hypoglycemic episodes and poor and labile glycemic control tended to have more prolonged P300 latencies and significantly lower test scores, including attention, learning and memory and abstraction scores, than patients having only two of the 3 conditions.
These results suggest that neuropsychological function deteriorates in diabetic patients not only as a result of hypoglycemia but because of poor or labile glycemic control.View full abstractDownload PDF (1491K) -
Yoshihiro Hirano, Yasuji Mizumura, Yoshihiro Nakao1992 Volume 35 Issue 5 Pages 417-422
Published: May 30, 1992
Released on J-STAGE: March 02, 2011
JOURNAL FREE ACCESSA 52-year-old man with a 9-year history of diabetes mellitus was admitted to our hospital because of dysesthesia in his extremities, orthostatic dizziness and marked emaciation (body mass index 13.4). On admission a casual blood glucose was 494 mg/dl and HbA1c 14.9%. Although his blood glucose level had been improving in response to insulin treatment (14-18 U/day), hyponatremia (109 mEq/l) and hypoosmolarity (236 mOsm/l) developed 2 months after admission. Subsequent water restriction restored these abnormalities to normal levels, and further examination failed to show any renal or endocrinological disorders, or malignant lesions, central nervous system or respiratory disorders. These findings led us to a diagnosis of SIADH. A water loading test showed a negative free water clearance and the plasma ADH response was not suppressed. These findings had partially normalized 8 months after admission when diabetic neuropathy became alleviated together with weight gain. These results suggest that a diabetic autonomic neuropathy could induce SIADH via osmoreceptor dysfunction.View full abstractDownload PDF (933K) -
Satoshi Ohguni, Kazumi Notsu, Yohji Masaki, Yuzuru Kato1992 Volume 35 Issue 5 Pages 423-427
Published: May 30, 1992
Released on J-STAGE: March 02, 2011
JOURNAL FREE ACCESSA 34-year-old woman with insulin-dependent diabetes mellitus (IDDM) was admitted to our hospital for glycemic control before bilateral cataract surgery. Glycemic control deteriorated during the luteal phase and just before menstruation during the 3-month period of continued strict diet therapy and CSII treatment.
Insulin sensitivity was assessed using the euglycemic clamp technique during the menstrual cycle. The glucose infusion rate (GIR) was lower in the luteal phase than in the menstrual or the follicular phases. Insulin resistance in the luteal phase was accompanied by elevated serum progesterone concentrations.
These findings suggest that changes in insulin sensitivity due to the menstrual cycle are one of the factors adversely affecting blood glucose control in women with IDDM.View full abstractDownload PDF (721K) -
A Case of Rhabdomyolysis Caused by Hyperosmolar Non-Ketotic Diabetic Coma with Prader-Willi SyndromeTsutomu Kanda, Makoto Iwasaki, Masahiko Wada, Mariko Kurotobi, Yohji S ...1992 Volume 35 Issue 5 Pages 429-435
Published: May 30, 1992
Released on J-STAGE: March 02, 2011
JOURNAL FREE ACCESSWe encountered the first case of Prader-Willi syndrome with hyperosmolar non-ketotic diabetic coma complicated by rhabdomyolysis in Japan.
The patient, a 21-year-old woman, was diagnosed as having type 2 diabetes mellitus in May 1986 and treated with diet therapy alone.She drank a great deal of juice without diet therapy from November 1989 onwards because of decayed teeth.She was admitted to a hospital because of diabetic coma on December 6, 1989, but failed to improve despite treatment. The next day she was transferred to our hospital. At that time she had muscle weakness, urinary tract infection and becteremia.Laboratory invesitgation revealed a plasma glucose of 736 mg/dl, osmolarity of 485 mOsm/l, pH of 7.449, serum LDH of 1682 IU/l, CPK of 981 IU/l (98% of the isozyme consisting of the MM type), myoglobin of 1376 ng/ml and Na of 188 mEq/l.
A diagnosis of HNKC was made, and a half day after treatment her consciousenss became clear, 4 days after treatment her muscle weakness disappeared, and 10 days after treatment her serum levels of LDH, CPK and myoglobin declined to within the normal range.
These observations indicate that the patient developed HNKC as a result of overeating and infection, and that rhabdomyolysis was complicated by hypernatremia, dehydration and insulindeficiency.View full abstractDownload PDF (1037K) -
Yutaka Mori, Masami Nemoto, Junichi Yokoyama, Masahiko Nishimura, Yosh ...1992 Volume 35 Issue 5 Pages 437-440
Published: May 30, 1992
Released on J-STAGE: March 02, 2011
JOURNAL FREE ACCESSWe have examined the distribution of subpopulations of infiltrating lymphocytes in the pancreatic islets of diabetic LETL rats immunohistochemically by a method which uses monoclonal antibodies specific for rat lymphocytes.Cryostat sections of the pancreas from diabetic LETL rats aged 8 to 15 weeks were immunostained by the SAB method using MRC OX-34, W3/25, OX-8, OX-33, OX-39 and anti-asialo GM1, which recognize pan-T cells, T helper cells (Th) and some macrophages, T suppressor/cytotoxic cells (Tc/s), B cells, interleukin-2 receptors, and natural killer cells and some macrophages, respectively.Pancreatic islets from diabetic LETL rats showed islet destruction with severe insulitis. Most infiltrating mononuclear cells were found to be positive for OX-34 antigens. These T lymphocytes consisted of W3/25-positive cells and OX-8-positive cells. However, no interleukin 2 receptor expression on these lymphocytes or anti-asialo GM1 positive cells was observed. We conclude that T lymphocytes predominate among the infiltrating lymphocytes and that interleukin 2 receptor positive lymphocytes may disappear after the complete destruction of /3-cells in LETL rats.View full abstractDownload PDF (3193K) -
1992 Volume 35 Issue 5 Pages 441-449
Published: May 30, 1992
Released on J-STAGE: March 02, 2011
JOURNAL FREE ACCESSDownload PDF (2066K)
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