Journal of the Japan Diabetes Society
Online ISSN : 1881-588X
Print ISSN : 0021-437X
ISSN-L : 0021-437X
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Volume 56, Issue 9
Displaying 1-12 of 12 articles from this issue
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Report of a Symposium of the 55th Annual Meeting of the Japan Diabetes Society
Diabetes and Pregnancy: Recent Advance in Maternal and Child Health Care
Original Articles
Epidemiology
  • Relationship between Physical Activity and Metabolic Syndrome in Male Workers
    Takako Ichihara, Ayako Tamura, Takako Minagawa, Yumi Kuwamura, Chisato ...
    2013 Volume 56 Issue 9 Pages 637-645
    Published: September 30, 2013
    Released on J-STAGE: October 30, 2013
    DOIhttps://doi.org/10.11213/tonyobyo.56.637
    JOURNAL FREE ACCESS
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    Objective: To conduct a cross-sectional study in order to elucidate the relationship between daily physical activity and metabolic syndrome (MetS) in male workers. Methods: A total of 547 male workers in Tokushima ranging from 20 to 60 years of age were enrolled between June 2008 and February 2009. To evaluate the level of physical activity, interviews were conducted using the Japanese international physical activity questionnaire (IPAQ) with six additional questions. Each participant's diet and medical history were evaluated, and physical examinations and laboratory blood tests were performed. A logistic regression analysis of the characteristics of the participants with MetS and those without identified various physical activities associated with MetS. Results: Seventy-five of the 547 participants were diagnosed with MetS. The participants with MetS had significantly higher BMI values, body fat percentages, abdominal circumferences and levels of fasting blood glucose, HbA1c and triglycerides than those without MetS. When the frequencies of various types of physical activity (days/week) were compared, significant differences were observed in the frequency of vigorous physical activity during recreation, sports and leisure time (OR=0.428) and the frequency of elevator use (OR=1.182). Conclusions: A low frequency of vigorous physical activity during recreation, sports and leisure time and a high frequency of elevator use may be associated with MetS.
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Pathophysiology, Metabolic Abnormalities, Complications
  • The Time Interval from Meal to Peak Postprandial Glucose Levels Measured by Continuous Glucose Monitoring in Pregnant Women with Diabetes Mellitus
    Sonomi Yoshino, Akinori Hayashi, Eriko Kishihara, Akifumi Ogawa, Raish ...
    2013 Volume 56 Issue 9 Pages 646-652
    Published: September 30, 2013
    Released on J-STAGE: October 30, 2013
    DOIhttps://doi.org/10.11213/tonyobyo.56.646
    JOURNAL FREE ACCESS
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    Background: Strict glycemic control is mandatory to decrease the risks of fetal and maternal complications in pregnant diabetic patients. However, the optimal time to measure the postprandial glucose levels has not yet been determined. Objectives: This study examined the duration of time from the start of the meal to reach the peak postprandial glucose level (postprandial glucose peak time) by continuous glucose monitoring (CGM). Methods: The blood glucose levels were measured 35 times in 29 pregnant women with diabetes mellitus (DP group) during a six- to 36-week period. The data were compared to seven controls who were not pregnant and had normal glucose tolerance (N group) as tested by the 75 g OGTT (oral glucose tolerance test). Results: The mean postprandial glucose peak time was 81#177;15 minutes in the DP group, which was significantly longer than that in the N group (52#177;13 minutes, p<0.0001). The mean postprandial glucose peak time was positively correlated with the gestational age of the fetus in the DP group (r=0.45, p<0.01). Conclusion: The time interval from meal to the peak postprandial glucose level is prolonged with gestational age in pregnant diabetic patients. This information should be considered when managing pregnant diabetic patients.
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Case Reports
  • A Case of Type 1 Diabetes Mellitus Associated with Ketoacidosis Triggered by a Rapid Reduction of the Dose of Insulin with the Administration of a Very-low-carbohydrate Diet
    Toru Fukushima, Akihiro Hamasaki, Kanae Asai, Mayumi Sasaki, Kimitaka ...
