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1

Painful Diabetic Neuropathy in Japanese Diabetic Patients Is Common but Underrecognized  

PubMed Central

Although chronic pain due to diabetic neuropathy, defined as painful diabetic neuropathy (PDN), is a debilitating and distressing complication of diabetes, epidemiological data on PDN has been scarce, especially in Asia. We evaluated the prevalence of Japanese PDN and its impact on their quality of life (QOL) and metnal state. In addition, we examined to which extent physicians are aware of patients' PDN. A total of 298 patients with diabetes were found to be eligible for the study. We revealed that substantial percentage (22.1%) of Japanese diabetic patients had PDN and that PDN had negative effect on patients' QOL and mental state. However, physicians were aware of PDN in only 36.4% of patients with the condition. To the best of our knowledge, this is the first report showing the extent of physicians' awareness of patients' PDN. In conclusion, physicians treating diabetes need to be more aware of patients' PDN in everyday clinical practice to prevent the progression of PDN and improve the patients' QOL and mental state. PMID:24377045

Tsuji, Mayumi; Matsuoka, Taka-aki; Hirose, Takahisa; Kawamori, Ryuzo; Iseki, Masako; Shimomura, Iichiro

2013-01-01

2

Social Orientation and Diabetes-Related Distress in Japanese and American Patients with Type 2 Diabetes  

PubMed Central

Objective Recent evidence in cultural and social psychology suggests Eastern cultures' emphasis on harmony and connection with others and Western cultures' emphasis on self-direction and autonomy. In Eastern society, relational harmony is closely linked to people's well-being. The impact of this cultural and social orientation on diabetes-related distress was investigated. Research Design and Methods Japanese and American patients with type 2 diabetes were surveyed by well-established questionnaire in Japan and in the United States, respectively. The association of personal values for interdependence, perceived emotional support, and the Problem Areas in Diabetes scale (PAID) were analyzed. Results A positive correlation between interdependence and PAID (r?=?0.18; P?=?0.025) and a negative correlation between perceived emotional support and PAID (r?=?? 0.24; P?=?0.004) were observed after adjustments for other factors in Japanese data (n?=?149), but not in American data (r?=?0.00; P?=?0.990, r?=?0.02; P?=?0.917, respectively, n?=?50). In Japanese data, the three-factor structure of PAID (negative feelings about total life with diabetes, about living conditions with diabetes, and about treatment of diabetes) was identified, and interdependence showed significant positive correlations with the first and second factors and perceived emotional support showed significant negative correlations with all three factors of PAID. Conclusions These results suggest that personal values for interdependence may be linked to the level of diabetes-related distress and that the distress may be relieved by perception of emotional support, especially in an interdependent cultural context. PMID:25333692

Ikeda, Kaori; Fujimoto, Shimpei; Morling, Beth; Ayano-Takahara, Shiho; Carroll, Andrew E.; Harashima, Shin-ichi; Uchida, Yukiko; Inagaki, Nobuya

2014-01-01

3

Long-Term Outcomes of Japanese Type 2 Diabetic Patients With Biopsy-Proven Diabetic Nephropathy  

PubMed Central

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

2013-01-01

4

Pharmacokinetics, Pharmacodynamics, Tolerability, and Safety of Exenatide in Japanese Patients With Type 2 Diabetes Mellitus  

Microsoft Academic Search

In this single-blind, parallel, placebo-controlled study, the pharmacokinetics, pharmacodynamics, tolerability, and safety of subcutaneous exenatide were evaluated in 40 Japanese patients with type 2 diabetes. Patients were allocated to 4 groups and randomized to receive exenatide (n = 8\\/group) or placebo (n = 2\\/group), with all receiving placebo on day 1. On day 2, patients received single-dose exenatide (2.5 µg

Prajakti A. Kothare; Helle Linnebjerg; Yoshitaka Isaka; Kazunori Uenaka; Ayuko Yamamura; Kwee Poo Yeo; Amparo de la Peña; Choo Hua Teng; Kenneth Mace; Mark Fineman; Hirofumi Shigeta; Yukikuni Sakata; Shin Irie

2008-01-01

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

Increased Risk of Acute Pancreatitis in Patients with Type 2 Diabetes: An Observational Study Using a Japanese Hospital Database  

PubMed Central

Background Increased risks of acute pancreatitis in patients with type 2 diabetes mellitus have been reported recently in several countries. We aimed to estimate the risks of acute pancreatitis in Japanese patients with diabetes mellitus. Methods/Findings We examined a large-scale hospital administrative database consisting of one million patients in 16 secondary medical care hospitals, from 2003 to 2010. The incidence rates of acute pancreatitis were estimated with cohort design; the odds ratios associated with diabetes mellitus and other comorbid risk factors were estimated with separate case-control analyses. In cohort analysis, the incidence of acute pancreatitis was higher in 14,707 diabetic patients than in 186,032 non-diabetic patients (4.75 vs. 1.65 per 1,000 patient-years) and increased in male patients and as age advanced. The adjusted odds ratio of acute pancreatitis in patients with diabetes mellitus was 1.86 (P<0.001) compared with non-diabetic patients in case-control analysis from 1,372 cases and 5,469 matched controls, which is consistent with the ones reported in previous studies. Alcoholism and gallstones were associated with a large increase in the risk of acute pancreatitis (adjusted odds ratio 13.40 and 14.29, respectively, P<0.001), although dyslipidemia was associated with significant risk reduction (adjusted odds ratio 0.62, P<0.001). Conclusions This observational study ascertained the elevated incidence rates and risk of acute pancreatitis in Japanese patients with diabetes. The risk estimates in Japanese patients with diabetes were in agreement with the ones reported in previous studies, and the elevated risk of acute pancreatitis in patients with diabetes would be generalized in different locations/populations. PMID:23300896

Urushihara, Hisashi; Taketsuna, Masanori; Liu, Ying; Oda, Eisei; Nakamura, Masaki; Nishiuma, Shinichi; Maeda, Rei

2012-01-01

7

Profile of saxagliptin in the treatment of type 2 diabetes: focus on Japanese patients  

PubMed Central

Saxagliptin is a selective and potent dipeptidyl peptidase (DPP)-4 inhibitor, approved as an adjunct to diet and exercise to improve glycemic control in type 2 diabetes mellitus (T2DM) in the USA on July 2009, and had been launched globally in over 86 countries by September 2013. In patients with T2DM, once-daily administration of saxagliptin before breakfast achieves sustained inhibition of plasma DPP-4 activity and reduction of postprandial hyperglycemia, including after dinner, associated with an increase in plasma glucagon-like peptide-1 levels. This paper reviews the safety and efficacy of saxagliptin in Japanese patients with T2DM. The clinical development study in Japan supported its usefulness for the disease. Saxagliptin 1, 2.5, and 5 mg led to significant improvements in glycated hemoglobin (HbA1c), and was generally well tolerated. Treatment with saxagliptin 5 mg induced a sustained reduction in HbA1c over 52 weeks. Long-term combination therapy with saxagliptin and other oral hypoglycemic agents also provided sustained glycemic control and was well tolerated for up to 52 weeks. Saxagliptin as add-on to sulfonylureas or glinides has a tendency to increase hypoglycemia, but not with other oral antidiabetic agents, such as ?-glucosidase inhibitors, metformin, or thiazolidinediones. The results of clinical trials have confirmed the long-term efficacy and safety of saxagliptin monotherapy as well as its use as add-on combination therapy, and support its usefulness as a therapeutic agent for T2DM. Saxagliptin has less concern for hypoglycemia and weight gain, which often becomes problematic in routine care of T2DM. Meta-analysis of clinical trials in the USA showed no evidence of increased risk of cardiovascular events associated with saxagliptin, suggesting the superior of saxagliptin in terms of safety. Recently, investigators in the SAVOR-TIMI (Saxagliptin Assessment of Vascular Outcomes Recorded in Patients with Diabetes Mellitus-Thrombolysis in Myocardial Infarction) 53 study suggested that DPP-4 inhibition with saxagliptin did not increase or decrease the rate of ischemic events, although the rate of hospitalization for heart failure was increased. Although saxagliptin improves glycemic control, other approaches are necessary to reduce cardiovascular risk in patients with diabetes. Saxagliptin is applicable for various pathological conditions, and is considered to be clinically significant as a new therapeutic option for Japanese patients with T2DM. PMID:25050065

Konya, Hiroyuki; Yano, Yuzo; Matsutani, Satoshi; Tsunoda, Taku; Ikawa, Takashi; Kusunoki, Yoshiki; Matsuo, Toshihiro; Miuchi, Masayuki; Katsuno, Tomoyuki; Hamaguchi, Tomoya; Miyagawa, Jun-ichiro; Namba, Mitsuyoshi

2014-01-01

8

Coffee consumption is inversely associated with depressive status in Japanese patients with type 2 diabetes  

PubMed Central

Depression has been reported to be more prevalent among diabetic patients than non-diabetic individuals. Although depression and diabetes are causally and bi-directionally related, the influence of food intake frequency on depressive symptoms in diabetic patients has not been fully evaluated. This cross-sectional study analyzed data obtained from 89 patients with type 2 diabetes who completed self-administered questionnaires regarding food intake frequency, diabetic variables, physical activity and depressive states. The prevalence of a “definite” depressive state was 16.9%. The duration of diabetes, hemoglobin A1c levels, diabetic microvascular complications and physical activity levels were similar between depressed and non-depressed patients. Daily intakes of total lipids, n-6 polyunsaturated fatty acids and lipid energy ratios were significantly lower, and the carbohydrate energy ratio was significantly higher in depressed than in non-depressed patients. Coffee consumption was inversely associated with depressive symptoms, but no significant association was found between tea or green tea consumption and depressive symptoms. The logistic regression analysis showed that coffee consumption was an independent predictor of non-depressed status in diabetic patients. This might be due to biologically active compounds containing in coffee other than caffeine.

Omagari, Katsuhisa; Sakaki, Mika; Tsujimoto, Yuki; Shiogama, Yukiko; Iwanaga, Akiko; Ishimoto, Makiko; Yamaguchi, Asami; Masuzumi, Miki; Kawase, Miku; Ichimura, Mayuko; Yoshitake, Takatoshi; Miyahara, Yoshiyuki

2014-01-01

9

Coffee consumption is inversely associated with depressive status in Japanese patients with type 2 diabetes.  

PubMed

Depression has been reported to be more prevalent among diabetic patients than non-diabetic individuals. Although depression and diabetes are causally and bi-directionally related, the influence of food intake frequency on depressive symptoms in diabetic patients has not been fully evaluated. This cross-sectional study analyzed data obtained from 89 patients with type 2 diabetes who completed self-administered questionnaires regarding food intake frequency, diabetic variables, physical activity and depressive states. The prevalence of a "definite" depressive state was 16.9%. The duration of diabetes, hemoglobin A1c levels, diabetic microvascular complications and physical activity levels were similar between depressed and non-depressed patients. Daily intakes of total lipids, n-6 polyunsaturated fatty acids and lipid energy ratios were significantly lower, and the carbohydrate energy ratio was significantly higher in depressed than in non-depressed patients. Coffee consumption was inversely associated with depressive symptoms, but no significant association was found between tea or green tea consumption and depressive symptoms. The logistic regression analysis showed that coffee consumption was an independent predictor of non-depressed status in diabetic patients. This might be due to biologically active compounds containing in coffee other than caffeine. PMID:25320461

Omagari, Katsuhisa; Sakaki, Mika; Tsujimoto, Yuki; Shiogama, Yukiko; Iwanaga, Akiko; Ishimoto, Makiko; Yamaguchi, Asami; Masuzumi, Miki; Kawase, Miku; Ichimura, Mayuko; Yoshitake, Takatoshi; Miyahara, Yoshiyuki

2014-09-01

10

High-Sensitivity C-Reactive Protein in Japanese Patients with Type 2 Diabetes  

Microsoft Academic Search

Objective: To assess the relationship between high-sensitivity (HS) C-reactive protein (CRP) and metabolic syndrome (MetS) or atherosclerosis and to assess effects of strict metabolic control on the degree of inflammation and MetS in patients with type 2 diabetes.Research Methods and Procedures: Four hundred thirteen patients with diabetes were enrolled in the cross-sectional study. Of these 413 patients, 161 patients were

Yuji Tajiri; Kazuo Mimura; Fumio Umeda

2005-01-01

11

Long-term lifestyle intervention lowers the incidence of stroke in Japanese patients with type 2 diabetes: a nationwide multicentre randomised controlled trial (the Japan Diabetes Complications Study)  

Microsoft Academic Search

Aims\\/hypothesis  The aim of the study was to clarify whether a therapeutic intervention focused on lifestyle modification affected the incidence\\u000a of vascular complications in patients with established diabetes.\\u000a \\u000a \\u000a \\u000a Methods  A total of 2,033 eligible Japanese men and women aged 40–70 years with type 2 diabetes from 59 institutes were randomised\\u000a to a conventional treatment group (CON), which continued to receive the usual care,

H. Sone; S. Tanaka; S. Iimuro; K. Oida; Y. Yamasaki; S. Oikawa; S. Ishibashi; S. Katayama; H. Yamashita; H. Ito; Y. Yoshimura; Y. Ohashi; Y. Akanuma; N. Yamada

2010-01-01

12

Impact of dietary fiber intake on glycemic control, cardiovascular risk factors and chronic kidney disease in Japanese patients with type 2 diabetes mellitus: the Fukuoka Diabetes Registry  

PubMed Central

Background Dietary fiber is beneficial for the treatment of type 2 diabetes mellitus, although it is consumed differently in ethnic foods around the world. We investigated the association between dietary fiber intake and obesity, glycemic control, cardiovascular risk factors and chronic kidney disease in Japanese type 2 diabetic patients. Methods A total of 4,399 patients were assessed for dietary fiber intake using a brief self-administered diet history questionnaire. The associations between dietary fiber intake and various cardiovascular risk factors were investigated cross-sectionally. Results Body mass index, fasting plasma glucose, HbA1c, triglyceride and high-sensitivity C-reactive protein negatively associated with dietary fiber intake after adjusting for age, sex, duration of diabetes, current smoking, current drinking, total energy intake, fat intake, saturated fatty acid intake, leisure-time physical activity and use of oral hypoglycemic agents or insulin. The homeostasis model assessment insulin sensitivity and HDL cholesterol positively associated with dietary fiber intake. Dietary fiber intake was associated with reduced prevalence of abdominal obesity, hypertension and metabolic syndrome after multivariate adjustments including obesity. Furthermore, dietary fiber intake was associated with lower prevalence of albuminuria, low estimated glomerular filtration rate and chronic kidney disease after multivariate adjustments including protein intake. Additional adjustments for obesity, hypertension or metabolic syndrome did not change these associations. Conclusion We demonstrated that increased dietary fiber intake was associated with better glycemic control and more favorable cardiovascular disease risk factors including chronic kidney disease in Japanese type 2 diabetic patients. Diabetic patients should be encouraged to consume more dietary fiber in daily life. PMID:24330576

2013-01-01

13

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. PMID:23803740

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

2013-01-01

14

Is a Switch From Insulin Therapy to Liraglutide Possible in Japanese Type 2 Diabetes Mellitus Patients?  

PubMed Central

Background To evaluate the efficacy of switching from insulin to the GLP-1 receptor agonist liraglutide in type 2 diabetes mellitus patients. Methods The subjects were 231 outpatients with type 2 diabetes mellitus being treated with liraglutide for the first time. For 161 patients, liraglutide was continued for 24 weeks (continuation group), and for 70 patients, liraglutide was discontinued before 24 weeks (discontinuation group). Fasting and postprandial blood glucose levels, HbA1c, body weight, and insulin dose were evaluated before the switch to liraglutide (baseline) and at 12 and 24 weeks of administration. Trends in HbA1c and weight were compared at 12 and 24 weeks of administration. Multiple regression analyses were conducted to identify clinical factors predicting a successful switch to liraglutide. Results Multiple regression analysis with ?HbA1c as the dependent variable in the continuation group indicated that HbA1c at 12 weeks of administration decreased with higher baseline HbA1c and increased with higher baseline daily insulin doses. Multiple regression analysis with ?weight as the dependent variable indicated that ?weight at 24 weeks of liraglutide administration was higher with higher baseline daily insulin doses and longer duration of diabetes. Based on the area under the receiver operating characteristic curve, cut-off values of 19 units for daily insulin dose and nine years for duration of diabetes were identified. Conclusions Switching from insulin to liraglutide therapy is possible for carefully selected patients. Daily insulin dosage and duration of insulin therapy appear to be clinically useful indicators for the efficacy of liraglutide therapy. PMID:24578756

Kawata, Takehiro; Kanamori, Akira; Kubota, Akira; Maeda, Hajime; Amamiya, Hikaru; Takai, Masahiko; Kaneshige, Hideaki; Minagawa, Fuyuki; Iemitsu, Kotaro; Kaneshiro, Mizuki; Ishikawa, Masashi; Takeda, Hiroshi; Takuma, Tetsurou; Mokubo, Atsuko; Machimura, Hideo; Obana, Mitsuo; Miyakawa, Masaaki; Naka, Yoshikazu; Suzuki, Daisuke; Terauchi, Yasuo; Toyoda, Masao; Tanaka, Yasushi; Matsuba, Ikuro

2014-01-01

15

Comparative study of low-dose pioglitazone or metformin treatment in Japanese diabetic patients with metabolic syndrome.  

PubMed

The aim of this study was to determine whether a relatively low dose of pioglitazone or metformin was effective in diabetic patients with metabolic syndrome. Fifty diabetic patients with metabolic syndrome were randomly assigned to a low-dose pioglitazone (15 mg/day) treatment group or a low-dose metformin (500 mg/day) treatment group. Drugs were administered for 12 weeks. Systolic and diastolic blood pressure, heart rate, body mass index, triglyceride (TG), HDL and LDL-cholesterol, fasting plasma glucose (FPG), fasting plasma insulin (IRI), postprandial glucose, and HOMA-IR in the 75gOGTT, HbA1c, high-sensitivity CRP (hs-CRP) determined by cervical artery echography, and pulse wave velocity (PWV) were measured before/after 12-week drug administration. Significant decreases in HbA1c and HOMA-IR were noted in the pioglitazone group, along with significant decreases in TG, AST, ALT, blood pressure, hs-CRP and PWV. Significant decreases in HbA1c, HOMA-IR, BMI and waist circumference were noted in the metformin group. The pioglitazone group significantly improved the values for ALT, systolic blood pressure, hs-CRP and PWV compared to the metformin group. However, the metformin group demonstrated significant improvement in BMI compared with the pioglitazone group. Using a low dose regimen, pioglitazone significantly improved blood pressure and hepatic function and may be more effective than metformin to reduce risk factors in Japanese diabetic patients with metabolic syndrome at preventing atherosclerosis. PMID:19924605

Kato, T; Sawai, Y; Kanayama, H; Taguchi, H; Terabayashi, T; Taki, F; Yamada, K; Yamazaki, Y; Hayakawa, N; Suzuki, A; Oda, N; Katada, N; Itoh, M

2009-11-01

16

Structure of the human glucokinase gene and identification of a missense mutation in a Japanese patient with early-onset non-insulin-dependent diabetes mellitus  

SciTech Connect

Glucokinase is thought to play a glucose-sensor role in the pancreas, and abnormalities in its structure, function, and regulation can induce diabetes. The authors isolated the human glucokinase gene, and determined its genomic structure including exon-intron boundaries. Structure of the glucokinase gene in human was very similar to that in rat. Then, by screening Japanese diabetic patients using polymerase chain reaction - single strand conformation polymorphism (PCR-SSCP) and direct-sequencing strategies, they identified a missense mutation substituting ariginine (AGG) for glycine (GGG) at position 261 in exon 7 of the glucokinase gene in a patient with early-onset non-insulin-dependent diabetes (NIDDM). 12 refs., 3 figs., 2 tabs.

Sakura, Hiroshi; Eto, Kazuhiro; Ueno, Hirohisa; Yazaki, Yoshio; Kadowaki, Takashi (Univ. of Tokyo (Japan)); Kadowaki, Hiroko; Simokawa, Kotaro; Akanuma, Yasuo (Asahi Life Foundation, Tokyo (Japan)); Koda, Naoya; Fukushima, Yoshimitsu (Saitama Children's Medical Center (Japan))

1992-12-01

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

Predictive factors for the efficacy of switch to oral hypoglycemic agents in Japanese type 2 diabetic patients with intensive insulin therapy temporarily introduced.  

