Journal of the Japan Diabetes Society
Online ISSN : 1881-588X
Print ISSN : 0021-437X
ISSN-L : 0021-437X
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Volume 51, Issue 11
Displaying 1-13 of 13 articles from this issue
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Lecture by President of 51st Annual Scientific Meeting
Special Lecture
Lecture by the Prize Winner of 2008
Original Article
  • Efficacy of Insulin Glargine on Basal Insulin Supplementation in Japanese Type 1 Diabetes Patients Treated with Basal-bolus Injection Therapy
    Tomoyuki Katsuno, Tomoya Hamaguchi, Etsuko Nagai, Kosuke Konishi, Yuko ...
    2008 Volume 51 Issue 11 Pages 983-990
    Published: 2008
    Released on J-STAGE: May 20, 2009
    DOIhttps://doi.org/10.11213/tonyobyo.51.983
    JOURNAL FREE ACCESS
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    To clarify the efficacy of the long acting insulin analog glargine on basal insulin supplementation, we studied daily insulin dose, basal or bolus insulin dose, blood glucose control, and weight change before and after conversion from NPH insulin to glargine in 23 type 1 diabetes outpatients treated with basal-bolus injection therapy.
    In those whose ratio of basal to total insulin dose were relatively low, i.e., 34.9%, both daily basal insulin doses and ratios of basal insulin increased significantly and blood glucose control improved after conversion.
    Since the amount of basal insulin was comparatively less in patients treated with regular human insulin as bolus, basal insulin doses were increased after conversion, significantly improving their blood glucose control.
    HbA1c in those treated with twice-a-day injections of glargine was significantly lower than in those undergoing once-a-day injection therapy, even at the same basal insulin doses.
    In conclusion, glargine has an advantage over NPH as a basal insulin derivative in basal-bolus injection therapy in type 1 diabetes patients.
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Case Report
  • A Case of Autoimmune Pancreatitis Presenting Marked Deterioration in Glycemic Control as an Initial Symptom
    M. Sugihara, T. Wakasugi
    2008 Volume 51 Issue 11 Pages 991-996
    Published: 2008
    Released on J-STAGE: May 20, 2009
    DOIhttps://doi.org/10.11213/tonyobyo.51.991
    JOURNAL FREE ACCESS
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    [in Japanese]
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  • A Case of Type 2 Diabetes Mellitus with Septic Pulmonary Embolism due to Prostate Abscess
    T. Hyodo, M. Nakano, M. Matsuo, M. Iwase, M. Iida
    2008 Volume 51 Issue 11 Pages 997-1000
    Published: 2008
    Released on J-STAGE: May 20, 2009
    DOIhttps://doi.org/10.11213/tonyobyo.51.997
    JOURNAL FREE ACCESS
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    [in Japanese]
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  • Cranial Magnetic Resonance Imaging of Diabetic Chorea: Report of a Case and Review of the Literature
    Sachie Tsuzura, Shuichi Nakayama, Masahiro Yamasaki, Naohisa Hamashige ...
    2008 Volume 51 Issue 11 Pages 1001-1006
    Published: 2008
    Released on J-STAGE: May 20, 2009
    DOIhttps://doi.org/10.11213/tonyobyo.51.1001
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    A 81-year-old woman admitted for involuntary right-side movement of the body for eight days prior to admission. On admission, this movement was diagnosed neurologically as hemichorea. Voluntary plasma glucose was 422 mg/dl and HbA1c 13.4%. Hemichorea disappeared a few days after insulin therapy was begun, and no relapse occurred. The definitive diagnosis was diabetic chorea. Brain magnetic resonance imaging (MRI) showed a high-intensity area in T1-weighted MRI and a low-intensity area in T2*-weighted MRI in the left putamen. Interestingly, magnetic resonance angiography (MRA) showed an oozing-like intensity area with an irregular margin in the left putamen, which was not reported previously as a characteristic finding of diabetic chorea. This characteristic MRA finding disappeared four months later. We studied brain MRI findings of diabetic chorea based on our case and 9 others previously reported, concluding that these findings in the left putamen on T2*-weighted MRI and MRA are useful for diagnosing diabetic chorea.
