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Volume 47, Issue 9
Displaying 1-10 of 10 articles from this issue
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Design and one-year interm report on feasibilitySakurako Ishida, Chikako Ito, Fumiyo Murakami, Chie Horikawa, Noriko G ...2004 Volume 47 Issue 9 Pages 707-713
Published: September 30, 2004
Released on J-STAGE: March 02, 2011
JOURNAL FREE ACCESSThe occurrence of type 2 diabetes mellitus is affected by genetic predisposition and lifestyle factors.In August 1998, we started a primary prevention program of type 2 diabetes mellitus by changing lifestyles among high-risk subjects. Each subject in the intervention group (n=102), assigned as borderline at 75gOGTT, received individualized counseling for losing weight and total energy intake and for increasing physical activity.We compared the incidence of diabetes 1 year after baseline examination with that of the control group (n=102).The cumulative incidence of diabetes was 6.9% in the intervention group and 19.6% in the control group, diabetes risk reduced by 65% in the intervention group.The greater the lifestyle modification, the less progression to diabetes in study subjects.We conclude that type 2 diabetes can be prevented by having high-risk subjects adopt a more suitable lifestyle.View full abstractDownload PDF (962K) -
Katsuhiro Miyashita, Masako Aoyama, Hajime Himei2004 Volume 47 Issue 9 Pages 715-722
Published: September 30, 2004
Released on J-STAGE: March 02, 2011
JOURNAL FREE ACCESSUrapidil was administered orally at 30mg/day for 1 month to 22 patients (17 men and 5 women) with diabetes and bladder dysfunction.After confirming the absence of adverse reactions, the dose was increased to 60mg/day for another 5 months.Urine flow was assessed with a uroflowmeter at the end of administration. Patients were assessed for symptoms using the International Prostate Symptom Score (IPSS) and the QOL score (an index of satisfaction).Uroflowmetry showed that maximum urine flow improved from 12.3±6.2 to 15.5±10.6 (ml/s), and that mean urine flow improved from 5.2±2.6 to 7.5±4.6 (ml/s), although neither change was statistically significant.IPSS and QOL scores decreased significantly, however, from 20.1±9.2 to 10.0±7.8 and 4.8±1.0 to 2.8±1.4.Efficacy, determined from Guidelines for Clinical Studies on Urinary Dysfunction, was 62.8%.Efficacy in patients with a pretreatment single voided urine volume of less than 200ml increased to 81.8%.Urapidil may thus be useful in treating diabetic neurogenic bladder, although it is important to select appropriate methods for evaluating response.View full abstractDownload PDF (1242K) -
Follow-up at Health ExaminationHiroyoshi Kikuoka, Hitomi Tatsuta, Keiko Yasuwaki, Tetsuhiro Kakimoto, ...2004 Volume 47 Issue 9 Pages 723-726
Published: September 30, 2004
Released on J-STAGE: March 02, 2011
JOURNAL FREE ACCESSSubjects were 110 patients with impaired fasting glucose (IFG) followed up for 5 years to compare clinical background factors in those becoming diabetic and in those who did not develop diabetes mellitus.Subjects with a diabetic response in OGYT or with fasting plasma glucose (FPG) exceeding 126 mg/dl twice or more were diagnosed with diabetes mellitus. Fifteen of the 110 cases (13.1%) developed diabetes mellitus within 5 years.These cases (n=15) showed significantly higher FPG and BMI at the start of the study and included significantly more patients with hypertension than others (n=95).These results suggest that among those with IFG, those with high plasma glucose and obesity or hypertention are more likely to become diabetic.View full abstractDownload PDF (534K) -
Masashi Kobayashi, Kohei Kaku, Ryuzo Kawamori, Yasuhiko Iwamoto, Yutak ...2004 Volume 47 Issue 9 Pages 727-735
Published: September 30, 2004
Released on J-STAGE: March 02, 2011