PubMed

Some type 2 diabetic patients can maintain optimal glycemic control by oral hypoglycemic agents (OHA) after their uncontrolled hyperglycemia is corrected by a temporary introduction of insulin therapy. The objective of this study was to investigate the clinical predictors for the efficacy of OHA after intensive insulin therapy was temporarily introduced. We analyzed a retrospective database of 108 Japanese type 2 diabetic patients who underwent a 75-g oral glucose tolerance test (OGTT) after the temporary introduction of intensive insulin therapy, and tried the switch to OHA. The multivariate logistic regression analysis revealed that shorter diabetic duration, higher body mass index, and lower 2-h post meal glucose levels were independently associated with the efficacy of OHA (all p < 0.001). The C statistic of the multivariate model was calculated to be 0.86. The addition of 120-min insulinogenic index, calculated from 0-, 30-, 60-, and 120-min data during an OGTT, to the model significantly increased the C statistic to 0.91 (p = 0.025). Interestingly, omitting 30- and 60-min data from the calculation of the index did not reduce the predictive performance. Furthermore, the ratio of 120-min insulin levels to 120-min glucose levels also provided a comparable predictive performance. In conclusion, 0- and 120-min data during an OGTT, or even 120-min data alone, in combination with diabetic duration, body mass index, and 2-h post meal glucose levels were useful in predicting the efficacy of OHA after intensive insulin therapy in Japanese type 2 diabetic patients. PMID:25048394

Yamamoto, Yuichi; Takahara, Mitsuyoshi; Yasuda, Tetsuyuki; Katakami, Naoto; Matsuoka, Taka-Aki; Kaneto, Hideaki; Shimomura, Iichiro

2014-09-29

19

Efficacy and safety of canagliflozin in Japanese patients with type 2 diabetes: a randomized, double-blind, placebo-controlled, 12-week study†  

PubMed Central

Aims We examined the efficacy, safety and tolerability of canagliflozin, a sodium glucose co-transporter 2 inhibitor, in Japanese patients with type 2 diabetes (T2DM) undergoing diet and exercise therapy. Methods Patients aged 20–80?years with T2DM diagnosed ?3?months previously, and HbA1c of 6.9–9.9% were randomized to 50, 100, 200 or 300?mg canagliflozin or placebo once daily for 12?weeks. The primary and secondary endpoints were changes in HbA1c, fasting plasma glucose (FPG), urinary glucose/creatinine and postprandial glycaemic parameters following a meal test. The safety assessments included adverse events (AEs) and clinical laboratory tests. Results Overall, 383 patients were randomized to receive either placebo (n?=?75), or 50?mg (n?=?82), 100?mg (n?=?74), 200?mg (n?=?77) or 300?mg canagliflozin (n?=?75). At week 12, significant reductions in HbA1c were observed in all canagliflozin groups relative to placebo (?0.61, –0.80, –0.79 and ?0.88% for 50, 100, 200 and 300?mg, respectively, versus +0.11% for placebo; all, p?Japanese patients with T2DM. Canagliflozin was well tolerated. PMID:23782594

Inagaki, N; Kondo, K; Yoshinari, T; Maruyama, N; Susuta, Y; Kuki, H

2013-01-01

20

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. PMID:23711224

2013-01-01

21

Randomized, Double-Blind, Dose-Ranging Study of TAK-875, a Novel GPR40 Agonist, in Japanese Patients With Inadequately Controlled Type 2 Diabetes  

PubMed Central

OBJECTIVE Assessment of the efficacy and safety of TAK-875 (a novel GPR40 agonist) in Japanese patients with type 2 diabetes inadequately controlled by diet/exercise. RESEARCH DESIGN AND METHODS This was a phase II, multicenter, randomized, double-blind, parallel-group, placebo-controlled, 12-week dose-ranging evaluation of TAK-875 (6.25–200 mg once daily) with the primary end point of change in A1C at week 12. A nonblinded group received 1 mg glimepiride once daily as an active control. RESULTS A total of 396 patients were randomized to receive TAK-875 (n = 299), placebo (n = 48), or glimepiride (n = 49). The least square mean changes in A1C at week 12 from baseline were as follows: 0.09% in the placebo group; ?0.54, ?0.67, ?0.88, ?1.27, ?1.29, and ?1.40% in the 6.25-, 12.5-, 25-, 50-, 100-, and 200-mg TAK-875 groups, respectively; and ?1.32% in the 1-mg glimepiride group. All TAK-875 groups had statistically significant reductions in A1C compared with placebo (P < 0.0001), and those receiving ?50 mg TAK-875 achieved reductions in A1C equivalent to those with glimepiride. Results for other glycemic parameters, including improvements during a meal tolerance test, mirrored these positive findings with TAK-875. There were no significant differences in incidence of adverse events among the groups and no dose-dependent changes in tolerability. Hypoglycemic episodes were reported in 0.7% of patients in the TAK-875 groups and in 4.1% of the glimepiride group. CONCLUSIONS TAK-875 produced clinically and statistically significant improvements in glycemic control in patients with type 2 diabetes inadequately controlled by diet and exercise, and it was well tolerated with a lower propensity to cause hypoglycemia. PMID:23086138

Kaku, Kohei; Araki, Takahiro; Yoshinaka, Ryoji

2013-01-01

22

Sex differences in the effect of cytochrome P450 2C19 polymorphisms on the risk of diabetic retinopathy: a retrospective longitudinal study in Japanese patients with type 2 diabetes.  

PubMed

Cytochrome P450 2C19 (CYP2C19) is expressed in human endothelial cells and catalyzes the biosynthesis of vasoprotective epoxyeicosatrienoic acids and 19-hydroxyeicosatetraenoic acid from arachidonic acid. This study investigated the association between CYP2C19 polymorphisms and an increased risk of diabetic retinopathy (DR). A clinic-based retrospective longitudinal analysis was carried out that included 383 Japanese patients with type 2 diabetes mellitus. Compared with male extensive metabolizers, female intermediate metabolizers [adjusted odds ratio (OR), 2.43; 95% confidence interval (95% CI), 1.17-5.06] and poor metabolizers (OR, 7.49; 95% CI, 2.64-21.26) were at a significantly higher risk of developing DR. Furthermore, the CYP2C19 poor metabolizer genotype was found to be an independent risk factor for DR only in women when patients were stratified by sex (OR, 4.18; 95% CI, 1.42-12.26). This is the first report showing the interactive effect of sex and CYP2C19 polymorphisms on microvascular disease in humans, although further investigations are needed to verify these findings. PMID:24113215

Kajiwara, Ayami; Saruwatari, Junji; Kita, Ayana; Kamihashi, Ryoko; Miyagawa, Haruna; Sakata, Misaki; Noai, Madoka; Oniki, Kentaro; Yoshida, Akira; Jinnouchi, Hideaki; Nakagawa, Kazuko

2013-12-01

23

X linked ocular albinism in Japanese patients  

Microsoft Academic Search

Thirteen affected Japanese male patients and 13 female carriers with X linked ocular albinism from seven families were examined to assess their clinical findings and to compare them with those of white and black patients. Affected Japanese patients had poor visual acuity, horizontal nystagmus, macular hypoplasia, and loss of stereopsis. Some affected patients had non-albinotic fundus with moderate pigmentation. The

T Shiono; M Tsunoda; Y Chida; M Nakazawa; M Tamai

1995-01-01

24

Japanese encephalitis virus in meningitis patients, Japan.  

PubMed

Cerebrospinal fluid specimens from 57 patients diagnosed with meningitis were tested for Japanese encephalitis virus. Total RNA was extracted from the specimens and amplified. Two products had highest homology with Nakayama strain and 2 with Ishikawa strain. Results suggest that Japanese encephalitis virus causes some aseptic meningitis in Japan. PMID:15757569

Kuwayama, Masaru; Ito, Mikako; Takao, Shinichi; Shimazu, Yukie; Fukuda, Shinji; Miyazaki, Kazuo; Kurane, Ichiro; Takasaki, Tomohiko

2005-03-01

25

A simple meal plan of 'eating vegetables before carbohydrate' was more effective for achieving glycemic control than an exchange-based meal plan in Japanese patients with type 2 diabetes.  

PubMed

This study aimed to determine whether educating diabetic patients to 'eat vegetables before carbohydrate' was as effective on long-term glycemic control as a traditional exchange-based meal plan. To test this hypothesis, we carried out a randomized, controlled trial in patients with type 2 diabetes that compared changes in HbA1c as the primary outcome. A total of 101 patients were stratified according to sex, age, BMI, duration of diabetes, and HbA1c, and then randomized to receive instructions to eat either vegetables before carbohydrate (VBC, n=69) or an exchange-based meal plan (EXB, n=32). The impact of the two plans on glycemic control was compared over 24 months of follow-up. Significant improvements in HbA1c over 24 months were observed in both groups (VBC, 8.3 to 6.8% vs EXB, 8.2 to 7.3%). HbA1c levels were significantly lower in the VBC group than in the EXB group after 6, 9, 12 and 24 months of the study. Both groups exhibited similar improvements in dietary practices with respect to intake of carbohydrate, fats and sweets, while the VBC group had a significant increase in consumption of green vegetables and a significant decrease in fruit consumption. A simple meal plan of 'eating vegetables before carbohydrate' achieved better glycemic control than an exchange-based meal plan in Japanese patients with type 2 diabetes over a 24-month period. PMID:21669583

Imai, Saeko; Matsuda, Mikuko; Hasegawa, Goji; Fukui, Michiaki; Obayashi, Hiroshi; Ozasa, Neiko; Kajiyama, Shizuo

2011-01-01

26

Association between subclinical hypothyroidism and diabetic nephropathy in patients with type 2 diabetes mellitus.  

PubMed

Subclinical hypothyroidism (SCH) has been associated with type 2 diabetes mellitus. However, it is unknown whether common complications of type 2 diabetes, such as diabetic nephropathy, are also present with SCH. Here, we investigated the association between SCH and diabetic nephropathy among Japanese patients with type 2 diabetes mellitus. In this multicenter cross-sectional study, we recruited 414 such patients who had no previous history of thyroid disease. Serum thyroid hormone levels and the urinary albumin:creatinine ratio were measured. SCH was defined as an elevated thyroid-stimulating hormone (TSH) level (>4.0 mIU/L), and diabetic nephropathy was defined as urinary albumin/creatinine ratio ?300 mg/g. The prevalence of SCH was 8.7% (n = 36) among patients with type 2 diabetes mellitus. The SCH group had a higher prevalence of dyslipidemia (p = 0.008) and diabetic nephropathy (p = 0.014) than the euthyroid group. Multivariate analysis identified significant positive associations between diabetic nephropathy and SCH (odds ratio [OR], 3.51; 95% confidence interval [CI], 1.10-10.0; p = 0.034), hypertension (OR, 4.56; 95% CI, 1.69-14.7; p = 0.001), and smoking (OR, 3.02; 95% CI, 1.14-7.91; p = 0.026). SCH may be independently associated with diabetic nephropathy in Japanese patients with type 2 diabetes mellitus. PMID:25100149

Furukawa, Shinya; Yamamoto, Shin; Todo, Yasuhiko; Maruyama, Kotatsu; Miyake, Teruki; Ueda, Teruhisa; Niiya, Tetsuji; Senba, Takatoshi; Torisu, Masamoto; Kumagi, Teru; Miyauchi, Syozo; Sakai, Takenori; Minami, Hisaka; Miyaoka, Hiroaki; Matsuura, Bunzo; Hiasa, Yoichi; Onji, Morikazu; Tanigawa, Takeshi

2014-10-31

27

Monotherapy with the once weekly GLP-1 receptor agonist dulaglutide for 12 weeks in Japanese patients with type 2 diabetes: dose-dependent effects on glycaemic control in a randomised, double-blind, placebo-controlled study.  

PubMed

The aim of this study was to evaluate the dose-dependent effect of dulaglutide, a glucagon-like peptide-1 receptor agonist, on glycaemic control in Japanese patients with type 2 diabetes mellitus who were treated with diet/exercise or oral antidiabetic drug monotherapy. In this randomised, double-blind, placebo-controlled, parallel-group, 12-week study, patients received once weekly subcutaneous dulaglutide doses of 0.25, 0.5, or 0.75 mg (DU 0.25, DU 0.5, and DU 0.75, respectively) or placebo (n=36, 37, 35, and 37, respectively). The primary measure was change from baseline in glycated haemoglobin (HbA1c; %) at 12 weeks. Continuous variables were analysed using a mixed-effects model for repeated measures. Significant dose-dependent reductions in HbA1c were observed (least squares mean difference versus placebo [95% confidence interval]): DU 0.25=-0.72% (-0.95, -0.48), DU 0.5=-0.97% (-1.20, -0.73), and DU 0.75=-1.17% (-1.41, -0.93); p<0.001. Significant improvements in plasma glucose (PG), both fasting and average 7-point self-monitored blood glucose, were also observed with dulaglutide versus placebo (p<0.001). Dulaglutide was well-tolerated. Gastrointestinal adverse events (AEs) were more common in dulaglutide-treated patients, with nausea the most frequent (8 [5.5%]). Few dulaglutide-treated patients discontinued due to AEs (4 [3.7%]), and no serious AEs related to study medication occurred. Three patients (DU 0.5=1 and DU 0.75=2) reported asymptomatic hypoglycaemia (PG ?70 mg/dL). The observed dose-dependent reduction in HbA1c and acceptable safety profile support further clinical development of dulaglutide for treatment of type 2 diabetes mellitus in Japan. PMID:25029955

Terauchi, Yasuo; Satoi, Yoichi; Takeuchi, Masakazu; Imaoka, Takeshi

2014-10-31

28

Liraglutide Versus Sitagliptin in a 24-week, Multicenter, Open-label, Randomized, Parallel-group Study in Japanese Type 2 Diabetes Mellitus Patients Responding Inadequately to a Sulfonylurea and/or One or Two Other Oral Antidiabetic Drugs (JDDM 33)  

PubMed Central

OBJECTIVE Liraglutide (glucagon-like peptide-1 [GLP-1] receptor agonist) and sitagliptin (dipeptidyl peptidase-4 inhibitor) are approved in Japan for treating type 2 diabetes mellitus (T2DM). We compared the efficacy and safety of adding liraglutide or sitagliptin to a sulfonylurea in Japanese T2DM patients. METHODS Patients aged 18 to <80 years with hemoglobin A1c (HbA1c; National Glycohemoglobin Standardization Program [NGSP]) of 6.9–9.4%, body mass index ?35 kg/m2, and treatment with a sulfonylurea and/or one or two non-sulfonylurea oral antidiabetic drugs for greater than or equal to eight weeks before enrollment were eligible. Patients were randomized in an open-label manner to either 0.9 mg/day liraglutide (n = 50) or 50–100 mg/day sitagliptin (n = 49) and were treated for 24 weeks. Non-sulfonylureas were discontinued before randomization. Patients using other oral antidiabetic drugs started sulfonylurea treatment. The primary endpoint was the change in HbA1c from baseline to Week 24. RESULTS HbA1c decreased in both groups, and the reduction was significantly greater throughout in the liraglutide group except for Week 24 (0.59 ± 0.80 vs. 0.24 ± 0.94%; P = 0.0525). Fasting plasma glucose (FPG) decreased significantly in the liraglutide group compared with the sitagliptin group (?21.15 ± 31.22 vs. +0.46 ± 39.39 mg/dL; P = 0.0014). Homeostasis model assessment of ? cell function and C-peptide increased significantly in the liraglutide group but not in the sitagliptin group. Hypoglycemic symptoms and adverse events occurred in four and nine patients, respectively, in the liraglutide group, and in two and five patients, respectively, in the sitagliptin group. CONCLUSION Treatment with liraglutide or sitagliptin together with a sulfonylurea improved HbA1c in Japanese T2DM patients in primary care. Both drugs were associated with low rates of adverse events and hypoglycemia. The improvement in ? cell function probably contributed to the improvement in glycemic control in the liraglutide group. PMID:25288908

Yokoyama, Hiroki; Hirao, Koichi; Yamaguchi, Kohei; Oishi, Mariko; Lee, Gendai; Yagi, Noriharu; Takamura, Hiroshi; Kashiwagi, Atsunori

2014-01-01

29

Japanese cases of acute onset diabetic ketosis without acidosis in the absence of glutamic acid decarboxylase autoantibody.  

PubMed

We report consecutive Japanese patients presented with acute onset diabetic ketosis who had negative glutamic acid decarboxylase autoantibody (GADAb) to clarify the clinical characteristics of them. A total of consecutive 1,296 in-patients with newly diagnosed diabetes mellitus, who were admitted to our center from April 2003 to October 2008, were analyzed. Among them, 17 patients who presented with acute onset diabetic ketosis without acidosis, and found to be negative for GADAb, were included. They showed male preponderance (n = 15). Ten patients had history of excessive ingestion of sugar-containing soft drink. Patients who successfully withdrew insulin therapy by 6 months (n = 7) showed significantly higher insulin secretion capacity and higher body mass index at the time of diagnosis than those who continued insulin therapy at least for 6 months (n = 10). These findings suggest that some of Japanese patients who presented with acute onset diabetic ketosis and negative for GADAb share several clinical characteristics with atypical type 2 diabetes such as ketosis-prone diabetes and "soft-drink ketosis," but others do not. PMID:20960264

Iwasaki, Yorihiro; Hamamoto, Yoshiyuki; Kawasaki, Yukiko; Ikeda, Hiroki; Honjo, Sachiko; Wada, Yoshiharu; Koshiyama, Hiroyuki

2010-04-01

30

Insulin secretion and insulin sensitivity in Japanese patients with type 2 diabetes: a cross-sectional study comparing the homeostasis model assessment-2 (HOMA2) indexes and indexes derived from the oral glucose tolerance test  

Microsoft Academic Search

We analyzed the results of a 75-g oral glucose tolerance test in 731 drug-naïve Japanese men with type 2 diabetes mellitus\\u000a (T2DM) with fasting plasma glucose values ranging between 126 and 199 mg\\/dl. We then determined the index of insulin sensitivity\\u000a and insulin secretion across the entire range of glucose loading. Next, we examined the correlation between these indexes\\u000a and the

Ritsuko Yamamoto-HondaKeiichiro; Keiichiro Osame; Hiroji Kitazato; Michiko Shinkai-Goromaru; Akihiro Isogawa; Yoko Yoshida; Shoji Kawazu; Yasuo Akanuma; Mitsuhiko Noda

2011-01-01

31

Rheumatic manifestations in diabetic patients.  

PubMed

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. PMID:23049626

Serban, A L; Udrea, G F

2012-09-15

32

JAMA Patient Page: Diabetic Foot Ulcers  

MedlinePLUS

... American Medical Association JAMA PATIENT PAGE Diabetic Foot Ulcers D iabetic foot ulcers are sores or wounds on the feet that ... preventing diabetic foot ulcers. WHAT CAUSES DIABETIC FOOT ULCERS? FOR MORE INFORMATION • National Diabetes Information Clearinghouse 1- ...

33

Antiatherogenic Effect of Pioglitazone in Type 2 Diabetic Patients Irrespective of the Responsiveness to Its Antidiabetic Effect  

Microsoft Academic Search

OBJECTIVE — Thiazolidinediones (TZDs), a class of insulin-sensitizing agents used clini- cally to treat type 2 diabetes, are also antiatherogenic. This study was designed to elucidate the relationship between the antiatherogenic and antidiabetic effects of pioglitazone, a TZD, in type 2 diabetic patients. RESEARCH DESIGN AND METHODS — A total of 136 Japanese type 2 diabetic patients were included and

NORIKO SATOH; YOSHIHIRO OGAWA; TAKESHI USUI; TETSUYA TAGAMI; SHIGEO KONO; HIROKO UESUGI; HIROYUKI SUGIYAMA; AKIRA SUGAWARA; KAZUNORI YAMADA; AKIRA SHIMATSU; HIDESHI KUZUYA; KAZUWA NAKAO

2003-01-01

34

Managing diabetes in dialysis patients.  

PubMed

Burgeoning levels of diabetes are a major concern for dialysis services, as diabetes is now the most common cause of end-stage renal disease in most developed nations. With the rapid rise in diabetes prevalence in developing countries, the burden of end stage renal failure due to diabetes is also expected to rise in such countries. Diabetic patients on dialysis have a high burden of morbidity and mortality, particularly from cardiovascular disease, and a higher societal and economic cost compared to non-diabetic subjects on dialysis. Tight glycaemic and blood pressure control in diabetic patients has an important impact in reducing risk of progression to end stage renal disease. The evidence for improving glycaemic control in patients on dialysis having an impact on mortality or morbidity is sparse. Indeed, many factors make improving glycaemic control in patients on dialysis very challenging, including therapeutic difficulties with hypoglycaemic agents, monitoring difficulties, dialysis strategies that exacerbate hyperglycaemia or hypoglycaemia, and possibly a degree of therapeutic nihilism or inertia on the part of clinical diabetologists and nephrologists. Standard drug therapy for hyperglycaemia (eg, metformin) is clearly not possible in patients on dialysis. Thus, sulphonylureas and insulin have been the mainstay of treatment. Newer therapies for hyperglycaemia, such as gliptins and glucagon-like peptide-1 analogues have become available, but until recently, renal failure has precluded their use. Newer gliptins, however, are now licensed for use in 'severe renal failure', although they have yet to be trialled in dialysis patients. Diabetic patients on dialysis have special needs, as they have a much greater burden of complications (cardiac, retinal and foot). They may be best managed in a multidisciplinary diabetic-renal clinic setting, using the skills of diabetologists, nephrologists, clinical nurse specialists in nephrology and diabetes, along with dietitians and podiatrists. PMID:22282737

O'Toole, Sam M; Fan, Stanley L; Yaqoob, M Magdi; Chowdhury, Tahseen A

2012-03-01

35

Gallbladder function in diabetic patients  

SciTech Connect

Gallbladder emptying and filling was studied in eight diabetic and six normal control patients. None of the patients had gallstones. Cholescintigraphy was performed using (/sup 99m/Tc)disofenin, and gallbladder emptying was studied using a 45-min i.v. infusion of the octapeptide of cholecystokinin (OP-CCK) 20 ng/kg X hr. The peak filling rate was greater in diabetic than in normal subjects; however, emptying of the gallbladder in response to OP-CCK was significantly less in the diabetic subjects (51.6 +/- 10.4% compared with 77.2 +/- 4.9%). When the diabetic group was subdivided into obese and nonobese diabetics, the obese diabetics had a much lower percentage of emptying than the nonobese diabetics (30.0 +/- 10.4% compared with 73.1 +/- 9.3%). These findings suggest that obese diabetics may have impaired emptying of the gallbladder even in the absence of gallstones. The more rapid rate of gallbladder filling in obesity may indicate hypotonicity of the gallbladder. The combination of these abnormalities may predispose the obese diabetic to the development of gallstones.

Shreiner, D.P.; Sarva, R.P.; Van Thiel, D.; Yingvorapant, N.

1986-03-01

36

Carboplatin dosing for adult Japanese patients.  

PubMed

Carboplatin is a platinum-based anticancer drug that has been long used to treat many types of solid cancer. Because the clearance of carboplatin strongly correlates with the glomerular filtration rate (GFR), its dosage is calculated with the Calvert formula on the basis of the patient's GFR to achieve the target area under the plasma drug concentration-time curve (AUC) for each patient. However, many lines of evidence from previous clinical studies should be interpreted with caution because different methods were used to estimate drug clearance and derive the dosage of carboplatin. There is a particularly high risk of carboplatin overdosing when the dosage is determined on the basis of standardized serum creatinine values. When deciding the dose of carboplatin for adult Japanese patients, preferred methods to assess renal function instead of directly measuring GFR include (1) 24-h urinary collection-based creatinine clearance adjusted by adding 0.2 mg/dl to the serum creatinine concentration measured by standardized methods, and (2) equation-based GFR (eGFR) with a back calculation to units of ml/min per subject. Given the limitations of serum creatinine-based GFR estimations, the GFR or creatinine clearance should be directly measured in each patient whenever possible. To ensure patient safety and facilitate a medical-team approach, the single most appropriate method available at each institute or medical team should be consistently used to calculate the dose of carboplatin with the Calvert formula. PMID:25129986

Ando, Yuichi; Shimokata, Tomoya; Yasuda, Yoshinari; Hasegawa, Yoshinori

2014-02-01

37

Colonic subepithelial collagenous thickening in diabetic patients  

Microsoft Academic Search

PURPOSE: This study was designed to investigate the effect of intestinal subepithelial collagenous thickening on diabetic diarrhea because one of the seven patients diagnosed with collagenous colitis was diabetic. METHODS: Rectosigmoidoscopic rectal biopsies were taken from 50 diabetic patients (8 with and 42 without diarrhea), 20 nondiabetic patients with diarrhea, and 10 healthy patients. Histopathologic examinations and measurements of subepithelial

Olcay Kandemir; Cengiz Utas; ömür Gönen; Tahir E. Patiroglu; ömer özbakir; Fahrettin Kelestimur; Mehmet Yücesoy

1995-01-01

38

Detection of glucokinase gene defects in non-obese Japanese children diagnosed with diabetes by school medical examinations.  

