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Volume 44, Issue 10
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[in Japanese]2001 Volume 44 Issue 10 Pages 785-789
Published: October 30, 2001
Released on J-STAGE: March 02, 2011
JOURNAL FREE ACCESSDownload PDF (1427K) -
Chizuru Takahashi, Reiko Kawahara, Satoru Shimizu, Yasuhiko Iwamoto2001 Volume 44 Issue 10 Pages 791-798
Published: October 30, 2001
Released on J-STAGE: March 02, 2011
JOURNAL FREE ACCESSTo evaluate insulin resistance clinically, we studied the reduction of senlm free fatty acids (%FFA 30') during the initial 30 minutes of oral glucose tolerance tests (OGTT) in 93 subjects-48 men and 45 women with a mean age was 47.1±13.2 years (mean±SD). We also conducted hyperinsulinemic euglycemic clampingin 18 obese subjects and calculated glucose infusion rates (GIRs). Blood glucose, insulin, fasting lipids, and %FFA 30'were measured during 75 g-OGTr. Multiple regression analysis was conducted using Akaike's infbrmation criterion. When primary correlations between %FFA 30'and other factors were evaluated, %FFA 30' was lower in subjects with glucose intolerance-a trend that increased with obesity. A significant correlation was seen between %FFA 30' and the results of homeostasis model assessment (r=-0.24, p=0.023). When GIR was calculated in obese subjects, %FFA 30' correlated significantly with 1/GIR (r=-0.51, p=0.031). The results of multiple regression analysis showed that a combination of 1/GIR, FFA 120', HbA1c, triglycerides, and body mass index was the most appropriate model to explain %FFA 30'. These findings suggest that the reduction of %FFA 30' during OGTT reflects the severity of insulin resistance.View full abstractDownload PDF (1210K) -
Phase III Clinical Trial in JapanYasuhiko Iwamoto, Yasuo Akanuma, Hiroo Niimi, Nozomu Sasaki, Naoko Taj ...2001 Volume 44 Issue 10 Pages 799-811
Published: October 30, 2001
Released on J-STAGE: March 02, 2011
JOURNAL FREE ACCESSThe efficacy and safety of insulin aspart (IAsp), a rapid-acting insulin analogue, were investigated in type 1 diabetes patients treated in a basal-bolus regimen compared to soluble human insulin (HI). IAsp or HI was administered as meal-related insulin immediately (IAsp) or 30 minutes (HI) before meals and basal insulin was administered once or twice daily.
Subjects numbered 143 in the IAsp group and 62 in the HI group.
In the primary endpoint, change of HbAic, mean difference, and 95% confidence interval (C. I.) between the groups were -0.18% and (-0.41, 0.05), and the upper limit of C. I. was less than the upper equivalence margin (0.6%) defined as the non-inferiority criterion. IAsp was thus not inferior to HI in glycemic control measured by HbAic after 24 weeks of treatment. A significant decrease in blood glucose at 90 minutes after breakfast was observed in the IAsp group.
The overall safety profile of IAsp was comparable to that of HI measured by adverse events, clinical laboratory parameters, insulin antibodies, and other parameters.
