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1

Variant forms of glucokinase gene in Japanese patients with late-onset type 2 diabetes  

Microsoft Academic Search

We have applied the technique of single-strand conformation polymorphism analysis to detect mutations of the glucokinase gene in 50 Japanese patients with lateonset type 2 diabetes and in 50 normal Japanese subjects. Out of the 50 patients with late-onset type 2 diabetes, we observed three kinds of variant patterns: one in exon 1b, one in exon 4, and one in

M. Tawata; A. Kurihara; N. Gan; E. Iwase; M. Ohtaka; M. Inoue; T. Onaya

1994-01-01

2

No association between MTHFR gene polymorphism and diabetic nephropathy in Japanese type II diabetic patients with proliferative diabetic retinopathy.  

PubMed

The development of diabetic nephropathy shows marked variation among individuals. Not only hyperglycemia, but also genetic factors may contribute to the development of diabetic nephropathy. Methylenetetrahydrofolate reductase (MTHFR) is involved in remethylation of homocysteine to methionine. Decreased activity of MTHFR which can result in hyperhomocysteinemia may lead to cerebrovascular disease and coronary artery disease. Recently, a common C to T mutation at nucleotide position 677 of the MTHFR gene (MTHFR677CT) has been reported to be correlated with hyperhomocysteinemia and the severity of coronary artery disease as macroangiopathy. In the present study, we recruited 173 of Japanese type II diabetic patients with proliferative diabetic retinopathy who would be exposed to long-term hyperglycemia, and examined the contribution of the MTHFR gene polymorphism to the development of diabetic nephropathy as microangiopathy. The frequency of the mutated allele was 43.3% in patients with nephropathy (n = 105) versus 41.9% in those without nephropathy (n = 68). The genotype frequencies were +/+, 16.2%; +/-, 54.3%; -/-, 29.5% in patients with nephropathy versus +/+, 13.2%; +/-, 57.4%; -/-, 29.4% in those without nephropathy (+ indicates the presence of the mutation). The MTHFR genotype and allele frequencies were not significantly different between patients with and without nephropathy. Therefore, we conclude that the MTHFR gene polymorphism is not associated with the development of diabetic nephropathy in Japanese type II diabetic patients. PMID:10765003

Fujita, H; Narita, T; Meguro, H; Ishii, T; Hanyu, O; Suzuki, K; Kamoi, K; Ito, S

3

Long-term outcomes of Japanese type 2 diabetic patients with biopsy-proven diabetic nephropathy.  

PubMed

OBJECTIVE We evaluated the structural-functional relationships and the prognostic factors for renal events, cardiovascular events, and all-cause mortality in type 2 diabetic patients with biopsy-proven diabetic nephropathy. RESEARCH DESIGN AND METHODS Japanese type 2 diabetic patients with biopsy-proven diabetic nephropathy (n = 260) were enrolled. Patients were stratified by albuminuria (proteinuria) and estimated glomerular filtration rate (eGFR) at the time of renal biopsy. The outcomes were the first occurrence of renal events (requirement of dialysis or a 50% decline in eGFR from baseline), cardiovascular events (cardiovascular death, nonfatal myocardial infarction, coronary interventions, or nonfatal stroke), and all-cause mortality. RESULTS The factors associated with albuminuria (proteinuria) regardless of eGFR were hematuria, diabetic retinopathy, low hemoglobin, and glomerular lesions. The factors associated with low eGFR regardless of albuminuria (proteinuria) were age and diffuse, nodular, tubulointerstitial, and vascular lesions. The glomerular, tubulointerstitial, and vascular lesions in patients with normoalbuminuria (normal proteinuria) and low eGFR were more advanced compared to those in patients with normoalbuminuria (normal proteinuria) and maintained eGFR. In addition, compared to patients with micro-/macroalbuminuria (mild/severe proteinuria) and low eGFR, their tubulointerstitial and vascular lesions were similar or more advanced in contrast to glomerular lesions. The mean follow-up period was 8.1 years. There were 118 renal events, 62 cardiovascular events, and 45 deaths. The pathological determinants were glomerular lesions, interstitial fibrosis and tubular atrophy (IFTA), and arteriosclerosis for renal events, arteriosclerosis for cardiovascular events, and IFTA for all-cause mortality. The major clinical determinant for renal events and all-cause mortality was macroalbuminuria (severe proteinuria). CONCLUSIONS Our study suggests that the characteristic pathological lesions as well as macroalbuminuria (severe proteinuria) were closely related to the long-term outcomes of biopsy-proven diabetic nephropathy in type 2 diabetes. PMID:24089538

Shimizu, Miho; Furuichi, Kengo; Toyama, Tadashi; Kitajima, Shinji; Hara, Akinori; Kitagawa, Kiyoki; Iwata, Yasunori; Sakai, Norihiko; Takamura, Toshinari; Yoshimura, Mitsuhiro; Yokoyama, Hitoshi; Kaneko, Shuichi; Wada, Takashi

2013-10-02

4

Correlations of high-sensitivity C-reactive protein and atherosclerosis in Japanese type 2 diabetic patients  

Microsoft Academic Search

Background: The elevated level of high-sensitivity C-reactive protein (HSCRP) and aortic stiffness are associated with high mortality in type 2 diabetic patients. We tested the hypothesis that the HSCRP correlates with aortic stiffness and insulin resistance in type 2 diabetic patients. Material and methods: The study consisted of 46 Japanese patients with type 2 diabetes and high HSCRP group (0.3-1.0

Futoshi Anan; Takayuki Masaki; Yoshikazu Umeno; Tetsu Iwao; Hidetoshi Yonemochi; Nobuoki Eshima; Tetsunori Saikawa; Hironobu Yoshimatsu

2007-01-01

5

Intensive insulin therapy prevents the progression of diabetic microvascular complications in Japanese patients with non-insulin-dependent diabetes mellitus: a randomized prospective 6-year study  

Microsoft Academic Search

To examine whether intensive glycemic control could decrease the frequency or severity of diabetic microvascular complications, we performed a prospective study of Japanese patients with non-insulin-dependent diabetes mellitus (NIDDM) treated with multiple insulin injection treatment. A total of 110 patients with NIDDM was randomly assigned to multiple insulin injection treatment group (MIT group) or to conventional insulin injection treatment group

Yasuo Ohkubo; Hideki Kishikawa; Eiichi Araki; Takao Miyata; Satoshi Isami; Sadatoshi Motoyoshi; Yujiro Kojima; Naohiko Furuyoshi; Motoaki Shichiri

1995-01-01

6

Effects of liraglutide on postprandial insulin and glucagon responses in Japanese patients with type 2 diabetes.  

PubMed

This study assessed the endocrine pancreatic responses to liraglutide (0.9 mg once a day) during normal living conditions in Japanese patients with type 2 diabetes. The study included 14 hospitalized patients with type 2 diabetes. Meal tests were performed after improvement of glycemic control achieved by two weeks of multiple insulin injection therapy and after approximately two weeks of liraglutide treatment. Continuous glucose monitoring was performed to compare daily variation in glycemic control between multiple insulin injection therapy and liraglutide treatment. Liraglutide reduced plasma glucose levels after the test meals (60-180 min; p<0.05), as a result of significant increases in insulin secretion (0-180 min; p<0.05) and decreases in the incremental ratio of plasma glucagon (15-60 min; p<0.05). Continuous glucose monitoring showed that liraglutide treatment was also associated with a decrease in glucose variability. We also demonstrated that optimal glycemic control seen as a reduction in 24-h mean glucose levels and variability was obtained only with liraglutide monotherapy. In conclusion, liraglutide treatment increases insulin secretion and suppresses glucagon secretion in Japanese patients with type 2 diabetes under normal living conditions. The main therapeutic advantages of liraglutide are its use as monotherapy and its ability to decrease glucose variability. PMID:23874074

Matsumoto, Shinobu; Yamazaki, Masahiro; Kadono, Mayuko; Iwase, Hiroya; Kobayashi, Kanae; Okada, Hiroshi; Fukui, Michiaki; Hasegawa, Goji; Nakamura, Naoto

2013-06-01

7

Decreased serum chemerin levels in male Japanese patients with type 2 diabetes: sex dimorphism.  

PubMed

Chemerin, a recently discovered adipocytokine plays an important role in obesity and obesity-associated metabolic complications. However, the role of chemerin in the pathogenesis of type 2 diabetes mellitus (T2DM) has not fully been elucidated. We compared the serum chemerin levels and metabolic parameters between 88 control subjects, 86 patients with metabolic syndrome (MS), and 147 patients with T2DM in a Japanese population and further analyzed their correlation. Enzyme-linked immunosorbent assay was used to measure the serum chemerin levels. The chemerin levels were significantly higher in male than in female control subjects (p < 0.005), with significant decreases in patients with T2DM compared with those with MS and control subjects (164.9 ± 6.3 ng/mL vs. 209.8 ± 7.7 and 218.7 ± 7.3 ng/mL; p < 0.0001 vs. p < 0.0001, respectively) but no significant differences in female subjects. The multiple regression analysis revealed that the chemerin levels negatively correlated with the fasting glucose and HbA1c levels in total and male subjects. In the patients with T2DM, the chemerin levels negatively correlated with fasting glucose and high-density lipoprotein cholesterol but positively correlated with body mass index (BMI), and total cholesterol and triglyceride levels. The negative correlation between the chemerin and fasting glucose levels remained significant after adjustment for age, sex, and BMI in the total and male subjects and those with T2DM. These results suggest the role of chemerin in sex dimorphism and a potential link between chemerin levels and T2DM pathogenesis in a Japanese population. PMID:22986456

Takahashi, Michiko; Inomata, Sumie; Okimura, Yasuhiko; Iguchi, Genzo; Fukuoka, Hidenori; Miyake, Kazuaki; Koga, Daisuke; Akamatsu, Suguru; Kasuga, Masato; Takahashi, Yutaka

2012-10-13

8

Prevalence of adrenal masses in Japanese patients with type 2 diabetes mellitus  

Microsoft Academic Search

INTRODUCTION: To date, there have been no reports on the prevalence of adrenal masses in type 2 diabetic patients. The present study aimed to evaluate the prevalence of adrenal incidentaloma in type 2 diabetic patients in Japan. SUBJECTS: We retrospectively evaluated the presence of adrenal masses using abdominal CT scans in 304 type 2 diabetic patients. In those with adrenal

Naoki Hiroi; Mariko Sue; Aya Yoshihara; Takamasa Ichijo; Mayumi Yoshida-Hiroi; Mariko Higa; Gen Yoshino

2010-01-01

9

Reevaluation of exercise prescription for Japanese type 2 diabetic patients by ventilatory threshold  

Microsoft Academic Search

Prescription of aerobic exercise for Type 2 diabetes mellitus (Type 2 DM) in clinical practice is frequently based on exercise intensity at maximum heart rate (60Japanese males with Type 2 DM at ventilatory threshold (VT) to investigate the exercise capacity of Type 2 DM

Mie Kunitomi; Kayo Takahashi; Jun Wada; Hisao Suzuki; Nobuyuki Miyatake; Saeko Ogawa; Sachiko Ohta; Hikaru Sugimoto; Kenichi Shikata; Hirofumi Makino

2000-01-01

10

Vascular complications and changes in body mass index in Japanese type 2 diabetic patients with abdominal obesity  

PubMed Central

Background Although many Asian type 2 diabetic patients have been considered to be not obese and have low capacity of insulin secretion, the proportion of obese patients with visceral fat accumulation has increased in recent years. We found previously considerable number of Japanese non-obese subjects (body mass index (BMI) diabetic patients with and without visceral fat accumulation, focusing on vascular complications and changes in BMI. Methods We enrolled 88 Japanese hospitalized type 2 diabetic patients. Abdominal obesity represented waist circumference (WC) of ?85 cm for males and ?90 cm for females (corresponding to visceral fat area of 100 cm2). Subjects were divided into two groups; with or without abdominal obesity. Results Hypertension, dyslipidemia and cardiovascular diseases were significantly more in the patients with abdominal obesity. The prevalence of cardiovascular disease in the non-obese patients (BMI patients (BMI ?25 kg/m2). The mean BMI of the patients with abdominal obesity was diabetic patients (52% in males and 43% in females) were not obese at 20 year-old (BMI?patients with abdominal obesity. The significant weight gain after 20 years of age in patients with abdominal obesity stresses the importance of lifestyle modification in younger generation, to prevent potential development of type 2 diabetes and future atherosclerotic cardiovascular disease.

2013-01-01

11

Effects of pioglitazone on metabolic parameters, body fat distribution, and serum adiponectin levels in Japanese male patients with type 2 diabetes  

Microsoft Academic Search

The aim of this study was to evaluate the effects of pioglitazone on clinical and metabolic parameters, body fat distribution, and serum adiponectin, a recently discovered antiatherosclerotic hormone, in Japanese patients with type 2 diabetes. Ten male patients aged 40 to 66 (57.7 [plusmn] 7.4) years, who were being treated with dietary therapy alone (n = 7) or with a

Hiroshi Hirose; Toshihide Kawai; Yukihiro Yamamoto; Matsuo Taniyama; Motowo Tomita; Koichi Matsubara; Yasunori Okazaki; Tatsuya Ishii; Yuko Oguma; Izumi Takei; Takao Saruta

2002-01-01

12

Efficacy of sitagliptin on blood glucose fluctuation in Japanese type 2 diabetic patients with basal-supported oral therapy.  

PubMed

We retrospectively investigated the effect of adding dipeptidyl peptidase-4 (DPP-4) inhibitor and tapering sulfonylurea on blood glucose fluctuation in Asian patients with type 2 diabetes mellitus under basal-supported oral therapy (BOT). We recruited twenty-two consecutive Japanese patients with type 2 diabetes mellitus who had blood glucose fluctuation under the combination therapy of insulin glargine and glimepiride and had sitagliptin initiated with glimepiride tapared. Their hemoglobin A1c levels and mean blood glucose profiles of seven points in self-monitoring blood glucose (SMBG) were 7.4 ± 0.6% and 8.6 ± 2.0 mmol/L, respectively. Sitagliptin was initiated with the dose of 50 mg per day and titrated up to 100 mg per day when necessary. Glimepiride was withdrawn if possible. Blood glucose fluctuation was evaluated with SMBG by calculating M-value, its range (the difference of maximum and minimum blood glucose levels), and its coefficient of variation (CV). Two months after sitagliptin add-on, M-value was decreased from 19 ± 13 to 13 ± 8 (p = 0.04). Blood glucose range and CV were also improved from 9.6 ± 2.9 mmol/L to 7.9 ± 2.6 mmol/L (p = 0.01), and from 33 ± 8% to 29 ± 8% (p < 0.01), respectively. Hemoglobin A1c levels and mean blood glucose profiles were unchanged (p = 0.93 and 0.47). In conclusion, blood glucose fluctuation was significantly improved two months after adding sitagliptin and tapering glimepiride in type 2 diabetic Japanese patients who were treated by BOT with insulin glargine and glimepiride. PMID:22850206

Takahara, Mitsuyoshi; Shiraiwa, Toshihiko; Kaneto, Hideaki; Katakami, Naoto; Matsuoka, Taka-Aki; Shimomura, Iichiro

2012-07-27

13

Assessment of daily food and nutrient intake in Japanese type 2 diabetes mellitus patients using dietary reference intakes.  

PubMed

Medical nutrition therapy for the management of diabetes plays an important role in preventing diabetes complications and managing metabolic control. However, little is known about actual eating habits of individuals with type 2 diabetic mellitus (T2DM), especially in Japan. Therefore, we sought to (1) assess the dietary intake of individuals with T2DM, and (2) characterize their intake relative to national recommendations. This cross-sectional study involved 149 patients (77 males and 72 females) aged 40-79 years with T2DM recruited at a Kyoto hospital. Dietary intake was assessed using a validated self-administered diet history questionnaire. Under-consumption, adequacy, and over-consumption, of nutrients were compared to the age- and sex-based standards of the Japanese Dietary Reference Intakes. Among the results, most notable are (1) the inadequacy of diets in men with respect to intake of vitamins and minerals, likely owing to low intake of vegetables and fruits; (2) excess contributions of fat intake to total energy in both sexes; and (3) excess consumption of sweets and beverages relative to the national average. The prevalence of diabetes complications may be increasing because of a major gap between the typical dietary intake of individuals with T2DM and dietary recommendation. PMID:23803740

Kobayashi, Yukiko; Hattori, Mikako; Wada, Sayori; Iwase, Hiroya; Kadono, Mayuko; Tatsumi, Hina; Kuwahata, Masashi; Fukui, Michiaki; Hasegawa, Goji; Nakamura, Naoto; Kido, Yasuhiro

2013-06-26

14

Assessment of Daily Food and Nutrient Intake in Japanese Type 2 Diabetes Mellitus Patients Using Dietary Reference Intakes  

PubMed Central

Medical nutrition therapy for the management of diabetes plays an important role in preventing diabetes complications and managing metabolic control. However, little is known about actual eating habits of individuals with type 2 diabetic mellitus (T2DM), especially in Japan. Therefore, we sought to (1) assess the dietary intake of individuals with T2DM, and (2) characterize their intake relative to national recommendations. This cross-sectional study involved 149 patients (77 males and 72 females) aged 40–79 years with T2DM recruited at a Kyoto hospital. Dietary intake was assessed using a validated self-administered diet history questionnaire. Under-consumption, adequacy, and over-consumption, of nutrients were compared to the age- and sex-based standards of the Japanese Dietary Reference Intakes. Among the results, most notable are (1) the inadequacy of diets in men with respect to intake of vitamins and minerals, likely owing to low intake of vegetables and fruits; (2) excess contributions of fat intake to total energy in both sexes; and (3) excess consumption of sweets and beverages relative to the national average. The prevalence of diabetes complications may be increasing because of a major gap between the typical dietary intake of individuals with T2DM and dietary recommendation.

Kobayashi, Yukiko; Hattori, Mikako; Wada, Sayori; Iwase, Hiroya; Kadono, Mayuko; Tatsumi, Hina; Kuwahata, Masashi; Fukui, Michiaki; Hasegawa, Goji; Nakamura, Naoto; Kido, Yasuhiro

2013-01-01

15

Reduced beta-cell mass and expression of oxidative stress-related DNA damage in the islet of Japanese Type II diabetic patients  

Microsoft Academic Search

.\\u000a Aims\\/hypothesis:   We examined the pancreatic islet lesions in Japanese patients with Type II diabetes mellitus to determine if the damage was\\u000a related to oxidative stress. \\u000a \\u000a \\u000a \\u000a Methods:   Morphometric analyses were performed on immunostained sections of the tail portion of the pancreas from 14 diabetic and 15\\u000a non-diabetic patients. Amyloid deposition and oxidative stress-induced tissue damage were evaluated by Congo-red staining

H. Sakuraba; H. Mizukami; N. Yagihashi; R. Wada; C. Hanyu; S. Yagihashi

2002-01-01

16

Polymorphism in gene for islet autoantigen, IA2, and type 1 diabetes in japanese subjects  

Microsoft Academic Search

Autoantibodies against IA-2 have been detected in up to 86% of newly diagnosed patients with type 1 diabetes and appear to identify a subgroup of prediabetic subjects who rapidly progress to type 1 diabetes. We examined the association of IA-2 gene polymorphism with type 1 diabetes in Japanese subjects. A total of 276 Japanese subjects were studied for disease association

Masanori Nishino; Hiroshi Ikegami; Yoshihiko Kawaguchi; Tomomi Fujisawa; Yumiko Kawabata; Maki Shintani; Masaya Ono; Mayumi Horiki; Eiji Kawasaki; Toshio Ogihara

2001-01-01

17

Antibodies to food antigens in Japanese patients with type 1 diabetes mellitus  

Microsoft Academic Search

To examine humoral and mucosal immune responses to food antigens and their relation to the pathophysiology of type 1 diabetes mellitus, IgA and IgG antibodies to cow's milk antigens (bovine serum albumin (BSA) and ?-lactoglobulin (BLG)) and another food antigen (ovalbumin, (OVA)) in human serum were assessed by enzyme-linked immunosorbent assay (ELISA). If anti-idiotype antibodies to the antibodies were present

Takeyuki Kohno; Yasuyuki Kobashiri; Yohko Sugie; Shigehisa Takai; Kazuhito Watabe; Yukikazu Kaino; Kaichi Kida

2002-01-01

18

Decreased activity of arachidonate 12-lipoxygenase in platelets of Japanese patients with non—insulin-dependent diabetes mellitus  

Microsoft Academic Search

To study the metabolism of the platelet 12-lipoxygenase pathway in diabetes, we evaluated the correlation between the activity and amount of arachidonate 12-lipoxygenase in the platelets of patients with non—insulin-dependent-diabetes mellitus (NIDDM). There were four parts in this investigation: (1) examination of abnormalities in platelet 12-lipoxygenase in patients with NIDDM recruited from the Hospital of Juntendo University School of Medicine;

Toshio Tohjima; Naoko Honda; Kentaro Mochizuki; Junichiro Kinoshita; Kenji Watanabe; Tomoyuki Arisaka; Ryuzo Kawamori; Michihiro Nakamura; Yuko Kurahashi; Tanihiro Yoshimoto; Shozo Yamamoto

1998-01-01

19

Nitric oxide system is involved in glomerular hyperfiltration in Japanese normo- and micro-albuminuric patients with type 2 diabetes  

Microsoft Academic Search

Glomerular hyperfiltration plays a pathogenic role in the early stages of diabetic nephropathy. Experimental studies in laboratory animals suggest that nitric oxide (NO) might be involved in the pathogenesis of glomerular hyperfiltration. We performed a cross-sectional study to determine the relationship between diabetic glomerular hyperfiltration and the NO system. Normoalbuminuric (n=41), microalbuminuric (n=25), and macroalbuminuric (n=16) patients with type 2

Keita Hiragushi; Hikaru Sugimoto; Kenichi Shikata; Tetsuji Yamashita; Nobuyuki Miyatake; Yasushi Shikata; Jun Wada; Isao Kumagai; Masaki Fukushima; Hirofumi Makino

2001-01-01

20

Impaired early insulin secretion in Japanese type 2 diabetes with metabolic syndrome  

Microsoft Academic Search

Although it is widely believed that type 2 diabetics with metabolic syndrome (MS) have insulin resistance, the ?-cell function of these patients is largely unknown. We evaluated the characteristics of insulin secretion in Japanese type 2 diabetics with MS after minimizing the influence of glucotoxity. A 75-g OGTT was performed in 192 diabetic subjects and 275 subjects with normal glucose

Etsuko Fukuda-Akita; Kohei Okita; Yukiyoshi Okauchi; Miwa Ryo; Tadashi Nakamura; Tohru Funahashi; Hiromi Iwahashi; Iichiro Shimomura; Junichiro Miyagawa; Kazuya Yamagata

2008-01-01

21

Serum Interleukin18 Levels Are Associated With Nephropathy and Atherosclerosis in Japanese Patients With Type 2 Diabetes  

Microsoft Academic Search

OBJECTIVE — Interleukin (IL)-18 is a proinflammatory cytokine secreted from mononu- clear cells. Serum concentration of IL-18 is a strong predictor of death in patients with cardio- vascular diseases. Recent studies have shown that microinflammation is involved in the pathogenesis of diabetic nephropathy as well as of cardiovascular diseases. This study aimed to test the hypothesis that the serum level

AKIHIKO NAKAMURA; KENICHI SHIKATA; MAKOTO HIRAMATSU; TATSUAKI NAKATOU; TAKUYA KITAMURA; JUN WADA; TATSUYA ITOSHIMA; HIROFUMI MAKINO

2005-01-01

22

Clinical features of non-diabetic renal diseases in patients with type 2 diabetes  

Microsoft Academic Search

Although persistent proteinuria is characteristic of diabetic nephropathy (DN), it is important to differentiate non-diabetic renal diseases (NDRD) in diabetic patients with proteinuria. In order to re-evaluate the indications for renal biopsy in the diabetic patients, we retrospectively analyzed the relationship between clinical features and histological diagnosis in 97 Japanese patients with type 2 diabetes manifesting overt proteinuria. Renal biopsy

Atsuhito Tone; Kenichi Shikata; Mitsuhiro Matsuda; Hitomi Usui; Shinichi Okada; Daisuke Ogawa; Jun Wada; Hirofumi Makino

2005-01-01

23

Self-reported rate of eating is significantly associated with body mass index in Japanese patients with type 2 diabetes. Japan Diabetes Clinical Data Management Study Group (JDDM26).  

PubMed

We examined whether the rate of eating was associated with the body mass index and glycemic control status in Japanese patients with type 2 diabetes (50% women, mean±SD age 59.4±7.5 years). Rapid eating was significantly associated with body mass index (p=0.047). The body mass index of those who reported eating quickly was 0.8 kg/m² higher than in individuals who reported eating at medium speed even after adjustment for known confounders. No significant association was observed between the rate of eating and HbA(1c). Our findings suggest an association between self-reported rapid eating and an elevated body mass index in patients with type 2 diabetes. PMID:22609333

Saito, Aki; Kawai, Koichi; Yanagisawa, Morifumi; Yokoyama, Hiroki; Kuribayashi, Nobuichi; Sugimoto, Hidekatsu; Oishi, Mariko; Wada, Takako; Iwasaki, Koichi; Kanatsuka, Azuma; Yagi, Noriharu; Okuguchi, Fuminobu; Miyazawa, Kazuhiro; Arai, Keiko; Saito, Kazumi; Sone, Hirohito

2012-05-17

24

Correlations of non-exercise activity thermogenesis to metabolic parameters in Japanese patients with type 2 diabetes  

PubMed Central

Background Non-exercise activity thermogenesis (NEAT) is the energy expenditure due to physical activities besides active sports-like exercise and resistance training in daily life. Methods We studied 45 subjects (22 women and 23 men) with type 2 diabetes who did not take any hypoglycemic, anti-hypertensive, or cholesterol-lowering agents and asked them about physical activity concerned with NEAT using an original questionnaire modified from a compendium of physical activities. We studied the association of the NEAT score to body weight, waist circumference, blood pressure, glucose and lipid metabolism, and arterial stiffness. Results The NEAT score was negatively correlated with serum insulin levels (r = -0.42, P < 0.05) in all subjects. The NEAT score was also negatively correlated with waist circumference (r = -0.509, P < 0.05) and positively correlated with high-density lipoprotein-cholesterol levels (r = 0.494, P < 0.05) in women, and negatively associated with serum insulin levels (r = -0.732, p < 0.005), systolic (r = -0.482, P < 0.05) and diastolic blood pressure (r = -0.538, P < 0.05) in patients with abdominal obesity. Furthermore, the NEAT score was negatively associated with pulse wave velocity (r = -0.719, P < 0.005) in smokers. Conclusion The study demonstrated that NEAT is associated with amelioration in insulin sensitivity, waist circumference, high-density lipoprotein-cholesterol, blood pressure and the marker for atherosclerosis in patients with type 2 diabetes.

2013-01-01

25

Six-month multicentric, open-label, randomized trial of twice-daily injections of biphasic insulin aspart 30 versus multiple daily injections of insulin aspart in Japanese type 2 diabetic patients (JDDM 11)  

Microsoft Academic Search

To evaluate glycemic control using convenience-oriented biphasic insulin analog compared with intensified insulin therapy, we conducted a 6-month multicentric, open-label, randomized trial in Japanese insulin-naïve patients with type 2 diabetes mellitus. A total of 160 adult patients at 19 centers were randomized into two groups: those who received twice-daily injections of biphasic insulin aspart 30 and those on three-times-daily injections

Koichi Hirao; Keiko Arai; Mikio Yamauchi; Hirofumi Takagi; Masashi Kobayashi

2008-01-01

26

Attainment of glycaemic goals by step-up therapy with biphasic insulin aspart-70/30 in Japanese type 2 diabetic patients.  

PubMed

We have made step-up titration protocol with biphasic insulin aspart-70/30 (BIAsp 30), and tried to achieve glycemic goals in poorly controlled Japanese type 2 diabetic patients. We summarized all results obtained to analyze the effectiveness of our protocol. The target of glycaemic control was defined as HbA1c over 7.0 %. In our insulin initiation protocol, all patients started a once-daily injection of BIAsp 30 before the breakfast in addition to their oral hypoglycaemic agents. The patients who could not achieve the target from 12 to 16 weeks after the start of insulin treatment proceeded to twice daily insulin injection before breakfast and dinner. Next, the patients who could not achieve the target from 12 to 16 weeks after the addition of another BIAsp injection proceeded to thrice daily insulin injection before each meal a day. The results of 39 patients were analyzed, and 10.3 % of all patients achieved the target after the start of once daily injection of BIAsp 30, 41.7 % achieved in twice daily injection of BIAsp, and 51.4 % achieved in thrice daily injection of BIAsp. Daily insulin dose at the end of each treatment was 9.3±4.1 U in once daily, 17.4±6.3 U in twice daily, and 28.4±10.4 U in thrice daily. Total body weight increase by 2.0±2.6 kg. The initiation and titration protocol with BIAsp 30 improved glycaemic control, and increased the number of patients with the achievement of glycaemic goals. PMID:21186332

Hosoi, Yasuhiro; Ohtani, Ken-Ichi; Shimizu, Hiroyuki; Kashima, Kouji; Sato, Noriyuki; Akiyama, Hitoshi; Mori, Masatomo

2010-12-21

27

Autoantibodies to Multiple Islet Autoantigens in Patients with Abrupt Onset Type 1 Diabetes and Diabetes Diagnosed with Urinary Glucose Screening  

Microsoft Academic Search

It has been reported that there is a heterogeneity in the clinical course of Japanese patients with type 1 diabetes. To elucidate the associations of expression of autoantibodies to multiple islet antigens with age of onset and mode of diagnosis of diabetes in Japanese patients with type 1 diabetes, autoantibodies against the protein tyrosine phosphatase-like molecules ICA512 (IA-2) and phogrin

Yasunori Sera; Eiji Kawasaki; Norio Abiru; Masako Ozaki; Takahiro Abe; Hirofumi Takino; Hideaki Kondo; Hironori Yamasaki; Yoshihiko Yamaguchi; Shoichi Akazawa; Shigenobu Nagataki; Yasuko Uchigata; Nobuo Matsuura; Katsumi Eguchi

1999-01-01

28

Comparisons of the effects of 12-week administration of miglitol and voglibose on the responses of plasma incretins after a mixed meal in Japanese type 2 diabetic patients.  

PubMed

To compare the effects of miglitol [an alpha-glucosidase inhibitor (AGI) absorbed in the intestine] and voglibose (an AGI not absorbed) on plasma glucagon-like peptide-1 (GLP-1) and gastric inhibitory polypeptide (GIP) levels, 26 and 24 Japanese type 2 diabetic patients were randomly assigned to receive miglitol or voglibose, respectively. After 12-week administration of both drugs, during 2-h meal tolerance test, plasma glucose, serum insulin and total GIP were significantly decreased and active GLP-1 was significantly increased. Miglitol group showed a significantly lower total GIP level than voglibose group. Miglitol, but not voglibose, significantly reduced body weight (BW). In all participants, the relative change in BW was positively correlated with that of insulin significantly and of GIP with a weak tendency, but not of GLP-1. In conclusion, both drugs can enhance postprandial GLP-1 responses and reduce GIP responses. The significant BW reduction by miglitol might be attributable to its strong GIP-reducing efficacy. PMID:22051162

Narita, T; Yokoyama, H; Yamashita, R; Sato, T; Hosoba, M; Morii, T; Fujita, H; Tsukiyama, K; Yamada, Y

2011-12-02

29

Factors associated with the glucose-lowering effect of vildagliptin identified from the results of the oral glucose tolerance test in Japanese patients with type 2 diabetes.  

PubMed

In order to investigate the factors contributing to the glucose-lowering effect of vildagliptin, we analyzed the results of the oral glucose tolerance test together with several clinical parameters in Japanese patients with type 2 diabetes before and after 24 weeks of treatment with vildagliptin. The data of the 13 patients who satisfactorily completed the follow-up examinations were included. After 24 weeks treatment with vildagliptin, the patients were classified into a responder group (69.2%) and a non-responder group (30.8%); the responders consisting of subjects whose HbA1c decreased following 24 weeks treatment with vildagliptin, and the non-responders consisting of subjects who did not show any significant decrease of HbA1c. There were no differences in baseline characteristics between the two groups before administration of vildagliptin. After 24 weeks of treatment, HbA1c was significantly reduced from 7.3 ± 0.5% to 6.7 ± 0.5% in the responder group (P = 0.0077), while it tended to rather increased from 7.1 ± 0.6% to 7.5 ± 0.7% in the non-responder group (P = 0.0679). Also, parameters reflecting the glucose-stimulated insulin secretion, such as the insulinogenic index and oral disposition index, were significantly higher in the responder group than in the non-responder group, whereas insulin sensitivity was similar between the two groups. These results suggest that the difference in the degree of improvement of the glucose tolerance between the responder group and non-responder group in this study could be associated with the effect of vildagliptin on the glucose-stimulated insulin secretion, but not on the insulin sensitivity. PMID:22972222

Nakamura, Akinobu; Terauchi, Yasuo

2012-10-09

30

Type 2 diabetes and the metabolic syndrome in Japanese Americans  

Microsoft Academic Search

Japanese Americans have experienced a higher prevalence of type 2 diabetes than in Japan. Research conducted in Seattle suggests that lifestyle factors associated with ‘westernization’ play a role in bringing out this susceptibility to diabetes. These lifestyle factors include consumption of a diet higher in saturated fat and reduced physical activity. A consequence of this is the development of central

Wilfred Y Fujimoto; Richard W Bergstrom; Edward J Boyko; Kwang-Wen Chen; Steven E Kahn; Donna L Leonetti; Marguerite J McNeely; Laura L Newell; Jane B Shofer; Patricia W Wahl

2000-01-01

31

Identification and Functional Analysis of Mutations in the Hepatocyte Nuclear Factor1a Gene in Anti-Islet Autoantibody-Negative Japanese Patients with Type 1 Diabetes  

Microsoft Academic Search

Mutations in the hepatocyte nuclear factor-1a (HNF-1a) gene are the cause of maturity-onset diabetes of the young type 3 (MODY 3), which is characterized by a severe impairment of insulin secretion and early onset of the disease. Although the majority of patients with type 1 diabetes have type 1A, immune-mediated diabetes, there is a significant percentage of the patients who

EIJI KAWASAKI; YASUNORI SERA; KENICHI YAMAKAWA; TAKAHIRO ABE; MASAKO OZAKI; SHIGEO UOTANI; NARIYUKI OHTSU; HIROFUMI TAKINO; HIRONORI YAMASAKI; YOSHIHIKO YAMAGUCHI; NOBUO MATSUURA; KATSUMI EGUCHI

32

TNF, TNF receptor type 1, and allograft inflammatory factor-1 gene polymorphisms in Japanese patients with type 1 diabetes  

Microsoft Academic Search

The human leukocyte antigen (HLA) class III region, located on chromosome 6p21, has been regarded as one of the susceptible loci for type 1 diabetes. Because it contains many genes related to inflammatory and immune responses, including tumor necrosis factor (TNF), lymphotoxin-? (LT-?), and allograft inflammatory factor 1 (AIF-1) genes, it is unclear which gene within the class III region

Masataka Nishimura; Hiroshi Obayashi; Ikuko Mizuta; Hirokazu Hara; Tetsuo Adachi; Mitsuhiro Ohta; Hisataka Tegoshi; Michiaki Fukui; Goji Hasegawa; Hirofumi Shigeta; Yoshihiro Kitagawa; Koji Nakano; Ryuji Kaji; Naoto Nakamura

2003-01-01

33

Efficacy and safety of vildagliptin and voglibose in Japanese patients with type 2 diabetes: a 12-week, randomized, double-blind, active-controlled study  

PubMed Central

Aim: To confirm the efficacy of vildagliptin in patients with type 2 diabetes (T2D) by testing the hypothesis that glycosylated haemoglobin (HbA1c) reduction with vildagliptin is superior to that with voglibose after 12 weeks of treatment. Methods: In this 12-week, randomized, double-blind, active-controlled, parallel-group study, the efficacy and safety of vildagliptin (50 mg bid, n = 188) was compared with that of voglibose (0.2 mg tid, n = 192) in patients with T2D who were inadequately controlled with diet and exercise. Results: The characteristics of two groups were well matched at baseline. The mean age, body mass index (BMI) and HbA1c were 59.1 years, 24.9 kg/m2 and 7.6%, respectively. At baseline, fasting plasma glucose (FPG) and 2-h postprandial glucose (PPG) were 9.01 mmol/l (162.2 mg/dl) and 13.57 mmol/l (244.3 mg/dl), respectively. The adjusted mean change in HbA1c from baseline to endpoint was ?0.95 ± 0.04% in the vildagliptin-treated patients and ?0.38 ± 0.04% in those receiving voglibose (between-group change = 0.57 ± 0.06%, 95% confidence interval (CI) (?0.68 to ?0.46%), p < 0.001), showing that vildagliptin was superior to voglibose. Endpoint HbA1c ? 6.5% was achieved in 51% vildagliptin-treated patients compared with 24% patients who were on voglibose (p < 0.001). Vildagliptin also exhibited significantly (p < 0.001) greater reduction compared with voglibose in both FPG [1.34 vs. 0.43 mmol/l (24.1 vs. 7.8 mg/dl)] and 2-h PPG [2.86 vs. 1.1 mmol/l (51.5 vs. 19.8 mg/dl)]. Overall adverse events (AEs) were lower in the vildagliptin-treated patients compared with that in the voglibose-treated patients (61.2 vs. 71.4%), with no incidence of hypoglycaemia and serious adverse events with vildagliptin. Gastrointestinal AEs were significantly lower with vildagliptin compared with that of the voglibose (18.6 vs. 32.8%; p = 0.002). Conclusions: Vildagliptin (50 mg bid) showed superior efficacy and better tolerability compared with voglibose in Japanese patients with T2D.

Iwamoto, Y; Kashiwagi, A; Yamada, N; Terao, S; Mimori, N; Suzuki, M; Tachibana, H

2010-01-01

34

Characterization of Diabetes Mellitus in Japanese Prader-Willi Syndrome  

PubMed Central

Prader-Willi syndrome (PWS) is frequently associated with marked obesity and diabetes mellitus (DM). Although the overall frequency of DM in PWS ranges from 7–20%, there is only limited data available on Japanese patients. This study evaluated five factors associated with DM in PWS: 1) frequency, 2) age of onset, 3) risk factors, 4) long-term complications and 5) treatment. Sixty-five patients, ranging in age from 10 to 53 yr, were studied retrospectively. The frequency of DM in patients over 10 yr of age was 26.2% (17/65 patients). The age of DM onset ranged from 10 to 29 yr with a median age of 15 yr. The body mass index (BMI) was significantly higher in the DM group in comparison with the non-DM group. The number of patients using growth hormone (GH) in the DM group was significantly lower than the number that did not. Proteinuria (urinary excretion of albumin/creatinine at spot collection: U-Alb/Cr ?300 mg/gCr) was observed in 1/17 patients (5.9%), microalbuminuria (U-Alb/Cr 30–300 mg/gCr) was observed in 4/17 patients (23.5%) and nonproliferative retinopathy was observed in 2/17 patients (11.8%). Among oral hypoglycemic agents, alpha-glucosidase inhibitors (?-GI) were most often used in our patients (10/17, 58.8%). Eleven out of 17 patients (64.7%) had been treated with insulin.

Tsuchiya, Takayoshi; Oto, Yuji; Ayabe, Tadayuki; Obata, Kazuo; Murakami, Nobuyuki; Nagai, Toshiro

2011-01-01

35

Association between IL18 gene promoter polymorphisms and CTLA-4 gene 49A\\/G polymorphism in Japanese patients with type 1 diabetes  

Microsoft Academic Search

Interleukin-18 (IL-18) is a potent proinflammatory cytokine which is strongly associated with the development of diabetes in NOD mice. To test the putative involvement of IL-18 gene polymorphism in predisposition to human type 1 diabetes, the SNPs at position –607 (C\\/A) and –137 (G\\/C) in the promoter region of IL-18 gene were analyzed by sequence-specific PCR in 116 patients with

Akane Ide; Eiji Kawasaki; Norio Abiru; Fuyan Sun; Masakazu Kobayashi; Tetsuya Fukushima; Ryoko Takahashi; Hironaga Kuwahara; Atsushi Kita; Katsuya Oshima; Shigeo Uotani; Hironori Yamasaki; Yoshihiko Yamaguchi; Katsumi Eguchi

2004-01-01

36

Six-month multicentric, open-label, randomized trial of twice-daily injections of biphasic insulin aspart 30 versus multiple daily injections of insulin aspart in Japanese type 2 diabetic patients (JDDM 11).  

PubMed

To evaluate glycemic control using convenience-oriented biphasic insulin analog compared with intensified insulin therapy, we conducted a 6-month multicentric, open-label, randomized trial in Japanese insulin-naive patients with type 2 diabetes mellitus. A total of 160 adult patients at 19 centers were randomized into two groups: those who received twice-daily injections of biphasic insulin aspart 30 and those on three-times-daily injections of insulin aspart with or without NPH insulin (multiple daily injections). At 6 months, mean HbA(1c) decreased by approximately 2.5% in both groups. Reduction of HbA(1c) on both regimens was better in patients whose prior therapy before starting the study was only diet and exercise (-5.0%) than in patients who were previously taking oral antidiabetic agents (-1.0%). No incidence of major hypoglycemia was observed in either regimen. These results suggest that convenience-oriented insulin therapy using biphasic insulin analog is as useful as intensified insulin therapy with insulin analog for the treatment of type 2 diabetes mellitus over 6 months. Furthermore, early induction of insulin therapy in individuals hitherto using only diet and exercise may provide good glycemic control. This study suggests that convenience-oriented biphasic insulin aspart 30 might be a useful option for the treatment of type 2 diabetes mellitus, especially for insulin-naive patients over 6 months, although it should be changed to another regimen when expected efficacy is not obtained. PMID:17919762

Hirao, Koichi; Arai, Keiko; Yamauchi, Mikio; Takagi, Hirofumi; Kobayashi, Masashi

2007-10-24

37

Prevalence and risk factors of erectile dysfunction in Japanese men with type 2 diabetes.  

PubMed

This study aimed to elucidate the prevalence and clinical risk factors of erectile dysfunction (ED) in Japanese male diabetics. Questionnaires were administered to 82 male diabetics and 25 male non-diabetics (controls), to determine the international index of erectile function (IIEF). This index consists of five parts, with questions related to erectile function (EF), intercourse satisfaction (IS), orgasmic function (OF), sexual desire (SD), and overall satisfaction (OS). IIEF scores were compared between diabetics and controls, and were also analyzed in relation to clinical factors. Although EF, IS, and OF scores (physical factors) in diabetic men were significantly lower than those of age-matched controls, no significant differences were apparent in SD and OS scores (psychological factors). All patients with EF score > or = 18 reported being able to achieve sexual intercourse, we determined the criterion for ED as EF < 18. The prevalence of ED in diabetics and age-matched controls was 60% and 20%, respectively. EF score decreased with duration of diabetes and progression of retinopathy, proteinuria, ischemic heart disease, delayed nerve conduction, orthostatic intolerance, and attenuated heart rate variability. ED was found to be common in Japanese male diabetics. Possible influences of both microangiopathy and macroangiopathy on ED are suggested. PMID:15563972

Yamasaki, Hiroshi; Ogawa, Kenichi; Sasaki, Hideyuki; Nakao, Taisei; Wakasaki, Hisao; Matsumoto, Eisaku; Furuta, Hiroto; Nishi, Masahiro; Ueda, Kazuya; Iwo, Kazuhiro; Nanjo, Kishio

2004-12-01

38

Smoking habits in Japanese patients with schizophrenia  

Microsoft Academic Search

Studies from North America and Western Europe have observed a marked increase of smoking in schizophrenia. This preliminary study investigated smoking habits in Japanese patients with schizophrenia (n=137). The prevalence of smokers (34%) was not higher than in the general Japanese population (37%). Variables associated with smoking were also different from those reported in the Western literature. Different cultural backgrounds

Takeyuki Mori; Tsukasa Sasaki; Akira Iwanami; Tsuyoshi Araki; Kaoru Mizuno; Tadafumi Kato; Nobumasa Kato

2003-01-01

39

Relationship between development of diabetes and family history by gender in Japanese-Americans  

Microsoft Academic Search

Japanese-Americans are more highly exposed to environmental factors related to diabetes, specifically a westernized lifestyle, compared with Japanese living in Japan. We investigated the relationship between family history and development of type 2 diabetes by gender in the westernized environment. Nine-hundred-and-sixty non-diabetic Japanese-American subjects who underwent the 75 g oral glucose tolerance test were followed for 6.8±0.1 years (mean±standard error).

Shuhei Nakanishi; Kiminori Yamane; Nozomu Kamei; Masamichi Okubo; Nobuoki Kohno

2003-01-01

40

Genetic analysis of HLA class II alleles and susceptibility to Type 1 (insulin-dependent) diabetes mellitus in Japanese subjects  

Microsoft Academic Search

Summary  Although HLA-DQB1 alleles encoding aspartic acid at position 57 (Asp-57) are protective against Type 1(insulin-dependent)\\u000a diabetes mellitus in Caucasians, most Japanese Type 1 diabetic patients carry at least one Asp-57 DQB1 allele. We analysed\\u000a the DRB1, DQA1 and DQB1 genes of 99 Japanese patients and 86 control subjects with polymerase chain reaction and sequence-specific\\u000a oligonucleotide hybridization. We found that (1)

T. Awatal; T. Kuzuyal; A. Matsuda; Y. Iwamoto; Y. Kanazawa

1992-01-01

41

Mutation in the mitochondrial tRNA leu at position 3243 and spontaneous abortions in Japanese women attending a clinic for diabetic pregnancies  

Microsoft Academic Search

Summary  Mitochondrial DNA is exclusively maternally inherited. We recently found the prevalence of diabetic patients with an A to\\u000a G transition at position 3243 of leucine tRNA (3243 base pair (bp) mutation) to be nearly 1 % in randomly selected Japanese\\u000a subjects. Here, we report the higher prevalence of diabetic patients with the 3243 bp mutation in a specific Japanese population

K. Yanagisawa; Y. Uchigata; M. Sanaka; H. Sakura; S. Minei; M. Shimizu; R. Kanamuro; T. Kadowaki; Y. Omori

1995-01-01

42

Association of obesity and diabetes with serum prostate-specific antigen levels in Japanese males.  

PubMed

Patients with diabetes have been reported to be at an increased risk for cancers of the pancreas, liver, and colon; however, recent studies have suggested that men with diabetes are at a decreased risk for prostate cancer. Previous studies have found that obese men have lower serum prostate-specific antigen (PSA) concentrations than do non-obese men. Further understanding of how obesity and diabetes affect the PSA concentration may improve our ability to detect clinically relevant prostate tumors. This study examined the relationships among serum PSA level, obesity, and diabetes in apparently healthy Japanese males. We analyzed the baseline data from 2,172 Japanese males (age, 56.8 +/- 6.1 years [mean +/- SD]) who participated in the Japan Multi-Institutional Collaborative Cohort Study. Diabetes was defined as the presence of both a hemoglobin A1c (JDS) of > or = 6.1% and a fasting plasma glucose level of > or = 126 mg/dL, or a positive medical history. After adjusting for age, the PSA levels were elevated among males with a higher normal BMI (ranging from 23.0 to 24.9) and lowered among men with a BMI of > or = 25.0. In the stratified analysis, these significant differences in BMI categories were absent among diabetics. The mean PSA levels were significantly lower in diabetics than in non-diabetics among subjects aged 60 and over. Our findings suggest that the pre-overweight men had increased PSA levels, and the diabetes was associated with a reduction of PSA levels in elderly. PMID:23092101

Naito, Mariko; Asai, Yatami; Mori, Atsuyoshi; Fukada, Yuko; Kuwabara, Mayumi; Katase, Shiro; Hishida, Asahi; Morita, Emi; Kawai, Sayo; Okada, Rieko; Nishio, Kazuko; Tamakoshi, Akiko; Wakai, Kenji; Hamajima, Nobuyuki

2012-08-01

43

Association study between CD30 and CD30 ligand genes and type 1 diabetes in the Japanese population  

Microsoft Academic Search

CD30-CD30 ligand (CD30L) signal transduction appears to protect against autoimmune diabetes by preventing expansion of autoreactive T cells and suppressing Th1-cytokine response. The purpose of this study was to determine whether CD30 or CD30L genes serve as a novel susceptibility gene for type 1 diabetes in humans. We screened CD30 and CD30L genes for polymorphisms in Japanese patients with type

S Ahmed; K Ihara; W M Bassuny; R Kuromaru; H Kohno; K Miyako; N Matsuura; I Iwata; S Nagafuchi; T Hara

2002-01-01

44

Clinicopathological study of Japanese patients with genetic iron overload syndromes.  

PubMed

In addition to hemochromatosis, aceruloplasminemia and ferroportin disease may be complicated by iron-induced multiple organ damage. Therefore, clinicopathological features should be evaluated in a wider range of genetic iron disorders. This study included 16 Japanese patients with genetic iron overload syndromes. The responsible genes were CP in four, HAMP in one, HJV in three, TFR2 in five, and SLC40A1 in three patients. No phenotype dissociation was observed in patients with the CP, TFR2, or HAMP genotypes. Two of the three patients with the HJV genotype displayed classic hemochromatosis instead of the juvenile type. Patients with the SLC40A1 genotype were affected by mild iron overload (ferroportin A) or severe iron overload (ferroportin B). Transferrin saturation was unusually low in aceruloplasminemia patients. All patients, except those with ferroportin disease, displayed low serum hepcidin-25 levels. Liver pathology showed phenotype-specific changes; isolated parenchymal iron loading in aceruloplasminemia, periportal fibrosis associated with heavy iron overload in both parenchymal and Kupffer cells of ferroportin B, and parenchyma-dominant iron-loading cirrhosis in hemochromatosis. In contrast, diabetes occurred in all phenotypes of aceruloplasminemia, hemochromatosis, and ferroportin disease B. In conclusion, clinicopathological features were partially characterized in Japanese patients with genetic iron overload syndromes. PMID:22924847

Hattori, Ai; Miyajima, Hiroaki; Tomosugi, Naohisa; Tatsumi, Yasuaki; Hayashi, Hisao; Wakusawa, Shinya

2012-09-01

45

Risk Factors for Type 2 Diabetes: Lessons Learned from Japanese Americans in Seattle  

PubMed Central

Migrant Japanese populations in both the United States and Brazil have for a long time shown a higher prevalence of type 2 diabetes than in native Japanese, suggesting an interaction of lifestyle and genetic predisposition in the etiology of type 2 diabetes. The overall objective of the Seattle Japanese American Community Diabetes Study was to learn more about the etiology and pathogenesis of type 2 diabetes in Japanese Americans. This metabolically based epidemiologic study included extensive assessments of insulin sensitivity, insulin response, and adiposity with the latter including measurements of body fat distribution by both anthropometry and computed tomography. Because of this, the importance of visceral adiposity as a risk factor for abnormal glucose tolerance, hypertension, coronary heart disease, and the metabolic syndrome was demonstrated. In conjunction with an examination of diet and physical activity patterns, the result was a clearer understanding of the etiology and pathogenesis of type 2 diabetes in Japanese Americans. Wepropose that a lifestyle that fosters increased weight gain, especially in the visceral adipose depot, promotes the development of insulin resistance which in turn exposes an underlying reduced beta-cell reserve in susceptible individuals, resulting in glucose intolerance and eventually in many the development of diabetes. We have shown that it may be possible to delay or prevent the development of diabetes through dietary and exercise interventions in individuals identified as having impaired glucose tolerance. The lessons learned from studying migrant Japanese in Seattle may in many ways be applicable to other populations of Asian origin.

Fujimoto, Wilfred Y.; Boyko, Edward J.; Hayashi, Tomoshige; Kahn, Steven E.; Leonetti, Donna L.; McNeely, Marguerite J.; Shuman, William P.

2012-01-01

46

Polymorphisms of interferon-? gene CA-Repeat and interleukin-10 promoter region (-592A\\/C) in Japanese type I diabetes  

Microsoft Academic Search

We investigated the association of the polymorphisms of interferon-? gene (IFNG) CA-repeat and IL-10-592A\\/C with clinical heterogeneity of type I diabetes as well as susceptibility to type I diabetes. Two hundred seven Japanese type I diabetic patients and 160 healthy control subjects were studied in this case-control study. No significant differences of global IFNG allele frequencies were found between controls

Hisataka Tegoshi; Goji Hasegawa; Hiroshi Obayashi; Koji Nakano; Yoshihiro Kitagawa; Michiaki Fukui; Satoshi Matsuo; Masako Deguchi; Mitsuhiro Ohta; Masataka Nishimura; Naoto Nakamura; Toshikazu Yoshikawa

2002-01-01

47

Heart disease in diabetic patients  

Microsoft Academic Search

Both type 1 and type 2 diabetic patients have an increased incidence of ischemic heart disease and congestive heart failure.\\u000a Cardiovascular disease accounts for up to 80% of the excess mortality in patients with type 2 diabetes. The burden of cardiovascular\\u000a disease is especially pronounced in diabetic women. Factors that underlie diabetic heart disease include multiple vessel coronary\\u000a artery disease,

Mihaela C. Blendea; Samy I. McFarlane; Esma R. Isenovic; Gregory Gick; James R. Sowers

2003-01-01

48

Diabetes, Glycosuria, and Proteinuria in a Japanese Cohort Followed for 20 Years.  

National Technical Information Service (NTIS)

An analysis of noninsulin-dependent diabetes mellitus, glycosuria, and proteinuria in a Japanese cohort, which has been followed for 20 years, is presented. For the last 14 years of follow-up in Hiroshima, the sex-specific incidence rates of diabetes were...

J. B. Brodsky D. F. Moore H. B. Hamilton R. Kawate

1988-01-01

49

Rheumatic manifestations in diabetic patients  

PubMed Central

Diabetes mellitus (DM), a worldwide high prevalence disease, is associated with a large variety of rheumatic manifestations. For most of these affections, pathophysiologic correlations are not well established. Some of them, such as diabetic cheiroarthropathy, neuropathic arthritis, diabetic amyotrophy, diabetic muscle infraction, are considered intrinsic complications of DM. For others, like diffuse idiopathic skeletal hyperostosis or reflex sympathetic dystrophy, DM is considered a predisposing condition. In most cases, these affections cause pain and disability, affecting the quality of life of diabetic patients, but once correctly diagnosed, they often respond to the treatment, that generally requires a multidisciplinary team. This article reviews some epidemiological, clinical, diagnostic and therapeutic aspects of these conditions.

