Journal of the Japan Diabetes Society
Online ISSN : 1881-588X
Print ISSN : 0021-437X
ISSN-L : 0021-437X
Volume 35, Issue 6
Displaying 1-9 of 9 articles from this issue
  • Makoto Hayashi, Noriyuki Takeda, Keigo Yasuda, Shinobu Goto, Kaori Aoy ...
    1992 Volume 35 Issue 6 Pages 455-464
    Published: June 30, 1992
    Released on J-STAGE: March 02, 2011
    JOURNAL FREE ACCESS
    Absorption and elimination kinetics of insulin were studied in 10 non-insulin dependent diabetic patients, 5 with and 5 without diabetic nephropathy and renal failure (RF), and 6 healthy volunteers. Plasma free insulin profiles following subcutaneous (sc) and intravenous (iv) injection of regular insulin (0.1 U/kg) were analyzed by the split-pool model. In the diabetic patients with RF, the kinetic model analysis revealed a higher rate constant of absorption (5.6±1.5×10-2 min-1) than in the patients without RF (1.9±0.4×10-2 min-1) and normal subjects (1.6±0.5×10-2 min-1).The rate constants of inter-pool transition and degradation of insulin in the subcutaneous space did not differ among the 3 groups. The elimination rate constant and distribution volume of insulin were de creased and increased, respectively in the patients with RF (7.3±0.3×10-2 min-1, 169±8.3 ml·kg-1) as compared with the diabetic patients without RF (10.6±0.4×10-2 min-1, 128.4±4.8 ml·Kg-1) and normal subjects (11.8±0.6×10-2 min-1 129.2±8.9 ml·kg-1). Accelerated absorption of insulin as well as decreased elimination of insulin from the systemic circulation was noted in the patients with diabetic nephropathy and renal failure.
    Download PDF (1463K)
  • Shoichi Tomono, Shoji Kawazu, Toshihiro Utsugi, Norihiro Kato, Mitsuo ...
    1992 Volume 35 Issue 6 Pages 465-470
    Published: June 30, 1992
    Released on J-STAGE: March 02, 2011
    JOURNAL FREE ACCESS
    The relationships between urinary albumin excretion and serum levels of lipids, apolipoproteins and aortic pulse wave velocity (PWV) were investigated in 117 NIDDM with normoalbuminuria (overnight urinary albumin excretion index;UAI<15mg/g·Cr), 5 6 NIDDM with microalbuminuria (UAI between 15 and 199mg/g·Cr) and 21 NIDDM with macroalbuminuria (UAI≥200mg/g·Cr). Serum total cholesterol, triglyceride, apo B, apo E and the apo B/apo A-I ratio became significantly higher and HDL-cholesterol tended to decrease as UAI increased. Particularly, in the patients with microalbuminuria, triglyceride, apo B and the apo B/apo A-I ratio were significantly higher than those in the normoalbuminuric patients (p<0.05). In addition, PWV was significantly faster in microalbuminuric and macroalbuminuric patients than in normalbuminuric subjects (p<0.02, p<0.05), depending on the severity of albuminuria. Thus, PWV correlated significantly with the apo B/apo A-I ratio (p<0.001). These results indicate that diabetic nephropathy, even in its early phase, could induce significant pathological alterations in lipid and apoprotein levels, furthering PWV as an index of atherosclerosis.
    Download PDF (1052K)
  • Toru Murakami
    1992 Volume 35 Issue 6 Pages 471-478
    Published: June 30, 1992
    Released on J-STAGE: March 02, 2011
    JOURNAL FREE ACCESS
    We compared serum lipoproteins and clinical factors between non-insulin dependent diabetic (NIDDM) patients with (n=50) and without (n=108) ischemic heart disease (IHD). The patients with IHD were older and had longer durations of diabetes mellitus than those without IHD. Serum lipids, lipoproteins and apoproteins were comparable between the two groups. The relative distribution of TG in the VLDL fraction was significantly higher, while the relative distribution of TG in the LDL fraction and Apo E/VLDL ratio were significantly lower in patients with IHD than in those without IHD. Multiple regression analysis also indicated that these factors were significantly related to the presence of IHD. It was suggested that hypertriglyceridemia, especially an increase in the relative distribution of TG, plays an important role in the development of IHD in patients with NIDDM.
    Download PDF (1434K)
  • Chronological Changes in Characteristics at the Initial Visit for the 29 Years between 1957 and 1985
    Toeko Matsumoto, Yasuo Ohashi, Nobuhiro Yamada, Masatoshi Kikuchi
    1992 Volume 35 Issue 6 Pages 479-486
    Published: June 30, 1992
    Released on J-STAGE: March 02, 2011
    JOURNAL FREE ACCESS
    The histories of 2083 non-insulin dependent diabetics (1180 males, 903 females) who visited the Diabetic Unit of the Third Department of Internal Medicine, Tokyo University, between 1957 and 1985 were analyzed to identify chronological changes in the characteristics of Japanese diabetics.
