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Volume 43, Issue 9
Displaying 1-16 of 16 articles from this issue
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[in Japanese]2000 Volume 43 Issue 9 Pages 753-757
Published: September 30, 2000
Released on J-STAGE: March 02, 2011
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[in Japanese]2000 Volume 43 Issue 9 Pages 759-760
Published: September 30, 2000
Released on J-STAGE: March 02, 2011
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[in Japanese]2000 Volume 43 Issue 9 Pages 761-764
Published: September 30, 2000
Released on J-STAGE: March 02, 2011
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[in Japanese]2000 Volume 43 Issue 9 Pages 765-767
Published: September 30, 2000
Released on J-STAGE: March 02, 2011
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Kouhei Ueda, Kouichi Iwasaki, Nobuaki Kizuki, Toshio Hosaka, Mari Ohsh ...2000 Volume 43 Issue 9 Pages 769-776
Published: September 30, 2000
Released on J-STAGE: March 02, 2011
JOURNAL FREE ACCESSTo survey the conditions of subjects with diabetes mellitus and those with glucose intolerance in Iwakuni City, questionnaires on life style and medical factors were sent to all practicing physicians in Iwakuni City. Among 1689 diabetic patients from whom information and informed consent were obtained, the mean body mass index was 23.4kg/m2 and exceeded 26.4 kg/rri in 17.2% of respondents. 27.1% of patients were treated with diet only, 58.5% with oral hypoglycemic agents and 13.3% with insulin. HbAic levels exceeded 7.0% in 39.4% of patients, 18.7% had retinopathy, 24, 5% nephropathy and 46.2% were treated with anti-hypertensive drugs. Anti-GAD antibody was positive in 12/818 randomly selected type 2 diabetes patients. Both worsening of blood glucose levels and progression of diabetic complications paralleled the duration of diabetes, suggesting difficulties in preventing disease progression and the importance of primary prevention of diabetes mellitus.View full abstractDownload PDF (1813K) -
A 9-year Follow-Up StudyYuka Sugimoto, Satoshi Tada, Noriyuki Kuroda, Tatsushi Kajikawa, Michi ...2000 Volume 43 Issue 9 Pages 777-783
Published: September 30, 2000
Released on J-STAGE: March 02, 2011
JOURNAL FREE ACCESSTo elucidate the role of lipoprotein (a)[Lp (a)] in the pathogenesis of vascular lesions in diabetic patients, ninety-four patients with type 2 diabetes mellitus (49 female and 45 male, mean age 57.4 years) were enrolled in this follow-up study. Lp (a) levels, serum lipids and glycemic status were evaluated over a 9-year period in all patients. Besides these biochemical parameters, the diabetic microangiopathies, such as neuropathy, retinopathy and nephropathy, and macroangiopathies, such as ischemic heart diseases, cerebrovascular diseases and arteriosclerosis obliterans (ASO), were monitored. Lp (a) levels were also measured in 100 control subjects without any detectable disease. Furthermore, phenotype classification of Lp (a) was performed by western blot analysis.
Lp (a) levels in patients with type 2 diabetes mellitus were significantly higher than those of control subjects, though serum Lp (a) levels of diabetics without vascular lesions were not higher than those of control subjects. There was no significant relationship between Lp (a) levels at the beginning of the study and degrees of microangiopathies or macroangiopathies. After the 9-year follow-up period, the serum Lp (a) increment was significantly correlated with the occurrence of diabetic retinopathy. In addition, there was also a significant relationship between the Lp (a) increment and the occurrence of ASO. Among 57 patients, in whom the Lp (a) phenotype was determined by western blot analysis, 32 (56%) were judged to have phenotype IV. In these patients with Lp (a) phenotype IV, the serum Lp (a) increment was significantly correlated with the occurrence of ischemic heart diseases, cerebrovascular disorders, and ASO.View full abstractDownload PDF (1388K) -
Katsuhiko Kishi, Akira Kawaguchi, Yoshinori Ikeda, Junichi Katoh, Kenz ...2000 Volume 43 Issue 9 Pages 785-790
Published: September 30, 2000
Released on J-STAGE: March 02, 2011