PubMed

We examined children who were diagnosed with asymptomatic type 2 diabetes by school medical examinations to investigate the existence of glucokinase (GCK) gene defects in this group. Among 20 children diagnosed with asymptomatic type 2 diabetes by school medical examinations between 2003 and 2009 at our 2 hospitals, 8 were classified as non-obese type. Among them, we screened 5 children (2 boys and 3 girls; age: 8-13 years) who had mild elevation of fasting plasma glucose (108-134 mg/dL) with slightly high internationally standardized HbA1c levels (6.3-6.9%) at first close examination. Written informed consent was obtained and all families agreed to participate in this study. We found 4 different mutations (G223S, G81C, S336X and T228M) in 4 of the examined children. The blood glucose control levels had not become worse in any children during the 2-6 years follow-up period. The inheritance of diabetes with GCK gene defect was later confirmed in 1 family. These results suggest that GCK gene defects exist in non-obese children who are diagnosed with asymptomatic diabetes by school medical examinations. Cases of diabetes that are caused by GCK mutations may not be as rare in Japanese subjects as previously described and could be found in patients tentatively diagnosed as type 2 diabetes. PMID:21720051

Yokota, Ichiro; Moritani, Maki; Nishisho, Kahoru; Miyoshi, Tatsuya; Kotani, Yumiko; Kagami, Shoji

2011-01-01

39

Comparison of Potentially Preventable Hospitalizations Related to Diabetes Among Native Hawaiian, Chinese, Filipino, and Japanese Elderly Compared with Whites, Hawai'i, December 2006-December 2010  

PubMed Central

Introduction Approximately 25% of individuals aged 65 years or older in the United States have diabetes mellitus. Diabetes rates in this age group are higher for Asian American and Pacific Islanders (AA/PI) than for whites. We examined racial/ethnic differences in diabetes-related potentially preventable hospitalizations (DRPH) among people aged 65 years or older for Japanese, Chinese, Filipinos, Native Hawaiians, and whites. Methods Discharge data for hospitalizations in Hawai‘i for people aged 65 years or older from December 2006 through December 2010 were compared. Annual rates of DRPH by patient were calculated for each racial/ethnic group by sex. Rate ratios (RRs) were calculated relative to whites. Multivariable models controlling for insurer, comorbidity, diabetes prevalence, age, and residence location provided final adjusted rates and RRs. Results A total of 1,815 DRPH were seen from 1,515 unique individuals. Unadjusted RRs for DRPH by patient were less than1 in all AA/PI study groups compared with whites, but were highest among Native Hawaiians and Filipinos. In fully adjusted models accounting for higher diabetes prevalence in AA/PI groups, Native Hawaiian (adjusted rate ratio [aRR] = 1.59), Filipino (aRR = 2.26), and Japanese (aRR = 1.86) men retained significantly higher rates of diabetes-related potentially preventable hospitalizations than whites, as did Filipino women (aRR = 1.61). Conclusion Native Hawaiian, Filipino, and Japanese men and Filipino women aged 65 years or older have a higher risk than whites for DRPH. Health care providers and public health programs for elderly patients should consider effective programs to reduce potentially preventable hospitalizations among Native Hawaiian, Filipino, and Japanese men and Filipino women aged 65 years or older. PMID:23886042

Ahn, Hyeong Jun; Juarez, Deborah T.; Tseng, Chien-Wen; Chen, John J.; Salvail, Florentina R.; Miyamura, Jill; Mau, Marjorie L.M.

2013-01-01

40

Closed ankle fractures in the diabetic patient.  

PubMed

Systemic and local manifestations of diabetes mellitus may complicate the treatment of ankle fractures in the diabetic population. We studied 98 patients (73 non-diabetics and 25 diabetics) who were treated for closed ankle fractures by either surgical or non-surgical methods. We found that overall, the risk of infection in the diabetic population (32%) was 4 times higher than in the non-diabetic population (8%). The infection rate in the diabetic group treated surgically more than doubled that in the non-diabetic group. Four out of six diabetic patients treated with cast became infected compared to no infections in the five non-diabetics treated with a cast. Even though the diabetic foot and ankle are well studied, the medical literature is not conclusive regarding the management of ankle fractures in the diabetic patient. Diabetic patients treated conservatively had a tendency to become infected over those treated surgically. Peripherovascular disease, peripheral neuropathy and swelling and/or ecchymosis increased the risk of infection in the diabetic population. Diabetic patients with poor compliance had a tendency to become infected more than those who were compliant. We concluded that the diabetic patient who is poorly compliant with evidence of neuropathic disease, peripherovascular disease and severe swelling and ecchymosis presents the most difficult group to manage. Although these patients are poor surgical candidates, they are also the most difficult to manage and also most prone to infection and complications if treated conservatively. When faced with this difficult scenario a multidisciplinary team approach would probably yield the best possible results by early identification and intervention in these patients. PMID:10808971

Flynn, J M; Rodriguez-del Rio, F; Pizá, P A

2000-04-01

41

Overtime Work and Prevalence of Diabetes in Japanese Employees: Japan Epidemiology Collaboration on Occupational Health Study  

PubMed Central

Objective Epidemiologic evidence on long working hour and diabetes has been conflicting. We examined the association between overtime work and prevalence of diabetes among Japanese workers. Methods The subjects were 40,861 employees (35,170 men and 5,691 women), aged 16 to 83 years, of 4 companies in Japan. Hours of overtime were assessed using self-reported questionnaires. Diabetes was defined as a fasting plasma glucose ?126 mg/dl (7.0 mmol/l), hemoglobin A1c ?6.5% (48 mmol/mol), or current use of anti-diabetic drug. Multiple logistic regression analysis was used to calculate odds ratio of diabetes for each category of overtime. Results After adjustment for age, sex, company, smoking, and BMI, there was a suggestion of U-shaped relationship between overtime work and prevalence of diabetes (P for quadratic trend?=?0.07). Compared with those who worked <45 hours of overtime per month, the adjusted odds ratios (95% confidence interval) of diabetes were 0.86 (0.77–0.94), 0.69 (0.53–0.89), and 1.03 (0.72–1.46) for those who worked 45–79, 80–99, and ?100 hours of overtime per month, respectively. In one company (n?=?33,807), where other potential confounders including shift work, job position, type of department, alcohol consumption, sleep duration, leisure time physical activity, and family history of diabetes was additionally adjusted for, similar result was obtained (P for quadratic trend?=?0.05). Conclusions Long hours of overtime work may not be associated with increased prevalence of diabetes among Japanese workers. PMID:24787995

Nishihara, Akiko; Nakagawa, Tohru; Yamamoto, Shuichiro; Honda, Toru; Miyamoto, Toshiaki; Kochi, Takeshi; Eguchi, Masafumi; Uehara, Akihiko; Kuroda, Reiko; Omoto, Daisuke; Kurotani, Kayo; Pham, Ngoc Minh; Nanri, Akiko; Kabe, Isamu; Mizoue, Tetsuya; Kunugita, Naoki; Dohi, Seitaro

2014-01-01

42

Efficacy and safety of monotherapy with the novel sodium/glucose cotransporter-2 inhibitor tofogliflozin in Japanese patients with type 2 diabetes mellitus: a combined Phase 2 and 3 randomized, placebo-controlled, double-blind, parallel-group comparative study  

PubMed Central

Background In recent years, several oral antidiabetic drugs with new mechanisms of action have become available, expanding the number of treatment options. Sodium/glucose cotransporter-2 (SGLT2) inhibitors are a new class of oral antidiabetic drugs with an insulin-independent mechanism promoting urinary glucose excretion. We report the results of a combined Phase 2 and 3 clinical study (Japic CTI-101349) of the SGLT2 inhibitor tofogliflozin (CSG452, RG7201) in Japanese patients with type 2 diabetes mellitus. Methods The efficacy and safety of tofogliflozin were assessed in this multicenter, placebo-controlled, randomized, double-blind parallel-group study involving 230 patients with type 2 diabetes mellitus with inadequate glycemic control on diet/exercise therapy. Between 30 October 2010 and 28 February 2012, patients at 33 centers were randomized to either placebo (n?=?56) or tofogliflozin (10, 20, or 40 mg; n?=?58 each) orally, once daily for 24 weeks. The primary efficacy endpoint was the change from baseline in HbA1c at week 24. Results Overall, 229 patients were included in the full analysis set (placebo: n?=?56; tofogliflozin 10 mg: n?=?57; tofogliflozin 20 and 40 mg: n?=?58 each). The least squares (LS) mean change (95% confidence interval) from baseline in HbA1c at week 24 was ?0.028% (?0.192 to 0.137) in the placebo group, compared with ?0.797% (?0.960 to ?0.634) in the tofogliflozin 10 mg group, ?1.017% (?1.178 to ?0.856) in the tofogliflozin 20 mg group, and ?0.870% (?1.031 to ?0.709) in the tofogliflozin 40 mg group (p?Japanese patients with type 2 diabetes mellitus. Phase 3 studies were recently completed and support the findings of this combined Phase 2 and 3 study. Trial registration This study was registered in the JAPIC clinical trials registry (ID: Japic CTI-101349). PMID:24678906

2014-01-01

43

Elevated serum levels of interleukin-18 in patients with overt diabetic nephropathy: effects of miglitol  

Microsoft Academic Search

Background  Interleukin-18 (IL-18), a pro-inflammatory cytokine, is a predictor of cardiovascular and renal disease in diabetic patients.\\u000a Postprandial hyperglycemia is one of the important factors contributing to an increase in the circulating pro-inflammatory\\u000a cytokine levels. This study investigated the effect of miglitol, an ?-glucosidase inhibitor, on postprandial hyperglycemia\\u000a and IL-18 levels in diabetic patients with nephropathy.\\u000a \\u000a \\u000a \\u000a \\u000a Methods  Fifteen Japanese diabetic patients with

Takashi UzuHiroki; Hiroki Yokoyama; Hirofumi Itoh; Daisuke Koya; Atsushi Nakagawa; Makoto Nishizawa; Hiroshi Maegawa; Yukiyo Yokomaku; Shin-ichi Araki; Atsuko Abiko; Masakazu Haneda

2011-01-01

44

Visual evoked potentials in diabetic patients.  

PubMed

Visual evoked potentials (VEPs) were assessed in 50 adult type I (insulin-dependent) and 19 type II (noninsulin-dependent) diabetes mellitus patients and in 54 controls. P100 wave latency was significantly longer in diabetic patients (P less than .001). Twenty-eight percent of diabetic patients had P100 wave latencies above the normal range. There was no correlation between P100 latency and type or duration of diabetes mellitus, quality of metabolic control, or presence of degenerative complications. The significance of VEP abnormalities in diabetes mellitus remains speculative. PMID:2702915

Algan, M; Ziegler, O; Gehin, P; Got, I; Raspiller, A; Weber, M; Genton, P; Saudax, E; Drouin, P

1989-03-01

45

Anaesthetic management of the patient with diabetes  

Microsoft Academic Search

Diabetes mellitus is the most common endocrine disorder. Type 1 diabetes is caused by an immune-mediated destruction of insulin-secreting islet cells. Type 2 is due to insulin resistance. The prevalence is expected to double by 2030 in the UK. Patients with both types of diabetes demand control of their metabolic status, normoglycaemia, the avoidance of ketoacidosis and electrolyte disturbances. The

Peter Klepsch

2008-01-01

46

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

47

Congenital bilateral perisylvian syndrome: first report in a Japanese patient.  

PubMed

A Japanese boy with congenital bilateral perisylvian syndrome is described. He had oropharyngoglossal dysfunction and severe dysarthria. Magnetic resonance imaging of the brain disclosed bilateral perisylvian malformations suggesting polymicrogyria. The patient also showed mental retardation, epilepsy, and poor motor skills. PMID:8914634

Hattori, H; Higuchi, Y; Maihara, T; Jung, E Y; Furusho, K; Asato, R

1996-03-01

48

Congenital bilateral perisylvian syndrome: First report in a Japanese patient  

Microsoft Academic Search

Summary A Japanese boy with congenital bilateral perisylvian syndrome is described. He had oropharyngoglossal dysfunction and severe dysarthria. Magnetic resonance imaging of the brain, disclosed bilateral perisylvian malformations suggesting polymicrogyria. The patient also showed mental retardation, epilepsy, and poor motor skills.

Haruo Hattori; Yoshihisa Higuchi; Toshiro Maihara; Eun-Young Jung; Kenshi Furusho; Reinin Asato

1996-01-01

49

Circulating adiponectin levels and risk of type 2 diabetes in the Japanese  

PubMed Central

Background: Adiponectin has anti-inflammatory and insulin-sensitizing properties. Prospective studies have consistently shown a lower risk of type 2 diabetes among those with higher circulating adiponectin levels. Objective: We examined prospectively the association between serum adiponectin levels and type 2 diabetes risk among Japanese workers, taking visceral fat mass into account. Subjects and methods: Subjects were 4591 Japanese employees who attended a comprehensive health screening in 2008; had biochemical data including serum adiponectin; were free of diabetes at baseline; and received health screening in 2011. Multiple logistic regression analysis was used to examine the association between adiponectin and incidence of diabetes among overall subjects, as well as subgroups. Stratified analyses were carried out according to variables including visceral fat area (VFA). Results: During 3 years of follow-up, 217 diabetic cases were newly identified. Of these, 87% had a prediabetes at baseline. Serum adiponectin level was significantly, inversely associated with incidence of diabetes, with odds ratios (95% confidence interval) adjusted for age, sex, family history, smoking, alcohol drinking, physical activity and body mass index (BMI) for the lowest through highest quartile of adiponectin of 1 (reference), 0.79 (0.55–1.12), 0.60 (0.41–0.88) and 0.40 (0.25–0.64), respectively (P-value for trend <0.01). This association was materially unchanged with adjustment for VFA instead of BMI. After further adjustment for both homeostasis model assessment of insulin resistance and hemoglobin A1c, however, the association became statistically nonsignificant (P-value for trend=0.18). Risk reduction associated with higher adiponectin levels was observed in both participants with and without obesity or insulin resistance at baseline. Conclusions: Results suggest that higher levels of circulating adiponectin are associated with a lower risk of type 2 diabetes, independently of overall and intra-abdominal fat deposition, and that adiponectin may confer a benefit in both persons with and without insulin resistance. PMID:25133442

Yamamoto, S; Matsushita, Y; Nakagawa, T; Hayashi, T; Noda, M; Mizoue, T

2014-01-01

50

Cardiorespiratory fitness and the incidence of type 2 diabetes: a cohort study of Japanese male athletes  

PubMed Central

Background In Japan, although the incidence of overweight (BMI???25) is still low compared with that in Europe and the United States, the prevalence of type 2 diabetes has increased over the last 15 years,. In both Japanese and Caucasian populations it has been reported that a high level of cardiorespiratory fitness protects against the development of type 2 diabetes. However, there are no reports focused specifically on athletes that investigate whether high cardiorespiratory fitness at a young age can prevent disease later in life. We examined the relationship between cardiorespiratory fitness at a young age and the development of type 2 diabetes in Japanese athletes using a cohort study. Methods The cardiorespiratory fitness of male alumni of the physical education department of Juntendo University, as measured by stored data of a 1,500-m endurance run in college (1971–1991) was compared with their incidence of type 2 diabetes as determined by follow-up questionnaires (2007–2009). This study used Cox’s proportional hazards models and adjusted for age, year of graduation, BMI, smoking, and sports club participation at college age. Results We collected data on cardiorespiratory fitness at college age and medical history survey data during 2007–2009 from 570 male alumni. The median follow-up period was 26 years (IQR: 23–29 years), and 22 men had developed type 2 diabetes. An inverse relationship was observed between incidence of type 2 diabetes and level of cardiorespiratory fitness at time of college after adjustment for age, year of graduation, BMI, smoking, and sports participation. The adjusted hazards ratio and 95% CI by category (low, medium, and high) were 1.00 (reference), 0.40 (0.14–1.13) and 0.26 (0.07–1.00) (p?=?0.03 for trend). Conclusions A high level of cardiorespiratory fitness at a young age can help prevent type 2 diabetes later in life. PMID:24885699

2014-01-01

51

Type 2 Diabetic Patient-Centered Care  

Microsoft Academic Search

Background : The prevalence of diabetes mellitus has increased worldwide including Thailand. Management of diabetes should be considered biological and psychosocial. Patient-centered care was applied in the present study. Patient-centered care is a process interaction between the clinician and the patient. It refers to the clinician's behavioral skill in the consultation. Patient-centered care customizes seeking and accepting the patient's ideas,

Somjit Prueksaritanond; Saisunee Tubtimtes; Kornthong Asavanich; Vasunee Tiewtranon

52

Diabetes and Cardiovascular Events in Hypertensive Patients  

Microsoft Academic Search

To determine the relation of self-reported history of diabetes as well as baseline and in-treatment blood sugar to subsequent cardiovascular disease (CVD) in treated hypertensive patients, we assessed the experience of 6886 participants in a systematic treatment program. The presence or absence of a history of diabetes was known for all patients, who were then stratified into 3 groups according

Michael H. Alderman; Hillel Cohen; Shantha Madhavan

53

Health Promotion in diabetes care : Studies on adult type 1 diabetes patients.  

E-print Network

??Introduction: A landmark report has shown that improving glycaemic control among type 1 diabetes patients markedly reduces diabetes-related complications. In clinical practice, however, many patients… (more)

Amsberg, Susanne

2008-01-01

54

Galectin-3 in diabetic patients.  

PubMed

Galectin-3 is a versatile molecule which exerts several and sometimes opposite functions in various pathophysiological processes. Recently, galectin-3 has gained attention as a powerful predictor of heart failure and mortality, thus becoming a useful prognostic marker in clinical practice. Moreover, though not specifically investigated in diabetic cohorts, plasma levels of galectin-3 correlated with the prevalence of diabetes and related metabolic conditions, thus suggesting that pharmacological blockade of this lectin might be successful for treating heart failure especially in subjects suffering from these disorders. Indeed, galectin-3 is considered not only as a marker of heart failure, but also as a mediator of the disease, due to its pro-fibrotic action, though evidence comes mainly from studies in galectin-3 deficient mice. However, these studies have provided contrasting results, with either attenuation or acceleration of organ fibrosis and inflammation, depending on the experimental setting and particularly on the levels of advanced glycation endproducts (AGEs)/advanced lipoxidation endproducts (ALEs), of which galectin-3 is a scavenging receptor. In fact, under conditions of increased AGE/ALE levels, galectin-3 ablation was associated with tissue-specific outcomes, reflecting the AGE/ALE-receptor function of this lectin. Conversely, in experimental models of acute inflammation and fibrosis, galectin-3 deficiency resulted in attenuation of tissue injury. There is a need for prospective studies in diabetic patients specifically investigating the relation of galectin-3 levels with complications and for further animal studies in order to establish the effective role of this lectin in organ damage before considering its pharmacological blockade in the clinical setting. PMID:24940712

Pugliese, Giuseppe; Iacobini, Carla; Ricci, Carlo; Blasetti Fantauzzi, Claudia; Menini, Stefano

2014-10-01

55

Toe amputation in the diabetic patient  

Microsoft Academic Search

Background. We considered whether it is more practical to amputate the toe of a diabetic patient with osteomyelitis and good circulation or to treat the patient with antibiotics for a prolonged period.Methods. We undertook a retrospective study of 141 diabetic patients who had undergone a toe-ray amputation for proven or documented osteomyelitis.Results. The mean ankle\\/brachial index of all patients was

Morris D Kerstein; Vincent Welter; Vivian Gahtan; Andrew B Roberts

1997-01-01

56

Distinct Characteristics in Japanese Dermatitis Herpetiformis: A Review of All 91 Japanese Patients over the Last 35 Years  

PubMed Central

We reviewed all 91 Japanese dermatitis herpetiformis (DH) patients reported over the last 35 years. The male-to-female ratio was 2?:?1. The mean age at onset was 43.8, and 13 years earlier for female patients. More than half of these Japanese DH patients showed granular IgA deposition in the papillary dermis, and another one-third showed fibrillar IgA deposition. The male patients with granular IgA deposition were 10 years older than those with fibrillar deposition. Whereas patients with granular IgA deposition showed typical distribution of the skin lesions, the predilection sites of DH tended to be spared in patients with fibrillar IgA deposition. Only 3 patients had definite gluten-sensitive enteropathy. There was a statistical difference in the frequency of human leukocyte antigen (HLA)-DR9 between the granular group and controls among Japanese. No patients had HLA-DQ2 or -DQ8, which is frequently found in Caucasian DH patients. The absence of HLA-DQ2/DQ8, the inability to identify celiac disease in most cases, the predominance of fibrillar IgA, and the unusual distribution of clinical lesions in Japanese patients suggest that Japanese DH may be a subset of DH patients and have a pathogenesis which is different from that currently proposed in Caucasian DH patients. PMID:22778765

Ohata, Chika; Ishii, Norito; Hamada, Takahiro; Shimomura, Yutaka; Niizeki, Hironori; Dainichi, Teruki; Furumura, Minao; Tsuruta, Daisuke; Hashimoto, Takashi

2012-01-01

57

A Japanese patient with Löfgren's syndrome with an HLA-DR12 allele and review of literature on Japanese patients.  

