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Volume 43, Issue 12
Displaying 1-16 of 16 articles from this issue
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[in Japanese]2000 Volume 43 Issue 12 Pages 1013
Published: December 30, 2000
Released on J-STAGE: March 02, 2011
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[in Japanese], [in Japanese]2000 Volume 43 Issue 12 Pages 1015-1017
Published: December 30, 2000
Released on J-STAGE: March 02, 2011
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[in Japanese]2000 Volume 43 Issue 12 Pages 1019-1021
Published: December 30, 2000
Released on J-STAGE: March 02, 2011
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[in Japanese]2000 Volume 43 Issue 12 Pages 1023-1024
Published: December 30, 2000
Released on J-STAGE: March 02, 2011
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[in Japanese]2000 Volume 43 Issue 12 Pages 1025-1027
Published: December 30, 2000
Released on J-STAGE: March 02, 2011
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[in Japanese]2000 Volume 43 Issue 12 Pages 1029
Published: December 30, 2000
Released on J-STAGE: March 02, 2011
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Yasuo Hiyoshi2000 Volume 43 Issue 12 Pages 1031-1036
Published: December 30, 2000
Released on J-STAGE: March 02, 2011
JOURNAL FREE ACCESSWe combined sulfonylurea and multiple insulin injections during hospitalization to treat nonobese type 2 diabetic patients having poor glycemic control with sulfonylurea alone. Within 20 hospital days, 23 of 27 patients (85%) discontinued intermediate-acting insulin at bedtime and 13 of these 23 discontinued rapid-acting insulin at lunch, maintaining good glycemic control with sulfonylurea plus rapid-acting insulin twice a day, once at breakfast and once at dinner. For the 23 no longer using intermediate-acting insulin at bedtime, the dose of sulfonylurea necessary to maintain FBG was under 2.5 mg as dose of glibenclamide all but three patients 10 of 15 patients (67%) whose glibenclamide dose on admission was under 5 mg attained good glycemic control with relatively fewer injections of insulin, i, e., rapid-acting insulin at breakfast and at dinner. In conclusion, sulfonylurea combined with insulin is acceptable by the reasoning that sulfonylurea be used only to ensure basal insulin secretion and maintain FBG and rapid-acting insulin be used to suppress postprandial hyperglycemia. The sulfonylurea dose appeared effective when small to intermediate.View full abstractDownload PDF (1254K) -
Hisaya Tada, Noriaki Kobayashi, Masayoshi Tsukamoto, Toshiki Inokuchi2000 Volume 43 Issue 12 Pages 1037-1041
Published: December 30, 2000
Released on J-STAGE: March 02, 2011
JOURNAL FREE ACCESSWe studied the effect of a-tocopherol on renal parameters in type 2 diabetic patients wit microalbuminuria. Subjects were 23 patients-12 receiving oral α-tocopherol (450 mg/day) for 8 months and 11 controls. No significant differences were seen between groups in blood pressure or Hb Ac during the observation period. Serum a-tocopherol showed an approximately 3-fold increase at 8 months compared to the baseline in patients receiving αa-tocopherol. The urinary excretion of albumin (p<0.05) and fibronectin degradation products (p<0.01) decreased significantly in patients receiving α-tocopherol, while no significant changes were observerd in controls. No significant changes in serum creatinine, lipid peroxide, or urinary NAG were seen between groups. Our results suggest that orally administered α-tocopherol is beneficial in diabetic nephropathy.View full abstractDownload PDF (917K) -
Akiko Ishii, Tetsuya Babazono, Osamu Tomonaga, Chieko Takahashi, Yasuh ...2000 Volume 43 Issue 12 Pages 1043-1049
Published: December 30, 2000
Released on J-STAGE: March 02, 2011
JOURNAL FREE ACCESSOsteopenia has been described in diabetic patients, however, the pathogenesis of this complication in early stage of diabetic nephropathy is unknown. To address this question, we perfomed a cross-sectional assessment of bone metabolism in 124 male and 67 female type 2-diabetic patients with normal serum creatinine concentration, who were classified into normo-, micro-, and macroalbuminuric groups. Serum levels of type I procollagen carboxy-terminal propeptide (PICP) and of cross-linked type I collagen carboxy-terminal telopeptide (ICTP) were determined as markers of bone formation and absorption, respectively. Serum concentrations of 1 α 25-dihydroxyvitamin D, intact PTH and bone-type alkaline phosphatase (ALP 3) were also determined. also determined.
