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Volume 46, Issue 11
Displaying 1-13 of 13 articles from this issue
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[in Japanese]2003 Volume 46 Issue 11 Pages 835-840
Published: November 30, 2003
Released on J-STAGE: March 02, 2011
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[in Japanese]2003 Volume 46 Issue 11 Pages 841-843
Published: November 30, 2003
Released on J-STAGE: March 02, 2011
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[in Japanese]2003 Volume 46 Issue 11 Pages 845-847
Published: November 30, 2003
Released on J-STAGE: March 02, 2011
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Part I: Change in Glucose Tolerance with AgeToshiaki Tanaka, Reiko Horikawa, Keinosuke Fujita, Masamichi Ogawa, Ka ...2003 Volume 46 Issue 11 Pages 849-856
Published: November 30, 2003
Released on J-STAGE: March 02, 2011
JOURNAL FREE ACCESSOral glucose tolerance tests in 104 patients with Turner syndrome were analyzed to evaluate the preva-lence of impaired glucose tolerance (IGT) according to age group. The prevalence of IGT increased signifi-cantly with increasing age (p<0.001): 5.4% in Group A (37 girls younger than 10 years old), 9.5% in Group B (42 girls between the ages of 11 and 20 years), and 36.0% in Group C (25 women older than 20 years old). The IGT patients in Group A exhibited an elevated BMI and HOMA-R, compared with the nor-mal glucose tolerance patients. The patients in Group B exihibited a physiological elevation in insulin secre-tion in both the IGT and the normal glucose tolerance patients. In Group C, the IGT patients exhibited hy-perinsulinemia and a lower insulinogenic index, compared with the normal glucose tolerance patients.
IGT in Turner syndrome can be attributed to increased insulin resistance as a result of the obesity ob-served in Group A. However, a reduction in the initial secretion of insulin in addition to insulin resistance seems to contribute to IGT in patients older than 10 years old.View full abstractDownload PDF (1250K) -
Part II: Change in Glucose Tolerance with Growth Hormone TreatmentToshiaki Tanaka, Reiko Horikawa, Keinosuke Fujita, Masamichi Ogawa, Ka ...2003 Volume 46 Issue 11 Pages 857-862
Published: November 30, 2003
Released on J-STAGE: March 02, 2011
JOURNAL FREE ACCESSOral glucose tests (OGTT) were performed in 35 patients with Turner syndrome before and during a 4-year period of growth hormone treatment to investigate the relation between glucose tolerance and GH treatment.
Two out of 35 (5.7%) patients exhibited impaired glucose tolerance (IGT: blood glucose at 120 minutes>140mg/dl) prior to GH treatment. Out of the 33 patients with a normal OGTT prior to GH treatment, 10 patients (30.3%) developed IGT during the 4-year GH treatment period. This percentage was significantly (p<0.05) higher than that of untreated Turner patients in the same age group, described in Part I of this report.
EIRI during GH treatment was significantly greater than that before treatment, and HOMA-R increased significantly after two years of treatment, compared with that prior to treatment. BMI also increased signifi-cantly after three years of treatment.
These data demonstrate that the percentage of patients with IGT increased during GH treatment and sug-gest that insulin resistance contributes to the occurrence of IGT in Turner syndrome. Since the GH dosage for patients with Turner syndrome is higher and the GH treatment period tends to be longer than that for patients with GH deficiency, Turner syndrome patients should be carefully investigated for impared glucose tolerance during and after GH treatment.View full abstractDownload PDF (904K) -
Takahide Noguchi, Takehito Kondou, Hisato Takatsu2003 Volume 46 Issue 11 Pages 863-868
Published: November 30, 2003
Released on J-STAGE: March 02, 2011
JOURNAL FREE ACCESSAlthough diabetic patients with renal insufficiency may or may not have nephro-tic syndrome, the pathological state of these patients at the time of initiation to hemodialysis therapy (HD) remains uncertain. Forty-three diabetic patients (DM group) with proliferative retinopathy and a diabetic history of more than ten years were reviewed. Various clinical parameters (serum albumin, serum creatinine, BUN, 24-our uri-nary protein excretion, and HbA1c) were analyzed at the initiation of HD and compared with those of pa-tients with chronic glomerulonephritis (CGN group, n=58). The significantly different variables between the DM and CGN groups consisted of severe hypoalbuminemia (less than 2.5g/dl, 32.6% for DM group vs 12.1% for CGN group) and edema in the DM group. On the other hand, gastrointestinal symptoms were more frequently observed in the CGN group than in the DM group at the initiation of HD. DM patients with severe hypoalbuminemia (less than 2.5g/dl) required HD eventhough their serum creatinine level was low (mean level: Cr=4.7±2.1mg/dl).
