Journal of the Japan Diabetes Society
Online ISSN : 1881-588X
Print ISSN : 0021-437X
ISSN-L : 0021-437X
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Volume 48, Issue 1
Displaying 1-12 of 12 articles from this issue
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Special Issue : Recent Progress of Stroke Care in Diabetes Mellitus
Original Articles
  • Development of a New Questionnaire on Glycemic Control and its Application to Insulin-treated Patients to Investigate the Frequency of Hypoglycemia and Hyperglycemia
    Hitoshi Ishii, Miyuki Furuya, Rieko Ishibashi, Satoru Tsujii
    2005 Volume 48 Issue 1 Pages 19-32
    Published: 2005
    Released on J-STAGE: April 11, 2008
    DOIhttps://doi.org/10.11213/tonyobyo.48.19
    JOURNAL FREE ACCESS
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    We developed a new questionnaire to assess quality of glycemic control and used it to investigate the frequency, timing, and severity of hypoglycemia, frequency of hyperglycemia and perception of glycemic control of insulin-treated patients. The questionnaire consists of 29 items, and its reliability was verified by the test-retest method. The results of this study (N=144) showed that 74.3% of the patients experienced hypoglycemia at least once a month, and that hypoglycemia occurred more frequently in type 1 patients and intensively treated patients. The results revealed high frequencies of hypoglycemia before lunch, before dinner, and while a sleep. The patients were most concerned nocturnal hypoglycemia, and 57.1% of the episodes of severe hypoglycemia occurred while a sleep, 15-26% of the patients were unaware of experiencing hypoglycemia. Although the target level of glycemic control perceived by the patients was very close to the standard level recommended by the Japan Diabetes Society, their actual HbA1c level was 1% higher. The levels of satisfaction with glycemic control and fluctuations in blood glucose were lower than on total insulin therapy. The patients expect such insulin therapy that provides better blood glucose control with lower frequency of hypoglycemia and hyperglycemia.
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  • Pancreatic Endocrine Function and Chronic Diabetic Complications Following Simultaneous Pancreas-Kidney Transplantation in Japan
    Masanori Iwase, Atsushi Sugitani, Kentaro Motoyama, Hirofumi Yamamoto, ...
    2005 Volume 48 Issue 1 Pages 33-42
    Published: 2005
    Released on J-STAGE: April 11, 2008
    DOIhttps://doi.org/10.11213/tonyobyo.48.33
    JOURNAL FREE ACCESS
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    Although simultaneous pancreas-kidney transplantation (SPK) is the established treatment for type 1 diabetic patients with end-stage renal failure, no studies have, to our knowledge, reported on chronic SPK patients after Japan's transplantation law was passed. We studied insulin secretion from pancreatic grafts and the effects of SPK on chronic diabetic complications in 4 patients with SPK conducted at least 1 year earlier. Insulin secretion in intravenous glucose tolerance tests decreased from 1 month after SPK in all 4, whereas 75 g oral glucose tolerance tests showed all but 1 patient (case 2), who had discontinued immunosuppresants due to noncompliance, to be normal. Two patients developed hypoglycemia 2 hours after glucose loading. Insulin secretion in glucagon load tests was low in case 2 and the patient donated from a non-beating heart donor (case 3). α-glucosidase inhibitor was administered in case 3 due to postprandial hyperglycemia (161 mg/dl). Glycemic control was excellent in all patients. After SPK, diabetic retinopathy remained unchanged, whereas autonomic neuropathy assessed by heart rate variability and the Schellong test was significantly improved (p<0.05). Ankle brachial blood pressure index and heart-carotid pulse wave velocity tended to improve. Although insulin secretion varied among the 4, blood glucose was well controlled and beneficial effects of SPK on chronic diabetic complications were observed. Despite the limited number of donors, with most donors marginal in Japan, our results appear to not be inferior those reported elsewhere.
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