Serban, AL; Udrea, GF

2012-01-01

50

CTLA4 gene polymorphism correlates with the mode of onset and presence of ICA512 Ab in Japanese Type 1 diabetes  

Microsoft Academic Search

Recently, the association of CTLA4 gene polymorphism with type 1 diabetes and AITD has been reported in several populations. CTLA4 was originally reported to regulate T-cell activity and T–B cognate interaction. To investigate the role of CTLA4 in autoimmune diseases, we examined the correlation between CTLA4 gene polymorphism and the clinical characteristics of Japanese patients with type 1 diabetes, including

Takahiro Abe; Hirofumi Takino; Hironori Yamasaki; Masako Ozaki; Yasunori Sera; Hideaki Kondo; Hiroyuki Sakamaki; Eiji Kawasaki; Takuya Awata; Yoshihiko Yamaguchi; Katsumi Eguchi

1999-01-01

51

Functional polymorphism in Z-DNA–forming motif of promoter of SLC11A1 gene and type 1 diabetes in Japanese subjects: Association study and meta-analysis  

Microsoft Academic Search

The association of the polymorphism of the Z-DNA–forming repeats in the promoter region of SLC11A1 (solute carrier family 11 member 1), formerly designated NRAMP1 (natural resistance associated macrophage protein 1), with type 1 diabetes was studied in a total of 244 Japanese subjects. Three alleles were detected in Japanese subjects. In diabetic patients, allele 2 was less frequent and allele

Masanori Nishino; Hiroshi Ikegami; Tomomi Fujisawa; Yoshihiko Kawaguchi; Yumiko Kawabata; Maki Shintani; Masaya Ono; Toshio Ogihara

2005-01-01

52

[Erythropoietin administration in diabetic patients].  

PubMed

This paper presents the role of erythropoietin application in diabetic patients with accompanying renal failure. The main cause of anemia in diabetics are: nephropathy, structural lesions of erythrocyte membrane and blood loss connected with diagnostic and therapeutic actions. There are publications which demonstrate that in patients with diabetes type 1 or 2 with accompanying nephropathy, anemia appears more frequently than in the group of patients with chronic renal failure caused by other factors. It is supposed, that the impaired erythropoietin synthesis in diabetics can be caused by autonomic neuropathy. Erythropoietin administration in case of diabetic nephropathy has a beneficial influence on fat metabolism, immune response and reduction of insuline resistance. Erythropoietin because of reduction of vascular endothelial growth factor synthesis blocks the development of diabetic retinopathy and macroangiopathy. Erythropoietin reduces the risk of the left-ventricular hypertrophy caused by anemia. Very important is that the erythropoietin resistance is lower in diabetics. Scientists who are adverse to erythropoietin administration in patients with diabetic nephropathy maintain, that it can lead to vascular complications and the deterioration of glycemia control. PMID:14974347

Zukowska-Szczechowska, Ewa; Tomaszewski, Maciej; Sedkowska, Agnieszka; Grzeszczak, W?adys?aw

2003-01-01

53

The Influence of a Single Nucleotide Polymorphism within CNDP1 on Susceptibility to Diabetic Nephropathy in Japanese Women with Type 2 Diabetes  

PubMed Central

Background Several linkage analyses have mapped a susceptibility locus for diabetic nephropathy to chromosome 18q22–23, and polymorphisms within the carnosine dipeptidase 1 gene (CNDP1), located on 18q22.3, have been shown to be associated with diabetic nephropathy in European subjects with type 2 diabetes. However, the association of this locus with diabetic nephropathy has not been evaluated in the Japanese population. In this study, we examined the association of polymorphisms within the CNDP1/CNDP 2 locus with diabetic nephropathy in Japanese subjects with type 2 diabetes. Methodology/Principal Findings We genotyped a leucine repeat polymorphism (D18S880) that is within CNDP1 along with 29 single nucleotide polymorphisms (SNPs) in the CNDP1/CNDP2 locus for 2,740 Japanese subjects with type 2 diabetes (1,205 nephropathy cases with overt nephropathy or with end-stage renal disease [ESRD], and 1,535 controls with normoalbuminuria). The association of each polymorphism with diabetic nephropathy was analysed by performing logistic regression analysis. We did not observe any association between D18S880 and diabetic nephropathy in Japanese subjects with type 2 diabetes. None of the 29 SNPs within the CNDP1/CNDP2 locus were associated with diabetic nephropathy, but a subsequent sex-stratified analysis revealed that 1 SNP in CNDP1 was nominally associated with diabetic nephropathy in women (rs12604675-A; p?=?0.005, odds ratio [OR]?=?1.76, 95% confidence interval [CI], 1.19?2.61). Rs12604675 was associated with overt proteinuria (p?=?0.002, OR?=?2.18, 95% CI, 1.32?3.60), but not with ESRD in Japanese women with type 2 diabetes. Conclusions/Significance Rs12604675-A in CNDP1 may confer susceptibility to overt proteinuria in Japanese women with type 2 diabetes.

Kurashige, Mahiro; Imamura, Minako; Araki, Shin-ichi; Suzuki, Daisuke; Babazono, Tetsuya; Uzu, Takashi; Umezono, Tomoya; Toyoda, Masao; Kawai, Koichi; Imanishi, Masahito; Hanaoka, Kazushige; Maegawa, Hiroshi; Uchigata, Yasuko; Hosoya, Tatsuo; Maeda, Shiro

2013-01-01

54

DNA Hypermethylation and Inflammatory Markers in Incident Japanese Dialysis Patients  

PubMed Central

Background/Aims Inflammation is an established mortality risk factor in chronic kidney disease (CKD) patients. Although a previous report showed that uremic Caucasian patients with inflammation had signs of global DNA hypermethylation, it is still unknown whether DNA hypermethylation is linked to inflammatory markers including a marker of bacterial infections in Japanese CKD patients. Methods In 44 consecutive incident dialysis patients (26 males, mean age 59 ± 12 years) without clinical signs of infection, global DNA methylation was evaluated in peripheral blood DNA using the HpaII/MspI ratio by the luminometric methylation assay method. A lower ratio of HpaII/MspI indicates global DNA hypermethylation. Procalcitonin (PCT), a marker of inflammation due to bacterial infections, was measured using an immunochromatographic assay. Results The patients were divided into hyper- and hypomethylation groups based on the median value of the HpaII/MspI ratio 0.31 (range 0.29–0.37). Whereas patients in the hypermethylation group had higher ferritin levels [133.0 (51.5–247.3) vs. 59.5 (40.0–119.0) ng/ml; p = 0.046], there were no significant differences in age, gender, diabetes, smoking, anemia or serum albumin levels. However, the HpaII/MspI ratio showed significant negative correlations with PCT (? = ?0.32, p = 0.035) and ferritin (? = ?0.33, p = 0.027) in Spearman's rank test. In a multiple linear regression analysis, PCT and ferritin were associated with a lower HpaII/MspI ratio (R2 = 0.24, p = 0.013). Conclusion In this study, global DNA hypermethylation was associated with ferritin and, most likely, PCT, suggesting that inflammation induced by subclinical bacterial infection promoted DNA methylation.

Kato, Sawako; Lindholm, Bengt; Stenvinkel, Peter; Ekstrom, Tomas J.; Luttropp, Karin; Yuzawa, Yukio; Yasuda, Yoshinari; Tsuruta, Yoshinari; Maruyama, Shoichi

2012-01-01

55

Metabolic Syndrome in Japanese Patients with Obstructive Sleep Apnea Syndrome  

Microsoft Academic Search

We investigated the prevalence of metabolic syndrome in patients with obstructive sleep apnea syndrome (OSAS) referred to a tertiary university–based medical center. A cross-sectional study of patients with a definite diagnosis of OSAS was performed using new diagnostic criteria for metabolic syndrome that were designed for the Japanese population. Clinical features and comorbidities related to metabolic syndrome were compared between

Ryujiro Sasanabe; Katsuhisa Banno; Kazuo Otake; Rika Hasegawa; Kengo Usui; Mikiko Morita; Toshiaki Shiomi

2006-01-01

56

Severe Neutropenia in Japanese Patients with X-Linked Agammaglobulinemia  

Microsoft Academic Search

X-linked agammaglobulinemia (XLA) is clinically characterized by recurrent bacterial infections during early infancy. Although it is not a phagocytic disorder, XLA is sometimes associated with neutropenia. We conducted a nation-wide survey to determine the frequency of neutropenia among Japanese XLA patients. Responses were received from 87 (86%) of 101 patients in which BTK mutations were previously identified, and of these,

Hirokazu Kanegane; Hiromichi Taneichi; Keiko Nomura; Takeshi Futatani; Toshio Miyawaki

2005-01-01

57

Obesity, weight change and risks for hypertension, diabetes and hypercholesterolemia in Japanese men  

Microsoft Academic Search

Objective: To examine the effects of the degree of body mass index and weight gain as the risks for hypertension, hypercholesterolemia and diabetes in Japanese men, and to compare that to the corresponding effects in a Caucasian population.Design: Prospective cohort study.Setting: Cohort of all male employees at a company.Subjects: A total of 4737 male employees followed until retirement or for

K Ishikawa-Takata; T Ohta; K Moritaki; T Gotou; S Inoue

2002-01-01

58

Ankyrin gene mutations in japanese patients with hereditary spherocytosis  

Microsoft Academic Search

We studied mutations of theankyrin-1 (ANK-1) gene of genomic DNA from Japanese patients with hereditary spherocytosis (HS). Forty-nine patients from 46 unrelated families\\u000a were included in this study. Of these patients, 19 cases from 16 unrelated families had HS of autosomal-dominant inheritance,\\u000a and 30 patients had non-autosomal-dominant HS. Fifteen mutations of theANK-1 gene pathognomonic for HS were identified: 4 nonsense

Hidekazu Nakanishi; Akio Kanzaki; Ayumi Yawata; Osamu Yamada; Yoshihito Yawata

2001-01-01

59

How to revascularize patients with diabetes mellitus—  

Microsoft Academic Search

Summary  The diabetic patient is at high risk for coronary artery disease. Incidence as well as severity of the disease is highly increased\\u000a in comparison to non–diabetic patients. The revascularization of the diabetic patient is a great challenge, since the longterm\\u000a results are disappointing when compared to non–diabetic patients. The success of coronary artery bypass grafting is limited\\u000a by increased perioperative

Albrecht Elsässer; Helge Möllmann; Holger M. Nef; Christian W. Hamm

2006-01-01

60

[Patient education of gestational diabetes].  

PubMed

Gestational diabetes is hyperglycaemia detected during pregnancy. Recent studies have shown the benefit of the intensive management of this form of diabetes in limiting the repercussions on the mother and foetus. Therapeutic education is an integral part of the support given to these patients. Based on a self-assessment of its educational practices, the diabetologyteam at the University Hospital of Besançon has focused on a management of the condition centred on technical and dietary aspects. For every issue, areas of improvement were suggested, implemented and assessed. PMID:23785963

Filiatre, Caroline; Zimmermann, Cécile

2013-05-01

61

Clinical features and visual outcomes of Japanese patients with scleritis  

Microsoft Academic Search

PurposeTo analyse clinical features, systemic associations, treatment and visual outcomes in Japanese patients with scleritis.MethodsClinical records of 83 patients with scleritis who presented between 1998 and 2008 to the Ocular Inflammation Service of the Kyorin Eye Center, Tokyo, were reviewed.ResultsOf the 83 patients, 57 (69%) had diffuse anterior scleritis, 9 (11%) had nodular anterior scleritis, 8 (10%) had necrotising anterior

H. Keino; T. Watanabe; W. Taki; C. Nakashima; A. A. Okada

2010-01-01

62

The diabetic patient with hypertension.  

PubMed Central

Hypertension and diabetes co-exist more commonly than would be expected from their individual prevalences. Elevated blood pressure is most commonly due to coexisting essential hypertension, or diabetic renal disease. Early stages of diabetic renal disease can be identified by detecting microalbuminuria. Standard measures of blood pressure are not necessarily raised, but 24-hour ambulatory measures frequently identify a loss of nocturnal drop in blood pressure. Treating hypertension aggressively is important in slowing the inexorable decline in glomerular filtration rate. In diabetes there appears to be no 'J'-shaped relationship between blood pressure and cardiovascular events, thus removing any concern about attaining low blood pressures as long as the patient is asymptomatic. Morbidity and mortality in these patients is usually associated with cardiovascular events, and it is important to assess the effect of drugs on left ventricular hypertrophy and metabolic parameters. Many drugs are effective at lowering blood pressure, but angiotensin-converting enzyme inhibitors may have an additional renoprotective action. alpha-Adrenergic antagonists may improve lipid profiles and calcium antagonists are probably lipid neutral, making these drugs useful alternatives. Dihydropyridine calcium antagonists (eg, nifedipine) may augment protein-uria, and hence non-dihydropyridine calcium antagonists (eg, verapamil, diltiazem) would be preferred. beta-Blockers and thiazide diuretics have the disadvantage of causing a deterioration in glycaemic and lipid profiles, but can be useful on occasions. Images Figure

Leese, G. P.; Savage, M. W.; Chattington, P. D.; Vora, J. P.

1996-01-01

63

Arm Length is Associated with Type 2 Diabetes Mellitus in Japanese Americans  

PubMed Central

Aims/Hypothesis To examine the association of type 2 diabetes mellitus with arm length as a marker for early life environment and development. Methods This was a cross-sectional analysis of 658 second and third generation Japanese Americans (349 men and 309 women). Different arm length (total, upper and forearm length) and leg length (total and lower leg length) measurements were performed. Type 2 diabetes was defined by use of hypoglycemic medication or a fasting plasma glucose (FPG) ?7mmol/L or 2 h ?11.1mmol/L during an OGTT. Persons meeting criteria for impaired glucose tolerance were excluded from these analyses (FPG<7mmol/L and 2 h <11.1 and ?7.8mmol/L). Multivariable logistic regression was used to estimate associations between diabetes prevalence and limb lengths while adjusting for possible confounders. Results 145 subjects had diabetes. On univariate analysis arm and leg length were not associated with diabetes. After adjustment for age, sex, CT measured intra-abdominal fat area, height, weight, smoking status and family history of diabetes, total arm length and upper arm length were inversely related to diabetes (Odds Ratio (OR) for a 1 standard deviation increase 0.49; 95% CI 0.29, 0.84 and OR 0.56; 95% CI 0.36, 0.87, respectively). Forearm length, height and leg length were not associated with diabetes after adjustment for confounding variables. Conclusions/interpretation Our findings of associations between arm lengths and type 2 diabetes prevalence supports a role for factors that determine bone growth or their correlates in the development of this condition.

Smits, M.M.; Boyko, E.J.; Utzschneider, K.M.; Leonetti, D.L.; McNeely, M.J.; Suvag, S.; Wright, L.A.; Fujimoto, W.Y.; Kahn, S.E.

2013-01-01

64

Efficacy of liraglutide, a glucagon-like peptide-1 (GLP-1) analogue, on body weight, eating behavior, and glycemic control, in Japanese obese type 2 diabetes  

PubMed Central

Background We recently reported that short-term treatment with liraglutide (20.0?±?6.4?days) reduced body weight and improved some scales of eating behavior in Japanese type 2 diabetes inpatients. However, it remained uncertain whether such liraglutide-induced improvement is maintained after discharge from the hospital. The aim of the present study was to determine the long-term effects of liraglutide on body weight, glycemic control, and eating behavior in Japanese obese type 2 diabetics. Methods Patients with obesity (body mass index (BMI) >25?kg/m2) and type 2 diabetes were hospitalized at Osaka University Hospital between November 2010 and December 2011. BMI and glycated hemoglobin (HbA1c) were examined on admission, at discharge and at 1, 3, and 6?months after discharge. For the liraglutide group (BMI; 31.3?±?5.3?kg/m2, n?=?29), patients were introduced to liraglutide after correction of hyperglycemic by insulin or oral glucose-lowering drugs and maintained on liraglutide after discharge. Eating behavior was assessed in patients treated with liraglutide using The Guideline For Obesity questionnaire issued by the Japan Society for the Study of Obesity, at admission, discharge, 3 and 6?months after discharge. For the insulin group (BMI; 29.1?±?3.0?kg/m2, n?=?28), each patient was treated with insulin during hospitalization and glycemic control maintained by insulin after discharge. Results Liraglutide induced significant and persistent weight loss from admission up to 6?months after discharge, while no change in body weight after discharge was noted in the insulin group. Liraglutide produced significant improvements in all major scores of eating behavior questionnaire items and such effect was maintained at 6?months after discharge. Weight loss correlated significantly with the decrease in scores for recognition of weight and constitution, sense of hunger, and eating style. Conclusion Liraglutide produced meaningful long-term weight loss and significantly improved eating behavior in obese Japanese patients with type 2 diabetes.

2012-01-01

65

Diabetic myonecrosis in a cystic fibrosis patient.  

PubMed

Cystic fibrosis (CF) related diabetes is an increasingly common comorbidity in CF patients, with scarce data on end-stage complications in the CF population. We report the case of a 32-year-old with poorly controlled diabetes presenting with sub-acute leg pain and focal quadriceps tenderness. Neuromuscular testing and extensive workup revealed diabetic myonecrosis. To our knowledge, this is the first reported case of diabetic myonecrosis in a patient with CF, and highlights the need for pulmonary physicians to recognize this diabetic complication in CF patients, which is associated with a poor long-term prognosis and existing microvascular complications. PMID:23362169

Kopp, Benjamin T; Kirkby, Stephen; Hayes, Don; Flanigan, Kevin M

2013-01-29

66

Missense Variations of the Gene Responsible for Wolfram Syndrome ( WFS1\\/ wolframin) in Japanese: Possible Contribution of the Arg456His Mutation to Type 1 Diabetes as a Nonautoimmune Genetic Basis  

Microsoft Academic Search

Recently, a novel gene for a putative transmembrane protein (WFS1\\/wolframin) was found to be mutated in patients with Wolfram syndrome or DI-DM-OA-D (diabetes insipidus, diabetes mellitus, optic atrophy, and deafness) syndrome. It is suggested that the WFS1 protein is important in the survival of islet ?-cells. We studied the WFS1 gene in a Japanese population to assess its possible role

Takuya Awata; Kiyoaki Inoue; Susumu Kurihara; Tomoko Ohkubo; Ikuo Inoue; Takahiro Abe; Hirofumi Takino; Yasunori Kanazawa; Shigehiro Katayama

2000-01-01

67

Oculocutaneous albinism and analysis of tyrosinase gene in Japanese patients.  

PubMed

Oculocutaneous albinism (OCA) is a heterogeneous groups of autosomal-recessive genetic disorders. The molecular pathogenesis of several types of OCA have been clarified in the ten years since our first report in 1989 on a pathologic mutation of the tyrosinase gene. In this article, a new classification of OCA based on genetic evidence is briefly reviewed, and our study on Japanese patients with tyrosinase-negative OCA is summarized. PMID:9879192

Tomita, Y; Miyamura, Y

1998-10-01

68

Working with Challenging Patients in Diabetes Treatment  

Microsoft Academic Search

Patients in diabetes treatment sometimes struggle with psychosocial problems that may interact with their abilities to manage\\u000a diabetes. Health care providers may feel frustrated, ineffective, and helpless because it is difficult to form a working alliance\\u000a with these challenging patients. This chapter defines the working alliance and presents it as an essential ingredient of patient-centered\\u000a diabetes treatment and as a

Marilyn D. Ritholz

69

Diabetes mellitus in chronic mental patients  

Microsoft Academic Search

Summary 1.A survey of 798 male patients living on the continued treatment service of the New Jersey State Hospital at Marlboro revealed that 37 had glycosuria and that 28 had diabetes mellitus ranging in degree from mild to severe.2.In this group of diabetic patients seven were diagnosed as schizophrenic reaction, paranoid type. Six patients had formally been assigned this diagnosis

Richard Winkelmayer

1962-01-01

70

Ankyrin gene mutations in japanese patients with hereditary spherocytosis.  

PubMed

We studied mutations of the ankyrin-1 (ANK-1) gene of genomic DNA from Japanese patients with hereditary spherocytosis (HS). Forty-nine patients from 46 unrelated families were included in this study. Of these patients, 19 cases from 16 unrelated families had HS of autosomal-dominant inheritance, and 30 patients had non-autosomal-dominant HS. Fifteen mutations of the ANK-1 gene pathognomonic for HS were identified: 4 nonsense mutations, 7 frameshift mutations, and 4 abnormal splicing mutations. These 15 mutations have not been previously reported. The frameshift mutations were found from exon 1 to exon 26, corresponding particularly to the band 3-binding domain of ankyrin. The nonsense mutations, on the contrary, were present mostly at the 3'-terminal side, especially in the spectrin-binding domain and the regulatory domain. The patients with ankyrin gene mutations tended to be more anemic with a higher level of reticulocytosis than those without these mutations. Fifteen silent mutations of the ANK-1 gene, most of which have previously been detected in HS patients in Western populations, were also found. The allele frequency of these silent mutations in the HS patients was nearly identical to that in normal subjects. There was no difference between the Japanese and Western populations in the allele frequency of these gene polymorphisms in healthy subjects or HS patients. PMID:11372755

Nakanishi, H; Kanzaki, A; Yawata, A; Yamada, O; Yawata, Y

2001-01-01

71

CUTANEOUS DISORDERS IN 500 DIABETIC PATIENTS ATTENDING DIABETIC CLINIC  

PubMed Central

Background: The metabolic complications and pathologic changes that occur in diabetes mellitus (DM) influence the occurrence of various dermatoses. Aim: To study the impact of control of diabetes on the pattern of cutaneous disorders. Materials and Methods: A cross-sectional descriptive study of patients attending diabetic clinic in a tertiary care hospital. A total of 500 consecutive patients were studied. Detailed history, clinical examination and relevant investigations were done to diagnose diabetic complications and cutaneous disorders. Dermatoses with or without known pathogenesis were correlated with age, gender, fasting plasma glucose (FPG), duration of diabetes, and complications of DM. Statistical analysis was carried out using Student “t” test and Chi-square test with 5% confidence interval (P value 0.05). Results: Majority of patients had well-controlled (FPG<130 mg/ml, 60%) type 2 DM (98.8%). No statistically significant difference (P>0.05) between the patients with or without DM specific cutaneous disorders was noticed with reference to age and gender distribution, duration of DM and FPG. Signs of insulin resistance, acrochordon (26.2%), and acanthosis nigricans (5%) were common, followed by fungal (13.8%) and bacterial (6.8%) infections. Eruptive xanthoma (0.6%), diabetic foot (0.2%), diabetic bulla (0.4%), diabetic dermopathy (0.2%), generalized granuloma annulare (0.2%), and insulin reactions (6.2%) and lipodystrophy (14%) were also seen. Conclusion: Well-controlled diabetes decreases the prevalence of DM-specific cutaneous disorders associated with chronic hyperglycemia. It is necessary to have a dermatologist in the diabetic clinic for early detection of potentially grave or predisposing conditions.

Ragunatha, Shivanna; Anitha, Bhaktavatsalam; Inamadar, Arun C; Palit, Aparna; Devarmani, Shashidhar S

2011-01-01

72

Effects of aspartame on diabetic rats and diabetic patients.  

PubMed

The effects of aspartame (L-aspartyl-L-phenylalanine methyl ester) on plasma glucose and insulin levels were investigated in diabetic rats and patients with non-insulin-dependent diabetes mellitus. The oral administration of 0.45 mg aspartame per 100g body weight, which is equivalent to 150 mg of glucose in sweetness, to streptozotocin-induced diabetic rats had no effect on the plasma glucose or insulin levels. Also, 225 mg oral aspartame loading, which is equivalent to 75 g of glucose in sweetness, to patients with non-insulin-dependent diabetes mellitus did not increase plasma glucose or insulin levels, although 75 g of oral glucose loading increased plasma glucose and insulin levels in diabetic patients as expected. Aspartame ingestion for three days at a dose of 24-48 mg per day and the intake of snacks flavored with 240 mg of aspartame also did not increase fasting plasma glucose levels. These results suggest that acute administration of aspartame has no influence on plasma glucose or insulin levels in diabetic rats and patients with non-insulin-dependent diabetes mellitus. PMID:3908628

Shigeta, H; Yoshida, T; Nakai, M; Mori, H; Kano, Y; Nishioka, H; Kajiyama, S; Kitagawa, Y; Kanatsuna, T; Kondo, M

1985-10-01

73

Genetic and Infectious Profiles of Japanese Multiple Sclerosis Patients  

PubMed Central

Background Nationwide surveys conducted in Japan over the past thirty years have revealed a four-fold increase in the estimated number of multiple sclerosis (MS) patients, a decrease in the age at onset, and successive increases in patients with conventional MS, which shows an involvement of multiple sites in the central nervous system, including the cerebrum and cerebellum. We aimed to clarify whether genetic and infectious backgrounds correlate to distinct disease phenotypes of MS in Japanese patients. Methodology/Principal Findings We analyzed HLA-DRB1 and -DPB1 alleles, and IgG antibodies specific for Helicobacter pylori, Chlamydia pneumoniae, varicella zoster virus, and Epstein-Barr virus nuclear antigen (EBNA) in 145 MS patients and 367 healthy controls (HCs). Frequencies of DRB1*0405 and DPB1*0301 were significantly higher, and DRB1*0901 and DPB1*0401 significantly lower, in MS patients as compared with HCs. MS patients with DRB1*0405 had a significantly earlier age of onset and lower Progression Index than patients without this allele. The proportion and absolute number of patients with DRB1*0405 successively increased with advancing year of birth. In MS patients without DRB1*0405, the frequency of the DRB1*1501 allele was significantly higher, while the DRB1*0901 allele was significantly lower, compared with HCs. Furthermore, DRB1*0405-negative MS patients were significantly more likely to be positive for EBNA antibodies compared with HCs. Conclusions Our study suggests that MS patients harboring DRB1*0405, a genetic risk factor for MS in the Japanese population, have a younger age at onset and a relatively benign disease course, while DRB1*0405-negative MS patients have features similar to Western-type MS in terms of association with Epstein-Barr virus infection and DRB1*1501. The recent increase of MS in young Japanese people may be caused, in part, by an increase in DRB1*0405-positive MS patients.

Yonekawa, Tomomi; Matsushita, Takuya; Masaki, Katsuhisa; Sato, Shinya; Kawano, Yuji; Yamamoto, Ken; Kira, Jun-ichi

2012-01-01

74

Glucose Monitoring of the Diabetic Patient  

Microsoft Academic Search

The use of home glucose monitoring products is increasing. The pharmacist can make an important contribution to the diabetic patient's care by becoming knowledgeable about the many monitoring products available and by providing a structured diabetes management program for his or her patients. This article will discuss the many products available for home blood glucose monitoring and the pharmacist's role

Janet P. Engle

1973-01-01

75

Testosterone Concentration in Young Patients With Diabetes  

PubMed Central

OBJECTIVE—We have previously shown that hypogonadotrophic hypogonadism is common in middle-aged patients with type 2, but not with type 1, diabetes. We have now investigated the total and free testosterone concentrations in young (aged 18–35 years) type 1 and type 2 diabetic patients. RESEARCH DESIGN AND METHODS—In this study carried out in a tertiary referral center, serum concentrations of total and free testosterone were measured in 38 type 1 diabetic (mean age 26.45 ± 0.89 years) and 24 type 2 diabetic (mean age 27.87 ± 0.97 years) subjects. The mean BMI of type 1 and type 2 diabetic patients was 27.41 ± 1.18 and 38.55 ± 2.04 kg/m2, respectively (P < 0.001). RESULTS—The mean total testosterone concentration of type 1 and type 2 diabetic patients was 22.89 ± 1.23 and 11.14 ± 0.99 nmol/l, respectively (P < 0.001). The mean free testosterone concentration of type 1 and type 2 diabetic patients was 0.489 ± 0.030 and 0.296 ± 0.022 nmol/l, respectively (P < 0.001). Eight of 24 (33%) type 2 diabetic patients had subnormal free testosterone concentrations (<0.225 nmol/l). Using an age-based reference range, 14 of 24 (58%) type 2 diabetic patients had low free testosterone concentrations (<0.278 nmol/l). Three of 38 (8%) type 1 diabetic patients had free testosterone concentrations below the lower limit of normal (P = 0.02 when compared with type 2 diabetes). Luteinizing hormone (LH) and follicle-stimulating hormone (FSH) concentrations in type 2 diabetic patients with low free testosterone concentrations were in the normal range and were similar to those in type 1 diabetic patients. CONCLUSIONS—Young type 2 diabetic patients have significantly lower plasma concentrations of total and free testosterone and inappropriately low LH and FSH concentrations with a very high prevalence of hypogonadotrophic hypogonadism, when compared with type 1 diabetic patients of a comparable age. The potential implications for their sexual and reproductive function during prime reproductive years are profound.

Chandel, Anil; Dhindsa, Sandeep; Topiwala, Shehzad; Chaudhuri, Ajay; Dandona, Paresh

2008-01-01

76

Second opinion behaviour among Japanese primary care patients.  

PubMed Central

BACKGROUND: Second opinion behaviour is often observed among Japanese primary care patients. These patients secretly visit university-affiliated hospitals without informing their doctors. Research to elucidate the psychosocial determinants of this behaviour in the Japanese primary care setting is needed. AIM: To describe the sociodemographic characteristics of second opinion patients (SOPs), and to determine the factors related to this behaviour. METHOD: Patients from the general medicine clinic answered our original questionnaire and a 30-item General Health Questionnaire (GHQ-30). A random sample of patients was questioned using the Diagnostic Interview Schedule. SOPs were defined as those patients who had visited another medical facility with the same complaint, and 'doctor-shopping' patients (DSPs) were defined as those patients who had visited two or more medical facilities with the same complaint. RESULTS: There were 420 SOPs among 1033 patients (41.0%). The multivariate analysis showed that residence and GHQ-30 were the significant differences between the SOPs and the first-visit patients (FVP) (P < 0.0005 for both factors). Also, the SOPs were anxious and sought advice from anybody, unlike the FVPs. Compared with the DSPs, they had a short duration of illness and they did not feel a worsening of their symptoms (P = 0.0001 for duration of illness; P = 0.006 for condition of illness). CONCLUSION: Our results showed that the SOPs who lived far from the medical school hospital felt anxiety and went to a university-affiliated hospital on the advice of anybody. Determining the reasons for this behaviour will require empirical studies regarding the nature of the patient's anxiety for illness.

Sato, T; Takeichi, M; Hara, T; Koizumi, S

1999-01-01

77

Hypothyroidism Complicating Nephropathy in a Diabetes Patient  

PubMed Central

We describe a patient with type 2 diabetes mellitus and autoimmune hypothyroidism who presented with elevated serum creatinine possibly due to subclinical rhabdomyolysis induced by hypolipidemic drug therapy in the background of diabetic nephropathy. Both hypothyroidism and rhabdomyolysis were asymptomatic in this case as evidenced by lack of classical clinical features of hypothyroidism despite elevated serum TSH and absent pigment cast in renal biopsy. The combination of diabetes mellitus and hypothyroidism is common in the general population and should not be forgotten in patients with diabetes and kidney disease.

Veerappan, Ilangovan; Abraham, Anila; Hariharan, Somasundaram

2012-01-01

78

Hypothyroidism complicating nephropathy in a diabetes patient.  

PubMed

We describe a patient with type 2 diabetes mellitus and autoimmune hypothyroidism who presented with elevated serum creatinine possibly due to subclinical rhabdomyolysis induced by hypolipidemic drug therapy in the background of diabetic nephropathy. Both hypothyroidism and rhabdomyolysis were asymptomatic in this case as evidenced by lack of classical clinical features of hypothyroidism despite elevated serum TSH and absent pigment cast in renal biopsy. The combination of diabetes mellitus and hypothyroidism is common in the general population and should not be forgotten in patients with diabetes and kidney disease. PMID:23304572

Sahoo, Jayaprakash; Veerappan, Ilangovan; Abraham, Anila; Hariharan, Somasundaram

2012-12-10

79

Difference in clinical features between Japanese and German patients with refractory anemia in myelodysplastic syndromes.  

PubMed

Several reports indicate that there might be differences in clinical features between Asian and Western myelodysplastic syndrome (MDS) cases. We analyzed refractory anemia (RA) in French-American-British (FAB) classification cases diagnosed in Japan and Germany to perform a more exact comparison between Asian and Western MDS types. In the first step, we analyzed agreement of morphologic diagnosis between Japanese and German hematologists. Blood and bone marrow slides of 129 patients diagnosed with FAB-RA, FAB-RA with ringed sideroblasts (RARS), or aplastic anemia were selected randomly and evaluated separately by each group. The agreements of diagnoses according to FAB and World Health Organization (WHO) classifications were 98.4% and 83.8%, respectively. Second, we compared clinical features between 131 Japanese and 597 German patients with FAB-RA. Japanese patients were significantly younger than German patients. Japanese patients had more severe cytopenias. However, prognosis of Japanese patients was significantly more favorable than that of German patients. Japanese patients had a significantly lower cumulative risk of acute leukemia evolution than did German patients. Frequency of WHO-RA in Japanese patients with FAB-RA was significantly higher than that in German patients. In conclusion, our results indicate that the clinical features of Japanese patients with FAB-RA differ from those of German patients. PMID:15972453

Matsuda, Akira; Germing, Ulrich; Jinnai, Itsuro; Misumi, Motohiro; Kuendgen, Andrea; Knipp, Sabine; Aivado, Manuel; Iwanaga, Masako; Miyazaki, Yasushi; Tsushima, Hideki; Sakai, Mari; Bessho, Masami; Tomonaga, Masao

2005-06-21

80

Suicidality in Terminally Ill Japanese Patients with Cancer Prevalence, Patient Perceptions, Contributing Factors, and Longitudinal Changes  

Microsoft Academic Search

BACKGROUND. The risk of suicide is higher in patients with cancer than in the general population, making end-of-life care of suicidal terminal patients with cancer critical. To identify factors and longitudinal changes associated with sui- cidality among terminally ill Japanese patients with cancer, a prospective cohort study was performed. METHODS. Consecutive outpatients with cancer who registered with a palliative care

Tatsuo Akechi; Toru Okuyama; Yuriko Sugawara; Tomohito Nakano; Yasuo Shima; Yosuke Uchitomi

81

Special patient populations: Onychomycosis in the diabetic patient  

Microsoft Academic Search

There are approximately 14 million persons with diabetes in the United States. These patients must cope with the serious complications of this disease, including neuropathy and impaired circulation (leading to the “diabetic foot” and possible amputation), renal disease, cardiovascular disease, and retinopathy (possibly leading to blindness). Although onychomycosis is no more common in diabetics than in the general population, it

Phoebe Rich

1996-01-01

82

Historical chronology of basic and clinical research in diabetic nephropathy and contributions of Japanese scientists  

Microsoft Academic Search

The most problematic issue in clinical nephrology worldwide is the relentless and progressive increase in patients with end-stage\\u000a renal disease (ESRD). Diabetic nephropathy has considerable impact on society in the areas of public health and social economy;\\u000a many scientists are involved in research for the elucidation of the pathogenesis of diabetic nephropathy and for the prevention\\u000a and cure of the

Jun Wada; Hirofumi Makino

2009-01-01

83

A single-nucleotide polymorphism in ANK1 is associated with susceptibility to type 2 diabetes in Japanese populations.  

PubMed

To identify a novel susceptibility locus for type 2 diabetes, we performed an imputation-based, genome-wide association study (GWAS) in a Japanese population using newly obtained imputed-genotype data for 2 229 890 single-nucleotide polymorphisms (SNPs) estimated from previously reported, directly genotyped GWAS data in the same samples (stage 1: 4470 type 2 diabetes versus 3071 controls). We directly genotyped 43 new SNPs with P-values of <10(-4) in a part of stage-1 samples (2692 type 2 diabetes versus 3071 controls), and the associations of validated SNPs were evaluated in another 11 139 Japanese individuals (stage 2: 7605 type 2 diabetes versus 3534 controls). Combined meta-analysis using directly genotyped data for stages 1 and 2 revealed that rs515071 in ANK1 and rs7656416 near MGC21675 were associated with type 2 diabetes in the Japanese population at the genome-wide significant level (P < 5 × 10(-8)). The association of rs515071 was also observed in European GWAS data (combined P for all populations = 6.14 × 10(-10)). Rs7656416 was in linkage disequilibrium to rs6815464, which had recently been identified as a top signal in a meta-analysis of East Asian GWAS for type 2 diabetes (r(2) = 0.76 in stage 2). The association of rs7656416 with type 2 diabetes disappeared after conditioning on rs6815464. These results indicate that the ANK1 locus is a new, common susceptibility locus for type 2 diabetes across different ethnic groups. The signal of association was weaker in the directly genotyped data, so the improvement in signal indicates the importance of imputation in this particular case. PMID:22456796

Imamura, Minako; Maeda, Shiro; Yamauchi, Toshimasa; Hara, Kazuo; Yasuda, Kazuki; Morizono, Takashi; Takahashi, Atsushi; Horikoshi, Momoko; Nakamura, Masahiro; Fujita, Hayato; Tsunoda, Tatsuhiko; Kubo, Michiaki; Watada, Hirotaka; Maegawa, Hiroshi; Okada-Iwabu, Miki; Iwabu, Masato; Shojima, Nobuhiro; Ohshige, Toshihiko; Omori, Shintaro; Iwata, Minoru; Hirose, Hiroshi; Kaku, Kohei; Ito, Chikako; Tanaka, Yasushi; Tobe, Kazuyuki; Kashiwagi, Atsunori; Kawamori, Ryuzo; Kasuga, Masato; Kamatani, Naoyuki; Nakamura, Yusuke; Kadowaki, Takashi

2012-03-28

84

Mucormycosis in a diabetic ketoacidosis patient.  

PubMed

Oral cavity is considered to be a kaleidoscope for body's general health. Many systemic conditions do present with diverse oral manifestations. Mucormycosis involving the oral cavity is one such entity that presents as necrosis of bone in immunocompromised patients. Mucormycosis is an opportunistic fungal infection that mainly affects the patients with uncontrolled diabetes mellitus. Hereby, we report a case of mucormycosis involving the palate in a patient with diabetic ketoacidosis. PMID:24075351

Vijayabala, G Sree; Annigeri, Rajeshwari G; Sudarshan, Ramachandran

2013-09-04

85

Mucormycosis in a diabetic ketoacidosis patient  

PubMed Central

Oral cavity is considered to be a kaleidoscope for body's general health. Many systemic conditions do present with diverse oral manifestations. Mucormycosis involving the oral cavity is one such entity that presents as necrosis of bone in immunocompromised patients. Mucormycosis is an opportunistic fungal infection that mainly affects the patients with uncontrolled diabetes mellitus. Hereby, we report a case of mucormycosis involving the palate in a patient with diabetic ketoacidosis.

Vijayabala, G. Sree; Annigeri, Rajeshwari G; Sudarshan, Ramachandran

2013-01-01

86

Liver disease in patients with diabetes mellitus  

Microsoft Academic Search

Liver function tests were assessed in 60 unselected out-patient diabetics stabilized on insulin or oral hypoglycaemic agents. Routine liver function tests, particularly plasma concentrations of gamma-glutamyl transpeptidase and alkaline phosphatase were elevated occasionally but rarely to more than twice the upper limit of normal. There was no correlation between measures of diabetic control and results of liver function tests. Twelve

K. J. Foster; A. H. Griffith; K. Dewbury; C. P. Price; R. Wright

1980-01-01

87

Evidence-based patient information in diabetes.  

PubMed

Patient education in diabetes has been successful in training and motivating patients to assume a more active and independent role in monitoring and treating their disease resulting in an improvement of patient-orientated outcomes. Traditionally, diabetes education has mainly aimed at increasing patient compliance to physician-defined therapeutic goals and treatment strategies. To strengthen their rights and autonomy, patients need to become more involved in medical decision making with respect to their individual therapeutic goals, such as HbA1c and blood pressure, body weight, etc., as well as choosing whether they pursue these goals. The importance of patient participatation is particularly relevant to Type 2 diabetes. Even perfect, long-term therapeutic co-operation will not eliminate diabetic complications, only reduce the risk of developing them. The benefits, lack of benefits and unwanted effects of various interventions need to be communicated to the patient in an unbiased manner, so that he/she can make an informed choice with regard to different therapeutic goals and strategies. In diabetes, ways of presenting patients with unbiased information to enable them to make such informed decisions are not yet available. We present ways of how this might be achieved using data provided by the UKPDS. The concept of patient participation in medical decision making represents a fundamental challenge for the future development of diabetes care. PMID:11168323

Mühlhauser, I; Berger, M

2000-12-01

88

[Management of type 2 diabetes: patient education].  

PubMed

Patient education emerged initially as an essential component of the management of type 1 diabetes. Patient education has also been for long an integral part of the recommendations for managing type 2 diabetes. Studies about patient education and type 2 diabetes have demonstrated the effectiveness of patient education by studying the evolution of bioclinic markers including HbA1c. However, if we return to the foundations of patient education definition, we cannot summarize the effectiveness of patient education on the only decrease of HbA1c. So, if the aim of patient education is to support patients to take better care of themselves, it might be interesting to use other types of evaluation methodology, including qualitative studies, to reflect the different dimensions of patient education, especially psychosocial. PMID:23523080

Meillet, Lucie; Combes, Jérôme; Penfornis, Alfred

2013-03-21

89

Prevalence and clinical characterization of Japanese diabetes mellitus with an A-to-G mutation at nucleotide 3243 of the mitochondrial tRNA{sup Leu (UUR)} gene  

SciTech Connect

An A-to-G mutation at nucleotide position 3243 of the mitochondrial genome has been associated with insulin-dependent diabetes mellitus (IDDM) and with noninsulin-dependent diabetes mellitus (NIDDM) with deafness. We investigated the prevalence of this mutation in Japanese patients with IDDM, NIDDM, and impaired glucose tolerance (IGT) and in nondiabetic control individuals, and we identified it in 3 of 300 patients with NIDDM or IGT (1.0%). None of these individuals had significant sensorineural hearing loss. None of the 94 IDDM or the 115 nondiabetic control subjects was positive for this mutation. Oral glucose tolerance test revealed that a 57-yr-old male with this mutation was rather hyperinsulinemic in the fasting state. The insulin secretion in this patient decreased with age; he did not complain of any hearing disorder, although audiometry revealed a slight elevation of hearing threshold at high frequencies. In conclusion, we found that a mitochondrial gene mutation at nucleotide position 3243 was present in about 1% of NIDDM patients including those patients with IGT. The subtype of diabetes mellitus with this mutation may have a clinical profile similar to that found in patients with NIDDM commonly seen in outpatient clinics. 25 refs., 2 figs., 1 tab.

Odawara, Masato; Sasaki, Kayoko; Yamashita, Kamejiro [Univ. of Tsukuba (Japan)

1995-04-01

90

The patient with diabetes: preventing cardiovascular complications.  

PubMed

In the United States, 18 million adults have diabetes and an additional 16 million have impaired glucose tolerance. Of these patients, 75% will die of some form of heart or vascular disease. Furthermore, recent data suggest that even prediabetic patients are at increased risk for cardiovascular (CV) events. Patients with diabetes often have multiple comorbid CV risk factors (e.g., dyslipidemia, hypertension, hyperglycemia) that synergistically interact to accelerate the pathogenesis of CV disease and dramatically increase the risk for CV events. For example, compared with patients without diabetes, patients with diabetes have a 3- to 5-fold increased risk of death due to congestive heart disease at every cholesterol level and are at increased risk for hypertension and hypertension-related CV events. Patients with diabetes are likely to benefit from intensive therapy incorporating multiple CV risk-reduction strategies. Lipid-modification--primarily reducing levels of low-density lipoprotein cholesterol (LDL-C) and triglycerides and increasing high-density lipoprotein cholesterol (HDL-C) through pharmacologic and lifestyle intervention--is an integral part of such therapy. Patients with diabetes will also benefit from intensive blood pressure-lowering therapy with multiple classes of antihypertensives including angiotensin-converting enzyme inhibitors and angiotensin receptor blockers in particular, as well as concomitant antiplatelet therapy. An intensive risk-reduction approach combining these treatments would dramatically reduce the incidence of CV morbidity and mortality in this high-risk patient population. PMID:17436822

Heinig, Robert E

2006-10-01

91

Congenital abnormalities in Japanese patients with Menkes disease.  

PubMed

Menkes disease (MNK) is an X-linked recessive disorder. Incidence of live-born infants with MNK is 2.8 per million live births in Japan. The aim of this study was to observe congenital malformations (CMs) in MNK patients. Subjects comprised 35 Japanese male patients with classical MNK who received copper histidine treatment. Patient clinical data were obtained anonymously from medical records or medical record summaries by pediatrician's retrospective review through a survey. We observed 21 different CMs in 14 patients. Eight of these had a single CM, while six had multiple CMs. The most frequent CM was higher arched palate with other CMs found in five patients. There was no relationship between CMs and mutations in the ATP7A gene. Using Mann-Whitney U tests, age at death was also significantly lower in MNK patients with CMs (P<0.05), compared to those without CMs, even though there was no significant difference of age onset, age at diagnosis and age at start of treatment with copper histidine between both groups of patients. Sudden death occurred in three MNK patients with CMs only: two with congenital heart disease, and one with microphallus. PMID:22361452

Gu, Yan-Hong; Kodama, Hiroko; Kato, Tadaaki

2012-02-22

92

Genetic Risk Score Constructed Using 14 Susceptibility Alleles for Type 2 Diabetes Is Associated With the Early Onset of Diabetes and May Predict the Future Requirement of Insulin Injections Among Japanese Individuals  

PubMed Central

OBJECTIVE We evaluated the clinical usefulness of a genetic risk score (GRS) based on 14 well-established variants for type 2 diabetes. RESEARCH DESIGN AND METHODS We analyzed 14 SNPs at HHEX, CDKAL1, CDKN2B, SLC30A8, KCNJ11, IGF2BP2, PPARG, TCF7L2, FTO, KCNQ1, IRS-1, GCKR, UBE2E2, and C2CD4A/B in 1,487 Japanese individuals (724 patients with type 2 diabetes and 763 control subjects). A GRS was calculated according to the number of risk alleles by counting all 14 SNPs (T-GRS) as well as 11 SNPs related to ?-cell function (?-GRS) and then assessing the association between each GRS and the clinical features. RESULTS Among the 14 SNPs, 4 SNPs were significantly associated with type 2 diabetes in the present Japanese sample (P < 0.0036). The T-GRS was significantly associated with type 2 diabetes (P = 5.9 × 10?21). Among the subjects with type 2 diabetes, the ?-GRS was associated with individuals receiving insulin therapy (? = 0.0131, SE = 0.006, P = 0.0431), age at diagnosis (? = ?0.608, SE = 0.204, P = 0.0029), fasting serum C-peptide level (? = ?0.032, SE = 0.0140, P = 0.022), and C-peptide index (? = ?0.031, SE = 0.012, P = 0.0125). CONCLUSIONS Our data suggest that the ?-GRS is associated with reduced ?-cell functions and may be useful for selecting patients who should receive more aggressive ?-cell–preserving therapy.

Iwata, Minoru; Maeda, Shiro; Kamura, Yutaka; Takano, Atsuko; Kato, Hiromi; Murakami, Shihou; Higuchi, Kiyohiro; Takahashi, Atsushi; Fujita, Hayato; Hara, Kazuo; Kadowaki, Takashi; Tobe, Kazuyuki

2012-01-01

93

Overtime, psychosocial working conditions, and occurrence of non- insulin dependent diabetes mellitus in Japanese men  

PubMed Central

OBJECTIVES: To ascertain the effects of overtime and psychosocial job conditions on the occurrence of non-insulin dependent diabetes mellitus (NIDDM) in Japan. DESIGN: An eight year prospective cohort study. SETTING: An electrical company in Japan. PARTICIPANTS: In 1984, a mailed questionnaire was sent to industrial workers of an electrical company in Japan. After excluding those who had a history of diabetes mellitus or other chronic diseases, 2597 male respondents were prospectively followed up for the succeeding eight years. Data from 2194 (84%) who were completely followed up were analysed. The occurrence of NIDDM during the follow up period was assessed according to the WHO criteria on the basis of an annual screening programme. MAIN RESULTS: The age adjusted incidence of NIDDM was significantly higher in those who worked overtime more than 50 hours per month than in those who worked 25 hours or less per month (p < 0.05). It was significantly higher in those who worked with new technology at baseline than in those who did not (p < 0.05). Cox's proportional hazard model indicated that those who worked overtime more than 50 hours per month had 3.7 times higher risk of NIDDM after controlling for known risk factors (p < 0.01) and those who worked with new technology had 2.4 times higher risk of NIDDM (p < 0.05). CONCLUSIONS: It is suggested that longer overtime and use of new technology are risk factors of NIDDM in Japanese men.  

Kawakami, N.; Araki, S.; Takatsuka, N.; Shimizu, H.; Ishibashi, H.

1999-01-01

94

JAMA Patient Page: Weight and Diabetes  

MedlinePLUS

... may require insulin shots. The June 18, 2008, issue of JAMA includes an article about an association between type 2 diabetes and depression. This Patient Page is based on one previously published in the March 15, 2006, ...

95

Vitreoretinal surgery in diabetic patients on hemodialysis.  

PubMed

The present paper reports our first results after pars plana vitrectomy in patients with diabetic retinopathy and hemodialysis with a follow-up of 6 to 24 months. Between January 1992 and October 1994 we performed vitreoretinal surgery with silicone oil tamponade in nine eyes of seven patients with diabetic nephropathy on hemodialysis. All patients had had type I diabetes for 19-32 years. Over the observation period the retina was completely attached in eight eyes. Final visual acuity of 0.1-0.7 was attained in four eyes, 0.06 two, hand movements in one eye. Two eyes had no useful final visual acuity because of redetachment of the retina or secondary glaucoma with rubeosis iridis. The small number of complications shows that pars plana vitrectomy can be done in diabetic patients with nephropathy on hemodialysis. This significantly improves their quality of life. PMID:9352284

Nawrocki, J; Chrzanowski, W; Koch, D; Dziegielewski, K

96

Improvement in the Prognosis of Japanese Breast Cancer Patients from 1946 to 2001—an Institutional Review  

Microsoft Academic Search

Background: Breast cancer has emerged as one of the most frequent malignancies among Japanese women; however, the long-term survival of Japanese breast cancer patients is uncertain. Methods:Weanalyzedthechronologicalchangesintheclinicalandpathologicalcharacteristics, treatment procedures and the long-term prognosis of 15 416 Japanese women with 16 217 primary breast cancers treated in the Cancer Institute Hospital in Tokyo between 1946 and 2001. Results: Our analysis revealed

Masataka Yoshimoto; Keiichiro Tada; Haruko Hori; Akira Morota; Masahiko Tanabe; Seiichiro Nishimura; Kaoru Takahashi; Masujiro Makita; Takuji Iwase; Fujio Kasumi; Syunji Takahashi; Yoshinori Ito; Masahiro Oguchi; Takashi Yamashita; Futoshi Akiyama; Goi Sakamoto

97

Home care of the elderly diabetic patient.  

PubMed

As the anticipated growth of sophisticated diabetic services continues to accelerated in homes across America, physicians must first be educated as to the potentially unlimited spectrum of diabetic home care products and services that will become increasingly available to the patients whom they serve. Second, much research must be completed to critically examine the safety, quality, and cost issues of diabetic home care, to provide the necessary data to assure that home care services will be neither under- or over-utilized and will meet the necessary acute and long-term health care needs of our diabetic patients. Third, physicians must take a leadership role in examining the pitfalls of our existing expensive and often fragmented acute care-oriented health care model, which has not effectively addressed the increasing costs and incidence of chronic diseases, such as diabetes, in our society. With computerization and the explosive mobilization of high-technology health care products and services, we are witnessing an exponential growth in the list of services available in the home setting for diabetic patients. There has never been a time in the history of medicine that we, as physicians, have needed to create new, innovative, high-quality approaches to necessary, accessible, and cost-effective alternative health care delivery systems as is the case now. I believe that the renewal of home care, with physician vision, direction, and review, will be a major step toward the highest-quality medical care provided to our diabetic patients at home. PMID:2224757

Bernstein, L H; Hankwitz, P E; Portnow, J

1990-11-01

98

Bone mineral density in Japanese prostate cancer patients under androgen-deprivation therapy  

Microsoft Academic Search

Androgen-deprivationtherapy(ADT) of patients with prostate cancer (PCa) is known toreducebone mineral density (BMD). However, the most studies examined Caucasian or black patients and the effectsofADTonthebonemetabolismofEastAsiansareunclear.Therefore,weperformedacross- sectional study to elucidate the influence of ADT on bone metabolism in Japanese patients. In total, 101 native Japanese patients with PCa were enrolled. They consisted of 58 ADT-treated and 43 hormone-naive patients. The BMD

Wei Wang; Takeshi Yuasa; Norihiko Tsuchiya; Shinya Maita; Teruaki Kumazawa; Takamitsu Inoue; Mitsuru Saito; Zhiyong M; Takashi Obara; Hiroshi Tsuruta; Shigeru Satoh; Tomonori Habuchi

99

Optic disc topographic analysis in diabetic patients.  

PubMed

The aim of our study was to evaluate the optic disc (OD) topographic parameters by using Heidelberg Retina Tomograph II (HRT II) in patients with type 2 diabetes mellitus (DM). The study group consisted of 78 patients with type 2 DM (patient group) and age-sex matched 50 healthy subjects (control group). All patients and controls underwent a detailed ophthalmological examination, automated perimetry, central corneal thickness (CCT) measurement and OD topography by using HRT II. Glycosylated haemoglobin (HbA1c) levels of the diabetic patients were also noted. Age, gender, intraocular pressure and CCT measurements were similar in patients with diabetes and control group. Mean retinal nerve fiber layer thickness (MRNFLT) and retinal nerve fiber layer cross-sectional area (RNFLcsA) parameters were found significantly lower in diabetic patients compared to those of the controls (p = 0.030, p = 0.038). In the patient group, MRNFLT value was found significantly lower in patients with DM duration ?120 months (p = 0.020) and HbA1c level ?7 % (p = 0.029). Rim volume, MRNFLT and RNFLcsA values were significantly lower in proliferative diabetic retinopathy group (p = 0.004, p = 0.003, p = 0.001 respectively) and laser treated patients (p = 0.003, p = 0.002, p = 0.004 respectively). In conclusion, poor metabolic control of diabetes, severe DR and received laser therapies cause RNFL damage. Heidelberg Retina Tomograph may help us to detect and follow-up the changes in optic disc and RNFL in diabetic patients. PMID:22825888

Toprak, Ibrahim; Yildirim, Cem; Yaylali, Volkan

2012-07-24

100

Blood pressure and lipid control status in Japanese hypertensive patients.  