Serum albumin levels exhibited a highly negative correlation with urinary protein excretion (r=-0.796, p<0.01), and a significant correlation was seen between the serum albumin levels and the serum creatinine levels (r=0.493, p<0.01) in the DM group.
Thus, many cases (27.9%) developed severe hypoalbuminemia with edema in the DM group, and these patients required HD, eventhough their serum creatinine levels were still relatively low (less than 5.0mg/dl).View full abstractDownload PDF (915K) -
[in Japanese], [in Japanese], [in Japanese], [in Japanese], [in Japane ...2003 Volume 46 Issue 11 Pages 869-872
Published: November 30, 2003
Released on J-STAGE: March 02, 2011
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Sakae Nohara, Masanori Iwase, Udai Nakamura, Kouichi Azuma, Keiichiro ...2003 Volume 46 Issue 11 Pages 873-879
Published: November 30, 2003
Released on J-STAGE: March 02, 2011
JOURNAL FREE ACCESSA 71-year-old woman was admitted to hospital because of poor glycemic control and liver dysfunction. Although the patient's diabetes had been well-controlled with glibenclamide and pioglitazone, the pioglitazone had been discontinued because of an adverse effect on body weight gain and edema. The patient's Hb A1c level subsequently rose from 7% to 11.6%. At admission, her BMI was 40.8kg/m2 and she exhibited hypertension, hyperlipidemia, and microalbuminuria. A lacunar brain infarction was also diagnosed. The patient's fasting blood glucose level was 302mg/dl, her serum IRI was 14.7μU/ml, a hypoglycemic response was not obtained on an insulin tolerance test, and her fasting bloodg lucose was 219mg/dl, and her postprandial blood glucose was 457mg/dl at an insulin dosage of 1U/kg body weight. Although she did not drink alcohol, she exhibited mild liver dysfdnction: AST, 80U/l; ALT, 70U/l;γGTP, 102U/l. A liver biopsy was performed, and the histological findings were compatible with a diagnosis of NASH. When 6mg of glimepiride, a sulfonylurea with an insulin-sensitizing extrapancreatic effect, was added to the patient's insulin therapy, her blood glucose control improved markedly: fasting blood glucose, 76mg/dl; postprandial blood glucose, 135mg/dl; insulin dosage, 0.5U/kg body weight. When insulin or oral hypoglycemic agents alone fail to control blood glucose in patients with type 2 diabetic associated with NASH, a combination therapy of glimepiride and insulin is recommended.View full abstractDownload PDF (1827K) -
[in Japanese], [in Japanese], [in Japanese], [in Japanese], [in Japane ...2003 Volume 46 Issue 11 Pages 881-885
Published: November 30, 2003
Released on J-STAGE: March 02, 2011
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[in Japanese], [in Japanese], [in Japanese]2003 Volume 46 Issue 11 Pages 887
Published: November 30, 2003
Released on J-STAGE: March 02, 2011
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[in Japanese]2003 Volume 46 Issue 11 Pages 888
Published: November 30, 2003
Released on J-STAGE: March 02, 2011
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Makoto Tominaga, Eiichi Makino, Gen Yoshino, Katsuhiko Kuwa, Izumi Tak ...2003 Volume 46 Issue 11 Pages 889-898
Published: November 30, 2003
Released on J-STAGE: March 02, 2011
JOURNAL FREE ACCESSIn 1999, The Japan Diabetes Society (IDS) Committee on Standardization of Laboratory Testing Related to Diabetes Mellitus in cooperation with the Japan Society of Clinical Chemistry (JSCC) revealed significant device-to-device variations in glucose levels measured with devices intended for use in the self-monitoring of blood glucose (SMBG). The main cause of the discrepancy seemed to arise from differences in the manufacturers' comparative methods. The Committee recommended the use of a venous blood method as the standardized comparative method. In 2001, the Committee confirmed that blood glucose measurements of venous blood performed using 10 SMBG devices did not show any large variations. However, the ordinary use of SMBG is to measure glucose levels in fingertip blood. In 2002, the Committee repeated the same experiment in cooperation with volunteer patients with diabetes mellitus. The results suggested the presence of two groups of SMBG devices. In one group, consisting of the Free Style, Medisafe Reader, Xtra and AccuChek Comfort, the measurement of glucose in fingertip blood samples was almost the same as the glucose levels measured in arterial blood measured with the hexokinase method. In the other group, consisting of the Glucocard α and Dexter Z II, the measurements were close to the glucose levels measured in venous blood measured with the hexokinase method. Clinical diabetes educators, who advise patients with diabetes mellitus about the use of SMBG devices, should be aware of these characteristics of SMBG devices.View full abstractDownload PDF (1589K) -
2003 Volume 46 Issue 11 Pages 900
Published: 2003
Released on J-STAGE: March 02, 2011
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