In conclusion, IAsp was considered useful mealtime insulin applicable even when administered immediately before meals in a multiple-injection regimen.View full abstractDownload PDF (2413K) -
Kumpei Tokuyama, Shoichiro Nagasaka, Ikuyo Kusaka, Tomoatsu Nakamura, ...2001 Volume 44 Issue 10 Pages 813-818
Published: October 30, 2001
Released on J-STAGE: August 04, 2011
JOURNAL FREE ACCESSFrequently sampled insulin-modified intravenous glucose tolerance tests with stable-labeled glucose were conducted on 23 individuals with normal glucose tolerance.The time course of labeled glucose was analyzed using a 2-compartment minimal model (Am J Physiol 277: E 481-, 1999) to evaluate insulin sensitivity specific to glucose uptake (SI2*) and kinetic parameters for exchanging glucose between the 2 compartments (k12, k21 and V1).From these parameters and the time course of glucose until its nadir, insulin sensitivity (total insulin sensitivity: SI2) responsible for stimulating glucose uptake and suppressing endogenous glucose output was calculated by the 2-compartment minimalmodel.Consistent with theoretical considerations, SI2 greater than SI2* in all subjects.The ability of insulin to suppress endogenous glucose production (hepaticinsulin sensitivity: HSI2) was defined as the difference between SI2 and SI2* and consisted 40% of total insulin sensitivity.View full abstractDownload PDF (1071K) -
Katsutoshi Kishi, Michiko Hayakawa, Yoshinori Ikeda, Masami Takada, To ...2001 Volume 44 Issue 10 Pages 819-823
Published: October 30, 2001
Released on J-STAGE: March 02, 2011
JOURNAL FREE ACCESSA 30-year-old man with a 4-year history of diabetes and receiving insulin was admitted after left transtib-ial amputation due to foot gangrene. Six months earlier he developed a left foot ulcer resulting in the ampu-tation and bilateral progressive weakness in the lower extremities resulting in complete paraplegia 4 months later. He developed urinary retention. His body mass index exceeded 30 in high school but he showed no signs or symptoms of hyperglycemia. At age 28, he underwent operation for a right-eye cata-ract.
Examination showed muscle atrophy and decreased tendon reflex in the lower limbs. Sensory nerve con-duction was extremely low in the upper limbs and motor nerve conduction studies showed varying combi-nation of conduction slowing and blockage and prolongation of distal latency. His right leg evidenced no sensory or motor response. Urodynanmic studies showed an increased threshold for initiating the micturi-tion reflex, decreased detrusor activity, and incomplete bladder emptying. These findings indicate that he had severe sensory, autonomic and motor diabetic neuropathy, although we could not rule out a possibility that he had diabetes and chronic inflammatory demyelinating polyneuropathy.View full abstractDownload PDF (704K) -
Toru Yago, Junnosuke Miura, Shoko Ohiwa, Masanobu Takeda, Makiko Ogata ...2001 Volume 44 Issue 10 Pages 825-830
Published: October 30, 2001
Released on J-STAGE: March 02, 2011
JOURNAL FREE ACCESSA 57-year-old woman with a 25-year history of diabetes reported nausea, severe emaciation and hearingdisturbance, and was admitted to our diabetes center. The diagnosis of mitochondrial myopathy, encephalo-pathy, lactic acidosis, and stroke-like episodes (MELAS) was based on severe muscle atrophy, progressive deafness, highly elevated lactate and pyruvate, and positive mitochondrial DNA 3243 point mutation. A high dose of coenzyme Q (150mg/day) was administered. On hospital day 37, she developed rapidly increasing abdominal fullness. Although abdominal X-ray showed severe accumulation of colonic gas, gastrointestinal and colonic examinations ruled out mechanical obstruction. Chronic intestinal pseudoobstruction (CIP) due to MELAS was suspected. Bethanechol chloride and erythromycin were started and cytochrome c added from the 40th hospital day, but did not improve clinical symptoms such as colonic gas accumulation. Anticholinesterase inhibitor (Neostigmine) was administered from hospital day 57th instead of bethanechol chloride and symptoms and gas accumulation markedly improved. CIP complicated by MELAS has been reported to be difficult to cure. Our case suggests that combined coenzyme Q and anticholinesterase inhibitor therapy are synergistically effective for CIP due to MELAS and diabetes mellitus.View full abstractDownload PDF (1500K) -
[in Japanese], [in Japanese], [in Japanese], [in Japanese], [in Japane ...2001 Volume 44 Issue 10 Pages 831-836
Published: October 30, 2001
Released on J-STAGE: March 02, 2011
JOURNAL FREE ACCESS -
2001 Volume 44 Issue 10 Pages 837-870
Published: October 30, 2001
Released on J-STAGE: March 02, 2011
JOURNAL FREE ACCESSDownload PDF (8496K)
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