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Volume 41, Issue 10
Displaying 1-12 of 12 articles from this issue
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Nobuaki Watanabe, Masato Iida, Shuji Kawamura, Koichi Seki1998 Volume 41 Issue 10 Pages 863-868
Published: October 30, 1998
Released on J-STAGE: March 02, 2011
JOURNAL FREE ACCESSAutoantibodies to glutamic acid decarboxylase (GAD-Ab) were measured by radioimmunoassay in280patients with non-insulin-dependent onset of diabetes. Ten patients were considered to be positive. Their mean age was59years and their mean body mass index was20.8kg/m2. Though anti-thyroid antibodies were positive in4patients, islet cell antibody was negative in the8patients tested. In4patients, for the lack of residual β-cell function, multiple insulin therapy was required. On HLA analysis, 6patients had class II haplotypes which confer susceptibility to IDDM. In contrast, a patient whose β-cell function was well preserved had IDDM-resistant alleles. In the5 patients whose initial GAD-Ab titers were higher (34-108U/ml), the titers declined continuously over several months. In the3patients whose initial titers were lower (5-6U/ml), GAD-Ab turned negative within a year. In the course of declining of the titers, serum C-peptide immunoreactivity did not change significantly. Though GAD-Ab is useful in screening for patients with slowly progressive IDDM, earlier examination should be conducted for precise diagnosis.View full abstractDownload PDF (865K) -
Akiko Hayakawa, Minoru Okubo, Jun-ichi Osuga, Tetsuro Kobayashi, Koji ...1998 Volume 41 Issue 10 Pages 869-876
Published: October 30, 1998
Released on J-STAGE: March 02, 2011
JOURNAL FREE ACCESSThe incidence of macrovascular complicationts and associated nisk faceors was determined in102 Japanose IDDM paeients (54males and48femnates). Soventeen paeaenes (16.7%) were identified as having complications; these included10with ischemic heart diseaso (IHD), 5with corebrovascular disease, and5with arteriosclerosis obliterans. Three with IHD had other complications. The incidence of complicatiomts increased with age, but gender differences were not observed. Fasting triglyceride and hemoglobin A1c lovels were higher in patients with complications than in those without them. The duration of diabotes was longer and the HDL-cholesterol concontration was lower in patients with complications, especially in those with IHD. However, triglyceride and hemoglobin A1c levels were not significantly different between pationts with and without IHD. These results suggost (1) that the incidonce of macrovascular complications in Japan is as high as that among Western comtries, incroasing with age and duration of diabotes;(2) there is no gender difference in lDDM; and (3) patients with macrovascular complicataons had lower HDL-cholesterol levels than patients without the complications.View full abstractDownload PDF (1240K) -
Koichi Hirao, Toru Kinoshita, Shinichi Urata, Setsuko Hirao, Hajime Ma ...1998 Volume 41 Issue 10 Pages 877-883
Published: October 30, 1998
Released on J-STAGE: March 02, 2011
JOURNAL FREE ACCESSThe euglycemic hyperinsulinemic clamp (insulin clamp) technique was used to determine the effect of Voglibose on insulin resistance. Voglibose and/ or sulfonylurea (SU) were administered to 18 patients with non- insulin- dependent diabetes mellitus (NIDDM), in order to assess the effect of voglibose on insulin sensitivity. Hemoglobin Aic (HbAic) was stabilized at less than 8%, by voglibose and/ or SU, and a euglycemic hyperinsulinemic clamp study was performed. Patients were then instructed not to change their amount of daily exercise and to maintain their body weight. After 6 months or more, another euglycemic hyperinsulinemic clamp study was performed to measure the patients' changes in insulin sensitivity. A multiple regression analysis was used to assess the effect of voglibose on changes in the M- value, excluding the effect of SU. The patients were interviewed monthly, and no changes in daily exercise were recorded. There were no statistically significant alterations in HbAic or body mass index (BMI), between the first and second insulin clamps. Voglibose adjusted for treatment with SU significantly (p=0. 006) elevated the Mvalue, which denotes the amount of glucose metabolized, but SU did not elevate it. Voglibose not only cerdrols postprandial hyperglycemia, but also improves impaired insulin sensitivity.View full abstractDownload PDF (822K) -
Yoh Miyashita, Yosiaki Itoh, Shouichiro Hashiguchi, Mitsuya Totsuka, T ...1998 Volume 41 Issue 10 Pages 885-890
Published: October 30, 1998
Released on J-STAGE: March 02, 2011
JOURNAL FREE ACCESSA high carbohydrate and low fat diet is widely used for patients with non-insulin dependent diabetes mellitus (NIDDM). But, for a low calory diet for NIDDM patients with obesity, the adequate composition is not yet established. Despite recommendation for such a diet, there is no consensus about its optimal composition. This study was conducted to determine the effects of the low carbohydrate content of a low calory diet for NIDDM patients with obesity. Twenty-six NIDDM patients with obesity (mean body mass index, 28.7±3.4) were given two low-calory study diets (1000kcal/day), a high-carbohydrate diet (F: P: C=26: 10: 62) and a low carbohydrate diet (F: P: C=25: 35: 39), for a period of 2 weeks each during phases 1 and 2. Body weight (BW), fasting blood sugar (FBS), urinary C-peptide (CPR-U), total cholesterol (TC), triglyceride (TG) and high density lipoprotein cholesterol (HDL-C) levels were measured weekly. During phases1and2, no significant difference was noted in the decrease in BW and TC between the two diets. During phase2, a decrease in FBS, CPR-U and TG, and an increase in HDL-C were more significant (FBS-30%, CPR-U-50%, TG-20%, HDL-C+5%, p<0.01 in all) in patients given the low-carbohydrate diet than high-carbohydrate diet.