PubMed

Sarcoidosis is a granulomatous disorder of unknown etiology, with several clinical manifestations. Löfgren's syndrome is an acute type of sarcoidosis, characterized by the triad of arthritis, erythema nodosum, and bilateral hilar lymphadenopathy (BHL), which spontaneously resolve within about 2 years. Löfgren's syndrome is common among young white women from Nordic countries and Ireland, but it is very rare in Japan. Because the incidence of Löfgren's syndrome varies according to race, most studies on Löfgren's syndrome, including HLA typing, have been reported in Western countries. Indeed, HLA-DR3 has been reported to be associated with Löfgren's syndrome in Western countries, although the association between HLA typing and Japanese Löfgren's syndrome remains unclear. Here we present a Japanese patient with Löfgren's syndrome. A 34-year-old female patient was hospitalized with arthritis and erythema nodosum. Chest computed tomography revealed mediastinal and BHL. Endobronchial ultrasound-guided transbronchial needle aspiration showed non-caseating epithelioid cell granulomas. Löfgren's syndrome was thus diagnosed. Her ankle arthralgia and bilateral ankle swelling recovered without steroid treatment within two months, and the BHL almost completely diminished one year after admission. Her HLA genotype contains DR12. We also reviewed the literature on 11 Japanese patients with Löfgren's syndrome, showing that HLA-DR12 is present in five out of nine patients (55.6%). The relevant data were unavailable in the remaining three patients. Importantly, only 5.4% of registered donors in the Japan Marrow Donor Program are positive for this allele. We suggest the potential link between HLA-DR12 and the pathogenesis of Löfgren's syndrome in Japanese patients. PMID:25274017

Ishimatsu, Yuji; Koyama, Hanako; Tomonaga, Masaomi; Harada, Tatsuhiko; Nakashima, Shota; Hara, Atsuko; Hara, Shintaro; Kakugawa, Tomoyuki; Sakamoto, Noriho; Hayashi, Tomayoshi; Kohno, Shigeru

2014-01-01

58

A Japanese patient with a mild Lenz–Majewski syndrome  

Microsoft Academic Search

We report on a sclerosing bone dysplasia, associated with cutis laxa, enamel dysplasia, and mental retardation. The patient\\u000a was a 17-year-old Japanese boy of normal height and muscular build. Cutis laxa with prominent veins in the scalp and abdominal\\u000a wall and delayed eruption of permanent teeth attracted the attention of clinicians in infancy and adolescence, respectively.\\u000a The clinical manifestations included

Sumito Dateki; Tatsuro Kondoh; Gen Nishimura; Katsuaki Motomura; Koh-ichiro Yoshiura; Akira Kinoshita; Hideo Kuniba; Yoshiyuki Koga; Hiroyuki Moriuchi

2007-01-01

59

Oncoplastic surgery for Japanese patients with ptotic breasts  

Microsoft Academic Search

Background  Oncoplastic techniques, which combine the concepts of oncologic and plastic surgery, are becoming more common, especially\\u000a in Western countries, however, only a few case reports have been published in Japan. We report the results of oncoplastic\\u000a surgery for Japanese patients with early breast cancer in the lateral quadrant area.\\u000a \\u000a \\u000a \\u000a Methods  In eight patients, their breasts were ptotic, and each lesion was

Yuko Kijima; Heiji Yoshinaka; Sumiya Ishigami; Munetsugu Hirata; Koichi Kaneko; Tadao Mizoguchi; Akihiro Nakajo; Hideo Arima; Yawara Funasako; Shinichi Ueno; Shoji Natsugoe

60

[Comprehensive care for diabetic patients with diabetic foot syndrome].  

PubMed

The author presents a definition of diabetic foot syndrome and its various classifications. Presented are its epidemiology and the risk factors of its development. Management of this condition is demanding with respect to medical as well as economic resources and thus prevention is at the forefront. However, should this condition develop in a patient, specialised care becomes equally important. Care for a patient with diabetic foot syndrome is as complex as are the underlying causes of this condition. Management requires attention of a specialized team of experts, led and coordinated by a diabetologist-podiatrist. Therapy includes diabetes control, weight reduction, infection therapy, revascularisation and, alternatively, conservative treatment of lower limb ischemia, surgery, wound healing and local therapy as well as nutritional care. The author only discusses the areas of management that are not a subject to separate papers. PMID:20465109

Olsovský, J

2010-04-01

61

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. PMID:23152786

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

2012-01-01

62

Vitamin D receptor initiation codon polymorphism influences genetic susceptibility to type 1 diabetes mellitus in the Japanese population  

Microsoft Academic Search

BACKGROUND: Vitamin D has been shown to exert manifold immunomodulatory effects. Type 1 diabetes mellitus (T1DM) is regarded to be immune-mediated and vitamin D prevents the development of diabetes in the NOD mouse. We studied the association between T1DM and the initiation codon polymorphism in exon 2 of the vitamin D receptor gene in a Japanese population. We also investigated

Yoshiyuki Ban; Matsuo Taniyama; Tatsuo Yanagawa; Satoru Yamada; Taro Maruyama; Akira Kasuga; Yoshio Ban

2001-01-01

63

Assessment of erectile dysfunction in diabetic patients.  

PubMed

Erectile dysfunction (ED) aetiology is multifactorial, including endocrine, neurological, vascular, systemic disease, local penile disorders, nutrition, psychogenic factors, and drug-related. This study was performed to compare the relevant comprehensive biochemical parameters as well as the clinical characteristics in diabetic ED and healthy control subjects and to assess the occurrence of penile neuropathy in diabetic patients and thus the relationship between ED and diabetes. A total of 56 patients accepted to undergo assessment for penile vasculature using intracavernosal injection and colour Doppler ultrasonography. Of the 56 diabetic patients, 38 patients were found with normal blood flow and thus they were considered as the diabetic-ED group, whereas, ED diabetic patients with an arteriogenic component were excluded. These patients with an age range between 17 and 58 years, complaining of ED, with duration of diabetic illness ranging from 2 to 15 years. The Control group comprised of 30 healthy subject aged between 19 and 55 years. Peripheral venous levels of testosterone, prolactin, follicle stimulating hormone (FSH), luteinizing hormone (LH), thyroid stimulating hormone (TSH), malondialdehyde and glycosylated haemoglobin (HbA(1)c) were obtained in all subjects. Valsalva manoeuvre and neurophysiological tests were also determined. Testosterone, prolactine, FSH, LH, and TSH hormones of the diabetic patients were not significantly different from those of the control group. Diabetic patients with ED have higher HbA(1)c and oxidative stress levels while the R-R ratio was significantly decreased. Bulbocavernosus reflex latency was significantly prolonged, whereas its amplitude, the conduction velocity and amplitude of dorsal nerve of penis were significantly reduced in the diabetic patients. We concluded that although ED is a multifactorial disorder, yet, the present study revealed that in ED patients without arteriogenic ED a neurogenic component is present. Furthermore, the complex effect of the Valsalva manoeuvre on cardiovascular function is the basis of its usefulness as a measure of autonomic function. Thus, it can be of value in the diagnosis of ED although these hypotheses require follow-up in a large study cohort. PMID:18298568

Hamdan, Farqad B; Al-Matubsi, Hisham Y

2009-04-01

64

[Orthopaedic neurological diseases in patient with diabetes].  

PubMed

Individuals with diabetes are at a greater risk for microvascular complications, such as retinopathy, neuropathy, and nephropathy, than are individuals without diabetes. Diabetic neuropathies are complex heterogeneous disorders that include both focal neuropathies and diffuse polyneuropathy. Entrapment neuropathy is an example of a focal neuropathy, while distal symmetric polyneuropathy is the most common type of diffuse polyneuropathy. Entrapment neuropathies are highly prevalent in the diabetic population, but they develop insidiously and progressively, making it difficult to determine their true prevalence. Entrapment neuropathies are suspected to be a more common complication of diabetes than is polyneuropathy. For example, carpal tunnel syndrome (CTS)-one of the most common entrapment neuropathies encountered in patients with diabetes-results from median nerve compression, and has been shown to occur three times more frequently in a diabetic population than in a normal healthy population. Entrapment neuropathies should be actively screened for in patients showing the signs and symptoms of neuropathy, because such patients may require surgical treatment. PMID:24523313

Natsume, Tadahiro; Hirata, Hitoshi

2014-02-01

65

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. PMID:21722563

Richesson, Rachel L

2011-01-01

66

Diabetes education improves depressive state in newly diagnosed patients with type 2 diabetes  

PubMed Central

Objectives: The prevalence of depression is relatively high in individuals with diabetes. However, screening and monitoring of depressive state in patients with diabetes is still neglected in developing countries and the treatment of diabetes-related depression is rarely performed in these countries. In this study, our aim was to study the role of diabetes education in the improvement of depressive state in newly diagnosed patients with type 2 diabetes. Methods: The Dutch version of the center for epidemiological studies depression scale (CES-D scale) and the problem areas in diabetes (PAID) questionnaire were used to assess depression and diabetes-specific emotional distress in 1200 newly diagnosed male adult patients with type 2 diabetes before and after a two-week diabetes education by professionally trained nurses. Pearson correlation and regression analysis were used to analyze the factors related to depression in patients with type 2 diabetes. Results: The incidence of depression in newly diagnosed patients with type 2 diabetes was 28%, and the rate of diabetes-specific emotional distress was 65.5%. High education levels, low income were correlated to depression in individuals with diabetes. After two weeks of diabetes education, the incidence of depression and diabetes-specific emotional distress decreased significantly to 20.5% (P < 0.05) and 11% (P < 0.001), respectively. Conclusions: The incidence of depression, especially diabetes-specific emotional distress, was relatively high in newly diagnosed patients with type 2 diabetes. The depression state could be improved by diabetes education. PMID:24353709

Chen, Bin; Zhang, Xiyao; Xu, Xiuping; Lv, Xiaofeng; Yao, Lu; Huang, Xu; Guo, Xueying; Liu, Baozhu; Li, Qiang; Cui, Can

2013-01-01

67

Rheumatic conditions in patients with diabetes mellitus.  

PubMed

Diabetes mellitus (DM) is a chronic systemic disease with a wide range of complications, including complications in the musculoskeletal system. DM is a common disease in nearly all countries and continues to increase in numbers and significance. Approximately 90 % of patients have type 2 DM which is caused by resistance to insulin. Type 1 DM results from an absolute deficiency of insulin due to an autoimmune destruction of insulin-producing beta cells within the pancreas. Diabetic patients suffer from diverse rheumatic conditions that affect their life quality. This article reviews the rheumatic conditions that are associated with DM and the pathophysiologic relationships that might link these conditions; it also summarizes recent advances in the field of diabetes and rheumatic conditions. The rheumatic conditions that are discussed in this review include limited joint mobility, Dupuytren's contracture, flexor tenosynovitis, carpal tunnel syndrome, adhesive capsulitis, diffuse idiopathic skeletal hyperostosis, neuropathic osteoarthropathy, diabetic muscle infarction, crystal induced arthritis, osteoarthritis, and reflex sympathetic dystrophy. PMID:23247555

Al-Homood, Ibrahim A

2013-05-01

68

[Coronary artery disease in diabetic patients].  

PubMed

It is possible to decrease the rate of progression of coronary artery disease in diabetic patients by controlling all risk factors including hyperglycemia and by the prescription of statin and aspirin in high risk patients. After a coronary event, the management of the patient must be as optimal as possible in terms of pharmacological treatment and revascularization. "Ever more" is the key line in these patients. PMID:18839684

Henry, Patrick

2008-09-30

69

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)] [Univ. of Tsukuba (Japan)

1995-04-01

70

Urodynamic Findings in Patients With Diabetic Cystopathy  

Microsoft Academic Search

To ascertain the relationship between voiding dysfunction associated with diabetes and bladder and sphincter behavior, the video urodynamic studies of 182 patients were retrospectively analyzed. Patients were classified based on urodynamic diagnosis and the presence or absence of signs of sacral cord involvement. Urodynamic findings were classified as either detrusor hyperreflexia, impaired detrusor contractility, detrusor areflexia, indeterminate and normal. The

Steven A. Kaplan; Alexis E. Te; Jerry G. Blaivas; Edward J. McGuire

1995-01-01

71

A comparative study of Japanese multiple sclerosis patients with and without oligoclonal IgG bands  

Microsoft Academic Search

The cerebrospinal fluid oligodonal IgG bands (OB) are less frequently observed in Japanese multiple sclerosis (MS) patients compared with Caucasian patients. We studied 40 consecutive Japanese MS patients to investigate the differences in the clinical and magnetic resonance imaging (MRI) features of MS between OB-positive patients and OB-negative ones. Among the 40 patients, 22 (55%) patients were OB-positive by either

I. Nakashima; K. Fujihara; T. Misu; J. Fujimori; S. Sato; S. Takase; Y. Itoyama

2002-01-01

72

Pulmonary functions in patients with diabetes mellitus  

PubMed Central

Background: A reduction in lung capacity has been reported previously among diabetics. According to WHO estimates, Pakistan is currently eighth in the prevalence of diabetes mellitus (DM) and will become fourth by the year 2025 with over 15 million individuals. This study was designed to see the impairment of lung functions on spirometry in DM patients. Objective: Our aim was to investigate the pulmonary functions tests of Pakistani patients with DM. Materials and Methods: Between January to July 2004, 128 subjects who were never-smokers and had no acute or chronic pulmonary disease were recruited. Sixty-four of these subjects had DM and 64 were healthy matched controls. All underwent screening with detailed history, anthropometry, lipid profile, and spirometric measurements at the Aga Khan University Hospital, Karachi, Pakistan. Results: The mean age of diabetics and matched control were 54.3±9 and 54.0±8 (P<0.87) years, respectively. Diabetes patients showed a significant reduction in the forced vital capacity (FVC) [mean difference (95% CI) – 0.36 (–0.64, –0.07) P<0.01], forced expiratory volume in one second (FEV1) [– 0.25(–0.50, –0.003) P<0.04], and slow vital capacity (SVC) [– 0.28(–0.54, –0.01) P<0.04], relative to nondiabetic controls. There was no significant difference noted in the forced expiratory ratio and maximum mid-expiratory flow between the groups. There was also a significant higher level of triglycerides noted among diabetics (P<0.001). Conclusion: Diabetic patients showed impaired lung function independent of smoking. This reduced lung function is likely to be a chronic complication of diabetes mellitus. PMID:21712938

Irfan, Muhammad; Jabbar, Abdul; Haque, Ahmed Suleman; Awan, Safia; Hussain, Syed Fayyaz

2011-01-01

73

Traditional Japanese Medicine Daikenchuto Improves Functional Constipation in Poststroke Patients  

PubMed Central

Poststroke patients with functional constipation, assessed by the Rome III criteria, from 6 hospitals were recruited in a study on the effects of the traditional Japanese medicine Daikenchuto (DKT) on constipation. Thirty-four patients (17 men and 17 women; mean age: 78.1 ± 11.6 years) were randomly assigned to 2 groups; all patients received conventional therapy for constipation, and patients in the DKT group received 15?g/day of DKT for 4 weeks. Constipation scoring system (CSS) points and the gas volume score (GVS) (the measure of the intestinal gas volume calculated from plain abdominal radiographs) were recorded before and after a 4-week observation period. The total score on the CSS improved significantly in the DKT group compared to the control (P < 0.01). In addition, scores for some CSS subcategories (frequency of bowel movements, feeling of incomplete evacuation, and need for enema/disimpaction) significantly improved in the DKT group (P < 0.01, P = 0.049, and P = 0.03, resp.). The GVS was also significantly reduced in the DKT group compared to the control (P = 0.03). DKT in addition to conventional therapy is effective in treating functional constipation in poststroke patients. This study was a randomized controlled trial and was registered in the UMIN Clinical Trial Registry (no. UMIN000007393). PMID:25089144

Numata, Takehiro; Takayama, Shin; Tobita, Muneshige; Ishida, Shuichi; Katayose, Dai; Shinkawa, Mitsutoshi; Oikawa, Takashi; Aonuma, Takanori; Kaneko, Soichiro; Tanaka, Junichi; Kanemura, Seiki; Iwasaki, Koh; Ishii, Tadashi; Yaegashi, Nobuo

2014-01-01

74

Safety of Itraconazole in Diabetic Patients  

Microsoft Academic Search

Background: Onychomycosis and dermatomycoses can result in serious complications in patients with underlying chronic diseases such as diabetes. To avoid these complications, these dermatological disorders need to be treated efficiently, for example with the triazole antifungal itraconazole. Itraconazole can inhibit the metabolism of drugs by CYP 3A4 and therefore might affect the efficacy of antidiabetic agents. Objective: To investigate this,

J. Verspeelt; G. Marynissen; A. K. Gupta; P. De Doncker

1999-01-01

75

Charcot spinal arthropathy in a diabetic patient.  

PubMed

We report a case of Charcot spinal arthropathy in a diabetic patient and emphasize the clinical reasoning leading to the diagnosis, discuss the differential diagnosis, and insist on the crucial role of the radiologist and pathologist which allows the distinction between Charcot spinal arthropathy and infectious or tumoural disorders of the spine. PMID:25012751

van Eeckhoudt, S; Minet, M; Lecouvet, F; Galant, C; Banse, X; Lambert, M; Lefèbvre, C

2014-08-01

76

Primary Perianal Tuberculosis in a Diabetic Patient  

PubMed Central

Primary perianal tuberculosis is a rare form of extra pulmonary tuberculosis. We present a case of perianal tuberculosis without any pulmonary or gastrointestinal involvement in a diabetic patient. Histopathological examination of perianal lesion demonstrated loose granulomas and positive staining for Erlich-Ziehl-Neelsen (EZN) stain. PMID:24404369

Chadha, Tandra; Adlekha, Shashikant

2013-01-01

77

Primary Infrainguinal Subintimal Angioplasty in Diabetic Patients  

SciTech Connect

The aim of this study was to prospectively evaluate technical and clinical results of infrainguinal subintimal angioplasty in a series of diabetic patients with limb-threatening ischemia. From July 2003 to December 2007, 60 consecutive diabetic patients (M/F = 41/19; mean age, 69.4 {+-} 9.4 years) with Fontaine stage IV critical limb ischemia, not suitable for surgical recanalization, underwent primary infrainguinal subintimal angioplasty. The technical success, perioperative morbidity and mortality, and clinical success (defined by ulcer healing) were evaluated. Kaplan-Meier life-table analysis was obtained for cumulative clinical success, limb salvage, and survival rates. The procedure was technically successful in 55 of 60 (91.7%) patients; in 5 cases we were not able to achieve a reentry. Periprocedural mortality was 5% (3 patients); three patients (5%) required major amputation periprocedurally. Mean follow-up was 23 months (range, 0-48 months). On an intention-to-treat basis, the limb salvage rate was 93.3% (56/60 patients); ulcer healing was observed in 45 of 60 (75%) patients and it was significantly (p < 0.05) associated with serum creatinine and HbA1c levels, diabetes duration, and infrapopliteal recanalization. One- and three-year cumulative survival rates were 91.5% and 83.1%, respectively; serum creatinine levels, patient age, and clinical success were significant predictors of survival. In conclusion, infrainguinal primary subintimal angioplasty is a safe and effective treatment in diabetic patients with limb-threatening ischemia not suitable for surgical recanalization. This procedure is aimed to create a 'temporary bypass' that facilitates ulcer healing.

Bargellini, Irene, E-mail: irenebargellini@hotmail.com; Petruzzi, Pasquale [University of Pisa, Department of Diagnostic and Interventional Radiology (Italy); Scatena, Alessia [University of Pisa, Department of Diabetology (Italy); Cioni, Roberto; Cicorelli, Antonio; Vignali, Claudio [University of Pisa, Department of Diagnostic and Interventional Radiology (Italy); Rizzo, Loredana; Piaggesi, Alberto [University of Pisa, Department of Diabetology (Italy); Bartolozzi, Carlo [University of Pisa, Department of Diagnostic and Interventional Radiology (Italy)

2008-07-15

78

Study on cavity induced conditions in diabetic patients  

Microsoft Academic Search

Diabetes mellitus (DM) is a chronic illness with multiple complications including oral cavity com- ponents. The study aims at identifying dental lesions in diabetic patients and assessing correlations between diabetes mellitus and dental caries index (DMF-T Decayed Missing, Filled Tooth). The analysis includes two patient samples: one with 52 patients previously diagnosed with DM and a control group with 50

Adina Magdalena Bunget; Gabriela P; Sanda Mihaela Popescu

79

A Simple Causal Model for Glucose Metabolism in Diabetes Patients  

E-print Network

that can capture how the blood sugar level changes in a diabetes patient. For this purpose we use distanceA Simple Causal Model for Glucose Metabolism in Diabetes Patients Kinzang Chhogyal1 , Abhaya Nayak2 and correct model of a diabetic patient. Keywords: Belief Revision, Belief Update, Causal Models, Glucose

Schwitter, Rolf

80

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

81

Coping with Type II diabetes: the patient's perspective  

Microsoft Academic Search

Aims\\/hypothesis. The Cost of Diabetes in Europe - Type II study is the first coordinated attempt to assess the total costs of Type II (non-insulin-dependent) diabetes mellitus in Europe. Although gaining a clearer understanding of the economics of diabetes was the goal of the study, a secondary objective was to consider the impact of Type II diabetes from the patient's

M. Koopmanschap

2002-01-01

82

The factorial structure of the mini mental state examination (MMSE) in Japanese dementia patients  

Microsoft Academic Search

BACKGROUND: The Mini-Mental State Examination (MMSE) is one of the most commonly used instruments in the evaluation of global cognitive status. Few studies have investigated the relationship among its components in terms of factorial structure in Japanese individuals suffering from dementia. The aims of this study were: 1) to analyze the factorial structure of MMSE in Japanese dementia patients, 2)

Kenta Shigemori; Shohei Ohgi; Eriko Okuyama; Takaki Shimura; Eric Schneider

2010-01-01

83

Choroidal thickness in patients with diabetic retinopathy  

PubMed Central

Purpose The aim of the study reported here was to assess choroidal thickness (CT) and central macular thickness (CMT) in patients with diabetic retinopathy. Materials and methods A total of 151 eyes from 80 patients from the retina department of Istanbul Training and Research Hospital who had type 2 diabetes mellitus with diabetic retinopathy were studied retrospectively in this cross-sectional research. Patients were divided into three groups: mild–moderate nonproliferative diabetic retinopathy without macular edema (NPDR), mild–moderate nonproliferative diabetic retinopathy with macular edema (DME), and proliferative diabetic retinopathy (PDR). In addition, 40 eyes of 20 healthy individuals comprised a control group. Choroidal thickness was measured from the posterior edge of the retinal pigment epithelium to the choroid/sclera junction at 500-?m intervals up to 1,500 ?m temporal and nasal to the fovea. The CMT measurement was obtained for each eye. Serum hemoglobin A1c (HbA1c) levels were measured. Results The study included 191 eyes, comprising 151 eyes of 80 patients and 40 eyes of 20 healthy individuals. Of the 151 patient eyes, 61 had NPDR, 62 had PDR, and 28 eyes had DME. There was no statistically significant difference in age between the groups (P>0.05). In both the PDR and DME groups, the CT was statistically significantly decreased compared with the control group (P<0.001, P<0.001 for the PDR and DME groups, respectively). The mean CMT in the DME group was increased significantly compared with both the NPDR and PDR groups (P<0.001, P<0.001, respectively). In all three groups, serum HbA1c levels were found to be increased significantly compared with the control group (P=0.000). We found a statistically weak–moderate negative correlation between central macular and foveal CT (r=?289, P=0.000). There was a statistically strong correlation between CMT and HbA1c levels (r=0.577, P=0.483) and a statistically weak–moderate negative correlation between the central CT and HbA1c levels (r=?0.331, P<0.001). Conclusion Diabetes changes the CT. CT was found to be significantly decreased in the DME and PDR groups. PMID:24707168

Unsal, Erkan; Eltutar, Kadir; Zirtiloglu, Sibel; Dincer, Nurhan; Ozdogan Erkul, Sezin; Gungel, Hulya

2014-01-01

84

Self-Medication Practices among Diabetic Patients in Kuwait  

Microsoft Academic Search

Objectives: The aim of this study was to estimate the prevalence of self-medication with proprietary medicines and\\/or herbs among diabetic patients and evaluate factors associated with self-medication among diabetic patients. Subjects and Methods: A total of 104 diabetic patients were selected randomly from eight diabetic clinics from three governorates. Data were collected via face-to-face structured interview of the respondents in

Abdelmoneim Awad; Shahd Al-Rabiy; Eman Abahussain

2008-01-01

85

Diabetic Muscle Infraction: An Unusual Cause of Muscle Pain in a Diabetic Patient on Hemodialysis  

Microsoft Academic Search

Diabetic muscle infarction (DMI) is a rare, painful and potentially serious complication in patients with poorly controlled diabetes mellitus and frequently misdiagnosed clinically as abscess, neoplasm, or myositis. A 36-year-old diabetic woman referred to our clinic with severe pain in the left antero-medial thigh. She had a 15-year history of Type 2 diabetes mellitus (DM). She was complicated by diabetic

Ibrahim Sahin; Cagatay Taskapan; Hulya Taskapan; Tamer Baysal; Recep Bentli; Selda Tekes; Feridun Kosar; Iclal Gurses

2005-01-01

86

Association between Sleep Duration and Urinary Albumin Excretion in Patients with Type 2 Diabetes: The Fukuoka Diabetes Registry  

PubMed Central

Objective Few studies have so far investigated the impact of sleep duration on chronic kidney disease in diabetic patients. The objective of the present study was to examine the relationship between sleep duration and albuminuria in type 2 diabetic patients. Research Design and Methods A total of 4,870 Japanese type 2 diabetic patients ?20 years of age were divided into six groups according to self-reported sleep duration: less than 4.5 hours, 4.5–5.4 hours, 5.5–6.4 hours, 6.5–7.4 hours, 7.5–8.4 hours and more than 8.5 hours. The association between sleep duration and urinary albumin-creatinine ratio (UACR) was examined cross-sectionally. Results Both short and long sleep durations were significantly associated with higher UACR levels and higher proportions of patients with albuminuria (?30 mg/g) and macroalbuminuria (?300 mg/g) compared with a sleep duration of 6.5–7.4 hours (P for quadratic trend <0.001). A U-shaped association between sleep duration and UACR remained significant even after adjustment for potential confounders, including age, sex, duration of diabetes, current smoking habits, former smoking habits, current drinking habits, regular exercise habits, total energy intake, total protein intake, hypnotic use and estimated glomerular filtration rate. Furthermore, the association remained substantially unchanged after additional adjustment for body mass index, hemoglobin A1c, systolic blood pressure, renin-angiotensin system inhibitor use and depressive symptoms. Conclusions Our findings suggest that sleep duration has a U-shaped association with the UACR levels in type 2 diabetic patients, independent of potential confounders. PMID:24265736

Ohkuma, Toshiaki; Fujii, Hiroki; Iwase, Masanori; Ogata-Kaizu, Shinako; Ide, Hitoshi; Kikuchi, Yohei; Idewaki, Yasuhiro; Jodai, Tamaki; Hirakawa, Yoichiro; Nakamura, Udai; Kitazono, Takanari

2013-01-01

87

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

88

Obesity, diabetes and survival in maintenance hemodialysis patients.  

