All issues
Volume 50, Issue 12
Displaying 1-9 of 9 articles from this issue
- |<
- <
- 1
- >
- >|
Original Article
-
Masaharu Urakaze, Katsuya Yamazaki, Isao Usui, Minoru Iwata, Tatsuhito ...2007 Volume 50 Issue 12 Pages 835-841
Published: 2007
Released on J-STAGE: May 20, 2009
JOURNAL FREE ACCESSGlimepiride, a sulfonylurea, is widely used at doses from 1 mg to 6mg to treat type 2 diabetes mellitus (T2DM). Doses of 0.5 mg per day are not normally considered as initial therapy and have not, to our knowledge, been formally studied in this setting. We designed a study to determine the efficacy and safety of glimepiride at 0.5 mg per day as first-line medical therapy for Japanese patients with mild T2DM (6.5%≤HbA1c<8.0%). Of 40 patients enrolled, 37 were evaluated for efficacy. Mean HbA1c decreased from 7.2% at baseline to 6.4% at 4 months; 54.5% of patients achieved HbA1c of<6.5% following treatment with a fixed dose of 0.5 mg/day for 4 months. Average weight did not change. Four cases of hypoglycemia occurred (1 asymptomatic, 3 symptomatic) but none was severe. No cases of hypoglycemia occurred within the first month of treatment. In conclusion, glimepiride at 0.5 mg per day is safe and effective as first-line medical treatment for patients with mild T2DM, reducing HbA1c with very few hypoglycemic symptoms and no weight gain.View full abstractDownload PDF (385K) -
Wataru Sano, Saeko Kushida, Hiroshi Mitsuoka, Takeshi Ogura, Yutaka Oh ...2007 Volume 50 Issue 12 Pages 843-847
Published: 2007
Released on J-STAGE: May 20, 2009
JOURNAL FREE ACCESSBased on waist circumference and the number of risk factors making up criteria for metabolic syndrome, we divided subjects-99 men and 103 women-into three groups, i.e., those with fewer than 2 risk factors (RF<2 group), nonmetabolic syndrome subjects with 2 or more risk factors [RF≥2+MetS (-) group] and metabolic syndrome patients [MetS (+) group], and studied the progress level of atherosclerosis and the frequency of cardio-and cerebrovascular disease. Both the RF≥2+MetS (-) and MetS (+) groups had significantly more progressive atherosclerosis and more frequent cardio-and cerebrovascular disease than the RF<2 group. Although the MetS (+) group had significantly higher HOMA-R than the RF≥2+MetS (-) group, no significant difference was seen between the RF≥2+MetS (-) and MetS (+) groups in the progression of atherosclerosis or the frequency of cardio-and cerebrovascular disease. We must therefore recognize that many patients have a risk for cardio-and cerebrovascular diseases equivalent to metabolic syndrome patients in nonmetabolic syndrome persons.View full abstractDownload PDF (223K)
Case Report
-
K. Kobayashi, T. Umezono, M. Maruyama, M. Abe, T. Kobayashi, M. Kato, ...2007 Volume 50 Issue 12 Pages 849-852
Published: 2007
Released on J-STAGE: May 20, 2009
JOURNAL FREE ACCESS -
Nobuko Ishizuka, Shimpei Fujimoto, Keiko Matsuoka, Kazuhito Fukuda, Na ...2007 Volume 50 Issue 12 Pages 853-858
Published: 2007
Released on J-STAGE: May 20, 2009
JOURNAL FREE ACCESSA 55-year-old man with abdominal pain and fever after drinking alcohol was found in blood chemistry examination to have elevated serum amylase (1,071 IU/l, normal range 40-125 IU/l) and in computed tomography (CT) to have pancreatic swelling. Blood glucose on admission for a diagnosis of acute pancreatitis was 107 mg/dl. Abdominal pain, fever, and elevated serum amylase lessened under conservative therapy on hospital day 4. On hospital day 6, however, he suddenly developed diabetic ketoacidosis, which was improved by insulin treatment. Pancreatic swelling was not detected in CT on hospital day 10. Urine C-peptide was <0.1 μg/day and serum C-peptide <0.1 ng/ml both before and 6 min after glucagon (1 mg) loading. Autoantibodies to glutamic acid decarboxylase and insulinoma-associated protein 2 were negative. He was diagnosed with fulminant type 1 diabetes mellitus based on rapid insulin secretion depletion. Clinical features diagnosed with acute pancreatitis were consistent with preceding symptoms of fulminant type 1 diabetes mellitus. We summarize cases in which pancreatic swelling was detected prior to ketoacidosis in fulminant type 1 diabetes mellitus.View full abstractDownload PDF (414K) -
Yuji Kamata, Raishi Ichikawa, Maya Kurosaka, Tomohiko Kurokawa, Madoka ...2007 Volume 50 Issue 12 Pages 859-863
Published: 2007
Released on J-STAGE: May 20, 2009
