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Volume 49, Issue 6
Displaying 1-9 of 9 articles from this issue
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Original Article
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Azuma Kanatsuka, Koichi Kawai, Koichi Hirao, Mariko Oishi, Hirofumi Ta ...2006 Volume 49 Issue 6 Pages 409-415
Published: 2006
Released on J-STAGE: January 19, 2009
JOURNAL FREE ACCESSTo clarify drug therapies and actual use of oral hypoglycemic agents (OHA) and insulin preparations (INS) in patients with type 2 diabetes mellitus in Japan, we analyzed clinical data collected from 41 institutes using CoDiC®, an electronic system for diabetes data collection and management. Cross-sectional surveys were made of 14,246, 17,576, and 19,228 type 2 diabetic patients registered in 2002, 2003, and 2004. Monotherapy with OHA was done in 38% of patients, combination therapy with OHAs in 32%, combination therapy with INS plus OHA in 10%, and monotherapy with INS in 20%. Among patients receiving OHA, sulfonylureas (SU) were mostly prescribed, but biguanides (BG) and other OHAs are become increasingly used. BG was mostly combined with SU in patients treated with combination therapy of OHAs. α-glucosidase inhibitors (α-GI), BG, and SU were mostly used in patients receiving combination therapy of INS plus OHA. In patients receiving monotherapy with INS, the use of premixed types of insulin have decreased and regular insulin or rapid-acting human insulin analog plus NPH insulin or long-acting human insulin analog therapy have increased.View full abstractDownload PDF (272K)
Case Report
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Kanji Igarashi, Takahiro Kawasaki, Nobuyuki Ogata, Tadashi Sakai, Kaor ...2006 Volume 49 Issue 6 Pages 417-421
Published: 2006
Released on J-STAGE: January 19, 2009
JOURNAL FREE ACCESSA 17-year-old man seen for thirst and unexpected weight loss was found in laboratory examinations on admission to have plasma glucose (PG) markedly elevated to 1,107 mg/dl and hemoglobin A1C of 13.5%, although his consciousness was alert. Serum keton body was elevated to 8,460 μg/l, while arterial pH remained within normal range i.e., 7.36. He was diagnosed with soft-drink ketosis because of a negative serum anti-GAD antibody, a habit of over drinking soft drinks and obesity (BMI 29.9). He was treated with fluids and insulin and hyperglycemia improved shortly. Serum fructose concentration extremely elevated to 517.3 μmol/l (standard range:<10 μmol/l, 1 μmol/l=0.018 mg/dl) on admission decreased to 67.9 μmol/l (PG 330 mg/dl) 1 day and to 18.9 μmol/l (PG 218 mg/dl) 11 days after admission. The mean serum fructose concentration of patients with soft-drink ketosis (n=3) is obviously higher than that of patients with diabetic ketoacidosis (n=10) at admission, although mean PG was similar. Markedly elevated serum fructose concentrations may thus play an important role in the pathogenesis of soft-drink ketosis.View full abstractDownload PDF (274K) -
Kenji Shima, Kazuhiko Kawahara, Machiko Komatsu, Shu Kawashima2006 Volume 49 Issue 6 Pages 423-427
Published: 2006
Released on J-STAGE: January 19, 2009
JOURNAL FREE ACCESSWe report 5 cases with spontaneous hypoglycemia (BS≤50 mg/dl) after 2 to 3-day fasting who were on hemodialysis due to end-stage renal disease. Except for 1 case having 7 U insulin glargine injection 38 hrs prior to a hypoglycemic episode, none had taken any hypoglycemic agents for at least a few days. No case showed abnormally high insulin or low counter regulatory hormone in blood determined in the early morning at latest the 4th day after the episode. Impaired renal gluconeogenesis is most likely a major cause of hypoglycemic episodes except for 1 case with alcohol-induced liver dysfunction.View full abstractDownload PDF (310K) -
Tsutomu Kodera, Michiko Tozawa, Nobuyuki Yoshida, Hiroshi Koso, Rie Yo ...2006 Volume 49 Issue 6 Pages 429-434
Published: 2006
Released on J-STAGE: January 19, 2009
JOURNAL FREE ACCESSWe report an elderly patient with insulinoma in whom severe hyperglycemia was induced by octreotide, and who was finally treated with a minimal dose of the agent. An 89-year-old woman found to be hypoglycemic (20 mg/dl) experienced morning faintness. Her plasma insulin was 12 μg/ml and C-peptide 3.3 mg/dl during hypoglycemia. We diagnosed insulinoma as her counter-regulatory hormones responded normally, chromogranin A was markedly elevated, and a tumor was detected at the pancreas head. In consideration of her age and a dissecting aneurysm, we selected octreotide treatment. Upon the administration of 50 μg of octreotide, her plasma glucose rose to 555 mg/dl, which finally recovered 36 hours later. After titration, we found that a dose of 10 μg/day was optimal to control plasma glucose and to avoid hypoglycemic faintness. Octreotide is often used for insulinoma treatment; however, a dose as low as 10 μg/day is unusual. The reaction may have been due to the tumor expression of hypersensitive subtype receptor(s) of somatostatin or its analogs. This mechanism, together with insulin resistance as an adaptation phenomenon against prolonged hyperinsulinemia, could also explain why octreotide, which usually does not induce hyperglycemia in any situation, caused hyperglycemia in this patient.View full abstractDownload PDF (392K) -
S. Miyauchi, I. Kyoraku, K. Noma, H. Ueno, K. Shiomi, M. Mizuta, M. Na ...2006 Volume 49 Issue 6 Pages 435-439
Published: 2006
Released on J-STAGE: January 19, 2009
JOURNAL FREE ACCESS -
S. Kawachi, J. Takeda2006 Volume 49 Issue 6 Pages 441-444
Published: 2006
Released on J-STAGE: January 19, 2009
JOURNAL FREE ACCESS -
Y. Kanazawa, T. Shigihara, Y. Okubo, J. Kudo, N. Shimizu, A. Shimada2006 Volume 49 Issue 6 Pages 445-449
Published: 2006
Released on J-STAGE: January 19, 2009
JOURNAL FREE ACCESS
Co-medical
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K. Kondou, K. Egawa, H. Maegawa, Y. Nishio, H. Iwakawa, N. Nakanishi, ...2006 Volume 49 Issue 6 Pages 451-457
Published: 2006
Released on J-STAGE: January 19, 2009
JOURNAL FREE ACCESS -
—The Result of Questionnaire in Peculiarity of Behavior for Type 2 Diabetic Patients—H. Tsutsui, Y. Oshida2006 Volume 49 Issue 6 Pages 459-463
Published: 2006
Released on J-STAGE: January 19, 2009
JOURNAL FREE ACCESS
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