PubMed

Increased body mass index (BMI) confers a survival advantage in maintenance hemodialysis (MHD) patients. Diabetic (diabetes mellitus (DM)) patients undergoing MHD have worse survival. There are limited studies examining the effect of obesity on the risk of death among MHD patients with diabetes. Ninety-eight MHD patients were studied for median follow-up time of 33 months. Patients were classified according to the presence of obesity (BMI ? 30 kg/m(2)) or DM. Primary outcome was all-cause mortality. Cox regression was used to evaluate the effect of obesity on time to death. Effect modification and mediation analysis were also performed. Mean age was 49 ± 13 years, 66% were male, 48% were obese and 34% were diabetic. Mortality rates (per 100 person-years) were: 3.4 for non-diabetic obese, 8.6 for non-diabetic non-obese, 14.3 for diabetic non-obese and 18.1 for diabetic obese patients. Log-rank comparing diabetic obese versus non-diabetic obese was significant (p=0.007). Diabetes was associated with an increased risk of mortality after adjustment for potential mediators. Effect modification of obesity in the mortality risk was different between patients with and without diabetes. With adjustment for adipokines, a greater effect modification by diabetes was observed; whereas, adjustment for inflammatory marker did not influence the effect modification. Diabetic obese MHD patients have increased mortality risk compared to non-diabetic obese. Obesity does not offer survival benefits in diabetic obese MHD patients and potentially may have detrimental effects. Larger studies evaluating the effect of adipokines and obesity in outcomes in the diabetic MHD population need to be undertaken. PMID:24467439

Deger, Serpil M; Ellis, Charles D; Bian, Ahuia; Shintani, Ayumi; Ikizler, T Alp; Hung, Adriana M

2014-05-01

89

Knowledge, attitude and practice (KAP) study on diabetes mellitus among Nepalese diabetic patients.  

PubMed

Present study was carried out to understand the knowledge, attitude and practices (KAP) regarding diabetes mellitus (DM) among the diabetic patients attending a diabetic education programme. Results showed that the majority of patients had correct knowledge regarding diabetic diet, three-fourths of them were subjected themselves to blood sugar checking at good intervals and almost all were under regular contact with physicians. This study might help in implementation of diabetic education programme giving more emphasis among older and younger groups of patients and encouraged the patients to have more contact with concerning physicians, so that complications that occurring at early stage of disease could be prevented. PMID:16295723

Shrestha, Lochana; Nagra, Jaswant Singh

2005-06-01

90

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

91

Cancer risk in patients with diabetes mellitus  

Microsoft Academic Search

Cancer incidence was ascertained in a population-based cohort of 51,008 patients in Uppsala, Sweden, who were given a discharge diagnosis of diabetes mellitus during 1965–83. Complete follow-up through 1984 with exclusion of the first year of observation showed that the observed number of cancers in females (1,294) was eight percent higher than expected (relative risk [RR]=1.1, 95 percent confidence interval

Hans-Olov Adami; Joseph McLaughlin; Anders Ekbom; Christian Berne; Debra Silverman; David Hacker; Ingemar Persson

1991-01-01

92

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 explore…

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

2009-01-01

93

A Japanese patient with a mild Lenz-Majewski syndrome.  

PubMed

We report on a sclerosing bone dysplasia, associated with cutis laxa, enamel dysplasia, and mental retardation. The patient was a 17-year-old Japanese boy of normal height and muscular build. Cutis laxa with prominent veins in the scalp and abdominal wall and delayed eruption of permanent teeth attracted the attention of clinicians in infancy and adolescence, respectively. The clinical manifestations included a progeroid facial appearance with prognathism, wrinkled skin, and interdigital webbing. The intelligence quotient was estimated at 60. Enamel dysplasia was histologically confirmed. Skeletal changes included calvarial hyperostosis, sclerosis of the skull base, an enlarged, sclerotic mandible, broad clavicles and ribs, and diaphyseal undermodeling of the tubular bones. Metaepiphyseal sclerosis or longitudinal striation was found in the long bones. Metaphyseal equivalents of the axial skeleton showed dense osteosclerosis. These clinical and radiological manifestations overlapped with those of Lenz-Majewski syndrome. Unlike the classical phenotype of the disorder, however, he did not show brachymesophalangy with proximal symphalangism or growth failure. The present case may be considered to fall in the mildest end in the phenotypic continuum of Lenz-Majewski syndrome, suggesting that the clinical spectrum of the disorder may be broader than currently thought. PMID:17593321

Dateki, Sumito; Kondoh, Tatsuro; Nishimura, Gen; Motomura, Katsuaki; Yoshiura, Koh-Ichiro; Kinoshita, Akira; Kuniba, Hideo; Koga, Yoshiyuki; Moriuchi, Hiroyuki

2007-01-01

94

Patients' Perspectives on Factors that Influence Diabetes Self-Care  

PubMed Central

Background Although diabetes mellitus is of high concern in Iran, and the level of control is unacceptable, few qualitative studies have been carried out to reflect the experiences of patients on the barriers and motivators to self-care. This study aimed to explore a culturally based experience of Iranian diabetic patients regarding the personal and environmental barriers to and facilitating factors for diabetes self-care. Methods: Six focus groups were conducted among type 2 diabetic patients in the Charity Foundation for Special Diseases’ diabetes clinic. Purposeful sampling was used. Newly diagnosed patients (less than six months) and all type 1 diabetic patients were excluded. Three focus groups were held on for each sex. A total of 43 patients participated in the study. Frame-work analysis was used to extract the themes from the data. Results: Data analysis showed five main barriers: physical barriers (such as physical effects of diabetes); psychological barriers (such as health beliefs); educational barriers (such as lack of knowledge about diabetes); social barriers (such as group pressure); and care system barriers (such as service availability). Along with the barriers, there were some motivators that the participants mentioned as a stimuli to control their diabetes. They include beliefs about diabetes, perceived responsibility for family, religious beliefs, and the views of significant others. Conclusion: Culturally based interventions are needed to improve diabetes care management in Iran. In addition to personal factors, diabetes health educators should pay attention to the environmental factors when they develop programs. PMID:23113114

Shakibazadeh, E; Larijani, B; Shojaeezadeh, D; Rashidian, A; Forouzanfar, MH; Bartholomew, LK

2011-01-01

95

Incidence and Therapeutic Outcome of Pouchitis for Ulcerative Colitis in Japanese Patients  

Microsoft Academic Search

Aim: The aim of this study was to examine the cumulative risk of pouchitis following restorative proctocolectomy for UC and FAP in Japanese patients, and to assess the response to medical treatment and its outcome. Patients and Methods: 521 patients with UC and 117 FAP patients underwent proctocolectomy and received a J-shaped IPAA at our department of surgery. We investigated

Hiroki Ikeuchi; Hiroki Nakano; Motoi Uchino; Mitsuhiro Nakamura; Hidenori Yanagi; Masafumi Noda; Takehira Yamamura

2004-01-01

96

Odontogenic infection involving the secondary fascial space in diabetic and non-diabetic patients: a clinical comparative study  

PubMed Central

Objectives This retrospective study was performed to evaluate the clinical impact of diabetes mellitus on the prognosis in secondary space infection. Materials and Methods Medical records, radiographic images, computed tomography, and microbial studies of 51 patients (25 diabetic patients and 26 non-diabetic patients) were reviewed. Patients were diagnosed as secondary fascial space infections with odontogenic origin and underwent treatment at Chonnam National University Hospital, in Department of Oral and Maxillofacial Surgery, from January 2007 to February 2009. Results Compared to patients without diabetes, patients with diabetes were presented with the following characteristics: older age (diabetic patients: 62.9 years, non-diabetic patients, 47.8 years), more spaces involved (diabetic patients, 60%; non-diabetic patients, 27.3%), more intense treatment, longer hospitalization (diabetic patients, 28.9 days; non-diabetic patients, 15.4 days), higher white blood cell and C-reactive protein values, higher incidence of complication (diabetic patients, 40%; non-diabetic patients, 7.7%), and distinctive main causative microorganisms. Conclusion These results suggest that the prognosis of diabetic patients is poorer than that of non-diabetic patients in secondary space infections since they had greater incidence rates of involved spaces, abnormal hematologic findings, more complications, and additional procedures, such as tracheostomy. PMID:24471039

Chang, Je-Shin; Yoo, Kil-Hwa; Yoon, Sung Hwan; Ha, Jiwon; Jung, Seunggon; Kook, Min-Suk; Park, Hong-Ju; Ryu, Sun-Youl

2013-01-01

97

Socioeconomic profile of diabetic patients with and without foot problems  

PubMed Central

Introduction To identify the differences in a socioeconomic profile between two cohorts of diabetic patients – one with diabetic foot problems and another without diabetic foot problems. Materials and methods The cohort with diabetic foot problems (including cellulitis, abscess, osteomyelitis, septic arthritis, gangrene, ulcers, or Charcot joint disease) consisted of 122 diabetic patients, while the other cohort without foot problems consisted of 112 diabetic patients. Both were seen at the National University Hospital from January to April 2007. A detailed protocol was designed and the factors studied included patient profile, average monthly household income, education, compliance to diabetic medication, attendance at clinics for diabetic treatment, exercise, smoking, alcohol consumption, gender, and glycosylated haemoglobin (HbA1C) level. These were studied for significant differences using univariate and stepwise multivariate logistic regression analysis. Results With multivariate analysis, Malay ethnicity (p<0.001), education of up to secondary school only (p=0.021), low average monthly household income of less than SGD $2,000 (p=0.030), lack of exercise (at least once a week, p=0.04), and elevated HbA1C level (>7.0%; p=0.015) were found to be significantly higher in the cohort with diabetic foot problems than the cohort without. Conclusions There are significant differences in the socioeconomic factors between diabetic patients with diabetic foot problems and those without. PMID:22396814

Nather, Aziz; Siok Bee, Chionh; Keng Lin, Wong; Qi Odelia, Koh Si; Yiong Huak, Chan; Xinyi, Li; Nambiar, Ajay

2010-01-01

98

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

99

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

100

Combining Cardiac, Diabetic and Regular Diets into One Patient Menu  

Microsoft Academic Search

LEARNING OUTCOME: To describe the action steps for consolidating three diets, cardiac, diabetic and coronary into one patient menu.To demonstrate healthful nutrition recommendations, the nutrition department of a 450 bed acute care facility combined the separate cardiac, diabetic and regular patient diets to form one menu. Patient satisfaction, cost savings, capability of production, medical staff and hospital staff response were

KS Hernke; J. A Sheehan; C. A Smith

1996-01-01

101

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. PMID:23601510

2013-01-01

102

Are there specific care requirements for patients with schizophrenia and diabetes or with a risk of diabetes?  

Microsoft Academic Search

An interactive workshop was held to discuss the risk of diabetes in patients with schizophrenia, to evaluate the available data concerninghow such patients should be managed in terms of minimising the risk of diabetes and of optimising their care where diabetes to develop. The subjects discussed covered monitoring of risk factors, education about lifestyle and the risk of diabetes, patient

P. Thomas; P. Raymondet; B. Charbonnel; G. Vaiva

2005-01-01

103

False-positive treponemal serology in patients with diabetes mellitus.  

PubMed

In sera from 476 diabetic outpatients, positive reaction in the Fluorescent Treponemal Antibody-Absorption (FTA-Abs) test, a commonly used serological test for syphilis, was found in 36 of the patients. None of 100 healthy control subjects were positive in the FTA-Abs test. Additional treponemal and nontreponemal tests confirmed the diagnosis of syphilis in only three of the diabetic patients. In 10 of the 36 patients, the positive FTA-Abs reactivity appeared to be due to cross-reactivity between the treponemal antigen and Borrelia burgdorferi, which causes Lyme borreliosis. In the remaining 23 patients (5%), no other explanation for a false-positive FTA-Abs reactivity was found besides diabetes. Diabetic patients with false-positive FTA-Abs reactivity had similar degree of long-term metabolic control and prevalence of islet cell antibodies (ICA) as well as late diabetic complications as FTA-Abs negative diabetic patients, matched regarding to sex, age, type, and duration of diabetes. In conclusion, false-positive FTA-Abs reactivity is not rare in diabetic patients. The reason for this phenomenon is unknown, but could be a sign of autoimmunity of its own. Hence, in diabetic patients with FTA-Abs test indicating syphilis, the diagnosis must be verified with a combination of other tests. PMID:8167389

Brauner, A; Carlsson, B; Sundkvist, G; Ostenson, C G

1994-01-01

104

Outcome of renal replacement treatment in patients with diabetes mellitus.  

PubMed Central

OBJECTIVE--To compare the outcome of renal replacement treatment in patients with diabetes mellitus and in non-diabetic patients with end stage renal failure. DESIGN--Retrospective comparison of cases and matched controls. SETTING--Renal unit, Western Infirmary, Glasgow, providing both dialysis and renal transplantation. PATIENTS--82 Diabetic patients starting renal replacement treatment between 1979 and 1988, compared with 82 matched non-diabetic controls with renal failure and 39 different matched controls undergoing renal transplantation. MAIN OUTCOME MEASURES--Patient characteristics, history of smoking, prevalence of left ventricular hypertrophy and myocardial ischaemia at start of renal replacement treatment; survival of patients with renal replacement treatment and of patients and allografts with renal transplantation. RESULTS--The overall survival of the diabetic patients during the treatment was 83%, 59%, and 50% at one, three, and five years. Survival was significantly poorer in the diabetic patients than the controls (p less than 0.001). Particularly adverse features for outcome at the start of treatment were increasing age (p less than 0.01) and current cigarette smoking (relative risk (95% confidence interval) 2.28 (0.93 to 4.84), p less than 0.05). Deaths were mainly from cardiac and vascular causes. The incidence of peritonitis in patients on continuous ambulatory peritoneal dialysis was the same in diabetic patients and controls (49% in each group remained free of peritonitis after one year), and the survival of renal allografts was not significantly worse in diabetic patients (p less than 0.5). CONCLUSIONS--Renal replacement treatment may give good results in diabetic patients, although the outlook remains less favourable than for non-diabetic patients because of coexistent, progressive vascular disease, which is more severe in older patients. PMID:2207427

McMillan, M A; Briggs, J D; Junor, B J

1990-01-01

105

A Genome-Wide Association Study for Diabetic Retinopathy in a Japanese Population: Potential Association with a Long Intergenic Non-Coding RNA  

PubMed Central

Elucidation of the genetic susceptibility factors for diabetic retinopathy (DR) is important to gain insight into the pathogenesis of DR, and may help to define genetic risk factors for this condition. In the present study, we conducted a three-stage genome-wide association study (GWAS) to identify DR susceptibility loci in Japanese patients, which comprised a total of 837 type 2 diabetes patients with DR (cases) and 1,149 without DR (controls). From the stage 1 genome-wide scan of 446 subjects (205 cases and 241 controls) on 614,216 SNPs, 249 SNPs were selected for the stage 2 replication in 623 subjects (335 cases and 288 controls). Eight SNPs were further followed up in a stage 3 study of 297 cases and 620 controls. The top signal from the present association analysis was rs9362054 in an intron of RP1-90L14.1 showing borderline genome-wide significance (Pmet?=?1.4×10?7, meta-analysis of stage 1 and stage 2, allele model). RP1-90L14.1 is a long intergenic non-coding RNA (lincRNA) adjacent to KIAA1009/QN1/CEP162 gene; CEP162 plays a critical role in ciliary transition zone formation before ciliogenesis. The present study raises the possibility that the dysregulation of ciliary-associated genes plays a role in susceptibility to DR. PMID:25364816

Awata, Takuya; Yamashita, Hisakuni; Kurihara, Susumu; Morita-Ohkubo, Tomoko; Miyashita, Yumi; Katayama, Shigehiro; Mori, Keisuke; Yoneya, Shin; Kohda, Masakazu; Okazaki, Yasushi; Maruyama, Taro; Shimada, Akira; Yasuda, Kazuki; Nishida, Nao; Tokunaga, Katsushi; Koike, Asako

2014-01-01

106

Multidisciplinary Approach to Managing Diabetic Patient Care  

Microsoft Academic Search

Revised criteria by the American Diabetes Association defined diabetes as serum glucose greater than 126mg\\/dl. This revision was expected to increase the number of individuals diagnosed with diabetes. The purpose of this study was to use a multidisciplinary approach to determine the impact on the Healthcare system of the increased number of individuals diagnosed with diabetes and to determine compliance

P. P. Jones; C. Plank; S. Morse

1999-01-01

107

Effect of Salvia officinalis on diabetic patients  

PubMed Central

Introduction: Herbs are rich sources of natural antioxidants, and are used in traditional medicine for the control and treatment of many diseases. The reducing effect of a large number of these plants on blood glucose has been approved in animal models and clinical studies. Objectives: This study was therefore, performed to investigate the hypoglycemic effect of Salvia officinalis on blood glucose, Glycosylated hemoglobin (HbA1c), lipid profile, liver and kidney function tests.Patients and Methods: A double-blind clinical trial was carried out on 80 type II diabetic patients who had not reached the ideal control of the disease. Patients were randomly divided into two equal groups of case and control. The case group received Salvia officinalis and the control group received placebo tablets three times a day for three months. The fasting blood sugar (FBS) and 2 hours postprandial (2hpp) glucose were checked at the beginning and every 2 weeks, for three months Glycosylated hemoglobin (HbA1c), lipid profile, liver and kidney function tests were also measured at the beginning and at the end of trial and compared in two mentioned groups. Results: The 2hpp blood sugar and cholesterol levels were significantly decreased in Salvia officinalis treated patients compared to control group (p<0.05). There were no significant changes in glycosylated hemoglobin and FBS between the two groups. Conclusion: Results showed that Salvia officinalis might be beneficial in diabetic patients to reduce 2hpp and cholesterol. However higher doses might be needed to decrease fasting blood glucose and glycosylated hemoglobin. PMID:25340127

Behradmanesh, Saeed; Derees, Fatemeh; Rafieian-kopaei, Mahmoud

2013-01-01

108

Dental implant survival in diabetic patients; review and recommendations  

PubMed Central

Rising population of diabetic individuals across the world has become a big concern to the society. The persistent hyperglycemia may affect each and every tissue and consequently results in morbidity and eventually mortality in diabetic patients. A direct negative response of diabetes has been observed on oral tissues with few contradictions however, little are known about effect of diabetes on dental implant treatment and the consequent results. Many studies concerned with osteointegration and prognosis of dental implant in diabetic patients have been conducted and published since 1994. These studies have been critically reviewed to understand the impact of diabetes on the success of dental implant and the factors to improve osseointegration and consequently survival of dental implant in diabetic patients. Theoretical literatures and studies in diabetic animals substantiate high failure rate of implants but most of clinical studies indicated statistically insignificant failure of dental implants even in moderately uncontrolled diabetic patients. Success of dental implant in well and fairly controlled diabetic patients with proper treatment planning, prophylactic remedies and adequate postsurgical maintenance appears as good as normal individuals. PMID:24665167

Dubey, Rajendra Kumar; Gupta, Deepesh Kumar; Singh, Amit Kumar

2013-01-01

109

Noise-Enhanced Vibrotactile Sensitivity in Older Adults, Patients With Stroke, and Patients With Diabetic Neuropathy  

E-print Network

With Diabetic Neuropathy Wen Liu, PhD, Lewis A. Lipsitz, MD, Manuel Montero-Odasso, MD, Jonathan Bean, MD, D, and patients with diabetic neuropathy. Arch Phys Med Rehabil 2002;83: 171-6. Objective: To test the hypothesis that vibrotactile detection thresholds in older adults, patients with stroke, and patients with diabetic neuropathy

Collins, James J.

