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ABSTRACT: To study the effects of chronic osmotic diuresis which were not associated with hyperglycaemia on the rat kidney, osmotic diuresis was induced by i.v. infusion of urea. A 5 mol/l urea solution was continuously infused at a rate of 100 ml.kg-1 x day-1 on the basis of body weight on day 0. Duration of infusion was 2, 6, 10 or 14 days. Control rats received continuously infused Ringer's solution. Urea-treated groups developed osmotic diuresis (urine flow = about 0.04 ml.min-1 x 100 g body weight-1) comparable to that in rats with experimental diabetes mellitus induced by i.v. streptozotocin (55 mg/kg), however urea-induced osmotic diuresis was not associated with blood glucose level increases. Compared with their controls, rats receiving urea for 2-14 days had markedly increased kidney weight. Rats receiving urea for 10 days showed greatest kidney weight increase, 0.565 +/- 0.044 g/100 g body weight (mean +/- SD), representing a 53% increase compared with the control (0.369 +/- 0.034 g/100 g body weight). Kidney weight was associated with increases in kidney protein content. In contrast, none of control kidney weight values differed significantly from day 0 values (= normal rats; 0.387 +/- 0.028 g/100 g body weight). Creatinine clearance values in urea-treated groups were also higher than those in controls. The maximum value, 0.65 +/- 0.17.ml-min-1 x 100 g body weight-1, was recorded in the 14-day group and was significantly higher than the corresponding control value (0.34 +/- 0.07 ml.min-1 x 100 g body weight-1) (p < 0.001).(ABSTRACT TRUNCATED AT 250 WORDS)
Diabetologia 04/1994; 37(3):225-31. · 6.81 Impact Factor
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ABSTRACT: The aim of this study is to obtain data for improving a training program for patients with diabetes mellitus. One hundred eighty-seven patients with non-insulin dependent diabetes mellitus were tested with 20 questions about their knowledge for self-management of diabetes mellitus. Then to draw out factors in their personal backgrounds relating to their correct answers, multiple regression analyses were conducted. As a result, four factors showed significant differences in the following order: Educational careers > ages > duration of disease > socioeconomic strata. The results of the present study have shown for the first time, that these four factors closely concern patients to acquire the necessary knowledge for their self-management of the disease. In addition, this study has raised some fundamental problems regarding the training program for patients: how education should be given to patients.
Acta medica Okayama 04/1993; 47(2):91-4. · 0.84 Impact Factor
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ABSTRACT: To evaluate urinary albumin index (UAI), the relationship between albumin excretion rate (AER) in the urine stored for 24 h and UAI in the urine collected arbitrarily on the morning of the same day was studied in 123 inpatients. The patients were admitted to our hospital from September 1, 1988 to August 31, 1989, consisting of 67 non-insulin dependent diabetics (Group 1), 40 patients with collagen disease (Group 2), and 16 patients with primary renal disease (Group 3). The relationship between log(e) AER and log(e)UAI was plotted on a graph. Pearson's rank correlation coefficients of Groups 1-3, Group 1, Group 2, and Group 3 were as follows: r = 0.725, r = 0.691, r = 0.855, and r = 0.611, respectively. The formula obtained by using Pearson's rank correlation coefficients to estimate log(e)AER from log(e)UAI in 123 cases of Groups 1-3, 67 cases of Group 1, 40 cases of Group 2, and 16 cases of Group 3 were: log(e)AER/log(e)UAI = 0.815, log(e)AER/log(e)UAI = 0.860, log(e)AER/log(e)UAI = 0.830, log(e)AER/log(e) = 0.722, respectively. In the present study, log(e)UAI was found to correlate well with log(e)AER. As AER is generally accepted to be the most reliable index to know the stage of albuminuria, UAI is considered to be clinically useful.
