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Volume 34, Issue 8
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Tatsuyuki Imai, Masafumi Matsuda1991 Volume 34 Issue 8 Pages 671-676
Published: August 30, 1991
Released on J-STAGE: August 10, 2011
JOURNAL FREE ACCESSThe frequency and relationship of transient refractive changes in the eyes with changes in the plasma glucose level in diabetic patients during treatment has remained unclear.In order to elucidate this problem, the authors determined the effect of plasma glucose decrement on the refractive conditions of the eye.
Ten diabetic patients, 4 males and 6 females, 48 to 64 years old, were studied.Refractive conditions of the eyes were examined before, and 14 to 30 days after treatment with insulin or oral hypoglycemic agents.
Refractive changes ranging from +0.25 to +2.75 diopters (ΔD), were observed in 9 out of 10 patients.There was blurring of vision in 3 patients with ΔD of more than +0.5, but none in those with ΔD below +0.5.It took several months for these changes to return to the pretreatment findings. There were significantly positive correlations between ΔD in both eyes and decrements in plasma glucose level (each eye: n=10)(right: r=0, 888, left: r=0, 863, p<0.01 in both), and the ΔD of the right eye and the rate of decrease in plasma glucose per day (right: r=0.722, p<0.05, left: r=0.613, not significant).These findings suggest that the refractive condition of the eye may not be stable during the course of treatment of diabetes, and should be considered when patients complain of blurred vision.View full abstractDownload PDF (849K) -
Yutaka Uehara, Hiroyuki Shimizu, Mayumi Negishi, Akira Fukatsu, Masaki ...1991 Volume 34 Issue 8 Pages 677-683
Published: August 30, 1991
Released on J-STAGE: August 10, 2011
JOURNAL FREE ACCESSThe present investigation was undertaken to determine the effects of glucocorticoid on insulin release after exogenous administration of recominant human interleukin-1 (IL-1).1) IP injection of IL-1 over 1μg/kg into adrenalectomized rats (adx) suppressed basal insulin secretion at 2 hours. 2) Plasma glucose levels of IL-1-injected adx rats were higher than those of vehicle-injected adx rats at 2 minutes after i.v.bolus of 0.5g/kg glucose, and plasma insulin levels decreased significantly in IL-1-injected rats. The Δinsulin /ΔPG ration at 2 minutes after glucose loading were significantly lower in IL-1-injected adx rats than those in adx controls, although no difference was observed in the ratios of sham-operated rats.3) Decreased plasma insulin levels were restored to the previous levels by dexamethasone (0.1 mg/kg) supplementation in adx rats, to a significant degree.The results obtained herein suggest that lack of glucocorticoid may enhance the effect of IL-1 on the inhibition of insulin release.View full abstractDownload PDF (2385K) -
Junko Miura, Junichi Yokoyama, Akira Mimura, Yutaka Mori, Kageki Ito, ...1991 Volume 34 Issue 8 Pages 685-691
Published: August 30, 1991
Released on J-STAGE: August 10, 2011
JOURNAL FREE ACCESSPatients with pancreatogenic diabetes (PD), secondary either to chronic calcified pancreatitis or to pancreatectomy, become unpredictably hypoglycemic during conventional insulin therapy and often have so-called brittle diabetes.We investigated insulin requirements in feedback control performed with Biostator® in 11 PD.On the basis of these data, a multiple insulin injection regimen was designed and evaluated in comparison with previous conventional insulin regimens in 16 PD.PD requiring nocturnal insulin infusion of more than 1.0 U/hr in feedback control were treated with prandial actrapid insulin (Bolus), using a pen injector, and once with ultratard insulin injection (Basal), PD requiring nocturnal insulin infusion of less than 1.0 U/hr were treated only with Bolus. HbAi significantly decreased after the Bolus or Basal-Bolus regimen (10.7±2.8% vs 9.4±1.6%, p< 0.01).The M-value also decreased significantly after the Bolus or Basal-Bolus regimen (41.6±16.3 vs 21.4±12.1, p<0.01).Furthermore, mean amplitude of glycemic exclusion and frequency of hypoglycemic events were remarkably improved.These results suggest that a multiple insulin injection regimen should be considered in PD despite the fact that PD can be controlled by single injection with relatively small doses of insulin.View full abstractDownload PDF (1070K) -
Ken Nagaya1991 Volume 34 Issue 8 Pages 693-699
Published: August 30, 1991
Released on J-STAGE: August 10, 2011
JOURNAL FREE ACCESSIn a group of 1144 pregnant women attending a prenatal clinic at Asahi General Hospital for 12 months (Sept.1st, 1987-Aug.31st, 1988), random plasma glucose values at the first clinic visit were investigated and used to screen for glucose intolerance.
