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Volume 39, Issue 9
Displaying 1-9 of 9 articles from this issue
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Nobuaki Watanabe, Yasuaki Fukumoto, Mitsuyoshi Namba, Toshiaki Hanafus ...1996 Volume 39 Issue 9 Pages 679-686
Published: September 30, 1996
Released on J-STAGE: March 02, 2011
JOURNAL FREE ACCESSThe effect of combination therapy consisting of an α-glucosidase inhibitor (acarbose) and conventional insulin therapy was evaluated in 19 non-insulin-dependent diabetic patients. The blood glucose levels of these elderly inpatients (72±7 years-old) were fairly controlled after a pretreatment period with conventional insulin therapy alone. Acarbose was administered orally immediately before each meal for 4 weeks. It significantly reduced postprandial blood glucose levels (after breakf ast: 210±45mg/dl to 166±41mg/dl, P<0.01, after lunch: 219±48 to 168±61, P<0.001, after dinner: 237±49 to 174±63, P<0.001), and this was accompanied by a signif icant decrease in HbA1c (8.6±1.7%to7.4±0.7%, P<0.001) and a significant increase in serum 1, 5-anhydroglucitol (4.8±3.5μg/mlto 6.1±2.4μg/ml, P<0.05). Serum C-peptide levels 2 hours after breakfast were significantly decreased after 4 weeks of combined therapy (3.8±2.1ng/ml to 3.2±1.9ng/ml, P<0.02), whereas serum C-peptide levels before breakfast were unaffected. These results indicate that an a-glucosidase inhibitor such as acarbose has a beneficial effect on postprandial hyperglycemia and postprandial hyperinsulinemia in NIDDM patients treated with conventional insulin therapy.View full abstractDownload PDF (1242K) -
The Causes, Risk Factors, Background and Life PrognosisYasuo Kida, Atsunori Kashiwagi, Rie Ide, Touru Kawabata, Katsuhiko Sak ...1996 Volume 39 Issue 9 Pages 687-692
Published: September 30, 1996
Released on J-STAGE: March 02, 2011
JOURNAL FREE ACCESSDiabetic retinopathy is known to be the leading cause of acquired blindness. We investigated the prevalence, causes, clinical characteristics and prognosis of blind subjects in 615 non-insulin dependent diabetes mellitus (NIDDM) patients.
The prevalence of binocular blindness and severe visual impairment was 4%(n=24) and 8%(n=51), respectively. Among the groups with visual impairment, which had a significantly longer duration, younger start and higher percentage of insulin treatment of diabetes than the group with good visual acuity, the blind group had the longest duration, the youngest start and the highest percentage of insulin treatment. The serum levels of HDL-cholesterol tended to be lowest.
Fourteen (58%) of the 24 blind subjects were on hemodialysis because of renal failure.The chief causes of blindness were: vitreous hemorrhage, retinal detachment, maculopathy, neovascular glaucoma, and/or cataract. Multiple regression analysis established aging, proliferative retinopathy, cataract, nephropathy, insulin therapy, and duration of diabetes as independent risk factors for visual impairment.Although there was no significant correlation between plasma glucose levels and blindness, probably because this study was cross-sectional, the patients'historyrevealed thatprevious control of diabetes had been very poor in the blind subjects. The high mortality rate of the blind subjects (245/1000 person-year) during the short observation period indicates that the life prognosis of blind diabetic subjects is very poor.View full abstractDownload PDF (1166K) -
Kenya Sakamoto, Tuyoshi Shimonagata, Shinsuke Nanto, Akio Kuroda, Taka ...1996 Volume 39 Issue 9 Pages 693-698
Published: September 30, 1996
Released on J-STAGE: March 02, 2011