JOURNAL FREE ACCESSProlongation of the heart-rate-adjusted QT interval (QTc) is prognostic of coronary heart disease, which is known to be associated with insulin resistance. Therefore, we studied the association of insulin resistance with QTc in 198 young healthy men (aged 18-20 years). QTc was positively associated with insulin (r=0.15, p=0.02) leptin (r=0.16, p=0.02), and both systolic and diastolic blood pressure (r= 0.18, p=0.009 and r=0.21, p=0.002, respectively). As compared with men in a median leptin tertile (1.5±0.2 [SD] ng/ml), those in a high tertile (4.2±4.2 ng/ml) had an increase in BMI (24.8±4.5 vs 20.7±1.6kg/m2), percent body fat (24.0±6.6 vs 17.1±2.9%) and QTc (391±23 vs 380±21 ms). In addition, mean QTc increased in a step-wise fashion from the lowest to the highest tertile of fasting insulin (378±22, 386±27, and 390±19 ms, respectively), a hallmark of insulin resistance, whereas mean QTc decreased in a step-wise fashion from the lowest to the top tertile of the ratio of fasting glucose to insulin (390±20, 386±25, and 379±23 ms), an estimate of insulin sensitivity in the nondiabetic population. In addition, mean QTc also decreased from the lowest to the top tertile of the insulin resistance index calculated using the homeostasis model assessment (381±22, 385±26, and 390±18 ms, p=0.06) These results suggest that QTc prolongation may be associated with insulin resistance.View full abstractDownload PDF (1068K) -
[in Japanese], [in Japanese], [in Japanese], [in Japanese], [in Japane ...2000 Volume 43 Issue 9 Pages 791-795
Published: September 30, 2000
Released on J-STAGE: March 02, 2011
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Nogiku Nogawa, Toshihiro Utsugi, Yoshio Ohyama, Takahiro Yamagishi, Te ...2000 Volume 43 Issue 9 Pages 797-802
Published: September 30, 2000
Released on J-STAGE: March 02, 2011
JOURNAL FREE ACCESSPrader-Willi syndrome (PWS) is a disorder characterized by obesity, hypogonadism, hypotonia, and mental retardation. Hyperphagia associated with PWS is severe and chronic, and is responsible for obesity and type-2 diabetes mellitus (DM). We report a case of PWS with DM and agenesis of the corpus callosum. On admission to our hospital, the female patient with PWS was 20 years old and her body mass index was 50.8 kg/m2. She had overt DM (HbA1c 11.6%) with hyperinsulinemia. Magnetic resonance neuroimaging (brain MRI) showed agenesis of the corpus callosum. This case is the first report of PWS with agenesis of the corpus callosum. Nutritional treatment was transiently effective during her hospital stay, but after discharge, she gained weight and her glycemic control got worse (HbA1c 11.1%). Troglitazone was administered because she was insulinresistant, as judged by homeostasis model assessment (HOMA 10.13). Troglitazone had beneficial effects on glycemic control by ameliorating impaired insulin sensitivity (HOMA 4.88), but it was very important to control body weight in order to realize this improvement.View full abstractDownload PDF (1461K) -
Motohiro Fujita, Kenji Takahashi, Norihiko Murakami, Toshihiko Yokota2000 Volume 43 Issue 9 Pages 803-808
Published: September 30, 2000
Released on J-STAGE: March 02, 2011
JOURNAL FREE ACCESSAn 80-year-old woman, who had been diagnosed with diabetes mellitus 14 years previously and treated with sulphonylurea, was admitted to the hospital because of elevated blood glucose and loss of weight of 5 Kg in several months. Laboratory data on admission showed that HbA1c was 11.4%, fasting serum C-peptide was 1.0 ng/ml and 1.9ng/ml 2 hours after breakfast, the increment of serum C-peptide 6 min after glucagon iv load of 1 mg was 0.5ng/ml, and mean urinary C-peptide was 21μg/day. ICA was 20-fold positive and GADAb was counted as 956.0U/ml. The patient had previously been admitted to our hospital one year earlier, and atthat time, ICA and GADAb were negative, fasting serum C-peptide was 1.8ng/ml and 3.9ng/ml after breakfast, and mean urinary C-peptide was 64μg/day.
The fact that islet-associated autoantibodies became positive within one year, and endocrine insulin concentrations progressively decreased, in a patient with a 14-year history of type 2 diabetes, may lead us to conclude that the patient could have two genetic susceptibilities, to type 1 and type 2 diabetes, and that type 1 diabetes overlapped type 2 diabetes within a one-year clinical course.
