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Volume 41, Issue 3
Displaying 1-8 of 8 articles from this issue
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Kimiko Igarashi, Takashi Abe, Hideyuki Eguchi, Makoto Tominaga, Hideo ...1998 Volume 41 Issue 3 Pages 159-163
Published: March 30, 1998
Released on J-STAGE: March 02, 2011
JOURNAL FREE ACCESSTo determine the prevalence of chronic diabetic complications in newly diagnosed diabetes mellitus (DM), microvascular and macrovascular complications were investigated in a populationbased Funagata Diabetes Study. The subjects were residents of Funagata, Yamagata Prefecture, who had been diagnosed with impaired glucose tolerance (IGT) and DM by the oral glucose tolerance test in the Funagata Diabetes Study (1990-92). During the same period, new outpatients in the diabetes clinic of Yamagata University Hospital were also investigated as a hospital-based diabetic control. The prevalence of retinopathy was 2.2% in patients with IGT, 7.1% in the DM subject and 41.2% in the hospital-based new outpatients. The prevalence of microalbuminuria and neuropathy showed almost the same tendency as that of retinopathy. The prevalence of macrovas cularcomplications such as an ischemic change in ECG (after Master-double loading) and the decrease in the ankle-pressure index was higher in DM than in IGT. Since even newly diagnosed DM have some chronic diabetic complications, glycemic control in the early stage is important to prevent chronic diabetic complications.View full abstractDownload PDF (767K) -
Yoshiastu Takahashi, Shinichiro Takayama, Takeshi Ito, Yukiko Inoue, Y ...1998 Volume 41 Issue 3 Pages 165-170
Published: March 30, 1998
Released on J-STAGE: March 02, 2011
JOURNAL FREE ACCESSEighty-six diabetic patients with post-treatment painful neuropathy were studied to clarify the clinical characteristics. The mean age of the patients was 46 years and ranged from 19 to 78. The male/female sex ratio was 55/31. Seventy-three patients had NIDDM, 11 had IDDM and 2 had secondary diabetes. The mean duration of diabetes was 7.7years including untreated periods of 5years. At the time glycemic control was started, the mean HbA1c was 14%(range, 9.2-23%) and the mean BMI was 18.7 (range, 13-30). Several weeks after initiating the therapy, dramatic and severe pain developed in their lower extremities and spread evenly throughout the body, ac companiedby anorexia, insomnia and much greater weight loss. The symptoms subsided during a year of treatment with such drugs as mexiletine, imipramine and fluphenazine. However, diabetic retinopathy developed in 67% of the subjects. The mechanism and pathogenesis of post-treatment painful neuropathy are still unclear but greater caution should be taken in starting glycemic control in diabetic patients with prolonged hyperglycemia and previous neuropathy.View full abstractDownload PDF (986K) -
Susumu Ogawa, Kazuhiko Sugimura, Motoshi Fukuda, Chiharu Sato, Tokutar ...1998 Volume 41 Issue 3 Pages 171-177
Published: March 30, 1998
Released on J-STAGE: March 02, 2011
JOURNAL FREE ACCESSOne hundred twenty-one outpatients (62 males and 59 females; 4 with insulin-dependent diabetes mellitus and 117 with non-insulin dependent diabetes mellitus) with a glycated hemoglobin A1c (HbA1c) level of more than 6.8% received voglibose 0.6mg t. i. d. Fasting plasma glucose (FPG), HbA1c and body weight (BW) were measured monthly for 6 months. FPG and BW were reduced after 4 to 6 months of treatment (FPG: from 153 to 128-138mg/dl; BW: from 58.1 to 56.3-57.5kg). However, the HbA1c level was not changed. These changes were unrelated to differences in mode of diabetic therapy employed for each patient. We investigated whether strict diet therapy enhanced the effects of voglibose. The HbAic level in the patients following the strict diet therapy (n=47) was reduced from 7.2 to 6.5%. In contrast, it was not changed in the nondietetic group (n=74). These changes were not associated with a change in BW. Thus, the improvement of diabetic control with voglibose seems to be achieved by good compliance with the prescribed diet therapy, particularly the intake of carbohydrates and sugar. It appears that strict diet therapy is essential for voglibose to exert its most beneficial effects on carbohydrate metabo lismin diabetic outpatients.View full abstractDownload PDF (1004K) -
Taro Wasada, Kozo Katsumori, Akiko Sato, Hiroyuki Kuroki, Hiroko Arii, ...1998 Volume 41 Issue 3 Pages 179-184
Published: March 30, 1998
Released on J-STAGE: March 02, 2011