JOURNAL FREE ACCESSTo elucidate the mechanisms of diabetic cardiomyopathy, dual SPECT imaging with thallium-201 (T1-201) and I-123 beta-methyl-p-iodophenyl pentadecanoic acid (BMIPP), a branched analogue of free fatty acid (FFA), and dipyridamole-infusion T1-201 scintigraphy were performed in 28 NIDDM patients without coronary artery disease. Twenty eight patients were divided-into two groups based on the presence of wall motion abnormalities on cineangiographic leftventriculography (LVG). Nineteen patients with normal wall motion documented on LVG (group A) out of 28 evaluated patients demonstrated normal T1-201 and I-123 BMIPP uptake in dual SPECTimaging, whereas 9 patients with reduced wall motion (group B) demonstrated reduced I-123 BMIPP uptake when compared with T1-201 uptake. On dipyridamole-infusion T1-201 scintigraphy, transient perfusion defects were demonstrated in 4 patients of group B and two patients of group A (p< 0.05). These results suggest that small vessel disease and the impairment of myocardial free fatty acid metabolism are etiologic or contributory factors for regional wall motion abnormality in diabetic cardiomyopathy.View full abstractDownload PDF (1104K) -
Profiles in Diabetic Patients with End-Stage Renal Disease (ESRD)Munehiro Miyamae, Tetsuya Babazono, Reiko Kawahara, Osamu Tomonaga, Ya ...1996 Volume 39 Issue 9 Pages 699-706
Published: September 30, 1996
Released on J-STAGE: March 02, 2011
JOURNAL FREE ACCESSTo determine the impact of renal replacement therapy (RRT) on serum lipid profiles in diabetic patients with ESRD, we measured serum lipids, apolipoproteins andlipoprotein (a)[Lp (a)] in diabetic patients undergoing hemodialysis (n =48), continuous ambulatory peritoneal dialysis (CAPD, n=17), and kidney transplantation (n=14), and in normal subjects (n=40). These parameters were compared using analysis of covariance to eliminate the effect of age on the lipid profiles.
HDL cholesterol (HDL-C) and Apo A-I levels were markedly elevated in the transplant patients. In contrast, HDL-C levels in the hemodialysis and CAPD patients were significantly lower than those in the normal subjects. Serum lipid and apolipoprotein levels other than HDL-C were similar among the male ESRD groups.
However, total cholesterol, Apo B, Apo CAT and Apo CAI levels were significantly higher in the female ESRD groups than in the normal female subjects. In addition, triglyceride levels were significantly increased in the female patients on hemodialysis and CAPD. No difference was found in Lp (a) levels among the four groups.
From these results, we conclude that Kidney transplantation is less associated with atherogenic lipid profiles than hemodialysis and CAPD in aiabetic patients.View full abstractDownload PDF (2718K) -
Kazuhisa Takami, Noriyuki Takeda, Junko Hanafusa, Kayoko Adachi, Hiros ...1996 Volume 39 Issue 9 Pages 707-712
Published: September 30, 1996
Released on J-STAGE: March 02, 2011
JOURNAL FREE ACCESSCystic fibrosis is very rare in Japan. The clinical features of diabetes mellitus associated with cystic fibrosis in Japanese are largely unknown. We present a Japanese patient with cystic fibrosis and diabetes mellitus in whom cystic fibrosis was unrecognized until adulthood. The patient, a 22-year-old non-obese woman was admitted to our hospital because of pulmonary infection and deterioration of diabetes mellitus. Diabetes was diagnosed at age 12 when she experienced an episode of ileus, and she has been treated with insulin ever since. The patient had experienced recurrent episodes of respiratory infection with concomitantexacerbation of diabetes over the previaus several years. On admission her plasma glucose was 462 mg/dL and there was no ketonuria. Pulmonary infection was controlled by antibiotics but repeated sputum cultures always yielded Pseudomonas aeruginosa.