JOURNAL FREE ACCESSA 37-year-old woman referred for hyperglycemia was found to have a plasma glucose level of 670 mg/dl, positive plasma ketone bodies, arterial gas indicating metabolic acidosis, and anti-GAD Ab of 96.0 U/ml, yielding a diagnosis of diabetic ketoacidosis (DKA) due to type 1A diabetes mellitus. Her DKA was normalized in 48 hours with intensive treatment. One week after multiple insulin injection were started, however, her weight rose from 49 kg to 55 kg associated with generalized edema. Her urinary sodium excretion on day 5 was less than 0.5 g/day and she developed bradycardia of 46/min and serum concentrations of epinephrine below 5 pg/ml and norepinephrine below 68 pg/ml. These changes disappeared following a low-sodium diet and furosemide administration. Edema was assumed to have been induced by the stimulatory effect of insulin on urinary sodium resorption in the renal distal tubules as indicated by others. We speculate that transient bradycardia may have been related to this edema, which suggests the need to clarify the role of bradycardia in the development of insulin edema.View full abstractDownload PDF (376K) -
Toshika Otani, Tadasu Kasahara, Yasuko Uchigata, Yasuhiko Iwamoto2007 Volume 50 Issue 12 Pages 865-871
Published: 2007
Released on J-STAGE: May 20, 2009
JOURNAL FREE ACCESSWe report 3 patients in whom severe hypoglycemia was frequent from 50 years of age, with a 44-year-plus history of type 1 diabetes mellitus developing in childhood. Patient 1, a 53-year-old woman, developed diabetes mellitus in November 1959 at the age of 6 years. Since March 2002 at the age of 48 years, she has experienced frequent hypoglycemia with loss of consciousness. Patient 2, a 53-year-old woman developed diabetes mellitus in December 1962 at the age of 9 years. Since June 2002 at the age of 48 years, she has experienced frequent hypoglycemia with loss of consciousness. Patient 3, a 52-year-old woman, developed diabetes mellitus in September 1959 at the age of 4 years. Since December 2005 at the age of 51 years, she has experienced frequent hypoglycemia with loss of consciousness. Hypoglycemia became severe in these patients at the climacteric. In patient 2, autonomic neuropathy may have been additionally involved. Some woman with childhood-onset type 1 diabetes mellitus frequently show severe hypoglycemia from about 50 years of age (climacteric), emphasizing the need for close, careful management in their treatment.View full abstractDownload PDF (940K) -
Shu Abe, Shigeru Ohta, Kenzo Uchida2007 Volume 50 Issue 12 Pages 873-876
Published: 2007
Released on J-STAGE: May 20, 2009
JOURNAL FREE ACCESSWe report a diabetic patient who developed induced acute heart failure after initiation of insulin treatment.
A 64-year-old woman with type 2 diabetes mellitus developed acute heart failure about 3 months after initiation of insulin treatment. When HbA1c had improved from 14.6% to 8.7%, she developed pretibial edema, pedal edema and effort dyspnea with a weight gain of 12 kg to 48 kg. Chest X ray showed marked cardiomegaly and bilateral pleural effusion. The cardiothoracic ratio (CTR) increased from 43% to 66%. Electrocardiography was normal and BNP levels rose markedly to 477 pg/ml. Doppler echocardiography showed severely reduced systolic and diastolic functions (restrictive pattern) and moderate pericardial effusion. Fourteen days after administration of digitalis and a diuretic, pretibial edema and pleural effusion in chest radiography disappeared. Follow-up ultrasonic cardiography taken two months later showed that the ejection fraction (EF) remained at 35% and the restrictive pattern was unchanged. Before the onset of heart failure, the resting and loaded radionuclide angiography showed no deficit in blood supply to the heart muscles and no ischemic heart disease although the EF of 37% preexisted. We surmise that the mechanism of heart failure was chronic abnormal myocardial stiffness due to diabetic toxicity and acute body fluid retention as a direct effect of insulin.View full abstractDownload PDF (336K)
Co-medical
-
—The Negative Influence of Storing a Device with the Needle Attached—T. Asakura, M. Kageyama, H. Seino2007 Volume 50 Issue 12 Pages 877-882
Published: 2007
Released on J-STAGE: May 20, 2009
JOURNAL FREE ACCESS -
Y. Yokota, S. Kanno, J. Tada, I. Ishimura, R. Yamashita, M. Okuda, H. ...2007 Volume 50 Issue 12 Pages 883-886
Published: 2007
Released on J-STAGE: May 20, 2009
JOURNAL FREE ACCESS
- |<
- <
- 1
- >
- >|