Journal of the Japan Diabetes Society
Online ISSN : 1881-588X
Print ISSN : 0021-437X
ISSN-L : 0021-437X
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Volume 53, Issue 1
Displaying 1-8 of 8 articles from this issue
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Original Article
  • Carotid Atherosclerosis and Coronary Artery Stenosis Association Assessed by Multislice Computed Tomography Angiography: Plaque Scores in Carotid Atherosclerosis and Coronary Artery Disease
    Shoichi Akazawa, Masayuki Tojikubo, Akiko Kuratomi, Tomoko Towatari, Y ...
    2010 Volume 53 Issue 1 Pages 1-9
    Published: 2010
    Released on J-STAGE: April 05, 2010
    DOIhttps://doi.org/10.11213/tonyobyo.53.1
    JOURNAL FREE ACCESS
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    We studied the relationship between carotid atherosclerosis and coronary artery disease in 131 subjects with diabetes mellitus undergoing multislice computed tomography (MSCT) coronary angiography. Carotid atherosclerosis was evaluated based on intima-media complex thickness (IMT) in the common carotid artery and plaque score (PS), defined as the sum of maximum thickness of all plaque observed in the bilateral carotid artery. IMT and PS were significantly higher in subjects with significant (≥50%) coronary artery disease (CAD) than in those without. Logistic regression analysis of significant CAD showed PS to be a significant independent variable. The receiver operating characteristic for IMT and PS use in predicting significant CAD showed sensitivity of 59% and specificity of 60% in IMT for a cutoff of 0.888 mm. Sensitivity was 74% and specificity 70% for PS for a cutoff of 3.6 mm.
    The number of significant (≥50%) stenotic segments correlated significantly with IMT (r=0.252, p<0.01) and PS (r=0.391, p<0.01). Multiple regression analysis showed PS and LDL-C to be significantly associated with the number of significant (≥50%) stenotic segments in the coronary artery (R2=0.205, p<0.001). The proportion of plaque type in the carotid artery was 3.1% in hypoechoic lesions, 20.8% in isoechoic lesions, 20.5% in hyperechoic lesions, and 55.6% in heterogenous (mixed) lesions. The proportion of plaque type in the coronary artery was 35.2% in noncalcified lesions, 30.4% in calcified lesions, and 34.4% in mixed lesions. The plaque type in the carotid and coronary arteries was similar in 24% of subjects.
    These results indicate that PS was more useful than IMT in identifying significant coronary artery disease. PS was also independently associated with coronary artery disease, together with such conventional risk factors as hyperlipidemia.
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Case Reports
Brief Clinical Note
  • Clinical Features of Severe Sulfonylurea-Induced Hypoglycemia in the Last 3 Years
    Satoshi Honjo, Toru Akahata, Emiko Okabe, Akira Matsuo
    2010 Volume 53 Issue 1 Pages 30-33
    Published: 2010
    Released on J-STAGE: April 05, 2010
    DOIhttps://doi.org/10.11213/tonyobyo.53.30
    JOURNAL FREE ACCESS
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    We determined the clinical features of severe sulfonylurea-induced hypoglycemia by analyzing 35 subjects with diabetes in the last 3 years. They averaged 76.7±1.4 years of age, with 25 (71.4%) over 75 years old. They averaged 6.7±0.4 drugs administered daily. By drug, 19 were administered glimepiride, 15 glibenclamide, and 1 gliclazide. Among the glimepiride-treated, 15 (78.9%) were administered over 3 mg. Of the glibenclamide-treated, 10 (66.7%) were administered over 5 mg. Overall HbA1c averaged 6.5±0.1%, with 12 of the 35 (34.3%) having HbA1c below 6.0%. Of the 12, 11 (91.7%) were older than 75 years and 9 (75.0%) were administered over 3 mg of glimepiride, 5 mg of glibenclamide, or 120 mg of gliclazide-excessive for their HbA1c and age-indicating that sulfonylurea administration in the elderly with diabetes should be reevaluated for appropriate dosing if unwanted effects such as hypoglycemia are to be avoided.
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Co-medicals Original Articles
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