Journal of the Japan Diabetes Society
Online ISSN : 1881-588X
Print ISSN : 0021-437X
ISSN-L : 0021-437X
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Volume 56, Issue 3
Displaying 1-6 of 6 articles from this issue
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Original Articles
Etiology, Classification
  • Associations between Fat Mass and Obesity-associated (FTO) Gene Polymorphism and Body Fat Accumulation and Glucose Metabolism Disorders in Japanese Females: The Effects of Endurance Training and Aging
    Midori Tanaka, Bin Wu, Norikazu Tanino, Keisuke Fukuo, Tsutomu Kazumi, ...
    2013 Volume 56 Issue 3 Pages 155-164
    Published: 2013
    Released on J-STAGE: April 05, 2013
    DOIhttps://doi.org/10.11213/tonyobyo.56.155
    JOURNAL FREE ACCESS
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    In order to determine the impact of endurance training and aging on the effects of the FTO polymorphism with respect to body fat accumulation and glucose dysregulation, we examined four groups of females: 147 young athletes, 303 young non-athletes, 132 middle-aged females and 202 elderly females. The fat mass was measured using whole-body dual-energy X-ray absorptiometry in the young and middle-aged females and an impedance method in the elderly females. Daily energy intake was also determined in 206 young non-athlete females and 94 middle-aged females. The genotype AA was found to be associated with general adiposity, with no differences between the young athletes and non-athletes. The AA homozygote was found to be associated with fasting hyperinsulinemia in the young non-athletes, but not in the young athletes. Among the middle-aged females, the AA homozygote was also found to be associated with central adiposity and fasting hyperglycemia coupled with higher levels of HbA1c. In contrast, no associations with genotype AA were found among any of the variables studied in the elderly females. The AA homozygote was found to be associated with a greater energy intake in the young non-athletes. Our results suggest that endurance training has little influence on the effects of genotype AA with respect to general adiposity in young females. The associations observed in the young and middle-aged females with FTO polymorphism were not evident among the postmenopausal elderly females.
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Diagnosis, Treatment
  • Factors Affecting Weight Gain Following Treatment with Pioglitazone for Five Years in Patients with Type 2 Diabetes (JDDM24)
    Katsutoshi Komori, Fuminobu Okuguchi, Azuma Kanatsuka, Masashi Kobayas ...
    2013 Volume 56 Issue 3 Pages 165-172
    Published: 2013
    Released on J-STAGE: April 05, 2013
    DOIhttps://doi.org/10.11213/tonyobyo.56.165
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    To investigate the factors affecting weight gain following 5-year treatment with pioglitazone (PIO), 1,184 type 2 diabetic patients were analyzed retrospectively. PIO administration caused a mean 2.8 kg in weight gain. The mean body weight increased up to one year and was maintained at a stable value for up to five years. The degree of weight gain in females was greater than that observed in males. The coadministration of sulfonylureas increased the degree of weight gain, whereas the coadministration of α-glucosidase inhibitors inhibited increased weight gain. A significant correlation was found between the degree of weight gain and the HbA1c level and body mass index before the administration of PIO. Although the administration of PIO caused significant weight gain, three risk factors of atherosclerosis (HbA1c, HDL-cholesterol and blood pressure) were observed to improve.