    Our study showed that age at diagnosis decreased (49±12 y. o. in the '50s vs 47±12 y. o. in the '80s), and that the duration of diabetes at the initial visit was prolorgel (4±6 years vs 7±7 years). Both the percentage of patients with symptoms at diagnosis and those with symptoms at the initial visit decreased by half (92% vs 54%, 72% vs 38%, respectively), and the percentage of patients with a diabetic family history doubled (22% vs 46%) during the same peried.The percentage of patients treated with oral agents prior to their initial visit was higher before the 1970s and decreased after that time.No change over time was found with regard to sex, age at the initial visit, maximum obesity or percentage of those with a family history of hypertension.
    Our results suggest that Japanese diabetics have been diagnosed earlier and more asymptomatically in recent years. However, patients who visited university hospitals became a biased group with a long history of diabetes at the time of the initial visit.
    Download PDF (1462K)
  • Yutaka Mori, Junichi Yokoyama, Junko Miura, Kageki Itoh, Naoko Tajima, ...
    1992 Volume 35 Issue 6 Pages 487-493
    Published: June 30, 1992
    Released on J-STAGE: March 02, 2011
    JOURNAL FREE ACCESS
    A 70-year-old woman with insulin-dependent diabetes mellitus was autopsied. Diabetes mellitus had occurred with diabetic ketosis at 65 years of age, and insulin therapy was started immediately. Urinary C-peptide excretion was 4.0-10μg/day and pancreatic β-cell function was almost absent. On the other hand, exocrine pancreatic insufficiency was not observed. No abnormal findings were observed on echography or a CT scan of the abdomen. Although her diabetes mellitus was well-controlled with insulin therapy, she died of cancer of the uterus. Although pathological examination of the pancreas showed almost completely intact exocrine tissue, a marked decrease in endocrine cells was observed in the islets. Immunohistochemical examination of the islets using anti-insulin, glucagon and somatostatin antibodies by the SAB peroxidase method showed selective disappearance of β-cells from the islets.Lymphocytic infiltration was also seen in the interstitial exocrine tissue, but not in the islets, and the infiltrating lymphocytes were T cells.
    Download PDF (6845K)
  • Yoshiyuki Sakai, Kaoru Inoue, Naoki Nakashima, Fujiko Hayashi, Takaaki ...
    1992 Volume 35 Issue 6 Pages 495-500
    Published: June 30, 1992
    Released on J-STAGE: March 02, 2011
    JOURNAL FREE ACCESS
    A 30-year-old woman was admitted for evaluation of hepatic function.Hepatomegaly in this patient was originally pointed out when she was one year old. On admission, her liver was palpable 5 f. b. below the costal margin in the right midclavicular line. She was diagnosed as having glycogen storage disease type 1 on the basis of changes in serum lactate levels in response to glucose ingestion and glucagon administration. Her fasting plasma glucose level was 66 mg/dland her HbA1c level was 4.0%. The concentration of serum insulin increased slightly from 4.6, μU/ml to 19.8 μU/ml in response to an injection of 75 g glucose, whereas the concentration of serum C-peptide increased markedly from 1.0 ng/ml to 8.4 ng/ml. In addition, urinary excretion of C-peptide was remarkably elevated varying from 253 μg/day to 268 μg/day. As to glucagon secretion, no response of plasma glucagon to hypoglycemia induced by insulin administration was observed, whereas the response of glucagon to arginine administration was normal. This patient is thought to be a rare case of glycogen storage disease type 1 with high levels of serum and urinary C-peptide and with an insensitivity of glucagon secretion to hypoglycemia.
    Download PDF (2835K)
  • Proinsulin Kyoto
    Norikazu Kitano, Hideki Yano, Masachika Morimoto, Tomohiko Taminato, S ...
    1992 Volume 35 Issue 6 Pages 501-504
    Published: June 30, 1992
    Released on J-STAGE: March 02, 2011
    JOURNAL FREE ACCESS
    We have identified a 65-year-old non-obese Japanese man with diabetes mellitus, fasting hyperinsulinemia (25-50 μU /ml), and a reduced fasting C-peptide/insulin molar ratio of 2.5-3.0.Fastinghyperinsulinemia was also found in his son and daughter. The patient responded normally to exogenous insulin. To define the basis of this disorder, the insulin gene of the patient was amplified by the polymerase chain reaction and the products were sequenced. A novel point mutation was identified in which guanine was replaced by thymine in the insulin gene. The resulting substitution of leucine for arginine at amino-acid position 65 gave rise to a new Hind-III recognition site. The replacement of Arg-65 by Leu also prevents recognition of the C-peptide-A-chain dibasic protease and results in elevation of a proinsulin like-material in the circulation. Furthermore, in this family the proinsulin like-material is the result of a biosynthetic defect inherited as an autosomal dominant trait.
    Download PDF (1716K)
  • 1992 Volume 35 Issue 6 Pages 505-513
    Published: June 30, 1992
    Released on J-STAGE: March 02, 2011
    JOURNAL FREE ACCESS
    Download PDF (2106K)
  • 1992 Volume 35 Issue 6 Pages 515-530
    Published: June 30, 1992
    Released on J-STAGE: March 02, 2011
    JOURNAL FREE ACCESS
    Download PDF (3857K)
feedback
Top