Journal of the Japan Diabetes Society
Online ISSN : 1881-588X
Print ISSN : 0021-437X
ISSN-L : 0021-437X
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Volume 49, Issue 4
Displaying 1-8 of 8 articles from this issue
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Original Article
  • Prevalence and Outcome of Severe Hypoglycemia at a Hospital in Aichi Prefecture, Based on a Questionnaire Survey
    Kazuo Katsumata, Yutaka Oiso, Jiro Nakamura, Manabu Shimizu, Katsumoto ...
    2006 Volume 49 Issue 4 Pages 251-257
    Published: 2006
    Released on J-STAGE: January 19, 2009
    DOIhttps://doi.org/10.11213/tonyobyo.49.251
    JOURNAL FREE ACCESS
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    We performed a 6-month self-evaluation survey on the prevalence of severe hypoglycemic emergencies at 309 hospitals in Aichi Prefecture between September 1,2002 and February 28,2003. Patients who had arrived at the hospital with assistance or by ambulance were diagnosed with severe hypoglycemia if their blood glucose level had fallen below 50 mg/dl.
    The results of the survey showed that 160 diabetic patients and 22 non-diabetic patients were diagnosed with severe hypoglycemia. Two elderly diabetic patients died after treatment with an SU agent or nateglinide. Three diabetic patients with severe hypoglycemia who recovered with sequelae were on SU medication. Seven elderly non-diabetic hypoglycemic patients died of a life-threatening disease, such as renal insufficiency, cancer, etc.
    Both early discovery and treatment of severe hypoglycemia are very important in emergencies involving both elderly diabetics and elderly non-diabetics with severe illness.
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  • Acid-base Disturbances in Japanese Patients with Diabetic Ketoacidosis
    Hiromichi Tanahashi, Keigo Yasuda, Makoto Hayashi, Kenichi Hashimoto, ...
    2006 Volume 49 Issue 4 Pages 259-265
    Published: 2006
    Released on J-STAGE: January 19, 2009
    DOIhttps://doi.org/10.11213/tonyobyo.49.259
    JOURNAL FREE ACCESS
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    Acid-base disturbances in Japanese patients with diabetic ketoacidosis (DKA) were studied. Plasma acid-base patterns in 18 patients at the time of 21 admissions to our hospitals were analyzed. The coexistence of primary metabolic acid-base disturbances with DKA was defined by the fulfillment of all of the following criteria: (1) corrected HCO3-[Δ anion gap (AG)+plasma HCO3-]: <22mEq/l or>26 mEq/l, (2) ΔAG/ΔHCO3-: <0.8 or>1.2, and (3) (AG-10)/ΔHCO3-: <1.0 or>1.6. Combined respiratory disturbance(s) with DKA were diagnosed by the fulfillment of (4) pCO2>or<1.5xHCO3-+8±2, and (5) ΔpCO2>or<ΔHCO3-x(1∼1.3). Pure DKA and mixed acid-base disorders were observed in 9 cases (43%) and 12 cases (57%), respectively, and the latter group consisted of 6 patients with metabolic alkalosis, 3 with respiratory alkalosis, and 3 with triple acid-base disorder. In concusion, the occurrence of mixed acid-base disorder is very common in Japanese DKA patients. The association of other acid-base disturbances with DKA should always be kept in mind in clinical practice.
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Case Report
Co-medical
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