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 8
Displaying 1-8 of 8 articles from this issue
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Mini Review
Original Article
  • Efficacy of a Short (2-Days) Educational Hospitalization to Prevent Impaired Fasting Glucose (IGT) from Progressing to Diabetes Mellitus
    Tetsuya Kawahara, Tadashi Arao, Takahiro Tabata, Yoshiko Morimoto, Yos ...
    2006 Volume 49 Issue 8 Pages 637-643
    Published: 2006
    Released on J-STAGE: January 19, 2009
    DOIhttps://doi.org/10.11213/tonyobyo.49.637
    JOURNAL FREE ACCESS
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    We divided 102 patients diagnosed as having impaired glucose tolerance (IGT) into a “Short term hospitalization group” (23 patients), “Non-hospitalization with supplemental hospitalization group” (13 patients), and “Non-hospitalization without supplemental hospitalization Group” (66 patients).
    We followed up body weight, blood pressure, fasting plasma glucose (FPG), 2h plasma glucose (2hPG), and serum lipids (total cholesterol (TC), triglyceride (TG) and high density lipoprotein cholesterol (HDL-C)) for one year. In both “Non-hospitalization groups”, the levels of HbA1C, FPG, 2hPG and TG showed worsening tendencies. However, in the “Short term hospitalization group” worsening of the same items was suppressed as compared with both “Non-hospitalization groups”. In addition, in “Short term hospitalization group” HbA1C level was shown to not increase meaningfully, as compared with before admission.
    Thus, we conclude that a short (2-days) educational hospitalization in the early stage improves blood sugar control and serum lipid control, and prevents of IGT from processing to diabetes mellitus.
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  • Silent Myocardial Ischemia in Japanese Diabetes Patients
    Toshiharu Ishizuka, Yoshiharu Tokuyama, Hitoshi Nakamura, Kouji Houzaw ...
    2006 Volume 49 Issue 8 Pages 645-652
    Published: 2006
    Released on J-STAGE: January 19, 2009
    DOIhttps://doi.org/10.11213/tonyobyo.49.645
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    To clarify the actual state of silent myocardial ischemia (SMI) in patients with diabetes mellitus (DM) and to identify the risk factor (s), we examined the frequency of SMI and the clinical characteristics in outpatients with diabetes mellitus and SMI. We performed treadmill exercise testing electrocardiography (ECG) in 387 diabetic patients without anginal pain. We compared the history of the disease, physical status, pulse wave velocity and laboratory data in patients with a positive result of the exercise testing with those in patients with a negative result. Coronary angiography was performed in 92 patients with positive results in exercise testing. A positive result was observed in 20-25% of men over the age of 40 years and 25% of women over the age of 50 years. The duration of DM tended to be longer in the patients with positive results than those who tested negative. The systolic blood pressure was significantly higher in the patients testing positive, as was aortic-upper arm pulse wave velocity was in both males and females, compared with that in the patients tested negative. The upper arm-ankle pulse wave velocity increased in females tested positive. Multiple logistic analysis showed that systolic blood pressure and aortic-upper arm pulse wave velocity were independent risk factors in males. Coronary angiography showed significant stenosis in 66% of the patients with positive results. The stenoses were observed in multiple branches in more than 70% of these patients. The patients with stenosis had higher fasting plasma glucose and higher HbA1C levels, compared with those in the patients without stenosis. Prevalence of SMI in diabetes patients was estimated as 16%. Therefore, it seems that an ECG exercise testing should be performed for the diagnosis of SMI in diabetic patients in males over 40 years of age and in postmenopausal females with long duration of the disease, hypertension and/ or increased pulse wave velocity. Coronary angiography should be performed for definitive diagnosis of SMI in patients whose ECG exercise testing is positive, and who have poor glycemic control.
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Case Report
  • Dietary Therapy in a Case of Gestational Diabetes Mellitus with Severe Obesity
    Shin Tsunekawa, Yoshitaka Miura, Atsuo Itakura, Yutaka Oiso
    2006 Volume 49 Issue 8 Pages 653-658
    Published: 2006
    Released on J-STAGE: January 19, 2009
    DOIhttps://doi.org/10.11213/tonyobyo.49.653
    JOURNAL FREE ACCESS
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    A severely obese 24-year-old pregnant woman (BMI 51.2 kg/m2) referred for treatment of gestational diabetes mellitus, presented a diabetic pattern in 75 g-OGTT and elevated HbA1C. Laboratory findings showed elevated blood glucose and ketone bodies. Diabetic diet of 1,840 kcal (ideal body weight×30 kcal) failed to control both glucose and ketone bodies. Mealtime insulin lispro injection achieved good blood glucose control, but ketone bodies remained elevated. Increased calories to 2,000 kcal ameliorated her condition and she was discharged.
    At 30 weeks gestational, she was hospitalized again due to impending premature delivery. Gestosis diet of 1,800 kcal elevated blood ketone bodies and liver dysfunction. Increased calories and protein ameliorated both symptoms. Her daily insulin dose was increased to 106 units and her condition stabilized. She delivered by cesarean section at 37 weeks gestation. The neonate weighed 2,542 g and had no abnormalities. The result of 75 g-OGTT in her postpartum period showed a normal pattern. Although calorie restriction was recommended for obese patients with gestational diabetes mellitus, adequate calorie control and insulin injection may be required for normal metabolic control.
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  • A Case of Type 2 Diabetes Mellitus Caused by Autoimmune Pancreatitis
    Y. Koike, H. Sato, S. Kojima, S. Hozawa, M. Yagame, H. Sakai
    2006 Volume 49 Issue 8 Pages 659-662
    Published: 2006
    Released on J-STAGE: January 19, 2009
    DOIhttps://doi.org/10.11213/tonyobyo.49.659
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    [in Japanese]
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  • A Case of Drug-induced Interstitial Pneumonitis Caused by Metformin
    Hiromichi Kijima, Keiko Sakai, Hajime Masuda, Masahiko Katoh
    2006 Volume 49 Issue 8 Pages 665-668
    Published: 2006
    Released on J-STAGE: January 19, 2009
    DOIhttps://doi.org/10.11213/tonyobyo.49.665
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    A 69-year-old woman with diabetes mellitus, hypertension, and chronic thyroiditis was admitted with recurrent attacks of syncope. Since coronary angiography showed total occlusion of right coronary artery, an atrioventricular block or sinus arrest was suspected and the patient was scheduled for implantation of a permanent pacemaker. Insulin treatment and administration of metformin, 500-750 mg/day were started in order to improve her glycemic conditions. About a month later, the patient developed a dry cough, low grade fever, and progressive dyspnea due to severe interstitial pneumonitis and pleural effusion Metformin was discontinued and an infectious etiology was ruled out by cultres, serology and lung biopsy. Prednisolone, 40 mg/day was administered orally and the pneumonitis rapidly improved. After reducing the prednisolone to 10 mg/day, metformin was reintroduced, but the next day the clinical symptome of interstitial pneumonitis reappeared and the metformin was once again discontinued. The patient apparently tested positive in a drug-induced lymphocyte stimulation for metformin. Pulmonary toxicity is a rare adverse effect of metformin and only one case has been previously reported. The clinical course and possible pathogenic mechanisms are discussed.
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