Acta medica Okayama 07/1992; 46(3):165-8. · 0.84 Impact Factor
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ABSTRACT: The case history of a woman, who at the age of 25 years on the birth of her second child was found to be diabetic, is reported. Over the subsequent 30 years the patient had been treated with insulin, the dose administered being monitored at regular intervals. At the age of 52 years, the patient was diagnosed as suffering from hypertension and diabetic nephropathy of the nephrotic type. The patient's condition gradually deteriorated and at 55 years of age 40 micrograms/day prostaglandin E1 was given intravenously for 84 days. Treatment resulted in a decline in urinary protein without a reduction in creatinine clearance. Renograms confirmed an improvement in the vascular and secretory phases of both kidneys.
The Journal of international medical research 05/1992; 20(2):190-6. · 0.90 Impact Factor
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ABSTRACT: In an investigation into the effect of prostaglandin E1 on proteinuria in nephrotic diabetic nephropathy, five patients were treated with 40 micrograms prostaglandin E1 administered intravenously over 2 h twice daily for 4 weeks. The following parameters were compared before and after treatment: protein excretion in urine; total serum protein concentration; serum albumin concentration; creatinine clearance; blood urea nitrogen; and serum creatinine content. A further five patients with nephropathy resulting from non-insulin-dependent diabetes mellitus were selected as controls. Analysis of the results using Student's t-test showed no significant change in any of the parameters before and after treatment.
The Journal of international medical research 03/1992; 20(1):94-7. · 0.90 Impact Factor
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ABSTRACT: We studied the pathways of complement activation associated with the islet cell surface antibody (ICSA) obtained from sera of 7 patients (age less than 15 years) with insulin dependent diabetes mellitus (IDDM). The target cells were 51CR labelled rat islet cells and the complement source was human AB serum. Complement-dependent antibody mediated cytotoxicity (CAMC activity) was obtained using the percentage of cytotoxicity. CAMC activity of untreated sera was significantly inhibited by treating with EGTA or EDTA (p less than 0.001). The CAMC activity of EDTA-treated sera was significantly lower than that of EGTA-treated sera (p less than 0.001). In the inactivated human AB serum, it was lower than that of EGTA-treated sera (p less than 0.05), but not different from that of EDTA-treated sera. These results show that the complement activation associated with ICSA in patients occurred not only via the classical pathway but also via the alternative pathway.
Acta medica Okayama 07/1991; 45(3):185-6. · 0.84 Impact Factor
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ABSTRACT: Attitudes were evaluated according to the 'Personal Responsibility Attitude Assessment System' (PRAS), which allows grading of patients' attitudes into five levels of perception of responsibility toward their disease. In 59 diabetics evaluated in this study, no sex difference was observed in attitude level, but more of those aged less than 40 years showed lower attitude levels (levels 1-4) than those aged 40 years or over (P less than 0.01). Of those aged 40 or over, more patients with a high attitude level (level 5) had had diabetes for 10 years or longer than those with low attitude levels (levels 1-4) (P less than 0.05). Among those not treated with insulin, patients with a low attitude level showed higher hemoglobin A1 (HbA1) levels (P less than 0.01) and more frequently had retinopathy (P less than 0.05) than patients with high attitude levels. As for women, low attitude level patients consumed less fruit, meat or fish, and vegetables (P less than 0.05) but more fat and sweetening agents (P less than 0.05) than high attitude level patients. These results suggest an association between the attitude level of diabetic patients evaluated by PRAS and the degree of their self-care. Evaluation of patients' attitudes is important in predicting the response to educational intervention in diabetes.
