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Volume 38, Issue 4
Displaying 1-9 of 9 articles from this issue
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[in Japanese]1995 Volume 38 Issue 4 Pages 243-245
Published: April 30, 1995
Released on J-STAGE: March 02, 2011
JOURNAL FREE ACCESSDownload PDF (382K) -
Teiko Amemiya, Reiko Kawahara, Masayo Yoshino, Masatoshi Fukuda, Yasue ...1995 Volume 38 Issue 4 Pages 247-253
Published: April 30, 1995
Released on J-STAGE: August 04, 2011
JOURNAL FREE ACCESSThe present study was designed to examine the relationship between the severity of retinopathy and general status 10 years after xenon photocoagulation was performed on 139 subjects (200 eyes) with proliferative retinopathy between June 1, 1971 and December 31, 1979. The immediate success rate after 6-12 months was 83.5%.
Sixty-eight patients (48.9%) were still coming to our hospital, 29 (20.9%) have died, and 42 (30.2%) have been lost to follow-up. The major causes of death were cerebrovascular accidents and cardiovascular disease, followed by renal failure and infection. Eighteen of the 42 patients who could not be followed up had been referred to local hospitals because of their physical disability, but the reason for the other drop-outs is unknown.
After 10 years the fundus findings had improved in 52 eyes (50%) of the 68 patients (104 eyes) available for the study, they were unchanged in 19 eyes (18.2%) and had deteriorated in 33 eyes (31.7%). Fifty five eyes (52.9%) exhibited non-proliferative retinopathy, 32 eyes (30.8%) proliferative retinopathy, and 17 eyes (16.3%) were blind.
Multiple regression analysis revealed that progression of retinopathy was significantly associated with poor glycemic control alone, all other factors (e. g., gender, age, duration of diabetes, body mass index, blood pressure, serum lipid levels and ischemic ECG changes) were insignificant.
These findings suggest that long-term glycemic control of diabetes is significantly related to the progression of retinopathy, even after photocoagulation.View full abstractDownload PDF (1018K) -
Masao Yano, Eisuke Maehata, Hiroji Shimomura, Minoru Yamakado, Hiroshi ...1995 Volume 38 Issue 4 Pages 255-260
Published: April 30, 1995
Released on J-STAGE: August 04, 2011
JOURNAL FREE ACCESSAlthough the oral glucose tolerance test is widely used to identify subjects with glucose intolerance or diabetes mellitus, it is often pointed out that there are many inconveniences in the performance of this test. The Japan Society of Multiphasic Health Testing and Services has recommended a combination of fasting blood glucose(FBG) and hemoglobin A1C(HbAie), which has been reported to have a sensitivity of 74.5% for screening.
In this study we evaluated the effect of 1, 5 anhydroglucitol(1, 5-AG) in improving screening sensitivity. Addition of 1, 5-AG to a combination of FBG and HbA1C resulted in a significant improvement in sensitivity for screening diabetic patients(89.6%, p <0.05), and a specificity of 80.5% was obtained. When subjects in the IGT-2 group(a high risk group for diabetes) with high glucose levels 2 hour after a glucose load were included, screening sensitivity was 91.6% and specificity was 75.4%, also showing a significant improvement (p <0.05) compared to combination of FBG and HbA1C without 1, 5-AG. We therefore conclude that addition of 1, 5-AG to FBG and HbA1C would greatly improve the screening of both diabetic patients and subjects with glucose intolerance at high risk.View full abstractDownload PDF (922K) -
Yukari Asakura, Hiroshi Nonogi, Kazuo Haze, Akira Satoh, Masaaki Suzuk ...1995 Volume 38 Issue 4 Pages 261-266
Published: April 30, 1995
Released on J-STAGE: March 02, 2011
JOURNAL FREE ACCESSIn order to evaluate the relationship between frequency of restenosis after percutaneous transluminal coronary angioplasty (PTCA) and glycemic control in patients with NIDDM, we assessed 86 NIDDM with stable angina pectoris who underwent elective and successful PTCA after excluding those with familial hypercholesterolemia, renal failure, unstable angina or coronary artery bypass graft surgery within 1 month previousty, between 1983 and 1991. Blood pressure, body mass index, history of smoking, fasting blood glucose, HbA1c, total cholesterol, triglyceride, number of stenotic vessels, and restenosis rate were assessed. The frequency of restenosis within one year after PTCA was significantly greater a poorly controlled NIDDM than in well or fairly well controlled NIDDM. Multivariate analysis showed that the degree of diabetic control was significantly correlated with restenosis. These findings indicate that diabetic control plays an important role in restenosis after PTCA.View full abstractDownload PDF (926K) -
Effects of Glycemic ControlYoshikazu Goriya, Masayuki Matsumoto, Hiroshi Tsuchiya, Mikihiro Takas ...1995 Volume 38 Issue 4 Pages 267-273
Published: April 30, 1995
Released on J-STAGE: March 02, 2011
