We studied the efficacy of 150 mg/day treatment with epalrestat, an aldose reductase inhibitor, on diabetic neuropathy in 22 type 2 diabetic patients-13 men and 9 women (mean age, 64.0±3.9 years old) who had a mean diabetes duration of 13.1±9.6 years, mean BMI of 22.1±3.9 kg/m², and mean HbA₁c of 6.8±0.8%. We compared symptoms of peripheral neuropathy, including foot numbness, paresthesia, and cold sensation between those treated with and without epalrestat in a crossover trial. We also analyzed patellar tendon reflex (PTR), achilles tendon reflex (ATR), vibration perception threshold (VPC), the coefficient of variation of the R-R interval (CV_R-R), and motor conduction velocity (MCV). Symptoms of peripheral neuropathy, including foot numbness, paresthesia, and cold sensation were ameliorated by eplrestat. Without epalrestat, VPC worsened significantly. No significant changes were observed in PTR, ATR, CV_R-R or MCV. This study suggests that epalrestat treatment effectively improves subjective symptoms of diabetic neuropathy.

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The effect of insulin lispro Mixture-25 and Mixture-50 on the quality of life (QOL) of Type 1 and Type 2 diabetes patients was assessed by means of the QOL questionnaire “Insulin Therapy Related QOL (ITR-QOL)”. Insulin lispro is a rapid-acting insulin analogue and administered to patients immediately before meals. In this open-label trial patients received lispro Mixture-25 or lispro Mixture-50 and the QOL assessment was performed turce : at the start of therapy and after 12 weeks of therapy.
The subjects of the analysis in this study consisted of 215 of the 238 patients enrolled. The average score on the ITR-QOL was significantly higher at the endpoint (99.2 points) than at baseline (94.2 points), demonstrating improvement of the patients' QOL. The largest incremeases in scores (+0.4 to +1.0 points) on the ITR-QOL were observed in the items related to meal in the domain of “Perception Score”. Compliance with treatment and adherence to the physician's instructions regarding treatment were significantly better. The improvements were similar to those observed in the clinical study on lispro multiple-injection therapy. Thus, the lispro mixture medications improve patients' QOL.

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[in Japanese]

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Ischemic heart disease is one of the major causes of fatal events in diabetics, and early detection and efficient evaluation of coronary artery stenosis in diabetic patients improves the outcome. We efficiently detected coronary artery stenosis in two cases of type 2 diabetes by coronary CT angiography by means of multi-ditector row computed tomography. No evidence of ischemia was detected by either excercise electrocardiography or excercise ²⁰¹Tl scintigraphy, although both patients had diabetic microangiopathy and abnormal findings on carotid echograms. Based on the coronary angiography findings, percutaneous coronary intervention was performed in one patient and coronary artery bypass grafting in the other. Coronary CT angiography is a non-invasive examination and may be useful in screening for coronary artery stenosis in diabetic patients.

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[in Japanese]

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The plasma adiponectin level has been reported to be increased in type 1 diabetes mellitus (T 1 DM), but the mechanism of the increase is unknown. We investigated the plasma adiponectin concentration of children with T 1 DM before (age : 9.4±1.7 yr ; mean±SEM, percentage overweight : -9.3±3.0%) and during insulin replacement therapy (11.2±2.0 yr, 3.7±1.9%), and of control children (10.4±1.6 yr, 0.33±4.4%). The plasma adiponectin levels of the untreated T 1 DM children (12.1±2.4 mg/l) and control children (12.6±1.3 mg/l) were similar. The adiponectin concentration of a 10-year-old girl with fulminant T 1 DM (type 1 B) was low, 5.6 mg/dl. The adiponectin level in T 1 DM significantly increased during insulin therapy (17.6±1.9 mg/l), and the average increase (during/before insulin therapy) was 1.8-fold. These results suggest that adiponectin secretion in children with T 1 DM is stimulated by insulin therapy, not by T 1 DM itself.

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[in Japanese]

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