Journal of the Japan Diabetes Society
Online ISSN : 1881-588X
Print ISSN : 0021-437X
ISSN-L : 0021-437X
Volume 48, Issue 12
Displaying 1-12 of 12 articles from this issue
Pathogenesis of Vascular Endothelial Cell Damage
Original Article
  • Hideki Hidaka, Katsumasa Tsujinaka, Yoshimitsu Yamasaki
    2005 Volume 48 Issue 12 Pages 841-847
    Published: 2005
    Released on J-STAGE: April 11, 2008
    JOURNAL FREE ACCESS
    We studied resources and candidates for the primary prevention of type 2 diabetes based on medical expenditure calculated by health insurance medical care claims and annual health-checkup results among employee at an electronics company. Men aged 40-60 years-old with fasting plasma glucose levels (FPG) exceeding 100 mg/dl in 1992 were more prone to be diabetic within 8 years of observation than subjects with FPG less than 90 mg/dl, and these subjects had higher medical expenditures in fiscal 1999 and 2000 (April 1999 to March 2001). Of 1242 subjects with FPG between 100 and 125 mg/dl in 1992, 21% showed a diabetic range of FPG, exceeding 126 mg/dl in 1996 or 1997. Medical expenditures calculated from claims in these subjects in 1999 and 2000 fiscal years was 410±58 (mean±SE, x 1,000 Japanese yen in two years), which was 100,000 JPY higher than those in subjects with FPG remaining similar or improved. When 25% effective intervention for the primary prevention of diabetes is supposed to be introduced to these high-risk subjects, medical expenditures in the group may decrease for 3,000 JPY per person per year if the medical expenditures in subjects who are prevented from becoming diabetic are similar to those in subjects with FPG remaining unchanged. In low-risk subjects with FPG less than 100 mg/dl, the expected reduction is 440 JPY. Primary prevention should be cost-effective in reducing short-term direct medical expenditures in newly diagnosed type 2 diabetic subjects detected in annual health checkups.
    Download PDF (365K)
  • Kazunari Matsumoto, Masako Ozaki, Naruhiro Fujita, Seibei Miyake
    2005 Volume 48 Issue 12 Pages 849-854
    Published: 2005
    Released on J-STAGE: April 11, 2008
    JOURNAL FREE ACCESS
    We followed up 47 subjects with borderline glucose tolerance (BGT) for 3 years, and compared differences between subjects who subsequently developed type 2 diabetes (T2DM) and those who did not, focusing on the role of insulin resistance (IR) and metabolic syndrome (MS) in the transition of BGT to T2DM. Insulin sensitivity was measured directly using the insulin tolerance test K index (Kitt). Patients who subsequently developed T2DM (n=16) within 3 years of follow-up had a significantly greater waist circumference (89±14 vs. 82±9 cm, p<0.05), higher fasting glucose concentration (111±17 vs. 101±10 mg/dl, p<0.05), a significantly lower Kitt (3.31±1.11 vs. 4.23±1.13%/min, p<0.05), and were more likely to be diagnosed with MS (68.8% vs. 32.3%, p<0.05) at baseline, compared to the other group (n=31). A significantly larger proportion of subjects diagnosed with MS at baseline developed T2DM than non-MS subjects (52.4% vs. 19.2%, p<0.05 ; odds ratio 4.6, 95% CI ; 1.3-16.9). Multiple logistic regression analysis showed that both IR and MS were significant independent contributors to the transition from BGT to T2DM. Reduced insulin secretion did not correlate, however, with the development of T2DM. Thus, individuals with BGT who have IR and/or MS have a higher relative risk for developing T2DM. The 75 g oral glucose tolerance test and the measurement of waist circumference, blood pressure, and serum lipids are thus important for identifying those at relatively high risk for T2DM among individuals with BGT.
    Download PDF (264K)
Case Report
Co-medical
feedback
Top