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  • A Case of Type 1 Diabetes Mellitus Coexisting with Autoimmune Thyroid Disease Occurring 12 Years after Churg-Strauss Syndrome Onset
    Yoko Sagara, Masayuki Tojikubo, Hideki Hayashi, Shoichi Akazawa
    2008 Volume 51 Issue 11 Pages 1007-1012
    Published: 2008
    Released on J-STAGE: May 20, 2009
    DOIhttps://doi.org/10.11213/tonyobyo.51.1007
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    We report an exceedingly rare case of a patient developed type 1 diabetes mellitus together with autoimmune thyroid disease 12 years after the onset of Churg-Strauss syndrome.
    A 60-year-old woman who had been operated on for sinusitis at age 33 developed Churg-Strauss syndrome at age 45 with symptoms of generalized numbness, fever, pain and weakness in the lower extremities, difficulty in walking, and eosinophilia and increased IgE in laboratory findings. Remission was achieved after treatment with predonisolone.
    At age 57, 12 years after Churg-Strauss syndrome onset, she developed type 1 diabetes mellitus with symptoms of thirst, polyuria, polydipsia, and weight loss, i.e., HbA1c of 12.8%, GAD antibody of 497 U/ml, and was treated using rapid-acting insulin analog of 38-45 unit/day plus NPH insulin of 10-18 unit/day. A thyroid function test showed hypothyroidism due to chronic (Hashimoto's) thyroiditis, i.e. TSH 297 μIU/ml, free T4 0.43 ng/dl, TPO antibody>50 U/ml, so she was treated with levothyroxine. During two years of insulin therapy, her postprandial serum CPR decreased from 0.92 ng/ml to less than 0.05 ng/ml and GAD antibody decreased from 497 U/ml to 10.1 U/ml. Her human leukocyte antigen (HLA) was A*2402 and DRB1*0901-DQB1*0303. Only one case of type 1 diabetes mellitus occurring during Churg-Strauss syndrome remission has, to our knowledge, been reported in Japan.
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  • A Case of Fulminant-like Autoimmune Type 1 Diabetes Associated with Diabetic Ketoacidosis, Hyperthyroidism, and Acute Necrotizing Esophagitis
    Masayoshi Ohnishi, Michiaki Fukui, Keiji Yoshioka, Sadayoshi Yokoo, Go ...
    2008 Volume 51 Issue 11 Pages 1013-1016
    Published: 2008
    Released on J-STAGE: May 20, 2009
    DOIhttps://doi.org/10.11213/tonyobyo.51.1013
    JOURNAL FREE ACCESS
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    A subtype of nonautoimmune type 1 diabetes with rapid-onset diabetic ketoacidosis (DKA), low HbA1c at onset, insulin deficiency, and negative diabetes-related autoantibodies has been proposed as nonautoimmune fulminant type 1 diabetes. A 67-year-old woman admitted with DKA, hyperthyroidism, and upper gastrointestinal hemorrhage had suffered from thirst, nausea, and epigastric pain for 3 days before admission. One day before admission, she was seen elsewhere for repetitive vomiting with coffee-ground emesis and was given medication for upper gastrointestinal symptoms. On the day of admission, she suffered DKA with consciousness disorder. Despite significantly increased plasma glucose, HbA1c was elevated only slightly. Anti-GAD antibody was slightly positive and anti-IA-2 antibody was negative. HLA typing was HLA DR4. These clinical and laboratory findings indicated symptoms of fulminant type 1 diabetes except for the preserved residual insulin-secretion function of the islets of Langerhans, so we diagnosed this case as autoimmune type 1 diabetes. This case is notable because (1) it showed fulminant type 1 diabetes-like clinical onset and (2) it showed acute necrotizing esophagitis, probably because autoimmune type 1 diabetes was complicated by hyperthyroidism at onset.
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