Diabetes Research and Clinical Practice 02/1990; 8(1):37-44. · 2.75 Impact Factor
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ABSTRACT: The role of complement in the pathogenesis of diabetes was studied in 31 Type 1 (insulin-dependent) diabetic children by assaying serum islet cell surface antibody, C3, C4 and serum complement-dependent antibody-mediated cytotoxicity. Nine of 21 islet cell surface antibody-positive children were within 5 months of disease onset and showed significantly lower serum C3 and C4 levels than either 1 year later or the remainder of the islet cell surface antibody-positive children at 6-12 months after disease onset. The overall trend of all islet cell surface antibody-positive diabetic children within 1 year of disease onset was toward increased serum C3 and C4 levels as the disease progressed. Serum C4 concentration and complement-dependent antibody-mediated cytotoxicity which showed an initial negative correlation were uncorrelated 1 year later. Four children who were initially strongly islet cell surface antibody-positive but negative 1 year later also exhibited significantly higher (p less than 0.05) mean serum C4 levels after 1 year. There was a significant decrease in complement-dependent antibody-mediated cytotoxicity when sera from the diabetic children were treated with either ethylene glycol tetra-acetic acid or ethylene diamine tetra-acetic acid. These data strongly suggest that complement-dependent antibody-mediated cytotoxicity induced by the classical complement pathway involving an islet cell surface antibody may play an important role in the pathogenesis of Type 1 diabetes.
Diabetologia 12/1987; 30(11):869-73. · 6.81 Impact Factor
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ABSTRACT: We have recently seen a case of non-insulin-dependent diabetes mellitus with hypertension in which chronic treatment with oral clonidine gave rise to elevation of blood glucose and decreased insulin secretion. When the response of insulin secretion to glucose administration during clonidine therapy was compared with that after 12 days of wash-out for clonidine in this patient (who was then receiving phentolamine mesylate), there was a marked suppression of insulin secretion to stimulation by intravenous glucose during oral clonidine therapy. This result indicates that the decreased insulin secretion associated with oral clonidine therapy is very unlikely to be due to any direct action of clonidine on beta cells of the pancreatic islets and may be due to suppression of catecholamine release via central alpha-adrenergic receptor stimulation.
The Journal of international medical research 02/1986; 14(6):299-302. · 0.90 Impact Factor
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ABSTRACT: A 41-year old male with insulin-dependent diabetes mellitus previously unsuccessfully treated with a controlled diet and glibenclamide, and subsequently with increasing insulin doses (5 and 20 IU/day) experienced polyuria, glycosuria and loss of weight. On admittance to hospital serum C3 concentrations were found to be depressed. The insulin dose was further increased to 30 IU/day and the patient was also treated with 20 mg nafamostat mesylate given intravenously twice daily for 6 days. On completion of nafamostat mesylate treatment serum C3 concentrations were increased but after 17 days they started to decrease again.
The Journal of international medical research 19(4):348-50. · 0.90 Impact Factor
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ABSTRACT: The effect of prostaglandin E1 (PGE1) on the renin-aldosterone system was investigated in hospitalized patients with non-insulin-dependent diabetes mellitus presenting with continuous proteinuria but without nephrotic syndrome. Of the 20 patients studied, 10 had continuous positive proteinuria > or = 200 mg/day and 10 had continuous positive proteinuria < 200 mg/day. Prostaglandin E1 (40 micrograms in 100 ml normal saline) was infused intravenously over 2 h twice daily for 4 weeks. Plasma renin activity (PRA) and the plasma aldosterone concentration (PAC) were determined by radioimmunoassay at 0 and 120 min after a frusemide injection given before the start of PGE1 treatment and during administration of PGE1 in week 4. The patients who had proteinuria < 200 mg/day showed significant decreases in the PRA0 and the ratio of PRA120:PRA0 and a decrease in the PAC120 during prostaglandin PGE1 administration. When the results for the two patient groups were combined, both the PAC120 and the PRA120 were found to be significantly lowered during administration of PGE1. The results indicate that PGE1 may be valuable in the treatment of diabetic nephropathy, since the compound inhibited the increased reactivity of the renin-aldosterone system in patients with non-insulin-dependent diabetes mellitus.