    2013 Volume 56 Issue 9 Pages 653-659
    Published: September 30, 2013
    Released on J-STAGE: October 30, 2013
    DOIhttps://doi.org/10.11213/tonyobyo.56.653
    JOURNAL FREE ACCESS
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    A 19-year-old female was diagnosed with Type 1 diabetes mellitus and began insulin therapy at 8 years of age. Although she took 20 units of glargine at bedtime and 14-18 units of lispro before each meal at 19 years of age, her glycemic control worsened [HbA1c (NGSP) 15 %] due to increased food intake. She was admitted to another hospital to begin a very-low-carbohydrate diet. The dose of glargine was reduced to 4-8 units at bedtime, and the lispro taken before each meal was discontinued after admission. However, the patient began to vomit at midnight on day 2, and her plasma glucose level was 532 mg/dl at 7 : 30 AM on day 3. Intravenous infusion of saline and insulin was initiated under a suspected diagnosis of diabetic ketoacidosis. She was subsequently urgently transferred to our hospital because her symptoms did not improve in spite of the administration of treatment for half a day. Following the urgent admission, her symptoms were markedly improved by intensive intravenous infusion of saline and insulin. This case suggests that insulin requirements should be carefully estimated when starting a very-low-carbohydrate diet in patients with insulin-dependent diabetes mellitus.
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  • A Case of Klinefelter's Syndrome Associated with Diabetes Mellitus Presenting with Ballism
    Akiko Takazakura, Shiho Kouno, Keiko Aoki, Taku Sanada, Hideo Kanehara ...
    2013 Volume 56 Issue 9 Pages 660-665
    Published: September 30, 2013
    Released on J-STAGE: October 30, 2013
    DOIhttps://doi.org/10.11213/tonyobyo.56.660
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    A 47-year-old male was referred to our hospital to undergo examinations for male infertility and was diagnosed with Klinefelter's syndrome (47XXY). He was subsequently referred to our institute due to the occurrence of involuntary movements in his left lower extremity and a high FPG level of 576 mg/dl. He suffered from ballism in the left lower extremity, and his HbA1c level was 11.8 % (NGSP value). He was diagnosed with both diabetes and renal dysfunction. Hypoplasia of both kidneys and hepatocellular carcinoma were detected on abdominal CT, while hypoplasia of the left vertebral and right internal carotid arteries was observed on neck MRA. Intensive insulin therapy was initiated, and the symptoms of ballism rapidly disappeared in association with normalization of the blood glucose level. Diabetes occurring concomitantly with Klinefelter syndrome is observed at a comparatively high rate of 15-50 %. The cause of ballism in this case was suspected metabolic aberration due to prominent hyperglycemia in addition to cerebral tissue ischemia resulting from hypoplasia of the blood vessels and dehydration.
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Brief Clinical Note
  • Effects of Imported Hand Cream Containing Various Reducing Substances on the Self-monitored Blood Glucose Level
    Natsuko Fujisaki, Mayumi Otsuji, Machiko Minobe, Akane Higo, Takahiko ...
    2013 Volume 56 Issue 9 Pages 666-669
    Published: September 30, 2013
    Released on J-STAGE: October 30, 2013
    DOIhttps://doi.org/10.11213/tonyobyo.56.666
    JOURNAL FREE ACCESS
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    Self-monitoring of the blood glucose level using a portable blood glucose meter is important for diabetes treatment. It is known that measurement values are affected by various factors; however, there have been no reports regarding the effects of topical agents. We encountered a patient with type 2 diabetes mellitus who exhibited underestimation of the blood glucose level after using an imported hand cream containing high levels of ascorbic acid and various reducing substances. We therefore investigated the effects of the hand cream on the blood glucose measurements in 10 healthy adults and evaluated differences in the values obtained with the colorimetric and enzyme electrode methods using portable blood glucose meter. Following application of the cream, the blood glucose levels significantly decreased (p=0.005) when measured using the colorimetric method and significantly increased (p=0.005) when measured using the enzyme electrode method compared to the values observed before application. These effects were reversed to the levels measured before application, with no significant differences observed after washing with water, although wiping with alcohol cotton was not effective. Education regarding self-monitoring of the blood glucose level requires a sufficient discussion with the patient regarding the use of topical agents, such as hand creams containing reducing substances, awareness of the effects of these creams and the importance of hand washing.
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Letters to the Editor
Proceeding of the Local Societies
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