Urinary recovery of PABA following BT-PABA ingestion revealed impaired pancreatic exocrine function. Cystic fibrosis was diagnosed based on a sweat Cl concentration greater than 60 mEq/L. Islet cell antibodies were negative.The common CF mutations reported in Caucasians, Δ F508, G542X, G551D, and R533X were not detected. The clinical characteristics of this patient's diabetes, including juvenile onset without obesity and the absence of ketoacidosis even in the face of rather severe hyperglycemia, closely matched the typical features of diabetes mellitus associated with cystic fibrosis in Caucasians.View full abstractDownload PDF (2721K) -
Junnosuke Miura, Akiko Saeki, Naohito Suzuki, Asako Sato, Naoko Iwasak ...1996 Volume 39 Issue 9 Pages 713-719
Published: September 30, 1996
Released on J-STAGE: March 02, 2011
JOURNAL FREE ACCESSA 66-year-old woman with poorly controlled diabetes mellitus developed spiky continuous fever for one month. After admission, she fell suddenly into respiratoryfailure with interstitial shadowin both of the lung fields by chest x-ray examination. This was diagnosed as adult respiratorydistress syndrome following DIC. In addition, the remarkable finding of a 2560 fold increase in antinuclear antibody (ANA) levels suggested that the syndrome was linked with a connective tissue disease with interstitial pneumonia. Steroid treatment, however, failed to cure the respiratory failure. Chest x-ray examination findings gradually changed toward milliary shadow, which required MTC-PCR and culture of Mycobacterium Tuberculae. Finally, she was diagnosed with disseminated milliary tuberculosis. These results taken together with the abnormal levels of ANA suggested that autoimmunological disturbances had occurred following severe systemic infection by Mycobacterium Tuberculae in this poorly controlled diabetic patient who was an immunocompromised host.View full abstractDownload PDF (2622K) -
Hiroaki Seino, Akihiko Hirata, Hirosi Yamaguchi, Toshio Yamazaki, Hiro ...1996 Volume 39 Issue 9 Pages 721-727
Published: September 30, 1996
Released on J-STAGE: March 02, 2011
JOURNAL FREE ACCESSWe have experienced some patients with diabetic ketoacidosis complicated with acute pancreatitis, who had elevated serum levels of amylase, lipase and elastase-1. In case 1, a 46 year-old man was admitted to our hospital because of diabeticketoacidosis. Laboratory findings revealed a blood glucose level of 763 mg/dl and a pH level of 6.93. In case 2, a 43 year-old man was adamitted becauseof diabetic ketocidosis, and laboratory findings revealed a blood glucose level of 1573 and pH levels of 7.19. During the treatment of diabetic ketoacidodis, themaximum serum levels of amylase and lipase were 762u/l and 520u/l respectively in case 1, and the maximum serum levels of amylase, elastase-1 and pancreatic phospholipase-A2 were 2107u/l, 8310ng/dl and 34300ng/dl respectively in case 2. We measured the serum cytokine levels of IL-6, IL-1βand GM-CSF in these two cases by ELISA. Only IL-6 was detected in the serum of the two patients with diabetic ketoacidosis complicated with acute pancreatitis. The maximum serum level of IL-6 was 380pg/ml in case 1 and 80pg/ml in case 2. In the other two cases of diabetic ketoacidosis which was not complicated with acute pancreatitis, the serum levels of IL-6 were at the lower levels of 14 pg/ml and 11pg/ml.
Serum IL-6 in patients with diabetic ketoacidosis may induce acute pancreatitis. According to our knowledge, this is the first report of detection of IL-6 in the serum of patients with diabetic ketoacidosis complicated with acute pancreatitis.View full abstractDownload PDF (990K) -
Tomofusa Ishii, Sirou Tanaka, Koichi Kawasaki, Toshihiko Satou, Satoru ...1996 Volume 39 Issue 9 Pages 729-732
Published: September 30, 1996
Released on J-STAGE: March 02, 2011
JOURNAL FREE ACCESSTo examine the effect of resistance training (RT) on insulin sensitivity we studied 13 previously sedentary non-obese non-insulin dependent diabetics (NIDDM) before and after 4-6 weeks of either RT (n=8) or no exercise (sedentary controls, n=5). The training program consisted of 2 sets of the following 9 exercises with 10-20 repetitions: arm curl, military press, push ups, squat, knee extension, heel raise, back extension, bent knee extension and upright rowing. Subjects trained 5 times a week. Glycosylated hemoglobin, insulin sensitivity assessed by euglycemic hyperinsulinemic clamp, body composition by dualenergy X-ray absorptiometry and maximal oxygen uptake (VO2max) were measured before and after the training period in both groups.
The two groups did not differ significantly on any variables before the programs. Glucose disposal rates (GDR) during the euglycemic hyperinsulinemic clamp increased 47% in the RT group (6.69±1.92 to 9.84±3.24 mg/kg lean body mass/min, p<0.005) and did not change in the sedentary controls (6.38±1.97 to 6.83 ± 1.92 mg/kg lean body mass/min). Glycosylated hemoglobin improved significantly in a similar manner in both groups. There was no significant change in VO2max in the RT group.
It was concluded that RT improved insulin sensitivity in non-obese NIDDM without any changes in VO2max.View full abstractDownload PDF (497K) -
1996 Volume 39 Issue 9 Pages 733-753
Published: September 30, 1996
Released on J-STAGE: March 02, 2011
JOURNAL FREE ACCESSDownload PDF (5879K)
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