The Journal of international medical research 21(3):126-32. · 0.90 Impact Factor
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ABSTRACT: Hydroxymethylglutaryl-coenzyme A (HMG-CoA) reductase inhibitor (pravastatin sodium) can selectively inhibit cholesterol biosynthesis in the liver and may lower serum cholesterol concentrations even where there are no particular dietary restrictions. A 72-year old housewife with non-insulin-dependent diabetes mellitus complicated by hyperlipaemia type IIb, who did not follow directions for diet therapy or kinesitherapy, was administered HMG-CoA reductase inhibitor. The initial dose of 10 mg/day HMG-CoA reductase inhibitor was increased by 10 mg/day every 4 weeks to 30 mg/day, maintained at 30 mg/day for 8 weeks and then reduced gradually until discontinuation after a further 27 weeks. Test results showed the changes in low-density lipoprotein cholesterol and apoprotein B to be dose-dependent. The findings represent the first clinical evidence that hypercholesterolaemia can be adequately managed by the use of HMG-CoA reductase inhibitor, even when no specific dietary restrictions are imposed, and may contribute to improvements in the quality of daily life for many patients suffering from hyperlipaemia type IIb.
The Journal of international medical research 21(2):105-11. · 0.90 Impact Factor
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ABSTRACT: The effects on serum lipid levels of reducing stress were examined in 20 patients with non-insulin-dependent diabetes mellitus. An anxiolytic, fludiazepam, was administered to the patients for 12 weeks and their lipid profiles and State-Trait Anxiety Inventory scores at the beginning and end of treatment were compared. The high-density lipoprotein cholesterol level increased significantly after the administration of anxiolytic, but other aspects of the lipid profile were unchanged. Both trait and state anxiety scores decreased significantly with the administration of anxiolytic. The results indicate that improvement of stress in patients with non-insulin-dependent diabetes mellitus increases high-density lipoprotein levels.
The Journal of international medical research 22(6):338-42. · 0.90 Impact Factor
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ABSTRACT: Ten patients with non-insulin-dependent diabetes mellitus who were being treated with a sulphonylureal compound but whose glucose metabolism needed further improvement were given a combination of their usual sulphonylurea treatment and an alpha-glucosidase inhibitor. Treatment with the alpha-glucosidase inhibitor (0.6 mg/day), in addition to glibenclamide (7.5 mg/day in two patients; 5.0 mg/day in four; 2.5 mg/day in one) or tolbutamide (500 mg/day in three patients) for 4 weeks, improved hyperglycaemia after meals from 237-247 mg/dl to 192 mg/dl, and reduced glycosylated haemoglobin levels from 8.5-8.6% to 7.9% without causing hypoglycaemia.
The Journal of international medical research 23(4):279-83. · 0.90 Impact Factor
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ABSTRACT: Twenty patients with non-insulin-dependent diabetes mellitus who had been receiving appropriate dietary treatment for 3 months but whose glucose metabolism needed further improvement were treated with an alpha-glucosidase inhibitor. Treatment with the alpha-glucosidase inhibitor (0.6 mg/day) for 4 weeks, had no significant effect on blood glucose levels 2 h after breakfast or on glycosylated haemoglobin levels.
The Journal of international medical research 23(4):294-8. · 0.90 Impact Factor
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ABSTRACT: The possibility of a relationship between diabetic somatic neuropathy and cardiosympathetic neuropathy was investigated in 103 patients with non-insulin-dependent diabetes mellitus. Cardiosympathetic nerve function was assessed by myocardial scintigraphy. The severity of diabetic somatic neuropathy was determined by measuring the motor conduction velocities of the peroneal and tibial nerves and the sensory conduction velocity of the sural nerve. Analysis of the results did not show any correlations between the measures of cardiosympathetic nerve function and the measures of diabetic somatic neuropathy. The results indicate that diabetic somatic neuropathy and cardiomyosympathetic neuropathy develop independently in patients with non-insulin-dependent diabetes mellitus.