110

Inhaled insulin for controlling blood glucose in patients with diabetes  

PubMed Central

Diabetes mellitus is a significant worldwide health problem, with the incidence of type 2 diabetes increasing at alarming rates. Insulin resistance and dysregulated blood glucose control are established risk factors for microvascular complications and cardiovascular disease. Despite the recognition of diabetes as a major health issue and the availability of a growing number of medications designed to counteract its detrimental effects, real and perceived barriers remain that prevent patients from achieving optimal blood glucose control. The development and utilization of inhaled insulin as a novel insulin delivery system may positively influence patient treatment adherence and optimal glycemic control, potentially leading to a reduction in cardiovascular complications in patients with diabetes. PMID:18200813

Silverman, Bernard L; Barnes, Christopher J; Campaigne, Barbara N; Muchmore, Douglas B

2007-01-01

111

Cytokine Profile of Peripheral Blood in Type 2 Diabetes Mellitus Patients with Diabetic Retinopathy  

Microsoft Academic Search

To evaluate the usefulness of cytokine levels of peripheral blood in diabetic retinopathy (DR), demographic and biochemical parameters including low-density lipoprotein (LDL) diameter as well as cytokine profiles were analyzed in 74 patients with type 2 diabetes mellitus (DM), with DR (n = 46) or without DR (n = 28). DM duration was longer in the patients with DR than

Jong-Han Lee; Woonhyung Lee; Oh Hun Kwon; Jeong-Ho Kim; Oh Woong Kwon; Kyung Hwan Kim; Jong-Baeck Lim

2008-01-01

112

Effects of renal dysfunction on cardiovascular events in diabetic patients with hypertension: Challenge-DM Study subgroup analysis  

Microsoft Academic Search

Background  This study investigated the relation between renal dysfunction and cardiovascular events in patients from the Challenge-DM\\u000a Study (a large-scale investigation of Japanese diabetic patients with hypertension on candesartan therapy).\\u000a \\u000a \\u000a \\u000a \\u000a Methods  The subjects were 4706 patients in whom renal function could be assessed at the time of registration among 16860 patients\\u000a analyzed in the Challenge-DM Study. The definition of renal dysfunction (low

Satoshi Umemura; Ryuzo Kawamori; Hiroaki Matsuoka; Yasushi Saito

2011-01-01

113

Patient support to reduce risk diabetic retinopathy.  

PubMed

Diabetic retinopathy (DR) is the most common cause of blindness in the western world resulting in damage to the blood vessels of the retina. This damage causes visual loss that can have a devastating effect on patients and their families, and is intensified by the loss of self-management abilities that may have physical and psychosocial implications. Nurses in both primary and secondary care settings need to understand the condition as they can play a vital role in reducing its incidence. This article discusses the causes, treatment and management of DR, and provides practical details of how nurses can help educate and empower patients to reduce their risk of developing it. PMID:25087401

Mclauchlan, Rita

114

Childhood trauma and parental bonding among Japanese female patients with borderline personality disorder  

Microsoft Academic Search

The present study explored the relationship between borderline personality disorder (BPD) and childhood trauma and perceived parental behaviours among a sample of Japanese female outpatients. Participants were 45 female patients who were diagnosed with BPD and 45 female patients with a diagnosis of other nonorganic psychological disorders (aged 19 to 53). The participants completed surveys that assessed recollection of childhood

2007-01-01

115

Association of diabetic retinopathy, ischemic heart disease, and albuminuria with diabetic treatment in type 2 diabetic patients  

Microsoft Academic Search

The management of type 2 diabetes has been a controversial issue. The objective of the present study was to estimate patients'\\u000a characteristics, particularly diabetes treatment, associated with retinopathy, coronary heart disease, and microalbuminuria\\u000a in an unselected population of 532 type 2 diabetic individuals from three communities. Questionnaires, clinic record review,\\u000a and physical examination were used for the assessment of the

S. Weitzman; M. Maislos; B. Bodner-Fishman; S. Rosen

1997-01-01

116

Anxiety and depression symptoms in patients with diabetes  

Microsoft Academic Search

Aims To identify the prevalence and major determinants of anxiety and depression symptoms in patients with diabetes. Methods A cross-sectional study of 2049 people with Types 1 and 2 diabetes, selected from patients experiencing three different models of care in Ireland: (i) traditional mixed care; (ii) hospital\\/general practitioner (GP) shared care; (iii) structured GP care. Anxiety and depression symptoms were

M. M. Collins; P. Corcoran; I. J. Perry

2009-01-01

117

NUTRITION THERAPY FOR THE HOSPITALIZED PATIENT WITH DIABETES  

Microsoft Academic Search

Objective: To summarize recommendations for medi- cal nutrition therapy (MNT), including how to implement it to achieve glycemic control targets for hospitalized patients with diabetes. ? Methods:? The MNT goals for hospitalized patients with diabetics are reviewed, and suggestions are made for attaining these goals. Emphasis is placed on the importance of proper screening and referral of inpatients to MNT

Carrie S. Swift; Jackie L. Boucher

2006-01-01

118

Treatment of hyperphosphatemia with bixalomer in Japanese patients on long-term hemodialysis with gastrointestinal symptoms.  

PubMed

Bixalomer (Bix) is an amine-functional polymer, non-calcium-containing phosphate (P) binder, and has been clinically available in Japan recently. Bix is expected to cause fewer gastrointestinal (GI) side-effects as compared with sevelamer hydrochloride (SH), because of less expansion of Bix in the GI tract. In this prospective observational study, we evaluated changes in GI symptoms by the Gastrointestinal Symptom Rating Scale (GSRS) score in long-term hemodialysis (HD) outpatients with SH-associated GI symptoms who switched to Bix from SH. A total of 114 patients (age 63.7±10.8 year (mean±SD), female 65.5%, HD vintage 11.2±8.6 years, diabetes mellitus 27.4%) were enrolled. The GSRS score was checked at 0 and 12 weeks after the start of Bix. Bix was started at the initial dose of 750?mg/day, and then was titrated. Serum albumin, P and corrected calcium levels did not significantly change during Bix treatment. However, serum low-density lipoprotein-cholesterol and bicarbonate levels significantly increased during Bix treatment (P<0.001). In GSRS scores, total and domain-specific scores, including constipation, diarrhea, reflux and abdominal pain were significantly reduced at 0, 4, 12 and 24 weeks as compared with those at 0 weeks (P<0.05). This study shows that Bix was well tolerated and managed hyperphosphatemia effectively after switching from SH in Japanese patients on long-term HD. In addition, Bix might be less often associated with GI symptoms as compared with SH. PMID:24975891

Ito, Kae; Takeshima, Akiko; Shishido, Kanji; Wakasa, Mikio; Kumata, Chiaki; Matsuzaka, Kantaro; Nakajima, Yutaka; Ogata, Hiroaki

2014-06-01

119

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

PubMed Central

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 up time tests and Schirmer. All the subjects underwent indirect ophthalmoscopy and retinal color photography. DR was graded according to early Treatment Diabetic Retinopathy (ETDRS) criteria. Results Of 199 subjects, 108 patients (54.3%) suffer from dry eye syndrome. Although dry eye syndrome was more common in older and female patients, this association was not significant. But there was significantly association between dry eye syndrome and duration of diabetes (P = 0.01). Dry eye syndrome was more frequent in diabetic patients with DR (P = 0.02). DR was found in 140 patients (70.35%), which included 34 patients (17.1%) with mild non proliferative DR (NPDR), 34 patients (17.1%) with moderate NPDR, 22 patients (11.1%) with severe NPDR and 25 patients (25.1%) with proliferative DR (PDR). There were significant relation between age, sex and duration of diabetes and DR. Conclusion In this study the prevalence of dry eye syndrome was 54.3%. Diabetes and dry eyes appear to have a common association. Further studies need to be undertaken to establish an etiologic relationship. However, examination for dry eye should be an integral part of the assessment of diabetic eye disease. PMID:18513455

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

2008-01-01

120

Comparitive Angiographic Profile in Diabetic and Non-Diabetic Patients with Acute Coronary Syndrome  

PubMed Central

Background: Cardiac adversity is by far the commonest cause of mortality in patients with diabetes. Cardiac involvement in diabetes commonly manifest as coronary artery disease (CAD). Definitive diagnosis,precise assessment and anatomic severity of CAD requires invasive diagnostic modality like coronary angiography. Aims and Objectives: To study angiographic extents, type of vessels, number of vessels, severity involving coronary artery and its branches in patients with acute coronary syndrome(ACS).Compare the same in diabetics and non diabetics with ACS. Materials and Methods: Hundred patients with ACS,50 diabetics and 50 nondiabetics admitted in Bapuji Hospital ICCU attached to J.J.M. Medical College were selected randomly during a period of approximately one and half years formed the study group. RBS, FBS was done in all 100 pateints, HbA1c in all diabetics. All subjects with ACS were taken up for coronary angiography. Statistical Analysis: Chi-square test was used to determine any significant difference between two groups. p-value of less than 0.05 was considered significant. Results: In our study 22 (44%) out of 50 diabetic patients had triple or multi-vessel disease compared to 8 (16%) out of 50 non diabetics. Hundred patients with ACS, number of vessels involved were 199, of which 61.3% in diabetics and 38.6% in non diabetics, 23(46%) of 50 diabetic patients required CABG as treatment outcome. HbA1c levels of >8.5%, 69.2% had triple / multi vessel disease and 19 (73.1%) of 23 patients who had to undergo CABG had HbA1c levels >8.5%, 24% of diabetics were in third decade, 40% were in fourth decade as compared to 10% and 26% of non-diabetics of similar age group. Interpretation and Conclusion: This study showed that ACS in diabetic patients presented much earlier in life, the severity and extent of CAD and incidence of triple/multi vessel disease was significantly high in diabetics when compared to nondiabetics with ACS. Diabetics with high HbA1c had more number of coronary vessel involvement and the mode of treatment required in them was CABG. PMID:25386473

Mallesh, P.; Yeli, S.M.; Gadad, Veeranna M.; M., Giri Punja

2014-01-01

121

Carotid Atherosclerosis as a Surrogate Maker of Cardiovascular Disease in Diabetic Patients  

PubMed Central

Many studies have shown that carotid intima-media thickness (IMT) is associated with cardiovascular disease (CVD). Although it remains inconclusive whether assessment of carotid IMT is useful as a screening test for CVD in Japanese diabetic patients, a total of 271 patients (151 men aged 66 ± 10 (standard deviation) years and 220 women aged 71 ± 8 years) were divided into two groups based on the presence of CVD. We cross-sectionally assessed the ability of carotid IMT to identify CVD corresponding to treatment that was examined by receiver-operating characteristic (ROC) curve analyses. Among the 271 diabetic patients, 199 non-CVD and 72 CVD patients were examined. Multiple linear regression analysis using the presence of CVD as an objective variable showed that carotid IMT (? = 0.259, P < 0.001) as well as other confounding factors was a significant independent contributing factor. The ROC curve analysis showed that the best marker of CVD was carotid IMT, with an area under the ROC curve of 0.718 (95% confidence interval (CI), 0.650–0.785). The greatest sensitivity and specificity were obtained when the cut-off value of mean carotid IMT was set at 0.95?mm (sensitivity = 0.71, specificity = 0.60, and accuracy = 0.627). Our study suggests that carotid IMT may be useful for screening diabetic patients with CVD. PMID:24319597

Kawamoto, Ryuichi; Katoh, Tateaki; Kusunoki, Tomo; Ohtsuka, Nobuyuki

2013-01-01

122

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

123

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. PMID:22087355

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

2011-01-01

124

Impact of Sleep Duration on Obesity and the Glycemic Level in Patients With Type 2 Diabetes  

PubMed Central

OBJECTIVE Few studies are currently available regarding the influence of sleep duration on glycemic control in diabetic patients. The objective of the current study was to examine the relationship between sleep duration, obesity, and the glycemic level in type 2 diabetic patients. RESEARCH DESIGN AND METHODS A total of 4,870 Japanese type 2 diabetic patients aged ?20 years were divided into six groups according to their self-reported sleep duration: less than 4.5 h, 4.5–5.4 h, 5.5–6.4 h, 6.5–7.4 h, 7.5–8.4 h, and more than 8.5 h. The associations of sleep duration with obesity and the HbA1c levels were examined in a cross-sectional manner. RESULTS The HbA1c levels showed a quadratic association with sleep duration; namely, a shorter or longer sleep duration was associated with a higher level compared with a sleep duration of 6.5–7.4 h (P for quadratic trend <0.001). This association remained significant after adjusting for potential confounders, including the total energy intake and depressive symptoms. Furthermore, additional adjustments for obesity, which also showed a U-shaped relationship with sleep duration, did not attenuate the U-shaped sleep-HbA1c association. A significant interaction between sleep duration and age or the use of insulin was observed for the HbA1c levels. CONCLUSIONS Sleep duration was shown to have U-shaped associations with obesity and the HbA1c levels in type 2 diabetic patients, independent of potential confounders, and therefore may be an important modifiable factor for the clinical management of patients with type 2 diabetes. PMID:23150286

Ohkuma, Toshiaki; Fujii, Hiroki; Iwase, Masanori; Kikuchi, Yohei; Ogata, Shinako; Idewaki, Yasuhiro; Ide, Hitoshi; Doi, Yasufumi; Hirakawa, Yoichiro; Nakamura, Udai; Kitazono, Takanari

2013-01-01

125

A comparative study of Japanese multiple sclerosis patients with and without oligoclonal IgG bands.  

PubMed

The cerebrospinal fluid oligodonal IgG bands (OB) are less frequently observed in Japanese multiple sclerosis (MS) patients compared with Caucasian patients. We studied 40 consecutive Japanese MS patients to investigate the differences in the clinical and magnetic resonance imaging (MRI) features of MS between OB-positive patients and OB-negative ones. Among the 40 patients, 22 (55%) patients were OB-positive by either agarose gel electrophoresis (AGE) or isoelectric focusing (IEF), and 18 (45%) patients were OB-negative by both AGE and IEF. There were differences between the two groups only in the clincal forms of MS, but not in terms of gender, onset age, disease duration, or disease severity. In the OB-negative group, nine (50%) of the patients had the optic-spinal form of MS (OS-MS), but only one patient (4.5%) in the OB-positive group had OS-MS. Although most OB-positive patients showed brain MRI lesions typical of MS, 13 (72%) of the OB-negative patients showed no or few brain MRI lesions and the rest of the OB-negative patients showed atypical MS lesions, such as diffuse white matter lesions or large ring-enhanced lesions. Our results suggest that the majority of OB-negative Japanese MS patents show either no or few brain MRI lesions or atypical brain MRI lesions. PMID:12474983

Nakashima, I; Fujihara, K; Misu, T; Fujimori, J; Sato, S; Takase, S; Itoyama, Y

2002-12-01

126

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

127

Clinical and molecular analysis of Japanese patients with neuronal ceroid lipofuscinosis.  

PubMed

Neuronal ceroid lipofuscinosis (NCL) is one of the most common inherited neurological diseases in childhood. It occurs every 12,500 births in northern-European populations. Mental retardation, visual impairment, and seizures are common symptoms. The prevalence of NCL is variable depending upon the races or countries. Although a wealth information is available in Caucasian populations, there is little information about NCL in Asian people. Because a nationwide survey in Japanese patients with NCL has never been performed, we pursued an epidemiological survey. We identified 36 NCL patients in Japan. Patients with infantile, late infantile, juvenile, and adult type accounted for 2, 15, 15, and 4 cases, respectively. Seizures were a major initial symptom in the late infantile type. In the juvenile type, visual failure was present in 73% at onset. Recently, the juvenile NCL (Batten disease) gene has been isolated. Studies of the mutations in this gene demonstrated that a 1.02-kb deletion was the most prevalent mutation among Caucasian patients, accounting for 81% of total alleles. To determine the prevalence of this 1.02-kb deletion in Japanese patients, we performed a rapid allele-specific polymerase chain reaction test. No 1.02-kb major deletion was detected in 5 Japanese juvenile NCL cases. These data suggest that the distribution of NCL and clinical findings are similar to those of Caucasian subjects; however, prevalence of mutations in Japanese patients with NCL would be distinct from that observed in Caucasians. PMID:10191127

Oishi, K; Ida, H; Kurosawa, K; Eto, Y

1999-04-01

128

Noise-Enhanced Balance Control in Patients with Diabetes and Patients with Stroke  

E-print Network

,8 and James J. Collins, PhD1 Objective: Somatosensory function declines with diabetic neuropathy and often-standing balance control in 15 patients with diabetic neuropathy and 15 patients with stroke. Sway data of 12 reduction in each of the eight sway parameters in the subjects with diabetic neuropathy, the subjects

Collins, James J.

129

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. PMID:21134520

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

2013-01-01

130

Skin and nail mycoses in patients with diabetic foot.  

PubMed

Diabetes mellitus affects all socioeconomic and age groups and its incidence is rapidly increasing worldwide. The diabetic foot complication represents one of the most complex and serious complications in these patients. Fungal infections can also contribute to the severity of the diabetic foot. The aim of the present study was to evaluate the prevalence of foot skin and toenail mycosis in a group of 75 patients with diabetic foot complication and in a matched control group. Diabetic patients showed onychomycosis in 53.3% and foot skin mycosis in 46.7% of the cases, with a prevalence of both fungal infections significantly higher than that observed in the control group. At least one type of these fungal infections was present in 69.3% of diabetic subjects with a highly significant difference compared to control group (P<0.001). Trichophyton rubrum and Trichophyton interdigitale were the most common species responsible of both nail and skin infections. Candida spp, Fusarium spp, Aspergillus spp and other moulds. were found in about 1/3 onychomycosis. Previous toe amputation was significantly associated with both skin and nail mycosis. The present study confirms that both tinea pedis and onychomycosis have a high prevalence in subjects suffering from diabetic foot complication, and that the problem of fungal infections of the foot in diabetic subjects is still highly underestimated. Consequently, there is an important clinical rationale for careful mycological examination of diabetic foot and an adequate treatment tailored for each individual patient according to the fungal species involved. PMID:24442040

Papini, M; Cicoletti, M; Fabrizi, V; Landucci, P

2013-12-01

131

Adequacy of Oral Health Information for Patients with Diabetes  

PubMed Central

Objective We investigated the perception of dental hygienists regarding their adequacy of providing diabetics with diabetes-related oral health preventive education. Methods A one-page questionnaire printed on both sides was mailed to 2,237 licensed registered dental hygienists with a South Carolina (SC) mailing address. In addition to the dental hygienists’ background and practice characteristics, the survey queried their perception of adequacy for educating patients with diabetes on various diabetes-related oral health topics and reasons for inadequate coverage of materials. Results After two follow-up mailings, 995 completed and usable surveys were returned. About 60% of respondents reported not covering all essential materials related to oral health when educating diabetic patients. The three most common reasons were: (1) insufficient time (60.1%), (2) patient disinterest (41.2%), and (3) insufficient information on oral care and diabetes (39.7%). Respondents reporting insufficient information were less likely to adequately address the effect of periodontal disease on diabetes (P < 0.001), effect of uncontrolled diabetes on periodontal disease (P < 0.001), and dry mouth management (P = 0.03). Conclusion This study indicates that SC dental hygienists do not routinely provide patient education on diabetes-related oral health and healthy lifestyle topics. Lack of time, patient disinterest, and insufficient information were the three main reasons for respondents not covering essentials. A practical method for improving dental hygienists’ comprehensive service to patients with diabetes is to offer more continuing education on diabetes and oral health to supplement their knowledge, skills, and confidence to educate this growing population. PMID:19192104

Yuen, Hon K.; Mountford, William K.; Magruder, Kathryn M.; Bandyopadhyay, Dipankar; Hudson, Pemra L.; Summerlin, Lisa M.; Salinas, Carlos F.

2009-01-01

132

Exogenous Endophthalmitis in Diabetic Patients: A Systemic Review  

PubMed Central

Diabetes mellitus is a systemic disease that increases the risk of infections. Exogenous endophthalmitis is an inflammatory disease to which diabetic patients are more predisposed to than nondiabetic patients undergoing any intraocular intervention. This might be because of the change in the immune and inflammatory factors that intervene in wound healing and in the bacterial flora of the ocular adnexa. We conducted a literature review to assess the risk of exogenous endophthalmitis in diabetic patients undergoing cataract extraction, pars plana vitrectomy, and intravitreal injections and to check whether its treatment differ from in non-diabetics. We found that diabetic patients are more predisposed to virulent organisms and that the incidence of ophthalmic symptoms was not substantially different in diabetic versus nondiabetic patients. Regarding treatment, all patients with light perception should receive pars plana vitrectomy, while those with hand motion and better vision should be given an intravitreal antibiotics injection. Some authors recommend vitrectomy to diabetic patients with even counting figure vision. PMID:24555128

El-Mollayess, Georges M.; Saadeh, Joanna S.; Salti, Haytham I.