Without screening using random plasma glucose values, 3 cases of gestational diabetes (GDM) and 16 of glucose intolerance were detected by 75 g oral glucose tolerance test (GTT) in 196 pregnancies as indicated by common criteria (mainly glucosuria).These case were detected at 27.5±7.5 weeks (MEAN±SD).
On the other hand, 7 GDM and 14 glucose intolerance cases were detected by GTT in 59 pregnancies, screened only by random plasma glucose values at their first visit as an outpatient, using a threshould of 100 mg/d/.Besides this screening, conducted using the standard procedures mentioned above, 8 GDM and 26 glucose intolerance cases were detected at 14.5±8.0 weeks.
The screening using random plasma glucose values is efficient, simple and inexpensive.It is also more valuable, especially in facilities where screening using a glucose tolerance test is difficult to perform.View full abstractDownload PDF (2940K) -
Sonoko Anazawa, Reiko Okazaki, Kiyoe Kato, Kempei Matsuoka, Shin-ichi ...1991 Volume 34 Issue 8 Pages 701-709
Published: August 30, 1991
Released on J-STAGE: August 10, 2011
JOURNAL FREE ACCESSThe effects of improved insulin therapy on maternal diabetic control and neonates were investigated in 42 consecutive deliveries in 31 insulin dependent diabetic women. These 42 deliveries were divided into two groups. Group A included 24 deliveries done before 1979 with conventional insulin therapy and group B 18 deliveries done after 1980 with improved insulin therapy consisting of self-monitoring of blood glucose and multiple doses of insulin. The following differences were observed in group B as compared with group A. 1) Increased maximal insulin requirement during gestation (0.83±0.20 vs 0.53±0.28 U/kg/day, p<0.01). 2) Increased numbers of cases with daily urinary glucose less than 20 g/day (8 vs 5). 3) Increased numbers of neonates beyond the 38th gestational week (7 vs 2, p<0.05). 4) Reduction in birth weight ratio (1.16±0.20 vs 1.28±0.37, p< 0.05).These findings indicate that improved insulin therapy in IDDM pregnant women resulted in better maternal diabetic control and better neonatal nutritional status. However, to obtain these good results, it is mandatory to educate diabetic mothers on the importance of strict glycemic control throughout gestation as well as its effect on neonates so that they are willing to accept more aggressive therapy and to follow itView full abstractDownload PDF (1439K) -
Junko Setoguchi, Koji Nakano, Toshihiro Kanaizuka, Manabu Sawada, Naot ...1991 Volume 34 Issue 8 Pages 711-716
Published: August 30, 1991
Released on J-STAGE: August 10, 2011
JOURNAL FREE ACCESSThe non-obese diabetic (NOD) mouse spontaneously develops autoimmune diabetes with insulitis. CY-treatment can effectively promote the development of insulitis and diabetes in NOD mice.
To assess this promoting effect of CY, we examined endogeneous TNFα production and pancreatic venular leakage (PVL) in CY-treated NOD males. CY-treatment did not affect the endogeous TNFα production, although PVL was enhanced.
In intact NOD females, hTNFα-treatment did inhibit both of the development in sulitis and PVL. Moreover, this experiment suggested that the grade of PVL might be ralated to the grade of insulitis. Next, westudied the effect of hTNFα on the development of insulitis and PVL in CY-treated NOD males. hTNFα-treatment inhibited the development of insulitis by CY, but did not inhibit the PVL enhanced by CY.