PubMed

Strict blood pressure (BP) as well as lipid control is important to prevent cardiovascular events. The purpose of this study was to evaluate BP and lipid control status in hypertensive patients. Subjects were a total of 717 hypertensive patients who had been followed at National Kyushu Medical Center in FuKuoka, Japan. Goal BP was defined as < 130/85 mmHg (< 65 years) or < 140/90 mmHg (> or = 65 years). According to the Japanese guidelines, goal LDL cholesterol (LDL-C) levels were defined based on the patient category. Average BP level and the number of anti-hypertensive drugs were 133 + or - 12/74 + or - 9 mmHg and 2.1 + or - 1.1, respectively, and the LDL-C level was 119 + or - 27 mg/dl. Goal BP was achieved in 40% of the patients of < 65 years and 67% of the elderly patients. Goal LDL-C was achieved in 65% of the patients. Even in the patients taking lipid-lowering agents (n = 178), 30% failed to achieve goal LDL-C levels. In the patients who achieved BP < 130/85 mmHg, 67% also achieved goal LDL-C, whereas 61% of the patients whose BP > or = 140/90 mmHg achieved goal LDL-C. Both goal BP and LDL-C were achieved in 39% of the male and 36% of the female patients. In contrast, neither goal BP nor goal LDL-C was achieved in 16% of the male and 17% of the female patients. Results suggest that intensive intervention should be required to achieve satisfactory BP and lipid control in hypertensive patients. PMID:19811358

Ohta, Yuko; Tsuchihashi, Takuya; Morinaga, Yuki; Onaka, Uran; Ueno, Michio

2009-06-01

101

Effect of the 2004 Mid Niigata Prefecture earthquake on glycemic control in type 1 diabetic patients  

Microsoft Academic Search

At 5:56 p.m. on October 23, 2004, a major earthquake of magnitude 6.8 on the Richter scale struck the Chuetsu district of Niigata Prefecture, Japan, a rural area with mountain villages. Strong aftershocks of grade 5-6 on the Japanese Intensity Scale continued for 2 months. We investigated changes in the HbA1c levels of 65 type 1 diabetic patients with insulin

Kyuzi Kamoi; Midori Tanaka; Tomoo Ikarashi; Masashi Miyakoshi

2006-01-01

102

NEMO gene rearrangement (exon 4-10 deletion) and genotype-phenotype relationship in Japanese patients with incontinentia pigmenti and review of published work in Japanese patients.  

PubMed

Incontinentia pigmenti (IP) is a rare X-linked dominant genodermatosis caused by mutations of the NEMO gene, which is required for activation of the nuclear factor-?B signaling pathway. NEMO gene rearrangement, exon 4-10 deletion, is the most common mutation with a frequency of 60-80%. Only four case reports about NEMO rearrangement in Japanese IP cases have been published. In our study, NEMO gene rearrangement was examined in 10 Japanese IP patients and their mothers and was revealed in five of 10 patients and three of their mothers. Interestingly, NEMO gene rearrangement was confirmed in the mothers of two patients without clinical symptoms; thus, NEMO mutation analysis is helpful to detect subclinical IP patients. The clinical symptoms of recently diagnosed Japanese IP patients were summarized for examination of the phenotype-genotype relationship and for comparison between those with and without NEMO gene rearrangement. Results revealed no definite difference in extracutaneous manifestations between the patients with NEMO rearrangement in our study and in other Japanese IP patients previously reported in both Japanese and English-language published work. However, there is higher frequency of ocular manifestation in our study than in other reports. Furthermore, evaluation of dental and nail abnormalities was difficult because most of our patients were observed for 1 year only. Long-term observation is needed for proper evaluation of the clinical status and phenotype-genotype relationship in IP patients. PMID:23398170

Okita, Mayuko; Nakanishi, Gen; Fujimoto, Noriki; Shiomi, Mariko; Yamada, Taku; Wataya-Kaneda, Mari; Takijiri, Chincho; Yokoyama, Yoko; Sunohara, Akiyo; Tanaka, Toshihiro

2013-02-11

103

Calcium, vitamin D and dairy intake in relation to type 2 diabetes risk in a Japanese cohort  

Microsoft Academic Search

Aims\\/hypothesis  Calcium and vitamin D have been implicated in the development of type 2 diabetes, but epidemiological evidence is limited.\\u000a We examined prospectively the relation of calcium and vitamin D intake to type 2 diabetes risk in a Japanese cohort.\\u000a \\u000a \\u000a \\u000a \\u000a Methods  Participants were 59,796 middle-aged and older men and women, who participated in the Japan Public Health Center-based Prospective\\u000a Study and had

K. Kirii; T. Mizoue; H. Iso; Y. Takahashi; M. Kato; M. Inoue; M. Noda; S. Tsugane

2009-01-01

104

Association of genetic variants with chronic kidney disease in Japanese individuals with or without hypertension or diabetes mellitus  

PubMed Central

Hypertension and diabetes mellitus are important risk factors for chronic kidney disease (CKD). The purpose of the present study was to identify genetic variants that confer susceptibility to CKD in individuals with or without hypertension or diabetes mellitus, thereby contributing to the personalized prevention of CKD in such individuals separately. The study population comprised 5835 unrelated Japanese individuals, including 1763 subjects with CKD and 4072 controls. The 150 polymorphisms were selected by genome-wide association studies of ischemic stroke and myocardial infarction with the use of the GeneChip Human Mapping 500K Array Set (Affymetrix). The genotypes for these polymorphisms were determined by a method that combines polymerase chain reaction and sequence-specific oligonucleotide probes with suspension array technology. The ?2 test, multivariable logistic regression analysis with adjustment for covariates, as well as a stepwise forward selection procedure revealed that two different polymorphisms were significantly (P<0.005) associated with the prevalence of CKD in individuals with or without hypertension or diabetes mellitus: the A?G (Lys625Arg) polymorphism of CDH4 (rs6142884) in individuals without diabetes mellitus, and the C?T polymorphism of PTPRN2 (rs1638021) in individuals with hypertension and diabetes mellitus. No polymorphism was significantly associated with CKD in individuals with or without hypertension, in those with diabetes mellitus, or in those without hypertension or diabetes mellitus. Stratification of subjects based on hypertension or diabetes mellitus may thus be fundamental to achieving the personalized prevention of CKD with the use of genetic information.

YOSHIDA, TETSURO; KATO, KIMIHIKO; YOKOI, KIYOSHI; OGURI, MITSUTOSHI; WATANABE, SACHIRO; METOKI, NORIFUMI; YOSHIDA, HIDEMI; SATOH, KEI; AOYAGI, YUKITOSHI; NOZAWA, YOSHINORI; YAMADA, YOSHIJI

2010-01-01

105

Alteration in plasma glucose levels in Japanese encephalitis patients  

PubMed Central

A unique factor, human T cell hypoglycaemic factor (hTCHF), has been shown to produce hypoglycaemia during the convalescent stage in the plasma of patients with Japanese encephalitis virus (JEV) infection. The present study was undertaken to investigate the ability of T cells from fresh peripheral blood mononuclear cells (PBMC) of such patients to produce hTCHF. The PBMC, as well as the individual subpopulations, were cultured for 24 h and the culture supernatants (CS) were assayed for hypoglycaemic activity. The activity was observed in the CD8+ T cells. The hypoglycaemia in JE-confirmed patients coincided with the gradual rise in circulating glucagon level, with no significant alterations in insulin, growth hormone and cortisol levels. The hTCHF was purified by ion exchange chromatography and the purified protein was observed as a ?25 kDa band on SDS-PAGE. Secretory hTCHF in the sera of patients and T cell CS was present in 88% of convalescent serum samples. We conclude that during the convalescent stage of JEV infection, a unique factor, hTCHF, is secreted by activated CD8+ T cells from patients and that this is responsible for the development of hypoglycaemia.

TANDON, APURVA; SINGH, ADITI; ATRISHI, EKTA; SAXENA, SK; MATHUR, ASHA

2002-01-01

106

Data Standards in Diabetes Patient Registries  

PubMed Central

Widespread adoption of electronic health records (EHRs) and expansion of patient registries present opportunities to improve patient care and population health and advance translational research. However, optimal integration of patient registries with EHR functions and aggregation of regional registries to support national or global analyses will require the use of standards. Currently, there are no standards for patient registries and no content standards for health care data collection or clinical research, including diabetes research. Data standards can facilitate new registry development by supporting reuse of well-defined data elements and data collection systems, and they can enable data aggregation for future research and discovery. This article introduces standardization topics relevant to diabetes patient registries, addresses issues related to the quality and use of registries and their integration with primary EHR data collection systems, and proposes strategies for implementation of data standards in diabetes research and management.

Richesson, Rachel L

2011-01-01

107

Subcutaneous Thigh Fat Area Is Unrelated to Risk of Type 2 Diabetes in a Prospective Study of Japanese Americans  

PubMed Central

Aims/Hypothesis Cross-sectional research has reported a negative association between subcutaneous thigh fat (STF) and type 2 diabetes prevalence but no prospective research on this association exists using direct measurements of STF obtained from imaging studies while adjusting for other fat depots. We studied the independent associations of intra-abdominal (IAF), subcutaneous abdominal (SAF), and STF with future risk of diabetes. Methods We prospectively followed 489 non-diabetic Japanese Americans (BMI 25.0-29.9 kg/m2 32.7%, ?30.0 kg/m2 5.4%) over 10 years for the development of diabetes defined by use of hypoglycemic medication or a fasting ?7.0 mmol/l or 2-hr ?11.1 mmol/l plasma glucose during an OGTT. STF, SAF, and IAF area were measure by CT scan and mid-thigh circumference (TC) by tape measure at baseline. Results Over 10 years, 103 persons developed diabetes. STF area was not independently associated with odds of developing diabetes in univariate or a multiple logistic regression model (odds ratio, 1 SD increase 0.8, 95% CI 0.5, 1.2) adjusted for age, gender, BMI, IAF, and SAF. The only fat depot associated with diabetes odds in this model was IAF. TC was borderline significantly associated with a lower odds of developing diabetes (0.7, 0.5, 1.0, p=0.052) Conclusions Similar to other research, TC was negatively associated with diabetes risk, while STF was not, arguing that the negative association between TC and diabetes observed in other research is not due to thigh subcutaneous fat mass. IAF area emerged as the only measured fat depot that was independently associated with type 2 diabetes risk.

Hoyer, D; Boyko, EJ; McNeely, MJ; Leonetti, DL; Kahn, SE; Fujimoto, WY

2013-01-01

108

Prescribing Exercise for Patients with Diabetes  

Microsoft Academic Search

Exercise prescription for patients with diabetes follows guidelines regarding frequency, intensity, duration, and mode of\\u000a exercise established for patients participating in a medically supervised exercise program. Physicians and health care professionals\\u000a should devise an exercise care plan that maximizes the benefits and minimizes the risks for each patient. The distinction\\u000a between prescribing exercise for patients with T1DM and patients with

Dalynn T. Badenhop

109

Prevalence of dry eye syndrome and diabetic retinopathy in type 2 diabetic patients  

Microsoft Academic Search

BACKGROUND: This study was performed to assess the prevalence of dry eye syndrome and diabetic retinopathy (DR) in type 2 diabetic patients and their contributing factors. METHODS: 199 type 2 diabetic patients referred to Yazd Diabetes Research Center were consecutively selected. All Subjects were assessed by questionnaire about other diseases and drugs. Dry eye syndrome was assessed with Tear break

Masoud Reza Manaviat; Maryam Rashidi; Mohammad Afkhami-Ardekani; Mohammad Reza Shoja

2008-01-01

110

Serum high density lipoprotein in diabetic patients  

Microsoft Academic Search

Summary  The purpose of the present investigation was the study of HDL lipoprotein changes in patients with diabetes mellitus. The comparison was made between 40 normal and 109 diabetic subjects and the following data was obtained: relative HDL concentration (polyacrylamide gel electrophoresis), HDL-cholesterol and apolipoprotein A concentrations. We found significant decreases in HDL (18–28%) and HDL-cholesterol (31–40 mg\\/ 100 ml) in

M. F. L. Lopes-Virella; P. G. Stone; J. A. Colwell

1977-01-01

111

Association of albuminuria and reduced estimated glomerular filtration rate with incident stroke and coronary artery disease in patients with type 2 diabetes  

Microsoft Academic Search

It is unclear whether albuminuria and reduced glomerular filtration rate (GFR) independently increase the risk of incident stroke and coronary artery disease (CAD) in Japanese patients with diabetes. We investigated the independent effects of albuminuria and estimated GFR (eGFR) on the first occurrence of stroke and CAD in patients with type 2 diabetes mellitus (T2DM). We studied 1002 T2DM patients

Ryotaro Bouchi; Tetsuya Babazono; Naoshi Yoshida; Izumi Nyumura; Kiwako Toya; Toshihide Hayashi; Ko Hanai; Nobue Tanaka; Akiko Ishii; Yasuhiko Iwamoto

2010-01-01

112

Mutational analysis of adrenoleukodystrophy (ALD) gene in Japanese ALD patients  

SciTech Connect

Recently a putative ALD gene containing a striking homology with peroxisomal membrane protein (PMP70) has been identified. Besides childhood ALD, various clinical phenotypes have been identified with the onset in adolescence or adulthood (adrenomyeloneuropathy (AMN), adult cerebral ALD or cerebello-brainstem dominant type). The different clinical phenotypes occasionally coexist even in the same family. To investigate if there is a correlation between the clinical phenotypes and genotypes of the mutations in the ALD gene, we have analyzed 43 Japanese ALD patients. By Southern blot analysis, we identified non-overlapping deletions of 0.5 kb to 10.4 kb involving the ALD gene in 3 patients with adult onset cerebello-brainstem dominant type. By detailed direct sequence analysis, we found 4 patients who had point mutations in the coding region. An AMN patient had a point mutation leading to {sup 266}Gly{r_arrow}Arg change, and another patient with adult cerebral ALD had a 3 bp deletion resulting in the loss of glutamic acid at codon 291, which is a conserved amino acid both in ALD protein and PMP70. Two patients with childhood ALD had point mutations leading to {sup 507}Gly{r_arrow}Val, and {sup 518}Arg{r_arrow}Gln, respectively. Since amino acids from 507 to 520 are highly conserved as ATP-binding cassette transporter proteins, mutations in this region are expected to result in dramatic changes of the function of this protein. Although there is a tendancy for mutation in childhood ALD to be present within the ATP-binding site motif, we found two adult patients who had large deletions involving the region. Taken together, strong correlation between genotypes and clinical phenotypes is unlikely to exist, and some other modifying factors might well play an important role for the clinical manifestations of ALD.

Koike, R.; Onodera, O.; Tabe, H. [Miigate Univ. (Japan)] [and others

1994-09-01

113

Quality of life in postoperative Japanese hip fracture patients: a hospital-based prospective study  

Microsoft Academic Search

Summary  This study aimed to study quality of life (QOL) in postoperative Japanese hip fracture patients. Although QOL in Japanese\\u000a patients recovered to pre-fracture levels 1 year following hospitalization, the recovery varied and was associated with physical\\u000a factors and living arrangements.\\u000a \\u000a \\u000a \\u000a Introduction  The aim of this study was to investigate quality-of-life (QOL) changes in postoperative Japanese hip fracture patients.\\u000a \\u000a \\u000a \\u000a Methods  Subjects were 113 hip

Nobuki Sugeno; Aya Goto; Seiji Yasumura; Shin-ichi Kikuchi

2008-01-01

114

Safety and pharmacokinetics of panitumumab in Japanese patients with advanced solid tumors  

Microsoft Academic Search

Background  Panitumumab is a fully human, monoclonal antibody against the epidermal growth factor receptor. Previous studies in non-Japanese\\u000a patients with solid tumors showed that panitumumab exhibited nonlinear pharmacokinetics, was well tolerated (skin toxicities\\u000a were the most common treatment-related adverse events), and had antitumor activity in some patients. This open-label, phase\\u000a 1 study investigated panitumumab safety and pharmacokinetics in Japanese patients.\\u000a \\u000a \\u000a \\u000a Methods  Japanese

Toshihiko Doi; Atsushi Ohtsu; Makoto Tahara; Tomohide Tamura; Kuniaki Shirao; Yasuhide Yamada; Satoru Otani; Bing-Bing Yang; Masayuki Ohkura; Tomoko Ohtsu

2009-01-01

115

Incidence of falls and fear of falling in Japanese patients with rheumatoid arthritis  

Microsoft Academic Search

The objective of this study is to determine the incidence of falls and fear of falling by gender and age in Japanese patients\\u000a with rheumatoid arthritis (RA). Among the Japanese patients who participated in a single-institute-based prospective observational\\u000a cohort study of patients with RA, namely the Institute of Rheumatology Rheumatoid Arthritis, 765 men (median age 63 years)\\u000a and 4,231 women (median

Kiyotaka Yamagiwa; Setsu Iijima; Takefumi Furuya; Tetsuo Ikai; Eisuke Inoue; Atsuo Taniguchi; Shigeki Momohara; Hisashi Yamanaka

2011-01-01

116

PIK3CA mutation status in Japanese lung cancer patients.  

PubMed

Somatic mutations of the PIK3CA (phosphatidylinostitol 3-kinase catalytic subunit) gene have been found in human cancer patients. Previous reports suggested that about 4% of lung cancers harbored PIK3CA gene mutations. However, the clinico-pathological background for PIK3CA gene mutations has not yet been investigated in lung cancer. We have genotyped the PIK3CA gene in Japanese lung cancer patients. The study included 235 lung cancer cases surgically removed in Nagoya City University Hospital. The two PIK3CA mutation hot spots (exon 9 and exon 20) were analyzed by real time polymerase chain reaction (PCR)-based assay. The data were confirmed by direct sequencing. In exon 9, somatic mutation was found in eight patients (3.4%). The mutation included three E542K (G1624A), three E545K (G1633A), one E542Q (G1624C), and one Q546K (C1636A). However, in exon 20, there was no mutation in our lung cancer patients. PIK3CA mutations were not correlated with gender (women versus men, p=0.4162), age (< or =60 versus >60, p=0.8027), or smoking status of the lung cancers (never versus smoker, p=0.5666). PIK3CA mutation incidence was significantly lower in adenocarcinoma (2/135, 1.5%) than in squamous cell carcinoma (5/77, 6.5%, p=0.0495). Among eight patients with a PIK3CA mutation, three patients also harbored an EGFR somatic mutation. PIK3CA gene mutations were rare in lung cancer; rarer in adenocarcinoma. Further functional analyses of the PIK3CA mutations are warranted to study if they could be the target of therapy for the lung cancer. PMID:16930767

Kawano, Osamu; Sasaki, Hidefumi; Endo, Katsuhiko; Suzuki, Eriko; Haneda, Hiroshi; Yukiue, Haruhiro; Kobayashi, Yoshihiro; Yano, Motoki; Fujii, Yoshitaka

2006-08-22

117

Silent myocardial ischemia screening in patients with diabetes mellitus  

Microsoft Academic Search

The prevalence of diabetes mellitus is fairly increasing, especially in the devel- oping countries. Diabetes is a major cardiovascular risk factor; it often leads to severe cardiovascular complications, and coronary artery disease (CAD) is the main cause of death in diabetic patients. Silent myocardial ischemia (SMI) is more frequent in diabetic patients. The progress made in detection and treat- ment

Olivier Barthelemy; Claude Le Feuvre; José Timsit

2007-01-01

118

Anesthetic considerations in diabetic patients. Part I: preoperative considerations of patients with diabetes mellitus  

Microsoft Academic Search

Diabetes mellitus is an increasingly common disease that affects people of all ages, resulting in significant morbidity and\\u000a mortality. Diabetic patients require perioperative care more frequently than their nondiabetic counterparts. The major risk\\u000a factors for diabetics undergoing surgery are the associated end-organ diseases: cardiovascular disease, autonomic neuropathy,\\u000a joint collagen tissue, and immune deficiency. Physicians need to pay extra attention to

Yuji Kadoi

2010-01-01

119

Post-marketing surveillance of the safety and effectiveness of tacrolimus in 3,267 Japanese patients with rheumatoid arthritis.  

PubMed

OBJECTIVES: A post-marketing surveillance (PMS) program was implemented to assess the safety and effectiveness of tacrolimus (TAC) in Japanese rheumatoid arthritis (RA) patients and to identify risk factors related to adverse drug reactions (ADRs). METHODS: Patients were registered centrally and monitored for all adverse events (AEs) for 24 weeks. Effectiveness was evaluated using the Disease Activity Score 28-CRP (DAS28-CRP). RESULTS: Data from 3,172 patients (mean age 62.2 years) were evaluated in the safety analysis. Of the safety population, 78.5 %were female and 25.9 % were in Steinbrocker's functional class 3 or 4. TAC was prescribed as monotherapy in 52.5 % and the most common concomitant disease modifying antirheumatic drug (DMARD) was methotrexate, used in 28.9 % of the patients. The incidence of AEs, serious AEs (SAEs), ADRs and serious ADRs were 41.2, 6.4, 36.0, and 4.9 %, respectively. The most frequent serious ADR category was infections and infestations. Age ?65 years, concurrent renal dysfunction, and concurrent diabetes mellitus were identified as significant risk factors for ADR. Based on EULAR response criteria, 65.4 % of the patients showed moderate or good response. CONCLUSIONS: The results demonstrate that TAC is well tolerated by Japanese patients with active RA, including those receiving concomitant methotrexate, in the real world. PMID:23670404

Takeuchi, Tsutomu; Kawai, Shinichi; Yamamoto, Kazuhiko; Harigai, Masayoshi; Ishida, Kota; Miyasaka, Nobuyuki

2013-05-14

120

Proteomic alteration in gastic adenocarcinomas from Japanese patients  

PubMed Central

Background Gastric adenocarcinomas comprise one of the common types of cancers in Asian countries including Japan. Comprehensive protein profiling of paired surgical specimens of primary gastric adenocarcinomas and nontumor mucosae derived from Japanese patients was carried out by means of two-dimensional gel electrophoresis (2D-EP) and liquid chromatography-electrospray ionic tandem mass spectrometry (LC-ESI-MS) to establish gastric cancer-specific proteins as putative clinical biomarkers and molecular targets for chemotherapy. Results Relatively common alterations in protein expression were revealed in the tumor tissues. Increases in manganese dismutase and nonhistone chromosomal protein HMG-1 (HMG-1) were observed, while decreases in carbonic anhydrases I and II, glutatione-S-transferase and foveolin precursor (gastrokine-1) (FOV), an 18-kDa stomach-specific protein with putative tumor suppressor activity, were detected. RT-PCR analysis also revealed significant down-regulation of FOV mRNA expression in tumor tissues. Conclusion A possible pathological role for down-regulation of FOV in gastric carcinogenesis was demonstrated. Evaluation of the specific decreases in gene and protein expression of FOV in patients may be utilized as clinical biomarkers for effective diagnosis and assessment of gastric cancer.

Yoshihara, Takahiro; Kadota, Yoshito; Yoshimura, Yoshiyuki; Tatano, Yutaka; Takeuchi, Naohiro; Okitsu, Hiroshi; Umemoto, Atsushi; Yamauchi, Takashi; Itoh, Kohji

2006-01-01

121

[Family diabetes and its consequences in cancer patients].  

PubMed

Preliminary data are confirmed on the more rare prevalence of family history of diabetes mellitus (DM) in cancer patients, mainly females, with diabetes in comparison with diabetics without cancer pathology. Familial diabetes does not worsen additionally tumor characteristics against the same in patients with non-familial diabetes. More than that, familial diabetes in diabetics with breast cancer goes together with lesser size of tumor and demonstrates an inclination to the rarer distant metastases in breast and endometrial cancer patients. The signs of systemic DNA damage (evaluated, in particular, on the basis of 8-OH-dG serum levels) are pronounced in postmenopausal diabetic cancer patients with familial diabetes in lesser degree than in non-familial variant of DM. In toto, this allows to consider family history of DM in patients with type-2 diabetes as a particular factor of tumor growth containment, which mechanisms and causes, warrant further studies. PMID:23909037

Bershte?n, L M; Vasil'ev, D A; Boiarkina, M P; Turkevich, E A; Dashian, G A; Poroshina, T E; Tsyrlina, E V; Kovalenko, I M; Kriukova, O G

2013-01-01

122

Human leukocyte antigens in Japanese patients with biliary atresia: Retrospective analysis of patients who underwent living donor liver transplantation  

Microsoft Academic Search

Biliary atresia (BA) is a neonatal obstructive cholangiopathy characterized by a fibrosclerosing obliteration of the extrahepatic bile duct. The aim of this study was to investigate the relationship between human leukocyte antigens (HLA) and susceptibility to BA. We retrospectively analyzed 392 Japanese patients with BA and without extrahepatic anomalies who underwent living donor liver transplantations at our institute. Healthy Japanese

Takeshi Yuasa; Hiroaki Tsuji; Shinya Kimura; Norimi Niwa; Kimiko Yurugi; Hiroto Egawa; Koichi Tanaka; Etsuko Maruya; Hiro-o Saji; Hiroaki Asano; Taira Maekawa

2005-01-01

123

Efficacy and Safety of Pulse Steroid Therapy in Japanese Pediatric Patients with Ulcerative Colitis: A Survey of the Japanese Society for Pediatric Inflammatory Bowel Disease  

Microsoft Academic Search

Aims: We have evaluated the therapeutic efficacy and safety of pulse steroid therapy for ulcerative colitis (UC) in a Japanese pediatric population by means of a survey. Methods: A questionnaire on UC patients treated with therapy between 2002 and 2006 was sent to 37 members of the Japanese Society for Pediatric Inflammatory Bowel Disease. Results: 21 of 62 cases in

Satoru Nagata; Toshiaki Shimizu; Takahiro Kudo; Takeshi Tomomasa; Hitoshi Tajiri; Atsushi Yoden; Seiichi Kagimoto; Takuji Tahara; Kohsuke Ushijima; Keiichi Uchida; Akio Kobayashi

2010-01-01

124

[Coronary artery disease in patients with diabetes].  

PubMed

Diabetes in patients with coronary artery disease multiplies the risk of a cardiovascular event by a factor of 2 to 3. The risk is still higher for patients with heart or kidney failure. The detection of silent ischemia makes it possible to identify patients with revascularizable stenosis of the coronary artery or three-vessel atheroma. The choice between angioplasty and coronary bypass for diabetes patients with multiple-vessel disease requires multidisciplinary discussion. The onset of acute coronary syndrome in a patient with diabetes justifies coronary angiography to attempt any possible revascularization. Coronary angioplasty with a drug-eluting stent reduces the risk of need for revascularization due to restenosis, without modifying the risk of death/infarction compared with a bare-metal stent. Prognosis is improved only if appropriate comprehensive management follows, including intensive correction of risk factors. The management of a patient with coronary artery disease and diabetes must be multidisciplinary, in a network of care coordinated by the general practitioner. PMID:19362802

Le Feuvre, Claude

2009-04-11

125

Low Incidence of Asymptomatic Contrast-Enhancing Brain Lesions in Japanese Patients with Multiple Sclerosis  

Microsoft Academic Search

Background: The number of contrast-enhancing brain lesions is used as an endpoint in multiple sclerosis (MS) clinical trials. However, the incidence of asymptomatic contrast-enhancing brain lesions (AEBLs) in Japanese patients with MS has not been determined. Objective: To describe the number of AEBLs per scan in Japanese patients with relapsing-remitting MS (RRMS). Methods: We reviewed the medical records of 23

Masami Tanaka; Masaru Matsui; Masayuki Tahara; Keiko Tanaka

2011-01-01

126

Elevation of Cerebrospinal Fluid Protein in Patients with Diabetes Mellitus Is Associated with Duration of Diabetes  

Microsoft Academic Search

We investigated the relationships between total cerebrospinal fluid (CSF) protein in diabetic patients and the clinical characteristics of diabetes mellitus. The subjects comprised 16 diabetic patients (median age = 60.5 years, range = 47–71) who were studied retrospectively. Patients with diseases known to be associated with increases in total CSF protein were excluded as far as possible. The median total

Hiroshi Kobessho; Kenichi Oishi; Hirotoshi Hamaguchi; Fumio Kanda

2008-01-01

127

Kidney transplant options for the diabetic patient.  

PubMed

For patients with diabetes and progressive chronic kidney disease, kidney transplantation is the optimal mode of renal replacement therapy, with or without a pancreas transplant. Additional benefits of pancreas transplant have become increasingly apparent due to advances in surgical outcomes and immunosuppression, and may be reasonably considered even in selected patients with type 2 diabetes. In general, pancreas transplantation is associated with long-term survival advantages despite an increased short-term morbidity and mortality risk. This is true with simultaneous pancreas kidney transplantation or pancreas after kidney transplantation compared to kidney transplantation alone, regardless of kidney donor status (living or deceased). Individual patient preferences, comorbidities, and expected waiting time influence selection of transplant modality, rather than a clear survival benefit of one strategy versus the other. In selected patients with type 2 diabetes, recent outcomes data support cautious utilization of simultaneous pancreas kidney transplantation when a living kidney donor transplant is not an option. The purpose of this review is to summarize current data regarding kidney and pancreas transplant treatment options in patients with both type 1 and 2 diabetes and the influence of current organ allocation policies to better understand the advantages and disadvantages of each of these strategies. PMID:23927899

Wiseman, Alexander C

2013-08-06

128

Increased Risk of Diabetes and Likelihood of Receiving Diabetes Treatment in Patients with Psoriasis  

PubMed Central

Objective Psoriasis is a common chronic inflammatory disorder that has been mechanistically linked to type II diabetes mellitus. We sought to assess the risk of incident diabetes in patients with psoriasis and to evaluate diabetes treatment patterns among patients with psoriasis and incident diabetes. Design Population-based cohort study. Setting UK-based electronic medical records. Patients We matched 108,132 psoriasis patients aged 18–90 years to 430,716 unexposed patients based on practice and time of visit. For our nested study, only patients who developed incident diabetes during our study time were included. Main Outcome Measure(s) Incident diabetes and adjusted risk of pharmacotherapy among those with incident diabetes. Results The fully adjusted HRs (95% CI) for incident diabetes were 1.14 (1.10–1.18), 1.11 (1.07, 1.15), and 1.46 (1.30, 1.65) in the overall, mild and severe psoriasis groups, respectively. Among those with incident diabetes and severe psoriasis, the adjusted risk for receiving diabetes pharmacotherapy was 1.55 (1.15–2.10). Conclusions Our results suggest that psoriasis is an independent risk factor for the development of type II diabetes mellitus in a dose dependent manner, and that patients with severe psoriasis who develop diabetes are more likely to receive systemic diabetic therapies in comparison to diabetics without psoriasis.

Azfar, Rahat S.; Seminara, Nicole M.; Shin, Daniel B.; Troxel, Andrea B.; Margolis, David J.; Gelfand, Joel M.

2013-01-01

129

Preventing cardiovascular events in patients with diabetes mellitus  

Microsoft Academic Search

Diabetes mellitus and obesity are becoming increasingly prevalent in the United States. Patients with diabetes are 2 to 3 times more likely to develop cardiovascular disease (CVD) than are individuals without diabetes, but proper diabetes management and metabolic control can reduce this risk. Nonpharmacologic interventions, such as diet and exercise, can help to reduce weight and control insulin resistance, blood

William T Abraham

2004-01-01

130

Physician–elderly patient–companion communication and roles of companions in Japanese geriatric encounters  

Microsoft Academic Search

Although the triadic encounter of physician, patient, and an accompanying family member is a common phenomenon in geriatrics, previous research on the communication in medical encounters has primarily focused on dyadic interactions between physician and patient. This study aimed to explore the triadic communication and communication roles of patient companions in Japanese geriatric encounters.Among elderly patients aged 65 or over

Hirono Ishikawa; Debra L. Roter; Yoshihiko Yamazaki; Tomoko Takayama

2005-01-01

131

Anesthetic considerations in diabetic patients. Part II: intraoperative and postoperative management of patients with diabetes mellitus  

Microsoft Academic Search

Some studies have reported that tight glycemic control in diabetic patients undergoing major surgery improves perioperative\\u000a morbidity and mortality rates. Recently, however, large randomized studies have shown such control increases the mortality\\u000a rate, since aggressive glycemic control induces more frequent incidences of hypoglycemia. Diabetic patients have cerebral\\u000a complications during the perioperative period more often than their nondiabetic counterparts. Further, anesthetic

Yuji Kadoi

2010-01-01

132

Patient education for preventing diabetic foot ulceration.  

PubMed

Treatment of diabetic foot ulceration is very challenging, costly and often needs to be of long duration. This leads to substantial economic burden. Population-based research suggests that a meaningful reduction of the incidence of amputations caused by diabetes mellitus has already been achieved since the St. Vincent resolution in 1989. Still, it cannot be inferred from these studies that the current preventive efforts are (cost-)effective because reduction of amputation incidence can also be the result of improvements in ulcer treatment. Nevertheless, education of people with diabetes is widely advocated and implemented in standard practice. Despite the fact that preventive interventions are often combined in daily practice, there is little scientific evidence demonstrating the effect of those efforts. In systematically reviewing the evidence, there is insufficient evidence that limited patient education alone is effective in achieving clinically relevant reductions in ulcer and amputation incidence. To date, high quality evidence that more complex interventions including patient education can prevent diabetic foot ulceration is not available either. This, however, should be interpreted as lack of evidence rather than evidence of no effect. Future directions for research and practice may be to concentrate preventive effort on those patients who appear to be at highest risk of foot ulceration after careful screening and selection. PMID:22271733

Dorresteijn, Johannes A N; Valk, Gerlof D

2012-02-01

133

Treatment of Patients With Diabetic Gastroparesis  

PubMed Central

Gastroparesis, or chronic delayed gastric emptying without mechanical obstruction, affects about 40% of patients with type 1 diabetes and up to 30% of patients with type 2 diabetes. Diabetic gastroparesis (DGP) typically causes nausea, vomiting, early satiety, bloating, and postprandial fullness. These symptoms can be extremely troubling and result in poor quality of life. The diagnosis of DGP is made by documenting the presence of chronic upper gastrointestinal (GI) symptoms, ruling out mechanical obstruction, and demonstrating delayed gastric emptying. The usual treatment for DGP includes dietary modifications, prokinetic agents, and antiemetic agents. Although the majority of patients have mild-to-moderate disease that can be managed using these measures, a substantial percentage of patients have severe DGP that is characterized by inadequate oral intake, malnutrition, weight loss, and frequent hospitalizations. Optimal management of these patients presents a difficult challenge for the clinician, although emerging treatment options, such as gastric neurostimulation, are encouraging. Patients with DGP often present with gastric comorbidities, including gastroesophageal reflux disease, intestinal dysmotility, and fungal and bacterial infections of the GI tract. This monograph will present an overview of the pathophysiology of DGP, review diagnostic testing with a discussion of emerging technology, and present the latest research in treatment options for DGP. In addition, management strategies for refractory DGP and gastric comorbidities will be described.

Parkman, Henry P.; Fass, Ronnie; Foxx-Orenstein, Amy E.

2010-01-01

134

[Therapeutic patient education in diabetes management].  

PubMed

Late complications of type 1 and type 2 diabetes can also be effectively avoided or delayed using active intervention and available therapies. Despite these facts, the percentage of people with diabetes following the therapy proposed by health care professionals is quite low. People with diabetes or any other chronic disease have to be involved in their own treatment. Basic knowledge is very important for the patient but the reinforcement of appropriate attitudes and a continuous process of motivation is fundamental in changing habits and behaviour. We need to educate patients, giving them the tools and skills to manage their disease, allowing them to become autonomous, empowering them. In the Therapeutic Patient Education model the patient is no longer the object but instead one of the actors in the process. He becomes part of the team and part of the solution. Goals are agreed as a result of input of the patient's desires, details of his daily life, his perceptions and the HCP's biomedical objectives. The patient takes care of himself and will, step by step, become aware of the consequences of his actions, in collaboration with his health team. PMID:23721977

Boavida, José Manuel

2013-04-01

135

Multiple system degeneration with basophilic inclusions in Japanese ALS patients with FUS mutation  

Microsoft Academic Search

Mutations in the fused in sarcoma gene (FUS) were recently found in patients with familial amyotrophic lateral sclerosis (ALS). The present study aimed to clarify unique\\u000a features of familial ALS caused by FUS mutation in the Japanese population. We carried out clinical, neuropathological, and genetic studies on a large Japanese\\u000a pedigree with familial ALS. In six successive generations of this

Takahisa TateishiToshihiro; Toshihiro Hokonohara; Ryo Yamasaki; Shiro Miura; Hitoshi Kikuchi; Akiko Iwaki; Hiroshi Tashiro; Hirokazu Furuya; Yuko Nagara; Yasumasa Ohyagi; Nobuyuki Nukina; Toru Iwaki; Yasuyuki Fukumaki; Jun-ichi Kira

2010-01-01

136

Zinc and copper in the serum of diabetic patients  

Microsoft Academic Search

The Zn\\/Cu ratio was examined in the serum of three groups of persons: healthy volunteers, diabetic patients on diabetic diet\\u000a (NIDDM), and diabetic patients on diabetic diet and insulin (IDDM). Zinc, copper, the Zn\\/Cu serum ratio, and the blood glucose\\u000a level were determined during fasting and 2 h after breakfast. Zn and Cu serum levels in NIDDM and IDDM patients

Nikica Car; A. Car; M. Grani?; Z. Škrabalo; B. Mom?ilovi?

1992-01-01

137

Development of a preliminary diabetes dietary satisfaction and outcomes measure for patients with type 2 diabetes  

Microsoft Academic Search

Adopting dietary lifestyle changes for diabetes management is often difficult for patients; yet the health-related quality of life (HRQOL) outcomes of dietary management for the patient are not extensively developed in the HRQOL assessments now widely used in diabetes research. This study developed a preliminary instrument, the diabetes dietary satisfaction and outcomes measure, to assess outcomes of individuals' experiences in

S. S. Ahlgren; J. A. Shultz; L. K. Massey; B. C. Hicks; C. Wysham

2004-01-01

138

Efficacy and Safety of Azathioprine and 6Mercaptopurine in Japanese Pediatric Patients with Ulcerative Colitis: A Survey of the Japanese Society for Pediatric Inflammatory Bowel Disease  

Microsoft Academic Search

Background and Aims: Azathioprine (AZA) and 6-mercaptopurine (6-MP) have recently been used in Japanese pediatric patients with ulcerative colitis. The aims of this study were to evaluate both the therapeutic efficacy and safety of AZA\\/6-MP in this group of patients. Methods: Fourteen members of the Japanese Society for Pediatric Inflammatory Bowel Disease reported 35 retrospective cases that received AZA\\/6-MP and

Hitoshi Tajiri; Tsuyoshi Tomomasa; Atsushi Yoden; Mutsuko Konno; Mika Sasaki; Shuniti Maisawa; Ryo Sumazaki; Toshikazu Shimizu; Shigeru Toyoda; Yuri Etani; Mariko Nakacho; Kosuke Ushijima; Akio Kobayashi

2008-01-01

139

Prevalence, Health and Demographics of Emergency Department Patients with Diabetes  

PubMed Central

Objective To determine the prevalence of diabetes in Southern California emergency department (ED) patients and describe the self-reported general health, demographic and social characteristics of these patients with diabetes. Methods Between April 2008 and August 2008, non-critical patients at two Southern California EDs completed a 57-question survey about their chronic medical conditions, general health, social and demographic characteristics. Results 11.3% of the 1,303 patients surveyed had diabetes. Patients with diabetes were similar to ED patients without diabetes with respect to gender, ethnicity and race. However, patients with diabetes were older (51 vs. 41), less likely to have a high school education (64.0% vs. 84.7%), less likely to speak English (44.9% vs. 55.4%), and less likely to be uninsured (33.3% vs. 49.5%). Additionally, patients with diabetes had markedly lower self-reported physical health scores (37.1 vs. 45.8) and mental component score and mental health scores (42.0 vs. 47.4) compared with ED patients without diabetes. Conclusion In this study of two Southern California EDs, 11.3% of surveyed patients had diabetes. These patients were often poorly educated, possessed limited English language skills and poor physical health. ED personnel and diabetes educators should be mindful of these findings when designing interventions for ED patients with diabetes.

Menchine, Michael D.; Vishwanath, Anita; Arora, Sanjay

2010-01-01

140

Characteristics of Japanese Duchenne and Becker muscular dystrophy patients in a novel Japanese national registry of muscular dystrophy (Remudy)  

PubMed Central

Background Currently, clinical trials for new therapeutic strategies are being planned for Duchenne and Becker muscular dystrophies (DMD/BMD). However, it is difficult to obtain adequate numbers of patients in clinical trials. As solutions to these problems, patient registries are an important resource worldwide, especially in rare diseases such as DMD/BMD. Methods We developed a national registry of Japanese DMD/BMD patients in collaboration with TREAT-NMD. The registry includes male Japanese DMD/BMD patients whose genetic status has been confirmed by genetic analysis. The registry includes patients throughout Japan. Results As of February 2012, 583 DMD and 105 BMD patients were registered. Most individuals aged less than 20 years. In terms of genetic mutations of registrants of DMD and BMD, deletion of exons was the most frequent (61.4% and 79.0%) followed by point mutations (24.5% and 14.3%) and duplications (13.6% and 4.8%), respectively. 43.6% of DMD are capable of walking, and 76.2% of BMD registrants are able to walk. 41.1% of DMD registrants in the database were treated using steroids. 29.5% of DMD and 23.8% of BMD registrants were prescribed one cardiac medicine at least. 22% of DMD used ventilator support, and non-invasive support was common. Small numbers of DMD and BMD registrants, only 3.9% and 1.0% of them, have received scoliosis surgery. 57 (9.8%) patients were eligible to clinical trial focused on ‘skipping’ exon 51. Conclusions The Remudy has already demonstrated utility in clinical researches and standardization of patients care for DMD/BMD. This new DMD/BMD patient registry facilitates the synchronization of clinical drug development in Japan with that in other countries.

2013-01-01

141

Recognizing and treating depression in patients with diabetes  

Microsoft Academic Search

Diabetes doubles the risk for depression, which in turn may interfere with effective diabetes self-management, and is associated\\u000a with hyperglycemia and with increased risk for diabetes complications. Despite its relevance to the course of diabetes and\\u000a its chronic character, depression is recognized and treated appropriately in fewer than 25% of depressed diabetic patients.\\u000a The authors discuss the use of screening

Richard R. Rubin; Paul Ciechanowski; Leonard E. Egede; Elizabeth H. B. Lin; Patrick J. Lustman

2004-01-01

142

Continuous Glucose Monitoring For Patients with Diabetes  

PubMed Central

Executive Summary Objective To determine the effectiveness and cost-effectiveness of continuous glucose monitoring combined with self-monitoring of blood glucose compared with self-monitoring of blood glucose alone in the management of diabetes. Clinical Need: Condition and Target Population Diabetes is a chronic metabolic disorder that interferes with the body’s ability to produce or effectively use insulin. In 2005, an estimated 816,000 Ontarians had diabetes representing 8.8% of the province’s population. Type 1 or juvenile onset diabetes is a life-long disorder that commonly manifests in children and adolescents. It represents about 10% of the total diabetes population and involves immune-mediated destruction of insulin producing cells in the pancreas. The loss of these cells necessitates insulin therapy. Type 2 or “adult-onset” diabetes represents about 90% of the total diabetes population and is marked by a resistance to insulin or insufficient insulin secretion. The risk of developing type 2 diabetes increases with age, obesity and lack of physical activity. Approximately 30% of patients with type 2 diabetes eventually require insulin therapy. Technology Continuous glucose monitors (CGM) measure glucose levels in the interstitial fluid surrounding skin cells. These measurements supplement conventional self monitoring of blood glucose (SMBG) by monitoring the glucose fluctuations continuously over a stipulated period of time, thereby identifying fluctuations that would not be identified with SMBG alone. To use a CGM, a sensor is inserted under the skin to measure glucose in the interstitial fluid. The sensor is wired to a transmitter. The device requires calibration using a capillary blood glucose measurement. Each sensor continuously measures glucose every 5-10 seconds averaging these values every 5 minutes and storing this data in the monitors memory. Depending on the device used, the algorithm in the device can measure glucose over a 3 or 6 day period using one sensor. After the 3 or 6 day period, a new sensor is required. The device is equipped with alarms which warn the patient of impending hypo-or hyperglycemia. Two types of CGM are available: Systems that is stored in a monitor and can be downloaded later. Real time systems that continuously provide the actual glucose concentration on a display. Research Questions What is the effectiveness and cost-effectiveness of CGM combined with SMBG compared with SMBG alone in the management of diabetes? Research Methods Literature Search Search Strategy A literature search was performed on September 15, 2010 using OVID MEDLINE, MEDLINE In-Process and Other Non-Indexed Citations, EMBASE, the Cumulative Index to Nursing & Allied Health Literature (CINAHL), the Cochrane Library, and the International Agency for Health Technology Assessment (INAHTA) for studies published from January 1, 2002 until September 15, 2010. Abstracts were reviewed by a single reviewer and, for those studies meeting the eligibility criteria, full-text articles were obtained. Reference lists were also examined for any additional relevant studies not identified through the search. Articles with unknown eligibility were reviewed with a second clinical epidemiologist, then a group of epidemiologists until consensus was established. The quality of evidence was assessed as high, moderate, low or very low according to GRADE methodology. Inclusion Criteria English language Randomized controlled trials (N>30 patients) Adults or pediatric patients with insulin dependent diabetes (type 1 or 2 or gestational) Studies comparing CGM plus SMBG versus SMBG alone Exclusion Criteria Case studies Studies that did not compare CGM plus SMBG versus SMBG alone Studies that did not report statistical analysis of outcomes or data was unextractable Outcomes of Interest Change in glycosylated hemoglobin (HbA1c) Frequency or duration of hypo-or hyperglycemic episodes or euglycemia Adverse effects Summary of Findings Moderate quality evidence that CGM + SMBG: is not more effective than self moni

2011-01-01

143

Application of Revised Diagnostic Criteria for Vogt-Koyanagi-Harada Disease in Japanese Patients  

Microsoft Academic Search

Purpose: To determine whether the International Revised Diagnostic Criteria for Vogt-Koyanagi-Harada (VKH) disease is applicable to Japanese patients at the early stage of VKH disease. Methods :T he medical records of 49 patients with VKH disease were studied. The patients had been examined at the Akita University School of Medicine Hospital between 1989 and 2001, and their mean age was

Kunihiko Yamaki; Koji Hara; Shozo Sakuragi

2005-01-01

144

Prognostic determinants of long-term survival in Japanese patients with cardiac sarcoidosis treated with prednisone  

Microsoft Academic Search

Cardiac involvement is an important prognostic factor in sarcoidosis, but reliable indicators of mortality risk in cardiac sarcoidosis are unstudied in a large number of patients. To determine the significant predictors of mortality and to assess the efficacy of corticosteroids, we analyzed clinical findings, treatment, and prognosis in 95 Japanese patients with cardiac sarcoidosis. Twenty of these 95 patients had

Yoshikazu Yazaki; Mitsuaki Isobe; Michiaki Hiroe; Shin-ichiro Morimoto; Shinya Hiramitsu; Takeshi Nakano; Tohru Izumi; Morie Sekiguchi

2001-01-01

145

Retroperitoneoscopic Nephrectomy in Overweight and Obese Japanese Patients: Complications and Outcomes  

Microsoft Academic Search

Introduction: The objective of the present study was to evaluate the safety of retroperitoneoscopic nephrectomy (RN) in obese Japanese patients. Patients and Methods: We retrospectively reviewed 190 consecutive RN procedures performed from May 2002 to May 2006. We divided patients into an obese group (BMI ?25, n = 54) and a normal group (BMI <24.9, n = 136). Operation time,

Kazuhide Makiyama; Noboru Nakaigawa; Yasuhide Miyoshi; Takayuki Murakami; Masahiro Yao; Yoshinobu Kubota

2008-01-01

146

Managing Gestational Diabetes. A Patient's Guide to a Healthy Pregnancy.  

National Technical Information Service (NTIS)

Managing Gestational Diabetes: A Patient's Guide to a Healthy Pregnancy provides some general guidelines for keeping yourself healthy and for promoting the best outcomes for your baby, if you have gestational diabetes. The booklet describes gestational di...

2004-01-01

147

Rhino-orbito-cerebral mucormycosis in patients with diabetic ketoacidosis.  

PubMed

Mucormycosis is a life-threatening fungal infection that occurs in immunocompromised patients. The most common predisposing risk factor for mucormycosis is diabetes mellitus. Rhino-orbito-cerebral mucormycosis is the most common form in diabetic patients and is characterized by paranasal sinusitis, ophthalmoplegia with blindness, and unilateral proptosis with cellulitis, facial pain with swelling, headache, fever, rhinitis, granular or purulent nasal discharge, nasal ulceration, epistaxis, hemiplegia or stroke, and decreased mental function. Diabetic ketoacidosis is the most common and serious acute complication of diabetic patients. We herein report 2 cases of fatal rhino-orbito-cerebral mucormycosis in a patient with diabetic ketoacidosis. PMID:23524816

Gen, Ramazan; Horasan, Elif ?ahin; Vayso?lu, Yusuf; Arpaci, Rabia Bozdo?an; Ersöz, Gülden; Özcan, Cengiz

2013-03-01

148

Stress and coping behavior in patients with diabetes mellitus  

Microsoft Academic Search

Diabetes mellitus is a disease which must be controlled over the lifetime of a patient. We investigated the issues of stress\\u000a and coping for diabetes mellitus which may influence self-management. In addition, we examined the association of these factors\\u000a with blood glucose control, in order to review self-management instructions for diabetes mellitus. The study included 153\\u000a patients with diabetes mellitus.

M. Nomura; K. Fujimoto; A. Higashino; M. Denzumi; M. Miyagawa; H. Miyajima; T. Nada; Y. Kondo; Y. Tada; R. Kawaguchi; T. Morishita; K. Saito; S. Ito; Y. Nakaya

2000-01-01

149

Increased Urinary-Free Cortisol Outputs in Diabetic Patients  

Microsoft Academic Search

We previously reported that diabetic patients show evidence of dysregulation of the hypothalamic-pituitary-adrenal (HPA) axis. To extend this work, we examined urinary-free cortisol (UFC) outputs in diabetic patients and whether or not they relate to diabetic complications. We compared a group of 35 insulin-dependent diabetic outpatients with a group of 32 normal controls for 24-h UFC outputs and examined the

Monique S Roy; Alec Roy; Stafford Brown

1998-01-01

150

Hypertension management in patients with diabetic nephropathy  

Microsoft Academic Search

Treatment of hypertension, to reverse and delay proteinuria progression and kidney failure, is the primary focus of medical\\u000a management in patients with diabetic nephropathy. The initial choice for hypertension treatment in those with early nephropathy\\u000a involves agents that block the renin-angiotensin system. However, it is not clear what the best choices for further drug therapy\\u000a management are, because there are

Anthony L. McCall

2004-01-01

151

Diabetes Stories: Use of Patient Narratives of Diabetes to Teach Patient-Centered Care  

ERIC Educational Resources Information Center

|A critical component to instituting compassionate, patient-centered diabetes care is the training of health care providers. Our institution developed the Family Centered Experience (FCE), a comprehensive 2-year preclinical program based on longitudinal conversations with patients about living with chronic illness. The goal of the FCE is to…

Kumagai, Arno K.; Murphy, Elizabeth A.; Ross, Paula T.

2009-01-01

152

Long-term clinical effects of epalrestat, an aldose reductase inhibitor, on progression of diabetic neuropathy and other microvascular complications: multivariate epidemiological analysis based on patient background factors and severity of diabetic neuropathy  

PubMed Central

Abstract Aims The goal of the study was to evaluate the efficacy of epalrestat, an aldose reductase inhibitor, on diabetic retinopathy and diabetic nephropathy, based on analysis of the results of the Aldose Reductase Inhibitor–Diabetes Complications Trial, a 3-year multicentre comparative clinical trial of conventional therapy (control group) and epalrestat therapy (epalrestat group) in Japanese patients with mild diabetic neuropathy. Methods The subjects of the study were patients enrolled in the Aldose Reductase Inhibitor–Diabetes Complications Trial for whom data for major patient characteristics, severity of diabetic neuropathy at the end of the study and time-courses of diabetic retinopathy and diabetic nephropathy were available (57 and 52 patients from the control and epalrestat groups, respectively). Progression of diabetic retinopathy/nephropathy (a primary endpoint) in relation to major patient characteristics, severity of diabetic neuropathy at the end of the study (assessed from the mean of z-scores in four neurological function tests) and epalrestat treatment were analysed using univariate analysis and multiple logistic regression analysis. Results Progression of diabetic retinopathy/nephropathy was significantly inhibited in the epalrestat group compared with the control group (odds ratio = 0.323, P = 0.014) and was dependent on the severity of diabetic neuropathy at the end of the study (odds ratio = 2.131, P = 0.025). Conclusions Epalrestat prevented progression of diabetic neuropathy and retinopathy/nephropathy. The effect on diabetic retinopathy/nephropathy may have occurred indirectly because of the prevention of progression of diabetic neuropathy, in addition to the inhibitory action of epalrestat on aldose reductase.

Hotta, N; Kawamori, R; Fukuda, M; Shigeta, Y

2012-01-01

153

Myocardial ischemia: a silent epidemic in Type 2 diabetes patients.  