These results suggest that low calory diets low in carbohydrate might be more useful for treatment of NIDDM patients with obesity than low calory diets high in carbohydrate.View full abstractDownload PDF (1003K) -
Kazunari Matsumoto, Mayumi Yano, Yukitaka Ueki, Seibei Miyake, Yuko To ...1998 Volume 41 Issue 10 Pages 891-896
Published: October 30, 1998
Released on J-STAGE: March 02, 2011
JOURNAL FREE ACCESSTo investigate the relative contribution of insulin secretion and insulin sensitivity in the pathophysiology of soft drink ketosis, we examined changes in insulin secretion and action in seven diabetic patients. All patients were treated with intensive insulin therapy, and insulin treatment was substequently withdrawn. Insulin secretion and insulin sensitivity were measured after correction of ketosis. The tests were repeated after withdrawal of insulin treatment.
Insulin secretion measured by24-hr urinary C-peptide excreation did not change significantly during treatment. However, insulin secretion measured by the fasting serum C-peptide method increased significantly from1.0 (SD0.7) to1.6 (0.7) ng/ml (p=0.015). The postprandial 2-hr serum C-peptide level also increased significantly from1.7 (0.8) to7.1 (4.6) ng/ml (p=0.018). Insulin sensitivity was measured by the K index of the insulin tolerance test (KITT). The value of KITT significantly improved during treatment from1.27 (0.99) to3.80 (0.86)%/min (p<0.01). Insulin treatment significantly decreased the serum triglyceride level from166.1 (86.1) to 92.3 (48.7) mg/dl (p=0.014). However, the same treatment did not change the serum levels of totaland HDL-cholesterol. A rise in insulin secretion and improvement in insulin sensitivity were observed in all study patients. We conclude that insulin deficiency and insulin resistance associated with marked hyperglycemia may play an important role in the pathophysiology of soft drink ketosis.View full abstractDownload PDF (1015K) -
A Hospital-Based Study 1976-1995Tomoko Nakagami, Reiko Kawahara, Munehiro Miyamae, Toshihiko Sato, Nao ...1998 Volume 41 Issue 10 Pages 897-906
Published: October 30, 1998
Released on J-STAGE: March 02, 2011
JOURNAL FREE ACCESSUsing standardized proportional mortality ratios (SPMRs), we investigated the causes of death in Japanese diabetics, specifically1, 256NIDDM patients from1976-1995, and compared findings with the number of deaths occurring concurrently among the general population in Japan. The most frequent cause of death in NIDDM patients was vascular disease (34.4%), including coronary heart disease (CHD, 16.3%), cerebrovascular disease (CVD, 13.3%) and diabetic nephropathy (DN, 4.8 %), the next most frequent cause of death was malignant neoplasms (22.3%), followed by other heart disease (14.3%). The CHD SPMR increased from10.9% in the1970's to19.0% in the1990's, whereas the CVD and DN ratios decreased during the same period. Compared with the number of deaths among the general population during the same period, NIDDM patients died more frequently from diabetes, CHD, other heart disease and infections (SPMR=3.60, 2.65, 2.35, 1.37respectively), but less frequently from CVD and malignant neoplasms (SPMR=0.41, 0.62respectively). In conclusion, the number of deaths from CHD among NIDDM patients increased gradually during the 20-year observation period.View full abstractDownload PDF (1429K) -
Yukari Arai1998 Volume 41 Issue 10 Pages 907-913
Published: October 30, 1998
Released on J-STAGE: March 02, 2011
JOURNAL FREE ACCESSThe aim of this study was to clarify the effect of elevated blood pressure on the metabolism of the anionic sites (AS) in the lamina rara externa (LRE) of the glomerular basement membrane (GBM) in STZ-induced diabetic rats. The rats were divided into two groups for observation. One group was administered barnidipine, a member of the dihydropiridine family of calcium antagonists, as a means of suppressing their high blood pressure; the other STZ-induced rats received no medication as the control group. Blood glucose, systolic blood pressure, creatinine clearance (Ccr) and urinary albumin excretion rate (UAE) were evaluated during a four week observation period. At the end of the study, the number of AS was calculated and kidney weight was measured.
