Journal of the Japan Diabetes Society
Online ISSN : 1881-588X
Print ISSN : 0021-437X
ISSN-L : 0021-437X
Volume 47, Issue 4
Displaying 1-10 of 10 articles from this issue
  • Ryuji Suzuki, Akira Shimada, Keisuke Hayashi, Takao Saruta
    2004 Volume 47 Issue 4 Pages 265-269
    Published: April 30, 2004
    Released on J-STAGE: March 02, 2011
    JOURNAL FREE ACCESS
    We studied the long-term efficacy of nateglinide after short-term insulin treatment to remove glucose toxicity in 41 patients with poorly controlled (HbA1c>10%) type 2 diabetes.We regarded a successful outcome as maintenance of HbAic at<6.5% for over 6 months.Outcome was successful in 33 (HbA1c4.6-6.4%) but unsuccessful in 8 (HbA1c6.9-10.7%).No significant difference was seen in age, gender, body mass index, fasting serum C-peptide, units of insulin at exchange, or period of insulin use between groups. Disease duration from diagnosis and the period of use of sulphonylurea (SU) agents, however, were significantly longer in unsuccessful control (5.0±4.1 vs 2.0±3.0 years;p<0.03, 1.6±1.1 vs 0.4±0.9 years;p=0.003).These factors were therefore considered important in determining a change from insulin treatment to oral hypoglycemic agents.Although SU agents are conventionally used in such a change, we suggest that nateglinide is the drug of choice due to its pharmacological characteristics in type 2 diabetes of short duration.
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  • Yukiko Kanda, Kayo Yamada, Yumiko Harada, Fumiko Kawasaki, Mieko Saito ...
    2004 Volume 47 Issue 4 Pages 271-275
    Published: April 30, 2004
    Released on J-STAGE: March 02, 2011
    JOURNAL FREE ACCESS
    In patients with type 2 diabetic mellitus treated with insulin, we studied the clinical parameters for predicting the possibility of insulin therapy withdrawal. Subjects were 83 patients undergoing intensive insulin therapy. Insulin therapy was withdrawn in 42 but not in 41. Age, BMI, diabetes duration, HbA1c, serum fasting CPR (s-CPR), 24 hour urinary CPR (u-CPR), and insulin dose were compared in the withdrawal and continuation groups. Indicators for insulin withdrawal were HbA1c 6.5% and insulin dose<0.3U/kg body weight. Age, BMI, HbA1c, s-CPR, and u-CPR at baseline did not differ significantly between groups, but diabetes duration was significantly shorter in the insulin withdrawal group (p<0.05).HbAic at withdrawal (about 4 months after induction) was significantly lower than at 4 months after induction in the group continuing insulin therapy (p<0.0001).At the same point, insulin dose was lower in those withdrawing (p<0.0001). These results indicate that diabetes duration may be a predictor in withdrawal from insulin therapy, and insulin dose and glycemic control assessed by HbA1c may be indicators for assessing insulin withdrawal.
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  • Hideki Urakawa, Akira Katsuki, Kazutaka Matsumoto, Noriko Maruyama, Ko ...
    2004 Volume 47 Issue 4 Pages 277-282
    Published: April 30, 2004
    Released on J-STAGE: March 02, 2011
    JOURNAL FREE ACCESS
    To determine the relationship between insulin resistance and visceral subcutaneous fat adiposity or serum triglyceride (TG) in nonobese Japanese patients with type 2 diabetes mellitus, we conducted a euglycemic hyperinsulinemic clamp study in 149 patients with type 2 diabetes.Visceral and subcutaneous fat were measured by computed tomography (CT).Glucose infusion rate (GIR;index of insulin sensitivity during the euglycemic hyperinsulinemic clamp study) correlated significantly negatively with visceral (r =-0.254, p<0.01), subcutaneous fat (r=-0.261, p<0.01) or serum TG (r=-0.180, p<0.05).Visceral fat areas correlated significantly positively with serum TG (r 0.299, p< 0.01). These results suggest that visceral subcutaneous fat accumulation and serum TG may contribute to the development of insulin resistance in nonobese Japanese patients with type 2 diabetes mellitus.
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  • Comparison to Glibenclamide by Retrospective Analysis
    Yumiko Takizawa, Jo Satoh, Kazuma Takahashi, Hisamitsu Ishihara, Masas ...