PubMed

The prevalence of diabetes mellitus is increasing consistently. Coronary artery disease (CAD) is the main cause of death; however, silent myocardial ischemia (SMI) is more frequent in diabetic patients. Early CAD diagnosis provided by SMI screening could lead to decreased cardiovascular complications and mortality. Current guidelines recommend screening for SMI in asymptomatic diabetic patients selected on a basis of high cardiovascular risk, followed by coronary angiogram in case of a positive stress test. However, the benefit of systematic SMI screening has not been demonstrated in diabetic patients with optimal treatment of risk factors. The benefit of revascularization in diabetic patients with SMI seems to be restricted to patients with severe CAD. Prospective studies are required to identify diabetic patients who may potentially benefit from SMI screening. These patients should have a high prevalence of severe CAD and potential benefit of revascularization, such as patients with renal failure, left ventricular dysfunction and peripheral or carotid occlusive arterial disease. PMID:21453025

Le Feuvre, Claude; Jacqueminet, Sophie; Barthelemy, Olivier

2011-03-01

154

Survival in dialysis patients is not different between patients with diabetes as primary renal disease and patients with diabetes as a co-morbid condition  

PubMed Central

Background On dialysis, survival among patients with diabetes mellitus is inferior to survival of non-diabetic patients. We hypothesized that patients with diabetes as primary renal disease have worse survival compared to patients with diabetes as a co-morbid condition and aimed to compare all-cause mortality between these patient groups. Methods Data were collected from the Netherlands Cooperative Study on the Adequacy of Dialysis (NECOSAD), a multicenter, prospective cohort study in which new patients with end stage renal disease (ESRD) were monitored until transplantation or death. Patients with diabetes as primary cause of ESRD were compared with patients with diabetes as co-morbid condition and both of these patient groups were compared to patients without diabetes. Analysis was performed using Kaplan-Meier and Cox regression. Results Fifteen % of the patients had diabetic nephropathy as primary renal disease (N = 281); 6% had diabetes as co-morbid condition (N = 107) and 79% had no diabetes (N = 1465). During follow-up 42% of patients (N = 787) died. Compared to non-diabetic patients, mortality risk was increased for both patients with diabetes as primary renal disease HR: 1.9 (95% CI 1.6, 2.3) and for patients with diabetes as co-morbid condition HR: 1.7 (95% CI 1.3, 2.2). Mortality was not significantly higher in patients with diabetes as primary renal disease compared to patients with diabetes as co-morbid condition (HR 1.06; 95% CI 0.79, 1.43). Conclusions This study in patients with ESRD showed no survival difference between patients with diabetes as primary renal disease and patients with diabetes as a co-morbid condition. Both conditions were associated with increased mortality risk compared to non-diabetic patients.

2011-01-01

155

Diabetes stories: use of patient narratives of diabetes to teach patient-centered care  

Microsoft Academic Search

A critical component to instituting compassionate, patient-centered diabetes care is the training of health care providers.\\u000a Our institution developed the Family Centered Experience (FCE), a comprehensive 2-year preclinical program based on longitudinal\\u000a conversations with patients about living with chronic illness. The goal of the FCE is to explore the experience of illness\\u000a from the patient’s perspective and ultimately to incorporate

Arno K. Kumagai; Elizabeth A. Murphy; Paula T. Ross

2009-01-01

156

Nonmydriatic retinal color photography in young Indian diabetic patients.  

PubMed

Retinopathy was assessed using a Canon nonmydriatic retinal camera (CR-45NM) in 42 young Indian diabetic patients (26 with malnutrition-related and 16 with insulin-dependent diabetes). Four patients with malnutrition-related diabetes (15.38%) had retinopathy (Level 3 in all 4). The duration of diabetes in them was 3.25 years. None of the four had hypertension or albuminuria. Five patients with insulin-dependent diabetes mellitus (31.25%) had retinopathy (Level 2 in 1 patient, Level 3 in 2, Level 5 and 6.5 in 1 each). The duration of diabetes in this group was 9.7 years. Three each (60%) had albuminuria and hypertension. Thus, retinopathy seemed to occur earlier in patients with malnutrition-related diabetes, and its incidence was discordant with that of nephropathy. PMID:8517590

Sridhar, G R; Satish, K; Ahuja, M M

1993-05-01

157

Prevention of type 2 diabetes in a primary healthcare setting: Three-year results of lifestyle intervention in Japanese subjects with impaired glucose tolerance  

Microsoft Academic Search

BACKGROUND: A randomized control trial was performed to test whether a lifestyle intervention program, carried out in a primary healthcare setting using existing resources, can reduce the incidence of type 2 diabetes in Japanese with impaired glucose tolerance (IGT). The results of 3 years' intervention are summarized. METHODS: Through health checkups in communities and workplaces, 304 middle-aged IGT subjects with

Naoki Sakane; Juichi Sato; Kazuyo Tsushita; Satoru Tsujii; Kazuhiko Kotani; Kokoro Tsuzaki; Makoto Tominaga; Shoji Kawazu; Yuzo Sato; Takeshi Usui; Isao Kamae; Toshihide Yoshida; Yutaka Kiyohara; Shigeaki Sato; Hideshi Kuzuya

2011-01-01

158

Optimal use of quick-acting insulin analogue in combination with basal insulin and its long-term effect in Japanese children and adolescents with type 1 diabetes  

Microsoft Academic Search

The aim of the study was to examine the optimal use of quick-acting insulin analogue (Q) switching from regular insulin (R) in combination with basal insulin and its long-term effects in 40 Japanese children and adolescents with type 1 diabetes. Insulin regimens after administration of Q were increased to twice daily injections of basal insulin and modified use of Q

Tatsuhiko Urakami; Ikuhiro Inami; Shigeo Morimoto; Misao Owada; Kensuke Harada

2005-01-01

159

Association study between B- and T-lymphocyte attenuator gene and type 1 diabetes mellitus or systemic lupus erythematosus in the Japanese population.  

PubMed

This study is to elucidate whether the B- and T-lymphocyte attenuator (BTLA) gene is a new susceptibility gene for the development of type 1 diabetes (T1D) and systemic lupus erythematosus (SLE). As a result, this study did not find any genetic contribution of the BTLA gene to the development of T1D and SLE in Japanese population. PMID:19207938

Inuo, M; Ihara, K; Matsuo, T; Kohno, H; Hara, T

2009-02-01

160

Seborrheic Area Erythema as a Common Skin Manifestation in Japanese Patients with Dermatomyositis  

Microsoft Academic Search

Background: Although dermatomyositis (DM)-associated facial erythema was noted in the nasolabial folds of Japanese patients, DM-associated facial erythema other than heliotrope rash has drawn little attention in previous studies. Objectives: To characterize phenotypical features and frequencies of erythema, especially those in the seborrheic area of the head, in DM patients. Methods: A retrospective study on skin manifestations in 33 DM

N. Okiyama; H. Kohsaka; N. Ueda; T. Satoh; I. Katayama; K. Nishioka; H. Yokozeki

2008-01-01

161

Presenilin-2 mutation and polymorphism in Japanese Alzheimer disease patients  

Microsoft Academic Search

The Asn141Ile mutation of the presenilin 2 gene is responsible for familial early-onset Alzheimer disease found in Volga-German kindreds. However, the genetic influence of presenilin 2 gene on sporadic Alzheimer disease remains unknown. In this study, the frequency of the mutation and genetic association with the presenilin 2 locus were investigated in Japanese sporadic cases. The Asn141Ile mutation was not

Hitoshi Tanimukai; Ichiro Tsujio; Ryota Hashimoto; Takashi Kudo; Koujin Kamino; Koujn Kamino; Masatoshi Takeda

1999-01-01

162

Diabetes and its care--what do patients expect?  

PubMed Central

A sample of 77% of the non-insulin dependent diabetics aged 30-70 years from two urban practices offering no structured diabetic care were interviewed. The 55 patients (mean age 60 years) were asked about their experiences and expectations of diabetes and the health professionals involved in their care. Twenty-six patients attended the hospital diabetic clinic regularly but 13 patients received no review at all; 46 patients wanted their general practitioner to be involved in future care and only six wanted to continue with hospital review alone. Patients gave hospital doctors and general practitioners similar high ratings for knowledge of diabetes and its management but general practitioners and practice nurses were rated more highly for communication and accessibility. The aspect of care valued most was being given clear information about diabetic management. Twenty two patients thought that diabetes would have a significant impact on their future health and 35 rated regular diabetic review as extremely important in keeping themselves healthy. Most patients felt it likely that they would have a high blood glucose level most of the time and develop diabetic complications. Little difference was found between the views of clinic attenders and non-attenders, and there was no evidence that non-attenders had actively rejected review. These non-insulin dependent diabetics considered diabetes to be a serious disorder warranting regular care and expressed confidence in the primary care team's ability to provide such care.

Kinmonth, A L; Murphy, E; Marteau, T

1989-01-01

163

Impact of acarbose on carotid intima-media thickness in patients with newly diagnosed impaired glucose tolerance or mild type 2 diabetes mellitus: A one-year, prospective, randomized, open-label, parallel-group study in Japanese adults with established coronary artery disease  

Microsoft Academic Search

Objective: This study examined the effect of acarbose therapy on carotid intima-media thickness (IMT) in patients with established coronary artery disease (CAD) who had been newly diagnosed with impaired glucose tolerance (IGT) or mild type 2 diabetes mellitus (T2DM).Methods: This was a 1-year, prospective, randomized, open-label, parallel-group study in patients with established CAD (?50% stenosis on quantitative coronary angiography) who

Masayoshi Koyasu; Hideki Ishii; Masato Watarai; Kenji Takemoto; Yasuya Inden; Kyosuke Takeshita; Tetsuya Amano; Daiji Yoshikawa; Tatsuaki Matsubara; Toyoaki Murohara

2010-01-01

164

A Novel Case of Diabetic Muscle Necrosis in a Patient with Cystic Fibrosis-Related Diabetes  

PubMed Central

Cystic fibrosis is a recessive autosomal disease caused by mutations in the cystic fibrosis transmembrane conductance regulator gene. Cystic fibrosis-related diabetes (CFRD) is a common comorbidity of cystic fibrosis. Diabetic myonecrosis is a rare self-limited complication of poorly controlled diabetes mellitus that commonly presents with acute, intense pain and swelling of lower extremities and responds well to conservative management. We report the first case of diabetic myonecrosis in a patient with CFRD.

Chalasani, Sreelatha; Bettadahalli, Shankar S.; Bhupathi, Satya V.; Aswani, Vijay H.

2013-01-01

165

A novel case of diabetic muscle necrosis in a patient with cystic fibrosis-related diabetes.  

PubMed

Cystic fibrosis is a recessive autosomal disease caused by mutations in the cystic fibrosis transmembrane conductance regulator gene. Cystic fibrosis-related diabetes (CFRD) is a common comorbidity of cystic fibrosis. Diabetic myonecrosis is a rare self-limited complication of poorly controlled diabetes mellitus that commonly presents with acute, intense pain and swelling of lower extremities and responds well to conservative management. We report the first case of diabetic myonecrosis in a patient with CFRD. PMID:23656801

Chalasani, Sreelatha; Bettadahalli, Shankar S; Bhupathi, Satya V; Aswani, Vijay H

2013-05-08

166

[Role of percutaneous coronary intervention in diabetic patients].  

PubMed

Clinical outcomes after revascularization, both for surgery and percutaneous coronary intervention (PCI), is significantly worse in diabetic patients compared with non-diabetic patients. While in acute coronary syndrome, PCI is favored because of the increased risk of surgery performed during ongoing infarction, in stable patients assessment of clinical factors, such as coronary anatomy and comorbidities should guide decision of the revascularization modality (e.g., surgical, PCI, or conservative). Surgery should be favored in patients with multivessel coronary disease and acceptable surgical risk. Overall, the threshold for surgery compared to PCI should be lower in diabetic patients compared with non-diabetic ones. PMID:23789182

Gencer, B; Noble, S; Bonvini, R F; Mach, F; Roffi, M

2013-05-29

167

Therapeutic efficacy of ozone in patients with diabetic foot  

Microsoft Academic Search

Oxidative stress is suggested to have an important role in the development of complications in diabetes. Because ozone therapy can activate the antioxidant system, influencing the level of glycemia and some markers of endothelial cell damage, the aim of this study was to investigate the therapeutic efficacy of ozone in the treatment of patients with type 2 diabetes and diabetic

Gregorio Martínez-Sánchez; Saied M. Al-Dalain; Silvia Menéndez; Lamberto Re; Attilia Giuliani; Eduardo Candelario-Jalil; Hector Álvarez; José Ignacio Fernández-Montequín; Olga Sonia León

2005-01-01

168

HLA Antigens in Japanese Patients with Primary Biliary Cirrhosis and Autoimmune Hepatitis  

Microsoft Academic Search

22 Japanese patients with primary biliary cirrhosis and 12 patients with autoimmune hepatitis were studied for HLA antigens. In the patients with primary biliary cirrhosis, HLA-DR2 showed a statistically higher frequency compared to the controls (68 versus 30%, ?2 corr. = 7.660, p < 0.007, p corr. < 0.042, RR = 5.00). In the patients with autoimmune hepatitis, HLA-A10 showed

Hirotoshi Miyamori; Yasuhiro Kato; Kenichi Kobayashi; Nobu Hattori

1983-01-01

169

Diseases of the hip. A comparative study of Japanese Oriental and American white patients.  

PubMed

Pelvic radiographs of 200 consecutive Japanese Oriental patients who were admitted for hip surgery at the Hospital of Kobe University in Japan were compared with those of 199 consecutive American white patients who were admitted for the same purpose to a New England hospital over a similar four and a half-year period between 1972 and 1976. One hundred and fifty-three Japanese Oriental and 157 American white patients had either primary or secondary osteoarthritis. The remainder had other types of hip pathology, such as avascular necrosis, rheumatoid arthritis, and ankylosing spondylitis. The radiographs of five Japanese Oriental and seven American white patients showed evidence of previous Legg-Calvé-Perthes disease, coxa vara, or slipped capital femoral epiphysis. With only two exceptions, the osteoarthritis in the remainder of the Japanese Oriental patients was secondary, caused by antecedent congenital hip disease: twenty-eight had one or two congenitally dislocated hips, ninety-two had acetabular dysplasia, and twenty-six had superolateral osteoarthritis. In contrast, only nine of the American white patients clearly had a diagnosis of acetabular dysplasia, and twenty-six had superolateral osteoarthritis. Twenty-one American white men had a femoral head-tilt deformity. Among the Americans, the largest group (sixty-five patients) had superomedial osteoarthritis. Nine had non-rheumatoid protrusio acetabuli and twenty had axillary or concentric osteoarthritic involvement. The majority of American white patients, therefore, had a type of osteoarthritis that was not seen in the Japanese Oriental patients.(ABSTRACT TRUNCATED AT 250 WORDS) PMID:4077908

Hoaglund, F T; Shiba, R; Newberg, A H; Leung, K Y

1985-12-01

170

A missense mutation in the CD38 gene, a novel factor for insulin secretion: association with Type II diabetes mellitus in Japanese subjects and evidence of abnormal function when expressed in vitro  

Microsoft Academic Search

Summary   Cyclic adenosine 5?diphosphate-ribose (cADPR) is thought to have a second messenger role in insulin secretion through mobilisation\\u000a of Ca2 +. As human lymphocyte antigen CD38 has both ADP-ribosyl cyclase and cADPR hydrolase activity, it may be important in glucose-induced\\u000a insulin secretion in islets. Thirty one randomly selected Japanese patients with Type II diabetes mellitus who had first-degree\\u000a and\\/or second-degree

K. Yagui; F. Shimada; M. Mimura; N. Hashimoto; Y. Suzuki; Y. Tokuyama; K. Nata; A. Tohgo; F. Ikehata; S. Takasawa; H. Okamoto; H. Makino; Y. Saito; A. Kanatsuka

1998-01-01

171

Diabetes does not affect outcome in patients with Enterobacteriaceae bacteremia  

PubMed Central

Background There is limited information about the effect of diabetes on the prognosis of patients with bacterial infections. We performed a retrospective cohort study to investigate possible correlations between diabetes and prognosis in patients with Enterobacteriaceae bacteremia. Methods We reviewed the medical charts of 1112 patients who were treated at a community teaching hospital for Enterobacteriaceae bacteremia from January 1997 through June 2007. Factors associated with in-hospital mortality were analyzed by logistic regression analysis. Results Among the 1112 patients with Enterobacteriaceae bacteremia, 181 (16.3%) were diabetic patients; 90 patients (8.1%) died while in the hospital. Compared to non-diabetic patients, diabetic patients were older (75.4 ± 11.9 years vs. 70 ± 16.6 years, p < 0.001) and had more comorbidities. However, mortality among diabetic and non-diabetic patients was not different [7.2% vs. 8.2%, RR 1.13; 95% CI (0.67–1.9); p = 0.39]. In a multivariate analysis, the variables associated with in-hospital mortality were age, the origin of the bacteremia, and the presence of immunosuppression. Diabetes was not associated with outcome. Conclusion In this cohort of patients with Enterobacteriaceae bacteremia, diabetes was not associated with a poorer prognosis.

2009-01-01

172

What the radiologist needs to know about the diabetic patient  

Microsoft Academic Search

Diabetes mellitus (DM) is recognised as a major health problem. Ninety-nine percent of diabetics suffer from type 2 DM and\\u000a 10% from type 1 and other types of DM. The number of diabetic patients worldwide is expected to reach 380 millions over the\\u000a next 15 years. The duration of diabetes is an important factor in the pathogenesis of complications, but other

Athanasios E. Raptis; Konstantinos P. Markakis; Maria C. Mazioti; Sotirios A. Raptis; George D. Dimitriadis

2011-01-01

173

Prognostic value of dobutamine stress echocardiography in patients with diabetes  

Microsoft Academic Search

OBJECTIVE: The aim of this study was to assess the incremental value of\\u000a dobutamine stress echocardiography (DSE) for the risk stratification of\\u000a diabetic patients who are unable to perform an adequate exercise stress\\u000a test. Exercise capacity is frequently impaired in patients with diabetes.\\u000a The role of pharmacologic stress echocardiography in the risk\\u000a stratification of diabetic patients has not been well

FABIOLA B. SOZZI; ABDOU ELHENDY; A. F. Schinkel; E. C. Vourvouri; J. J. Bax; Sutter de J; A. Borghetti; D. Poldermans; J. R. T. C. Roelandt; Domburg van R. T

2003-01-01

174

Shoulder capsulitis in type I and II diabetic patients: association with diabetic complications and related diseases.  

PubMed Central

OBJECTIVE: To examine the association between shoulder capsulitis and chronic diabetic complications and diseases closely related to diabetes. METHODS: A cross sectional study in 291 type I [mean (SD) age 33.2 (9.9) years] and 134 type II [61.1 (12.4) years] diabetic patients. The presence of shoulder capsulitis, Dupuytren disease, and limited joint mobility was sought. The patients were assessed for background and proliferative retinopathy, nephropathy, autonomic neuropathy, and peripheral symmetrical somatic polyneuropathy. Diseases closely related to diabetes (hypertension, history of myocardial infarction, coronary heart disease, and peripheral vascular disease) were also recorded. RESULTS: Prevalence of shoulder capsulitis was 10.3% in type I and 22.4% in type II diabetic subjects. Shoulder capsulitis was associated with the age in types I (P < 0.01) and II (P < 0.05) diabetic patients, and with the duration of diabetes in type I patients (P < 0.01). Odds ratios for autonomic neuropathy in type I and type II diabetic subjects with shoulder capsulitis were 4.1 (95% confidence interval, 1.6 to 10.9) and 2.7 (95% CI, 1.1 to 7.0), respectively, after controlling for age and duration of diabetes. Odds ratio for history of myocardial infarction in type I diabetic subjects with shoulder capsulitis was 13.7 (95% CI, 1.3 to 139.5) after controlling for age, duration of diabetes, hypertension, and smoking habits. Other associations between shoulder capsulitis and diabetic complications, related diseases, and other hand abnormalities were fully explained by age and the duration of diabetes. CONCLUSIONS: Shoulder capsulitis is common in type I and type II diabetic patients. It is associated with age in type I and II diabetic patients and with the duration of diabetes in type I patients. It is associated with autonomic neuropathy in type I and II diabetic patients and with history of myocardial infarction in type I diabetic patients, independently of time related variables.

Arkkila, P E; Kantola, I M; Viikari, J S; Ronnemaa, T

1996-01-01

175

Body Fat Distribution and the Risk of Hypertension and Diabetes among Japanese Men and Women  

Microsoft Academic Search

To identify anthropometrical indices of body fat distribution for predicting the risk of hypertension and diabetes, a population-based prospective study was designed. Subjects in two communities (n=2,422 and 3,195), who were free of hypertension and diabetes, respectively, were followed-up. The area and gender-specific risk of hypertension and diabetes were compared among tertiles of body mass index (BMI) and body fat

Choy-Lye Chei; Hiroyasu Iso; Kazumasa Yamagishi; Takeshi Tanigawa; Renzhe Cui; Hironori Imano; Masahiko Kiyama; Akihiko Kitamura; Shinichi Sato; Takashi Shimamoto

2008-01-01

176

Patient Understanding of Diabetes Self-Management: Participatory Decision-Making in Diabetes Care  

PubMed Central

Objective: Our aim was to determine whether patient participation in decision-making about diabetes care is associated with understanding of diabetes self-management and subsequent self-care practices. We also identified issues that would impact messaging for use in mobile diabetes communication. Research Design and Methods: A cross-sectional observational study was conducted with type 2 diabetes patients (n = 81) receiving their care at the University of Maryland Joslin Diabetes Center. A convenience sample of patients were eligible to participate if they were aged 25–85 years, had type 2 diabetes, spoke English, and visited their physician diabetes manager within the past 6 months. In-person patient interviews were conducted at the time of clinic visits to assess patient understanding of diabetes management, self-care practices, and perceptions of participation in decision-making about diabetes care. Results: African Americans reported fewer opportunities to participate in decision-making than Caucasians, after controlling for education [mean difference (MD) = -2.4, p = .02]. This association became insignificant after controlling for patient–physician race concordance (MD = -1.5, p = .21). Patient understanding of self-care was predicted by having greater than high school education (MD = 3.6, p = .001) and having physicians who involved them in decision-making about their care. For each unit increase in understanding of diabetes self-care, the mean patient self-care practice score increased by 0.16 (p = .003), after adjustment for patient race and education. Conclusions: Patient participation in decision-making is associated with better understanding of care. Participation in decision-making plays a key role in patient understanding of diabetes self-management and subsequent self-care practices. Patients with limited education need specific instruction in foot care, food choices, and monitoring hemoglobin A1c.

Quinn, Charlene C; Royak-Schaler, Renee; Lender, Dan; Steinle, Nanette; Gadalla, Shahinaz; Zhan, Min

2011-01-01

177

Patient understanding of diabetes self-management: participatory decision-making in diabetes care.  

PubMed

Objective: Our aim was to determine whether patient participation in decision-making about diabetes care is associated with understanding of diabetes self-management and subsequent self-care practices. We also identified issues that would impact messaging for use in mobile diabetes communication. Research Design and Methods: A cross-sectional observational study was conducted with type 2 diabetes patients (n = 81) receiving their care at the University of Maryland Joslin Diabetes Center. A convenience sample of patients were eligible to participate if they were aged 25-85 years, had type 2 diabetes, spoke English, and visited their physician diabetes manager within the past 6 months. In-person patient interviews were conducted at the time of clinic visits to assess patient understanding of diabetes management, self-care practices, and perceptions of participation in decision-making about diabetes care. Results: African Americans reported fewer opportunities to participate in decision-making than Caucasians, after controlling for education [mean difference (MD) = -2.4, p = .02]. This association became insignificant after controlling for patient-physician race concordance (MD = -1.5, p = .21). Patient understanding of self-care was predicted by having greater than high school education (MD = 3.6, p = .001) and having physicians who involved them in decision-making about their care. For each unit increase in understanding of diabetes self-care, the mean patient self-care practice score increased by 0.16 (p = .003), after adjustment for patient race and education. Conclusions: Patient participation in decision-making is associated with better understanding of care. Participation in decision-making plays a key role in patient understanding of diabetes self-management and subsequent self-care practices. Patients with limited education need specific instruction in foot care, food choices, and monitoring hemoglobin A1c. PMID:21722588

Quinn, Charlene C; Royak-Schaler, Renee; Lender, Dan; Steinle, Nanette; Gadalla, Shahinaz; Zhan, Min

2011-05-01

178

O(6)-methylguanine DNA methyltransferase activity in diabetic patients.  

PubMed

In the present study, we evaluated O(6)-methylguanine-DNA methyltransferase (MGMT) activity in diabetic patients. The study was performed on 27 patients with Type 1 diabetes, and 42 with Type 2 diabetes. Patients with complications were excluded from the study. 36 non-diabetic volunteers, non-smokers who do not consume alcoholic beverage, were chosen from the medical staff as control subjects. MGMT activity was measured by the transfer of radiolabeled methyl groups from a prepared methylguanine-DNA substrate to the enzyme fraction of leukocyte extract. Leukocyte MGMT activity was significantly reduced in both Type 1 and Type 2 diabetes patients as compared with control subjects (P<0.001). The present study demonstrates decreased MGMT activity in leukocytes from patients with Type 1 and Type 2 diabetes. PMID:12849917

Akçay, Tülay; Dinçer, Yildiz; Celebi, Nilgün; Ilkova, Hasan

2003-07-01

179

Prognosis of Japanese Metastatic Renal Cell Carcinoma Patients in the Cytokine Era: A Cooperative Group Report of 1463 Patients  

Microsoft Academic Search

BackgroundIncidence rate of renal cell carcinoma (RCC) differs among countries. The rates of Asian countries are lower than those of countries in North America or Europe but are exceptionally high in Japanese males. Approximately 30% of patients with RCC have metastasis at initial diagnosis, and another 30% have metastasis after nephrectomy. Clinical studies of risk factors in patients with metastatic

Sei Naito; Naoki Yamamoto; Tatsuya Takayama; Masatoshi Muramoto; Nobuo Shinohara; Kenryu Nishiyama; Atsushi Takahashi; Ryo Maruyama; Takashi Saika; Senji Hoshi; Kazuhiro Nagao; Shingo Yamamoto; Issei Sugimura; Hirotsugu Uemura; Shigehiko Koga; Masayuki Takahashi; Fumio Ito; Seiichiro Ozono; Toshiro Terachi; Seiji Naito; Yoshihiko Tomita

2010-01-01

180

Nosocomial myiasis in a patient with diabetes.  

PubMed

This report describes a case of nosocomial myiasis caused by larvae of Sarcophaga (Bercaea) africa. The parasitosis developed in an ulcer on the heel of a patient with type 2 diabetes. The ulcer was dressed when the deposition occurred. An experiment was performed in order to demonstrate the ability of Sarcophaga larvae to move through bandages and reach purulent wounds. This report highlights the need for particular attention, education and specific protocols in hospitals in order to avoid myiasis, which can compromise the organization's reputation for hygienic standards with possible legal consequences. PMID:23149058

Dutto, M; Pellegrino, M; Vanin, S

2012-11-11

181

Population-Based Study of Nonproliferative Diabetic Retinopathy Among Type 2 Diabetic Patients in Kinmen, Taiwan  

Microsoft Academic Search

Purpose  This study was conducted to assess the prevalence and associated factors of nonproliferative diabetic retinopathy among type\\u000a 2 diabetic patients in Kinmen, Taiwan.\\u000a \\u000a \\u000a \\u000a Methods  From 1991 to 1993, 971 type 2 diabetic patients in Kinmen underwent diabetic retinopathy screening performed by a panel of\\u000a ophthalmologists using indirect ophthalmoscopy and 45 color fundus retinal photographs.\\u000a \\u000a \\u000a \\u000a Results  Of the 971 patients screened in 1991–1993,

Tao-Hsin Tung; Jorn-Hon Liu; Fenq-Lih Lee; Shih-Jen Chen; An-Fei Li; Pesus Chou

2006-01-01

182

Diabetic retinopathy in type 1 diabetes—a contemporary analysis of 8,784 patients  

Microsoft Academic Search

Aims\\/hypothesis  The aim of this study was to analyse the risk profile for diabetic retinopathy under real-life conditions in a large cohort\\u000a of patients with type 1 diabetes.\\u000a \\u000a \\u000a \\u000a \\u000a Methods  Patients (n?=?18,891) with childhood, adolescent or adult onset of type 1 diabetes from the prospective German Diabetes Documentation\\u000a System survey were analysed. A total of 8,784 patients fulfilled the inclusion criterion, which was

H. P. Hammes; W. Kerner; S. Hofer; O. Kordonouri; K. Raile; R. W. Holl

2011-01-01

183

General practice based diabetes surveillance: the views of patients.  

PubMed Central

Forty three patients with non-insulin dependent diabetes registered at two suburban practices were interviewed at least one year after the introduction of an organized general practice based system of diabetic surveillance and the results compared with data gathered from interviews administered before the introduction of the system. Structured data from the two interviews were compared in relation to the importance which patients attached to diabetes and its medical review, patients' preference for place of future review and the health professionals from whom they wished to receive diabetes care. Patients' ratings of the performance of health professionals on various aspects of care were compared with the ratings given before the introduction of the new service. At the follow-up interviews the reasons behind patients' responses to the structured questions were explored using a qualitative method. The introduction of a general practice based diabetes service was marked by an improvement in attendance for diabetes monitoring (56% before introduction, 98% in the year following introduction). This was associated with an increase in the importance which patients attached to diabetes and its medical review. After experience of diabetes care in general practice, patients remained enthusiastic about general practice involvement and confident in their general practitioners' knowledge about diabetes management. In spite of an improvement in the patients' ratings of hospital doctors' communication skills, they continued to rate general practitioners significantly more highly in these skills (P < 0.01) and in terms of convenience and accessibility (P < 0.001).(ABSTRACT TRUNCATED AT 250 WORDS)

Murphy, E; Kinmonth, A L; Marteau, T

1992-01-01

184

Screening for diabetic retinopathy and nephropathy in patients with diabetes: a nationwide survey in Korea.  

PubMed

This study was performed to identify factors associated with screening for diabetic retinopathy and nephropathy. Data from the Korean National Health and Nutrition Examination Survey between 2007 and 2009 were analyzed. Of 24,871 participants, 1,288 patients diagnosed with diabetes at ?30 years of age were included. 36.3% received screening for diabetic retinopathy, and 40.5% received screening for diabetic nephropathy during the previous year. Patients living in rural areas, those with less education, those who had not received education about diabetes care, and those who did not receive medical care for diabetes were screened less often for retinopathy or nephropathy. Patients with poorer self-reported health status were screened more often. Occupation, smoking status, and diabetes duration were associated with retinopathy screening. Lower family income was associated with decreased nephropathy screening. Receiving education about diabetes care and receiving medical care for diabetes were significant factors in patients with a shorter duration of diabetes (the significant odds ratio [OR] of not receiving education varied between 0.27 and 0.51, and that of not receiving medical care varied between 0.34 and 0.42). Sociodemographic factors and health-related factors as well as education and medical care influenced screening for diabetic complications among those with a longer duration of diabetes (for retinopathy and nephropathy, the significant OR of living in a rural area varied between 0.56 and 0.61; for retinopathy, the significant OR of current smokers was 0.55, and the p-trend of subjective health status was <0.001; for nephropathy, the significant OR of a monthly household income of <3000 dollars was 0.61 and the p-trends of education and subjective health status were 0.030 and 0.007, respectively). Efforts to decrease sociodemographic disparities should be combined with education about diabetes care to increase the screening, especially for those with a longer duration of diabetes. PMID:23667557

Byun, Sang-Ho; Ma, Seung Hyun; Jun, Jae Kwan; Jung, Kyu-Won; Park, Boyoung

2013-05-08

185

Sleep Dysfunction in Japanese Patients with Gastroesophageal Reflux Disease: Prevalence, Risk Factors, and Efficacy of Rabeprazole  

Microsoft Academic Search

Background and Aim: Several studies performed in Western countries demonstrate the association between sleep dysfunction and gastroesophageal reflux disease (GERD), especially when nighttime heartburn is present. The purpose of this study was to examine the prevalence and risk factors of sleep dysfunction, and the effect of rabeprazole on reflux symptoms and sleep dysfunction in Japanese GERD patients. Methods: A total

Yasuhiro Fujiwara; Yukie Kohata; Makiko Kaji; Hiroko Nebiki; Tomoaki Yamasaki; Eiji Sasaki; Tsuyoshi Hayakawa; Hirohisa Machida; Tetsuya Tanigawa; Kenji Watanabe; Toshio Watanabe; Kazunari Tominaga; Tetsuo Arakawa

2010-01-01

186

Lack of common NOD2 variants in Japanese patients with Crohn's disease  

Microsoft Academic Search

Background & Aims: Previous studies have linked Crohn's disease (CD) to the pericentromeric region of chromosome 16 (IBD1). Three independent studies of Western populations have recently shown that 3 variants of NOD2, a gene located at 16q12, are associated with susceptibility to CD. Here, we have evaluated the 3 NOD2 variants in Japanese patients to determine whether the gene is

Nagamu Inoue; Kazuo Tamura; Yoshitaka Kinouchi; Yoshihiro Fukuda; Seiichi Takahashi; Yasunori Ogura; Naohiro Inohara; Gabriel Núñez; Yusuke Kishi; Yuji Koike; Tooru Shimosegawa; Takashi Shimoyama; Toshifumi Hibi

2002-01-01

187

The serum vaspin levels are reduced in Japanese chronic hemodialysis patients  

PubMed Central

Background Visceral adipose tissue-derived serine proteinase inhibitor (vaspin) is an adipokine identified in genetically obese rats that correlates with insulin resistance and obesity in humans. Recently, we found that 7% of the Japanese population with the minor allele sequence (A) of rs77060950 exhibit higher levels of serum vaspin. We therefore evaluated the serum vaspin levels in Japanese chronic hemodialysis patients. Methods Healthy Japanese control volunteers (control; n?=?95, 49.9±6.91?years) and Japanese patients undergoing hemodialysis therapy (HD; n?=?138, 51.4±10.5?years) were enrolled in this study, and serum samples were subjected to the human vaspin RIA system. Results The measurement of the serum vaspin levels demonstrated that a fraction of control subjects (n?=?5) and HD patients (n?=?11) exhibited much higher levels (> 10?ng/ml; VaspinHigh group), while the rest of the population exhibited lower levels (< 3?ng/ml; VaspinLow group). By comparing the patients in the VaspinLow group, the serum vaspin levels were found to be significantly higher in the control subjects (0.87±0.24?ng/ml) than in the HD patients (0.32±0.15?ng/ml) (p?Japanese HD patients in the VaspinLow group.

2012-01-01

188

Diabetes Screening, Diagnosis, and Therapy in Pediatric Patients With Type 2 Diabetes  

PubMed Central

Abstract and Introduction Abstract The dramatic rise in the incidence and prevalence of type 2 diabetes mellitus in the pediatric and adolescent populations has been associated with the ongoing epidemic of overweight, obesity, insulin resistance, and metabolic syndrome seen in these age groups. Although the majority of pediatric patients diagnosed with diabetes are still classified as having type 1 diabetes, almost 50% of patients with diabetes in the pediatric age range (under 18 years) may have type 2 diabetes. Screening of high-risk patients for diabetes and prediabetes is important. Prompt diagnosis and accurate diabetes classification facilitate appropriate and timely treatment and may reduce the risk for complications. This is especially important in children because lifestyle interventions may be successful and the lifelong risk for complications is greatest. Treatment usually begins with dietary modification, weight loss, and a structured program of physical exercise. Oral antidiabetic agents are added when lifestyle intervention alone fails to maintain glycemic control. Given the natural history of type 2 diabetes, most if not all patients will eventually require insulin therapy. In those requiring insulin, improved glycemic control and reduced frequency of hypoglycemia can be achieved with insulin analogs. It is common to add insulin therapy to existing oral therapy only when oral agents no longer provide adequate glycemic control. Introduction The incidence of type 2 diabetes in children and adolescents has reached epidemic proportions in the United States.[1] Recent reports indicate that as many as 45% of pediatric patients diagnosed with diabetes in the United States have type 2 diabetes.[1] Furthermore, the prevalence of type 2 diabetes may be underestimated due to misclassification of the disease.[2] Prior to the late 1990s, only 1% to 2% of children diagnosed with diabetes mellitus in the United States had type 2 diabetes. Since then, owing to a combination of greater awareness, increased screening, and higher incidence, the prevalence of type 2 diabetes among US children has not only increased, but is expected to continue to grow and to exceed that of type 1 diabetes.[3] If this increase in the incidence and prevalence of type 2 diabetes is not reversed, our society will face devastating consequences in terms of the health of future generations and the increasing burden on the healthcare system.[1] To address these issues, we need to understand why this epidemic is occurring and to reassess our current approaches to the medical management of this disease in children.[4] In the present article, we review the risk factors for diabetes and explore the current and emerging strategies for screening, diagnosis, and management of type 2 diabetes in the pediatric and adolescent populations.

Rodbard, Helena W.

2008-01-01

189

Platelet Isoprostane Overproduction in Diabetic Patients Treated With Aspirin  

PubMed Central

Aspirin modestly influences cardiovascular events in patients with type 2 diabetes mellitus (T2DM), but the reason is unclear. The aim of the study was to determine whether in T2DM patients aspirin enhances platelet isoprostanes, which are eicosanoids with proaggregating properties derived from arachidonic acid oxidation by platelet NOX2, the catalytic subunit of reduced NAD phosphate oxidase. A cross-sectional study was performed comparing T2DM patients, treated (n = 50) or not treated (n = 50) with 100 mg/day aspirin, with 100 nondiabetic patients, matched for age, sex, atherosclerosis risk factors, and aspirin treatment. A short-term (7 days) treatment with 100 mg/day aspirin also was performed in 36 aspirin-free diabetic and nondiabetic patients. Higher platelet recruitment, platelet isoprostane, and NOX2 activation was found in diabetic versus nondiabetic patients and in aspirin-treated diabetic patients versus nontreated patients (P < 0.001). Platelet thromboxane (Tx) A2 (P < 0.001) was inhibited in all aspirin-treated patients. In the interventional study, aspirin similarly inhibited platelet TxA2 in diabetic and nondiabetic patients (P < 0.001). Platelet recruitment, isoprostane levels, and NOX2 activation showed a parallel increase in diabetic patients (P < 0.001) and no changes in nondiabetic patients. These findings suggest that in aspirin-treated diabetic patients, oxidative stress–mediated platelet isoprostane overproduction is associated with enhanced platelet recruitment, an effect that mitigates aspirin-mediated TxA2 inhibition.

Cangemi, Roberto; Pignatelli, Pasquale; Carnevale, Roberto; Nigro, Carmen; Proietti, Marco; Angelico, Francesco; Lauro, Davide; Basili, Stefania; Violi, Francesco

2012-01-01

190

Bone mineral density in Japanese prostate cancer patients under androgen-deprivation therapy.  

PubMed

Androgen-deprivation therapy (ADT) of patients with prostate cancer (PCa) is known to reduce bone mineral density (BMD). However, the most studies examined Caucasian or black patients and the effects of ADT on the bone metabolism of East Asians are unclear. Therefore, we performed a cross-sectional study to elucidate the influence of ADT on bone metabolism in Japanese patients. In total, 101 native Japanese patients with PCa were enrolled. They consisted of 58 ADT-treated and 43 hormone-naive patients. The BMD in the lumbar spine, total hip, and femoral neck was measured by dual energy X-ray absorptiometry and expressed in s.d. units relative to young adult men (T-score) or age-matched men (Z-score). Serum levels of bone metabolism markers were also measured. The BMDs at the three sites revealed that 2.3% (1/43) and 8.6% (5/58) of the hormone-naive and ADT-treated PCa patients had osteoporosis respectively, but this difference failed to achieve statistical significance (P=0.294). The two groups also did not differ significantly in their Z-scores of the three sites, and univariate and multivariate analyses indicated that ADT was not a significant risk factor for decreased BMD. In addition, a significant correlation between the duration of ADT and BMD was not observed for all three sites measured. However, the ADT-treated patients had significantly higher serum levels of N-terminal telopeptide of type I collagen (NTx) than the hormone-naive patients (P=0.017). To our knowledge, this is the first study to demonstrate the low prevalence of osteoporosis in both ADT-treated and hormone-naive Japanese PCa patients. Moreover, ADT did not significantly increase the prevalence of osteoporosis in this Japanese population. PMID:18667685

Wang, Wei; Yuasa, Takeshi; Tsuchiya, Norihiko; Maita, Shinya; Kumazawa, Teruaki; Inoue, Takamitsu; Saito, Mitsuru; Ma, Zhiyong; Obara, Takashi; Tsuruta, Hiroshi; Satoh, Shigeru; Habuchi, Tomonori

2008-07-30

191

Eye movement during facial affect recognition by patients with schizophrenia, using Japanese pictures of facial affect.  

PubMed

A possible relationship between recognition of facial affect and aberrant eye movement was examined in patients with schizophrenia. A Japanese version of standard pictures of facial affect was prepared. These pictures of basic emotions (surprise, anger, happiness, disgust, fear, sadness) were shown to 19 schizophrenic patients and 20 healthy controls who identified emotions while their eye movements were measured. The proportion of correct identifications of 'disgust' was significantly lower for schizophrenic patients, their eye fixation time was significantly longer for all pictures of facial affect, and their eye movement speed was slower for some facial affects (surprise, fear, and sadness). One index, eye fixation time for "happiness," showed a significant difference between the high- and low-dosage antipsychotic drug groups. Some expected facial affect recognition disorder was seen in schizophrenic patients responding to the Japanese version of affect pictures, but there was no correlation between facial affect recognition disorder and aberrant eye movement. PMID:22185055

Shiraishi, Yuko; Ando, Kazuhiro; Toyama, Sayaka; Norikane, Kazuya; Kurayama, Shigeki; Abe, Hiroshi; Ishida, Yasushi

2011-10-01

192

Identification of patients at risk for diabetic foot  

Microsoft Academic Search

The aim of the study was the comparison of a simple standardized noninvasive examination of neuropathy and angiopathy with routine diagnostic practice in community diabetes clinics for the identification of patients at risk of foot ulceration. Consecutive patients (n=322), aged 30 years and more, with a diabetes duration of more than 5 years, were examined by trained podiatric nurses in

Alexandra Jirkovská; Petr Bou?ek; Veronika Wosková; Vladim??r Bartoš; Jelena Skibová

2001-01-01

193

Prognostic value of exercise echocardiography in diabetic patients  

Microsoft Academic Search

BACKGROUND: Coronary artery disease (CAD) is the leading cause of death in diabetic patients. Although exercise echocardiography (EE) is established as a useful method for diagnosis and stratification of risk for CAD in the general population, there are few studies on its value as a prognostic tool in diabetic patients. The purpose of this investigation was to evaluate the value

Joselina LM Oliveira; José AS Barreto-Filho; Carla RP Oliveira; Thaiana A Santana; Fernando D Anjos-Andrade; Érica O Alves; Adão C Nascimento-Junior; Thiago JS Góes; Nathalie O Santana; Francis L Vasconcelos; Martha A Barreto; Argemiro D'Oliveira Junior; Roberto Salvatori; Manuel H Aguiar-Oliveira; Antônio CS Sousa

2009-01-01

194

Stress echocardiography for risk assessment of diabetic patients  

PubMed Central

Coronary artery disease in patients suffering from diabetes mellitus will become an increasing problem in the future. Because diabetic patients benefit from treatment of symptomatic but also asymptomatic coronary artery disease, early diagnosis is warranted. The diagnostic techniques used to detect ischaemia, with a focus on stress echocardiography, are described. ImagesFigure 1

Baur, L.H.B.; Graal, M.

2004-01-01

195

Mutational analysis of the RET proto-oncogene in 71 Japanese patients with medullary thyroid carcinoma  

Microsoft Academic Search

Multiple endocrine neoplasia types 2A and 2B (MEN2A and MEN2B) and familial medullary thyroid carcinomas (FMTC) are caused\\u000a by germline mutations in the RET proto-oncogene. To investigate the spectrum of RET mutations among Japanese patients, we screened the RET gene in 71 patients with thyroid carcinomas. The panel included representatives of 44 families carrying FMTC or MEN2, 22\\u000a sporadic medullary

Syuya Shirahama; Kenji Ogura; Hiroshi Takami; Kunihiko Ito; Tohichi Tohsen; Akira Miyauchi; Yusuke Nakamura

1998-01-01

196

Analysis of helicase gene mutations in Japanese Werner’s syndrome patients  

Microsoft Academic Search

The profile of helicase gene mutations was studied in 89 Japanese Werner’s syndrome (WRN) patients by examining the previously\\u000a described mutations 1– 4 as well as a new mutation found during this study, designated mutation 5. Of 178 chromosomes (89\\u000a patients), 89 chromosomes (50%) had mutation 4, 11 (6.2%) chromosomes had mutation 1, and two chromosomes (1.1%) contained\\u000a mutation 5.

Makaoto Goto; Osamu Imamura; Junro Kuromitsu; Takehisa Matsumoto; Yukako Yamabe; Yoshiki Tokutake; Noriyuki Suzuki; Brian Mason; Dennis Drayna; Minoru Sugawara; Masanobu Sugimoto; Yasuhiro Furuichi

1997-01-01

197

Association of advanced hypodontia and craniofacial morphology in Japanese orthodontic patients  

Microsoft Academic Search

The purpose of this study was to examine the effects of advanced hypodontia on craniofacial morphology in Japanese patients. We defined advanced hypodontia as a congenital absence of four or more permanent teeth, excluding the third molars. Lateral cephalometric radiographs of 20 female orthodontic patients (age range, 8.5 to 19 years; mean age, 13.9 years) were examined. Twenty-eight angular and

Toshiya Endo; Sugako Yoshino; Rieko Ozoe; Koji Kojima; Shohachi Shimooka

2004-01-01

198

Gene deletions in Japanese patients with Duchenne and Becker muscular dystrophy  

Microsoft Academic Search

Summary Thirty-eight unrelated Japanese patients with Duchenne and Becker muscular dystrophy (DMD and BMD) have been investigated with the DMD cDNA probes. The 14-kb DMD cDNA was subdivided into 6 subclones andHindIII-digested DNAs were analyzed by Southern blotting. Out of 38 unrelated patients, 14 showed a deletion of one or several of the exon-containingHindIII fragments (36.8%). These corresponded to 50%

Jun-ichi Asano; Shunji Tomatsu; Kazuko Sukegawa; Seiji Yamaguchi; Yuko Ikedo; Ryoji Minami; Mitsuo Iida; Masaaki Nishimura; Masanori Nakagawa; Morio Ohshiro; Tadao Orii

1990-01-01

199

Typical fibrolamellar hepatocellular carcinoma in Japanese patients: Report of two cases  

Microsoft Academic Search

We report herein the cases of two Japanese patients with typical fibrolamellar hepatocellular carcinoma treated at our institute. The first patient was a 19-year-old man with no hepatitis B or C viral infection and a normal, noncirrhotic liver in the nontumorous area. The second was a 36-year-old woman with no viral infection and a noncirrhotic liver in the nontumorous area.

Junji Tanaka; Nobuo Baba; Shigeki Arii; Ken-Ichi Fujita; Jun Tamura; Yoshiyuki Kawakami; Shoichiro Tsuji; Masayuki Imamura; Hirohiko Yamabe; Satoshi Nakai; Takayoshi Tobe

1994-01-01

200

Obesity in hospitalized type 2 diabetes patients: A descriptive study  

PubMed Central

Background The association between obesity and type 2 diabetes has been well documented in epidemiological studies. Patients with type 2 diabetes have a higher body weight than control populations. Relatively few studies, however, have examined the prevalence of obesity in a cohort of hospitalized type 2 diabetes mellitus patients using an electronic health records database. This study measured the prevalence of obesity in hospitalized type 2 diabetes patients and described demographic and clinical characteristics using electronic health records from Convergence CT sites located in the southwestern United States. Material/Methods Hospitalized patients with type 2 diabetes mellitus were identified in electronic health records from the Convergence Global Research Network. Demographic and clinical characteristics were examined for hospitalized patients with type 2 diabetes. Comparisons were made between males and females across different clinical characteristics as well as between obese patients (BMI ?30 kg/m2) and patients with BMI <30 kg/m2. Results Approximately 26.8% of hospitalized type 2 diabetes patients were overweight (BMI=25–29.9 kg/m2) and 57.7% were obese (BMI ?30 kg/m2). A higher percentage of females (61.3%) were obese compared to males (54.6%) (p=0.002). Obese patients with type 2 diabetes were younger, appeared to have inadequate glycemic control, exhibited higher blood pressure, and had worse lipid profiles compared to type 2 diabetes patients with BMI <30 kg/m2. Conclusions Approximately 84.5% of the hospitalized type 2 diabetes patients identified in this study were overweight or obese (BMI ?25 kg/m2), suggesting the need for effective weight loss intervention in this population.

Blumentals, William A.; Hwu, Peter; Kobayashi, Norihiro; Ogura, Eriko

2013-01-01

201

Fibrocalculous pancreatic diabetes in a young Ugandan patient, a rare form of secondary diabetes  

PubMed Central

Background Fibrocalculous pancreatic diabetes is an infrequent type of secondary diabetes due to chronic tropical non alcoholic calcific pancreatitis. It has been widely described exclusively in developing tropical countries. A diagnosis is made basing on the presence of abdominal pain, presence of pancreatic calcifications, steatorrhoea, and diabetes mellitus. Case presentation We report a case of a 20 year old Ugandan female patient who presented with features of chronic tropical calcific pancreatitis complicated by diabetes mellitus, oedematous malnutrition and micronutrient deficiencies. Conclusion This case report demonstrates that fibrocalculous pancreatic diabetes still exists in developing countries like Uganda. Clinicians in such settings should possess a high clinical suspicion of fibrocalculous pancreatic diabetes especially in presence of malnutrition. Challenges of management of such patients in resource limited settings are comprehensively discussed in the review of literature.

2012-01-01

202

Medical management of the diabetic patient with coronary artery disease.  

PubMed

The prevalence of type 2 diabetes is rising at an alarming rate worldwide. Coronary artery disease (CAD) is the leading cause of morbidity and mortality in the diabetic population. Future CAD risk should be routinely assessed in patients with diabetes as specific subgroups might benefit from information derived from cardiac stress testing and other diagnostic procedures. Risk factor control is of paramount importance in all cases and it usually requires sustained lifestyle modifications, coupled with pharmacological interventions. Statins and angiotensin-converting enzyme (ACE) inhibitors are the first-line agents for the treatment of dyslipidaemia and hypertension, respectively. Microvascular, but not macrovascular, complications of diabetes are effectively prevented by good glycaemic control. Metformin is considered the first-choice agent in overweight diabetic subjects, while the role of thiazolidinediones is currently the focus of medical research. The diagnosis of acute coronary events in patients with diabetes is often challenging because of the high prevalence of silent ischaemia in these subjects. All acute cardiac events need to be promptly treated and myocardial reperfusion attempted without delay. Maintaining glucose levels as close to normal as possible, during and shortly after an acute event, improves prognosis in patients with diabetes. Risk factor control remains the cornerstone of secondary prevention; beta-blockers, ACE-inhibitors and antiplatelet agents confer additional symptomatic and survival benefit. Similar therapeutic principles also apply to patients with type 1 diabetes. This article addresses the complex problem of managing patients with diabetes and coronary artery disease. PMID:18991670

Karastergiou, Kalypso; Kaski, Juan Carlos

2008-01-01

203

R278TER and P431L mutations of the tyrosinase gene exist in Japanese patients with tyrosinase-negative oculocutaneous albinism  

Microsoft Academic Search

We examined the tyrosinase gene of two Japanese patients with tyrosinase-negative oculocutaneous albinism by allele-specific amplification analysis on two known point mutations in Japanese, and the results indicated that they were compound heterozygouts, namely, one allele of the tyrosinase gene harbored one of two known mutations and another allele probably had a mutation unknown in Japanese patients. Therefore, we have

Jun Matsunaga; Miwako Dakeishi; Hiroshi Shimizu; Yasushi Tomita

1996-01-01

204

Disordered eating behaviors in type 1 diabetic patients  

PubMed Central

Patients with type 1 diabetes mellitus are at high risk for disordered eating behaviors (DEB). Due to the fact that type 1 diabetes mellitus is one of the most common chronic illnesses of childhood and adolescence, the coexistence of eating disorders (ED) and diabetes often affects adolescents and young adults. Since weight management during this state of development can be especially difficult for those with type 1 diabetes, some diabetics may restrict or omit insulin, a condition known as diabulimia, as a form of weight control. It has been clearly shown that ED in type 1 diabetics are associated with impaired metabolic control, more frequent episodes of ketoacidosis and an earlier than expected onset of diabetes-related microvascular complications, particularly retinopathy. The management of these conditions requires a multidisciplinary team formed by an endocrinologist/diabetologist, a nurse educator, a nutritionist, a psychologist and, frequently, a psychiatrist. The treatment of type 1 diabetes patients with DEB and ED should have the following components: diabetes treatment, nutritional management and psychological therapy. A high index of suspicion of the presence of an eating disturbance, particularly among those patients with persistent poor metabolic control, repeated episodes of ketoacidosis and/or weight and shape concerns are recommended in the initial stage of diabetes treatment, especially in young women. Given the extent of the problem and the severe medical risk associated with it, more clinical and technological research aimed to improve its treatment is critical to the future health of this at-risk population.

Larranaga, Alejandra; Docet, Maria F; Garcia-Mayor, Ricardo V

2011-01-01

205

Study abroad experience is related to Japanese doctors' behavior to see foreign patients.  

PubMed

Globalization in Japan involves increases in the number of foreign residents. While there are some English-speaking Japanese doctors that are willing to see foreign patients, many are reluctant to do so. In this study, we attempted to clarify the factors that encourage Japanese doctors to see foreign patients. We conducted a questionnaire survey among medical doctors in Kobe City, Japan. The questionnaire was distributed to 172 doctors, and we received 139 responses. Statistical analysis showed a significant correlation between the frequency of seeing foreign patients and having the experience of studying abroad (p<0.05), confirming our hypothesis. There was also a significant correlation between having the experience of studying abroad and the doctors' self-evaluations of their English ability (p<0.05). There was no significant correlation found, however, between the frequency of seeing foreign patients and that of reading English research articles. These data suggested that the experience of living abroad rather than the exposure to English research articles was more highly correlated with seeing greater numbers of foreign patients. In conclusion, greater exposure to colloquial English was one of the determinants of the doctors' greater willingness to see foreign patients. In the Japanese medical education curriculum, therefore, it would be necessary to offer alternatives to studying abroad for those students who do not have such opportunities. PMID:23756658

Tamamaki, Kinko; Nishio, Hisahide

2013-04-17

206

Environmental exposure to lead and progressive diabetic nephropathy in patients with type II diabetes  

Microsoft Academic Search

Studies indicate that environmental exposure to lead is associated with reduced renal function. Whether lead affects progressive diabetic nephropathy is unclear. Eighty-seven patients with type II diabetes and diabetic nephropathy (serum creatinine of 1.5–3.9 mg\\/dl) with normal body lead burden and no lead exposure history were observed over a 12-month period. Thirty subjects with high normal body lead burdens (80–600

J-L Lin; D-T Lin-Tan; C-C Yu; Y-J Li; Y-Y Huang; K-L Li

2006-01-01

207

[Importance of the determination of fructosamine in monitoring diabetic patients].  

PubMed

Protein glycosylation plays a role in the metabolic control and in the pathogenesis of diabetic complications; indeed it has an important role in the process leading to micro- and macroangiography in diabetes. In an attempt to determine the clinical value of fructosamine assay for monitoring type II diabetic patients, the correlation of fructosamine and HbA1c, glycemia, cholesterol and triglycerides was studied. The results show that fructosamine is a good index for short-term metabolic control of diabetic patients. PMID:2381275

Vinci, V S; Masotti, G; Citro, G; De Marca, S; Quaglia, C; Galasso, R

208

Serum leptin levels in diabetic patients on hemodialysis: the relationship to parameters of diabetes metabolic control.  

