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 5
Displaying 1-16 of 16 articles from this issue
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Regulation of Energy Metabolism by Interorgan Crosstalk
Original Article
  • Clinical Evaluation of Endogenous Insulin Secretion via Sulfonylurea Receptor and Insulin Sensitivity Estimated by the Nateglinide Administration Test in Type 2 Diabetics
    Masao Omura, Kazutoshi Fujibayashi, Nobuko Sakuma, Kazuko Mochizuki, R ...
    2008 Volume 51 Issue 5 Pages 403-410
    Published: 2008
    Released on J-STAGE: May 20, 2009
    DOIhttps://doi.org/10.11213/tonyobyo.51.403
    JOURNAL FREE ACCESS
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    We attempted to estimate endogenous insulin secretion via sulfonylurea receptor and insulin sensitivity to endogenous insulin simultaneously using the nateglinide administration test. The levels of plasma glucose and serum immunoreactive insulin (IRI) were measured before and 30, 45, 60, and 75 min after oral administration of 60 mg of nateglinide. We investigated serum IRI n min after nateglinide administration (IRIn) associatied with CPR 120 min after standard meal intake (CPR120), and the nateglinide index n min after nateglinide administration (NGIn) associated with the rate constant for plasma glucose disappearance after insulin injection (Kitt). We found 27 subjects with a positive relationship between CPR120 and IRI60 (r=0.56, p=0.0023) and between Kitt and NGI60 (r=0.71, p<0.0001). In 50 type 2 diabetics, ROC analysis revealed that IRI60 was more sensitive and specific for screening for the indication of insulin therapy for screening for glycemic control than CPR120 when the cut-off value of IRI60 was 7.8 μU/ml. ROC analysis also showed that NGI60 sensitivity and specificity for screening for the insulin sensitizer were similar to those of Kitt when NGI60 was 1.0 0/000 min-1 μU-1. We concluded that IRI60 and NGI60 are clinically useful parameters in deciding how to treat type 2 diabetics.
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  • Evaluation of Miglitol and Voglibose Effect on Postprandial Plasma Glucose after Test Meal A Loading
    Daigaku Uchida, Susumu Nakamura, Takamichi Yamane, Shunichiro Onishi, ...
    2008 Volume 51 Issue 5 Pages 411-418
    Published: 2008
    Released on J-STAGE: May 20, 2009
    DOIhttps://doi.org/10.11213/tonyobyo.51.411
    JOURNAL FREE ACCESS
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    Two alpha-glucosidase inhibitors (α-GIs), acarbose and voglibose, have been used to treat patients with type 2 diabetes in Japan, and a new α-GI, miglitol, became available for clinical use in 2006. Postprandial hyperglycemia and postprandial hyperlipidemia have been found to be closely related to cardiovascular disease. Test meal A was developed to simultaneously evaluate postprandial hyperglycemia and hyperlipidemia.
    We evaluated the effects of miglitol and voglibose on postprandial plasma glucose and plasma insulin in 20 patients with type 2 diabetes after test meal A loading. Miglitol strongly suppressed the rapid rise of postprandial plasma glucose 0.5 to 1 hour after meal loading compared to voglibose. Changes and incremental AUC0-120 min of postprandial plasma insulin were decreased more significantly by miglitol than by voglibose.
    We concluded that miglitol suppressed the rapid rise of postprandial plasma glucose more markedly than voglibose in type 2 diabetic patients, thus more strongly suppressing endogenous insulin secretion.
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  • Epidemiological Analysis of Metabolic Syndrome in General Health Examination in Marugame, Japan
    Michio Niimi, Yoichiro Miyai
    2008 Volume 51 Issue 5 Pages 419-425
    Published: 2008
    Released on J-STAGE: May 20, 2009
    DOIhttps://doi.org/10.11213/tonyobyo.51.419
    JOURNAL FREE ACCESS
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    Based on the new Japanese diagnostic criteria for metabolic syndrome (MetS) prepared in 2005, we studied MetS prevalence in subjects who underwent health examinations between June and October 2006 at a rural internal medicine clinic. We also evaluated the association of serum creatinine, uric acid, hepatic enzymes, alcohol intake, smoking, and MetS.
    We measured the waist circumference of 910 people aged 50 to 92 (316 men and 594 women) and determined MetS prevalence. Prevalence in all participants was 13.8%, i.e., 21.2% in men and 9.9% in women. The 2-fold difference between men than in women, reflects the difference in visceral obesity defined by waist circumference, i.e., 46.5% in men and 27.9% in women. Analyzing biochemical data in addition to metabolic abnormality in individuals who had undergone general health checkups, we found that alanine aminotransferase (ALT), aspartate aminotransferase (AST), and γGTP are associated with MetS in both genders. Serum uric acid levels in women with MetS were significantly higher than those in women without. No significant difference was seen in serum creatinine levels between subjects with and without MetS in either gender. No association was seen among cigarette smoking, alcohol intake, and MetS.
    The gender-specific prevalence of MetS is thus consistent with information indicating that men have about twice the risk for cardiovascular events. Japanese diagnostic criteria for MetS were thus considered appropriate from the perspective of preventing cardiovascular disease (CVD). Intervention to reduce the prevalence of MetS is also needed to reduce the risk of CVD.
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  • Clinical Trial of Metformin Monotherapy in Children and Adolescents with Type 2 Diabetes Mellitus in Japan
    Nobuo Matsuura, Masahiro Takeuchi, Shin Amemiya, Shigetaka Sugihara, Y ...
    2008 Volume 51 Issue 5 Pages 427-434
    Published: 2008
    Released on J-STAGE: May 20, 2009
    DOIhttps://doi.org/10.11213/tonyobyo.51.427
    JOURNAL FREE ACCESS
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    A clinical trial by a Study Group supported by ministry of Health, Labour and Welfare Research Grants for Clinical Research on Pediatric Disease investigated whether a 750 mg/d and double that dose of metformin could be used to treat Japanese children with T2DM by means of an open, non-randomized single arm study. The primary efficacy outcome measure was a significant improvement in HbA1c level between wk 0 and wk 24. The subjects were 50 patients between 10 and 19 y/o who had not been given any anti-diabetic medication for at least for 28 days before the study (naïve group) or whose diabetes had been treated with metformin alone at dose of 750 mg/day for at least 28 days before study (already-on group). At entry their HbA1c had to be≥5.8% (reference upper limit<5.8%) and their SDS-BMI had to be>0 for their age and sex. Secondary efficacy outcome measures, including fasting plasma glucose (FPG), and adverse events, including lactic acidosis, were observed. Metformin 750 mg/d was given to both groups for the first 12 wk. For the second 12 wk, the metformin dosed was increased to 1,500 mg/d if the HbA1c was ≥6.5% at wk 12, but remained at 750 mg/d, if the HbA1c value was <6.4% at wk 12. Ultinately, 47 patients (24 in group A and 23 in group B) were enrolled, and 38 patients completed the clinical study. The mean HbA1c level of the 38 patients was 7.4±1.3 at 0 wk and 6.9±1.2% at wk 24, and the improvement between wk 0 and wk 24 was significant (p=0.01). The FPG value also decrease significantly (p=0.017), from 165.3±79.6 to 135.3±37.7 mg/dl. No serious adverse events were observed. This fourth clinical trial in the world of metformin for pediatric use demonstrated once again that metformin is effective and safe in children and adolescents with T2DM.
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Case Report
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