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Volume 46, Issue 12
Displaying 1-14 of 14 articles from this issue
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[in Japanese]2003 Volume 46 Issue 12 Pages 901
Published: December 30, 2003
Released on J-STAGE: March 02, 2011
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[in Japanese], [in Japanese], [in Japanese], [in Japanese]2003 Volume 46 Issue 12 Pages 903-906
Published: December 30, 2003
Released on J-STAGE: March 02, 2011
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[in Japanese], [in Japanese]2003 Volume 46 Issue 12 Pages 907-909
Published: December 30, 2003
Released on J-STAGE: March 02, 2011
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[in Japanese]2003 Volume 46 Issue 12 Pages 910-912
Published: December 30, 2003
Released on J-STAGE: March 02, 2011
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[in Japanese]2003 Volume 46 Issue 12 Pages 913-915
Published: December 30, 2003
Released on J-STAGE: March 02, 2011
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[in Japanese], [in Japanese]2003 Volume 46 Issue 12 Pages 916-918
Published: December 30, 2003
Released on J-STAGE: March 02, 2011
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Ikuyo Ogawa, Yuko Akehi, Reiko Nakagawachi, Kenzo Iino, Keizo Anzai, K ...2003 Volume 46 Issue 12 Pages 919-924
Published: December 30, 2003
Released on J-STAGE: March 02, 2011
JOURNAL FREE ACCESSThe amount of urinary C-peptide (U-CPR) is a good parameter for estimating the insulin secretory ability of diabetic patients. However, a preservative must be added to urine samples to prevent reductions in the CPR level. Sodium azide (NaN3) is a routinely used preservative, but its use and handling are strictly controlled. A new preservative, composed mainly of Na2CO3, has been developed as a safer preservative. We examined the effects of this new preservative by comparing the 24-hr U-CPR levels obtained at 4°C and 28°C with or without NaN3 or Na2CO3. The C-peptide level was measured using two commercially available assay kits. The levels of U-CPR in urine samples kept at 28°C and containing Na2CO3 were well correlated with the levels of U-CPR in samples kept at 4°C and were higher than those in any other sample. Among the other urine components commonly measured by laboratories, urea nitrogen, creatinine and chloride were measured without any interference. This newly-eveloped preservative was therefore found to be a useful alternative to NaN3 for the accurate measurement of U-CPR levels.View full abstractDownload PDF (895K) -
Hiroko Takaike, Yasuko Uchigata, Maki Okudaira, Mari Ohsawa, Junnosuke ...2003 Volume 46 Issue 12 Pages 925-931
Published: December 30, 2003
Released on J-STAGE: March 02, 2011
JOURNAL FREE ACCESSWe experienced seven type 1 diabetic children with six type 1 diabetic parents in Japan, where the incidence of type 1 diabetes is low. The onset age in the parents was older than that of the children in all families. Five out of six parents started insulin therapy more than one year after the diagnosis of diabetes (slowly progressive insulin-dependent diabetes mellitus). On the other hand, the children were diagnosed as acute-onset type 1 diabetes. The positive rate for GAD-Ab, ICA, or IA-2 among parents and childrenwas 85%(11/13), and four patients were positive for autoimmune thyroid disease.
Many cases exhibited HLA-A24 (8/13), B54 (6/13), or DR4 (8/13), and 6 patients had high-risk haplotypes for type 1 diabetes (DRB 1*0405-DQB 1*0401).
The positive rate of GAD-Ab seems to be high in patients with familial predisposition, compared to that of isolated cases of type 1 diabetes. The measurement of islet-associated antibody is important in patients with a family history of type 1 diabetes.View full abstractDownload PDF (1376K) -
Masahiro Yamamoto, Yoko Yamane, Tadashi Shimizu, Soichi Kurioka, Junko ...2003 Volume 46 Issue 12 Pages 933-938
Published: December 30, 2003
Released on J-STAGE: March 02, 2011
JOURNAL FREE ACCESSA 55-year-old woman was admitted to hospital because of poor blood glucose control and an elevated serum aminotransferase level. She had been diagnosed as having type 2 diabetes mellitus 20 years earlier. The patient did not have a history of alcohol abuse or any known etiologies of liver dysfunction. However, a percutaneous liver biopsy revealed histological findings similar to those of alcoholic hepatitis. Weight loss, the administration of ursodeoxycholic acid, and insulin therapy resulted in an improvement of the patient's blood glucose and aminotransferase levels. Terminal ileum resections performed in obese patients with type 2 diabetes mellitus may cause nonalcoholic steatohepatitis.View full abstractDownload PDF (1716K) -
Marked Reduction of Skin Eruptions after Treatment with PioglitazoneHironari Sano, Shigeko Iwasaki, Kazunori Utsunomiya, Manabu Narimiya, ...2003 Volume 46 Issue 12 Pages 939-942
Published: December 30, 2003
Released on J-STAGE: March 02, 2011
JOURNAL FREE ACCESSA 55-year-old man with type 2 diabetes was diagnosed as having pustulosis palmaris et plantaris (PPP). He was treated with pioglitazone, and his PPP skin lesions improved. At the same time, an improvement in insulin resistance was demonstrated using the euglycemic hyperinsulinemic glucose clamp method. The recovery of the patient's PPP skin lesions might have been associated with a reduction in insulin resistance brought on by the pharmacological effect of pioglitazone.View full abstractDownload PDF (1475K) -
Satoru Sumitani, Shogo Kurebayashi, Kunihiko Hashimoto, Takahisa Hiros ...2003 Volume 46 Issue 12 Pages 943-948
Published: December 30, 2003
Released on J-STAGE: March 02, 2011
