We studied the acute effects of a core exercise machine on glucose metabolism using the euglycemic glucose clamp technique. The subjects were 9 healthy adults (3 men, 6 women). The glucose infusion rate (GIR) significantly increased during 30 minutes of exercise (p<0.05), after which the rate decreased at recovery time. These results suggest that the use of a core exercise machine led to increased energy expenditure and the enhanced uptake of glucose in the skeletal muscles, especially the abdomen, thigh, and core muscles.

The purpose of this study is to clarify the direction of care by reviewing the literature with the aim of developing nursing support guidelines for end-of-life care in diabetic patients. We carefully reviewed 33 papers on end-of-life care for diabetic patients in Japan and overseas and extracted the contents that indicated the "direction of end-of-life care for diabetic patients." Labels were created based on those contents and analyzed by the qualitative integration method (KJ method). As a result, six symbols were derived, and a theory concerning the structure was derived, which required two of them like wheels of vehicle: "Support for maintaining one's health until death: Avoiding acute complications through foot care and adjustment of medication" and "Support for maintaining peace and dignity until death: Symptom control and an empowerment approach focused on the needs of the patients and their families". The results emphasized the importance of diabetes professionals continuing to provide physical support as well as continued care, including psychological, social and spiritual support, and recording and sharing the needs of patients and their families by paying close attention to their desires until the end of life [please check this carefully].

A 36-year-old male Thai patient visited our hospital because of a high HbA1c level and microcytic hypochromic anemia (RBC 5.56×10¹²/L, Hb 9.7 g/dL, MCV 65.3 fL). His plasma glucose and HbA1c values as determined by TOSOH HLC-723-G11 were 87 mg/dL and 10.9 %, respectively. The plasma glucose on the 75-g OGTT was 89 mg/dL (before) and 104 mg/dL (after 2 h). The glycoalbumin and 1,5-AG levels were normal at 13.2 % and 25.8 μg/dL, respectively. Thus, the HbA1c value measured in our laboratory seemed to be spuriously elevated. Supravital staining of RBCs with Brilliant crysyl blue demonstrated frequent Hemoglobin H (HbH; β4) inclusion bodies. A gene analysis revealed [--/α^Tα]-type HbH disease, where non-deletion-type α thalassemia (α^T) was Hb Constant Spring [HBA2: c.427T>C, or Codon142 TAA (Stop) →CAA (Gln) ]. A pair of α globin genes deleted in cis [--/] was of Southeast Asian-type α⁰ thalassemia. The presence of denatured HbH may have given rise to spuriously elevated HbA1c values because of its co-elution with normal HbA1c on high-performance liquid chromatography. α^T including Hb Constant Spring is common among Southeast Asians, a population that is relatively large in Japan. Thus, Japanese physicians need to be careful when interpreting the significance of HbA1c findings when they encounter such patients in their clinic.