    2004 Volume 47 Issue 4 Pages 283-289
    Published: April 30, 2004
    Released on J-STAGE: March 02, 2011
    JOURNAL FREE ACCESS
    Because gliclazide (GCZ), a sulfonylurea with various bioactivities, in addition to insulin-secretagogue activity, including free-radical scavenging, may suppress the development of diabetic microangiopathy, we retrospectively compared the duration from diabetes onset until diagnosis of retinopathy and nephropathy between patients treated with GCZ and those treated with glibenclamide (GBC) as a control by the Kaplan-Meier method and Cox's proportional hazard analysis. The duration from onset until diagnosis of retinopathy was significantly longer in the GCZ group. Independent variables affecting prognosis were lower HbAic and BMI in the GCZ group but not GCZ or GBC per se.Although the period until diagnosis of microalbuminuria or proteinuria did not differ between groups, proteinuria in patients with diabetes duration of more than 25 years tended to be less frequent in the GCZ group.This study confirmed the preventive effect of good glycemic control on diabetic retinopathy and indicated a relationship between BMI and retinopathy.
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  • Konomu Uehara, Kazunori Utsunomiya, Keiko Kamachi, Rie Yoshihara, Kant ...
    2004 Volume 47 Issue 4 Pages 291-295
    Published: April 30, 2004
    Released on J-STAGE: March 02, 2011
    JOURNAL FREE ACCESS
    The clinical evaluation of the effect of a low-protein diet (LPD) on diabetic nephropathy in outpatients is hampered by the standardization in estimating the protein intake.To simplify estimation, we studied the relationship between protein intake and urinary urea nitrogen (UN) concentration in patients with diabetic nephropathy. Subjects were 51 patients divided into 2 groups based on creatinine clearance (Ccr): group A with Ccr of 30-60 ml/min and group B with Ccr of <30ml/min. The daily protein intake was calculated from total UN excretion in 24-hour urine collection. Urine samples were used to determine the ratio of UN per creatinine concentration (UN/Cr).Group A showed a significant positive correlation between daily protein intake and UN/Cr in urine samples. According to an ROC curve, 4.46 UN/Cr as the cutoff point yielded 90.48% sensitivity and 77.78% specificity for 0.8 g/kg/day of protein intake. Group B showed no correlation between protein intake and urinary UN/Cr.These results suggest that UN/Cr in urine samples is a useful indicator of daily protein intake in patients whose Ccr is 30-60ml/min.
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  • [in Japanese], [in Japanese], [in Japanese], [in Japanese], [in Japane ...
    2004 Volume 47 Issue 4 Pages 297-301
    Published: April 30, 2004
    Released on J-STAGE: March 02, 2011
    JOURNAL FREE ACCESS
  • Masako Deguchi, Yasushi Hibino, Keizo Yamada, Shigeki Shintani, Tohru ...
    2004 Volume 47 Issue 4 Pages 303-307
    Published: April 30, 2004
    Released on J-STAGE: March 02, 2011
    JOURNAL FREE ACCESS
    A 62-year-old woman with mildly elevated fasting plasma glucose at 119mg/dl and HbA1c of 6.2% in July 1999 experienced thirst and weight loss in January 2000 and was hospitalized to assess elevated plasma glucose of 520 mg/dl and HbAic of 12.4% and for positive urine ketone body.Her fasting serum CPR concentration was 24μg/day and urinary CPR concentration 0.3ng/ml, indicated decreasing insulin secretion.Although both her glutamic acid dehydrogenase (GAD) antibody level and islet cell antibody (ICA) tests were negative, she was diagnosed with type 1 diabetes mellitus due to high IA-2 antibody (28.7U/ml).She was treated with insulin during hospitalization.Her diabetic control was good without insulin therapy for 6 months after discharge, but she later resumed insulin therapy, which continues today.IA-2 antibody has been continuously positive, but her GAD antibody remains negative.She carries both human leukocyte antigen (HLA) haplotype, which is a genetic risk for Japanese type 1 diabetes mellitus, DRB 1*0405-DQB 1*0401 and DRB 1*0901-DQB 1*0303.
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  • Akinobu Nakamura, Yuri Ono
    2004 Volume 47 Issue 4 Pages 309-311
    Published: April 30, 2004
    Released on J-STAGE: March 02, 2011
    JOURNAL FREE ACCESS
    We studied the difference between plasma glucose levels and self-monitored blood glucose (SMBG) levels in 9 diabetic women during pregnancy. Although no significant differences were seen between the two during the first or second trimester, SMBG was significantly lower than plasma glucose during the third trimester. Percentage fluctuations in SMBG were greater in the third trimester in the group whose plasma glucose was less than 100mg/dl than in the group whose plasma glucose was 100mg/dl or more. Since SMBG was lower than plasma glucose during the third trimester, such patients may be mistakenly diagnosed as hypoglycemic despite normal plasma glucose levels.
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  • [in Japanese], [in Japanese], [in Japanese], [in Japanese], [in Japane ...
    2004 Volume 47 Issue 4 Pages 313-318
    Published: April 30, 2004
    Released on J-STAGE: March 02, 2011
    JOURNAL FREE ACCESS
  • 2004 Volume 47 Issue 4 Pages 319-352
    Published: April 30, 2004
    Released on J-STAGE: March 02, 2011
    JOURNAL FREE ACCESS
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