Even in a patient with long-term type 2 diabetes, if progressive loss of endocrine insulin is recognized, immunological markers of type 1 diabetes should be repeatedly checked.View full abstractDownload PDF (1043K) -
Teruki Kondo, Hiroaki Yamarnoto, Tsunesuke Kono, Takashi Kouda, Takash ...2000 Volume 43 Issue 9 Pages 809-813
Published: September 30, 2000
Released on J-STAGE: March 02, 2011
JOURNAL FREE ACCESSBecause of the low incidence of type 1 diabetes in the general population, familial clustering of this type of diabetes is rare among Japanese. We encountered a clustering of it in a mother and daughter, and the clinical characteristics of the cases are herein reported. Case 1 (mother) was a 49-year-old woman who had been diagnosed as having diabetes at the age of 39 because of grossly elevated random sample plasma glucose level, 360 mg/dl. After an initial treatment at that time, near-normal glycemia was maintained without drug therapy for 8 months. However, insulin injection had to be resumed for glycemic control thereafter and she is currently on intensive insulin therapy. Insulin secretion was well measurable at the onset, but it gradually deteriorated, and has been totally absent for the past 5 years. Anti-GAD antibody, measured 10 years after the onset, was 2U/ml. The daughter (Case 2) was 17-year-old and found to be diabetic (fasting plasma glucose, 313 mg/dl) during a preoperative examination for ovarian tumor. Insulin therapy was instituted and continued thereafter. Insulin secretion is maintained in this case. Anti-GAD antibody was 68.7U/ml 3 months after the onset. A younger sister is currently normoglycemic with normal insulin response at 75 g OGIT. All three of these patients were homozygotes for DR 9-DQA 1*03-DQB 1*0303, a high-risk haplotype for the development of type 1 diabetes.View full abstractDownload PDF (873K) -
Sinichi Teno, Yuko Nakajima, Shiro Onizuka, Hiroaki Shinmura, Yasue Om ...2000 Volume 43 Issue 9 Pages 815-820
Published: September 30, 2000
Released on J-STAGE: March 02, 2011
JOURNAL FREE ACCESSAlthough painful sensation and paresthesia are sometimes precipitated by strict glycemic control in diabetic patients, cases that present severe autonomic neuropathy as a sign of posttreatment neuropathy are very rare. We report a patient with type 2 diabetes who showed acute exacerbation of autonomic neuropathy and motor nerve function without painful symptoms after treatment with insulin.
A 63-year-old man with type 2 diabetes was admitted to our hospital for the improvement of hyperglycemia. He had been diagnosed as having diabetes mellitus at age 50, and had been treated with glibenclamide. Upon admission, his fasting plasma glucose (FPG) and HbA1c levels were 496 mg/dl and 15.8%, respectively. He already had neuropathy with muscle atrophy and delay of motor nerve conduction, preproliferative retinopathy, and microalbuminuria. Because of his poor insulin secretion and severe hyperglycemia, he was placed on insulin therapy. FPG levels decreased to 150mg/dl within 6 days. He had severe diarrhea with incontinence several times on the 10 th hospital day, and urinary retention on the 15th hospital day. Culture of stool revealed no bacteria except E. coli. After treatment with loperamide chloride (2mg t.i.d.) and intermittent self-catheterization of urine, he recovered from diarrhea and urinary retention. During the whole clinical course, the patient experienced no spontaneous pain in the extremities.
This is, to the best of our knowledge, the first description of case of a type 2 diabetes with severe autonomic neuropathy without pain occurring after insulin therapy, which may be a feature of a complicated syndrome presenting as a variant of posttreatment neuropathy.View full abstractDownload PDF (1546K) -
[in Japanese], [in Japanese], [in Japanese], [in Japanese], [in Japane ...2000 Volume 43 Issue 9 Pages 821-826
Published: September 30, 2000
Released on J-STAGE: March 02, 2011
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2000 Volume 43 Issue 9 Pages 827-836
Published: September 30, 2000
Released on J-STAGE: March 02, 2011
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[in Japanese], [in Japanese]2000 Volume 43 Issue 9 Pages 838
Published: September 30, 2000
Released on J-STAGE: March 02, 2011
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[in Japanese]2000 Volume 43 Issue 9 Pages 839
Published: September 30, 2000
Released on J-STAGE: March 02, 2011
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