JOURNAL FREE ACCESSWe report a case of type 1 diabetes treated with continuous subcutaneous insulin infusion (CSII) for 19 years. A 44-year-old female developed type 1 diabetes when she was 24 years old and was treated with Lente insulin for one year. As a result of poor glycemic control, she was switched to CSII and her glycemic control subsequently stabilized. She was hospitalized due to a hypoglycemic coma at an age of 29 years and due to diabetic ketoacidosis at an age of 38 years. During the 19 years of CSII, her mean HbA1c, systolic blood pressure, and diastolic blood pressure were 7.8%, 112mmHg, and 67mmHg, respectively. At present, her optic fundi are normal and her urine albumin excretion rate is 4.7mg/g·Cr. Nerve conduction velocity studies showed a decrease in sensory nerve action potential in the median and sural nerves, indicating the presence of early diabetic polyneuropathy. A carotid ultrasonography showed no increase in the intima-media thickness. An echocardiography revealed a mild diastolic dysfunction of the left ventricle. Pulse wave velocity measurements showed a slight increase in the brachial-ankle pulse wave velocity. We believe that the present case illustrates the effectiveness of CSII as a therapeutic option for type 1 diabetes.View full abstractDownload PDF (864K) -
Shigeki Yamamoto, Hiroshi Fujimoto, Noriko Hirakawa, Isao Morimoto2003 Volume 46 Issue 12 Pages 949-954
Published: December 30, 2003
Released on J-STAGE: March 02, 2011
JOURNAL FREE ACCESSWe report the case of a 57-year-old woman who developed autoantibody-negative fulminant type 1 diabetes during the course of treatment for drug-induced hypersensitivity syndrome. She was admitted to hospital because of a severe drug allergy and was treated with predonisolone.The further development of mucocutaneous lesions, lymphadenopathy and liver dysfunction was consistent with a diagnosis of drug-induced hypersensitivity syndrome. Human herpes virus 6 (HHV 6)-DNA, which is associated with hypersensitivity syndrome, was detected in her blood. Her blood glucose level was 88 mg/dl at the time of admission and increased to 428 mg/dl after the administration of predonisolone for 7 days. She has had insulindependent diabetes ever since. Her HbA1c level was 5.4%, she tested negative for diabetes-related glutamic acid decarboxylase (GAD) antibody, and her serum levels of pancreatic exocrine enzymes were elevated. Her urinary C-peptide (CPR) excretion level was 4.4μg/day, and serum CPR was not detected after the intravenous administration of 1 mg of glucagon. These observations were consistent with a diagnosis of fulminant type 1 diabetes mellitus. Taken together, these observations suggest that HHV 6 reactivated by hypersensitivity syndrome might be involved in the development of rapid-onset type 1 diabetes.View full abstractDownload PDF (1214K) -
Kenichi Matsuura, Yutaka Mori, Miho Hikita, Naoko Tajima2003 Volume 46 Issue 12 Pages 955-959
Published: December 30, 2003
Released on J-STAGE: March 02, 2011
JOURNAL FREE ACCESSA 76-year-old female visited our clinic with suspected angina pectoris. A coronary angiography confirmed a stenosis of 75%. The patient was diagnosed as having angina pectoris, tachycardiac arrhythmia, and hyperlipidemia, and treatment with a nitrate-containing drug, a β-blocker, and HMG Co-A reductase inhibitor was started.
The administration of the β-blocker produced an increase in serum triglyceride levels in the range of 500-600mg/dl, along with a corresponding increase in HbA1c. A 75-g OGTr showed her to be diabetic, with marked hyperinsulinemia. Bezafibrate administration resulted in an increase in preheparin LPL and a decrease in triglycerides to 200mg/dl, RLP-TG, small dense LDL, and MDA-LDL. The hyperinsulinemia had improved when 75-gOGTT were performed at 4, 8 and 16 weeks after the start of treatment, and the HOMA-R decreased from 8.3 to 3.3 following treatment, with a corresponding improvement in the HbA1c level.
No significant changes in the leptin or PAI-1 levels occured during the treatment. However, the TNF-α and HS-CRP levels decreased, whereas the adiponectin level increased with bezafibrate treatment.
In conclusion, this case demonstrated that hypertriglyceridemia is closely associated with insulin resistance through the involvement of relevant adipocytokines.View full abstractDownload PDF (836K) -
The Seventh National Survey on Hemoglobin A1cMakoto Tominaga, Eiichi Makino, Gen Yoshino, Katsuhiko Kuwa, Izumi Tak ...2003 Volume 46 Issue 12 Pages 961-965
Published: December 30, 2003
Released on J-STAGE: March 02, 2011
JOURNAL FREE ACCESSThe Japan Diabetes Society (JDS) Committee on Standardization of Laboratory Testing Related to Diabetes Mellitus established primary standard material, i. e., deeply frozen material, 5 levels, designated JDS Lot 2, for measurement of hemoglobin A1c (HbA1c) on March 31, 2001. The numerical values of Lot 2 were carried over from the JDS Lot 1. Two calibrators, Lot 1 and Lot 2 traceable calibrators, are thus now being used in Japan for routine laboratory measurement of HbA1c. The Seventh National Survey on HbA1c was done to ditermine whether HbA1c standardization has been maintained. In November 2002, 4 test samples, i. e. 2 freeze-dried and 2 deeply frozen samples, were sent to about 800 laboratories throughout Japan. We found that 177 laboratories used Lot 1 and 573 Lot 2 traceable calibrators. The difference in the mean between Lot 1 and Lot 2 traceable calibrators was almost negligible, i. e., 0.11-0.15%. In all laboratories, CVs of HbA1c measurements for the 4 test samples were from 2.7 to 4.0%. We concluded that standardization of HbA1c measurement is currently maintained satisfactorily in Japan.View full abstractDownload PDF (661K)
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