PubMed

Leptin is a protein hormone produced predominantly by adipocytes that affects food intake and energy expenditure. Its serum levels are significantly higher in patients with chronic renal failure compared to healthy subjects. The aim of this study was to compare serum leptin levels in hemodialyzed patients with type II diabetes mellitus (n=26) with body content-matched hemodialyzed patients without diabetes (n=26) and to explore the relationship between parameters of the long term diabetes metabolic control and serum leptin levels. Serum leptin levels in diabetic patients did not significantly differ from those of non-diabetic patients (25.3+/-8.8 vs 25.7+/-8.7 ng/ml). Serum leptin levels in diabetic patients positively correlated with body fat content, body mass index and predialysis serum insulin levels. No significant relationship were observed between serum leptin levels and blood glucose, glycated hemoglobin, glycated protein, serum urea, creatinine, leukocyte count and total hemoglobin respectively. The multiple stepwise regression analysis revealed that body fat content together with body mass index accounted for 77.8% of variations in predialysis serum leptin levels, while insulin levels and the parameters of diabetes metabolic control had only slight prediction value for leptin concentrations. We conclude that serum leptin levels in hemodialysed patients with type III diabetes mellitus do not significantly differ from those of hemodialysed non-diabetic patients. The body fat content and body mass index are the strongest predictors of serum leptin levels, while parameters of long term diabetes metabolic control play probably only minor direct role in its regulation. PMID:10921455

Haluzik, M; Sulková, S; Svobodová, J; Bedárová, V; Bodláková, B; Marková, M; Turková, G; Jiskra, J; Haas, T

2000-05-01

209

Novel NF1 gene mutation in a Japanese patient with neurofibromatosis type 1 and a gastrointestinal stromal tumor  

Microsoft Academic Search

Many mutations of the NF1 gene have been reported in patients with neurofibromatosis type 1 (NF1); however, there have been no documented NF1 gene mutations in Japanese NF1 patients. In the present study, we used the polymerase chain reaction (PCR) and DNA sequencing\\u000a analysis to characterize the NF1 gene in a 53-year-old Japanese patient with NF1 who suffered from neurofibroma,

Hiroshi Nemoto; Genshu Tate; Annalisa Schirinzi; Takao Suzuki; Shoji Sasaya; Yasuo Yoshizawa; Takemasa Midorikawa; Toshiyuki Mitsuya; Bruno Dallapiccola; Yutaka Sanada

2006-01-01

210

Management of type 2 diabetes: evolving strategies for the treatment of patients with type 2 diabetes  

PubMed Central

The prevalence of type 2 diabetes continues to increase at an alarming rate around the world, with even more people being affected by prediabetes. Although the pathogenesis and long-term complications of type 2 diabetes are fairly well known, its treatment has remained challenging, with only half of the patients achieving the recommended hemoglobin A1c target. This narrative review explores the pathogenetic rationale for the treatment of type 2 diabetes, with the view of fostering better understanding of the evolving treatment modalities. The diagnostic criteria including the role of hemoglobin A1c in the diagnosis of diabetes are discussed. Due attention is given to the different therapeutic maneuvers and their utility in the management of the diabetic patient. The evidence supporting the role of exercise, medical nutrition therapy, glucose monitoring, and antiobesity measures including pharmacotherapy and bariatric surgery is discussed. The controversial subject of optimum glycemic control in hospitalized and ambulatory patients is discussed in detail. An update of the available pharmacologic options for the management of type 2 diabetes is provided with particular emphasis on newer and emerging modalities. Special attention has been given to the initiation of insulin therapy in patients with type 2 diabetes, with explanation of the pathophysiologic basis for insulin therapy in the ambulatory diabetic patient. A review of the evidence supporting the efficacy of the different preventive measures is also provided.

Nyenwe, Ebenezer A.; Jerkins, Terri W.; Umpierrez, Guillermo E.; Kitabchi, Abbas E.

2013-01-01

211

Ambulatory blood pressure in microalbuminuric type 1 diabetic patients  

Microsoft Academic Search

Ambulatory blood pressure in microalbuminuric type 1 diabetic patients. Twenty-four-hour ambulatory blood pressure (AMBP) was performed in microalbuminuric (micro.) type 1 diabetic patients, with the aim of comparison with a matched group of normoalbuminuric patients (normo.) and healthy controls. Thirty-four patients without antihypertensive medication were investigated in each group. Urinary albumin excretion (UAE) for micro, was (geometric mean, tolerance factor

Klavs W Hansen; Cramer K Christensen; Per H Andersen; Margrethe Mau Pedersen; Jens S Christiansen; Carl Erik Mogensen

1992-01-01

212

Association between single nucleotide polymorphisms within genes encoding sirtuin families and diabetic nephropathy in Japanese subjects with type 2 diabetes  

Microsoft Academic Search

Background  Sirtuin is a member of the nicotinamide adenine dinucleotide (NAD)-dependent deacetylases, and has been reported to play a\\u000a pivotal role in energy expenditure, mitochondrial function and pathogenesis of metabolic diseases, including aging kidneys.\\u000a In this study, we focused on the genes encoding sirtuin families, and examined the association between single nucleotide polymorphisms\\u000a (SNPs) within genes encoding sirtuin families and diabetic

Shiro Maeda; Daisuke Koya; Shin-ichi Araki; Tetsuya Babazono; Tomoya Umezono; Masao Toyoda; Koichi Kawai; Masahito Imanishi; Takashi Uzu; Daisuke Suzuki; Hiroshi Maegawa; Atsunori Kashiwagi; Yasuhiko Iwamoto; Yusuke Nakamura

2011-01-01

213

White blood-cell count and the risk of impaired fasting glucose or Type II diabetes in middle-aged Japanese men  

Microsoft Academic Search

.\\u000a Aims\\/hypothesis:   To investigate the association between white blood-cell (WBC) count and the development of diabetes, independent of cigarette\\u000a smoking. \\u000a \\u000a \\u000a \\u000a Methods:   We examined 2953 Japanese men who were office workers and between 35 and 59 years of age and who did not have impaired fasting\\u000a glucose (IFG) (a fasting glucose concentration of 6.1–6.9 mmol\\/l), Type II (non-insulin-dependent) diabetes mellitus (a

N. Nakanishi; H. Yoshida; Y. Matsuo; K. Suzuki; K. Tatara

2002-01-01

214

[Nursing diagnoses for diabetic patients using insulin].  

PubMed

This is a descriptive study with a qualitative approach that has as objective to identify the nursing diagnoses of diabetic patients using insulin, having as inquiry method the study of multiple cases. The data were obtained by the researcher by means of physical examination and the technique of interview directed in the instrument based on the Orem's Self-Care Theory. After data collection, the diagnostic indentification was proceeded from the nominated nursing diagnoses of NANDA Taxonomy II, using Risner's reasoning diagnostic process. The identified nursing diagnoses with a higher frequency than 50% were six: impaired skin integrity (100%), risk for infection (100%), behavior of health search (57,2%), disturbed sleep (57,2%), chronic pain (57,2%) and risk for peripheral neurovascular dysfunction (57,2%). The application of the nursing process based in Orem and the importance of the identified diagnostic for clients nursing care were evidenced. PMID:19142391

Becker, Tânia Alves Canata; Teixeira, Carla Regina de Souza; Zanetti, Maria Lúcia

215

Association of single-nucleotide polymorphisms in the suppressor of cytokine signaling 2 ( SOCS2) gene with type 2 diabetes in the Japanese  

Microsoft Academic Search

Several previous linkage scans in type 2 diabetes (T2D) families indicated a putative susceptibility locus on chromosome 12q15–q22, while the underlying gene for T2D has not yet been identified. We performed a region-wide association analysis on 12q15–q22, using a dense set of >500 single-nucleotide polymorphisms (SNPs), in 1492 unrelated Japanese individuals enrolled in this study. We identified an association between

Hitoshi Kato; Kyoko Nomura; Dai Osabe; Shuichi Shinohara; Osamu Mizumori; Rumi Katashima; Shoji Iwasaki; Koichi Nishimura; Masayasu Yoshino; Masato Kobori; Eiichiro Ichiishi; Naoto Nakamura; Toshikazu Yoshikawa; Toshihito Tanahashi; Parvaneh Keshavarz; Kiyoshi Kunika; Maki Moritani; Eiji Kudo; Kazue Tsugawa; Yoichiro Takata; Daisuke Hamada; Natsuo Yasui; Tatsuro Miyamoto; Hiroshi Shiota; Hiroshi Inoue; Mitsuo Itakura

2006-01-01

216

[Evoked acoustic oto-emissions in patients with diabetes mellitus].  

PubMed

The purpose of this study was to evaluate the cochlear function in patients with diabetes mellitus by analysis of evoked otoacoustic emissions (EOAE). EOAE were studied in 20 diabetic patients with normal hearing. The parameters used for analysis were the EOAE intensity and amplitude measured per 100 Hz frequency bands between 700 and 4000 Hz These data were compared to the data obtained in a group of non-diabetic control subjects with normal hearing using a Student's t test. The mean EOAE intensity and amplitude by 100 Hz frequency band was significantly lower in diabetic patients than in the control group. This seems to indicate the existence of an alteration in cochlear micromechanics in diabetic patients possibly due to changes in the functioning of the hair cells. PMID:8304697

Simoncelli, C; Ricci, G; Molini, E; Scionti, L; Giommetti, S; Pennacchi, A; Bottini, P

1993-01-01

217

Human leukocyte antigens in Japanese patients with biliary atresia: retrospective analysis of patients who underwent living donor liver transplantation.  

PubMed

Biliary atresia (BA) is a neonatal obstructive cholangiopathy characterized by a fibrosclerosing obliteration of the extrahepatic bile duct. The aim of this study was to investigate the relationship between human leukocyte antigens (HLA) and susceptibility to BA. We retrospectively analyzed 392 Japanese patients with BA and without extrahepatic anomalies who underwent living donor liver transplantations at our institute. Healthy Japanese volunteers (n = 828) served as normal controls. A significant positive association was observed between BA and HLA-DR2 (39.0% of patients vs. 30.4% of controls, odds ratio = 1.46, p = 0.029). Two-locus analyses disclosed that DR2 was not independently associated with BA, but the increased frequency of HLA-A24 and -B52 reflected the linkage disequilibrium between -A24, -B52, and -DR2. Moreover, the frequency of the haplotype HLA-A24-B52-DR2 was significantly higher in patients with BA than in the general Japanese populations described in the literature (odds ratio = 2.20, p = 0.00124). These results indicate that the gene for BA susceptibility is in close linkage disequilibrium with the HLA-A24-B52-DR2 haplotype observed in the Japanese population. We speculate that a gene at the locus close to HLA plays an important role in the pathogenesis of BA. PMID:15784468

Yuasa, Takeshi; Tsuji, Hiroaki; Kimura, Shinya; Niwa, Norimi; Yurugi, Kimiko; Egawa, Hiroto; Tanaka, Koichi; Maruya, Etsuko; Saji, Hiro-O; Asano, Hiroaki; Maekawa, Taira

2005-03-01

218

Endothelial barrier function after phacoemulsification: a comparison between diabetic and non-diabetic patients  

Microsoft Academic Search

In all, 21 diabetic and 23 non-diabetic patients underwent endothelial fluorophotometry before and at 4 days, 3 weeks and 6 weeks after phacoemulsification with posterior chamber intraocular lens (IOL: PMMA) implantation. After topical fluorescein instillation, fluorophotometry was performed using an automated computerized fluorophotometer. The aim of this study was to assess early postoperative endothelial damage quantitatively and to detect possible

Martin Goebbels; Manfred Spitznas

1991-01-01

219

Diabetes screening, diagnosis, and therapy in pediatric patients with type 2 diabetes.  

PubMed

The dramatic rise in the incidence and prevalence of type 2 diabetes mellitus in the pediatric and adolescent populations has been associated with the ongoing epidemic of overweight, obesity, insulin resistance, and metabolic syndrome seen in these age groups. Although the majority of pediatric patients diagnosed with diabetes are still classified as having type 1 diabetes, almost 50% of patients with diabetes in the pediatric age range (under 18 years) may have type 2 diabetes. Screening of high-risk patients for diabetes and prediabetes is important. Prompt diagnosis and accurate diabetes classification facilitate appropriate and timely treatment and may reduce the risk for complications. This is especially important in children because lifestyle interventions may be successful and the lifelong risk for complications is greatest. Treatment usually begins with dietary modification, weight loss, and a structured program of physical exercise. Oral antidiabetic agents are added when lifestyle intervention alone fails to maintain glycemic control. Given the natural history of type 2 diabetes, most if not all patients will eventually require insulin therapy. In those requiring insulin, improved glycemic control and reduced frequency of hypoglycemia can be achieved with insulin analogs. It is common to add insulin therapy to existing oral therapy only when oral agents no longer provide adequate glycemic control. PMID:18924636

Rodbard, Helena W

2008-08-06

220

Predictors of direct cost of diabetes care in pediatric patients with type 1 diabetes  

Technology Transfer Automated Retrieval System (TEKTRAN)

This study examines factors that predict elevated direct costs of pediatric patients with type 1 diabetes. Methods: A cohort of 784 children with type 1 diabetes at least 6 months postdiagnosis and managed by pediatric endocrinologists at Texas Children's Hospital were included in this study. Actual...

221

Diabetic retinopathy in newly diagnosed middle-aged and elderly diabetic patients. Prevalence and interrelationship with microalbuminuria and triglycerides  

Microsoft Academic Search

Background: The exact role of factors such as serum lipids, body mass index and (micro-)albuminuria as possible determinants of diabetic retinopathy remains to be determined. We have scrutinized the prevalence of diabetic retinopathy and its concomitants in terms of risk factors and other diabetic complications in newly diagnosed diabetic patients. Methods: A population-based sample of 1,251 newly diagnosed diabetic patients

Niels de Fine Olivarius; Niels Vesti Nielsen; Anne Helms Andreasen

2001-01-01

222

Th1 immune response takeover among patients with severe Japanese encephalitis infection.  

PubMed

The present study was intended to explore the dynamics of viral and host factors determining the outcome of Japanese encephalitis viral infection. 223 patients with acute encephalitic syndrome, 126 with febrile illness suspected of JE and 79 apparently healthy individuals as control were enrolled. Elevated levels of TNF-? and IL-6 in encephalitis patients and IFN-? in febrile JE patients without encephalitis were observed. A cutoff value of >55pg/ml of TNF-? and >370pg/ml of IL-6 in CSF was found as poor prognostic marker. Th1 shift (IFN-?/IL-4: >1) was observed in encephalitis patients. PMID:23993655

Pujhari, Sujit Kumar; Prabhakar, Sudesh; Ratho, Radhakanta; Mishra, Baijayantimala; Modi, Manish; Sharma, Sandeep; Singh, Paramjeet

2013-08-14

223

Diabetes patients and non-diabetic patients intensive care unit and hospital mortality risks associated with sepsis  

PubMed Central

AIM: To compare mortality risks associated with known diabetic patients to hyperglycemic non-diabetic patients. METHODS: PubMed data base was searched for patients with sepsis, bacteremia, mortality and diabetes. Articles that also identified new onset hyperglycemia (NOH) (fasting blood glucose > 125 mg/dL or random blood glucose > 199 mg/dL) were identified and reviewed. Nine studies were evaluated with regards to hyperglycemia and hospital mortality and five of the nine were summarized with regards to intensive care unit (ICU) mortality. RESULTS: Historically hyperglycemia has been believed to be equally harmful in known diabetic patients and non-diabetics patients admitted to the hospital. Unexpectedly, having a history of diabetes when admitted to the hospital was associated with a reduced risk of hospital mortality. Approximately 17% of patients admitted to hospital have NOH and 24% have diabetes mellitus. Hospital mortality was significantly increased in all nine studies of patients with NOH as compared to known diabetic patients (26.7% ± 3.4% vs 12.5% ± 3.4%, P < 0.05; analysis of variance). Unadjusted ICU mortality was evaluated in five studies and was more than doubled for those patients with NOH as compared to known diabetic patients (25.3% ± 3.3% vs 12.8% ± 2.6%, P < 0.05) despite having similar blood glucose concentrations. Most importantly, having NOH was associated with an increased ICU and a 2.7-fold increase in hospital mortality when compared to hyperglycemic diabetic patients. The mortality benefit of being diabetic is unclear but may have to do with adaptation to hyperglycemia over time. Having a history of diabetes mellitus and prior episodes of hyperglycemia may provide time for the immune system to adapt to hyperglycemia and result in a reduced mortality risk. Understanding why diabetic patients have a lower than expected hospital mortality rate even with bacteremia or acute respiratory distress syndrome needs further study. CONCLUSION: Having hyperglycemia without a history of previous diabetes mellitus is a major independent risk factor for ICU and hospital mortality.

Tayek, Chandler J; Tayek, John A

2012-01-01

224

Height at diagnosis of insulin dependent diabetes in patients and their non-diabetic family members.  

PubMed Central

Height at the onset of insulin dependent diabetes mellitus was evaluated in 200 newly diagnosed children, 187 non-diabetic siblings, and 169 parents. Diabetic children 5-9 years of age at diagnosis were consistently taller than the national average. Non-diabetic siblings of the same age were also tall. Diabetic children aged 14 or over at diagnosis were short, while their siblings and parents were of normal height. Diabetic children positive for islet cell antibodies were taller than those without islet cell antibodies. No association between height and HLA antigens was found. Non-diabetic siblings at high risk for the disease were closer in height to the diabetic children than were the lower risk, non-diabetic siblings. Siblings, particularly those under 10, were also significantly more obese than the general population. Deviations in growth in patients with insulin dependent diabetes mellitus appear to be related to age at diagnosis and a factor(s) not related to parental height.

Songer, T J; LaPorte, R E; Tajima, N; Orchard, T J; Rabin, B S; Eberhardt, M S; Dorman, J S; Cruickshanks, K J; Cavender, D E; Becker, D J

1986-01-01

225

Hypertension management in patients with diabetic nephropathy.  

PubMed

Treatment of hypertension, to reverse and delay proteinuria progression and kidney failure, is the primary focus of medical management in patients with diabetic nephropathy. The initial choice for hypertension treatment in those with early nephropathy involves agents that block the renin-angiotensin system. However, it is not clear what the best choices for further drug therapy management are, because there are few data concerning the impact that antihypertensive drug combinations have on hard clinical outcomes, such as preventing the need for dialysis, and death. Patients usually require several drugs for controlling hypertension, which becomes harder to control as nephropathy progresses. In this review, it is suggested that quantitatively tracking proteinuria to guide therapy and a broad focus on the cardiovascular and renal end points are important for best outcomes in patients. Strategies may vary based on stage of disease, comorbidities, and age. Therapies not directed specifically at hypertension may also significantly aid hypertension management in prevention of progressive nephropathy, comorbidities, and mortality. PMID:15257861

McCall, Anthony L

2004-08-01

226

Presence of myocilin sequence variants in Japanese patients with open-angle glaucoma  

PubMed Central

Purpose To examine the myocilin (MYOC) gene for mutations in Japanese patients with primary open-angle glaucoma (POAG) and to determine the phenotypes of the patients with the mutations. Methods One-hundred thirty-eight unrelated Japanese patients with POAG were studied. Genomic DNA was extracted from leukocytes of peripheral blood, and the three coding exons including the intron-exon boundaries were amplified by polymerase chain reaction (PCR) and directly sequenced bi-directionally. Results Two sequence variants were identified, one novel non-synonymous amino acid change (p.Gln297His) and one reported synonymous amino acid change (p.Ala363Thr). These mutations were not detected in the 118 ethnically-matched controls. p.Gln297His was found in a 70-year-old man, who developed POAG at a late age, and his intraocular pressure was high. p.Ala363Thr was found in two cases, and both patients developed POAG at an early age and had high intraocular pressures that responded poorly to medical treatment. Conclusions Two non-synonymous variants, p.Gln297His and p.Ala363Thr, indicate that they are involved in the pathogenesis of POAG. p.Ala363Thr has been found in another Japanese population and would be useful in genetic testing.

Mengkegale, MingGe; Miyazawa, Akiko; Takahashi, Kana; Seimiya, Motohiko; Yasui, Tomoki; Tamai, Makoto; Nakazawa, Toru; Nishida, Kohji

2008-01-01

227

Erectile dysfunction and coronary artery disease in patients with diabetes.  

PubMed

The review deals with recent findings regarding the association between erectile dysfunction (ED) and coronary artery disease (CAD) in patients with diabetes. Indeed recent longitudinal studies have shown that ED is able to predict future cardiovascular events not only in nondiabetic but also in diabetic patients. In addition, in diabetic patients ED seems to be strongly associated with the presence of silent CAD. The mechanism by which ED is linked to CAD seems to be the presence of endothelial dysfunction. This pathophysiological mechanism has been extensively analysed. The possible clinical usefulness of ED to identify diabetic patients with silent CAD or at particularly high cardiovascular risk has been discussed in the review. At last, the review reports current guidelines and recent data available in the literature on the treatment of ED in patients with and without CAD and on the prevention of CAD in patients with ED. PMID:21348816

Gazzaruso, Carmine; Coppola, Adriana; Giustina, Andrea

2011-03-01

228

The role of oral dryness in interdialytic weight gain by diabetic and non-diabetic haemodialysis patients  

Microsoft Academic Search

Background. Factors influencing the percentage of daily interdialytic weight gain (IDWG%) and their interactions in haemodialysis (HD) patients have not been well-defined, especially in diabetic patients. We analysed contributing factors for the increase of IDWG%, particularly xerostomia (oral dryness), among diabetic and non-diabetic HD patients. Methods. We collected 3 month prospective data in 184 stable HD patients (116 non-diabetic and

Junne-Ming Sung; Shih-Chen Kuo; Shu-Fen Chuang; Szu-Yuan Lee; Jeng-Jong Huang

229

Overtime, psychosocial working conditions, and occurrence of non-insulin dependent diabetes mellitus in Japanese men  

Microsoft Academic Search

OBJECTIVES: To ascertain the effects of overtime and psychosocial job conditions on the occurrence of non-insulin dependent diabetes mellitus (NIDDM) in Japan. DESIGN: An eight year prospective cohort study. SETTING: An electrical company in Japan. PARTICIPANTS: In 1984, a mailed questionnaire was sent to industrial workers of an electrical company in Japan. After excluding those who had a history of

N. Kawakami; S. Araki; N. Takatsuka; H. Shimizu; H. Ishibashi

1999-01-01

230

Prevention of type 2 diabetes by lifestyle intervention: a Japanese trial in IGT males  

Microsoft Academic Search

Prevention of type 2 diabetes by intensive lifestyle intervention designed to achieve and maintain ideal body weight was assessed in subjects with impaired glucose tolerance (IGT). Male subjects with IGT recruited from health-screening examinees were randomly assigned in a 4:1 ratio to a standard intervention group (control group) and intensive intervention group (intervention group). The final numbers of subjects were

Kinori Kosaka; Mitsuihiko Noda; Takeshi Kuzuya

2005-01-01

231

Attitudes towards cross-border reproductive care among infertile Japanese patients.  

PubMed

OBJECTIVES: The attitudes towards cross-border reproductive care (CBRC) held by infertile Japanese patients have not been explored. The objective of the present study was to examine interest levels, preferred destinations, motivations, and sources of information related to CBRC. Our findings provide a general outline of CBRC and the future of reproduction and assisted reproductive technology (ART) in Japan. METHODS: The study used a cross-sectional design. Data were collected from 2,007 infertile Japanese patients from 65 accredited ART clinics in Japan (response rate, 27.4 %) via anonymous questionnaires. RESULTS: Most of the infertile Japanese patients who responded denied using CBRC. However, by group, 171 (8.5 %) patients in non-donor in vitro fertilization, 150 (7.5 %) in egg donation, 145 (7.2 %) in pre-implantation genetic diagnosis, and 129 (6.4 %) in surrogacy said that, depending on the situation, they might travel abroad in the future. Older respondents were more likely to express an intention to travel overseas for egg donation in the future. The most popular destination for CBRC was the United States. Popular reasons for interest in CBRC among those considering or planning using this approach to third-party reproduction were that egg donation or surrogacy was unavailable or that obtaining ethical approval takes too long in Japan, whereas these processes are legal and affordable overseas. However, high cost was the most common reason for hesitancy regarding CBRC. Among the participants who were considering or planning to travel abroad for this purpose, TV, medical agencies, print media, and message boards on websites were popular sources of information, whereas doctors, friends, and patient self-help groups were not. CONCLUSIONS: Although CBRC among infertile Japanese patients is not at present common, the demand for and use of this approach may increase in the future in the context of the increasingly aging population. Lack of regulation and unavailability of third-party reproduction is a major cause of CBRC among Japanese patients. Health care provider faces an urgent need for giving useful information for patients regarding CBRC. PMID:23749591

Hibino, Yuri; Shimazono, Yosuke; Kambayashi, Yasuhiro; Hitomi, Yoshiaki; Nakamura, Hiroyuki

2013-06-01

232

Replication Study for the Association of 9 East Asian GWAS-Derived Loci with Susceptibility to Type 2 Diabetes in a Japanese Population  

PubMed Central

Aims East Asian genome-wide association studies (GWAS) for type 2 diabetes identified 8 loci with genome-wide significance, and 2 loci with a borderline association. However, the associations of these loci except MAEA locus with type 2 diabetes have not been evaluated in independent East Asian cohorts. We performed a replication study to investigate the association of these susceptibility loci with type 2 diabetes in an independent Japanese population. Methods We genotyped 7,379 Japanese participants (5,315 type 2 diabetes and 2,064 controls) for each of the 9 single nucleotide polymorphisms (SNPs), rs7041847 in GLIS3, rs6017317 in FITM2?R3HDML?HNF4A, rs6467136 near GCCI?PAX4, rs831571 near PSMD6, rs9470794 in ZFAND3, rs3786897 in PEPD, rs1535500 in KCNK16, rs16955379 in CMIP, and rs17797882 near WWOX. Because the sample size in this study was not sufficient to replicate single SNP associations, we constructed a genetic risk score (GRS) by summing a number of risk alleles of the 9 SNPs, and examined the association of the GRS with type 2 diabetes using logistic regression analysis. Results With the exception of rs1535500 in KCNK16, all SNPs had the same direction of effect (odds ratio [OR]>1.0) as in the original reports. The GRS constructed from the 9 SNPs was significantly associated with type 2 diabetes in the Japanese population (p = 4.0 × 10-4, OR = 1.05, 95% confidence interval: 1.02–1.09). In quantitative trait analyses, rs16955379 in CMIP was nominally associated with a decreased homeostasis model assessment of ?-cell function and with increased fasting plasma glucose, but neither the individual SNPs nor the GRS showed a significant association with the glycemic traits. Conclusions These results indicate that 9 loci that were identified in the East Asian GWAS meta-analysis have a significant effect on the susceptibility to type 2 diabetes in the Japanese population.

Tanaka, Yasushi; Iwata, Minoru; Hirose, Hiroshi; Kaku, Kohei; Maegawa, Hiroshi; Watada, Hirotaka; Tobe, Kazuyuki; Kashiwagi, Atsunori; Kawamori, Ryuzo; Maeda, Shiro

2013-01-01

233

[Application of "reytoil" in prevention of atherosclerosis in diabetes patients].  

PubMed

The paper was conducted sonographic study of extracranial atherosclerotic vascular changes in patients with diabetes mellitus, and lipid profile study of the dynamics under the influence of treatment with the inclusion of the drug "Reytoil". Structural changes of the vascular wall correlates with changes of lipid profile in patients with diabetes. Structural assessment of intima-media complex (IMC) can be used as a marker for early diagnosis of vascular remodeling in patients with diabetes, as well as the criterion of efficiency of a treatment. Detection of lipid exchange and evaluation of IMC in the early stages of diabetes mellitus will make it possible pathogenetic approach to providing comprehensive treatment of diabetes with dyslipidemia, including the drug "Reytoil". PMID:23786025

Popov, S V; Melekhovets, O K; Demikhova, N V; Vynnychenko, L B; Khil'ko, Ie S; Tychyna, D O; Murga, I V

2012-12-01

234

Survey of Japanese physicians' attitudes towards the care of adult patients in persistent vegetative state.  

PubMed Central

OBJECTIVES: Ethical issues have recently been raised regarding the appropriate care of patients in persistent vegetative state (PVS) in Japan. The purpose of our study is to study the attitudes and beliefs of Japanese physicians who have experience caring for patients in PVS. DESIGN AND SETTING: A postal questionnaire was sent to all 317 representative members of the Japan Society of Apoplexy working at university hospitals or designated teaching hospitals by the Ministry of Health and Welfare. The questionnaire asked subjects what they would recommend for three hypothetical vignettes that varied with respect to a PVS patient's previous wishes and the wishes of the family. RESULTS: The response rate was 65%. In the case of a PVS patient who had no previous expressed wishes and no family, 3% of the respondents would withdraw artificial nutrition and hydration (ANH) when the patient did not require any other life-sustaining treatments, 4% would discontinue ANH, and 30% would withhold antibiotics when the patient developed pneumonia. Significantly more respondents (17%) would withdraw ANH in the case of a PVS patient whose previous wishes and family agreed that all life support be discontinued. Most respondents thought that a patient's written advance directives would influence their decisions. Forty per cent of the respondents would want to have ANH stopped and 31% would not want antibiotics administered if they were in PVS. CONCLUSIONS: Japanese physicians tend not to withdraw ANH from PVS patients. Patients' written advance directives, however, would affect their decisions.

Asai, A; Maekawa, M; Akiguchi, I; Fukui, T; Miura, Y; Tanabe, N; Fukuhara, S

1999-01-01

235

Mastication and Risk for Diabetes in a Japanese Population: A Cross-Sectional Study  

PubMed Central

Background Associations between mastication and insufficient nutrient intake, obesity, and glucose metabolism have been shown in previous studies. However, the association between mastication and diabetes has not been clarified. Our objective was to examine the association between mastication, namely masticatory performance or rate of eating, and diabetes in a population-based cohort. Methods We conducted a cross-sectional study of the association between mastication and diabetes in the Nagahama Prospective Cohort Study, an ongoing study which recruits citizens of Nagahama City in Shiga Prefecture, central Japan. 2,283 male and 4,544 female residents aged 40–74 years were enrolled from July 2009 to November 2010. Masticatory performance was evaluated by spectrophotometric measurement of color changes after masticating color-changeable chewing gum. Categorical rate of eating (fast, intermediate or slow) was self-assessed using a questionnaire. Results 177 males (7.7%) and 112 (2.4%) females were diagnosed with diabetes. We divided participants into four groups by quartile of masticatory performance, namely Q1 (lowest), 2, and 3 and 4 (highest). Compared to the lowest performance group, the multivariable adjusted odds ratio (OR) of diabetes was 0.91 (95% confidence interval (CI), 0.58–1.4) in Q2, 0.77 (95% CI, 0.48–1.2) in Q3, and 0.53 (95% CI, 0.31–0.90) in the highest group in males, and 1.2 (95% CI, 0.73–2.0), 0.95 (95% CI, 0.54–1.6) and 0.56 (95% CI, 0.30–1.0) in females. We also estimated ORs of diabetes by rate of eating. Compared to the fast eating group, ORs in males were 0.87 (95% CI, 0.61–1.2) in the intermediate group and 0.38 (95% CI, 0.16–0.91) in the slow group, and ORs in females were 0.92 (95% CI, 0.59–1.4) and 1.5 (95% CI, 0.73–3.0). Conclusions These findings support the hypothesis that higher masticatory performance and slow eating prevent the occurrence of diabetes.

Yamazaki, Toru; Yamori, Masashi; Asai, Keita; Nakano-Araki, Ikuko; Yamaguchi, Akihiko; Takahashi, Katsu; Sekine, Akihiro; Matsuda, Fumihiko; Kosugi, Shinji; Nakayama, Takeo; Inagaki, Nobuya; Bessho, Kazuhisa

2013-01-01

236

Factors Associated with Diabetic Retinopathy in Chinese Patients with Type 2 Diabetes Mellitus  

PubMed Central

Objective. To investigate the risk factors of DR in Chinese T2DM patients. Methods. 2009 patients with T2DM were included in this cross-sectional study. All patients underwent eye examination, and the DR stage was defined by an ophthalmologist. Correlation analysis was performed to evaluate the relation between DR and clinical variables. Logistic regression models were used to assess risk for those factors associated with DR. Results. A total of 597 T2DM patients (29.7%) had DR, of which 548 (27.3%) were nonproliferative diabetic retinopathy and 49 (2.4%) were proliferative diabetic retinopathy. Positive correlations were found between DR and duration of diabetes, systolic blood pressure (SBP), diastolic blood pressure, glycated hemoglobin, glycated albumin, 24 hurinary albumin excretion, peripheral atherosclerosis (PA), diabetes nephropathy (DN), diabetic peripheral neuropathy, and anemia. Negative correlations were found between DR and C-peptide and glomerular filtration rate. Logistic regression analysis revealed that duration of diabetes, SBP, DN, anemia, PA, and C-peptide were each independent risk factors of DR. Conclusion. The duration of diabetes, SBP, DN, anemia, and PA are positively associated with DR in Chinese T2DM patients, while C-peptide is negatively associated with DR. Monitoring and evaluation of these related factors will likely contribute to the prevention and treatment of DR.

He, Bin-Bin; Wei, Li; Gu, Yun-Juan; Han, Jun-Feng; Li, Ming; Liu, Yu-Xiang; Bao, Yu-Qian; Jia, Wei-Ping

2012-01-01

237

Comparison of Plaque Composition in Diabetic and Non-Diabetic Patients With Coronary Artery Disease Using Multislice CT Angiography  

PubMed Central

Background and Objectives Plaque composition rather than degree of luminal narrowing may be predictive of future coronary events in high risk patients. The purpose of this study was to compare degree of plaque burden and composition with multislice computed tomography (MSCT) angiography between diabetic and non-diabetic patients. Subjects and Methods A total of 452 consecutive MSCT angiography examinations were performed between July 2007 and June 2009. Of these, the patients who underwent invasive coronary angiography were evaluated for the presence and type of atherosclerotic plaque and severity of luminal narrowing. Results Ninety two (46 in the diabetic group and 46 in the non-diabetic group) patients underwent both MSCT angiography and invasive coronary angiography. Among them, 30 patients (65.2%) in the diabetic group and 26 patients (56.5%) in the non-diabetic group had significant coronary narrowing on MSCT angiography. Sixteen patients (34.8%) in the diabetic group and 15 patients (32.6%) in non-diabetic group underwent coronary angioplasty and stenting. Forty-two patients (93.3%) in the diabetic group and 39 patients (88.6%) in the non-diabetic group had multiple types of coronary plaque (p=0.485). MSCT angiography was similar to conventional coronary angiography in its ability to predict significant coronary artery disease in that the area under the curve was 0.88 (95% confidence interval, 0.81 to 0.95). Diabetic patients had more mixed plaque compared with non-diabetic patients. Conclusion Differences in coronary plaque composition between diabetic and non-diabetic patients can be determined noninvasively by MSCT angiography. In patients with diabetes, mixed plaque types contribute to the total plaque burden to a higher degree than in non-diabetic patients.

Kwon, Yong-Seop; Lee, Chang-Won; Kim, Dong-Kie; Kim, Ung; Seol, Sang-Hoon; Kim, Doo-Il; Jo, Young-Wan; Jin, Han Young; Seo, Jeong-Sook; Yang, Tae-Hyun; Kim, Dae-Kyeong; Kim, Dong-Soo

2010-01-01

238

Complete Genome Sequences of Two Helicobacter pylori Bacteriophages Isolated from Japanese Patients  

PubMed Central

Helicobacter pylori causes peptic ulcers and gastric cancer, which lead to significantly higher morbidity in Japan than elsewhere in the world. As bacteriophage (phage) and host bacteria coevolve, the study of H. pylori phages is important to extend understanding of the evolution and pathogenesis of H. pylori. Here we report two complete genome sequences of H. pylori phages KHP30 and KHP40, which were released spontaneously from the most pathogenic East Asian-type isolates from Japanese patients.

Uchiyama, Jumpei; Takeuchi, Hiroaki; Kato, Shin-ichiro; Takemura-Uchiyama, Iyo; Ujihara, Takako; Daibata, Masanori

2012-01-01

239

Complete genome sequences of two Helicobacter pylori bacteriophages isolated from Japanese patients.  

PubMed

Helicobacter pylori causes peptic ulcers and gastric cancer, which lead to significantly higher morbidity in Japan than elsewhere in the world. As bacteriophage (phage) and host bacteria coevolve, the study of H. pylori phages is important to extend understanding of the evolution and pathogenesis of H. pylori. Here we report two complete genome sequences of H. pylori phages KHP30 and KHP40, which were released spontaneously from the most pathogenic East Asian-type isolates from Japanese patients. PMID:22997420

Uchiyama, Jumpei; Takeuchi, Hiroaki; Kato, Shin-ichiro; Takemura-Uchiyama, Iyo; Ujihara, Takako; Daibata, Masanori; Matsuzaki, Shigenobu

2012-10-01

240

DAX-1 Gene Mutations and Deletions in Japanese Patients with Adrenal Hypoplasia Congenita and Hypogonadotropic Hypogonadism  

Microsoft Academic Search

Abnormality of the DAX-1 gene accounts for many instances of congenital adrenal hypoplasia. In the present study, we performed molecular genetic analysis of DAX-1 in 4 unrelated Japanese patients with adrenal hypoplasia congenita and hypogonadotropic hypogonadism. A double-point mutation for V126M and W171X was identified in 1 family and a complex de novo insertion-deletion mutation was identified in a second.

Ei-ichi Kinoshita; Masaaki Yoshimoto; Katsuaki Motomura; Tomoko Kawaguchi; Ryogo Mori; Tsuneyoshi Baba; Kahoru Nishijo; Tomonobu Hasegawa; Toru Momoi; Tom Yorihuji

1997-01-01

241

Lenalidomide plus dexamethasone treatment in Japanese patients with relapsed\\/refractory multiple myeloma  

Microsoft Academic Search

We conducted a multicenter, open-label study to investigate the safety, efficacy, and pharmacokinetics of lenalidomide in\\u000a Japanese patients with relapsed or refractory multiple myeloma The study was composed of the “monotherapy phase”, a dose-escalation\\u000a phase, to determine the tolerability to single agent lenalidomide and the “combination phase” to determine the safety and\\u000a obtain preliminary data on the efficacy of lenalidomide

Shinsuke IidaTakaaki; Takaaki Chou; Shinichiro Okamoto; Hirokazu Nagai; Kiyohiko Hatake; Hirokazu Murakami; Toshiyuki Takagi; Kazuyuki Shimizu; Henry Lau; Kenichi Takeshita; Masaaki Takatoku; Tomomitsu Hotta

2010-01-01

242

Protein and gene analyses of dysferlinopathy in a large group of Japanese muscular dystrophy patients  

Microsoft Academic Search

Mutations in the dysferlin gene cause muscular dystrophies called dysferlinopathy, which include limb-girdle muscular dystrophy type 2B (LGMD2B) and Miyoshi myopathy (MM). To clarify the frequency, clinicopathological and genetic features of dysferlinopathy in Japan, we performed protein and gene analyses of dysferlin. We examined a total of 107 unrelated Japanese patients, including 53 unclassified LGMD, 28 MM and 26 other

Kazuhiko Tagawa; Megumu Ogawa; Kiyokazu Kawabe; Gaku Yamanaka; Tsuyoshi Matsumura; Kanako Goto; Ikuya Nonaka; Ichizo Nishino; Yukiko K. Hayashi

2003-01-01

243

Novel mutations of the ATP7B gene in Japanese patients with Wilson disease  

Microsoft Academic Search

Wilson disease (WD) is an autosomal recessive disorder characterized by copper accumulation in the liver, brain, kidneys,\\u000a and corneas, and culminating in copper toxication in these organs. In this study, we analyzed mutations of the responsible\\u000a gene, ATP7B, in four Japanese patients with WD. By direct sequencing, we identified five mutations, of which two were novel, and 16 polymorphisms,\\u000a of

Yoichiro Kusuda; Kazuyuki Hamaguchi; Tetsu Mori; Rie Shin; Masataka Seike; Toshiie Sakata

2000-01-01

244

Association of the TNFa13 microsatellite with systemic sclerosis in Japanese patients  

Microsoft Academic Search

OBJECTIVESTo elucidate the contribution of microsatellite polymorphisms of TNFa and TNFb alleles to the pathogenesis of systemic sclerosis (SSc) by comparing the allele distribution among populations with different HLA susceptibility genes in SSc.METHODSTNFa and TNFb microsatellite polymorphisms were determined by PCR in 54 Japanese and 50 German SSc patients and in normal controls. HLA-DR genotyping was carried out by PCR-SSCP.RESULTSThe

Fujio Takeuchi; Hiromi Nabeta; Monika Füssel; Karsten Conrad; Karl-Heinz Frank

2000-01-01

245

Treatment of 153 Japanese patients with Q-switched alexandrite laser  

Microsoft Academic Search

We have recently used Q-switched alexandrite laser for the treatment of various kinds of pigmented skin lesions. We retrospectively\\u000a compared therapeutic outcomes of 153 Japanese patients who consulted our department. This approach was not very efficient\\u000a for nevus spilus\\/café-au-lait spots, which seemed laser-resistant, especially when the pigmentation had appeared after 1 year\\u000a of age, was treated after 5 years of age, was

Shinji Kagami; Akihiko Asahina; Rei Watanabe; Yoshihiro Mimura; Akira Shirai; Naoko Hattori; Takahiro Watanabe; Kunihiko Tamaki

2007-01-01

246

Phase II Study to Investigate the Efficacy, Safety, and Pharmacokinetics of Sorafenib in Japanese Patients with Advanced Renal Cell Carcinoma  

Microsoft Academic Search

Objective: Sorafenib (Nexavarw) is an oral multi-kinase inhibitor that targets tumor growth and angiogenesis. This phase II study investigated efficacy, safety, and pharmacokinetics of sorafenib in Japanese patients with advanced renal cell carcinoma (RCC). Methods: Nonrandomized, open-label study in Japanese patients with metastatic renal cell carcinoma who had received nephrectomy and failed ? 1 cytokine-containing therapy. The primary endpoint was

Hideyuki Akaza; Taiji Tsukamoto; Masaru Murai; Keiko Nakajima; Seiji Naito

2007-01-01

247

Phosphate diabetes in patients with chronic fatigue syndrome  

Microsoft Academic Search

Phosphate depletion is associated with neuromuscular dysfunction due to changes in mitochondrial respiration that result in a defect of intracellular oxidative metabolism. Phosphate diabetes causes phosphate depletion due to abnormal renal re-absorption of phosphate be the proximal renal tubule. Most of the symptoms presented by patients with phosphate diabetes such as myalgia, fatigue and mild depression, are also common in

F. De Lorenzo; J. Hargreaves; V. V. Kakkar

1998-01-01

248

Direct Health Care Costs of Diabetic Patients in Spain  

Microsoft Academic Search

OBJECTIVE — The goal of this study was to estimate the health care resources spent by type 1 and type 2 diabetic patients in Spain during the year 2002. RESEARCH DESIGN AND METHODS — This is a cost-of-illness study focusing on direct health care costs estimated from primary and secondary sources of information. A prev- alence of diabetes ranging from

JUAN OLIVA; FELIX LOBO; B. Molina; S. Monereo

2004-01-01

249

Pancreas and islet transplantation for patients with diabetes  

Microsoft Academic Search

i s t o r i c a l l y, patients with diabetes have expended tremendous eff o rt in pursuing a re t u rn to norm o g l y c e m i a . The relatively recent results of the Diabetes C o n t rol and Complications Trial (DCCT), demonstrating an approximate 50% re

R. PAUL ROBERTSON; CONNIE DAVIS; JENNIFER LARSEN; ROBERT STRATTA; DAVID E. R. SUTHERLAND

2000-01-01

250

The health status of diabetic patients receiving orthotic therapy  

Microsoft Academic Search

Diabetes has a major impact on the quality of life and those with related foot ulcers are among those most affected. The main aim of the study, which was carried out over an 18-month time period, was to compare the self-reported health status of a group of diabetic patients receiving orthotic therapy with that of other groups who did not

S. Davies; O. Gibby; C. Phillips; P. Price; W. Tyrrell

2000-01-01

251

Internet use among primary care patients with type 2 diabetes  

Microsoft Academic Search

BACKGROUND: The Internet represents a promising tool to improve diabetes care.\\u000a \\u000a \\u000a OBJECTIVE: To assess differences in demographics, self-care behaviors, and diabetes-related risk factor control by frequency of Internet\\u000a use.\\u000a \\u000a \\u000a \\u000a \\u000a DESIGN AND PARTICIPANTS: We surveyed 909 patients with type 2 diabetes attending primary care clinics.\\u000a \\u000a \\u000a \\u000a \\u000a MEASUREMENTS: Frequency of Internet use, socioeconomic status, and responses to the Problem Areas in Diabetes (PAID),

Richard W. Grant; Enrico Cagliero; Henry C. Chueh; James B. Meigs

2005-01-01

252

Approach to the Patient with Gestational Diabetes after Delivery  

PubMed Central

The diagnosis of gestational diabetes mellitus (GDM) identifies patients with a pancreatic ?-cell defect. In some patients, the defect is transient or stable, but in most it is progressive, imparting a high risk of diabetes for at least a decade after the index pregnancy. The ?-cell defects in GDM can result from many causes, including genetic variants typical of monogenic forms of diabetes and autoimmunity typical of evolving type 1 diabetes. No specific disease-modifying therapies are available for those patients. The majority of women with GDM have clinical characteristics indicating a risk for type 2 diabetes (T2D). Available evidence indicates that T2D can be prevented or delayed by intensive lifestyle modification and by medications, particularly those that ameliorate insulin resistance. Clinical management should include assessment of glucose tolerance in the postpartum period to detect diabetes or assess diabetes risk. Women who don't have diabetes should be advised about their risk and participate in family planning to prevent subsequent pregnancies with undiagnosed hyperglycemia. All patients should be monitored for rising glycemia indicative of progressive ?-cell deterioration. We suggest a combination of fasting glucose and glycosylated hemoglobin measurements for this purpose. Monitoring should be initiated at least annually and should be intensified if glycemia is rising and/or impaired. Lifestyle modification is advised to reduce the risk for T2D. Like monitoring, lifestyle modification should be intensified for rising glycemia and/or development of impaired glucose levels. At present, there is insufficient evidence to recommend medications to prevent T2D. Close follow-up and monitoring will allow initiation of pharmacological treatment as soon as diabetes develops. Children of women with GDM are at increased risk for obesity and diabetes. They should receive education, monitoring, and lifestyle advice to minimize obesity and diabetes risk.

Page, Kathleen A.

2011-01-01

253

Approach to the patient with gestational diabetes after delivery.  

PubMed

The diagnosis of gestational diabetes mellitus (GDM) identifies patients with a pancreatic ?-cell defect. In some patients, the defect is transient or stable, but in most it is progressive, imparting a high risk of diabetes for at least a decade after the index pregnancy. The ?-cell defects in GDM can result from many causes, including genetic variants typical of monogenic forms of diabetes and autoimmunity typical of evolving type 1 diabetes. No specific disease-modifying therapies are available for those patients. The majority of women with GDM have clinical characteristics indicating a risk for type 2 diabetes (T2D). Available evidence indicates that T2D can be prevented or delayed by intensive lifestyle modification and by medications, particularly those that ameliorate insulin resistance. Clinical management should include assessment of glucose tolerance in the postpartum period to detect diabetes or assess diabetes risk. Women who don't have diabetes should be advised about their risk and participate in family planning to prevent subsequent pregnancies with undiagnosed hyperglycemia. All patients should be monitored for rising glycemia indicative of progressive ?-cell deterioration. We suggest a combination of fasting glucose and glycosylated hemoglobin measurements for this purpose. Monitoring should be initiated at least annually and should be intensified if glycemia is rising and/or impaired. Lifestyle modification is advised to reduce the risk for T2D. Like monitoring, lifestyle modification should be intensified for rising glycemia and/or development of impaired glucose levels. At present, there is insufficient evidence to recommend medications to prevent T2D. Close follow-up and monitoring will allow initiation of pharmacological treatment as soon as diabetes develops. Children of women with GDM are at increased risk for obesity and diabetes. They should receive education, monitoring, and lifestyle advice to minimize obesity and diabetes risk. PMID:22143829

Buchanan, Thomas A; Page, Kathleen A

2011-12-01

254

Spinal magnetic resonance imaging manifestations at neurological onset in Japanese patients with spinal cord sarcoidosis.  

PubMed

Objective We retrospectively investigated spinal magnetic resonance imaging (MRI) manifestations at neurological onset in Japanese patients with spinal cord sarcoidosis. Methods Between July 2000 and April 2012, we reviewed our database and recruited patients with spinal cord sarcoidosis. On spinal MRI performed at neurological onset, the following items were evaluated: the vertebral-segment distribution and length of intramedullay T2-elongated lesions, abnormal enhancement patterns and distributions and the concomitant presence of spondylosis and associated extraspinal lesions. If available, brain MRI scans were concomitantly assessed. Results Nine patients were enrolled (four men and five women; median, 49 years). Reflecting Japanese epidemiological backgrounds, a predilection for occurrence was observed in young men and middle-aged women. Intramedullary T2-elongated lesions were present in eight patients, peaking at the C5 level, with a mean length of 3.7±2.6 vertebral segments. Spondylosis coexisted in the middle-aged patients. Abnormal intramedullary enhancement with concomitantly involved the nerve roots was observed in six patients, comprised of two types reflecting the disease progression: linear- and/or nodular enhancement along the surface of the spinal cord and intramedullary enhancement consisting of patchy, broad-based enhancement adjacent to the cord surface. Five patients had associated extraspinal lesions, including lymphadenopathy in four patients and brain involvement in four patients. Conclusion Spinal cord sarcoidosis exhibits a predilection for young men and middle-aged women among Japanese individuals and is characterized by intramedullary T2-elongated lesions spreading more than three vertebral segments peaking at the C5 level, two types of abnormal intramedullary enhancement reflecting disease progression, frequent nerve root involvement and lymphadenopathy. PMID:24042510

Kobayashi, Shigeru; Nakata, Waka; Sugimoto, Hideharu

2013-01-01

255

The clinical relevance of serum antinuclear antibodies in Japanese patients with systemic sclerosis  

PubMed Central

Background Systemic sclerosis (SSc) is a connective tissue disorder with excessive fibrosis of the skin and various internal organs. Although SSc is a heterogeneous disease, it has been reported that the particular antinuclear antibodies (ANA) are often indicative of clinical features, disease course and overall severity. Objective To clarify the association of clinical and prognostic features with serum ANA in Japanese patients with SSc. Methods We studied 203 Japanese patients diagnosed with SSc, who visited our hospital during the period 1983–2005. Six SSc-related ANA were identified using indirect immunofluorescence, double immunodiffusion and immunoprecipitation assays. Results Patients with SSc were classified into six ANA-based subgroups and a group without ANA. As expected, antitopoisomerase I antibody (Ab, n = 64), anti-RNA polymerases (RNAP) Ab (n = 12) and anti-U3 RNP Ab (n = 5) were associated with diffuse cutaneous SSc, whereas anticentromere Ab (ACA, n = 75), anti-Th/To Ab (n = 7) and anti-U1 RNP Ab (n = 10) were frequently detected in patients with limited cutaneous SSc. Clinical features of the ANA-negative group (n = 10) were heterogeneous. Consistent with previous findings in Caucasian and/or black African patients, antitopoisomerase I Ab was associated with the involvement of vascular and pulmonary fibrosis, leading to decreased survival rate. However, no patients with anti-RNAP Ab developed renal crisis and the frequency of isolated pulmonary hypertension in patients with ACA, anti-Th/To Ab or anti-U3 RNP Ab was similar to that in other ANA-based subgroups. Conclusion These results indicate that the clinical relevance of SSc-related ANA in Japanese patients differs in some aspects from that in Caucasian and/or black African patients.

Hamaguchi, Y; Hasegawa, M; Fujimoto, M; Matsushita, T; Komura, K; Kaji, K; Kondo, M; Nishijima, C; Hayakawa, I; Ogawa, F; Kuwana, M; Takehara, K; Sato, S

2008-01-01

256

Sugar-sweetened beverage and diet soda consumption and the 7-year risk for type 2 diabetes mellitus in middle-aged Japanese men.  

PubMed

PURPOSE: This cohort study investigated the association between sugar-sweetened beverage (SSB) and diet soda consumption and the incidence of type 2 diabetes in Japanese men. METHODS: The participants were 2,037 employees of a factory in Japan. We measured consumption of SSB and diet soda using a self-administered diet history questionnaire. The incidence of diabetes was determined in annual medical examinations over a 7-year period. Hazard ratios (HRs) with 95 % confidence intervals (CIs) for diabetes were estimated after adjusting for age, body mass index, family history, and dietary and other lifestyle factors. RESULTS: During the study, 170 participants developed diabetes. The crude incidence rates (/1,000 person-years) across participants who were rare/never SSB consumers, <1 serving/week, ?1 serving/week and <1 serving/day, and ?1 serving/day were 15.5, 12.7, 14.9, and 17.4, respectively. The multivariate-adjusted HR compared to rare/never SSB consumers was 1.35 (95 % CI 0.80-2.27) for participants who consumed ?1 serving/day SSB. Diet soda consumption was significantly associated with the incident risk of diabetes (P for trend = 0.013), and multivariate-adjusted HRs compared to rare/never diet soda consumers were 1.05 (0.62-1.78) and 1.70 (1.13-2.55), respectively, for participants who consumed <1 serving/week and ?1 serving/week. CONCLUSIONS: Consumption of diet soda was significantly associated with an increased risk for diabetes in Japanese men. Diet soda is not always effective at preventing type 2 diabetes even though it is a zero-calorie drink. PMID:23575771

Sakurai, M; Nakamura, K; Miura, K; Takamura, T; Yoshita, K; Nagasawa, S Y; Morikawa, Y; Ishizaki, M; Kido, T; Naruse, Y; Suwazono, Y; Sasaki, S; Nakagawa, H

2013-04-11

257

Medicare coverage for patients with diabetes  

Microsoft Academic Search

The prevalence of diabetes in the U.S. Medicare population is growing at an alarming rate. From 1980 to 2004, the number of\\u000a people aged 65 or older with diagnosed diabetes increased from 2.3 million to 5.8 million. According to the Centers for Medicare\\u000a and Medicaid (CMS), 32% of Medicare spending is attributed to the diabetes population. Since its inception, Medicare

M. J. Abrahamson

2006-01-01

258

Gene Mutations in Adult Japanese Patients With Dilated Cardiomyopathy  

Microsoft Academic Search

Background Some patients with dilated cardiomyopathy (DCM) have mutations of the genes that encode sarcomeric or cytoskeletal proteins of cardiomyocytes, but the prevalence of these mutations in Japan remains unclear. Methods and Results A group of 99 unrelated adult patients with DCM (familial n=27, sporadic n=72) were screened for the following genes: cardiac -myosin heavy chain, cardiac myosin-binding protein C

Masami Shimizu; Hidekazu Ino; Toshihiko Yasuda; Noboru Fujino; Katsuharu Uchiyama; Tomohito Mabuchi; Tetsuo Konno; Tomoya Kaneda; Takashi Fujita; Eiichi Masuta; Masahiro Katoh; Akira Funada; Hiroshi Mabuchi

2005-01-01

259

Assessment of awareness of diabetic retinopathy and utilization of eye care services among Turkish diabetic patients.  