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Case Reports
  • Mitochondrial Diabetes Associated with a tRNALeu (UUR) Mutation at Position 3271: Over a 15-year Follow-up Observation
    Yoshihiko Suzuki, Akira Shimada, Motoaki Sano, Shigeo Ota
    2013 Volume 56 Issue 3 Pages 173-178
    Published: 2013
    Released on J-STAGE: April 05, 2013
    DOIhttps://doi.org/10.11213/tonyobyo.56.173
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    A 54-year-old man had mitochondrial diabetes associated with a tRNALeu (UUR) mutation at position 3271. The patient's glycemic control deteriorated transiently when he became positive for glutamic acid decarboxylase (GAD) antibodies, then improved as he became negative for GAD antibodies. Only seven cases of mitochondrial diabetes with GAD antibodies have so far been reported in the literature, and no other patient has reverted to GAD negativity with insulin independence. The phenomenon observed in this case is so rare that it is important to understand the associations between GAD antibodies, mitochondrial dysfunction and diabetes. Six years later, the patient's insulin secretion gradually decreased. Therefore, we initiated treatment with sitagliptin (dipeptidyl peptidase-4 inhibitor) at a dose of 50 mg/day, then increased the dose up to 100 mg/day. After nine months, the patient's glycemic control improved with increased early insulin secretion and suppression of postprandial hyperglycemia. To our knowledge, this is the first case report in the literature indicating that a DPP-4 inhibitor is effective for the treatment of mitochondrial diabetes associated with tRNA Leu (UUR) mutations at position 3271. Hence, this case report provides important insight into a rare phenomenon. The patient's family history showed a strong inheritance of type 2 diabetes but no hearing loss. This provides a hint to understanding the different roles of 3243 and 3271 mitochondrial DNA mutations in the characteristics of mitochondrial diabetes.
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  • A Potential Improvement of Rheumatoid Arthritis in a Patient Treated with Liraglutide for Glucocorticoid-induced Diabetes
    Michiko Kohno, Masatoshi Nomura, Ichiro Abe, Yusuke Matsumura, Yayoi M ...
    2013 Volume 56 Issue 3 Pages 179-184
    Published: 2013
    Released on J-STAGE: April 05, 2013
    DOIhttps://doi.org/10.11213/tonyobyo.56.179
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    A 74-year-old male, who had been prescribed prednisolone (PSL) for rheumatoid arthritis (RA) since age 63 and who had developed glucocorticoid-induced diabetes at age 69, was hospitalized due to poor glycemic control. On admission, he was taking 7.5 mg/day of PSL and his HbA1c was 8.1 % despite infusion of 27 U/day of insulin. As preserved β-cell function was confirmed by a glucagon challenge test, liraglutide therapy was introduced. A stepwise increase in liraglutide successfully improved his glucose tolerance and led to discontinuation of insulin treatment. A good glycemic control was finally achieved by the combination of 0.9 mg/day of liraglutide and 3 mg/day of glimepiride. Interestingly, the level of matrix metalloproteinase-3, which indicates the RA activity, was dramatically reduced from 356 ng/ml to 187 ng/ml in parallel with this treatment. The present case may imply that there is a correlation between the administration of glucagon-like peptide-1 and an improvement in the symptoms associated with rheumatoid arthritis.
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  • A Case of Transverse Sinus Thrombosis Resulting in Sensory Aphasia in a Patient with Poorly Controlled Type 2 Diabetes
    Hironori Bando, Hiroyuki Yamada, Yasuhiro Omori, Daisuke Tsuchihashi, ...
    2013 Volume 56 Issue 3 Pages 185-191
    Published: 2013
    Released on J-STAGE: April 05, 2013
    DOIhttps://doi.org/10.11213/tonyobyo.56.185
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    A 76-year-old Japanese female with type 2 diabetes was admitted to our hospital with impaired consciousness and hyperglycemia. She was under treatment with glimepiride and voglibose. On admission, she presented with confusion and sensory aphasia. Her HbA1c level was 12.8 %, and her random plasma glucose level was 330 mg/dl. Magnetic resonance (MR) imaging and MR venography showed a left transverse sinus thrombosis. Anticoagulant therapy was administered, the patient was rehydrated and insulin was administered. The sensory aphasia improved three days after admission, and did not recur thereafter. Dehydration, abnormal hemostasis and decreased fibrinolytic activity due to chronic hyperglycemia could have caused the cerebral venous thrombosis. Inspection of MR images acquired at a later stage showed hypoplasia of the left transverse venous sinus, and the thrombus was thought to have formed in this region. When patients with poorly controlled diabetes mellitus present with neuropsychiatric symptoms, then the possible occurrence of transverse sinus thrombosis should be considered.
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Proceeding of the Local Societies
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