We studied the acute glucose-lowering effect of low-intensity, short-duration bodyweight squat (SQ) exercise on hyperglycemia after glucose loading by examining 15 healthy adult males. All subjects drank water containing 75 g of glucose. All subjects stayed in a supine position for 120 min (C). The subjects then performed SQ exercise (10 SQs/set; 3 sets; interval time, 1 min) at 80 beats per minute (SQ80) and 40 beats per minute (SQ40) 30 min after glucose loading. The blood glucose levels in the subjects who performed SQ80 and SQ40 at 30 min after glucose loading were significantly lower than at C, and the glucose level in SQ40 was significantly lower than that in SQ80. The glucose level at 60 min after glucose loading in SQ40 was significantly lower than that at C. The incremental area under the curve of the blood glucose level in SQ40 was significantly lower than that at C. The exercise intensity in SQ40 (4.0±0.6 metabolic equivalents; METs) was significantly higher than that in SQ80 (3.5±0.5 METs). This study suggests that low-intensity, short-duration SQ exercise has an acute glucose-lowering effect on hyperglycemia after glucose loading.

Type 1 diabetes (T1D) applies a heavy economic as well as physical and psychological burden to affected individuals. Alongside the Physically Disabled Persons' Welfare Act has emerged, as a potential means of economic assistance for individuals with TID. A questionnaire survey in 183 adults on the economic and social impact of T1D showed that while 98.4 % of the patients had nearly achieved their expected social life, the impact of T1D on their education, employment, quality of life and economic burden was far from negligible. Notably, more than 50 % suggested that their economic status may have adversely affected the medical treatments afforded them, thus raising concern about the risk of progression of associated diabetic complications. Of all public funds available, disability pension was the most frequently applied for by these adult patients; however, it benefited only 10 % of the applicants. This suggests that the current program may be insufficient as a financial assistance program. These findings should help establish further financial assistance programs for T1D patients.

A woman had been diagnosed with type 2 diabetes mellitus at 11 years old. Despite initiating treatment, she frequently suspended outpatient visits and finally discontinued treatment at 26 years old. She remained asymptomatic until developing involuntary movement in her left upper limb at 29 years old. She was hospitalized 12 days after the onset. Her glucose level was 603 mg/dL, and HbA1c was 16.1 % at that time. She was clinically diagnosed with diabetic chorea, although magnetic resonance imaging revealed no abnormalities of either the putamen or the striatum on T1-weighted imaging. The movements resolved the next day after insulin therapy, while glucose levels often dropped below 70 mg/dL during hospitalization. Five days after discharge, she experienced eye pain, visual field impairment, and right eyelid ptosis. She was re-hospitalized and diagnosed with diabetic ophthalmoplegia. Her clinical features appeared to be attributable to long-term untreated hyperglycemia and microthrombus formation caused by decreased glucose levels, underlying simultaneous development of both rare diseases despite her youth, which are commonly developed in the elderly. In addition, severe microangiopathy, such as proliferative diabetic retinopathy and nephrotic syndrome, was likely to have accompanied the focal ischemic changes, leading to the development of diabetic chorea and ophthalmoplegia.

A 24-year-old woman with uncontrolled Graves' disease was referred for treatment of thyroid storm. The thyroid storm was improved by multidisciplinary therapy with antithyroid drug and iodine solution. On admission, the level of plasma glucose was 128 mg/dL, HbA1c was 6.6 % and anti-GAD antibody was 3620 U/mL. The impaired glucose tolerance was diagnosed as slowly progressive type 1 diabetes mellitus (SPIDDM) based on the maintenance endogenous insulin secretion assessed by a glucagon stimulation test and was able to be successfully managed by dietary therapy alone. Based on characteristic radiological findings showing marked replacement of the entire pancreas with adipose tissue on computed tomography and magnetic resonance imaging, lipomatous pseudohypertrophy of pancreas (LPP) was diagnosed. LPP is an extremely rare disease characterized by the replacement of pancreatic acinar cells with adipose tissue, although the pancreatic ducts and islets are preserved. LPP occasionally causes a decreased pancreatic exocrine function. It will be important to conduct longitudinal observation of the pancreatic endocrine and exocrine function in the present case due to the differing pathologies of SPIDDM and LPP.