PubMed

AIMS: Raising awareness of diabetic retinopathy (DR) was shown to be a key element for early diagnosis and treatment of this blinding disease. There is very limited data about the knowledge level, attitude, and behavior of diabetic patients regarding DR in Turkey. This study was planned to assess the awareness of DR and the utilization of eye care services among Turkish diabetic patients. METHODS: Diabetic patients who were under the care of ophthalmologists, endocrinologists, and/or primary care physicians were administered a questionnaire in order to assess their awareness of diabetes and its ocular complications. RESULTS: A total of 437 patients (51.8% female and 48.2% male) with a mean age of 55.2±11.9 were included in the study. Of the 437 patients, 31.8% had not been educated about diabetes, 88.1% were aware that diabetes can affect the eyes, and 39.8% thought that diabetics with good glycaemic control might suffer from DR. While 86.7% thought that early diagnosis was possible in DR, 77.3% previously had eye examinations, and 41.9% stated that annual eye examinations were necessary for diabetics. An educational level of middle school or higher, duration of DM longer than 5years, previous DM education, and recruitment from the university (ophthalmology department and endocrinology department) were associated with better awareness of DR. The independent factors associated with visiting an ophthalmologist on a regular basis were DM education, DM duration, and site of recruitment. CONCLUSION: Although most of the patients know that DM affects the eye, there is a lack of appropriate knowledge and behavior about the management of DR. The importance of better control of DM and regular eye examination in the prevention of DR should be emphasized. PMID:23639610

Cetin, Ebru N; Zencir, Mehmet; Fenkçi, Semin; Ak?n, Fulya; Y?ld?r?m, Cem

2013-04-29

260

Adverse events and bone health during anastrozole therapy in postmenopausal Japanese breast cancer patients  

Microsoft Academic Search

Background  Although anastrozole (ANA), an aromatase inhibitor (AI), has been widely used for breast cancer patients; adverse events during\\u000a ANA therapy in Japanese patients have not been reported.\\u000a \\u000a \\u000a \\u000a \\u000a Methods  The study included 656 postmenopausal breast cancer patients receiving ANA as postoperative adjuvant therapy in our hospital.\\u000a Adverse events during ANA therapy, such as musculoskeletal effects and cerebro- and cardiovascular accidents, were investigated

Yasuaki Sagara; Shoichiro Kosha; Shinichi Baba; Fumiko Dokiya; Shugo Tamada; Yoshiaki Sagara; Yoshito Matsuyama; Yasuyo Ohi; Mitsutake Ando; Yoshiaki Rai; Yoshiatsu Sagara; Tsutomu Douchi

2010-01-01

261

A qualitative study of mindfulness-based meditation therapy in Japanese cancer patients  

Microsoft Academic Search

Purpose  The primary objective of the study was to examine mindfulness-based meditation therapy qualitatively. A secondary goal was\\u000a to examine the differences in themes selected by Japanese and Western patients receiving this therapy.\\u000a \\u000a \\u000a \\u000a \\u000a Methods  The subjects were 28 patients who were undergoing anti-cancer treatment. The subjects participated in two sessions of mindfulness-based\\u000a meditation therapy, including breathing, yoga movement, and meditation. Each patient

Michiyo Ando; Tatsuya Morita; Tatsuo Akechi; Yuka Ifuku

2011-01-01

262

A Hospital Survey of the Care of Elderly Patients with Diabetes Mellitus  

Microsoft Academic Search

Summary Elderly diabetic patients are at especially high risk of developing hypoglycaemia, diabetic retinopathy, foot ulcers and infection. We have surveyed 100 elderly diabetic inpatients to assess level of diabetes supervision, prevalence of risk factors for complications, and uptake of chiropody and fundoscopic services. Of all the diabetic patients, 19% received no supervision. A large proportion (71%) had two or

A. K. FLETCHER; J. DOLBEN

1996-01-01

263

Clinical characteristics of silent myocardial ischemia diagnosed with adenosine stress 99mTc-tetrofosmin myocardial scintigraphy in Japanese patients with acute cerebral infarction.  

PubMed

It is well known that silent myocardial ischemia (SMI) often complicates patients with cerebral infarction and that stroke patients often die of ischemic heart disease. Therefore, it is considered important to treat myocardial ischemia in stroke patients. This study investigated SMI complicating Japanese patients with fresh stroke, using (99m)Tc-tetrofosmin myocardial scintigraphy with pharmacologic stress testing to elucidate their clinical manifestations. This study included 41 patients (26 men, mean age 76.0 ± 10.7 years) with acute cerebral infarction and no history of coronary artery disease. All patients underwent (99m)Tc-tetrofosmin myocardial scintigraphy with intravenous administration of adenosine to diagnose SMI. Of the 41 patients, myocardial ischemia was confirmed in 17 patients (41.5%). Atherosclerotic etiology was the major cause of stroke in the ischemia(+) group and embolic origin was the major cause in the ischemia(-) group. Patients with myocardial ischemia had a higher incidence of diabetes mellitus (52.9 vs 20.8%; P = 0.0323) and more than two conventional cardiovascular risk factors (64.7 vs 25.0%; P = 0.0110) compared with the nonischemic patients. Infarction subtype of atherosclerotic origin was an independent positive predictor of asymptomatic myocardial ischemia in patients with stroke. These findings indicate that the prevalence of asymptomatic myocardial ischemia is relatively high, especially in patients with stroke of atherosclerotic origin. Therefore, it is beneficial for us to narrow the target population who are at the highest risk when screening for SMI in Japanese patients with acute cerebral infarction. PMID:22124530

Nomura, Tetsuya; Kusaba, Tetsuro; Kodama, Naotoshi; Terada, Kensuke; Urakabe, Yota; Nishikawa, Susumu; Keira, Natsuya; Matsubara, Hiroaki; Tatsumi, Tetsuya

2011-11-29

264

The impact of the NSF for Diabetes on patient empowerment.  

PubMed

The National Service Framework (NSF) for Diabetes was developed by the UK government to tackle variations in care for patients with diabetes. This article critically analyses the impact of this policy and its effect on health care, focusing specifically on Standard 3 of the NSF. This standard discusses patient empowerment and involving patients in their own care. A number of education programmes have been set up to empower patients to better manage their diabetes, and two of these are explored in detail: Dose Adjustment for Normal Eating (DAFNE) and Diabetes Education and Self-Management for Ongoing and Newly Diagnosed (DESMOND). Research has shown however, that many people are not aware of these initiatives, suggesting that more needs to be done to ensure that patients, nurses and other health professionals are aware of the services available for people with diabetes in the community. Furthermore, research suggests that there is a lack of emotional and psychological support for patients living with this chronic condition. It is suggested here that nurses can provide patients with this support, as well as with information to help them access services to manage their diabetes. This, together with education about diet and exercise, and appropriate referrals, will enable the nurse to ensure that all patients receive high-quality care. PMID:20647980

Begum, Shahina; Por, Jitna

265

Discontinuation of imatinib in Japanese patients with chronic myeloid leukemia.  

PubMed

It was recently recognized that some chronic myeloid leukemia patients with a complete molecular response could sustain that response after discontinuation of imatinib. To characterize the clinical outcomes and profiles of chronic phase chronic myeloid leukemia patients who could discontinue imatinib, we conducted a nationwide survey in Japan. Among 3,242 imatinib-treated chronic myeloid leukemia patients, we identified 50 who had discontinued imatinib for at least six months; of these we analyzed 43. Molecular recurrence was detected in 19 patients, and a complete molecular response rate was estimated to be 47% following imatinib discontinuation. Based on multivariate regression analysis, imatinib dose intensity and prior interferon-? administration were independently predictive of molecular recurrence within 12 months. The depth of the molecular response should be a factor influencing long-term sustained complete molecular response after discontinuation of imatinib. Additionally, an immunological mechanism modified by interferon-? might control chronic myeloid leukemia stem cells. PMID:22180435

Takahashi, Naoto; Kyo, Taiichi; Maeda, Yasuhiro; Sugihara, Takashi; Usuki, Kensuke; Kawaguchi, Tatsuya; Usui, Noriko; Okamoto, Shinichiro; Ohe, Yokiko; Ohtake, Shigeki; Kitamura, Kunio; Yamamoto, Masahide; Teshima, Hirofumi; Motoji, Toshiko; Tamaki, Toshiharu; Sawada, Kenichi; Ohyashiki, Kazuma

2011-12-16

266

Sexual dysfunction in Japanese patients with schizophrenia treated with antipsychotics  

Microsoft Academic Search

Various studies have revealed that sexual dysfunction is prevalent in schizophrenia patients treated with either first- or second-generation antipsychotics. Although sexual dysfunction may have a negative impact on adherence to treatment, no reports have studied sexual dysfunction in schizophrenia patients compared with healthy controls in Asian populations. We employed a cross-sectional, case-control survey design to collect data from 352 schizophrenic

Akira Fujii; Norio Yasui-Furukori; Norio Sugawara; Yasushi Sato; Taku Nakagami; Manabu Saito; Sunao Kaneko

2010-01-01

267

Silent myocardial ischemia in diabetic and nondiabetic patients with coronary artery disease  

Microsoft Academic Search

Background: Patients with diabetes mellitus are at increased risk for CAD; silent ischemia is reported to be frequent in diabetic populations. The aim of the present study was to evaluate the prevalence of silent ischemia in diabetic and nondiabetic patients with assessed CAD. Methods and results: We recruited a total of 618 patients with CAD: 309 were consecutive diabetic patients

C. Falcone; L. Nespoli; D. Geroldi; C. Gazzaruso; M. P. Buzzi; C. Auguadro; L. Tavazzi; P. J. Schwartz

2003-01-01

268

HLA class I markers in Japanese patients with carbamazepine-induced cutaneous adverse reactions.  

PubMed

Carbamazepine (CBZ) is frequently used for treating epilepsy, but this drug causes cutaneous adverse drug reactions (cADRs) that may range from mild to severe. It is reported recently that the human leukocyte antigen HLA-B*1502 is associated with Stevens-Johnson syndrome (SJS) induced by CBZ in Han Chinese. We examined HLA class I in 15 Japanese patients who fulfilled the diagnostic criteria for CBZ-induced cADRs (mild in 10 and severe = SJS in 5). HLA-B*1518, HLA-B*5901 and HLA-C*0704 alleles showed higher relative risks (above 10.0) for severe cADRs. The haplotype (HLA-A*2402-B*5901-C*0102) had high relative risk (16.09) for severe cADRs. In patients with severe cADRs, frequencies of HLA-A*1101, HLA-A*3303, HLA-B*1501, HLA-B*4403, HLA-B*5101, HLA-B*5201, HLA-C*0702, and HLA-C*1202 alleles are relatively lower than in the Japanese population. These data may suggest that HLA-B*5901 is one of the candidate markers for CBZ-induced SJS in Japanese. PMID:19694795

Ikeda, Hiroko; Takahashi, Yukitoshi; Yamazaki, Etsuko; Fujiwara, Tateki; Kaniwa, Nahoko; Saito, Yoshiro; Aihara, Michiko; Kashiwagi, Mariko; Muramatsu, Masaaki

2009-08-19

269

[Antibacterial therapy in patients with diabetic foot syndrome].  

PubMed

Character of microflora in patients with infection complications of diabetic foot syndrome was analyzed. The efficacy of modern antibacterial preparations for empirical and specific therapy was studied up. PMID:21510362

Palamarchuk, V I; Siriachenko, V H; Markov, K V; Muz', M I; Shuliarenko, O V; Shuliarenko, L V

2011-01-01

270

Big Breakfast May Be Best for Diabetes Patients  

MedlinePLUS

... morning meal rich in protein, fat actually curbed hunger, helped control blood sugar levels (*this news item ... with type 2 diabetes better control both their hunger and their blood sugar levels. Patients who ate ...

271

Past 10-year status of insulin therapy for preschool-age Japanese children with type 1 diabetes  

Microsoft Academic Search

The aim of this study was to evaluate the past 10-year status of insulin therapy for preschool-age children with type 1 diabetes in Japan. One-hundred and forty-two patients who had been diagnosed at less than 5 years of age within the past 10 years (1993–2002) at 36 hospitals were registered in this study on April 2003. The methods of daily

Ichiro Yokota; Shin Amemiya; Kaichi Kida; Nozomu Sasaki; Nobuo Matsuura

2005-01-01

272

Retrospective Study of Japanese Patients with Schizophrenia Treated with Aripiprazole  

PubMed Central

Aim. The purpose of this retrospective study was to evaluate changes in clinical indicators which influence the quality of life (QOL) of patients with schizophrenia treated by antipsychotic therapy before and after switching to aripiprazole. Methods. A retrospective chart review of 27 patients diagnosed with schizophrenia and who were switched from one antipsychotic to aripiprazole was performed. Clinical indicators about the daily dosage of antipsychotics and antiparkinsonian drugs, psychiatric condition, and glucose/lipid metabolism, clinical evaluation by nursing observation were used to measure the responsiveness of subjects to aripiprazole. Results. Of the 27 subjects, 14 responded to the switch to aripiprazole with significant improvement of the Brief Psychiatric Rating Scale (BPRS) score (P = 0.04), significant decrease in dosage of antipsychotics in 71% of patients (P = 0.03), and tendency toward reduction in dosage of antiparkinsonian drugs (P = 0.07) and body mass index (BMI) (P = 0.06). However, 8 of 27 subjects had a significant increase in lipid levels after switching to aripiprazole (P = 0.01). Conclusion. QOL for subjects who responded to the switch to aripiprazole improved as indicated by lower doses of antipsychotic and antiparkinson medications, improvement in BPRS score, and a decrease in BMI. Results indicate little influence on patient's QOL.

Tanioka, Tetsuya; Fuji, Syoko; Kataoka, Mika; King, Beth; Tomotake, Masahito; Yasuhara, Yuko; Locsin, Rozzano; Sekido, Keiko; Mifune, Kazushi

2012-01-01

273

Elevated plasma endothelin in patients with diabetes mellitus  

Microsoft Academic Search

Summary  Plasma concentrations of endothelin, a vasoconstrictor peptide released from vascular endothelial cells, have been measured by radioimmunoassay in 100 patients with diabetes mellitus and 19 healthy subjects. The plasma immunoreactive-endothelin concentrations were found to be greatly raised in the patients with diabetes (1,880±120 fmol\\/l, mean±SEM) compared with the healthy subjects (540±50 fmol\\/l, p

K. Takahashi; M. A. Ghatei; H.-C. Lam; D. J. O'Halloran; S. R. Bloom

1990-01-01

274

Lower Extremity Arterial Reconstruction in Patients With Diabetes Mellitus  

Microsoft Academic Search

Foot problems remain the most common reason for hospitalization for patients with diabetes mellitus (1,2). Approximately 20% of the 12–15 million patients with diabetes in the United States can expect to be hospitalized for a\\u000a foot problem at least once during their lifetime, and account for an annual health care cost for this problem alone in excess\\u000a of one billion

Kakra Hughes; David Campbell; Frank B. Pomposelli Jr

275

Cost-effectiveness of lifestyle modification in diabetic patients  

Microsoft Academic Search

OBJECTIVE To explore the potential long-term health and economic consequences of lifestyle interventions for diabetic patients. RESEARCH DESIGN AND METHODS A literature search was performed to identify interventions for diabetic patients in which lifestyle issues were addressed. We selected recent (2003–2008), randomized controlled trials with a minimum follow-up of 12 months. The long-term outcomes for these interventions, if implemented in

M. A. M. Jacobs-van der Bruggen; Baal van P. H; R. T. Hoogenveen; T. L. Feenstra; A. H. Briggs; K. Lawson; E. J. M. Feskens; C. A. Baan

2009-01-01

276

Detection of isopropyl alcohol in a patient with diabetic ketoacidosis  

Microsoft Academic Search

A 29-year-old man presented to the Emergency Department with acute mental status changes. He was unable to give a history. He was found to be in diabetic ketoacidosis, although his family reported no prior history of diabetes. A toxic exposure work-up revealed the presence of isopropyl alcohol in the patient’s blood. His condition improved with treatment of the ketoacidosis, and

Alan E Jones; Richard L Summers

2000-01-01

277

Rosiglitazone Monotherapy Is Effective in Patients with Type 2 Diabetes  

Microsoft Academic Search

This study evaluated the efficacy and safety of rosiglitazone mono- therapy in patients with type 2 diabetes. After a 4-week placebo run-in period, 493 patients with type 2 diabetes were randomized to receive rosiglitazone (2 or 4 mg twice daily (bd)) or placebo for 26 weeks. The primary end point was change in hemoglobin A1c; other variables assessed included fasting

HAROLD E. LEBOVITZ; JO F. DOLE; RITA PATWARDHAN; ELIZABETH B. RAPPAPORT; MARTIN I. FREED; SmithKline Beecham

2010-01-01

278

Prevalence of diabetic nephropathy complicating non-diabetic renal disease among Chinese patients with type 2 diabetes mellitus  

PubMed Central

Background The incidence of diabetes mellitus (DM) and diabetic nephropathy (DN) have risen rapidly in the past few decades and have become an economic burden to the healthcare system in China. DN is a major complication of DM and is a leading cause of end-stage renal disease (ESRD). The occurrence of non-diabetic renal disease (NDRD) in diabetic patients has been increasingly recognized in recent years. It is generally believed that it is difficult to reverse DN, whereas some cases of NDRD are readily treatable and remittable. However, DN is known to co-exist with NDRD in a poorly defined population of patients with type 2 diabetes mellitus (T2DM). This study estimated the prevalence of co-existing DN and NDRD in Chinese patients. Methods Data were retrospectively analyzed from 244 patients with T2DM who had undergone a renal biopsy between January 2003 and December 2011 at the Nephrology Department, China-Japan Friendship Hospital, China. Male patients numbered 151 (61.9%) of the study population. The biopsies were performed because urinary abnormalities or renal function were atypical of a diagnosis of DN. Biopsy samples were examined using light, immunofluorescence (IF) and electron microscopy (EM). Clinical parameters were recorded for each patient at the time of biopsy. Results Nineteen of 244 diabetic patients (7.8%) had co-existing DN and NDRD. These patients showed clinical features and pathologic characteristics of DN, including a high prevalence of diabetic retinopathy (89.5%), a long duration of diabetes, increased thickness of the glomerular basement membrane (GBM) and mesangial expansion. However, they also presented with clinical findings which were inconsistent with DN, such as hematuria, rapidly progressive renal failure and marked proteinuria. Immunoglobulin A (IgA) nephropathy was apparent in 10 out of the 19 patients (52.6%), tubulointerstitial lesions were found in four patients (21.1%), membrano-proliferative glomerulonephritis (MPGN) in three patients (15.8%) and membranous nephropathy (MN) in two patients (10.5%). Conclusion Retrospective analysis of biopsy data suggests that approximately 8% of Chinese patients with T2DM may have co-existing DN and NDRD. The most common histological diagnosis in our small series was IgA nephropathy.

2013-01-01

279

Depression Increases Risk of Dementia in Patients with Type 2 Diabetes: The Diabetes & Aging Study  

PubMed Central

Context Although depression is a risk factor for dementia in the general population, its association with dementia among patients with diabetes has not been well studied. Objective To determine whether comorbid depression in patients with type 2 diabetes increases the risk of development of dementia. Main Outcome Measures The Patient Health Questionnaire-8 (PHQ-8), ICD-9 diagnoses of depression, and/or antidepressant prescriptions in the 12 months prior to baseline were used to identify prevalent cases of depression. Clinically recognized dementia was identified among subjects with no prior ICD-9 diagnoses of dementia. To exclude the possibility that depression was a prodrome of dementia, dementia diagnoses were only based on ICD-9 diagnoses identified in years 3 to 5 post-baseline. The risk of dementia for patients with depression and diabetes relative to patients with diabetes alone was estimated using Cox proportional hazard regression models that adjusted for sociodemographic, clinical and health risk factors, and health utilization. Design The Diabetes and Aging Study was a cohort investigation that surveyed a racially/ethnically stratified random sample of patients with type 2. Setting A large integrated nonprofit managed care setting in Northern California. Participants A sample of 19,239 diabetes registry members 30 to 75 years of age. Results During the 3- to 5-year period, 80 (2.12%) of 3,766 patients with comorbid depression and diabetes (incidence rate of 5.5 per 1,000 person years) versus 158 (1.02%) of 15,473 patients with diabetes alone (incidence rate of 2.6 per 1000 person-years) had one or more ICD-9 diagnoses of dementia. Patients with comorbid depression had a 100% increased risk of dementia during the 3 to 5 years post-baseline period (adjusted hazard ratio 2.02, 95% CI 1.73, 2.35). Conclusion Depression in patients with diabetes was associated with a substantively increased risk for development of dementia compared to those with diabetes alone.

Katon, Wayne; Lyles, Courtney R.; Parker, Melissa M.; Karter, Andrew J.; Huang, Elbert S.; Whitmer, Rachel A.

2013-01-01

280

DIETARY MISCONCEPTIONS AMONG DIABETIC PATIENTS IN MAKKA CITY, SAUDI ARABIA  

PubMed Central

Objectives: To assess the prevalence of some dietary misconceptions among primary health care center-registered diabetic patients in Makka City, Saudi Arabia. Methods: A sample of 1039 primary health care center- registered diabetic patients was interviewed using a structured questionnaire on diabetic diet -related misconceptions. A scoring system was used to document the frequency of misconceptions. The relationship of the misconceptions to socio-demographic and diabetes-related variables was assessed using chi-squared tests. Results: Most patients (68.7%) had a high diet misconception score. More than half of the sample had the misconception that carbohydrates were to be completely eliminated from the diet, and only dried bread and bitter foods were to be consumed. Data included the belief in the consumption of honey and dates; the omission of snacks; belief in the carcinogenicity of the sugar substitutes; and obesity as a sign of good health. The score was significantly higher among males (p<0.01), patients older than 35 years (p<0.02), and among patients whose level of education was low (p<0.01). Conclusion: It is important to note that the rate of diet-related misconceptions among diabetics in Makka city is high. The study pointed to the target fraction of diabetic patients among whom these misconceptions prevailed. There is a need for constant motivation and appropriate education at frequent intervals to encourage better knowledge of the disease so that there is compliance to treatment.

Al-Saeedi, Mohammed; Elzubier, Ahmed G.; Al-Dawood, Kasim M.; Bahnasi, Ahmed A.

2002-01-01

281

Clinicopathologic Study of Angiogenesis in Japanese Patients with Breast Cancer  

Microsoft Academic Search

. To evaluate the clinicopathologic significance of angiogenesis as a prognostic factor and the objective methods\\u000a for evaluating angiogenesis, we immunohistochemically stained a representative section of breast tumors with factor VIII-related\\u000a antigen staining. There were 109 patients with primary breast cancer from 1971 to 1979. The two methods of identifying angiogenesis\\u000a were the average microvessel count per square millimeter (AMC)

Takao Kato; Tsunehito Kimura; Ryuhei Miyakawa; Shinichi Tanaka; Akiho Fujii; Kazuko Yamamoto; Shingo Kameoka; Kyoichi Hamano; Makio Kawakami; Motohiko Aiba

1997-01-01

282

DAX-1 gene mutations and deletions in Japanese patients with adrenal hypoplasia congenita and hypogonadotropic hypogonadism.  

PubMed

Abnormality of the DAX-1 gene accounts for many instances of congenital adrenal hypoplasia. In the present study, we performed molecular genetic analysis of DAX-1 in 4 unrelated Japanese patients with adrenal hypoplasia congenita and hypogonadotropic hypogonadism. A double-point mutation for V126M and W171X was identified in 1 family and a complex de novo insertion-deletion mutation was identified in a second. The DAX-1 gene was entirely deleted in a 3rd patient as well as in a 4th with the additional feature of glycerol kinase deficiency. PMID:9195207

Kinoshita, E; Yoshimoto, M; Motomura, K; Kawaguchi, T; Mori, R; Baba, T; Nishijo, K; Hasegawa, T; Momoi, T; Yorihuji, T

1997-01-01

283

Longitudinal analysis of growth and body composition of Japanese 21-OHD patients in childhood.  

PubMed

Substitution therapy of glucocorticoid is a major part of the treatment for 21-OHD (21-hydroxylase deficiency). However, the therapy causes two major adverse effects, impairment of linear growth and obesity, so that collecting precise growth data is essential for optimizing the therapy. We longitudinally evaluated the linear growth and the body composition of Japanese 21-OHD patients during childhood. For the present study, we chose 16 patients (eight of each sex) who were diagnosed during the newborn period, and continuously observed them in our institute until they were at least 15 years old. All patients were treated according to the guidelines from The Japanese Society for Pediatric Endocrinology. The final height standard deviation score (Ht-SDS) of all the patients was -1.18 ± 0.85 SD, and no significant differences were observed between males and females or between the simple virilizing form and the salt wasting form. As previously reported, in spite of nearly normal height at the onset of puberty, the pubertal height gains were severely impaired, resulting in reduced final heights. Body composition of the patients was evaluated with BMI-SDS. Our longitudinal data showed that BMI was increased up to +1.23 SD in males and up to +1.75 SD in females, and that adiposity rebound was precipitated. Our study should alert physicians to the risk of metabolic syndrome and provide a framework for further studies of metabolic syndrome in 21-OHD patients. PMID:23018978

Matsubara, Yohei; Ono, Makoto; Miyai, Kentaro; Takizawa, Fumihiko; Takasawa, Kei; Onishi, Toshikazu; Kashimada, Kenichi; Mizutani, Shuki

2012-09-28

284

Molecular Cloning of the Human Hepatitis C Virus Genome From Japanese Patients with NonA, Non-B Hepatitis  

Microsoft Academic Search

The nucleotide sequence of the Japanese type of hepatitis C virus (HCV-J) genome, consisting of 9413 nucleotides, was determined by analyses of cDNA clones from plasma specimens from Japanese patients with chronic hepatitis. HCV-J genome contains a long open reading frame that can encode a sequence of 3010 amino acid residues. Comparison of HCV-J with the American isolate of HCV

Nobuyuki Kato; Makoto Hijikata; Yuko Ootsuyama; Masanori Nakagawa; Showgo Ohkoshi; Takashi Sugimura; Kunitada Shimotohno

1990-01-01

285

Comparison of HLA class II genes in Caucasoid, Chinese, and Japanese patients with primary Sjoegren's syndrome  

SciTech Connect

To better define the genetic factors that predispose to primary Sjoegren's syndrome (SS), the authors used polymerase chain reaction in combination with oligonucleotide probe hybridization and DNA sequencing to analyze HLA-DRB1, -DQA1, -DQB1, and -DPB1 alleles in Caucasoid (California), Japanese (Tokyo), and Chinese (Shanghai and Beijing) SS patients. In comparison to local controls in each region, we found: (1) increased frequency of the predicted haplotype HLA-DRB1[sup *]0301-DRB3[sup *]0101-DQA1[sup *]0501-DQB1[sup *]0201 in Caucasoid patients (p < 0.001); (2) increased frequency of the predicted haplotype HLA-DRB1[sup *]0405-DRB4[sup *]0101-DQA1[sup *]0301-DQB1[sup *]0401 in Japanese patients (p < 0.05); (3) increased frequency of the predicted haplotype DRB1[sup *]0803-DQA1[sup *]0103-DQB1[sup *]0601 in Chinese patients (p < 0.05); and (4) no statistically significant association with DBP1 alleles in any group, although an increased number of Caucasoid and Japanese SS patients possessed DPB1[sup *]0301. Comparison of DNA sequences for the three disease-associated haplotypes in these ethnic groups revealed a shared region of predicted amino acids from positions 58 to 69 in the first domain of HLA-DQB1. These results extend previous studies by demonstrating that no single class II allele was associated with 1[degrees] SS in the different ethnic groups. However, a shared amino acid motif in the DQB1 first domain was present in each disease-associated haplotype. 25 refs., 2 figs., 6 tabs.

Kang, Ho-II.; Chan, E.; Peebles, C.; Fox, R.I. (Scripps Research Institute, La Jolla, CA (United States)); Fei, I.; Chen, S. (Shanghai II Medical Univ., Shanghai (China)); Saito, Ichiro; Sawada, Shigemasa (Nihon Univ. School of Medicine, Tokyo (Japan)); Bugawan, T.L.; Erlich, H.A. (Roche Molecular Systems, Alameda, CA (United States)); Yi, D. (Peking Union Medical Center, Beijing (China))

1993-04-15

286

Multilevel model based glucose control for type-1 diabetes patients.  

PubMed

Diabetes is a disease that involves alterations at multiple biological levels, ranging from intracellular signalling to organ processes. Since glucose homeostasis is the consequence of complex interactions that involve a number of factors, the control of diabetes should be based on a multilevel analysis. In this paper, a novel approach to design of closed-loop glucose controllers based on multilevel models is presented. A control scheme is proposed based on combining a pharmacokinetic/pharmacodynamic model with an insulin signal transduction model for type 1 diabetes mellitus patients. Based on this, an insulin feedback control schemes is designed. Two main advantages of explicitly utilizing information at the intracellular level were obtained. First, significant reduction of hypoglycaemic risk by reducing the undershoot in glucose levels in response to added insulin. Second, robust performance for inter-patient changes, demonstrated through application of the multilevel control strategy to a well established in silico population of diabetic patients. PMID:24110588

Garcia-Gabin, Winston; Jacobsen, Elling W

2013-07-01

287

Novel mutation of L718X in the ATP7A gene in a Japanese patient with classical Menkes disease, and four novel polymorphisms in the Japanese population  

Microsoft Academic Search

Menkes disease is an X-linked recessive disorder of the copper membrane transport system caused by mutations in the ATP7A gene. While various mutations in the ATP7A gene have been reported, a genotype-phenotype correlation has not been clearly defined. A novel mutation in the ATP7A gene in a Japanese patient with classical Menkes disease was identified via analysis of reverse-transcriptase polymerase

Atsushi Ogawa; Shigenori Yamamoto; Masaki Kanazawa; Emi Ogawa; Masaki Takayanagi; Shuji Hasegawa; Yoichi Kohno

2000-01-01

288

From the diabetic foot ulcer and beyond: how do foot infections spread in patients with diabetes?  

PubMed Central

A diabetic foot infection is usually the result of a pre-existing foot ulceration and is the leading cause of lower extremity amputation in patients with diabetes. It is widely accepted that diabetic foot infections may be challenging to treat for several reasons. The devastating effects of hyperglycemia on host defense, ischemia, multi-drug resistant bacteria and spreading of infection through the foot may complicate the course of diabetic foot infections. Understanding the ways in which infections spread through the diabetic foot is a pivotal factor in order to decide the best approach for the patient's treatment. The ways in which infections spread can be explained by the anatomical division of the foot into compartments, the tendons included in the compartments, the initial location of the point of entry of the infection and the type of infection that the patient has. The aim of this paper is to further comment on the existed and proposed anatomical principles of the spread of infection through the foot in patients with diabetes.

Aragon-Sanchez, Javier; Lazaro-Martinez, Jose Luis; Pulido-Duque, Juan; Maynar, Manuel

2012-01-01

289

From the diabetic foot ulcer and beyond: how do foot infections spread in patients with diabetes?  

PubMed

A diabetic foot infection is usually the result of a pre-existing foot ulceration and is the leading cause of lower extremity amputation in patients with diabetes. It is widely accepted that diabetic foot infections may be challenging to treat for several reasons. The devastating effects of hyperglycemia on host defense, ischemia, multi-drug resistant bacteria and spreading of infection through the foot may complicate the course of diabetic foot infections. Understanding the ways in which infections spread through the diabetic foot is a pivotal factor in order to decide the best approach for the patient's treatment. The ways in which infections spread can be explained by the anatomical division of the foot into compartments, the tendons included in the compartments, the initial location of the point of entry of the infection and the type of infection that the patient has. The aim of this paper is to further comment on the existed and proposed anatomical principles of the spread of infection through the foot in patients with diabetes. PMID:23050067

Aragón-Sánchez, Javier; Lázaro-Martínez, Jose Luis; Pulido-Duque, Juan; Maynar, Manuel

2012-10-01

290

Phase II Study of Single-agent Bevacizumab in Japanese Patients with Recurrent Malignant Glioma†  

PubMed Central

Objective This single-arm, open-label, Phase II study evaluated the efficacy and safety of single-agent bevacizumab, a monoclonal antibody against vascular endothelial growth factor, in Japanese patients with recurrent malignant glioma. Methods Patients with histologically confirmed, measurable glioblastoma or World Health Organization Grade III glioma, previously treated with temozolomide plus radiotherapy, received 10 mg/kg bevacizumab intravenous infusion every 2 weeks. The primary endpoint was 6-month progression-free survival in the patients with recurrent glioblastoma. Results Of the 31 patients enrolled, 29 (93.5%) had glioblastoma and 2 (6.5%) had Grade III glioma. Eleven (35.5%) patients were receiving corticosteroids at baseline; 17 (54.8%) and 14 (45.2%) patients had experienced one or two relapses, respectively. The 6-month progression-free survival rate in the 29 patients with recurrent glioblastoma was 33.9% (90% confidence interval, 19.2–48.5) and the median progression-free survival was 3.3 months. The 1-year survival rate was 34.5% with a median overall survival of 10.5 months. There were eight responders (all partial responses) giving an objective response rate of 27.6%. The disease control rate was 79.3%. Eight of the 11 patients taking corticosteroids at baseline reduced their dose or discontinued corticosteroids during the study. Bevacizumab was well-tolerated and Grade ?3 adverse events of special interest to bevacizumab were as follows: hypertension [3 (9.7%) patients], congestive heart failure [1 (3.2%) patient] and venous thromboembolism [1 (3.2%) patient]. One asymptomatic Grade 1 cerebral hemorrhage was observed, which resolved without treatment. Conclusion Single-agent bevacizumab provides clinical benefit for Japanese patients with recurrent glioblastoma.

Nagane, Motoo; Nishikawa, Ryo; Narita, Yoshitaka; Kobayashi, Hiroyuki; Takano, Shingo; Shinoura, Nobusada; Aoki, Tomokazu; Sugiyama, Kazuhiko; Kuratsu, Junichi; Muragaki, Yoshihiro; Sawamura, Yutaka; Matsutani, Masao

2012-01-01

291

Psychological characteristics of Japanese patients with chronic pain assessed by the Rorschach test  

PubMed Central

Background The increasing number of patients with chronic pain in Japan has become a major issue in terms of the patient's quality of life, medical costs, and related social problems. Pain is a multi-dimensional experience with physiological, affective, cognitive, behavioral and social components, and recommended to be managed via a combination of bio-psycho-social aspects. However, a biomedical approach is still the dominant method of pain treatment in Japan. The current study aimed to evaluate comprehensive psychological functions and processes in Japanese chronic pain patients. Methods The Rorschach Comprehensive System was administered to 49 in-patients with non-malignant chronic pain. Major variables and frequencies from the test were then compared to normative data from non-patient Japanese adults by way of the t-test and chi-square test. Results Patients exhibited high levels of emotional distress with a sense of helplessness with regard to situational stress, confusion, and ambivalent feelings. These emotions were managed by the patients in an inappropriate manner. Cognitive functions resulted in moderate dysfunction in all stages. Information processing tended to focus upon minute features in an inflexible manner. Mediational dysfunction was likely to occur with unstable affective conditions. Ideation was marked by pessimistic and less effective thinking. Since patients exhibited negative self-perception, their interpersonal relationship skills tended to be ineffective. Originally, our patients displayed average psychological resources for control, stress tolerance, and social skills for interpersonal relationships. However, patient coping styles were either situation- or emotion-dependent, and patients were more likely to exhibit emotional instability influenced by external stimuli, resulting in increased vulnerability to pain. Conclusions Data gathered from the Rorschach test suggested psychological approaches to support chronic pain patients that are likely to be highly beneficial, and we thus recommend their incorporation into the course of current pain treatments.

2010-01-01

292

Age, Race, Diabetes, Blood Pressure, and Mortality among Hemodialysis Patients  

PubMed Central

Observational studies involving hemodialysis patients suggest a U-shaped relationship between BP and mortality, but the majority of these studies followed large, heterogeneous cohorts. To examine whether age, race, and diabetes status affect the association between systolic BP (SBP; predialysis) and mortality, we studied a cohort of 16,283 incident hemodialysis patients. We constructed a series of multivariate proportional hazards models, adding age and BP to the analyses as cubic polynomial splines to model potential nonlinear relationships with mortality. Overall, low SBP associated with increased mortality, and the association was more pronounced among older patients and those with diabetes. Higher SBP associated with increased mortality among younger patients, regardless of race or diabetes status. We observed a survival advantage for black patients primarily among older patients. Diabetes associated with increased mortality mainly among older patients with low BP. In conclusion, the design of randomized clinical trials to identify optimal BP targets for patients with ESRD should take age and diabetes status into consideration.

Myers, Orrin B.; Adams, Christopher; Rohrscheib, Mark R.; Servilla, Karen S.; Miskulin, Dana; Bedrick, Edward J.

2010-01-01

293

Diabetic nephropathy in African-American patients  

Microsoft Academic Search

Diabetic nephropathy (DN) is the number one cause of endstage renal disease (ESRD) in the United States and is highly prevalent\\u000a in African Americans. Since 1997, DN has been the number one cause of ESRD in African Americans. In African Americans, almost\\u000a all DN is due to type 2 diabetes mellitus (T2DM), and nephropathy may affect female more than male

Errol D. Crook; Sejal R. Patel

2004-01-01

294

Thyroid Cancer Risk Is Not Increased in Diabetic Patients  

PubMed Central

Objective This study evaluated thyroid cancer risk with regards to diabetes status and diabetes duration, and with the use of anti-diabetic drugs including sulfonylurea, metformin, insulin, acarbose, pioglitazone and rosiglitazone, by using a population-based reimbursement database in Taiwan. Methods A random sample of 1,000,000 subjects covered by the National Health Insurance was recruited. After excluding patients with type 1 diabetes, 999730 subjects (495673 men and 504057 women) were recruited into the analyses. Logistic regression estimated the odds ratios (OR) and their 95% confidence intervals (CI) for independent variables including age, sex, diabetes status/duration, anti-diabetic drugs, other medications, comorbidities, living regions, occupation and examinations that might potentially lead to the diagnosis of thyroid cancer in various models. Results The diabetic patients had a significantly higher probability of receiving potential detection examinations (6.38% vs. 5.83%, P<0.0001). After multivariable-adjustment, the OR (95% CI) for diabetes status was 0.816 (0.652–1.021); and for diabetes duration <1 year, 1–3 years, 3–5 years and ?5 years vs. non-diabetes was 0.071 (0.010–0.507), 0.450 (0.250–0.813), 0.374 (0.203–0.689) and 1.159 (0.914–1.470), respectively. Among the anti-diabetic agents, only sulfonylurea was significantly associated with thyroid cancer, OR (95% CI): 1.882 (1.202–2.947). The OR (95% CI) for insulin, metformin, acarbose, pioglitazone and rosiglitazone was 1.701 (0.860–3.364), 0.696 (0.419–1.155), 0.581 (0.202–1.674), 0.522 (0.069–3.926) and 0.669 (0.230–1.948), respectively. Furthermore, patients with benign thyroid disease or other cancer, living in Kao-Ping/Eastern regions, or receiving potential detection examinations might have a significantly higher risk; and male sex, hypertension, dyslipidemia, chronic obstructive pulmonary disease, vascular complications or use of statin, aspirin or non-steroidal anti-inflammatory drugs might be associated with a significantly lower risk. Conclusions There is a lack of an overall association between diabetes and thyroid cancer, but patients with diabetes duration <5 years have a significantly lower risk. Sulfonylurea may increase the risk of thyroid cancer.

Tseng, Chin-Hsiao

2012-01-01

295

Three novel ZBTB24 mutations identified in Japanese and Cape Verdean type 2 ICF syndrome patients.  

PubMed

Immunodeficiency, centromeric instability and facial anomalies (ICF) syndrome is a rare autosomal recessive disorder that shows DNA hypomethylation at pericentromeric satellite-2 and -3 repeats in chromosomes 1, 9 and 16. ICF syndrome is classified into two groups: type 1 (ICF1) patients have mutations in the DNMT3B gene and about half of type 2 (ICF2) patients have mutations in the ZBTB24 gene. Besides satellite-2 and -3 repeats, ?-satellite repeats are also hypomethylated in ICF2. In this study, we report three novel ZBTB24 mutations in ICF2. A Japanese patient was homozygous for a missense mutation (C383Y), and a Cape Verdean patient was compound heterozygous for a nonsense mutation (K263X) and a frame-shift mutation (C327W fsX54). In addition, the second Japanese patient was homozygous for a previously reported nonsense mutation (R320X). The C383Y mutation abolished a C2H2 motif in one of the eight zinc-finger domains, and the other three mutations caused a complete or large loss of the zinc-finger domains. Our immunofluorescence analysis revealed that mouse Zbtb24 proteins possessing a mutation corresponding to either C383Y or R320X are mislocalized from pericentrometic heterochromatin, suggesting the importance of the zinc-finger domains in proper intranuclear localization of this protein. We further revealed that the proper localization of wild-type Zbtb24 protein does not require DNA methylation. PMID:23739126

Nitta, Hirohisa; Unoki, Motoko; Ichiyanagi, Kenji; Kosho, Tomoki; Shigemura, Tomonari; Takahashi, Hiroshi; Velasco, Guillaume; Francastel, Claire; Picard, Capucine; Kubota, Takeo; Sasaki, Hiroyuki

2013-06-06

296

Long-term efficacy and safety of eculizumab in Japanese patients with PNH: AEGIS trial.  

PubMed

Paroxysmal nocturnal hemoglobinuria (PNH) is a rare, progressive hematopoietic stem cell disorder characterized by chronic complement-mediated hemolysis leading to life-threatening complications and early mortality. Eculizumab, a humanized anti-C5 monoclonal antibody, inhibits terminal complement activation, reduces hemolysis, decreases the risk of thrombosis, and improves renal function and quality of life in PNH patients. The long-term efficacy and safety of eculizumab in Japanese patients were assessed in a 2-year extension to a 12-week, open-label study (AEGIS). Eculizumab treatment led to an immediate and sustained reduction in intravascular hemolysis (P < 0.001) and red blood cell transfusions (P = 0.0016) compared with baseline levels. There were no reports of thromboembolism during eculizumab treatment. The majority of patients had stable (56 %) or improved (41 %) renal function and an improved quality of life (P = 0.015), with sustained reductions in fatigue and dyspnea. Eculizumab was well tolerated; no deaths or serious hemolytic events were reported, and the rate of infections declined over time. There were no significant differences in the response to eculizumab in patients with or without bone marrow dysfunction. These results demonstrate that eculizumab is an effective, well-tolerated long-term treatment for Japanese PNH patients and leads to continued amelioration of some hemolytic complications. PMID:23934275

Kanakura, Yuzuru; Ohyashiki, Kazuma; Shichishima, Tsutomu; Okamoto, Shinichiro; Ando, Kiyoshi; Ninomiya, Haruhiko; Kawaguchi, Tatsuya; Nakao, Shinji; Nakakuma, Hideki; Nishimura, Jun-Ichi; Kinoshita, Taroh; Bedrosian, Camille L; Ozawa, Keiya; Omine, Mitsuhiro

2013-08-11

297

Nonalcoholic fatty liver disease in patients with type 2 diabetes  

Microsoft Academic Search

Background & Aims: Nonalcoholic fatty liver disease (NAFLD) is reported commonly in patients with type 2 diabetes mellitus (DM), which has been suggested as a risk factor for the progressive form of NAFLD, or nonalcoholic steatohepatitis. The aim of this study was to assess the outcome of patients with NAFLD and DM. Methods: A cohort of patients with NAFLD was

Zobair M Younossi; Terry Gramlich; Christi A Matteoni; Navdeep Boparai; Arthur J McCullough

2004-01-01

298

The State of Lipid Control in Patients with Diabetes in a Public Health Care Centre  

Microsoft Academic Search

Achieving treatment targets has been difficult in treating diabetic patients. This cross-sectional study describes the lipid profiles of patients with diabetes mellitus at a public primary health care centre in Sarawak, Malaysia. The targets for lipid control were based on the International Diabetes Federation recommendation (2002). 1031 patients (98% Type 2 Diabetes) were studied. Fasting lipid profiles were available in

JS Wong; F. Tan; PY Lee

2007-01-01

299

Plasma Level of Oxidized Low Density Lipoprotein in Macroalbuminuric Type 2 Diabetic Patients versus Normoalbuminuric Group  

Microsoft Academic Search

Accumulating evidence suggest that in patients with diabetes mellitus, increased rate of lipoprotein oxidation and oxidative stress have imp ortant role in diabetic angiopathy, including nephr opathy. To evaluate the association of oxidized low- densit y lipoprotein (ox-LDL) with the development of diabetic nephropathy, plasma level of ox-LDL were measured in 70 diabetic patients with macro and 63 patients w

Manoochehr Nakhjavani; Firouzeh Asgarani; Fatemeh Esfahanian; Alireza Esteghamati

300

[Gastric emptying in non-insulin dependent diabetic patients].  

PubMed

Disordered gastrointestinal motility is an often overlooked clinical problem. Delayed gastric emptying of solid and/or liquid meal in patients with both type 1 and type 2 diabetes mellitus occurs in approximately 50% of these patients. Gastric emptying time (GET) was studied in seventy four non-insulin dependent (type 2) diabetic out-patients by using radionuclide gamma-photography with Tc-99m phytate solid experimental meal. Thirty nine of them received Tc-99m phytate liquid test meal on the next day. Forty six normal healthy volunteers acted as controls. The results showed that solid GET in patients with type 2 diabetes mellitus was significantly delayed (149.44 +/- 64.0 min) as compared with that in the control group (88.7 +/- 14.2 min) (p < 0.001). Fifty three among these 74 diabetic patients had delayed solid GET, accounting for 71.6%. Only 5 of 39 (12.8%) diabetic patients showed delayed liquid GET (average 38.7 +/- 35.3 min; control 46.2 +/- 11.1 min). There were no differences in sugar control, duration of the disease, and upper gastrointestinal symptoms between patients with delayed GET and those with normal GET. We concluded that delayed gastric emptying is very common in patients with non-insulin dependent diabetes mellitus and which has no direct correlation to blood sugar control, duration of the disease, and upper gastrointestinal symptoms. Radionuclide solid gastric emptying test is a both safe (low radioactivity) and convenient (non-invasive) diagnostic tool in non-insulin dependent diabetic gastroparesis. PMID:8699568

Yang, S S; Huang, C K; Chen, G H; Kao, C H; Chang, C S

1996-06-01

301

Low-Dose Aspirin Therapy in Patients With Type 2 Diabetes and Reduced Glomerular Filtration Rate  

PubMed Central

OBJECTIVE Type 2 diabetes accompanied by renal damage is a strong risk factor for atherosclerotic events. The purpose of this study was to investigate the efficacy of low-dose aspirin therapy on primary prevention of atherosclerotic events in patients with type 2 diabetes and coexisting renal dysfunction. RESEARCH DESIGN AND METHODS The Japanese Primary Prevention of Atherosclerosis With Aspirin for Diabetes (JPAD) trial was a prospective, randomized, open-label trial conducted throughout Japan that enrolled 2,539 type 2 diabetic patients without a history of atherosclerotic diseases. Patients were assigned to the aspirin group (81 mg/day or 100 mg/day) or the nonaspirin group and followed for a median of 4.37 years. The primary end points were atherosclerotic events of fatal and nonfatal ischemic heart disease, stroke, and peripheral arterial disease. RESULTS The analysis included 2,523 patients who had serum creatinine measured. In 1,373 patients with baseline estimated glomerular filtration rate (eGFR) 60–89 mL/min/1.73 m2, the incidence of primary end points was significantly lower in the aspirin group than in the nonaspirin group (aspirin, 30/661; nonaspirin, 55/712; hazard ratio 0.57 [95% CI 0.36–0.88]; P = 0.011). Low-dose aspirin therapy did not reduce primary end points in patients with eGFR ?90 mL/min/1.73 m2 (aspirin, 9/248; nonaspirin, 11/270; 0.94 [0.38–2.3]) or those with eGFR <60 mL/min/1.73 m2 (aspirin, 29/342; nonaspirin, 19/290; 1.3 [0.76–2.4]). The Cox proportional hazard model demonstrated a significant interaction between mild renal dysfunction (eGFR 60–89 mL/min/1.73 m2) and aspirin (P = 0.02). CONCLUSIONS These results suggest a differential effect of low-dose aspirin therapy in diabetic patients with eGFR 60–89 mL/min/1.73 m2.

Saito, Yoshihiko; Morimoto, Takeshi; Ogawa, Hisao; Nakayama, Masafumi; Uemura, Shiro; Doi, Naofumi; Jinnouchi, Hideaki; Waki, Masako; Soejima, Hirofumi; Sugiyama, Seigo; Okada, Sadanori; Akai, Yasuhiro

2011-01-01

302

Are diabetic patients being screened for sleep related breathing disorder?  

PubMed

Prevalence of both diabetes mellitus and obstructive sleep apnea (OSA) is high among general population. Both of these conditions are associated with significant morbidity. OSA affects approximately 25% of men and 9% of women, and its prevalence is even higher among obese, Hispanics, African American and diabetic patients. Diabetes on the other hand besides having high prevalence in general population has even higher prevalence among ethnic populations as Hispanics and African American. Despite the availability of several simple screening tools for OSA, as Berlin questionnaire, STOP-BANG questionnaire, NAMES Criteria, the utility for screening of OSA among the diabetic population remains marginal. This in turn can lead to significant morbidity and complications related to OSA as well as worsening of diabetes mellitus and increase in diabetic complications due to untreated sleep related breathing disorder. It is therefore imperative for the primary care giver to screen for OSA among the diabetic population as a part of their routine evaluation to prevent worsening of diabetes, and its cardiovascular, renal, ophthalmologic and neurological complications. PMID:24147199

Surani, Salim

2013-10-15

303

Are diabetic patients being screened for sleep related breathing disorder?  

PubMed Central

Prevalence of both diabetes mellitus and obstructive sleep apnea (OSA) is high among general population. Both of these conditions are associated with significant morbidity. OSA affects approximately 25% of men and 9% of women, and its prevalence is even higher among obese, Hispanics, African American and diabetic patients. Diabetes on the other hand besides having high prevalence in general population has even higher prevalence among ethnic populations as Hispanics and African American. Despite the availability of several simple screening tools for OSA, as Berlin questionnaire, STOP-BANG questionnaire, NAMES Criteria, the utility for screening of OSA among the diabetic population remains marginal. This in turn can lead to significant morbidity and complications related to OSA as well as worsening of diabetes mellitus and increase in diabetic complications due to untreated sleep related breathing disorder. It is therefore imperative for the primary care giver to screen for OSA among the diabetic population as a part of their routine evaluation to prevent worsening of diabetes, and its cardiovascular, renal, ophthalmologic and neurological complications.

Surani, Salim

2013-01-01

304

Improvements in Care and Reduced Self-Management Barriers Among Rural Patients With Diabetes  

ERIC Educational Resources Information Center

|Improved preventive care and clinical outcomes among patients with diabetes can reduce complications and costs; however, diabetes care continues to be suboptimal. Few studies have described effective strategies for improving care among rural populations with diabetes. In 2000, the Park County Diabetes Project and the Montana Diabetes Control…

Dettori, Nancy; Flook, Benjamin N.; Pessl, Erich; Quesenberry, Kim; Loh, Johnson; Harris, Colleen; McDowall, Janet M.; Butcher, Marcene K.; Helgerson, Steven D.; Gohdes, Dorothy; Harwell, Todd S.

2005-01-01

305

[Causes of emergency hospitalization of elderly diabetic patients].  

PubMed

In recent years there has been a rise in the number of diabetic patients in Japan, with the increase in elderly diabetic patients becoming a serious problem. This study looked at 488 elderly type 2 diabetes patients who were admitted as emergency cases to the Department of Internal Medicine, JA Yoshida General Hospital, Akitakada City, Japan. All patients were classified by age into three groups: <70, 70-80 and >80. The most common cause of emergency hospitalization in each of the three age groups was infection. This was significantly higher in the >80 group in comparison with<70 (p<0.05). The most common infection among the three groups was respiratory infection, followed by urinary tract infection. The number of emergency hospitalization cases due to hypoglycemia was much higher in the over 80 group, particularly in comparison with<70-80 (p<0.05). The incidence of hypoglycemia in our patients could be explained mainly by reduced energy intake. Most cases were treated with oral administration of hypoglycemic drugs. As elderly diabetic patients have a number of underlying illnesses that are prone to aggravation and may lead to unfavorable prognosis, early medical examination and disease detection are considered to be important. Pharmacists are required to educate patients, home-visit nursing care personnel on sick-day rule, and provide diabetes care. PMID:23546590

Horikawa, Shunji; Kajitani, Shinya; Kawakami, Keiko; Tadasa, Nobuko; Ito, Akihiko

2013-01-01

306

Circulating soluble RAGE as a predictive biomarker of cardiovascular event risk in patients with type 2 diabetes.  