Both the barnidipine administered group and the control group showed high blood glucose levels, but no other significant differences were found between the two groups.
Increases in the Ccr level and the UAE of the barnidipine administered group had been effectively prevented when comparing the results with those of the control group. There was also strong indication that the number of AS in the control group was markedly decreased, however, no significant reduction was seen in the barnidipine administered group.
Furthermore, no significant difference in kidney weight was noted between the two groups.
These results suggest that the decrease in the number of AS in the LRE of the GBM is affected by an elevation of blood pressure in diabetic rats.View full abstractDownload PDF (3311K) -
Yoshio Ogino, Osamu Mokuda, Eiichi Ubukata, Yoshikasu Shakamoto, Masaa ...1998 Volume 41 Issue 10 Pages 915-921
Published: October 30, 1998
Released on J-STAGE: March 02, 2011
JOURNAL FREE ACCESSA 44year-old man presented with hypoglycemia-related symptoms such as hyperhydrolysis and loss of consciousness as the onset of insulinoma. He also had hypervascular metastatic liver tumors and primary hyperparathyroidism, which indicated the diagnosis of multiple endocrine neoplasia type1. Although reduction of the metastatic liver tumors was achieved by transarterial embolization and combined chemotherapy of streptozocin and5FU, hypoglycemic attack was not prevented. Administration of both diazoxide and octreotide caused marked elevation of blood glucose levels and suppression of insulin secretion. According to this treatment control of his glycemia was easily achieved for32months. He finally died of hepatic failure due to metastatic tumors and giant liver cysts49months after onset.View full abstractDownload PDF (4716K) -
Norio Nakamura, Munetoshi Narukawa, Toshimi Asahi, Katsuya Yamazaki, A ...1998 Volume 41 Issue 10 Pages 923-928
Published: October 30, 1998
Released on J-STAGE: March 02, 2011
JOURNAL FREE ACCESSAn84-year-old male was hospitalized on Oct. 13, 1996. On admission lab values were as follows: plasma glucose concentration (928mg/dl), arterial blood gas analysis (pH7. 201, PaCO216.2 mmHg, HCO3 6.3mmol/l). All signs indicated severe hyperglycemia with metabolic acidosis. Under a diagnosis of diabetic ketoacidosis (DKA), he was immediately transfused with fluid, insulin and antibiotics. With these treatments, his general condition gradually improved for about3days. His past history revealed that chlormadinone acetate (CMA) had been administered for the treatment of prostatic cancer. Our experience with this patient suggested that CMA might have induced DKA, and futhermore that examination of glucose metabolism was prudent in patients under going CMA treatment.View full abstractDownload PDF (817K) -
[in Japanese], [in Japanese], [in Japanese], [in Japanese], [in Japane ...1998 Volume 41 Issue 10 Pages 929-932
Published: October 30, 1998
Released on J-STAGE: March 02, 2011
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Yuya Yamada, Hiroto Sakoda, Toru Inoue, Masaharu Kubo, Hisako Fushimi, ...1998 Volume 41 Issue 10 Pages 933-936
Published: October 30, 1998
Released on J-STAGE: March 02, 2011
JOURNAL FREE ACCESSLead poisoning due to a side effect of Chinese herbal medication in two patients with non-insulindependent diabetes mallitus is reported here. Both patients complained of abdominal pain, severe constipation and insomnia. Laboratory data showed normocytic anemia with reticulocytosis, basophilic stippling in erythrocytes, elevated hemoglobin F level and increased excretion of urinary porphyrin, indicating abnormalities of hemoglobin synthesis. Blood lead level and urinary lead excretion were increased by their own judgement, both patients had taken several non-autorized drugs, one of which, “Zhen qi jiang tang, ” was thought to be the causative drug containing a high level of lead.Since lead contents in the capsules were distributed over a wide range, and another patient had taken the same drug but did not show symptoms of lead poisoning, it was suggested that some capsules were contaminated with lead. Patients were treated by dimercaprol intramuscularly, and gradually symptons and data have improved.View full abstractDownload PDF (586K) -
1998 Volume 41 Issue 10 Pages 937-951
Published: October 30, 1998
Released on J-STAGE: March 02, 2011
JOURNAL FREE ACCESSDownload PDF (3736K)
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