Journal of the Japan Diabetes Society
Online ISSN : 1881-588X
Print ISSN : 0021-437X
ISSN-L : 0021-437X
Volume 49, Issue 10
Displaying 1-12 of 12 articles from this issue
Lecture by the President of 49th Annual Scientific Meeting
Lecture by the Prize Winner of 2006
Original Article
  • Yohei Ogawa, Masae Minami, Yasuko Uchigata, Yasuhiko Iwamoto
    2006 Volume 49 Issue 10 Pages 783-789
    Published: 2006
    Released on J-STAGE: January 19, 2009
    JOURNAL FREE ACCESS
    We studied the frequency, history, and knowledge of self-monitoring of blood glucose (SMBG) and the relevance of these factors to blood glucose control in diabetic patients by questionnaire. Subjects were 215 patients with type 1 diabetes (Group T1) and 99 with type 2 diabetes (Group T2).
    Responses from 86.0% of Group T1 and 78.8% of Group T2 indicated that they had had operation instructions (“how to operate”) explained, while 30-50% of patients in both groups had had other items (“Significance of SMBG,” “SMBG use” “a Coping with hyperglycemia and hypoglycemia,” and “Other”) explained about SMBG. Furthermore, in both groups, 60% did not test the accuracy of SMBG devices. The duration of insulin treatment, SMBG history,and SMBG frequency were not related to HbA1C levels in either group. Predicting blood glucose levels before SMBG was not related to HbA1C levels in either group. Training in blood glucose awareness is more important in improving blood glucose control than simply predicting blood glucose levels out of habits. Even in patients with a long history of SMBG, it is necessary to reconfirm their training to use SMBG more effectively.
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Case Report
Co-medical
  • Kunihisa Kobayashi, Naoki Nakashima, Toyoshi Inoguchi, Daisuke Nishida ...
    2006 Volume 49 Issue 10 Pages 817-824
    Published: 2006
    Released on J-STAGE: January 19, 2009
    JOURNAL FREE ACCESS
    Based on practice guidelines, we created a critical pathway to support general caring for outpatients with diabetes mellitus, using an “overlay” to make optimal personalized critical pathways. Our critical pathway overviews consist of basic sheets for regular examinations and optional sheets on which the type and frequencies of medical examinations are determined based on parameters such as treatment methods, the severity of diabetic complications, and knowledge levels. The critical pathway is modified continuously as the patitent's condition changes. This is now being evaluated in a clinical trial for outpatients with diabetes mellitus.
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Report of the committee
  • Committee of the Japan Diabetes Society, Makoto Tominaga, Hideichi Ma ...
    2006 Volume 49 Issue 10 Pages 825-833
    Published: 2006
    Released on J-STAGE: January 19, 2009
    JOURNAL FREE ACCESS
    Since the hemoglobin A1C (HbA1C) measurement is to standardized internationally using references proposed by the International Federation of Clinical Chemistry and Laboratory Medicine (IFCC), we determined reference interval of HbA1C (IFCC). At the same time, we also determined reference interval of glycoalbumin (GA). The reference population (n=699 (men: 363, women: 336), age distribution: 23-91 years old) consisted of participants of the Funagata Diabetes Study and 3 other health checkup programs in Japan. All participants were subjected to a 75 g oral glucose tolerance test. HbA1C (IFCC) levels were measured with two types of routine HPLC and two types of routine immunoassay calibrated with JDS Lot 2 (assigned IFCC). Since no significant variation was found among the four measurements, the mean of these measurements was used as the representative value. GA levels in subjects were measured with an enzyme assay. Reference individuals for HbA1C (IFCC) and GA reference intervals were primarily selected based on National Committee of Clinical Laboratory Standards (NCCLS) recommendation. Multiple regression analysis showed that neither HbA1C (IFCC) or GA was associated with age, gender, questionnaire items suspected of influencing test results such as “Do you think you are healthy?,” physical examination results, or routine laboratory tests, e.g., hemoglobin, albumin, and creatinine. Reference individuals were selected from the reference population, with normal glucose tolerance, i.e., fasting plasma glucose<110 mg/dl and plasma glucose<140 mg/dl 2 hours after glucose loading. Reference individuals were further narrowed down using latent abnormal value exclusion method. Finally, using power transformation based on the parametric method, HbA1C (IFCC) and GA reference intervals were determined to be from 3.0 to 4.1%, and from 12.3 to 16.9%.
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