These results suggest that the enhancement of PVL by CY-treatment might be involved in one of the promoting effects of CY on the development of insulitis and diabetes in NOD mice.View full abstractDownload PDF (2625K) -
H. Kakita, S. Aoki, Y. Tsutsumi, M. Sawada, G. Hasegawa, S. Takagi, K. ...1991 Volume 34 Issue 8 Pages 717-723
Published: August 30, 1991
Released on J-STAGE: August 10, 2011
JOURNAL FREE ACCESSUrinary microalbumin excretion rate (AER), GFR and blood pressure (BP) were examined in streptozocin (SZ) induced diabetic rats. SZ induced diabetic rats were divided in 2 groups, one untreated and the other treated, and both groups were followed for 20 weeks with a control group. Captopril, an angiotensin converting enzyme inhibitor (ACEI), was given to the treated group. In the SZ control group, AER gradually increased just after the induction of diabetes mellitus and GFR increased by 1.5 times from the 1st to 4th experimental week and returned to the former value at the 8th experimental week. With the treatment of ACEI, increments in AER and GFR were both significantly improved and BP fell significantly.
We also divided the ACEI treated group into 2 groups, one was treated with ACEI in the former 10 weeks and the other in the latter 10 weeks. In the group treated during the former phase, increased AER detected in the SZ control group was significantly improved by ACEI treatment and did not increase even during the latter untreated phase. Whereas, in the group treated during the latter phase, increased AER was not improved by ACEI treatment in the latter phase. BP significantly fell with the ACEI treatment in both groups but AER did not correlate with the BP change.
We conclude that both AER and GFR increase in the early stage in the SZ induced diabetic kidney and that the increment in GFR might be the initiator. ACEI is effective for treatment of the early stage of SZ induced diabetic kidney because of its hypotensive action, and also because it improves glomerular hyperfuncti on.View full abstractDownload PDF (1061K) -
Taro Maruyama, Yutaka Suzuki, Yukari Yoshimura1991 Volume 34 Issue 8 Pages 725-730
Published: August 30, 1991
Released on J-STAGE: August 10, 2011
JOURNAL FREE ACCESSA 29-year-old male was admitted to our hospital with hyperglycemia (800 mg/dl) and hyper-amylasemia (5080 IU/m/).He died one hour after admission and autopsy was performed.The pancreas weighed 100 gm.Neither reduction in the number of pancreatic islets nor atrophy of the islet were found, but scattered and sparse lymphocytic infiltration was seen in the islets (insulitis). Lymphocytic infiltration was also seen in the exocrine gland and parotid gland.Histochemical staining demonstrated normal glucagon and somatostatin containing cells but no insulin-staining cells.These findings are similar to those of islet-cell lesions in mice with diabetes induced by EMC-virus diabetic strain.The majority of infiltrated lymphocytes were Leu 7-positive cells plus a few Leu Ml-positive cells.This case was regarded as IDDM which had developed abruptly due to distruction of both endocrine and exocrine pancreatic tissue.This is a useful case for understanding the pathogenesis of insulin-dependent diabetes mellitus in Japanese patients and also for clarifying the significance of hyperamylasemia in IDDM.View full abstractDownload PDF (6621K) -
Kiyoko Takahashi, Taro Maruyama, Izumi Takei, Hiroshi Maruyama, Toshih ...1991 Volume 34 Issue 8 Pages 731-737
Published: August 30, 1991
Released on J-STAGE: August 10, 2011
JOURNAL FREE ACCESSAllergic granulomatous angitis (AGA) is a rare collagen disease.We report here the case of a 71-year-old woman who developed insulin-dependent diabetes mellitus during a period of remission of AGA in which insulitis was subsequently recognized by pancreatic biopsy.She developed AGA in 1987, was treated with predonisolone and has been in remission since July, 1989.In December 1989, she developed hyperglycemia and was admitted to Urawa City Hospital.Laboratory data showed a plasma glucose level of 504 mg/dl, ketonuria, HLA DR9 and she was positive for islet cell antibodies.Pancreatic biopsy was performed on the 39th day of hospitalization, and marked lymphocytic infiltration of the islets was recognized.This insulitis was similar to that seen in the NOD mouse and the insulin containing cells were atrophic.The association of IDDM and collagen disease is rare and the coexistence of IDDM and AGA in one patient has not previously been reported in the literature to our knowledge.Reports of insulitis in patients with IDDM are also rare in Japan.This case may enhance our understanding of the role of autoimmune phenomena of the pathogenesis of IDDMView full abstractDownload PDF (6562K) -
1991 Volume 34 Issue 8 Pages 739-755
Published: August 30, 1991
Released on J-STAGE: August 10, 2011
JOURNAL FREE ACCESSDownload PDF (4360K)
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