Kobe West City Hospital is located in the region most severely damaged during The Great Hanshin Earthquake. The influence of the earthquake on the glycemic control of 177 diabetics in our hospital was investigated retrospectively. The values of HbA1c before and after the earthquake were compared. The mean value of HbA1c increased significantly after the earthquake (7.74±1.82% vs 8.34±2.07%; p<0.01). Ninety nine of 177 patients (55.9%) showed a greater than 0.5% increase in HbA1c after the earthquake. We examined the causes of this exacerbation. The level of HbA1c was not significantly changed by the following factors, the opportunity to exercise, the state of the state patients' houses, or from long-term residence in shelters, sex or age.The increase in HbA1c was more frequently observed in the patients receiving insulin therapy than those with other therapy. An interruption of drug therapy was seen in 15 of 144 patients. Fluctuations in HbA1c were also compared between patients with appropriate diet (AD) and those with inappropriate diet (IAD). The increase in HbA1c was statistically significant in patients with IAD (p<0.01), but not in patients with AD. This study showed an increase in HbA1c in diabetic patients after The Great Hanshin Earthquake. The increase in HbA1c was mostly caused by IAD.
We investigated the diagnostic accuracy of a combined radioligand binding assay (RBA) for both glutamic acid decarboxylase (GAD) 65 and IA-2 autoantibodies (Ab), compared to separate RBAs for each autoantibody. 35S-GAD65 and 3H-IA-2 were produced by in vitro translation. Sera from 18 insulin-dependent diabetes mellitus (IDDM) patients and 20 healthy subjects were tested. Neither GAD65 nor IA-2 was detected by either combined or separate RBAs in the healthy subjects. In the IDDM patients, the concordance between the two RBAs for GAD65Ab was 100%. The concordance for IA-2, however, was 89%, because two sera with high titer GAD65Ab were falsely positive. There were strong correlations between the indexes of the two RBAs (r=0.982, r=0.965 for GAD65 and IA-2, respectively). In conclusion, the combined RBA for GAD65Ab and IA-2Ab has good diagnostic accuracy and will be a useful screening test for large numbers of NIDDM patients or for the general population.