PubMed

It is still controversial whether circulating soluble form of receptor for AGE (sRAGE) is associated with atherosclerosis in diabetic patients. In this study, we enrolled 276 Japanese type 2 diabetic subjects without history of cardiovascular disease (CVD), assessed their baseline clinical and biochemical data including serum sRAGE levels, and prospectively evaluated the association between these parameters and CVD events. The median follow-up period was 5.6 years and there were 25 new CVD events. The tertile analysis showed that the risk for CVD events was higher as serum sRAGE levels were increased (p for trend = 0.046). A multivariate Cox proportional hazards regression analysis revealed that serum sRAGE levels were independently associated with CVD (HR per 1SD = 1.59, 95% CI 1.04-2.45, p = 0.034), even after adjusting for conventional coronary risk factors. In summary, elevated sRAGE levels were associated with the increased risk of CVD in Japanese type 2 diabetic subjects. PMID:23384720

Fujisawa, Keiko; Katakami, Naoto; Kaneto, Hideaki; Naka, Toyoko; Takahara, Mitsuyoshi; Sakamoto, Fumie; Irie, Yoko; Miyashita, Kazuyuki; Kubo, Fumiyo; Yasuda, Tetsuyuki; Matsuoka, Taka-Aki; Shimomura, Iichiro

2013-01-23

307

Comparison of blood electrolytes and glucose during cardiopulmonary bypass in diabetic and non-diabetic patients  

PubMed Central

Background: Cardiopulmonary bypass (CPB) during coronary artery bypass grafting is thought to contribute significantly to increased blood glucose level and altered blood electrolytes balance during the operation. In this (CABG) study, blood electrolytes and glucose during CPB in insulin-dependent diabetic and non-diabetic patients were assessed with special emphasis on the trend of the changes. Materials and Methods: Blood glucose and electrolytes were assessed in 30 insulin-dependent diabetic and 30 non-diabetic patients, classified as class II and III American Society of Anesthesiologist, before, during, and after CPB. Repeated-measures analysis of variance (ANOVA) was used to compare the trend of the changes during CPB for the two groups. Results: The trend in blood glucose level did not show any significant difference between two groups (P = 0.59). For other blood factors, no significant between-group difference was detected except for PaCO2 (P = 0.002). Conclusion: The study suggested that the changes in blood electrolytes and the increase in blood glucose level do not differ between insulin dependent diabetic and non-diabetic patients.

Maasoumi, Golamreza; Saberi, Kianoush

2013-01-01

308

Alcohol use of diabetes patients: the need for assessment and intervention  

Microsoft Academic Search

It is well known that diabetes self-care behaviors are critical to disease progression. Unfortunately, many patients do not\\u000a adhere to diabetes self-care recommendations despite their importance. Alcohol use has been identified as a barrier to diabetes\\u000a self-care adherence. Excessive alcohol consumption not only negatively impacts diabetes self-care adherence but also affects\\u000a the course of diabetes. Diabetes patients who are at-risk

Patricia A. EnglerSusan; Susan E. Ramsey; Robert J. Smith

309

Trandolapril/verapamil combination in hypertensive diabetic patients  

PubMed Central

Cardiovascular diseases are directly affected by arterial hypertension. When associated with diabetes mellitus, the potential deleterious effects are well amplified. Both conditions play a central role in the pathogenesis of coronary artery disease, heart failure, stroke, and renal insufficiency. Prevalence of hypertension is much higher among diabetic than non-diabetic patients, and the hypertensive patient is more likely to develop type 2 diabetes. Current international guidelines recommend aggressive reductions in blood pressure (BP) in hypertensive patients with additional risk factors, including cardiovascular risk factors, and emphasize the relevance of intensive reduction in patients with diabetes mellitus; a goal of 130/80 mm Hg is required. To achieve BP target a combination of antihypertensives will be needed, and the use of long-acting drugs that are able to provide 24-hour efficacy with a once-daily dosing confers the noteworthy advantages of compliance improvement and BP variation lessening. Lower dosages of the individual treatments of the combination therapy can be administered for the same antihypertensive efficiency as that attained with high dosages of monotherapy. Angiotensin-converting enzyme inhibitors and calcium-channel blockers as a combination have theoretically compelling advantages for vessel homeostasis. Trandolapril/verapamil sustained release combination has showed beneficial effects on cardiac and renal systems as well as its antihypertensive efficacy, with no metabolic disturbances. This combination can be considered as an effective therapy for the diabetic hypertensive population.

Garcia Donaire, Jose A; Ruilope, Luis M

2007-01-01

310

Low Lung Function and Risk of Type 2 Diabetes in Japanese Men: The Toranomon Hospital Health Management Center Study 9 (TOPICS 9)  

PubMed Central

Objective To evaluate the effect of elevated fasting plasma glucose (FPG) and hemoglobin A1c (HbA1c) concentrations on lung dysfunction and to prospectively investigate whether reduced lung function would be independently predictive of diabetes. Participants and Methods From January 6, 1997, through December 22, 2008, we observed 5346 men with no history of diabetes or lung dysfunction. Hazard ratios (HRs) for incident diabetes (FPG ?126 mg/dL, HbA1c ?6.5%, or self-reported clinician-diagnosed diabetes) were estimated for spirometry indices as continuous and categorical variables. Results Elevated HbA1c concentrations within the normal range were significantly and more strongly associated with reduced forced vital capacity and forced expiratory volume in the first second after expiration (FEV1) than were FPG concentrations. During a 4.0-year follow-up, diabetes developed in 214 individuals. A 10-point decrease in percentage of FEV1 predicted value was associated with an increased HR of 1.21 (95% confidence interval [CI], 1.09-1.34; P=.001) for diabetes after adjustment for demographic factors and body mass index. This association remained significant even after adjustment for metabolic factors, smoking status, and FPG or HbA1c concentrations but was attenuated substantially after adjustment for baseline HbA1c values (HR, 1.13; 95% CI, 1.01-1.26; P=.03). Lower quartile (Q) categories of percentage of FEV1 predicted value were associated with increased risk of diabetes independently of known predictors including HbA1c (HR, 1.73; 95% CI, 1.14-2.62 for Q1; and HR, 1.76; 95% CI, 1.15-2.69 for Q2). Conclusion Reduced lung function was significantly related to chronic glycemic exposure within a normal range. Relatively low pulmonary function was an independent risk factor for diabetes in apparently healthy Japanese men.

Heianza, Yoriko; Arase, Yasuji; Tsuji, Hiroshi; Saito, Kazumi; Amakawa, Kazuhisa; Hsieh, Shiun Dong; Kodama, Satoru; Shimano, Hitoshi; Yamada, Nobuhiro; Hara, Shigeko; Sone, Hirohito

2012-01-01

311

Severe hypoglycaemia and cognitive impairment in older patients with diabetes: the Fremantle Diabetes Study  

Microsoft Academic Search

Aims\\/hypothesis  The aim was to investigate the relationship between severe hypoglycaemia and cognitive impairment in older patients with diabetes.\\u000a \\u000a \\u000a \\u000a Methods  A sample of 302 diabetic patients aged ?70 years was assessed for dementia or cognitive impairment without dementia in 2001–2002\\u000a and a subsample of non-demented patients (n?=?205) was followed to assess cognitive decline. A history of severe hypoglycaemia was determined from self-reports, physician

D. G. Bruce; W. A. Davis; G. P. Casey; R. M. Clarnette; S. G. A. Brown; I. G. Jacobs; O. P. Almeida; T. M. E. Davis

2009-01-01

312

LRRK2 Mutations and Risk Variants in Japanese Patients with Parkinson's Disease  

PubMed Central

Mutations in the leucine-rich repeat kinase 2 (LRRK2) gene are the most common genetic determinant of Parkinson’s disease (PD) in European-derived populations, but far less is known about LRRK2 mutations and susceptibility alleles in Asians. To address this issue, we sequenced the LRRK2 coding region in 36 patients with familial PD, then genotyped variants of interest in an additional 595 PD cases and 1,641 controls who were all of Japanese ancestry. We also performed a meta-analysis of studies on G2385R, a polymorphism previously reported to associate with PD. One pathogenic (G2019S) and one putative pathogenic (R1067Q) mutation were each observed in two patients with sporadic PD. The overall mutation frequency among patients was 0.6%. G2385R was highly associated with PD under a dominant model in our dataset (adjusted OR, 1.83; 95% CI, 1.31–2.54; P = 3.3 × 10?4) and similar results were seen in the meta-analysis (summary OR assuming fixed effects, 2.55; 95% CI, 2.10–3.10). G2385R represents the first consistently replicated common PD susceptibility variant in a non-European population and its effect size is substantially greater than that reported for other well-validated genetic risk factors for the disease. However, LRRK2 mutations appear to be rare among Japanese patients with PD.

Zabetian, Cyrus P.; Yamamoto, Mitsutoshi; Lopez, Alexis N.; Ujike, Hiroshi; Mata, Ignacio F.; Izumi, Yuishin; Kaji, Ryuji; Maruyama, Hirofumi; Morino, Hiroyuki; Oda, Masaya; Hutter, Carolyn M.; Edwards, Karen L.; Schellenberg, Gerard D.; Tsuang, Debby W.; Yearout, Dora; Larson, Eric B.; Kawakami, Hideshi

2010-01-01

313

Prevalence of Diabetic Retinopathy and Cataract in Adult Patients With Type 1 And Type 2 Diabetes in Russia  

PubMed Central

AIM: The aim of the study was to identify the prevalence of diabetic retinopathy (DR) and diabetic cataract (DC) in type 1 and type 2 diabetic patients within the Russian Federation. Also, the stage of DR at the time of its identification and the proportion of new cases diagnosed with DR or DC were to be determined. METHODS: A random sample of 7,186 adult patients with diabetes was screened for DR and DC using fundoscopy and fundus photography. Levels of HbA1c, total cholesterol, triglycerides, creatinine and urinary albumin excretion rate were assessed. RESULTS: In diabetic patients, the prevalence of DR and DC was 45.9% and 30.6%, respectively. These complications appeared significantly more frequently in patients with type 1 diabetes than in type 2 diabetes. The prevalence of background, preproliferative and proliferative DR among diabetic patients was 28.1%, 8.1%, and 6.7%, respectively. Patients with DR were older, had a longer duration of diabetes, higher HbA1c, elevated plasma total cholesterol, increased triglicerides, and higher systolic BP, compared with patients without DR. Microalbuminuria and proteinuria were more prevalent among patients with DR compared with non-DR patients. CONCLUSIONS: The results showed that diabetic retinopathy and cataract are wide-spread complications among diabetic patients in Russia. However, the disease course is more aggressive and accelerated in patients with type 1 diabetes than in those having type 2 diabetes. Therefore, it is important to prevent DR by identifying diabetes and signs of retinopathy at the earliest possible stage of progression for timely and adequate retina laser coagulation or surgical treatment, compensation of carbohydrate and lipid metabolism, and normalization of blood glucose and pressure.

Dedov, Ivan; Maslova, Oxana; Suntsov, Yurii; Bolotskaia, Lubov; Milenkaia, Tamara; Besmertnaia, Lena

2009-01-01

314

Impact of intensive nutritional education with carbohydrate counting on diabetes control in type 2 diabetic patients.  

PubMed

This pilot study assessed the impact of an intensive carbohydrate counting educational intervention on diabetes control in type 2 diabetic patients. An experimental, prospective study design was used to assess the effect of nutritional education on diabetes control. The impact and efficacy of the education were measured over a 1-year period through changes in diabetes clinical markers, including hemoglobin A(1c), lipid profiles, glucose levels, patients' energy levels, and sense of well-being. Six patients were initially enrolled in the pilot study, with only three patients completing the intervention phase and the 3-month follow-up. Two patients were followed-up at the 1-year mark for their diabetes, although neither continued participation in the study beyond the 3-month mark. Marginal improvements in clinical markers at 3 months were found. However, due to the small sample size, changes in the clinical profiles may have occurred because of variables unrelated to the nutritional intervention. Further research is indicated for the control of these variables. PMID:21311697

Zipp, Christopher; Roehr, Jessica Terrone; Weiss, Lucia Beck; Filipetto, Frank

2010-12-30

315

Impact of intensive nutritional education with carbohydrate counting on diabetes control in type 2 diabetic patients  

PubMed Central

This pilot study assessed the impact of an intensive carbohydrate counting educational intervention on diabetes control in type 2 diabetic patients. An experimental, prospective study design was used to assess the effect of nutritional education on diabetes control. The impact and efficacy of the education were measured over a 1-year period through changes in diabetes clinical markers, including hemoglobin A1c, lipid profiles, glucose levels, patients’ energy levels, and sense of well-being. Six patients were initially enrolled in the pilot study, with only three patients completing the intervention phase and the 3-month follow-up. Two patients were followed-up at the 1-year mark for their diabetes, although neither continued participation in the study beyond the 3-month mark. Marginal improvements in clinical markers at 3 months were found. However, due to the small sample size, changes in the clinical profiles may have occurred because of variables unrelated to the nutritional intervention. Further research is indicated for the control of these variables.

Zipp, Christopher; Roehr, Jessica Terrone; Weiss, Lucia Beck; Filipetto, Frank

2011-01-01

316

Mutations in argininosuccinate synthetase mRNA of Japanese patients, causing classical citrullinemia  

SciTech Connect

Citrullinemia is an autosomal recessive disease caused by a genetic deficiency of argininosuccinate synthetase. In order to characterize mutations in Japanese patients with classical citrullinemia, RNA isolated from 10 unrelated patients was reverse-transcribed, and cDNA amplified by PCR was cloned and sequenced. The 10 mutations identified included 6 missense mutations (A118T, A192V, R272C, G280R, R304W, and R363L), 2 mutations associated with an absence of an exon 7 or exon 13, 1 mutation with a deletion of the first 7 bp in exon 16 (which might be caused by abnormal splicing), and 1 mutation with an insertion of 37 bp within exons 15 and 16 in cDNA. The insertion mutation and the five missense mutations (R304W being excluded) are new mutations described in the present paper. These are in addition to 14 mutations (9 missense mutations, 4 mutations associated with an absence of an exon in mRNA, and 1 splicing mutation) that we identified previously in mainly American patients with neonatal citrullinemia. Two of these 20 mutations, a deletion of exon 13 sequence and a 7-bp deletion in exon 16, were common to Japanese and American populations from different ethnic backgrounds; however, other mutations were unique to each population. Furthermore, the presence of a frequent mutation - the exon 7 deletion mutation in mRNA, which accounts for 10 of 23 affected alleles - was demonstrated in Japanese citrullinemia. This differs from the situation in the United States, where there was far greater heterogeneity of mutations.

Kobayashi, Keiko; Shaheen, Nazma; Terazono, Hiroki; Saheki, Takeyori [Kagoshima Univ. (Japan)

1994-12-01

317

Long-term efficacy and safety of gabapentin enacarbil in Japanese restless legs syndrome patients.  

PubMed

Several short- and long-term studies conducted in Europe/North America have demonstrated good efficacy and tolerability of 600-1800 mg gabapentin enacarbil (GEn). However, no studies have evaluated the efficacy of long-term treatment with GEn in Asian patients. Therefore, the objective of this study was to evaluate the efficacy and safety of long-term treatment with GEn in Japanese patients with restless legs syndrome (RLS) in a multicenter open-label study. RLS patients aged 20-80 years were allocated to receive oral GEn 1200 mg/day for a treatment period of 52 weeks. International Restless Legs Syndrome Scale (IRLS) score, investigator- and patient-rated Clinical Global Impression (CGI) scores, Pittsburgh Sleep Quality Index (PSQI) total scores and subscores, and short form (SF)-36 subscores were assessed, and adverse events (AEs) were monitored. In 181 patients (mean age, 54.9±12.2 years; BMI, 23.0±2.6 kg/m²) IRLS score decreased from 24.4±0.4 at baseline to 6.3±0.6 at week 52, with a reduction of -18.0±0.6. The IRLS responder rate was 80.3% at week 52. ICGI and PCGI responder rates were 87.1% and 87.1%, respectively. PSQI and SF-36 also showed significant improvements. AEs were reported in 96.2% of patients but remained mild-to-moderate in nearly all the cases. Serious AEs occurred in 1.6%. Dizziness and somnolence were noted in 46.2% and 41.2% of patients, respectively, and mostly occurred during the first 4 weeks. No episodes of augmentation were reported. In conclusion, long-term treatment with GEn improved RLS symptoms as well as investigator- and patient-reported outcomes in Japanese patients with moderate-to-severe RLS, with an acceptable safety profile. Randomized, double-blind, placebo/active-controlled trials are desirable to confirm these preliminary results. PMID:22036917

Inoue, Yuichi; Uchimura, Naohisa; Kuroda, Kenji; Hirata, Koichi; Hattori, Nobutaka

2011-10-19

318

Assessment of Japanese Stimulant Control Law Offenders Using the Addiction Severity Index--Japanese Version: Comparison with Patients in Treatment Settings  

PubMed Central

The present study assessed problems in Japanese prisoners (inmates) who abused methamphetamine. Fifty-two male inmates were assessed in 2005–2007 using the Addiction Severity Index-Japanese version and compared with 55 male methamphetamine abusers in hospitals and recovery centers. The ?2 and Mann-Whitney-Wilcoxon tests showed that the inmates had a significantly lower education level, more frequently had full-time jobs, had more experience living with a sexual partner, and more frequently had a history of juvenile delinquency and criminal records than patients. Although psychiatric symptoms, such as depression, anxiety, and hallucinations, were not common among inmates, suicidal behavior and trouble controlling violence were common in both groups.

Watanabe, Takashi; Ogai, Yasukazu; Koga, Takehiro; Senoo, Eiichi; Nakamura, Kazuhiko; Mori, Norio; Ikeda, Kazutaka

2009-01-01

319

Proteinuria in Type 2 Diabetic Patients with Renal Impairment: The Changing Face of Diabetic Nephropathy  

Microsoft Academic Search

Type 2 diabetic nephropathy (type 2 DN) patients traditionally develop significant proteinuria prior to the development of renal impairment. However, this clinical paradigm, based on observations prior to the widespread usage of angiotensin-converting enzyme inhibitors (ACEi) or angiotensin receptor blockers (ARB), has recently been questioned. 2,303 patients enrolled in the Sulodexide Overt Nephropathy Study (OVERT) were analyzed. Prior therapy with

David K. Packham; Sara E. Ivory; Anne T. Reutens; Rory Wolfe; Richard Rohde; Hiddo Lambers Heerspink; Jamie P. Dwyer; Robert C. Atkins; Julia Lewis

2011-01-01

320

Quantitative estimation of antioxidant therapy efficiency in diabetes mellitus patients  

NASA Astrophysics Data System (ADS)

The aim of this work was to find out to which degree Tanakan affects the microcirculation parameters and the malonic dialdehyde level as a parameter of intense lipid peroxidation in insulin-independent diabetes patients with different disease durations. We used computerized capillaroscope GY-0.04 designed by the Centre for Analysis of Substances, Russia for the non-invasive measurement of capillary blood velocity as well as the size of the perivascular zone and density of blood aggregates and lipid inclusions. The microcirculation parameters were studied in two groups of insulin-independent diabetes patients. The basic group included 58 patients (61+/- 9,0 years, disease duration 14,7+/- 7,8 years). The patients had late diabetic complications as retinopathy and nephrophathy, neuropathy, confirmed by clinical and tool investigation. In this group we also studied the level of serum malonic dialdehyde, as a parameter of intense lipid peroxidation. The reference group included 31 patients (57+/- 1,3 years, disease duration 3,6+/- 0,6 years) with minimum diabetic complication. We show that Tanakan in daily dosage 120 mg for 2 months reduces the malonic dialdehyde level in the blood serum and the erythrocyte membranes of type II diabetes patients and improves the microcirculation parameters. There are correspondences between the density of lipid inclusions as determined with computerized capillaroscopy and the lipid exchange parameters as determined using a routing blood test. Thus, noninvasive blood lipid quantification is feasible and reliable.

Gurfinkel, Youri I.; Ishunina, Angela M.; Ovsyannickov, Konstantin V.; Strokov, Igor A.

2000-11-01

321

Ultrasonic Measurement of Common Carotid Intima-Media Thickness in Type 2 Diabetic and Non-Diabetic Patients  

PubMed Central

Background Diabetes mellitus is a widespread disease. Its vascular complications can be characterized by arteriosclerosis formation in carotid arteries. Due to its delayed diagnosis resulting in more complications in Iran, it seems that screening diabetic patients is mandatory. Objectives The aim of this study was to compare the intima-media thickness (IMT) of carotid artery in diabetic and non-diabetic patients. Patients and Methods This is a cross-sectional study, which included 80 participants (40 diabetics and 40 non-diabetics). By using ultrasound, bilateral IMTs of the distal carotid were measured and the data were analyzed using ANOVA and multivariate regression tests in SPSS 14. Results The mean IMT was 0.97 in diabetic patients and 0.63 in non-diabetics (P < 0.001). Age and gender had significant positive effects on the increase of IMT (P < 0.05 and P < 0.005, respectively for age and gender). Past medical history of coronary heart disease (CHD) and cerebrovascular accident (CVA) in diabetes is associated significantly with an increase in IMT (P =0.019 and 0.027 respectively). Other confounding variables such as smoking, history of hypertension (HTN) and hyperlipoproteinemia (HLP) in diabetic patients showed no significant relationship with the increase of IMT. Conclusions Although measuring the IMT of the carotid artery by sonography is a useful tool for screening diabetic patients, more studies are needed for determining how to use these measurements in promoting the patients outcomes.

Alizadeh, Ahmad; Roudbari, Ali; Heidarzadeh, Abtin; Babaei Jandaghi, Ali; Bani Jamali, Maryam

2012-01-01

322

Screening for undiagnosed diabetes in patients with acute myocardial infarction  

Microsoft Academic Search

Background  Screening for undiagnosed diabetes in patients with acute myocardial infarction is recommended (ESC and EASD Task Force 2007).\\u000a Glucose tolerance testing in the peri-infarct period may not be valid because of confounding, e.g. by the acute stress reaction.\\u000a The aim was to evaluate undiagnosed diabetes (DM) and impaired glucose regulation (IGR) in AMI during hospital stay and 3\\u000a months after

Mark Lankisch; Reiner Füth; Hartmut Gülker; Harald Lapp; Alexander Bufe; Burkhard Haastert; Stephan Martin; Wolfgang Rathmann

2008-01-01

323

Efficacy, tolerability, and safety of risedronate in Japanese patients with Paget’s disease of bone  

Microsoft Academic Search

This study evaluated the clinical efficacy of treatment with oral risedronate (17.5 mg once daily) for 8 weeks in 11 Japanese\\u000a patients with Paget’s disease of bone (PDB). Risedronate suppressed the excessive bone turnover associated with PDB and improved\\u000a several biochemical markers, including serum alkaline phosphatase (ALP), serum bone-specific ALP (BALP), urinary deoxypyridinoline\\u000a (DPD), and urinary cross-linked N-telopeptide of type 1 collagen

Shinjiro Takata; Noriko Yoshimura; Jun Hashimoto

2010-01-01

324

A retrospective analysis of voriconazole pharmacokinetics in Japanese pediatric and adolescent patients.  

PubMed

Voriconazole (VFEND(®)) is a triazole antifungal agent which inhibits the biosynthesis of ergosterol, a fungal cell membrane component. In Japan, voriconazole has become a commonly used antimicrobial in off-label use for pediatric patients. The aims of this report were to provide information about voriconazole pharmacokinetics (PK) in Japanese pediatric and adolescent patients, and to explore relationships between the PK, administered dose, and laboratory test results. In total, data from 24 pediatric or adolescent patients (18 males and 6 females) were used for the analysis. For the measurement of plasma voriconazole concentrations, 103 blood samples were collected from the 24 patients. As a whole, median plasma voriconazole concentrations following intravenous and oral administrations were comparable, and the trough plasma concentrations at steady state (C (12,ss)) increased with increasing voriconazole doses (mg/kg). However, no systematic trend was observed between C (12,ss) and laboratory test results. PMID:22714745

Mori, Masaaki; Fukushima, Keitaro; Miharu, Masashi; Goto, Hiroaki; Yoshida, Makoto; Shoji, Satoshi

2012-06-21

325

Properties of erythrocyte light refraction in diabetic patients.  

PubMed

Since hyperglycaemia changes the erythrocyte cell membrane fluidity and impairs cell deformity, our goal was to characterize hemoglobin and red blood cell (RBC) light refractive property changes in diabetic patients. Microscopic investigation was carried out on intact and fixed RBCs. To determine the refractive index (RI): smears of peripheral blood were air dried and fixed for 3 min in methanol. Mixtures of polyvinylpyrolidine and buffer of different pH (1:1) were used as embedding media. Intact RBCs were mixed with a buffered embedding medium, placed on a slide and overlaid with a coverslip. Interference microscopy was used for RI measurements at 18 different pH (pH=2-13). The results showed that curves of the RI of diabetic patients and of a control group were of similar configuration, with one branch in the acidic portion of the pH scale, a maximum and two minima in the neutral (middle) portion, and one branch in the alkaline portion. The curves of the individuals from the control group overlapped each other. To the contrary, the curves of the diabetic patients were not uniform in the neutral portion and the alkaline portion. The curves of the diabetic patients in the neutral zone were shifted towards the alkaline end of the pH scale, and the RBC RI curves were lower in comparison to the control curves. The center maximum of the curves of diabetic patients corresponded to pH=6.6 whereas the central maximum of the control group curves was at pH=6.2-6.8. Contrary to in the diabetic group, intact RBC RI curves in the control group revealed only one significantly different minimum at pH of 7.2 in the neutral zone. Using this method it is possible to show phenotypic differences between uniform type intact and fixed cells, erythrocytes of diabetic patients and of healthy donors. PMID:11966310

Mazarevica, Gunta; Freivalds, Talivaldis; Jurka, Antra

2002-04-01

326

Myocardial perfusion scintigraphy in asymptomatic diabetic patients: a critical review.  

PubMed

The increasing prevalence of diabetes mellitus and the associated high cardiovascular risk has made the non-invasive identification of silent coronary heart disease in diabetic individuals an important issue. This strategy could identify higher risk asymptomatic patients with diabetes mellitus in whom coronary revascularization may improve the outcome beyond that achieved by currently recommended medical management. Stress myocardial perfusion imaging has been shown to be effective in detecting coronary heart disease and predicting adverse cardiac events in asymptomatic diabetic patients. However, the clinical utility of myocardial perfusion scintigraphy is debated intensively due to the paucity of prospective and outcome based evidence. The controversy stems from several observational studies, epidemiologic data and cost-effectiveness analyses. Thus, although several authors and professional organizations advocate the use of stress imaging for screening higher risk asymptomatic diabetic patients, others are cautious in recommending any kind of stress testing in that population. This review is based on a broad survey of the literature and discusses the potential role of stress myocardial perfusion scintigraphy in screening asymptomatic diabetic subjects for coronary heart disease in the current era and in relation with other non-invasive screening tools. PMID:20583311

Moralidis, E; Didangelos, T; Arsos, G; Athyros, V; Mikhailidis, D P

2010-07-01

327

Osteoprotegerin as a Marker of Atherosclerosis in Diabetic Patients  

PubMed Central

Atherosclerosis is the principal cause of cardiovascular disease (CVD) and has many risk factors, among which is diabetes. Osteoprotegerin (OPG) is a soluble glycoprotein, involved in bone metabolism. OPG is also found in other tissues, and studies have shown that it is expressed in vascular smooth muscle cells. OPG has been implicated in various inflammations and also has been linked to diabetes mellitus. Increased serum OPG levels were found in patients with diabetes and poor glycemic control. Furthermore, prepubertal children with type 1 diabetes have significantly increased OPG levels. Receptor activator of nuclear factor kappa-B ligand (RANKL) is not found in the vasculature in normal conditions, but may appear in calcifying areas. OPG and RANKL are important regulators of mineral metabolism in both bone and vascular tissues. Few data are available on the relationship between plasma OPG/RANKL levels and endothelial dysfunction as assessed using noninvasive methods like ultrasound indexes, neither in the general population nor, more specifically, in diabetic patients. The aim of our review study was to investigate, based on the existing data, these interrelationships in order to identify a means of predicting, via noninvasive methods, later development of endothelial dysfunction and vascular complications in diabetic patients.

Augoulea, Areti; Vrachnis, Nikolaos; Lambrinoudaki, Irene; Dafopoulos, Konstantinos; Iliodromiti, Zoe; Daniilidis, Angelos; Varras, Michail; Alexandrou, Andreas; Deligeoroglou, Efthymios; Creatsas, George

2013-01-01

328

Decline in the Cumulative Incidence of Severe Diabetic Retinopathy in Patients With Type 1 Diabetes  

PubMed Central

OBJECTIVE To determine if the cumulative incidence of severe retinopathy in patients with type 1 diabetes has changed. RESEARCH DESIGN AND METHODS The study looked at 3,781 patients diagnosed with type 1 diabetes (1939–2005), median age at onset 13 (interquartile range [IQR] 9–21) years, and duration of diabetes 19 (IQR 13–27) years. The severe retinopathy was based on a history of laser treatment. Patients were divided into <1975, 1975–1979, 1980–1984, and ?1985 cohorts according to the diagnosis of diabetes. RESULTS The cumulative incidence of severe retinopathy has declined (P < 0.0001). After 20 years of duration, the cumulative incidence was 23% (95% CI 21–25) and 33 (30–35) in the earliest cohorts, 18 (15–21) in the next cohort, and 6 (4–9) in the recent cohort. After 30 years, the cumulative incidence was 52 and 48% in the earliest cohorts, while it was 62% after 40 years in the earliest cohort. CONCLUSIONS The cumulative incidence of severe retinopathy has declined in patients with type 1 diabetes.

Kyto, Janne P.; Harjutsalo, Valma; Forsblom, Carol; Hietala, Kustaa; Summanen, Paula A.; Groop, Per-Henrik

2011-01-01

329

Earlobe crease and coronary heart disease in Japanese  

Microsoft Academic Search

Summary To evaluate whether a significant statistical correlation exists between earlobe crease (EC) and coronary heart disease (CHD), 1000 Japanese adult patients (573 males, 427 females) were examined for the presence or absence of EC, clinical or angiographic evidence of CHD, and the following coronary risk factors: male sex, age over 50 years, obesity, hypertension, diabetes mellitus, cigarette smoking, and

Nobuo Toyosaki; Masao Tsuchiya; Toyozou Hashimoto; Ken-ichi Kawasaki; Akira Shiina; Teruhiko Toyooka; Toshitaka Noda; Norihiko Terao; Katsuji Takeda; Akito Ishibashi; Muneya Suzuki; Yasushi Asano; Toshio Yaginuma; Saichi Hosoda

1986-01-01

330

Risk factors in patients with type 2 diabetes mellitus.  

PubMed

This study was carried out to evaluate the risk factors of type 2 diabetic patients through sociodemographic data, habits of health, anthropometric and biochemist profiles, assisted at a basic public health care unit in Maringá, Paraná. Sixty-six patients, 56 women aged over than 50 years-old were interviewed. High prevalence factors for cardiovascular risk were observed, such as: overweight and obesity, hypertension, dyslipidemia, sedentariness and inadequate diet. Data suggested the need for multidisciplinary intervention programs in health care units associated to educative programs, adjusted diet intake and regular physical activity for these diabetic patients. PMID:18506342

Carolino, Idalina Diair Regla; Molena-Fernandes, Carlos Alexandre; Tasca, Raquel Soares; Marcon, Sonia Silva; Cuman, Roberto Kenji Nakamura

331

Socio-economic factors and diabetes consequences among patients with type 2 diabetes  

PubMed Central

Background: Considering the effect of socio-economic factors on the emergence of chronic diseases and the importance of this aspect of diseases for policy makers and authorities of health care organizations, this study tried to investigate the role of these factors in type 2 diabetes and its consequences, which can be used in health policy making for preventing from this disease. Materials and Methods: This descriptive-analytical study was conducted on 384 diabetic patients who were admitted to a diabetes center in the city of Isfahan. The participants were selected using simple random sampling. A questionnaire with 42 questions was used for gathering the data which were analyzed using chi-square and Fisher's statistical tests. Results: The studied population consisted of 52.1% male and 47.9% female participants. There was a statistically significant relationship between diabetes complications, age group, educational level, job status, relationship with family members, number of family visits and the reassurance provided by the family, type of leisure time activities, health status, years with diabetes, smoking, type of treatment, fried food consumption and income (P < 0.001), sense of security and communication in living environment (P < 0.002) and daily intake of vegetables (P < 0.02). Conclusion: It seems that the application of supportive resources and secondary strategies is an essential issue in the patients with chronic diseases, particularly diabetes. Empowering strategies can induce basic changes in order to increase positive expectations, hope, self-esteem and self- confidence in patients; this is the exact strategy which must be used to efficiently control diabetes and its different types of complications among patients.

Tol, Azar; Sharifirad, Gholamreza; Shojaezadeh, Davoud; Tavasoli, Elahe; Azadbakht, Leila

2013-01-01

332

CPVL/CHN2 Genetic Variant Is Associated With Diabetic Retinopathy in Chinese Type 2 Diabetic Patients  

PubMed Central

OBJECTIVE Diabetic nephropathy and retinopathy are two important microvascular diabetes complications with a high concordance rate in diabetic patients. A recent genome-wide association study in type 1 diabetic patients of European descent identified four loci to be associated with diabetic nephropathy. The aim of this study was to test the effects of single nucleotide polymorphisms (SNPs) from these four loci on diabetic nephropathy and retinopathy in Chinese type 2 diabetic patients. RESEARCH DESIGN AND METHODS In stage 1, we recruited 1,276 type 2 diabetic patients, including 378 patients with diabetic nephropathy but no retinopathy, 374 patients with diabetic retinopathy but no nephropathy, 244 patients with both diabetic retinopathy and nephropathy, and 280 control subjects with diabetes for >10 years and no diabetic retinopathy or nephropathy. Fifty-five SNPs from four loci (CPVL/CHN2, FRMD3, CARS, and IRS2) were genotyped. The SNPs that showed associations to diabetic retinopathy or nephropathy were genotyped in stage 2 samples for replication. RESULTS SNPs from CPVL/CHN2 and FRMD3 were associated with diabetic retinopathy with rs39059 and rs10868025 as the top SNPs (odds ratio [OR] 1.292, 95% CI 1.097–1.523, P = 0.0022, for rs39059; 1.201, 1.014–1.422, P = 0.0343, for rs10868025) in stage 1 samples. In stage 2 analysis, only rs39059 showed similar effect to diabetic retinopathy (OR 1.269, 0.989–1.628, P = 0.0689), and meta-analysis showed a significant association between rs39059 and diabetic retinopathy, with an OR of 1.285 (1.120–1.474, P = 0.0003). CPVL/CHN2 rs39059 was also associated with levels of diabetic retinopathy (P = 0.0007 for trend). However, no association was detected between these SNPs and diabetic nephropathy. CONCLUSIONS In this study, we found CPVL/CHN2 rs39059 was associated with diabetic retinopathy in the Chinese type 2 diabetic patients.

Hu, Cheng; Zhang, Rong; Yu, Weihui; Wang, Jie; Wang, Congrong; Pang, Can; Ma, Xiaojing; Bao, Yuqian; Xiang, Kunsan; Jia, Weiping

2011-01-01

333

Association Between Urinary Type IV Collagen Level and Deterioration of Renal Function in Type 2 Diabetic Patients Without Overt Proteinuria  

PubMed Central

OBJECTIVE Cross-sectional studies have reported increased levels of urinary type IV collagen in diabetic patients with progression of diabetic nephropathy. The aim of this study was to determine the role of urinary type IV collagen in predicting development and progression of early diabetic nephropathy and deterioration of renal function in a longitudinal study. RESEARCH DESIGN AND METHODS Japanese patients with type 2 diabetes (n = 254, 185 with normoalbuminuria and 69 with microalbuminuria) were enrolled in an observational follow-up study. The associations of urinary type IV collagen with progression of nephropathy and annual decline in estimated glomerular filtration rate (eGFR) were evaluated. RESULTS At baseline, urinary type IV collagen levels were higher in patients with microalbuminuria than in those with normoalbuminuria and correlated with urinary ?2-microglobulin (? = 0.57, P < 0.001), diastolic blood pressure (? = 0.15, P < 0.01), eGFR (? = 0.15, P < 0.01), and urinary albumin excretion rate (? = 0.13, P = 0.01) as determined by multivariate regression analysis. In the follow-up study (median duration 8 years), urinary type IV collagen level at baseline was not associated with progression to a higher stage of diabetic nephropathy. However, the level of urinary type IV collagen inversely correlated with the annual decline in eGFR (? = ?0.34, P < 0.001). Multivariate regression analysis identified urinary type IV collagen, eGFR at baseline, and hypertension as factors associated with the annual decline in eGFR. CONCLUSIONS Our results indicate that high urinary excretion of type IV collagen is associated with deterioration of renal function in type 2 diabetic patients without overt proteinuria.

Araki, Shin-ichi; Haneda, Masakazu; Koya, Daisuke; Isshiki, Keiji; Kume, Shinji; Sugimoto, Toshiro; Kawai, Hiromichi; Nishio, Yoshihiko; Kashiwagi, Atsunori; Uzu, Takashi; Maegawa, Hiroshi

2010-01-01

334

Molecular basis for phenotypic heterogeneity in galactosaemia: prediction of clinical phenotype from genotype in Japanese patients.  

PubMed

We identified 14 mutations in 15 Japanese subjects from 13 families with galactose-1-phosphate uridyltransferase (GALT) deficiency using denaturing gradient gel electrophoresis (DGGE) and direct sequence analysis. These mutations accounted for 22 (96%) of 23 mutant alleles in 15 Japanese subjects. The mutational spectrum included nine missense mutations (M142V, G179D, A199T, R231H, W249R, N314D, P325L, R333Q, and R333W), two deletions (L275fsdelT and Q317fsdelC), a nonsense mutation (W249X), and two splicing mutations (V85-N97fsdel38bp and IVS4nt+1). Ten of the 14 mutations have not been reported in Caucasians. Differences in frequency and spectrum of GALT mutations suggest that the mutations may have occurred after racial divergence of Caucasians and Asians. The Duarte variant in Japanese was associated with the N314D mutation, g.1105G > C, g.1323G > A, and g.1391G > A (SacI -) polymorphisms, as in Caucasians. The Duarte variant may have occurred before racial divergence, and was an ancient mutation. In vitro GALT activities of nine missense mutations were determined by a COS cell expression system, and indicated between 1.3% and 35% of wild-type control. Patients with R333Q (29% in vitro GALT activity) or A199T (35%) showed mild clinical phenotypes, i.e. no ovarian failure or neurological deterioration. Genotype determination is useful for predicting biochemical and clinical phenotypes in classic galactosaemia, and can be of further help in managing patients with this disorder. PMID:10573007

Hirokawa, H; Okano, Y; Asada, M; Fujimoto, A; Suyama, I; Isshiki, G

335

Cardiovascular disease prevention in patients with type 2 diabetes: the role of oral anti-diabetic agents  

Microsoft Academic Search

M ultiple risk factor intervention is essential in order to prevent cardiovascular (CV) disease in patients with diabetes. Therefore, to reduce atherothrombotic events, an ideal oral anti-diabetic agent should be able to modulate most, and preferably all, car- diovascular risk factors associated with diabetes. Of the currently available agents, the insulin sensitis- ers (metformin, thiazolidinediones) seem to have most promise

RAMZI A AJJAN; PETER J GRANT

2010-01-01

336

Cardiovascular disease prevention in patients with type 2 diabetes: the role of oral anti-diabetic agents  

Microsoft Academic Search

Multiple risk factor intervention is essential in order to prevent cardiovascular (CV) disease in patients with diabetes. Therefore, to reduce atherothrombotic events, an ideal oral anti-diabetic agent should be able to modulate most, and preferably all, cardiovascular risk factors associated with diabetes.Of the currently available agents, the insulin sensitisers (metformin, thiazolidinediones) seem to have most promise in cardiovascular protection. Metformin

Ramzi A Ajjan; Peter J Grant

2006-01-01

337

Lifestyle intervention for type 2 diabetes patients – trial protocol of The Copenhagen Type 2 Diabetes Rehabilitation Project  

Microsoft Academic Search

BACKGROUND: Current guidelines recommend education, physical activity and changes in diet for type 2 diabetes patients, yet the composition and organization of non-pharmacological care are still controversial. Therefore, it is very important that programmes aiming to improve non-pharmacological treatment of type 2 diabetes are developed and evaluated. The Copenhagen Type 2 Diabetes Rehabilitation Project aims to evaluate the effectiveness of

Eva S Vadstrup; Anne Frølich; Hans Perrild; Eva Borg; Michael Røder

2009-01-01

338

Cognitive impairment, physical disability and depressive symptoms in older diabetic patients: the Fremantle Cognition in Diabetes Study  

Microsoft Academic Search

Objective: To determine whether the prevalence of dementia, depression and\\/or disability in older diabetic subjects warrants an active screening approach by diabetes health care workers. Patients and methods: The initial 223 members of a cohort of 529 eligible diabetic subjects, aged 70 years or over, were screened for cognitive impairment (using the Mini-Mental State Examination (MMSE) and Informant Questionnaire for

David G. Bruce; Genevieve P. Casey; Valerie Grange; Roger C. Clarnette; Osvaldo P. Almeida; Jonathan K. Foster; Franklyn J. Ives; Timothy M. E. Davis

2003-01-01

339

Yogic practice and diabetes mellitus in geriatric patients  

PubMed Central

Background: Stress has negative effect on health and type 2 diabetes patients may be at an increased risk. Abnormally high levels of free radicals and the simultaneous decline of antioxidant defense mechanisms can increase lipid peroxidation and insulin resistance. The objective of the present study was to demonstrate the efficacy of yogic practice in geriatric patients with type 2 diabetes mellitus and also to compare the efficacy with the state of glycaemic control. Materials and Methods: Seventy three (73) healthy elderly patients of type 2 diabetes mellitus in the age group of 60 to 70 years with a history of diabetes for 5 to 10 years and with poor glycaemic control (HbA1c >8 %) residing in Kozhikode district were recruited for the study. The subjects were divided into three groups according to their glycaemic control. Group I with HbA1c 8.6–9.7 %, group II with HbA1c 9.8–10.7 % and group III with HbA1c 10.8–12.7 %. Participants did yogic practice under the supervision of experienced trainer, daily 90 minutes and for three months. Biochemical estimation of HbA1c, glucose, lipid profile, cortisol, ferritin, malondialdehyde (MDA) and catalase activity were carried out on 0 day and 90th day. Seventy patients participated in a comparable control session. Results: The participants in the test group showed statistically significant (P < 0.001) decrease in glucose, HbA1c, lipids, cortisol, ferritin, MDA and significant increase in catalase activity after yogic practice. Conclusions: Yoga may improve risk profiles induced by stress in geriatric patients with type 2 diabetes and may have promise for the prevention or delay in diabetes complications. And at all stages of the disease a significant improvement can be achieved by yogic practice in geriatric diabetes.

Beena, Rani K; Sreekumaran, E

2013-01-01

340

Understanding diabetes in patients with HIV\\/AIDS  

Microsoft Academic Search

ABSTRACT: This paper reviews the incidence, pathogenetic mechanisms and management strategies of diabetes mellitus in patients with human immunodeficiency virus (HIV) and acquired immunodeficiency syndrome (AIDS). It classifies patients based on the aetiopathogenetic mechanisms, and proposes rational methods of management of the condition, based on aetiopathogenesis and concomitant pharmacotherapy.

Sanjay Kalra; Bharti Kalra; Navneet Agrawal; AG Unnikrishnan

2011-01-01

341

Intrapartum Performance of Patients Presenting with Diabetes Mellitus in Pregnancy  

Microsoft Academic Search

Objective: To investigate the intrapartum performance of pregnancies complicated by diabetes mellitus (DM). Subjects and Methods: A pilot study (April–June 2005) of medical records of patients with DM admitted into the labour wards of the Maternity Hospital, Kuwait, was undertaken. Consecutive patients, matched for age and parity with the study group and with no medical complications, admitted for induction of

Michael F. Diejomaoh; Madhu Gupta; Rasheda Farhat; Jiri Jirous; Manal Al-Jaber; Asiya T. Mohd

2009-01-01

342

Urinary tract infections in patients with diabetes  

Microsoft Academic Search

Results of various epidemiologic studies suggest that bacteriuria and urinary tract infection (UTI) occur more commonly in women with diabetes than in women without this disease. Similar findings have been demonstrated for asymptomatic bacteriuria (ASB), with ASB being a risk factor for pyelonephritis and subsequent decline in renal function. Although ASB is not associated with serious health outcomes in healthy

Ann Stapleton

2002-01-01

343

JAMA Patient Page: Diabetic Foot Ulcers  

MedlinePLUS

... and increases the risk of infection and amputation. PREVENTION • Diabetic foot ulcers can often be prevented by careful control of ... sign of a foot problem. • Avoid putting any pressure on the foot wound. • Keep the ulcer clean and change the dressings regularly, as instructed ...

344

Prevention of Macrovascular Disease in Patients with Diabetes Mellitus: Opportunities for Intervention  

Microsoft Academic Search

Individuals with diabetes mellitus are at considerably higher risk for coronary artery disease compared with individuals without diabetes. In the United States, diabetes is the most prevalent factor putting patients at risk for coronary events. Intensive control of blood glucose has been demonstrated to reduce the risk for cardiovascular disease in patients with type 1 diabetes, but this has yet

Theodore Mazzone

2007-01-01

345

A Review of Current Evidence with Continuous Glucose Monitoring in Patients with Diabetes  

Microsoft Academic Search

Devices that measure glucose on a near-continuous basis may provide a better insight into glycemic profiles, allowing patients with diabetes to make therapeutic adjustments to improve metabolic control, thereby reducing the risk of diabetic complications. Motivated and technologically adept patients with brittle diabetes, hypoglycemia unawareness, diabetic pregnancy, or who use pumps might benefit. Current evidence of continuous glucose monitoring (CGM)

Begoña Manuel-y-Keenoy; Luc Van Gaal

2008-01-01

346

Long-term outcome in diabetic heart failure patients treated with cardiac resynchronization therapy  

Microsoft Academic Search

Background: Diabetes mellitus is an independent risk factor for increased morbidity and mortality in heart failure (HF) patients. Aims: To compare functional and structural improvement, as well as long-term outcome, between diabetic and non-diabetic HF patients treated with cardiac resynchronization therapy (CRT). Methods: We compared response to CRT in 141 diabetic and 214 non-diabetic consecutive patients. Major events were; death

Cecilia Fantoni; François Regoli; Ali Ghanem; Santi Raffa; Catherine Klersy; Antonio Sorgente; Francesco Faletra; Massimo Baravelli; Luigi Inglese; Jorge A. Salerno-Uriarte; Helmut U. Klein; Tiziano Moccetti; Angelo Auricchio

2008-01-01

347

Case report: diabetic myonecrosis of the neck complicated by infection in an islet transplanted patient.  

PubMed

Diabetic muscle infarction, also known as diabetic myonecrosis, is an uncommon neuromuscular complication of longstanding diabetes. It usually involves the thigh or calf muscles. Patients typically present with severe pain in the affected area. This complication is more often seen in middle-aged diabetic patients with poorly controlled glycemia. We describe a 38-year-old female Type 1 diabetic patient who developed acute neck pain 3 weeks following islet transplantation. PMID:18358751

Salehi, Payam; Stull, Margaret A; Martellotto, Joan; Gangemi, Antonio; Hatipoglu, Betul; Benedetti, Enrico; Oberholzer, Josè

2008-03-21

348

Natural Antibodies to Human Retrovirus HTLV in a Cluster of Japanese Patients with Adult T Cell Leukemia  

Microsoft Academic Search

Human T cell lymphoma leukemia virus (HTLV) is a human retrovirus (RNA tumor virus) that was originally isolated from a few patients with leukemias or lymphomas involving mature T lymphocytes. Here we report that the serum of Japanese patients with adult T cell leukemia, but not the serum of tested normal donors, contains high titers of antibodies to HTLV. These

Marjorie Robert-Guroff; Yoshinobu Nakao; Kunihiro Notake; Yohei Ito; Ann Sliski; Robert C. Gallo

1982-01-01

349

Detection of partial deletion and partial duplication of dystrophin gene in Japanese patients with Duchenne or Becker muscular dystrophy  

Microsoft Academic Search

Summary The dystrophin gene was analyzed in 59 Japanese patients with Duchenne muscular dystrophy (DMD) from 48 unrelated families, including 11 pairs of siblings, and three patients with Becker muscular dystrophy (BMD) from two unrelated families, including one pair of siblings. The relationship between the type of gene abnormality and clinical symptoms was examined. Twenty-seven of 50 (54.0%) unrelated DMD

Keiko Hiyama; Mieko Kodaira; Chiyoko Satoh; Takenori Karakawa; Hitoshi Kameo; Michio Yamakido

1993-01-01

350

Dabigatran Etexilate Prevents Venous Thromboembolism After Total Knee Arthroplasty in Japanese Patients With a Safety Profile Comparable to Placebo  

Microsoft Academic Search

We assessed the efficacy, safety, and dose-response of dabigatran etexilate (DAB) in preventing venous thromboembolism (VTE) in Japanese patients undergoing total knee arthroplasty (TKA). Five hundred twelve patients received DAB (110, 150, or 220 mg) or placebo once daily for 11 to 14 days, starting the day after surgery. The primary efficacy end point was the incidence of total VTE

Takeshi Fuji; Satoru Fuijita; Toru Ujihira; Toru Sato

2010-01-01

351

Revisiting Shimoda's "Shuuchaku-Kishitsu" (Statothymia): A Japanese View of Manic-Depressive Patients  

PubMed Central

Although the empiric paradigm is now dominant in academic research, in Japan quite a few psychiatric clinicians still take phenomenological-anthropological approaches into consideration, especially when they address manic-depressive illness with typical endogenous features. This is because Shimoda's concept of “shuuchaku-kishitsu” (statothymia) has been widely accepted, together with other phenomenological views of continental origin. In the present paper the author first delineates Shimoda's concept which is based on observations of patients' personality features and the characteristics of their emotionality. He then attempts to refine this concept in spatiotemporal terms, presenting the view that in patients the past self tends to adhere to the present self (the term “shuuchaku” means “adhering to” or “preoccupied with”). He also considers that patients tend to incorporate “soto” (outer space) into “uchi” (inner space), where they believe that symbiotic relations are preserved. Finally, he argues the clinical significance of the presented views in the cultural milieu in which Japanese psychiatric practices are situated.

Tsuda, Hitoshi

2011-01-01

352

Epicardial adipose tissue thickness in type 1 diabetic patients.  

PubMed

Insulin resistance is getting important in the course of type 1 diabetes mellitus. Visceral fat depot is associated with insulin resistance and assessment of epicardial fat thickness is a way of measuring visceral fat. The aim of the study was to measure epicardial adipose tissue (EAT) thickness and to determine its relationship with waist-hip-ratio (WHR) and estimated glucose disposal rate (eGDR) in adult type 1 diabetic patients. Thirty-six type 1 diabetic patients (aged 31±8 years; Female/Male: 22/14) and 43 age, gender and BMI matched healthy controls were included. Fasting blood glucose (FBG), hemoglobin A1c, and lipid profiles were measured. Waist-hip-ratio (WHR) was calculated. Daily insulin dose/kg of patients were recorded and eGDR of all subjects was calculated. Epicardial adipose tissue (EAT) thickness was evaluated by echocardiography. EAT thickness of the type 1 diabetic patients was significantly higher than controls (3.30±1.06 vs. 2.30±0.34 mm, P<0.0001). EAT thickness was correlated with age (P=0.05; r=0.35), WHR (P=0.003; r=0.67), daily insulin dose/kg (r=0.45, P=0.005), and eGDR (r=-0.55, P=0.0004). Multivariate analysis revealed WHR and eGDR to be related to EAT among age, WHR, daily insulin dose/kg, eGDR, FBG, and hemoglobin A1c (r2 of the model=0.64). Epicardial adipose tissue thickness is increased in type 1 diabetic patients compared to controls and is related to WHR and eGDR in this group of patients. This measurement may point to the presence of insulin resistance in type 1 diabetic patients. PMID:21553302

Yaz?c?, Dilek; Özben, Beste; Yavuz, Dilek; Deyneli, O?uzhan; Ayd?n, Hasan; Tarcin, Özlem; Akal?n, Sema

2011-05-08

353

Urinary angiotensinogen is a marker for tubular injuries in patients with type 2 diabetes  

PubMed Central

Purpose Urinary angiotensinogen has been reported as a marker for the activation of intrarenal renin–angiotensin system (RAS) in various kidney diseases. To investigate the importance of urinary angiotensinogen in diabetic nephropathy, we compared the urinary levels of angiotensinogen, albumin, and ?1-microglobulin. Materials and methods Japanese patients with type 2 diabetes at various stages of nephropathy (n=85) were enrolled, and we measured albumin/creatinine ratio (ACR) and urinary excretion of angiotensinogen and ?1-microglobulin. We also compared the clinical data of the patients treated with or without angiotensin II receptor blockers or angiotensin-converting enzyme inhibitors (RAS inhibitors [+], n=51; RAS inhibitors [?], n=34). Results Urinary angiotensinogen levels positively correlated with ACR (r=0.367, P=3.84×10?4) and urinary ?1-microglobulin (r=0.734, P=1.32 × 10?15), while they negatively correlated with estimated glomerular filtration ratio (eGFR) (r=?0.350, P=1.02 × 10?3) and high-density lipoprotein cholesterol (r=?0.216, P=0.049). Multiple regression analysis was carried out to predict urinary angiotensinogen levels by employing eGFR, ACR, and urinary ?1-microglobulin as independent variables; only urinary ?1-microglobulin entered the regression equation at a significant level. Although ACR was higher in the RAS inhibitors (+) group, urinary ?1-microglobulin and angiotensinogen did not show significant increase in the RAS inhibitors (+) group. Conclusion Urinary angiotensinogen is well correlated with urinary ?1-microglobulin and reflected the tubular injuries which may be associated with the intrarenal RAS activation in patients with type 2 diabetes.

Terami, Takahiro; Wada, Jun; Inoue, Kentaro; Nakatsuka, Atsuko; Ogawa, Daisuke; Teshigawara, Sanae; Murakami, Kazutoshi; Katayama, Akihiro; Eguchi, Jun; Makino, Hirofumi

2013-01-01

354

Association of C-reactive protein and hyperuricemia with diabetic nephropathy in Chinese type 2 diabetic patients  

Microsoft Academic Search

To investigate the relationship of micro-albuminuria with C-reactive protein (CRP) and hyperuricemia in Chinese patients with\\u000a type 2 diabetes. All patients with type 2 diabetes, 40 years old and over were recruited consecutively from diabetic clinics\\u000a at a medical center. Serum lipid, creatinine, uric acid, CRP, HbA1C and urinary albumin concentration were measured. A total of 515 patients, aged 60.3 ± 10.7 years were

Chen-Chung Fu; Du-An Wu; Ji-hung Wang; Wen-Chin Yang; Chin-Hsiao Tseng

2009-01-01

355

[Endocrine abnormalities and vessels in patients with diabetes].  