The Journal of international medical research 23(4):228-33. · 0.90 Impact Factor
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ABSTRACT: The effects of clinofibrate on serum lipoprotein concentrations, lecithin cholesterol acyl transferase activity and atherogenic index were studied in 10 diabetes mellitus patients. The patients comprised five with well-controlled non-insulin-dependent diabetes, and five with poorly controlled insulin-dependent diabetes; six non-insulin-dependent diabetics acted as placebo controls. No adverse side-effects were reported and there were no significant changes in total cholesterol, triglyceride or high-density lipoprotein 3-cholesterol concentrations following 600 mg/kg clinofibrate treatment for 4 weeks in either insulin-dependent or non-insulin-dependent diabetics. High-density lipoprotein-cholesterol concentrations and lecithin cholesterol acyl transferase activity were significantly (P less than 0.05) increased by clinofibrate treatment in insulin-dependent and non-insulin-dependent diabetics and high-density lipoprotein 2-cholesterol concentrations were significantly (P less than 0.05) increased by clinofibrate in insulin-dependent diabetics. The atherogenic index was significantly (P less than 0.01) reduced in non-insulin-dependent diabetics. It is suggested that the enhanced plasma lecithin cholesterol acyl transferase activity following clinofibrate therapy is the result of increased high-density lipoprotein-cholesterol and high-density lipoprotein 2-cholesterol concentrations and may play a central role in the efficacy of clinofibrate.
The Journal of international medical research 17(6):521-5. · 0.90 Impact Factor
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ABSTRACT: Treatment of non-insulin-dependent diabetes mellitus patients with nephropathy of the nephrotic type using 40 micrograms prostaglandin E1 given intravenously twice daily for 4 weeks reduced the urinary protein concentration. Prostaglandin E1 also increased the total serum protein and serum albumin concentrations, and reduced creatinine clearance and plasma renin activity following frusemide loading. Treatment with the prostaglandin did not, however, significantly affect the blood urea nitrogen and the serum creatinine concentration. It is concluded that prostaglandin E1 has overt effects on diabetic nephropathy.
The Journal of international medical research 19(2):171-3. · 0.90 Impact Factor
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ABSTRACT: The effect of adding a very low dose of a sulphonylurea (tolbutamide) to the treatment of 10 patients with noninsulin-dependent diabetes mellitus (NIDDM) was investigated. Patients took 0.1 mg tds of an alpha-glucosidase inhibitor orally for 8 weeks, and 50 mg tds of the sulphonylurea, tolbutamide, for the last 4 weeks of this period. The glycosylated haemoglobin level was significantly reduced during the combined treatment period compared with the level after treatment with alpha-glucosidase inhibitor alone (P = 0.035), although not compared with the pretreatment level. There were no significant changes in post-prandial blood glucose, serum lipid levels or connective peptide immunoreactivities. These preliminary results indicate that the addition of a very low dose of tolbutamide to a recommended diet and treatment with an alpha-glucosidase inhibitor, may improve glucose metabolism without raising insulin secretion or influencing lipid metabolism.
The Journal of international medical research 24(5):433-7. · 0.90 Impact Factor
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ABSTRACT: Studies were carried out to assess various ways of improving glycaemic control and lipid profiles of patients with noninsulin-dependent diabetes mellitus (NIDDM) in whom glucose metabolism was poor. Part or all of the dose of the sulphonylurea that had been used to treat patients in Group 1 (n = 8) was replaced by an alpha-glucosidase inhibitor. Symptoms related to hypoglycaemia disappeared and the postprandial blood glucose level was significantly increased (P < 0.043) but serum lipid levels were not significantly altered and the mean glycosylated haemoglobin level was unchanged. In Group 2 (n = 10) patients, a large part of the insulin dose was replaced by an alpha-glucosidase inhibitor. Hypoglycaemia-related symptoms disappeared but there were no significant changes in lipid profiles, postprandial blood glucose or glycosylated haemoglobin levels. The third group of patients (n = 9) had been treated with insulin alone and were given additional alpha-glucosidase inhibitor without changing their insulin dose. This did not significantly change their lipid profiles, postprandial blood glucose or glycosylated haemoglobin levels. In Group 4 (n = 9) the addition of an alpha-glucosidase inhibitor to the initial sulphonylurea did not produce any significant changes in mean postprandial blood glucose or glycosylated haemoglobin levels. The results for individual patients indicated that the glycosylated haemoglobin levels had improved after the change of treatment only in those patients whose connective peptide immunoreactivity was > or = 6.0 ng/ml.
The Journal of international medical research 24(5):438-47. · 0.90 Impact Factor