In female patients, serum PICP and vitamin D levels decreased and ICTP levels increased in statistical correlation with the progression of nephropathy. Vitamin D levels correlated with the levels of both type I collagen-associated peptides. A similar tendency was observed in male patients but with minor or no statistical significance. There was no significant correlation of intact PTH level with the stage of nephropathy in either male or female patients.
Thus, early stage of diabetic nephropathy, especially in females, is associated with increased absorption and decreased formation of bone tissue. Our data also suggest that decreased 1 α 25-dihydroxyvitamin D levels may be responsible for the uncoupling of bone turnover.View full abstractDownload PDF (1294K) -
Comparative Analysis with Radioligand Binding AssayEiji Kawasaki, Yasunori Sera, Naruhiro Fujita, Takahiro Abe, Mikako Ya ...2000 Volume 43 Issue 12 Pages 1051-1056
Published: December 30, 2000
Released on J-STAGE: March 02, 2011
JOURNAL FREE ACCESSTo determine the assay accuracy of a newly developed radioimmunoassay (RIA) kit for ICA 512/IA-2 autoantibodies, we analyzed kit disease sensitivity and specificity compared to highly sensitive radioligand binding assay (RBA) using sera from 72 patients with type 1 diabetes, 127 patients with type 2 diabetes, and 71 healthy subjects. The prevalence of ICA 512/IA-2 autoantibodies by RIA and RBA were 43.1% and 48.6% in type 1 diabetics, and 3.9% and 2.4% in type 2 diabetics. No healthy subjects were positive in either assay (specificity 100%). Although ICA 512/IA-2 autoantibody levels correlated significantly between RIA and RBA, some sera showed negative results in RIA but positive in RBA in a low titer range. With analysis using the standard deviation score (SDS) in each serum from patients with type 1 diabetes, we observed some sera with high SDS by RBA but low SDS by RIA even though all were positive. The newly developed RIA has high specificity but lower disease sensitivity than RBA. Re-evaluation of the sera using the assay with higher sensitivity or combined analysis with other islet-autoantibodies required in type 1 diabetic patients negative for ICA 512/IA-2 autoantibodies measured by this RIA.View full abstractDownload PDF (1123K) -
Akira Sasaki, Takao Shimizu, Kyoichi Hasegawa, Masuko Uehara2000 Volume 43 Issue 12 Pages 1057-1063
Published: December 30, 2000
Released on J-STAGE: March 02, 2011
JOURNAL FREE ACCESSWe studied factors related to death from coronary heart disease (CHD) and cerebro-vascular disease (CVD) in 1, 939 patients with type 2 diabetes mellitus who entered the study during 1960-1974 and were followed up to the end of 1993 (mean observation: 14.9±6.6 years). At the end of follow-up, 1, 000 patients (51.6%) were alive, 880 (45.4%) had died, and 56 (3.0%) could not be followed up. Of the 880 deceased, 111 died of CHD and 128 of CVD. We analyzed the relationship of risk factors to CHD and CVD deaths by mortality, odds ratio, and multiple logistic regression. CHD deaths were found to be related to fasting plasma, blood pressure, ischemic ECG change, serum cholesterol, retinopathy, proteinuria, and treatment type, CVD deaths were found to be related to hypertension, proteinuria, and treatment type. Multiple logistic analysis indicated a significant relatinship to systolic blood pressure, ischemic ECG findings, and serum cholesterol in CHD mortality, and a significant relatinship to hypertension in CVD mortality, in addition to age.View full abstractDownload PDF (1466K) -
Yasuyuki Kihara, Shingo Nakayamada, Shigekazu Nakano, Makoto Otsuki2000 Volume 43 Issue 12 Pages 1065-1070
Published: December 30, 2000
Released on J-STAGE: March 02, 2011
JOURNAL FREE ACCESSA 50-year-old man with poorly controlled diabetes was admitted to our hospital due to a high fever. Enhanced abdominal computed tomography (CT) showed a focal low-density wedged-shaped area in the right kidney and a low-density area with an enhanced wall in the left lobe of the liver. Enhanced chest CT showed scattered multiple nodules with cavitation in the lung periphery. Pulmonary perfusion scintigraphy showed perfusion defects in the same area as in chest CT. Klebsiella pneumoniae was detected from venous blood, sputum, urine and discharge from a liver abscess. We diagnosed the patient as having septic pulmonary emboli (SPE), and a pyogenic liver abscess secondary to acute focal bacterial nephritis (AFBN). Clinical symptoms, liver abscess, and multiple nodular lesions in the lung improved following treatment with insulin and antibiotics. Poorly controlled diabetes should be recognized as predispositional for AFBN, SPE, and pyogenic liver abscess.View full abstractDownload PDF (1642K) -
Norihiro Hirai, Eiko Sinji, Masahiro Yotsukura, Yukari Jin, Keiji Tana ...2000 Volume 43 Issue 12 Pages 1071-1076
Published: December 30, 2000
Released on J-STAGE: March 02, 2011
JOURNAL FREE ACCESSA 83-year-old woman with type 2 diabetes mellitus but without diabetic triopathy was admitted to Kitasato University Hospital due to a sense of urinary retention, pollakiuria, and left lower abdominal quadrant pain. The patient was suspected of urinary tract infection, diabetic hyperglycemia, and ketoacidosis based on laboratory finding, and given antibiotics and insulin. Congestive heart failure developed on the 10 th hospital day, followed by right upper limb hemiparsis and consciousness disturbance on 21st hospital day.