PubMed

Endocrine impairment is more common in patients with diabetes than in general population. Both hyper- and hypothyroidism increases cardiovascular morbidity and mortality. Subclinical hypothyroidism is a risk factor for coronary hearth disease in patients younger than 65 years. In elderly is its influence questionable or even preventive and the benefit of substitution should be weighted against the risks. Treatment with glucocorticoids in a dose of 7.5 mg methylprednisolone and higher considerably increases risk of vascular impairment. Patients cured from endogenous Cushing's syndrome maintain increased cardiovascular risk factors and structural changes of vessels. Subclinical hypercortisolism seems to have little effect. Growth hormone (GH) insufficiency increases cardiovascular risks and contributes to increased mortality of these patients. To the contrary increased GH production in acromegaly effect more heart than vessels. Hypogonadism is established risk factor for ischemic accidents in men. The relationship between hypogonadism and diabetes is bidirectional. Low testosterone level increases the risk of type-2 diabetes and in diabetics is the testosterone level often low. Substitution with testosterone can not only ameliorate hypogonadal symptoms but also decrease cardiovascular risk and even improve control of diabetes. PMID:20465095

Cáp, J

2010-04-01

356

Do diabetic neuropathy patients benefit from balance training?  

PubMed

Peripheral neuropathy is a common complaint of diabetes. Peripheral neural damage in turn will cause balance impairments in diabetic patients. The purpose of this study was to investigate the effects of balance exercises on sway indices in diabetic patients with neuropathy. In this clinical trial study, 10 diabetic patients with peripheral neuropathy were recruited through simple nonprobability sampling along with 10 nondisabled aged-matched subjects. Participants in both groups were examined for balance abilities with the Biodex Balance System before intervention. The experimental group was tested again after intervention. Intervention consisted of progressive Biodex stability and rocker and wobble-board training for 10 sessions. All tests were done in eyes open and closed conditions with bilateral standing. After intervention, the experimental group was re-examined in the same way. Student and paired t-tests were used for data analysis. The overall stability index and anterior-posterior stability index were significantly decreased after treatment in the experimental group during different conditions. Balance indices in the experimental group were significantly higher than the control group before treatment. There was no significant difference in indices between the two groups after treatment. The results show that balance training can improve stability indices in diabetic patients with neuropathy. PMID:22773533

Akbari, Mohammad; Jafari, Hassan; Moshashaee, Afsaneh; Forugh, Bijan

2012-01-01

357

Evidence-based hypertension treatment in patients with diabetes.  

PubMed

Both impaired glucose tolerance and diabetes are associated with substantially increased prevalence of hypertension, cardiovascular and renal disease. The goal for hypertension treatment in diabetic patients is in evolution, because of recent clinical trials. For example, the results of the recent Action to Control Cardiovascular Risk in Diabetes-BP Arm (ACCORD BP) trial failed to show an additional benefit on cardiovascular event reduction at a mean systolic BP of 119?mm?Hg. A post hoc analysis of 6,400 patients with type 2 diabetes from the International Verapamil-Trandolapril Study (INVEST) also failed to show additional cardiovascular risk reduction among patients who achieved a BP <130/80?mm?Hg. While the evidence fails to support a lower BP goal to reduce coronary events, there was a risk reduction in stroke events both in ACCORD and the Appropriate Blood Pressure Control in NIDDM (ABCD) trial. A number of other clinical trials also demonstrate that when systolic pressures fall to less than 130?mm?Hg, a reduction in stroke but not coronary disease events occurs. Thus, the precise BP goal for diabetic patients remains unresolved. We would posit that a BP goal of 135/85?mm?Hg may be a reasonable compromise when viewing the impact of BP reduction on composite stroke and coronary artery disease in extant trials. PMID:22277142

Garcia-Touza, Mariana; Sowers, James R

2011-12-19

358

Nephrogenic systemic fibrosis: a case report and review on Japanese patients.  

PubMed

Nephrogenic systemic fibrosis is a fibrosing disorder that affects patients with advanced renal dysfunction and is associated with gadolinium-based contrast media. As the number of reports increase, it is becoming clear that its clinical course and symptoms are various. We describe a 14-year-old boy and 71-year-old man with nephrogenic systemic fibrosis and review the Japanese cases documented thus far. In Japan, there are only 10 cases definitely associated with gadolinium, whereas over 500 cases have been recorded worldwide. We found a remarkable difference in clinical signs among Japanese cases. Some cases showed keratotic papules or plaques on the extremities. This group tended to develop symptoms after a shorter interval following gadolinium exposure. The remainder of the cases presented glossy and smooth surfaces, with symptoms tending to develop after a longer interval following their last gadolinium exposure. The discrepancies between the actual and the estimated number of patients, and the various clinical manifestations can be explained by the comparatively smaller dosage of gadolinium-based contrast agents commonly administrated in Japan, in contrast to the higher dosages administrated in the USA and Europe. PMID:22035371

Matsumoto, Yuka; Mitsuhashi, Yoshihiko; Monma, Fumiko; Kawaguchi, Masakazu; Suzuki, Tamio; Miyabe, Chie; Igarashi, Atsuyuki; Tsuboi, Ryoji

2011-10-31

359

Aspergillus terreus-related ureteral obstruction in a diabetic patient.  

PubMed

An Aspergillus fungal ball is a rare cause of ureteral obstruction attributed to indwelling catheters, stents, antibiotics, anastomotic leaks, obstruction, and immunosuppressive therapy and other immunocompromised states. We describe a case of unilateral ureteral obstruction caused by Aspergillus terreus following ureteroscopic lithotripsy and ureteral stenting in a 45-year-old diabetic man. The patient was successfully treated with endoscopic removal of the fungal mass and oral voriconazole. We also review briefly the clinical features, treatment, and outcome in 9 previously reported diabetic patients with ureteral obstruction due to aspergillosis. Obstructive uropathy related to Aspergillus mass may be suspected in diabetic patients with a history of manipulation, impaired kidney function, and persistent passage of a soft mass in urine. Direct microscopy and culture of multiple urine and ureteral washing are necessary for early diagnosis. Antifungal therapy and endoscopic removal of the mass are needed to reduce morbidity. PMID:23485541

Najafi, Narges; Shokohi, Tahereh; Basiri, Abbas; Parvin, Mahmoud; Yadegarinia, Davood; Taghavi, Faramarz; Hedayati, Mohammad Taghi; Abdi, Roholah

2013-03-01

360

Tolerability and safety of classic cyclophosphamide, methotrexate, and fluorouracil treatment in japanese patients with early Breast Cancer  

Microsoft Academic Search

Background  Few reports have addressed the feasibility and safety of classic Cyclophosphamide, Methotrexate, and Fluorouracil (CMF) therapy\\u000a in Japanese female breast cancer patients.\\u000a \\u000a \\u000a \\u000a Methods  Twenty-four Japanese patients who received classic CMF, identical to the originally described treatment regimen were studied\\u000a in terms of treatment dose, treatment delay, and toxicity.\\u000a \\u000a \\u000a \\u000a Results  Classic CMF was not discontinued in any of the cases. The median delay

Keiichiro Tada; Yoshinori Ito; Shunji Takahashi; Kohtaro lijima; Yumi Miyagi; Seiichiro Nishimura; Kaoru Takahashi; Masujiro Makita; Takuji Iwase; Masataka Yoshimoto; Fujio Kasumi

2006-01-01

361

Fasting Insulin Levels and Metabolic Risk Factors in Type 2 Diabetic Patients at the First Visit in Japan  

PubMed Central

OBJECTIVE To investigate the relationship between fasting insulin levels and metabolic risk factors (MRFs) in type 2 diabetic patients at the first clinic/hospital visit in Japan over the years 2000 to 2009. RESEARCH DESIGN AND METHODS In total, 4,798 drug-naive Japanese patients with type 2 diabetes were registered on their first clinic/hospital visits. Conventional clinical factors and fasting insulin levels were observed at baseline within the Japan Diabetes Clinical Data Management (JDDM) study between consecutive 2-year groups. Multiple linear regression analysis was performed using a model in which the dependent variable was fasting insulin values using various clinical explanatory variables. RESULTS Fasting insulin levels were found to be decreasing from 2000 to 2009. Multiple linear regression analysis with the fasting insulin levels as the dependent variable showed that waist circumference (WC), BMI, mean blood pressure, triglycerides, and HDL cholesterol were significant, with WC and BMI as the main factors. ANCOVA after adjustment for age and fasting plasma glucose clearly shows the decreasing trend in fasting insulin levels and the increasing trend in BMI. CONCLUSIONS During the 10-year observation period, the decreasing trend in fasting insulin was related to the slight increase in WC/BMI in type 2 diabetes. Low pancreatic ?-cell reserve on top of a lifestyle background might be dependent on an increase in MRFs.

Matsuba, Ikuro; Saito, Kazumi; Takai, Masahiko; Hirao, Koichi; Sone, Hirohito

2012-01-01

362

Should all diabetic patients receive statins?  

Microsoft Academic Search

Diabetes is known to play a causal role in promoting both microvascular and macrovascular complications. Reducing rates of\\u000a end-organ damage has been a key objective of multiple clinical trials. In addition to the roles of glycemic and blood pressure\\u000a control, it is evident that lipid reduction via statin therapy independently helps to reduce the risk of primary and secondary\\u000a vascular

Paul J. Garcia; Craig W. Spellman

2006-01-01

363

Should cisapride be avoided in patients with diabetic gastroparesis?  

PubMed

The gastrointestinal motility stimulants, cisapride and erythromycin, have been used in the management of diabetic gastroparesis. However, drug interactions may result in prolongation of the electrocardiographic QT interval with the risk of ventricular arrhythmias. These drugs should, therefore, not be used in combination. We report two cases that illustrate inappropriate use of these agents. Moreover, patients with recurrent severe hypoglycemia or renal impairment may be at increased risk from cisapride-related cardiotoxicity. Thus, even as monotherapy, cisapride may pose dangers for high-risk diabetic patients. PMID:10765008

Evans, A J; Krentz, A J

364

Various adiposity measures show similar positive associations with type 2 diabetes in Caucasians, Native Hawaiians, and Japanese Americans: The Multiethnic Cohort  

PubMed Central

We evaluated the association of body mass index (BMI), waist (WC) and hip circumferences (HC), waist-to-hip ratio (WHR), and waist-to-height ratio (WHtR) with diabetes in Caucasians, Native Hawaiians, and Japanese Americans aged 45–75 years in the Multiethnic Cohort. Diabetes cases were obtained from self-reports and by linkages with health insurance plans. We estimated adjusted prevalence odds ratios (POR) and compared the area under the receiver operating characteristic curves (AUC). All measures were positively associated with diabetes prevalence; the PORs were 1.24–1.64 in men and 1.52–1.83 in women. In all 3 ethnic groups, the AUCs in men were greater for BMI than for the other measures, while in women the AUCs were greater for combined models than for BMI alone, but the differences were small and not clinically significant. It does not appear that one anthropometric measure best reflects diabetes prevalence or performs better in one ethnic group than in another.

Steinbrecher, A; Heak, S; Morimoto, Y; Grandinetti, A; Kolonel, LN; Maskarinec, G

2013-01-01

365

Scleredema Diabeticorum in a Patient with Type 2 Diabetes Mellitus  

PubMed Central

Background. Scleredema adultorum, a connective tissue disorder of unknown aetiology, is characterized by a thickening of the reticular dermis in the upper back of the body that may decrease the mobility of the affected tissues. It has been reported in diabetic patients with poor metabolic control. Therapeutic options are limited with generally poor results. Case Report. 53-year-old white male with type 2 diabetes mellitus was referred to our department for evaluation of incipient nephropathy and retinopathy. On examination, he presented erythematous, indurated, painless and ill-defined plaque on the skin of the upper back with limited movement of shoulders. A biopsy was done revealing scleredema. PUVA treatment and physiotherapy were started with the amelioration of mobility and acquiring some elasticity of the upper back. Discussion. The development of scleredema in diabetic patients has been related to prolonged exposure to chronic hyperglycaemia. Our patient has had diabetes for 20 years with an acceptable glucose control, however he developed the scleredema 10 years ago. Conclusions. Scleredema is a rare connective disorder that seems to appear most frequently in diabetic subjects. Good metabolic control seems not to preclude its development. PUVA treatment and physiotherapy are therapeutic options that seem to be of some help.

Martin, C.; Requena, L.; Manrique, K.; Manzarbeitia, F. D.; Rovira, A.

2011-01-01

366

Scleredema diabeticorum in a patient with type 2 diabetes mellitus.  

PubMed

Background. Scleredema adultorum, a connective tissue disorder of unknown aetiology, is characterized by a thickening of the reticular dermis in the upper back of the body that may decrease the mobility of the affected tissues. It has been reported in diabetic patients with poor metabolic control. Therapeutic options are limited with generally poor results. Case Report. 53-year-old white male with type 2 diabetes mellitus was referred to our department for evaluation of incipient nephropathy and retinopathy. On examination, he presented erythematous, indurated, painless and ill-defined plaque on the skin of the upper back with limited movement of shoulders. A biopsy was done revealing scleredema. PUVA treatment and physiotherapy were started with the amelioration of mobility and acquiring some elasticity of the upper back. Discussion. The development of scleredema in diabetic patients has been related to prolonged exposure to chronic hyperglycaemia. Our patient has had diabetes for 20 years with an acceptable glucose control, however he developed the scleredema 10 years ago. Conclusions. Scleredema is a rare connective disorder that seems to appear most frequently in diabetic subjects. Good metabolic control seems not to preclude its development. PUVA treatment and physiotherapy are therapeutic options that seem to be of some help. PMID:22937286

Martín, C; Requena, L; Manrique, K; Manzarbeitia, F D; Rovira, A

2011-07-31

367

The Association between Serum GGT Concentration and Diabetic Peripheral Polyneuropathy in Type 2 Diabetic Patients  

PubMed Central

Background Diabetic peripheral polyneuropathy (DPP) is one of the common complications of diabetes mellitus (DM) and can lead to foot ulcers or amputation. The pathophysiology of DPP includes several factors such as metabolic, vascular, autoimmune, oxidative stress and neurohormonal growth-factor deficiency and recent studies have suggested the use of serum gamma-glutamyl transferase (GGT) as an early marker of oxidative stress. Therefore, we investigated whether serum GGT may be useful in predicting DPP. Methods We assessed 90 patients with type 2 DM who were evaluated for the presence of DPP using clnical neurologic examinations including nerve conduction velocity studies. We evaluated the association between serum GGT and the presence of DPP. Results The prevalence of DPP was 40% (36 cases) according to clinical neurological examinations. The serum GGT concentration was significantly elevated in type 2 diabetic patients with DPP compared to patients without DPP (P < 0.01). There were other factors significantly associated with DPP including smoking (P = 0.019), retinopathy (P = 0.014), blood pressure (P < 0.05), aspartate aminotransferase (P = 0.022), C-reactive protein (P = 0.036) and urine microalbumin/creatinine ratio (P = 0.004). Serum GGT was independently related with DPP according to multiple logistic analysis (P < 0.01). Conclusion This study shows that increased levels of serum GGT may have important clinical implications in the presence of DPP in patients with type 2 diabetes.

2010-01-01

368

Hypertension and progression of nephropathy in diabetic and non-diabetic chronic kindney disease patients  

PubMed Central

Background: Hypertension is associated with more rapid progression of chronic kidney disease. Several studies have shown that treating hypertension in patients with chronic kidney disease and proteinuria may attenuate the decline in glomerular filtration rate. Study objective: The study evaluates the prevalence of hypertension and its association with chronic kidney disease progression in patients without and with diabetic nephropathy. Methods: Patients with CKD stage 2-4 were followed up by a nephrologist for 12-52 months. A total of 137 patients were included in the study, 70 with non-diabetic CKD and 67 with type 2 diabetes and diabetic nephropathy. Demographic and clinical parameters were recorded at initiation and during follow-up. Glomerular filtration rate was estimated by the Cockroft-Gault formula and progression of CKD by the slope of the estimated GFR decline . Results: Out of 70 patients in the non-diabetic group, 34 were males, (mean age 50.37±12.2 years). Out of 67 diabetic patients, 30 were (males, mean age 57.8±8.4 years). 77% in the non-diabetic group had SBP above 140 mmHg. The higher SBP was associated with older age, (53.16±10.8 vs 40.9±12.2 years, p<0.0001). Diastolic blood pressure above 90 was present in 73%. Pulse pressure above 80 had 5.7% and was associated with older age (p<0.02). Progression of chronic kidney disease correlated inversely with age, and positively with diastolic blood pressure and proteinuria (p=0.005, p=0.019 and p=0.02 respectively). Multiple regression analysis showed that only younger age and higher proteinuria were predictive for chronic kidney disease progression (p=0.00002). 6% of pts in the diabetic group had SBP below 140, 19% between 140 and 160, and 75% above 160 mmHg. Diastolic blood pressure below 80 had only 6% of patients, between 80 and 90 had 37% and above 90 mmHg had 57%. Pulse pressure below 80 mmHg had 55% and it was correlated positively with age, p=0.009. Progression of chronic kidney disease in the diabetic group correlated positively with mean arterial pressure, systolic blood pressure and proteinuria, (p=0.017, 0.036 and 0.000000 respectively) and inversely with age (p=0.0003). Multiple regression analysis showed that proteinuria, age and SBP were the only predictors for chronic kidney disease progression in diabetics. Conclusion: Isolated systolic hypertension predominates the older age groups, proteinuria and age significantly correlate with GFR decline in both groups, and SBP is associated with more rapid progression of CKD in the diabetic patients.

Stojceva-Taneva, O; Selim, G; Stojkovski, L; Ivanovski, N

2007-01-01

369

Analysis of LOXL1 gene variants in Japanese patients with branch retinal vein occlusion  

PubMed Central

Purpose Previous studies have described a possible association between exfoliation syndrome (EX) and various ocular and systemic vascular disorders; however, the association between EX and branch retinal vein occlusion (BRVO) remains unclear. Because slit-lamp examination may overlook latent deposits of exfoliation materials, an ocular biopsy is usually needed for a precise diagnosis. We evaluated a possible association between EX and BRVO using lysyl oxidase-like 1 (LOXL1) gene variants as alternative markers for EX. Methods Allelic and genotypic frequencies of three LOXL1 variants (rs1048661, rs3825942, and rs2165241) were determined for 78 consecutive Japanese patients with BRVO (11 patients with exfoliation syndrome [EX+], 67 patients without exfoliation syndrome [EX-]), and 158 patients with cataract without EX (CT) as controls. Results The rs1048661 variant differed between the BRVO and CT groups in allelic and genotypic frequencies (p=0.0137 and p=0.0203, respectively). Subgroup analysis, compared to the CT group, showed that BRVO EX+ had significantly different allelic and genotypic frequencies of rs1048661 (p=0.00011 and p=0.000189, respectively), while BRVO EX- did not (p=0.175 and p=0.288, respectively). The frequencies of rs3825942 and rs2165241 did not differ between the BRVO and CT groups. Conclusions No association was found between BRVO and EX if LOXL1 variants were used as disease markers for clinically undetectable EX. The results suggested that LOXL1 variants, well established markers for EX, are not likely genetic markers for BRVO in Japanese subjects.

Hara, Katsunori; Akahori, Masakazu; Kaidzu, Sachiko; Ohira, Akihiro; Iwata, Takeshi

2011-01-01

370

Ibudilast may improve retinal circulation in patients with diabetes mellitus.  

PubMed

Ibudilast selectively vasodilates cerebral vessels without reducing blood pressure. We investigated the effect of the drug on retinal circulation in 8 patients with diabetes mellitus, using the video-densitometric image analysis of fluorescein angiography. We compared the build up time, the time constant of washout rate and the mean circulation time (MCT) before and after oral therapy with ibudilast. After 2 weeks of daily administration (30 mg), MCT was shortened significantly (4.2 +/- 2.8 vs. 3.0 +/- 1.6 s, p = 0.0215). Since retinal circulation in patients with diabetes mellitus was improved by ibudilast, the drug may be useful to treat disorders such as diabetic retinopathy. PMID:1436980

Suzuki, R; Sugihara, I; Ishibashi, T; Kurimoto, S

1992-01-01

371

Prevalence and viral DNA loads of three novel human polyomaviruses in skin cancers from Japanese patients.  

PubMed

Merkel cell polyomavirus (MCPyV), human polyomaviruses 6 (HPyV6) and 7 (HPyV7) are novel human polyomaviruses. This study investigated their detection rates and DNA loads in various skin cancers from Japanese patients. MCPyV, HPyV6 and HPyV7 were detected in 22.2%, 3.2% and 1.6% of squamous cell carcinomas, 18.0%, 2.0% and 4.0% of basal cell carcinomas, and 19.1%, 4.3% and 4.3% of melanomas, respectively. Quantitative real-time polymerase chain reaction showed that their DNA loads were low. These findings provide the first evidence of the prevalence of HPyV6 and HPyV7 in skin cancers in Asia. Nucleotide differences were found in the large T-sequenced region between Japanese and North American isolates: a nucleotide substitution of A to G for HPyV6; and a nucleotide substitution of T to C and the insertion of a gap for HPyV7. This suggested that two genotypes of HPyV6 and HPyV7 would be present and associated with geographical origin. PMID:23682950

Imajoh, Masayuki; Hashida, Yumiko; Nakajima, Hideki; Sano, Shigetoshi; Daibata, Masanori

2013-05-20

372

Aging-associated inflammation in healthy Japanese individuals and patients with Werner syndrome.  

PubMed

Minor inflammation-driven aging (inflammaging) has been proposed to explain human aging mechanism. To study the inflammatory condition associated with normal human aging, highly sensitive CRP (hsCRP) was examined in the sera collected from 217 healthy Japanese individuals aged between 1 and 100years and 41 mutation-proven Japanese Werner syndrome (WS) patients. The serum hsCRP was assayed by ELISA. The serum hsCRP level increased significantly (p<0.001) with normal aging from both sexes. The serum hsCRP was significantly elevated in WS (mean±SE: 11.0±1.6?g/ml) compared with age-matched normal population (1.3±0.3?g/ml, p<0.001) and normal elderly population ages between 71 and 100years (4.2±0.7?g/ml, p<0.001). Both normal aging and WS were associated with minor inflammation that can be evaluated by serum hsCRP. WS may be a good candidate to study inflammaging. PMID:22960593

Goto, Makoto; Sugimoto, Kazunori; Hayashi, Seigaku; Ogino, Tetsuhito; Sugimoto, Masanobu; Furuichi, Yasuhiro; Matsuura, Masaaki; Ishikawa, Yuichi; Iwaki-Egawa, Sachiko; Watanabe, Yasuhiro

2012-08-31

373

The effect of diabetes on outcomes of patients with advanced heart failure in the BEST trial  

Microsoft Academic Search

ObjectivesThis was a retrospective analysis to determine the effect of diabetes on outcome in patients with advanced heart failure (HF), and to determine the effect of beta-blockade in patients with HF with and without diabetes mellitus.

Michael Domanski; Heidi Krause-Steinrauf; Prakash Deedwania; Dean Follmann; Jalal K Ghali; Edward Gilbert; Steven Haffner; Richard Katz; JoAnn Lindenfeld; Brian D Lowes; Wade Martin; Frank McGrew; Michael R Bristow

2003-01-01

374

Physician-elderly patient-companion communication and roles of companions in Japanese geriatric encounters.  

PubMed

Although the triadic encounter of physician, patient, and an accompanying family member is a common phenomenon in geriatrics, previous research on the communication in medical encounters has primarily focused on dyadic interactions between physician and patient. This study aimed to explore the triadic communication and communication roles of patient companions in Japanese geriatric encounters. Among elderly patients aged 65 or over who were under continuous care of nine attending physicians at a university affiliated geriatric clinic in Tokyo, 63 accompanied patients and 82 unaccompanied patients were included for this study. The consultation was audiotape recorded and analyzed using the Roter Interaction Analysis System (RIAS) with additional categories developed to code aspects of companion communication. In dyadic encounters, the average proportions of physician's talk and patient's talk were 54% and 46%, respectively, while in triadic encounters the average talk proportions of physician, patient, and companion were 49%, 29%, and 22%. Companions made a significant contribution to the communication during the visit by providing information and asking the physician questions, as well as facilitating patient's talk. The companion's communication may influence not only the patient's but also the physician's communication. The patient's expectation of the companion's role during the visit and the companion's intention regarding their role were generally related to one another, and had positive associations with the companion's actual behavior during the visit. Nevertheless, companions often anticipated playing a more direct communication role during the visit, including the provision of information and asking of questions, than patients expected of them. Further investigation is needed to explore the communication dynamics in triads and dyads, and its relation to patient outcomes. PMID:15748678

Ishikawa, Hirono; Roter, Debra L; Yamazaki, Yoshihiko; Takayama, Tomoko

2004-12-08

375

Levetiracetam add-on therapy in Japanese patients with refractory partial epilepsy.  

PubMed

The aim of this observational study was to obtain information regarding efficacy and safety of add-on levetiracetam (LEV; n=32) in Japanese patients with refractory partial seizures in an everyday clinical setting, relative to control AEDs (n=30). This is the first study of LEV add-on therapy conducted in Japan since approval was made. The medical charts of patients were retrospectively reviewed. The efficacy variables were seizure freedom and ?50% reduction in seizure frequency. A significantly higher response to LEV was demonstrated in patients with all seizure types at baseline, relative to control AEDs. In patients with a duration of epilepsy of at least 10 years, significant effects in response to LEV were demonstrated with regards to efficacy variables, relative to control AEDs, thus providing meaningful results. Only two patients (6.2%) discontinued LEV treatment due to worsening of seizures, but no discontinuation was reported due to adverse events. LEV as add-on therapy to other AEDs is a promising useful treatment option for patients with refractory partial seizures without notable effects on safety, indicating that this treatment regimen might be recommended for such patients. PMID:23774199

Tanaka, Shigeya; Tanaka, Tatsuya

2013-06-01

376

Early Neurodegeneration in the Retina of Type 2 Diabetic Patients  

PubMed Central

Purpose. The purpose of this study was to determine whether diabetes type 2 causes thinning of retinal layers as a sign of neurodegeneration and to investigate the possible relationship between this thinning and duration of diabetes mellitus, diabetic retinopathy (DR) status, age, sex, and glycemic control (HbA1c). Methods. Mean layer thickness was calculated for retinal layers following automated segmentation of spectral domain optical coherence tomography images of diabetic patients with no or minimal DR and compared with controls. To determine the relationship between layer thickness and diabetes duration, DR status, age, sex, and HbA1c, a multiple linear regression analysis was used. Results. In the pericentral area of the macula, the retinal nerve fiber layer (RNFL), ganglion cell layer (GCL), and inner plexiform layer (IPL) were thinner in patients with minimal DR compared to controls (respective difference 1.9 ?m, 95% confidence interval [CI] 0.3–3.5 ?m; 5.2 ?m, 95% CI 1.0–9.3 ?m; 4.5 ?m, 95% CI 2.2–6.7 ?m). In the peripheral area of the macula, the RNFL and IPL were thinner in patients with minimal DR compared to controls (respective difference 3.2 ?m, 95% CI 0.1–6.4 ?m; 3.3 ?m, 95% CI 1.2–5.4 ?m). Multiple linear regression analysis showed DR status to be the only significant explanatory variable (R = 0.31, P = 0.03) for this retinal thinning. Conclusions. This study demonstrated thinner inner retinal layers in the macula of type 2 diabetic patients with minimal DR than in controls. These results support the concept that early DR includes a neurodegenerative component.

van Dijk, Hille W.; Verbraak, Frank D.; Kok, Pauline H. B.; Stehouwer, Marilette; Garvin, Mona K.; Sonka, Milan; DeVries, J. Hans; Schlingemann, Reinier O.; Abramoff, Michael D.

2012-01-01

377

Beta cell (dys)function in non-diabetic offspring of diabetic patients  

Microsoft Academic Search

Aims\\/hypothesis  The first-degree offspring of patients with type 2 diabetes are prone to develop type 2 diabetes, and have both insulin resistance\\u000a and beta cell impairment. However, it is still unclear whether both pathophysiological features are inseparably combined and\\u000a which is the outstanding determinant in the offspring.\\u000a \\u000a \\u000a \\u000a \\u000a Methods  Glucose metabolism, insulin sensitivity (calculated as M value divided by insulin [M\\/I]) and beta

M. Stadler; G. Pacini; J. Petrie; A. Luger; C. Anderwald

2009-01-01

378

Safety during the monitoring of diabetic patients: trial teaching course on health professionals and diabetics - SEGUDIAB study  

Microsoft Academic Search

Background  Safety for diabetic patients means providing the most suitable treatment for each type of diabetic in order to improve monitoring\\u000a and to prevent the adverse effects of drugs and complications arising from the disease. The aim of this study is to analyze\\u000a the effect of imparting educational interventions to health professionals regarding the safety of patients with Diabetes Mellitus\\u000a (DM).

Juan J Cabré; Marta Ripoll; Josep M Hernández; Josep Basora; Ferran Bejarano; Victoria Arija

2011-01-01

379

Are diabetic patients in danger at renal transplantation? An invasive perioperative study.  

PubMed

It is assumed that diabetic patients with uraemia have more complications at renal transplantation than those who are not diabetic. We compared the preoperative ECGs, and invasive perioperative haemodynamic and oxygenation parameters in 15 diabetic and 15 non-diabetic uraemic patients undergoing renal transplantation. The number of patients with increased QT dispersion in the ECG was higher in diabetic than in non-diabetic patients (P<0.05). Before anaesthesia, heart rate and mean arterial pressure were higher (P<0.05) in the diabetic than in the non-diabetic group. After preanaesthetic volume loading all patients showed a hyperdynamic circulation, which subsided during anaesthesia. However, stroke volume index remained unchanged. Four patients in the diabetic group and six in the non-diabetic group needed additional oxygen therapy after surgery. No cardiac dysrhythmias were noted. However, the increased QT dispersion in diabetic patients calls for an adequate perioperative ECG monitoring for dysrhythmias. The diabetic and non-diabetic uraemic patients performed equally well at renal transplantation. In conclusion, renal transplantation for diabetics is justified. PMID:11122310

Norio, K; Mäkisalo, H; Isoniemi, H; Groop, P H; Pere, P; Lindgren, L

2000-12-01

380

Optic Disc Swelling and Vision Loss in a Patient with Cystic Fibrosis and Diabetes  

PubMed Central

Advances in cystic fibrosis management have significantly improved life expectancy in these patients. However, we are now faced with a growing number of long-term extrapulmonary consequences of this disease, including ophthalmic complications of diabetes in cystic fibrosis patients. We present a unique report that documents a case of diabetic papillopathy progressing to nonarteritic anterior ischemic optic neuropathy resulting in vision loss in a patient with CF and diabetes. It highlights the potentially devastating consequences of longstanding diabetes in CF patients.

Chuo, Jean Y.; Godinho, Derek V.; Wilcox, Pearce G.; Kreisman, Stuart H.; Quon, Bradley S.

2013-01-01

381

Balneotherapy and platelet glutathione metabolism in type II diabetic patients  

NASA Astrophysics Data System (ADS)

Effects of balneotherapy on platelet glutathione metabolism were investigated in 12 type II (non-insulin-dependent) diabetic patients. Levels of the reduced form of glutathione (GSH) on admission were well correlated with those of fasting plasma glucose (FPG; r=0.692, P<0.02). After 4 weeks of balneotherapy, the mean level of GSH showed no changes; however, in well-controlled patients (FPG <150 mg/dl), the level increased ( P<0.01) and in poorly controlled patients (FPG >150 mg/dl), the value decreased ( P<0.05). There was a negative correlation between glutathione peroxidase (GPX) activities and the levels of FPG ( r=-0.430, P<0.05). After balneotherapy, the activity increased in 5 patients, decreased in 3 patients and showed no changes (alteration within ±3%) in all the other patients. From these findings in diabetic patients we concluded: (1) platelet GSH synthesis appeared to be induced in response to oxidative stress; (2) lowered GPX activities indicated that the antioxidative defense system was impaired; and (3) platelet glutathione metabolism was partially improved by 4 weeks balneotherapy, an effect thought to be dependent on the control status of plasma glucose levels. It is suggested that balneotherapy is beneficial for patients whose platelet antioxidative defense system is damaged, such as those with diabetes mellitus and coronary heart disease.

Ohtsuka, Yoshinori; Yabunaka, Noriyuki; Watanabe, Ichiro; Noro, Hiroshi; Agishi, Yuko

1996-09-01

382

Benchmark analysis of diabetic patients with neuropathic (Charcot) foot deformity.  

PubMed

During a 10-year period, 237 patients (129 women, 108 men) with a diagnosis of neuropathic (Charcot) arthropathy of the foot and ankle were treated in a tertiary care university hospital medical center. During this period, 115 of the patients (48.5%) were treated nonoperatively as outpatients with local skin and nail care, accommodative shoe wear, and custom foot orthoses. A total of 120 (50.6%) underwent 143 operations. Surgery included 21 major limb amputations, 29 ankle fusions, 26 hindfoot fusions, 23 exostectomies, and 23 debridements for osteomyelitis. It is widely accepted that patients with diabetes are at risk for developing foot ulcers, which can lead to lower extremity amputation. Within the population of diabetic patients, it is widely accepted that patients with neuropathic (Charcot) arthropathy of the foot and ankle have one of the highest likelihoods of having to undergo lower extremity amputation. The current emphasis in care of the foot of a diabetic patient involves a multidisciplinary team approach combining patient education, skin and nail care, and accommodative shoe wear. As data from prophylactic programs become available, resource allocation and cost of care can be compared with this benchmark baseline. This benchmark analysis can be used by those who are responsible for allocating resources and projecting healthcare costs for this "high utilization"/high risk patient population. PMID:10509683

Pinzur, M S

1999-09-01

383

Mutational analysis of TSC1 and TSC2 in Japanese patients with tuberous sclerosis complex revealed higher incidence of TSC1 patients than previously reported.  

PubMed

Tuberous sclerosis complex (TSC) is an autosomal dominant disorder characterized by multiple hamartias and hamartomas involving throughout the body. To date, many TSC1 and TSC2 mutations have been reported all over the world, however, few TSC mutation studies have been performed in the Japanese population, and genetic characteristics of Japanese TSC patients are not yet clear. In this study, we analyzed TSC1 and TSC2 in 57 Japanese patients with TSC (8 familial and 49 sporadic; 46 definite and 11 suspect TSC) and identified 31 mutations including 11 TSC1 mutations (two familial and nine sporadic; all definite TSC) and 20 TSC2 mutations (2 familial and 18 sporadic; 19 definite and 1 suspect TSC). We also reviewed all Japanese TSC mutations previously reported. Our study demonstrates significantly higher incidence (P=0.007) of TSC1 mutations among sporadic TSC patients in the Japanese population compared with US and European studies. No differences emerged in mutation distributions and types in precedent studies, excepting low frequency of the TSC2 nonsense mutation. Comparing clinical manifestations, developmental delay and/or mental retardation were milder in TSC1 patients than TSC2 patients for its frequency (P=0.032) and severity (P=0.015); however, no other symptoms were clearly different. PMID:23389244

Niida, Yo; Wakisaka, Akiko; Tsuji, Takanori; Yamada, Hiroshi; Kuroda, Mondo; Mitani, Yusuke; Okumura, Akiko; Yokoi, Ayano

2013-02-07

384

Prevention of type 2 diabetes in a primary healthcare setting: Three-year results of lifestyle intervention in Japanese subjects with impaired glucose tolerance  

PubMed Central

Background A randomized control trial was performed to test whether a lifestyle intervention program, carried out in a primary healthcare setting using existing resources, can reduce the incidence of type 2 diabetes in Japanese with impaired glucose tolerance (IGT). The results of 3 years' intervention are summarized. Methods Through health checkups in communities and workplaces, 304 middle-aged IGT subjects with a mean body mass index (BMI) of 24.5 kg/m2 were recruited and randomized to the intervention group or control group. The lifestyle intervention was carried out for 3 years by public health nurses using the curriculum and educational materials provided by the study group. Results After 1 year, the intervention had significantly improved body weight (-1.5 ± 0.7 vs. -0.7 ± 2.5 kg in the control; p = 0.023) and daily non-exercise leisure time energy expenditure (25 ± 113 vs. -3 ± 98 kcal; p = 0.045). Insulin sensitivity assessed by the Matsuda index was improved by the intervention during the 3 years. The 3-year cumulative incidence tended to be lower in the intervention group (14.8% vs.8.2%, log-rank test: p = 0.097). In a sub-analysis for the subjects with a BMI > 22.5 kg/m2, a significant reduction in the cumulative incidence was found (p = 0.027). Conclusions The present lifestyle intervention program using existing healthcare resources is beneficial in preventing diabetes in Japanese with IGT. This has important implications for primary healthcare-based diabetes prevention. Trial registration number UMIN000003136

2011-01-01

385

Efficacy, tolerability, and safety of risedronate in Japanese patients with Paget's disease of bone.  

PubMed

This study evaluated the clinical efficacy of treatment with oral risedronate (17.5 mg once daily) for 8 weeks in 11 Japanese patients with Paget's disease of bone (PDB). Risedronate suppressed the excessive bone turnover associated with PDB and improved several biochemical markers, including serum alkaline phosphatase (ALP), serum bone-specific ALP (BALP), urinary deoxypyridinoline (DPD), and urinary cross-linked N-telopeptide of type 1 collagen (NTX). These markers began to decrease within about 2 weeks after the initiation of treatment in most patients, and the response persisted for up to 40 weeks after the cessation of treatment. Risedronate reduced pain by week 24 in most patients. According to quantitative bone scintigraphy, the lesion with the highest radioisotope (RI) uptake showed a decrease of uptake from 12.7 +/- 6.8 to 6.0 +/- 2.3 (mean +/- SD) in week 24, although each lesion of patients with polyostotic disease had a different scintigraphic response. Overall, risedronate at a dose of 17.5 mg once daily was well tolerated by patients with PDB, even though the dosage was seven times higher than that approved for the treatment of osteoporosis in Japan (2.5 mg once daily). In conclusion, treatment with high-dose risedronate for 8 weeks resulted in clinically significant and sustained improvement of biochemical markers of bone turnover for 48 weeks in patients with PDB, and this improvement was associated with a decrease of RI uptake by Paget's bone lesions and with reduced pain. PMID:20179977

Yoh, Kousei; Takata, Shinjiro; Yoshimura, Noriko; Hashimoto, Jun

2010-02-24

386

Should Cisapride Be Avoided in Patients with Diabetic Gastroparesis?  

Microsoft Academic Search

The gastrointestinal motility stimulants, cisapride and erythromycin, have been used in the management of diabetic gastroparesis. However, drug interactions may result in prolongation of the electrocardiographic QT interval with the risk of ventricular arrhythmias. These drugs should, therefore, not be used in combination. We report two cases that illustrate inappropriate use of these agents. Moreover, patients with recurrent severe hypoglycemia

Alison J Evans; Andrew J Krentz

1999-01-01

387

Oxidative Retinal Products and Ocular Damages in Diabetic Patients  

Microsoft Academic Search

Several evidences suggest a retinal participation to the genesis of diabetic eye complications by means of an increased free radical production at this level. However, no direct proof exists that this happens in humans in vivo. Therefore, the concentrations of malondialdehyde (MDA), carbonyl and sulfhydryl (P-SH) proteins, and vitamin E have been assessed in the subretinal fluid (SF) of patients

Ignazio Grattagliano; Gianluigi Vendemiale; Francesco Boscia; Tommaso Micelli-Ferrari; Luigi Cardia; Emanuele Altomare

1998-01-01

388

Ibudilast May Improve Retinal Circulation in Patients with Diabetes mellitus  

Microsoft Academic Search

Ibudilast selectively vasodilates cerebral vessels without reducing blood pressure. We investigated the effect of the drug on retinal circulation in 8 patients with diabetes mellitus, using the video-densitometric image analysis of fluorescein angiography. We compared the build up time, the time constant of washout rate and the mean circulation time (MCT) before and after oral therapy with ibudilast. After 2

Ryo Suzuki; Itsuko Sugihara; Takeshi Ishibashi; Shinji Kurimoto

1992-01-01

389

Neuropathy in type 1 diabetic renal transplanted patients.  

PubMed

This study was undertaken to study the changes in neuropathy in type 1 diabetic patients with end-stage renal disease (ESRD) after renal transplantation. From April 2007 to June 2010, 30 renal transplanted patients with type 1 diabetes mellitus (RT) and 30 type 1 diabetic patients with ESRD were enrolled in this study. Electroneurodiagnostic tests of peroneal, sural, ulnar, and median nerves were performed. Nerve conduction velocity (NCV), compound motor action potentials (CMAPs), and sensory nerve action potentials (SNAPs) were analyzed at 6, 12, and 18 months after renal transplantation. The NCV improved in the RT group in 18 months of the follow-up period (P <0.01 versus baseline). This parameter worsened significantly in the control group throughout the study period (P = 0.03), but in the cross-sectional analysis between the groups, we could not find any remarkable differences (P = 0.07). Both SNAP and CMAP amplitudes improved in the RT (SNAP Sural = 0.04, SNAP Median = 0.01 and CAMP Peroneal = 0.03, CAMP Ulnar = 0.02) but worsened in the control group (SNAP Sural < 0.001, SAP Median < 0.01 and CAMP Peroneal < 0.01, CAMP Ulnar < 0.01). Comparison of both groups did not show any significant statistical changes. Electroneurodiagnostic values improved after renal transplantation in type 1 diabetic patients with ESRD, but cross-sectional analysis did not reveal statistically significant differences between the studied groups. PMID:22805383

Noshad, Hamid

2012-07-01

390

Duloxetine vs. placebo in patients with painful diabetic neuropathy  

Microsoft Academic Search

The aim of this study was to examine the efficacy and safety of duloxetine, a balanced and potent dual reuptake inhibitor of serotonin and norepinephrine, in the management of diabetic peripheral neuropathic pain. Serotonin and norepinephrine are thought to inhibit pain via descending pain pathways. In a 12-week, multicenter, double-blind study, 457 patients experiencing pain due to polyneuropathy caused by

David J. Goldstein; Yili Lu; Michael J. Detke; Thomas C. Lee; Smriti Iyengar

2005-01-01

391

Diabetes mellitus patients' family caregivers' subjective quality of life.  

PubMed Central

OBJECTIVES: To assess the subjective quality of life (QOL) of family caregivers of Sudanese type-1 and type-2 diabetic outpatients, using the WHO 26-item QOL instrument, compared with a general population sample; and to examine the factors associated with caregiver QOL. METHOD: Responses of caregivers of 105 outpatients with type-1 diabetes and 135 with type-2 diabetes were compared with 139 general population subjects. RESULTS: Caregivers were satisfied with the content of items related to general social supports. Type-1 caregivers had significantly lower QOL scores than type-2 caregivers and the general population. Parents and siblings had lowest scores compared with other family groups. Caregivers scored higher than patients. Patients' age and duration of illness, and caregivers' education, marital status and state of health were positively associated with caregiver QOL. Caregivers' QOL was predicted by their appraisal of patients' QOL. CONCLUSIONS: Caregivers who were sick, younger, single, less educated and caring for patients with more recent illness appeared relatively vulnerable. Clinicians should be interested in the dynamics of the family caregiving situation--as it impacts QOL--and in promoting caregiver awareness of diabetes in order to enhance the caregiving role, quality of care and QOL.

Awadalla, Abdel W.; Ohaeri, Jude U.; Al-Awadi, Shafika A.; Tawfiq, Adel M.

2006-01-01

392

The role of glucose lowering agents on restenosis after percutaneous coronary intervention in patients with diabetes mellitus  

Microsoft Academic Search

INTRODUCTION: The prevalence of diabetes is increasing rapidly, and individuals with diabetes are at high risk for cardiovascular disorders. Subsequently the percentage of patients with diabetes subjected to revascularisation, i.e. either percutaneous coronary intervention (PCI) or coronary artery bypass grafting (CABG) also rises rapidly. The outcome of patients with diabetes after PCI is worse than for patients without diabetes. Restenosis

Chris PH Lexis; Braim M Rahel; Joan G Meeder; Felix Zijlstra; Iwan CC van der Horst

2009-01-01

393

Evaluation of the safety and efficacy of micafungin in Japanese patients with deep mycosis: a post-marketing survey report  

Microsoft Academic Search

The safety and efficacy of micafungin were evaluated in a Japanese post-marketing survey involving 1,142 patients with deep\\u000a mycosis caused by Candida or Aspergillus. The overall clinical response was 83.0%, and the respective responses for patients with candidiasis or aspergillosis were\\u000a 86.3 and 70.8%. With regard to drug reactions, 562 adverse reactions were observed in 28.5% of patients. Among the

Tomoko Hanadate; Masahiro Wakasugi; Keizo Sogabe; Toshimitsu Kobayashi; Hisanori Horita; Ikuo Kawamura; Yasuhiro Hori; Keita Matsui; Yo Hoshino; Masahiro Sou

394

Prevalence of Mutations in Core Promoter\\/Precore Region in Japanese Patients with Chronic Hepatitis B Virus Infection  

Microsoft Academic Search

We examined the frequency and significance ofmutations in the core promoter and precore region in 103Japanese patients with chronic hepatitis B virus (HBV)infection. HBV DNAs from the patients' sera were amplified by polymerase chain reaction andwere directly sequenced. A double mutation(T1762 A1764) in the core promoterwas frequently observed in the patients regardless ofHBeAg status except for asymptomatic carriers with HBeAg.

Atsushi Nagasaka; Shuhei Hige; Masumi Marutani; Izumi Tsunematsu; Makoto Saito; Yoshiya Yamamoto; Shigeru Konishi; Masahiro Asaka

1998-01-01

395

Circadian rhythm of autonomic activity in non diabetic offsprings of type 2 diabetic patients  

PubMed Central

The aim of the present study was to evaluate, by heart rate variability (HRV) with 24-hours ECG Holter (HRV), the circadian autonomic activity in offspring of type 2 diabetic subjects and the relation with insulin-resistance. METHODS: 50 Caucasian offsprings of type 2 diabetic subjects were divided in two groups: insulin-resistant offsprings (IR) and non insulin-resistant offsprings (NIR). Autonomic nervous activity was studied by HRV. Time domain and spectral analysis (low frequency, LF, and high frequency, HF, provide markers of sympathetic and parasympathetic modulation when assessed in normalized units) were evaluated. RESULTS. Time domain showed a reduction of total SDNN in IR (p < 0.001) and NIR (p 0.047) versus controls. Spectral analysis showed a total and night LF higher in IR and NIR than in control group (all p < 0.001). CONCLUSION. In frequency domain, the analysis of sympathetic (LF) and parasympathetic (HF) component evidenced an association between the offspring of type 2 diabetic subjects and a sympathetic overactivity. A global reduction and alteration of circadian rhythm of autonomic activity are present in offspring of type 2 diabetic patients with and without insulin resistance. The data of our study suggested that an autonomic impairment is associated with the familiarity for type 2 diabetes independently to insulin resistance and that an impairment of autonomic system activity could precede the insulin resistance.

Fiorentini, A; Perciaccante, A; Paris, A; Serra, P; Tubani, L

2005-01-01

396

Patterns and predictors of statin prescription in patients with type 2 diabetes  

Microsoft Academic Search

BACKGROUND: The benefit of statins for prevention of cardiovascular events in type 2 diabetes is established, but a gap exists between guideline recommendations and clinical practice. The aim of the study was to identify patient-related factors predicting statin prescription. METHODS: We assessed the quality of care in 51,640 patients with type 2 diabetes in a German diabetes registry. Patients were

Heiner K Berthold; Ioanna Gouni-Berthold; Michael Böhm; Wilhelm Krone; Kurt P Bestehorn

2009-01-01

397

Homocysteine concentrations in type 2 diabetic patients with silent myocardial ischemia  

Microsoft Academic Search

BackgroundSilent myocardial ischemia (SMI) is a frequent finding among diabetic patients. There are very few data on the relationship between homocysteine, which is a novel cardiovascular risk factor, and SMI in diabetic patients. We investigated whether plasma homocysteine has a predictive value for early diagnosis of SMI in type 2 diabetic patients.

?lhan Tarkun; Berrin Çetinarslan; Zeynep Cant; Pinar Tarkun; Ay?en A; Baki Komsuo

2004-01-01

398

Impaired Taste Acuity in Patients with Diabetes mellitus on Maintenance Hemodialysis  

Microsoft Academic Search

Aims: It has been reported that taste acuity for the four primary tastes, sour, sweet, salty and bitter, is impaired in hemodialysis (HD) patients. However, there have been no studies reported on taste acuity of diabetic HD patients. The present study aimed to quantify and compare the taste acuity of diabetic and non-diabetic HD patients, and further to determine if

Shunya Matsuo; Masahiko Nakamoto; Gakusen Nishihara; Chikao Yasunaga; Taihei Yanagida; Kenzo Matsuo; Takanobu Sakemi

2003-01-01

399

Simultaneous pancreas-kidney transplant versus kidney transplant alone in diabetic patients  

Microsoft Academic Search

Simultaneous pancreas-kidney transplant versus kidney transplant alone in diabetic patients. The decision for simultaneous pancreas-kidney (SPK) versus kidney transplant alone (KTA) in diabetic patients with renal failure depends on the potential risks and benefits for each procedure. The purpose of this study was to compare the morbidity, mortality, and renal allograft survival in diabetic patients who underwent SPK versus KTA,

Alan H S Cheung; David E R Sutherland; Kristen J Gillingham; Lois E McHugh; Kay C Moudry-Munns; David L Dunn; John S Najarian; Arthur J Matas

1992-01-01

400

An Audit of Foot Infections in Patients with Diabetes Mellitus Following Renal Transplantation  

Microsoft Academic Search

Foot lesions in postrenal transplant diabetics are often overlooked and hence underestimated. An audit of patients attending the authors’ department was done. They reviewed the case notes to assess the presentation, clinical profiles, and outcomes of foot infections in patients with diabetes mellitus who received renal transplants at their center. Medical records of 192 diabetic foot patients were assessed, of

Robbie K. George; Ashok K. Verma; Amit Agarwal; Gaurav Agarwal; Saroj K. Mishra

2004-01-01

401

Blood pressure lowering in patients with diabetes—one level might not fit all  

Microsoft Academic Search

Hypertension and diabetes mellitus frequently occur together, leading to increased complications and mortality in patients with both these conditions. Blood pressure (BP) goals for patients with diabetes have consistently been more aggressive than for patients without diabetes. Although the benefits of lowering BP are well documented, data to support this more aggressive goal are lacking. In fact, lowering BP might

Eric F. Egelund; Carl J. Pepine; Rhonda M. Cooper-DeHoff

2010-01-01

402

Continuous ambulatory peritoneal dialysis in insulin-dependent diabetic patients: A 40-month experience  

Microsoft Academic Search

Diabetic nephropathy is becoming a major and growing cause of endstage renal disease (ESRD) in all industrialized countries [1, 2]. In Europe, the number of patients with diabetic nephropathy and ESRD that have been put on renal replacement therapy has increased rapidly during the last years. By the end of 1980, diabetic patients accounted for 3% of all patients alive

Jacques Rottembourg; Yassim el Shahat; Athanasios Agrafiotis; Yvette Thuillier; François de Groc; Claude Jacobs; Marcel Legrain

1983-01-01

403

Erythropoietin requirement in patients with type 2 diabetes mellitus on maintenance hemodialysis therapy  

Microsoft Academic Search

Summary Diabetes is known to be a risk factor for the severity of anemia in nondialyzed patients with renal failure. The aim of this study was to evaluate differences in hemoglobin (Hb) response to erythropoietin (EPO) in diabetic and nondiabetic patients on chronic hemodialysis (CHD). Sixty-four patients on CHD were included in the study: 24 type 2 diabetics (mean age,

Georg Biesenbach; Bernhard Schmekal; Gabriela Eichbauer-Sturm; Otmar Janko

2004-01-01

404

Diabetic patients have abnormal cerebral autoregulation during cardiopulmonary bypass  

SciTech Connect

We tested the hypothesis that insulin-dependent diabetic patients with coronary artery bypass graft surgery experience altered coupling of cerebral blood flow and oxygen consumption. In a study of 23 patients (11 diabetics and 12 age-matched controls), cerebral blood flow was measured using 133Xe clearance during nonpulsatile, alpha-stat blood gas managed cardiopulmonary bypass at the conditions of hypothermia and normothermia. In diabetic patients, the cerebral blood flow at 26.6 +/- 2.42 degrees C was 25.3 +/- 14.34 ml/100 g/min and at 36.9 +/- 0.58 degrees C it was 27.3 +/- 7.40 ml/100 g/min (p = NS). The control patients increased cerebral blood flow from 20.7 +/- 6.78 ml/100 g/min at 28.4 +/- 2.81 degrees C to 37.6 +/- 8.81 ml/100 g/min at 36.5 +/- 0.45 degrees C (p less than or equal to 0.005). The oxygen consumption was calculated from jugular bulb effluent and increased from hypothermic values of 0.52 +/- 0.20 ml/100 g/min in diabetics to 1.26 +/- 0.28 ml/100 g/min (p = 0.001) at normothermia and rose from 0.60 +/- 0.27 to 1.49 +/- 0.35 ml/100 g/min (p = 0.0005) in the controls. Thus, despite temperature-mediated changes in oxygen consumption, diabetic patients did not increase cerebral blood flow as metabolism increased. Arteriovenous oxygen saturation gradients and oxygen extraction across the brain were calculated from arterial and jugular bulb blood samples. The increase in arteriovenous oxygen difference between temperature conditions in diabetic patients and controls was significantly different (p = 0.01). These data reveal that diabetic patients lose cerebral autoregulation during cardiopulmonary bypass and compensate for an imbalance in adequate oxygen delivery by increasing oxygen extraction.

Croughwell, N.; Lyth, M.; Quill, T.J.; Newman, M.; Greeley, W.J.; Smith, L.R.; Reves, J.G. (Duke Univ. Medical Center, Durham, NC (USA))

1990-11-01

405

Organizational safety climate differently affects on patient safety behavior of nurses according to the hospital scale in Japanese private hospitals  

Microsoft Academic Search

Introduction: The aim of this study is to elucidate how patient safety behavior of nurses is associated with organizational safety climate and nurse's individual factors by covariance structure analysis of the results of the questionnaires, such as professional awareness and job- satisfaction, in 10 Japanese private hospitals. Methodology: In this study, the questionnaire was developed including organizational factors (organizational safety

Takayasu Inoue; Risuke Karima

406

Reducing patient drug acquisition costs can lower diabetes health claims.  

PubMed

Concerned about rising prevalence and costs of diabetes among its employees, Pitney Bowes Inc recently revamped its drug benefit design to synergize with ongoing efforts in its disease management and patient education programs. Specifically, based on a predictive model showing that low medication adherence was linked to subsequent increases in healthcare costs in patients with diabetes, the