2012-01-01

133

Sexual dysfunctions in patients with diabetes: a study from Iran  

PubMed Central

Background Diabetes mellitus is a chronic disease that causes short and long-term complications. This study aimed to investigate the prevalence of sexual dysfunctions (SD) among diabetic patients in Iran and to examine whether glycemic control has a role in SD. Methods A consecutive sample of diabetic women and men who were registered in the Isfahan Endocrine and Metabolism Center, Iran were studied. Sexual dysfunction was evaluated using the Female Sexual Function Index (FSFI) in women and the International Index of Erectile Function (IIEF) in men. In addition the level of glycosylated hemoglobin was assessed to classify the diabetes status in patients. Results In all 200 patients (100 male and 100 female) were entered into the study. The mean age of patients was 48.6 (SD = 7.3) years and most had type 2 diabetes (91.0%). The results showed that sexual dysfunctions were widespread in both gender and 165 (82.5%) patients reported that experienced at least one sexual dysfunction. There were significant associations between sexual dysfunctions and gender and type of diabetes (P = 0.04). Women and patients with type 1 diabetes had higher rates of SD. No major differences were found between SD and age, diabetes status, duration of diabetes and hypertension. In addition, glycemic control did not show a significant association with SD in both genders. Conclusion The findings of this study showed that SD prevalence was high in diabetic patients of both genders and the glycemic control did not correlate with the frequency of SD in the study population. It is recommended that SD should be addressed more precisely in health care practice in Iran. PMID:20482781

2010-01-01

134

Infections in patients with diabetes mellitus: A review of pathogenesis  

PubMed Central

In general, infectious diseases are more frequent and/or serious in patients with diabetes mellitus, which potentially increases their morbimortality. The greater frequency of infections in diabetic patients is caused by the hyperglycemic environment that favors immune dysfunction (e.g., damage to the neutrophil function, depression of the antioxidant system, and humoral immunity), micro- and macro-angiopathies, neuropathy, decrease in the antibacterial activity of urine, gastrointestinal and urinary dysmotility, and greater number of medical interventions in these patients. The infections affect all organs and systems. Some of these problems are seen mostly in diabetic people, such as foot infections, malignant external otitis, rhinocerebral mucormycosis, and gangrenous cholecystitis. In addition to the increased morbidity, infectious processes may be the first manifestation of diabetes mellitus or the precipitating factors for complications inherent to the disease, such as diabetic ketoacidosis and hypoglycemia. Immunization with anti-pneumococcal and influenza vaccines is recommended to reduce hospitalizations, deaths, and medical expenses. PMID:22701840

Casqueiro, Juliana; Casqueiro, Janine; Alves, Cresio

2012-01-01

135

Seizures and raised intracranial pressure in Vietnamese patients with Japanese encephalitis  

Microsoft Academic Search

Summary Japanese encephalitis (JE) causes at least 10 000 deaths each year. Death is presumed to result from infection, dysfunction and destruction of neurons. There is no antiviral treatment. Seizures and raised intracranial pressure (ICP) are potentially treatable complications, but their importance in the pathophysiology of JE is unknown. Between 1994 and 1997 we prospectively studied patients with suspected CNS

Tom Solomon; Nguyen Minh Dung; Rachel Kneen; Mary Gainsborough; Ananda Nisalak; Fenella J. Kirkham; David W. Vaughn; Shelagh Smith; Nicholas J. White

2002-01-01

136

Macular microcirculation in cystoid maculopathy of diabetic patients  

Microsoft Academic Search

BACKGROUND--In patients with diabetic macular oedema and central cysts ischaemia of the retina appears to be an important contributing factor in the pathogenesis of cysts. This study was performed to further elucidate the role of the inner retinal microcirculation in diabetic cystoid macular oedema (CMO). METHODS--Video fluorescein angiography allows visualisation of the macular microvasculature and measurements of the capillary blood

O Arend; A Remky; A Harris; B Bertram; M Reim; S Wolf

1995-01-01

137

Clinical Characteristics of Diabetic Patients Transferred to Korean Referral Hospitals  

PubMed Central

Background We evaluated the disease profile and clinical management, including the status of both glycemic control and complications, in patients with diabetes who were transferred to referral hospitals in Korea. Methods Patients referred to 20 referral hospitals in Gyeongsangnam/Gyeongsangbuk-do and Jeollanam/Jeollabuk-do with at least a 1-year history of diabetes between January and June 2011 were retrospectively reviewed using medical records, laboratory tests, and questionnaires. Results A total of 654 patients were enrolled in the study. In total, 437 patients (67%) were transferred from clinics and 197 (30%) patients were transferred from hospitals. A total of 279 patients (43%) visited higher medical institutions without a written medical request. The main reason for the referral was glycemic control in 433 patients (66%). Seventy-three patients (11%) had received more than one session of diabetic education. Only 177 patients (27%) had been routinely self-monitoring blood glucose, and 146 patients (22%) were monitoring hemoglobin A1c. In addition, proper evaluations for diabetic complications were performed for 74 patients (11%). The most common complication was neuropathy (32%) followed by nephropathy (31%). In total, 538 patients (82%) had been taking oral hypoglycemic agents. A relatively large number of patients (44%) had been taking antihypertensive medications. Conclusion We investigated the clinical characteristics of diabetic patients and identified specific problems in diabetic management prior to the transfer. We also found several problems in the medical system, which were divided into three medical institutions having different roles in Korea. Our findings suggested that the relationships among medical institutions have to be improved, particularly for diabetes.

Oh, Min Young; Kim, Sang Soo; Lee, In Kyu; Baek, Hong Sun; Lee, Hyoung Woo; Chung, Min Young

2014-01-01

138

How Patients with Diabetes Perceive Their Risk for Major Complications  

Microsoft Academic Search

CONTEXT. To educate patients with diabetes about their illness and to motivate these patients to pursue intensive treatment, physicians often inform them about their risk for serious complications. However, little is known about patient perceptions of these risks. OBJECTIVE. To compare patient perceptions of risk for major complications of dia- betes with actual risk for these complications. DESIGN. Structured interviews

DAVID MELTZER; BRIAN EGLESTON

139

Two novel missense mutations in the myostatin gene identified in Japanese patients with Duchenne muscular dystrophy  

PubMed Central

Background Myostatin is a negative regulator of skeletal muscle growth. Truncating mutations in the myostatin gene have been reported to result in gross muscle hypertrophy. Duchenne muscular dystrophy (DMD), the most common lethal muscle wasting disease, is a result of an absence of muscle dystrophin. Although this disorder causes a rather uniform pattern of muscle wasting, afflicted patients display phenotypic variability. We hypothesized that genetic variation in myostatin is a modifier of the DMD phenotype. Methods We analyzed 102 Japanese DMD patients for mutations in the myostatin gene. Results Two polymorphisms that are commonly observed in Western countries, p.55A>T and p.153K>R, were not observed in these Japanese patients. An uncommon polymorphism of p.164E>K was uncovered in four cases; each patient was found to be heterozygous for this polymorphism, which had the highest frequency of the polymorphism observed in the Japanese patients. Remarkably, two patients were found to be heterozygous for one of two novel missense mutations (p.95D>H and p.156L>I). One DMD patient carrying a novel missense mutation of p.95D>H was not phenotypically different from the non-carriers. The other DMD patient was found to carry both a novel mutation (p.156L>I) and a known polymorphism (p.164E>K) in one allele, although his phenotype was not significantly modified. Any nucleotide change creating a target site for micro RNAs was not disclosed in the 3' untranslated region. Conclusion Our results indicate that heterozygous missense mutations including two novel mutations did not produce an apparent increase in muscle strength in Japanese DMD cases, even in a patient carrying two missense mutations. PMID:17428346

Nishiyama, Atsushi; Takeshima, Yasuhiro; Saiki, Kayoko; Narukage, Akiko; Oyazato, Yoshinobu; Yagi, Mariko; Matsuo, Masafumi

2007-01-01

140

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

MedlinePLUS

... Campaigns & Programs Safe to Sleep, Media-Smart Youth, Maternal/Child Health Education Program NICHD Publications Order/print ... and clinical practice to improve the health of mothers, children, and families. Managing Gestational Diabetes: A Patient's ...

141

Depression Among Patients With Type-II Diabetes Mellitus.  

PubMed

This study aimed to determine the frequency of depression among patients with type-II diabetes mellitus in Peshawar at Khyber Teaching Hospital, Peshawar, from March to September 2010. Depression was assessed by using Beck Depressive Inventory-II (BDI-II). Out of 140 patients with type-II diabetes, 85 (61%) were women and 55 (39%) were men. Mean age was 45 ± 7.45 years. Eighty four (60%) patients presented with severe depression. Depression was higher in females than males and widows. Depression was high in diabetic patients, especially in females and widows. It is of essence that psychiatric attention may be necessary to be incorporated in diabetes care both for prevention and treatment. PMID:25327926

Khan, Mohammad Akmal; Sultan, Sayed Mohammad; Nazli, Rubina; Akhtar, Tasleem; Khan, Mudasar Ahmad; Sher, Nabila; Aslam, Hina

2014-10-01

142

Prevalence of oral mucosal alterations in type 2 diabetes mellitus patients attending a diabetic center  

PubMed Central

Objective: To explore an association between oral mucosal alterations and type 2 Diabetes mellitus. Methods: This study was conducted at Baqai Institute of Diabetology and Endocrinology and Baqai Medical University from September 2010 to September 2012. A total of 800 individuals’ 395 type 2 diabetes mellitus patients and 405 healthy individuals were enrolled in this study. An oral clinical examination was carried out for all participants using a mouth mirror, visible light source and cotton gauze. Results: The prevalence of oral mucosal lesions was high significantly < 0.0001; odd ratio 2.601, CI 1.929-3.509 in type 2 diabetic as compared to non-diabetic. With respect to specific oral mucosal lesions, highly significant association p<0.0001; Odd ratio 4.275, CI 2.798-6.534 was found between coated tongue with type 2 diabetes mellitus. This study did not find any association (p>0.05) between type 2 diabetes mellitus and potentially malignant disorders. Conclusion: This study showed that the prevalence of oral mucosal lesions was higher in type 2 diabetic than non-diabetics. This study provides evidence that diabetes has a negative influence on oral health. PMID:25097503

Mohsin, Syed Fareed; Ahmed, Syed Azhar; Fawwad, Asher; Basit, Abdul

2014-01-01

143

Predictors of the progression of renal insufficiency in patients with insulin-dependent diabetes and overt diabetic nephropathy  

Microsoft Academic Search

Predictors of the progression of renal insufficiency in patients with insulin-dependent diabetes and overt diabetic nephropathy. We designed a prospective, double-blind controlled trial to determine predictors of loss of renal function in patients with insulin dependent diabetes and established nephropathy. A total of 409 insulin-dependent diabetic patients with established nephropathy enrolled in a trial on the effect of Captopril on

Julia A Breyer; Raymond P Bain; Joni K Evans; N Stanley Nahman; Edmund J Lewis; Melisa Cooper; Janet McGill; Tomas Berl

1996-01-01

144

Impulsive disorders in Japanese adult patients with obsessive-compulsive disorder  

Microsoft Academic Search

In this study, we sought to characterize obsessive-compulsive disorder (OCD) patients with impulsive features, and to determine whether they constitute a distinct subtype of OCD. Therefore we systematically assessed impulse control disorders and other impulsive conditions categorized as obsessive-compulsive spectrum disorders (OCSDs) in 153 Japanese adult patients with OCD. Forty-five subjects (29%) had concurrent impulsive disorders, and they were differentiated

Hisato Matsunaga; Nobuo Kiriike; Tokuzo Matsui; Kenzo Oya; Dan J. Stein

2005-01-01

145

HLA class II genes associated with anticentromere antibody in Japanese patients with systemic sclerosis (scleroderma)  

Microsoft Academic Search

OBJECTIVE--To define further HLA class II gene associations with anticentromere antibody (ACA), a major serum antinuclear antibody in patients with systemic sclerosis (SSc). METHODS--HLA class II genes were determined using polymerase chain reaction\\/restriction fragment length polymorphisms in 94 Japanese patients with SSc (22 ACA positive and 72 ACA negative) and 50 race matched normal control subjects. RESULTS--Frequency of DQB1*0501 was

M Kuwana; Y Okano; J Kaburaki; H Inoko

1995-01-01

146

Combined Clozapine and Electroconvulsive Therapy in a Japanese Schizophrenia Patient: A Case Report  

PubMed Central

Clozapine is well-known for successful use in schizophrenic patients treatment resistant to other antipsychotics. However, even with clozapine, 25% of schizophrenic patients are not in remission. Recently, as adjunctive treatment with clozapine, electroconvulsive therapy has been reported to be an effective and safe adjunctive treatment. We report a Japanese schizophrenic woman who was not in remission with clozapine alone but with both clozapine and electroconvulsive therapy. PMID:25191508

Ozaki, Yuki; Kawasoe, Koichiro; Ochi, Shinichiro; Niiya, Takanori; Sonobe, Naomi; Matsumoto, Teruhisa; Ueno, Shu-ichi

2014-01-01

147

Surgically induced miosis during phacoemulsification in patients with diabetes mellitus  

Microsoft Academic Search

Purpose To assess the incidence of surgically induced miosis during phacoemulsification in diabetic patients.Methods A total of 76 patients with diabetes mellitus were compared to 76 age- and race-matched controls. A combination of cyclopentolate 1%, phenylephrine 2.5% and diclofenac sodium 0.1% was applied topically 60, 45 and 30 min before surgery. Adrenaline mixed with buffered saline solution was used for

S A Mirza; A Alexandridou; T Marshall; P Stavrou

2003-01-01

148

Feasibility of diabetes peer education for Turkish type 2 diabetes patients in Dutch general practice  

Microsoft Academic Search

The feasibility of a 9-month educational diabetes programme (tailored to Turkish patients, provided by Turkish bicultural female educators) was assessed in terms of dropout rate, patient and GP satisfaction, and GP’s perceived workload. Of the 54 Turkish patients (39% males) that signed informed consent, 45 actually started the education. Dropout rate during the programme was 41% (main reason: going abroad

Paulus Uitewaal; Marc Bruijnzeels; Tine de Hoop; Arno Hoes; Siep Thomas

2004-01-01

149

Prevalence of dialysis-related amyloidosis in diabetic patients. Diabetes Amyloid Study Group.  

PubMed

It has recently been shown that beta 2-microglobulin isolated from amyloid deposits in dialysis patients is modified by advanced glycation (AGE). In this context it appeared of interest to examine in a cross-sectional multicentre study whether dialysis-related amyloidosis, as evaluated by X-ray assessment of cysts in the metacarpal bones, was different in diabetic patients on maintenance haemodialysis for more than 5 years time compared with matched non-diabetic controls. We evaluated the hand skeleton of 75 diabetic patients (9 type I, 66 type II; 35 male, 40 female; median age 64 years, range 31-86; median duration of dialysis 7 years, range 5-17). They were compared with 150 patients without diabetes mellitus who were matched for age, gender and duration of dialysis. Hand X-rays were centrally evaluated by one radiologist unaware of the underlying clinical diagnosis. The overall frequency of amyloid cysts was 9/75 (12%) in diabetic patients (95% confidence interval 4.6-19.3%) and 28/150 (19%) in matched controls (95% confidence interval 12.4-24.9%). The results indicate that diabetes mellitus does not confer an increased risk of dialysis-related amyloid cysts. The results are of interest with respect to the mechanism of amyloid formation. PMID:8918714

Lehnert, H; Jacob, C; Marzoll, I; Schmidt-Gayk, H; Stein, G; Ritz, E

1996-10-01

150

The COL4A5 gene in Japanese Alport syndrome patients: Spectrum of mutations of all exons  

Microsoft Academic Search

The COL4A5 gene in Japanese Alport syndrome patients: Spectrum of mutations of all exons. To determine the spectrum of mutations of the COL4A5 gene encoding type IV collagen among Japanese Alport syndrome (AS) patients, 60 unrelated patients (47 males and 13 females) from all over the country were recruited. Screening for mutations in all the exons (1 to 51) of

Shinichiro Kawai; Shinsuke Nomura; Teruo Harano; Keiko Harano; Tatsuo Fukushima; Gengo Osawa

1996-01-01

151

ATP binding cassette transporter retina genotypes and age related macular degeneration: an analysis on exudative non-familial Japanese patients  

Microsoft Academic Search

AIMTo determine whether mutations in the Stargardt’s disease gene, ATP binding cassette transporter retina (ABCR) affect the occurrence of age related macular degeneration (AMD) in Japanese non-familial patients.METHODS80 unrelated Japanese patients with AMD (67 males and 13 females; mean age, 67.2 years) diagnosed by indocyanine green angiography and 100 age matched control subjects were studied. Among the AMD patients, 70

Sachiko Kuroiwa; Hidenobu Kojima; Takanobu Kikuchi; Nagahisa Yoshimura

1999-01-01

152

The preliminary study of individual cognitive behavior therapy for Japanese patients with social anxiety disorder.  

PubMed

Research has demonstrated the effectiveness of both individual and group cognitive behavior therapy (CBT) programs for social anxiety disorder (SAD) with patients in many countries. The present preliminary study reports the effectiveness of individual CBT for Japanese patients with SAD. Fifteen outpatients diagnosed with SAD completed an individual CBT program of six 50-min sessions with several components, including cognitive restructuring to modify cost and probability bias, repeated speech exposure, and homework about idiosyncratic anxiety-provoking situations. The results show that SAD symptoms improved after completion of the program. Large effect sizes were found for cognitive factors of SAD. In addition, repeated speech exposure was highly effective for improving the self-perception of subjective anxiety. The present findings suggest that an individual CBT program can be effective for reducing SAD symptoms with Japanese patients. PMID:24219020

Shirotsuki, Kentaro; Kodama, Yoshio; Nomura, Shinobu

2014-05-01

153

Evaluation of the PD adequest program in Japanese patients on peritoneal dialysis.  

PubMed

To perform adequate peritoneal dialysis, it is necessary to individualize the dialysis regimen. PD Adequest is a software program based on the three-pore model that can be used to predict solute clearance and ultrafiltration volume during peritoneal dialysis. We evaluated the ability of this program to predict the solute clearance and ultrafiltration volume in Japanese patients on peritoneal dialysis. The weekly creatinine clearance and weekly urea Kt/V were determined in 45 patients. The PD Adequest was used to simulate their current dialysis regimens and the predicted values of these parameters were calculated. Strong positive correlations were obtained between the actual and predicted weekly creatinine clearance (r = 0.993) and weekly urea Kt/V (r = 0.991). In conclusion, this program is potentially useful for designing peritoneal dialysis regimens in Japanese patients, even though they have a smaller body mass than Canadians and Americans for whom it was designed. PMID:10532428

Katsutani, M; Yorioka, N; Ito, T; Naito, T; Kanahara, K; Oda, H; Yamakido, M

1999-09-01

154

Detection of Early Diabetic Change with Optical Coherence Tomography in Type 2 Diabetes Mellitus Patients without Retinopathy  

Microsoft Academic Search

Purpose: To detect early diabetic damage in type 2 diabetes mellitus patients with no diabetic retinopathy (NDR) using optical coherence tomography (OCT) and to evaluate OCT as a clinical test. Methods: Thirty-two patients with NDR (n = 32) were enrolled. We examined retinal and retinal nerve fiber layer (RNFL) thickness using OCT. Two healthy normal populations were also enrolled for

Masahiko Sugimoto; Mikio Sasoh; Masashi Ido; Yoshikatsu Wakitani; Chisato Takahashi; Yukitaka Uji

2005-01-01

155

Technological intervention for obese patients with type 2 diabetes  

Microsoft Academic Search

This study applied a 6-month educational intervention that used the technology of the short message service (via cellular phones) and the Internet for obese patients with type 2 diabetes. Eighteen patients were randomly assigned to an intervention group and 16 were assigned to a control group (N = 34). Patients in the intervention group were asked to access a web

Hee-Seung Kim; Min-Sun Song

2008-01-01

156

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. PMID:20947632

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

2010-01-01

157

Estimation of Salivary Amylase in Diabetic Patients and Saliva as a Diagnostic Tool in Early Diabetic Patients  

PubMed Central

Aim: The aim of this study was to estimate the salivary amylase levels in non-insulin dependent diabetes mellitus patients and to correlate these findings with those in normal individuals, in order to provide salivary amylase level as a bio-chemical indicator for diagnosing and monitoring the glucose levels. Material and Methods: The study samples consisted of 60 individuals. Both males and females participated in the study. Thirty non-insulin dependent diabetes mellitus patients of age group of 30 to 60 years and healthy individuals of same number and age group were included in this study. The data obtained in this study were statistically analyzed by using Student’s t–test. Results: In estimation of salivary amylase levels, the comparison of mean and standard deviation showed the highest mean score (2739.48 +1525.20) among the diabetic patients and lowest mean score (1740.38 + 638.51) among the non-diabetic patients. The p-value obtained was less than 0.01. Hence, a highly significant difference in the mean scores regarding salivary amylase (u/l) was found among the two groups. Conclusion: The mean scores of age, fasting blood sugar, post prandial blood sugar, HbA1c and salivary amylase levels were greater in diabetic patients than in non-diabetic patients. PMID:24392426

Malathi, L.; Masthan, K.M.K.; Balachander, N.; Babu, N. Aravindha; Rajesh, E.

2013-01-01

158

Relationship between erectile dysfunction and silent myocardial ischemia in apparently uncomplicated type 2 diabetic patients  

Microsoft Academic Search

Background—Erectile dysfunction (ED) is associated with coronary artery disease (CAD). In diabetic patients, CAD is often silent. Among diabetic patients with silent CAD, the prevalence of ED has never been evaluated. We investigated whether ED is associated with asymptomatic CAD in type 2 diabetic patients. Methods and Results—We evaluated the prevalence of ED in 133 uncomplicated diabetic men with angiographically

Carmine Gazzaruso; Stefano Giordanetti; Emanuela De Amici

2004-01-01

159

Novel and emerging diabetes mellitus drug therapies for the type 2 diabetes patient.  