JOURNAL FREE ACCESSThe clinical data of 10 elderly diabetics who developed dementia were assessed to elucidate factors affecting dementia. When the frequency distribution of FBG and HbA1c levels in elderly diabetics was investigated, dementia was found to occur frequently in both well-controlled and poorly controlled diabetics. The diabetics were then divided into a well-controlled group (n=6) and a poorly controlled group (n=4) according to their degree of glycemic control. Non-demented diabetics matched for age, sex, BMI, duration and treatment served as a matched-control group (n=10). FRG and MA1c. were reviewed retrospectively to assess the effects of preceding glycemic control on mental deterioration. HbA1c. levels were significantly lower in the well-controlled group and higher in the poorly controlled group than in the matched-control group beginning 12 months before the onset of dementia but differences in FBG values were not significant. Thus, it was concluded that chronic hyperglycemia with HbA1c levels over 10% for a year can serve as a risk factor for vascular dementia with CVA and hypertension and that even chronic subclinical hypoglycemia with HbA1c, levels below 7% for a year can serve as a risk factor for hypoglycemic dementia with or without vascular dementia in elderly diabetics over 75 years of age treated with insulin or oral hypoglycemic agents.View full abstractDownload PDF (824K) -
Yasuhiko Kido, Fumiaki Koyama, Shunji Miake, Yukimasa Hirata1995 Volume 38 Issue 4 Pages 275-282
Published: April 30, 1995
Released on J-STAGE: August 04, 2011
JOURNAL FREE ACCESSSince Jan 1993 we have been investigating the effect of restriction of dietary protein on progression of the nephrotic syndrome in seven consecutive nephrotic inpatients with non-insulin-dependent diabetes mellitus(NIDDM)(restriction of dietary protein group, group R). All of the patients were assigned a low protein diet(0.7g/kg of IBW/day). For comparison with group R, five other consecutive inpatients were chosen as a control group(group C) based on medical records before Dec 1992. All baseline clinical characteristics of renal disease in the two groups were comparable. The amounts of protein given were 0.70±0.05g/kg in group R and 1.24±0.28g/kg of IBW/day in group C(mean±SD, P<0.001), respectively.
In group R, edema improved with medical treatment within one month in all patients. After institution of diet-therapy, only two patients changed hospitals for dialysis, one, who had advanced end-stage renal disease, at 3 months, and the other, whose compliance with dietary therapy became poor after discharge, at 9 months. In group C, on the other hand, nephrosis deteriorated in four of the five patients. In all four patients, renal failure rapidly progressed and required hemodialysis within 6 months after institution of therapy.
In conclution, a low protein diet(in this study, average 0.7g/kg of IBW/day) can ameliorate not only the nophrotic syndrome but the clinical course of renal failure in nephrotic patients with NIDDM.View full abstractDownload PDF (1186K) -
Keiko Yanagisawa, Teiko Amemiya, Yuko Morita, Hiroyuki Kuroki, Mayumi ...1995 Volume 38 Issue 4 Pages 283-288
Published: April 30, 1995
Released on J-STAGE: August 04, 2011
JOURNAL FREE ACCESSWe report a case of insulin-dependent diabetes mellitus (IDDM) which developed during interferon therapy for chronic hepatitis C. The subject was a 37-year-old man and interferon therapy for chronic active hepatitis C was started in December, 1992. Thirst, polyuria, polydipsia and weight loss were first noted in April, 1993. After a total dose of 3.84 x 108 units of interferon a, the patient was admitted because of diabetic ketosis. On admission, his blood glucose level was 712mg/dl, serum ketone bodies were 3, 960 Emol// and the anti-GAD antibody titer was 52, 590 units/ml. In February, before the onset of IDDM, his anti-GAD antibody titer was 3, 249 units/ml. There have been several reports on the occurrence of autoimmune disease and autoimmune-antibodies associated with interferon therapy. In this patient, the anti-GAD antibody titer rose during interferon therapy, suggesting the development of insulin-dependent diabetes mellitus associated with interferon therapy.View full abstractDownload PDF (720K) -
Takahiro Noguchi, Toshimitsu Okeda, Tomoko Nawata, Yasuko Ito, Masatos ...1995 Volume 38 Issue 4 Pages 289-295
Published: April 30, 1995
Released on J-STAGE: March 02, 2011
JOURNAL FREE ACCESSNN'e report a case of efficacy of CAPD therapy in improving diabetic retinopathy associated with chronic renal failure.A 43 year-old woman with a 14-year history of diabetes mellitus was admitted to our hospital because of nephrosis.She had retinal edema, especially in the macula lutea, and proliferative changes in both eyes.After the edema improved, her left ocular fundus was treated by photocoagulation.No treatment was performed on her right eye.One year later, she underwent CAPD therapy.Five months later, retinal bleeding, edema and neovascularization of both fundi had improved, but retinachoroid atrophy and decreased visual acuity in her left eye had not improve. These findings suggest that photocoagulation for diabetic retinopathy with retinal edema may have an adverse effect, and that early dialysis therapy is necessary to improve diabetic retinopathy.View full abstractDownload PDF (5084K) -
[in Japanese]1995 Volume 38 Issue 4 Pages 297-330
Published: April 30, 1995
Released on J-STAGE: March 02, 2011
JOURNAL FREE ACCESSDownload PDF (8141K)
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