Serum glycated aibumin (GA) is used in ciinical dliabetes as an index of glycemic control for the preceding two weeks. GA was measured in pregnant normal and diabetic women by GAA 2000 (Kyoto Daiichi Kagaku).
We studied the usefulness of GA in evaiuating the control of pregnant diabetics in comparison with fructosamine and HbA1c measured in the same sample.
There was no difference between GA in normal non pregnant and normal pregnant women. In diabetic women GA normalized faster than HbA1c, during pregnancy, according to glycemic control, and as fast as fructosamine.
GA measured by this method was not influenced by protein or albumin, and normalized faster than HbA1c. These findings suggest that GA is an useful index of control in pregnant diabetics.

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As reported previously, we have been conducting studies on the cause of death among diabetic patients during the past 25 year period, 1960-1984, in Osaka Japan. We added the most recent 5 year data for 1985 1989, and analyzed changes in causes of death during the 30-year period as a whole. The material used as the subject of this study were 32, 222 death certificates filed in Osaka Prefecture during 1960 1989, mentioning diabetes either as the underlying cause or a contributory condition. The ratio of death certificates mentioning diabetes as the underlying cause, which had decreased during the previous 25 year period, showed a further decrease, reaching its minimum figure, 33.4%, in1985 1989. The mean age at death exceeded 70 years for all causes of death, showing a continuous increasing trend. An increase in disease of the heart and a decrease in cerebrovascular disease were observed, making the difference between the two causes greater since 1980 1984. Malignant neoplasms, ischemic heart disease and pneumonia and bronchitis also exhibited a steady increase. The O/E ratio of malignant neoplasms was as low as about 0.5, suggesting a low defection rate of diabetic cases with cancer. Among malignant neoplanms, an increasing trend to ward liver cancer was remarkable, with a relatively high O/E ratio, suggesting a pathogenetic relationship between the metabolic disturbance in diabetes and liver cancer.

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We report a case of diabetic microangiopathic hemolytic anemia (1¥111A) caused by steroid withdrawal. On March 1989, a 61-year-old woman presented with diabetes mellitus complicated only by simple retinopathy. During her first admission, in March 1989, treatment consisted of glybenclamide and glycemic control was well maintained. Her local physician had been prescribing steroids to her arthritis for 12 years. She discontinued taking the steroids on Dec., 1989 when her local physician died. In Feb. 1990, she was admitted because of proliferative retinopathy, marked proteinuria, hypertension and severe anemia (hemoglobin concentration 6.5 g/d/, hematocrit 19.3%). Her peripheral blood smear contained fragmented erythrocytes associated with shortened Cr-red cell survival (12 days). These findings indicated microangiopathic hemolytic amenia. The clinical course suggests that the diabetic MHA may have been associated with steroid withdrawal. Steroids are known to affect platelets. Platelet abnormalities associated with steroid withdrawal may play a role in the pathogenesis of diabetic MI IA.

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Recent studies have demonstrated that free radicals and/or cytokines secreted by macrophages are involved in autoimmune islet destruction and that several antioxidants prevent the development of type I diabetes in animal models. CS-045 is a newly developed oral antidiabetic agent.This agent lowers plasma glucose in NIDDM by increasing insulin sensitivity and also displays strong anitioxidative effects. In this study, the effect of CS-045 as an antioxidant on the development of autoimmune diabetes was studied.NOD female mice were given either a standard or 0.2%CS-045-containing diet at 5 weeks of age. Cyclophosphamide (150mg/kg) was injected intraperitoneally at 10 weeks of age. After cyclophosphamide injection, animals were screened for diabetes for 4 weeks and sacrificed at 14 weeks of age. During the screening period, 14 of the 24 control mice became diabetic, whereas, only one mouse fed CS-045 (1/15) developed diabetes. Although, there was no difference percentage of between groups in insulitis (48.9±17.1vs62.2±18.7%, us), islet β cell mass was well preserved in CS-045 treated mice in comparison with control mice (0.26±0.17vs0.06±0.01%, P<0.01). These findings indicate that CS-045 retained more islet β cells and reduced the incidence of diabetes in NOD mice.

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Lipids extracted from erythrocyte membranes were analyzed by gas chromatographic mass spectrometry.7-ketocholestadiene (KD) was identified in diabetics as a product of cholesterol peroxidation, but not identified in healthy subjects. In addition, a significant correlation was found between HbA_1c values and relative peak areas of KD and cholesterol in the chromatograms.
These results suggest that 1) lipid peroxidation occurs not only to unsaturated fatty acids but to cholesterol in erythrocyte membranes, and 2) KD from erythrocyte membranes is suitable as marker of lipid peroxidation and is a useful indicator of peroxidative damage in diabetics.

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