JOURNAL FREE ACCESSTo search for a simple index for estimating the degree of whole-body insulin resistance, we analyzed the correlation between glucose infusion rate (GIR) during a glucose clamp study, an established measure for insulin resistance, and 7 clinical variables: body mass index (BMI), fasting plasma glucose (FPG), HbAic, T. Chol, HDL-C, TG and fasting plasma immunoreactive insulin (FIRI). The data were obtained from 21 patients with normal glucose tolerance (NGT), 69 with impaired glucose tolerance (IGT), and 156 NIDDM subjects who had undergone a euglycemic hyperinsulinemic clamp study. The GIR correlated best with TG (r=-0.616, p=0.0029) in the NGT group, with FIRI (r=-0.513, p<0.0001) in the IGT group, and with FIRI (r=0.380, p<0.0001) in the NIDDM group. The correlation coefficient with GIR increased when the product of FIRI by one of the other variables was used instead of any single variable itself, However, 5 independent variables with HbAic and T. Chol excepted accounted for a minor portion of GIR (R: 51.6% in NGT, 41.2% in IGT, and 22.1% in NIDDM). In conclusion, we found no reliable alternative to estimate the degree of in vivo insulin resistance.View full abstractDownload PDF (863K) -
Satomi Itaya, Tatsuo Ishizuka, Hiroaki Wada, Osamu Taniguchi, Atsushi ...1998 Volume 41 Issue 3 Pages 185-194
Published: March 30, 1998
Released on J-STAGE: March 02, 2011
JOURNAL FREE ACCESSIt has been reported that increased platelet aggregation is associated with the development of diabetic complications. We examined the effect of alterations in diabetic treatment, from diet alone to sulphonylurea (glyburide) and from sulphonylurea to insulin, on platelet aggregation, phos phoinositidemetabolism and protein phosphorylation in patients with NIDDM. Low-dose thrombin-stimulated platelet aggregation and phosphatidic acid (PA) formation were suppressed by the alteration of diet alone to sulphonylurea administration. Moreover, substitution of insulin treatment for sulphonylurea administration resulted in decreased ADP-, collagen- and thrombin stimulatedplatelet aggregation, and thrombin-induced PA formation. In conclusion, both sul phonylureaand insulin treatments suppressed platelet aggregation via suppression of thrombin inducedactivation of phosphoinositide metabolism.View full abstractDownload PDF (1381K) -
Yoshikazu Umeno, Rika Tomimasu, Ryuichirou Jo, Yoshirou Ota1998 Volume 41 Issue 3 Pages 195-199
Published: March 30, 1998
Released on J-STAGE: March 02, 2011
JOURNAL FREE ACCESSWe report the case of a 51-year-old male with type C chronic hepatitis who developed hyperglycemia during interferon-α(IFN) therapy. He had no history of diabetes mellitus. IFN therapy was started in September 1996. The level of FPG gradually increased following IFN administration, though it had been normal prior to therapy. He began to experience thirst in January 1997, and the hyperglycemic symptoms increased in March 1997. The levels of FPG and HBA1c were 383mg/dl and 14.4%, respectively. A diagnosis of NIDDM was made because endogenous insulin secretion was not reduced. Urinary CPR was 33μg/day, and ΔCPR 6' during a 1mg glucagon load iv was 2.1 ng/ml. Good glycemic control was achieved with intensified conventional insulin therapy, allowing a change in therapeutic modality for diabetes mellitus from insulin to an α-glucosidase inhibitor. This case suggests that there is a possibility of IFN inducing hyperglycemia even in patients with type C chronic hepatitis who have no history of diabetes mellitus and whose level of FPG is normal. It appears that the degree of glucose tolerance should be examined adequately when IFN is administered. It is also necessary that plasma glucose be monitered carefully during IFN therapy.View full abstractDownload PDF (725K) -
Tomoko Mori, Toshihiko Sato, Tetsuya Yamakita, Kohichi Kawasaki, Katsu ...1998 Volume 41 Issue 3 Pages 201-206
Published: March 30, 1998
Released on J-STAGE: March 02, 2011
JOURNAL FREE ACCESSThe patient was a 26-year-old woman, who was first found to have glucose intolerance at 20 weeks of gestation during her 1st pregnancy. An HbA1c concentration of 8.1% was detected at 23 weeks of gestation. For treatment of the hyperglycemia, a daily dose of 80-100 units of insulin was required until delivery. A normal 2860-g infant was born at 39 weeks of gestation. In the postpartum period the patient could be treated by dietary therapy alone and the results of OGTT showed a borderline pattern (Japanese Diabetes Association) with low C-peptide levels. Glutamic acid decarboxylase (GAD) antibody was negative at that time. One year later she was pregnant again. She required insulin injections after 23 weeks of gestation. A daily dose of 60-70 units of insulin was needed to maintain a normal glucose level. At that time FPG was 94mg/dl and HbA1c was 5.1%. A normal 2820-g infant was born at 40 weeks of gestation. After delivery the patient needed no insulin; however, GAD antibody changed to positive (16.1U/ml), and OGTT showed a diabetic pattern. Her HLA genotypes were DRB 10405 and DQB 10401, which are IDDM associated types in Japan. Gestational diabetes is a heterogeneous disorder. In this case, the type of diabetes seems to be NIDDM now, but it is suspected that pancreatic β-cell dysfunction may develop in the future.View full abstractDownload PDF (875K) -
1998 Volume 41 Issue 3 Pages 207-228
Published: March 30, 1998
Released on J-STAGE: March 02, 2011
JOURNAL FREE ACCESSDownload PDF (5517K)
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