She died without definitive diagnosis on the 51 st hospital day. Autopsy showed verrucous endocarditis and multiple microabscesses of the brain and kidneys; these could not be diagnosed from blood and urinary cultures, and echocardiography was not considered diagnostic.View full abstractDownload PDF (1839K) -
Naruhiro Fujita, Hironori Yamasaki, Hirofumi Takino, Chikako Kato, Mik ...2000 Volume 43 Issue 12 Pages 1077-1083
Published: December 30, 2000
Released on J-STAGE: March 02, 2011
JOURNAL FREE ACCESSType B insulin resistance is an autoimmune disorder caused by antiinsulin receptor autoantibodies in circulation.
A 50-year-old Japanese woman with type B insulin resistance was diagnosed with systemic lupus erythematosus (SLE). We measured antiinsulin receptor antibody titer and parameters reflecting SLE activity. Both diabetes and SLE went into remission about 3 months after predonisolone administration. IM 9 human lymphocytes preincubated with the patient's dialyzed serum showed dramatically 125-I-insulin binding to these cells. Insulin binding increased to binding levels seen with normal serum (4.7% to 81.6%) as hospitalization advanced. Complement and titer serum levels of anti-DNA antibodies also normalized in parllallel with antiinsulin receptor antibodies. The patient was eventually able to stop insulin therapy and no longer suffered from hyperinsulinemia, butterflyrash, or Raynaud's phenomenon. We have demonstrated the dose correlation between type B insulin resistance and SLE in this patient, suggesting that the production of antiinsulin receptor antibodies may be due to the autoimmune nature of SLE and that glucocorticoid therapy used in this patient may affect autoimmune mechanisms common to type B insulin resistance and SLE.View full abstractDownload PDF (1764K) -
Development and Evaluation of a Questionnaire Using the Diabetes Quality of Life (DQOL) ScaleK. Asao, M. Matsushima, H. Sano, T. Agata, H. Shimizu, N. Tajima2000 Volume 43 Issue 12 Pages 1085-1091
Published: December 30, 2000
Released on J-STAGE: March 02, 2011
JOURNAL FREE ACCESSTo develop an instrument to measure the quality of life (QOL) in Japanese patients with type 2 diabetes, we evaluated the Diabetes Quality of Life (DQOL) Scale developed for the Diabetes Control and Complications Trial (DCCT) and translated into Japanese with the permission of the DCCT Research Group. Subjects were 239 outpatients 40 years and over at Jikei University Hospital, studied to assess the instrument's reliability and validity. Using the 40 questions in the DQOL, we reconstructed the questionnaire by factor analysis. Four newly detected factors are interpreted as the domains of “limitation on daily life, ” “overall satisfaction, ” “psychological burden, ” and “satisfaction with treatment.” Cronbach's alpha coefficients indicated that the instrument was internally consistent (alpha=0.73 to 0.92). The four domains of the instrument mutually correlated. Our findings suggest that the instrument is useful for assessing QOL in patients with type 2 diabetes in Japan, although further revision may be necessary.View full abstractDownload PDF (1288K) -
[in Japanese]2000 Volume 43 Issue 12 Pages 1093-1097
Published: December 30, 2000
Released on J-STAGE: March 02, 2011
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