JOURNAL FREE ACCESSThis prospective observational study evaluated the efficacy and safety of once-daily glimepiride monotherapy, together with the effect on body weight, for 6 months in Japanese Type 2 diabetic patients.Subjects were 1, 236 Japanese type 2 diabetes mellitus patients (mean age: 62.7±10.7years), recruited from 183 study sites across Japan.Patients who were oral hypoglycemic agent (OHA) naive numbered 30%, and 61% had been switched from previous mono or combination therapy with other oral hypoglycemic agents (OHA).HbA1c improved significantly in the 293 OHA naive patients [median:(25%, 75%), 7.60:(7.10, 8.00)% to 6.50:(6.10, 7.00)%, p<0.0001], and a significant decrease in HbA1c was observed in patients switched from other oral monotherapy (nateglinide, α-GI, biguanide). In switching from other SU monotherapy to glimepiride, glycemic control improved significantly for patients with HbA1c>7 prior to treatment, while patients with already good control (HbA1c≤7) maintained control.Similar trends in improvement were also observed in FPG.Glimepiride did not result in any clinically relevant weight gain.Although initiating glimepiride in OHA naive patients resulted in a median BMI increase of+0.28kg/m2 [23.72:(21.77, 26.18) kg/m2 to 24.00 (22.20, 26.37) kg/m2, p<0.0001], no significant change in BMI was observed in subgroups previously treated with other OHA monotherapy (except nateglinide and α-GI).Adverse effects, including hypoglycemia, occurred in 8.54%(103/1206).This study confirmed that monotherapy with oncedaily administration of glimepiride is safe and improves glycemic control to a satisfactory level in OHA naive patients and in switching from most OHA monotherapy regimens.View full abstractDownload PDF (1225K) -
Ikuko Hanaoka, Tokuji Tanaka, Seiji Muro, Hitomi Watanabe, Shogo Oki2004 Volume 47 Issue 9 Pages 737-742
Published: September 30, 2004
Released on J-STAGE: March 02, 2011
JOURNAL FREE ACCESSMitochondrial diabetes mellitus, also called maternally inherited diabetes mellitus and deafness (MIDD), has characteristic clinical features.We report 7 cases in 4 families with MIDD associated with MELAS.The subjects were 3 men and 4 women, aged 20 to 59 years.The mean duration of diabetes was 15.0 years and the mean body mass index was 16.5kg/m2.The mean HbAic at the initial visit was 9.7%.None had a history of obesity, and diabetes onset preceded 40 years of age in all but 1 subject.Fasting serum C-peptide ranged from 0.2 to 2.7ng/ml and was markedly reduced (<1.0ng/ml) in subjects whose diabetes durations exceeded 10 years.Simple diabetic retinopathy was seen in 3, neuropathy in 4, early nephropathy in 3, and focal glomerulosclerosis in 1.Plasma glucose was well controlled with diet therapy in 1 subject and insulin therapy was required in 6.All showed elevated serum lactic acid/pyruvic acid ratio, cardiomyopathy, and cardiac conduction abnormalities.Six showed neurosensory deafness, inherited maternally in the 3 families. Abnormal findings in brain imaging were seen in 6.Five showed mental retardation and muscle weakness. Five had an A to G transition at position 3243 (3243 mutation) in genetic examination.Two had characteristic clinical features and a family history of MIDD.Common clinical features did not appear in family members and complications progressively worsened with disease onset and duration.These results suggest the importance of carefully observing the clinical course, including diabetes mellitus, and other clinical status.View full abstractDownload PDF (1383K) -
Kazuma Miwa, Yoji Hamada, Eitaro Nakashima, Keiko Naruse, Mika Nakae, ...2004 Volume 47 Issue 9 Pages 743-747
Published: September 30, 2004
Released on J-STAGE: March 02, 2011
JOURNAL FREE ACCESSA 41-year-old man diagnosed with diabetes mellitus 2 years earlier and admitted for severe leg pain had started insulin therapy 4 months before admission, and his HbA1c had decreased 3.4% per month. Several weeks after leg pain followed insulin therapy, pain gradually developed until admission.
Although hypopotassemia and hyperosmotic urine were present, his antidiuretic hormone was not curbed. We diagnosed him as having inappropriate secretion of antidiuretic hormone (SIADH) not compatible with drug-induced SIADH.
His pain gradually subsided by hospital day 150 and laboratory data showed that SIADH had deereased.
Given the pros and cons of pain-induced SIADH, we considered that pain may have been the major cause of SIADH in this case.
In conclusion, we reported what, to the best of our knowledge, is the first case of PPN-induced SIADH in Japan.View full abstractDownload PDF (782K) -
[in Japanese], [in Japanese], [in Japanese], [in Japanese]2004 Volume 47 Issue 9 Pages 749-753
Published: September 30, 2004
Released on J-STAGE: March 02, 2011
JOURNAL FREE ACCESS -
[in Japanese], [in Japanese], [in Japanese], [in Japanese], [in Japane ...2004 Volume 47 Issue 9 Pages 755-758
Published: September 30, 2004
Released on J-STAGE: March 02, 2011
JOURNAL FREE ACCESS -
Masakazu Fujii, Itsuro Nakano, Shoichi Natori2004 Volume 47 Issue 9 Pages 759-765
Published: September 30, 2004
Released on J-STAGE: March 02, 2011
JOURNAL FREE ACCESSWe evaluated the efficacy of ultra-short-acting insulin (Insulin Lyspro) in glycemic control for patients with diabetes caused by chronic pancreatitis who also underwent partial gastrectomy.Three men with pancreatic diabetes aged 47, 47, and 57 years had frequent hypoglycemic attacks during conventional insulin therapy, either multiple injections of regular insulin or injectionsof premixed insulin once or twice daily.All showed impaired pancreatic endocrine and exocrine function. Endocrine disturbance included decreased secretion of insulin and glucagon.After ultra-short-acting insulin therapy was started, hypoglycemic attacks decreased and glycemic control and nutritional condition improved in all subjects.The frequent hypoglycemic attacks observed in these patients were thus considered to involve decreased secretion of glucagon, a major counterregulatory hormone, in addition to digestive and absorptive malfunction caused by deficient enzyme secretion and partial gastrectomy.In such patients, ultra-short-acting insulin is effective because it closely mimics a physiologic postprandial insulin secretion pattern, reducing postprandial glucose elevation and preventing subsequent hypoglycemia.View full abstractDownload PDF (1600K) -
Sakae Nohara, Masanori Iwase, Udai Nakamura, Tamotsu Asano, Hideki Yot ...2004 Volume 47 Issue 9 Pages 767-772
Published: September 30, 2004
Released on J-STAGE: August 04, 2011
JOURNAL FREE ACCESSA 46-year-old woman admitted for hypokalemia had been emaciated since 15years old and was diagnosed with renal glucosuria at 21years and borderline GTT at 35years.She developed gestational diabetes at 38years, and a Caesarean section was conducted at 29weeks of gestation, while her blood glucose was controlled by 62 units of insulin per day.After the delivery, her glycemia was controlled by diet alone, but 75g OGTT showed a diabetes mellitus pattern and hyperinsulinemic response (before, 7.7μU/ml;120 min, 149.4μU/ml).At 46 year sold, her body mass index was 13.3kg/m2. Renal tubular function tests showed panaminoaciduria, reduced reabsorption of phosphorus, increased excretion of uric acid and carnitine, and decreased serum carnitine, leading to a diagnosis of Fanconi syndrome.75g OGTT showed delayed and hyperinsulinemic response similar to that at 38years old.It is rare for Fanconi syndrome to be associated with insulin-resistant diabetes mellitusdespite marked emaciation.The relationship of insulin resistanceand carnitine deficiency is discussed.View full abstractDownload PDF (1288K)
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