PubMed

Type 2 diabetes mellitus is a metabolic disorder of deranged fat, protein and carbohydrate metabolism resulting in hyperglycemia as a result of insulin resistance and inadequate insulin secretion. Although a wide variety of diabetes therapies is available, yet limited efficacy, adverse effects, cost, contraindications, renal dosage adjustments, inflexible dosing schedules and weight gain significantly limit their use. In addition, many patients in the United States fail to meet the therapeutic HbA1c goal of < 7% set by the American Diabetes Association. As such new and emerging diabetes therapies with different mechanisms of action hope to address some of these drawbacks to improve the patient with type 2 diabetes. This article reviews new and emerging classes, including the sodium-glucose cotransporter-2 inhibitors, 11?-Hydroxysteroid dehydrogenase type 1 inhibitors, glycogen phosphorylase inhibitors; protein tyrosine phosphatase 1B inhibitors, G Protein-Coupled receptor agonists and glucokinase activators. These emerging diabetes agents hold the promise of providing benefit of glucose lowering, weight reduction, low hypoglycemia risk, improve insulin sensitivity, pancreatic ? cell preservation, and oral formulation availability. However, further studies are needed to evaluate their safety profile, cardiovascular effects, and efficacy durability in order to determine their role in type 2 diabetes management. PMID:24936252

Rochester, Charmaine D; Akiyode, Oluwaranti

2014-06-15

160

Patient Web Portals to Improve Diabetes Outcomes: A Systematic Review  

Microsoft Academic Search

Patient web portals (PWPs), defined as the integration of electronic medical records and patient health records, have been\\u000a related to enhanced patient outcomes. A literature review was conducted to characterize the design and evaluation of PWPs\\u000a to improve health care processes and outcomes in diabetes. A summary of 26 articles revealed the positive impact PWPs have\\u000a on patient outcomes, patient-provider

Chandra Y. Osborn; Lindsay Satterwhite Mayberry; Shelagh A. Mulvaney; Rachel Hess

2010-01-01

161

Clinical analyses of 379 Japanese and 2 non-Japanese patients with venous or arterial vascular diseases: combined B cell anomalies, gastric cancer, and aggravated ectopic splenosis  

Microsoft Academic Search

To investigate the increased expression of activation-induced cytidine deaminase (AID) in vascular diseases, 379 Japanese\\u000a and 2 non-Japanese composed of 87 varix, 81 arteriosclerosis obliterans (ASO), 206 aortic aneurysm (AA), and 7 venous thrombosis\\u000a (VT) patients, whose ages were ranged from 60.7 ± 13.3 to 74.5 ± 8.8 years old, were analyzed clinically. Their coagulation\\u000a anomalies were described well using their levels of thrombin antithrombin

Tadako Nakatsuji

162

Low-dose aspirin-associated upper gastric and duodenal ulcers in Japanese patients with no previous history of peptic ulcers  

PubMed Central

Background Long-term administration of low-dose aspirin (LDA) is associated with a greater risk of adverse events, including gastroduodenal ulcers. The purpose of this study was to identify the risk factors for and assess the role of medication use in the development of peptic ulcer disease in Japanese patients with no history of peptic ulcers. Methods Consecutive outpatients receiving LDA (75 mg/day) who underwent esophagogastroduodenoscopy between January and December 2010 were enrolled. Clinical parameters, peptic ulcer history, concomitant drugs, the presence of Helicobacter pylori infection, reason for endoscopy, and endoscopic findings were analysed. Results Of 226 total patients, 14 (6.2%) were endoscopically diagnosed with peptic ulcer. Age, sex, current smoking status, current alcohol consumption, endoscopic gastric mucosal atrophy, and abdominal symptoms were not significantly associated with peptic ulcers. Diabetes mellitus was more frequent (42.9% vs. 16.5%; P?=?0.024) in patients with peptic ulcers than in those without peptic ulcers. Using multiple logistic regression analysis, co-treatment with anticoagulants or proton pump inhibitors (PPIs) was significantly associated with increased and decreased risk for peptic ulcer, respectively (odds ratio [OR], 5.88; 95% confidence interval [CI], 1.19???28.99; P?=?0.03 and OR, 0.13; 95% CI, 0.02???0.73; P?=?0.02, respectively). Co-treatment with additional antiplatelet agents, H2-receptor antagonists, angiotensin II Type 1 receptor blockers, angiotensin-converting enzyme inhibitor, 3-hydroxy-3-methylglutaryl-CoA reductase inhibitor, or nonsteroidal anti-inflammatory drugs was not associated with peptic ulcer development. Conclusion The use of PPIs reduces the risk of developing gastric or duodenal ulcers in Japanese patients taking LDA without pre-existing gastroduodenal ulcers. However, this risk is significantly increased in both patients ingesting anticoagulants and patients with diabetes. These results may help identify patients who require intensive prophylaxis against aspirin-induced peptic ulcers. PMID:24215903

2013-01-01

163

Retinal Blood Flow Changes in Patients With Insulin Dependent Diabetes Mellitus and No Diabetic Retinopathy A Video Fluorescein Angiography Study  

Microsoft Academic Search

Purpose. The authors investigated retinal blood flow changes in patients with insulin-depen- dent diabetes mellitus (IDDM) and no diabetic retinopathy compared to age-matched subjects without diabetes. They also investigated whether blood glucose levels could modulate retinal blood flow in these patients with diabetes and whether this modulation would impact retinal blood flow data used in cross-sectional studies assessing changes in

Sven-Erik Bursell; Allen C. Clermont; Brendan T. Kinsley; Donald C. Simonson; Lloyd M. Aiello; Howard A. Wolpertf

164

Attenuated Purinergic Receptor Function in Patients With Type 2 Diabetes  

PubMed Central

OBJECTIVE Extracellular nucleotides and nucleosides are involved in regulation of skeletal muscle blood flow. Diabetes induces cardiovascular dysregulation, but the extent to which the vasodilatatory capacity of nucleotides and nucleosides is affected in type 2 diabetes is unknown. The present study investigated 1) the vasodilatatory effect of ATP, uridine-triphosphate (UTP), and adenosine (ADO) and 2) the expression and distribution of P2Y2 and P2X1 receptors in skeletal muscles of diabetic subjects. RESEARCH DESIGN AND METHODS In 10 diabetic patients and 10 age-matched control subjects, leg blood flow (LBF) was measured during intrafemoral artery infusion of ATP, UTP, and ADO, eliciting a blood flow equal to knee-extensor exercise at 12 W (?2.6 l/min). RESULTS The vasodilatatory effect of the purinergic system was 50% lower in the diabetic group as exemplified by an LBF increase of 274 ± 37 vs. 143 ± 26 ml/?mol ATP × kg, 494 ± 80 vs. 234 ± 39 ml/?mol UTP × kg, and 14.9 ± 2.7 vs. 7.5 ± 0.6 ml/?mol ADO × kg in control and diabetic subjects, respectively, thus making the vasodilator potency as follows: UTP control subjects (100) > ATP control subjects (55) > UTP diabetic subjects (47) > ATP diabetic subjects (29) > ADO control subjects (3) > ADO diabetic subjects (1.5). The distribution and mRNA expression of receptors were similar in the two groups. CONCLUSIONS The vasodilatatory effect of the purinergic system is severely reduced in type 2 diabetic patients. The potency of nucleotides varies with the following rank order: UTP > ATP > ADO. This is not due to alterations in receptor distribution and mRNA expression, but may be due to differences in receptor sensitivity. PMID:19808895

Thaning, Pia; Bune, Laurids T.; Hellsten, Ylva; Pilegaard, Henriette; Saltin, Bengt; Rosenmeier, Jaya B.

2010-01-01

165

Pulse Pressure and Mortality from Cerebrovascular Diseases in Type 2 Diabetic Patients: The Verona Diabetes Study  

Microsoft Academic Search

Background\\/Objective: Previous studies conducted both in the general and diabetic population have shown that pulse pressure (PP) can predict mortality from cardiovascular diseases. The aim of the present study was to investigate the relationship between PP and specific cardiovascular mortality, i.e. from cerebrovascular and ischemic heart diseases, in a well-characterized cohort of type 2 diabetic patients. Methods: A cohort of

Giacomo Zoppini; Giuseppe Verlato; Cristina Zamboni; Cristina Venturi; Nicola Gennaro; Valeria Biasi; Enzo Bonora; Michele Muggeo

2007-01-01

166

Micronuclei in diabetes: folate supplementation diminishes micronuclei in diabetic patients but not in an animal model.  

PubMed

Diabetes mellitus (DM) is associated with a high risk of health complications, mainly due to excessive free radical (FRs) production that could result in an increased frequency of micronuclei. The consumption of antioxidants, like folic acid (FA), may mitigate the effects of the FRs. In the present study, micronucleated polychromatic erythrocyte (MNPCE) frequencies were determined in blood sampled weekly from the tails of pregnant female Wistar rats and pregnant Wistar rats with experimental diabetes that were given unsupplemented diets and diets supplemented with FA. At birth, the pups were sampled to analyze micronucleated erythrocyte (MNE) and MNPCE frequencies. Moreover micronucleated cells (MNCs) were evaluated in buccal mucosa samples taken from 81 healthy adult subjects, 48 patients with DM, and 30 DM patients who were sampled before and after FA treatment. Increases in MNPCE frequencies were significant only at the first sampling (P<0.01 and P<0.03) in pregnant rats with experimental diabetes. In addition, the pups from the diabetic group and from diabetic group treated with FA had higher frequencies of MNEs (P<0.03 and P<0.001, respectively) and MNPCEs (P<0.009 and P<0.05, respectively) than the controls. No differences were found in diabetic rats and newborn rats born to diabetic mothers treated with FA compared with untreated animals. Patients with DM had a higher frequency of MNCs compared with healthy subjects (P<0.001). Also FA reduced the frequency of MNCs in DM patients (P<0.001). The results of this study indicate that diabetes results in elevated frequencies of micronuclei, and that, at least in humans, FA can protect against the elevation. PMID:17669682

Zúñiga-González, Guillermo M; Batista-González, Cecilia M; Gómez-Meda, Belinda C; Ramos-Ibarra, María L; Zamora-Perez, Ana L; Muñoz-Magallanes, Tereza; Ramos-Valdés, Carmen; Gallegos-Arreola, Martha P

2007-12-01

167

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

168

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

169

Plasma 25-Hydroxyvitamin D and Progression to Diabetes in Patients at Risk for Diabetes  

PubMed Central

OBJECTIVE To investigate the association between vitamin D status, assessed by plasma 25-hydroxyvitamin D, and risk of incident diabetes. RESEARCH DESIGN AND METHODS Prospective observational study with a mean follow-up of 2.7 years in the Diabetes Prevention Program (DPP), a multicenter trial comparing different strategies for prevention of diabetes in patients with prediabetes. We assessed the association between plasma 25-hydroxyvitamin D, measured repeatedly during follow-up, and incident diabetes in the combined placebo (n = 1,022) and intensive lifestyle (n = 1,017) randomized arms of the DPP. Variables measured at multiple study time points (25-hydroxyvitamin D, BMI, and physical activity) entered the analyses as time-varying “lagged” covariates, as the mean of the previous and current visits at which diabetes status was assessed. RESULTS After multivariate adjustment, including for the DPP intervention, participants in the highest tertile of 25-hydroxyvitamin D (median concentration, 30.1 ng/mL) had a hazard ratio of 0.72 (95% CI 0.56–0.90) for developing diabetes compared with participants in the lowest tertile (median concentration, 12.8 ng/mL). The association was in the same direction in placebo (0.70; 0.52–0.94) versus lifestyle arm (0.80; 0.54–1.17). CONCLUSIONS Higher plasma 25-hydroxyvitamin D, assessed repeatedly, was associated with lower risk of incident diabetes in high-risk patients, after adjusting for lifestyle interventions (dietary changes, increased physical activity, and weight loss) known to decrease diabetes risk. Because of the observational nature of the study, the potential association between vitamin D and diabetes needs to be confirmed in intervention studies. PMID:22323410

Pittas, Anastassios G.; Nelson, Jason; Mitri, Joanna; Hillmann, William; Garganta, Cheryl; Nathan, David M.; Hu, Frank B.; Dawson-Hughes, Bess

2012-01-01

170

Cognitive profile of patients with burning mouth syndrome in the Japanese population  

Microsoft Academic Search

The present study investigated which cognitive characteristics, including cancer phobia, self-efficacy, pain-related catastrophizing,\\u000a and anxiety sensitivity, affect burning mouth syndrome (BMS) symptoms in the Japanese population. A total of 46 BMS patients\\u000a (44 women and 2 men; mean age, 59.98 ± 9.57 years; range, 30–79 years) completed a battery of questionnaires, including measures\\u000a of pain severity, oral-related quality of life

Hirofumi Matsuoka; Mika Himachi; Hirokazu Furukawa; Shiho Kobayashi; Harumi Shoki; Ryo Motoya; Masato Saito; Yoshihiro Abiko; Yuji Sakano

2010-01-01

171

Novel mutations of EVER1\\/TMC6 gene in a Japanese patient with epidermodysplasia verruciformis  

Microsoft Academic Search

Germline mutations of the EVER1\\/TMC6 gene are associated with epidermodysplasia verruciformis (EV), which is characterized by an abnormal susceptibility to human papillomaviruses that were considered to be innocuous for the general population. In this study, we have employed polymerase chain reaction and DNA sequencing analysis to characterize the EVER1 gene in a 65-year-old Japanese EV patient. Direct sequence analyses resulted

Genshu Tate; Takao Suzuki; Koji Kishimoto; Toshiyuki Mitsuya

2004-01-01

172

Mutational analysis of TSC1 and TSC2 genes in Japanese patients with tuberous sclerosis complex  

Microsoft Academic Search

We have surveyed the mutations of TSC1 and TSC2 from 38 (25 sporadic, 11 familial, and 2 unknown) Japanese patients with tuberous sclerosis complex. In 23 of 38 subjects,\\u000a we detected 18 new mutations in addition to 4 mutations that had been previously reported. We also found 3 new polymorphisms.\\u000a The mutations were not clustered on a particular exon in

Haidi Zhang; Eiji Nanba; Toshiyuki Yamamoto; Haruaki Ninomiya; Kousaku Ohno; Masashi Mizuguchi; Kenzo Takeshita

1999-01-01

173

Platelet vasopressin receptors in patients with congenital nephrogenic diabetes insipidus  

Microsoft Academic Search

Platelet vasopressin receptors in patients with congenital nephrogenic diabetes insipidus. Arginine-vasopressin(AVP), interacts with at least two types of receptors: V1 receptors which mediate the aggregating effects of AVP on human blood platelets and other AVP actions on vascular smooth muscle and hepatocytes; and V2 receptors which mediate the antidiuretic effects on renal tubules. Congenital nephrogenic diabetes insipidus (CNDI) is a

Daniel G Bichet; Marie-Françoise Arthus; Michèle Lonergan

1991-01-01

174

HDLC and the diabetic patient: Target for therapeutic intervention?  

Microsoft Academic Search

A low level of high-density lipoprotein cholesterol (HDL-C) is a key feature of the metabolic syndrome and type 2 diabetes. HDL particles exert an anti-atherogenic effect, and low HDL-C levels are associated with increased cardiovascular disease risk. The profile of lipoprotein sub-classes may also be abnormal in patients with the metabolic syndrome or type 2 diabetes, with an excess of

Robert S. Rosenson

2005-01-01

175

Early prediction of blonanserin response in Japanese patients with schizophrenia  

PubMed Central

Background Blonanserin is a second-generation antipsychotic used for the treatment of schizophrenia in Japan and Korea. The present study aimed to examine early prediction of blonanserin in patients with schizophrenia. Methods An 8-week, prospective, single-arm, flexible-dose clinical trial of blonanserin in patients with schizophrenia was conducted under real-world conditions. The inclusion criteria were antipsychotic naïve, and first-episode schizophrenia patients or schizophrenia patients with no consumption of any antipsychotic medication for more than 4 weeks before enrollment in this study. The positive predictive value, negative predictive value, sensitivity, specificity, and predictive power were calculated for the response status at week 4 to predict the subsequent response at week 8. Results Thirty-seven patients were recruited (56.8% of them had first-episode schizophrenia), and 28 (75.7%) completed the trial. At week 8, blonanserin was associated with a significant improvement in the Positive and Negative Syndrome Scale (PANSS) total score (P<0.0001) and in positive (P<0.0001), negative (P<0.0001), and general subscale scores (P<0.0001). In terms of percentage improvement of PANSS total scores from baseline to week 8, 64.9% of patients showed a ?20% reduction in the PANSS total score and 48.6% showed a ?30% reduction. However, 8.1% of patients experienced at least one adverse event. Using the 20% reduction in the PANSS total score at week 4 as a definition of an early response, the negative predictive values for later responses (ie, reductions of ?30 and ?40 in the PANSS total scores) were 88.9% and 94.1%, respectively. The specificities were 80.0% and 51.6%, respectively. Conclusion Our results suggest that the blonanserin response at week 4 could predict the later response at week 8.

Kishi, Taro; Matsuda, Yuki; Fujita, Kiyoshi; Iwata, Nakao

2014-01-01

176

Efficacy and safety of intravenous daptomycin in Japanese patients with skin and soft tissue infections.  

PubMed

Daptomycin is a lipopeptide antibiotic active against gram-positive organisms and recently approved for marketing in Japan. This study investigates the efficacy and safety of daptomycin in Japanese patients with skin and soft tissue infections (SSTIs) caused by methicillin-resistant Staphylococcus aureus (MRSA) for regulatory filing in Japan. Overall, 111 Japanese patients with SSTI were randomized in this open-label, randomized, active-comparator controlled, parallel-group, multicenter, phase III study. Patients received intravenous daptomycin 4 mg/kg once daily or vancomycin 1 g twice daily for 7-14 days. Efficacy was determined by a blinded Efficacy Adjudication Committee. Among patients with SSTIs caused by MRSA, 81.8 % (95 % CI, 69.1-90.9) of daptomycin recipients and 84.2 % (95 % CI, 60.4-96.6) of vancomycin recipients achieved a successful clinical response at the test-of-cure (TOC) visit. The microbiological success rate against MRSA at the TOC visit was 56.4 % (95 % CI, 42.3-69.7) with daptomycin and 47.4 % (95 % CI, 24.4-71.1) with vancomycin. Daptomycin was generally well tolerated; most adverse events were of mild to moderate severity. The measurement of daptomycin concentration in plasma revealed that patients with mild or moderate impaired renal function showed similar pharmacokinetics profiles to patients with normal renal function. Clinical and microbiological responses, stratified by baseline MRSA susceptibility, suggested that patients infected with MRSA of higher daptomycin MIC showed a trend of lower clinical success with a P value of 0.052 by Cochran-Armitage test. Daptomycin was clinically and microbiologically effective for the treatment of MRSA-associated SSTIs in Japanese patients. PMID:23085743

Aikawa, Naoki; Kusachi, Shinya; Mikamo, Hiroshige; Takesue, Yoshio; Watanabe, Shinichi; Tanaka, Yoshiyuki; Morita, Akiko; Tsumori, Keiko; Kato, Yoshiaki; Yoshinari, Tomoko

2013-06-01

177

Perceptions of Japanese patients and their family about medical treatment decisions.  

PubMed

Internationally, nurses and physicians are increasingly expected to undertake roles in communication and patient advocacy, including in Japan, where the reigning principle underlying medical ethics is in transition from paternalism to respect for patient autonomy. The study reports the results of a survey in two Japanese teaching hospitals that clarified the perspectives of 128 patients and 41 family members regarding their current and desired involvement in health decision-making. The commonest process that was desired by patients and their family was for patients to make decisions after consultation with both the physician and their family. The decision-making preferences for competent patients varied among the participants, who believed that families have a crucial role to play in health-care decision-making, even when patients are competent to make their own decisions. The findings will inform health professionals about contemporary Japanese health-care decision-making and the ethical issues involved in this process, as well as assist the future development of a culturally relevant model to support patients' preferences for ethical decision-making. PMID:20727082

Ito, Misae; Tanida, Noritoshi; Turale, Sue

2010-09-01

178

Diabetic patients: their knowledge and perception of oral health  

PubMed Central

Objectives The objectives of the study were to: (1) assess the knowledge and awareness of diabetic patients of their risk for systemic and oral diseases as complications associated with diabetes, (2) to assess their attitudes toward sustaining good oral health through proper oral hygiene and regular dental check-ups, and (3) to the extent that they are aware, to determine how they became aware. Methods Two hundred self-administered questionnaires were distributed to assess the main objectives of the study. Only completed questionnaires were used in the current study data analysis. Results A majority of the participants had Type 2 diabetes (58%). The awareness of diabetic patients of their increased risk for oral diseases is low compared to their awareness of systemic diseases. Their attitude toward maintaining good oral health was also not to desired standard. Of the participants, 50% brushed their teeth once daily and 66% never used dental floss. Regarding participants’ sources of awareness, 37% learned from dentists and 45% through other media sources. Conclusions Diabetic patients are found to have little knowledge of their increased risk for oral diseases. In order to promote proper oral health and to reduce the risk of oral diseases, health professionals in both the dental and medical fields need to take the responsibility to develop programs to educate the public about the oral manifestations of diabetes and its complications on oral health. PMID:21562635

Eldarrat, Aziza H.

2011-01-01

179

Association between Related Purine Metabolites and Diabetic Retinopathy in Type 2 Diabetic Patients  

PubMed Central

Aims. The purpose of the study was to investigate the differences of adenosine, adenine, inosine, xanthine, hypoxanthine, and uric acid concentrations in patients with type 2 diabetes mellitus and diabetic retinopathy and assess the relationship between purine metabolites and disease. Materials and Methods. The study group consisted of 114 subjects which were divided into three groups: control (n = 40), type 2 diabetes without retinopathy (n = 35), and type 2 diabetes with retinopathy (n = 39). Levels of metabolites were measured in plasma of all participants. Results. There is a significant increase of levels of adenosine (0.94 ± 0.17?mg/L versus 0.17 ± 0.01?mg/L, P < 0.001), inosine (0.297 ± 0.078?mg/L versus 0.086 ± 0.010?mg/L, P < 0.001), xanthine (1.01 ± 0.21?mg/L versus 0.54 ± 0.05?mg/L, P = 0.009), and uric acid (70.55 ± 3.97?mg/L versus 53.81 ± 2.36?mg/L, P < 0.001) with diabetic retinopathy compared to diabetes mellitus. The levels of adenine, hypoxanthine, and xanthine oxidase did not change. Uric acid, xanthine, inosine, and adenosine correlated positively with systolic blood pressure and urea nitrogen. Conclusions. The levels of adenosine, inosine, uric acid, and xanthine may be useful for monitoring the progression of diabetic retinopathy and evaluating the treatment. PMID:24688543

Xia, Jianfei; Wang, Zonghua; Zhang, Feifei

2014-01-01

180

The role of met-enkephalin in silent myocardial ischemia in diabetic patients.  

PubMed

Met-enkephalin plasma levels were evaluated in 20 cardioischemic diabetic patients. All the patients had ECG ischemic signs. Ten patients with diabetic autonomic neuropathy, experienced no pain during myocarial ischemia. Met-enkephalin levels in the diabetic patients with silent myiocardial ischemia were significantly lower compared to those in the symptomatic patients. This demonstrates that the absence of myocardial ischemic pain in neuropathic diabetic patients is not accounted for by met-enkephalin action. PMID:11958273

Parlapiano, C; Borgia, M C; Tonnarini, G; Campana, E; Giancaspro, G; Pantone, P; Giovanniello, T; Cardarelli, G; Vincentelli, G M; Alegiani, F; Negri, M

2001-01-01

181

Glycemic control and diabetes management in hospitalized patients in Brazil  

PubMed Central

Background The importance of tight blood glucose control among outpatients with diabetes mellitus is well established, however, the management of diabetes in the hospital setting is generally considered secondary in importance. This study sought to assess glycemic control and diabetes management in adult patients admitted to hospitals in Brazil. Methods A cross-sectional and nationwide survey was conducted from July 2010 to January 2012. Eligible cases were 18 years of age or older, had a diagnosis of diabetes and a hospitalization length of stay ?72 hours. Socio-demographic information, hospitalization details, and data on diabetes diagnosis, management and treatment were collected for all patients by chart review. Information on all blood glucose (BG) readings for a maximum of 20 consecutive days of hospitalization was recorded for each patient. Results Overall, 2,399 patients were surveyed in 24 hospitals located in 13 cities from all five Brazilian regions. The prevalence of patients presenting hyperglycemic (BG >180 mg/dL) or hypoglycemic (BG <70 mg/dL) events was 89.4% and 30.9% in patients in general wards, and 88.2% and 27.7% in those in Intensive Care Units (ICUs), respectively. In addition, a BG measure >180 mg/dL was recorded in two-thirds of the patient-days. A high proportion of patients were treated with sliding-scale insulin regimen alone in the general wards (52.0%) and in the ICUs (69.2%), and only 35.7% and 3.9% received appropriate insulin therapy in general wards (basal + bolus insulin) and in ICUs (continuous IV insulin), respectively. Conclusions Inpatient glycemic control and diabetes management needs improvement. Opportunities to improve care in Brazilian hospitals include expanded use of intravenous insulin and subcutaneous basal-bolus insulin protocols, avoiding use of sliding-scale insulin alone, increased frequency of blood glucose monitoring, and institution wide quality improvement efforts targeting both physician and nursing behavior. PMID:24499564

2013-01-01

182

Dietary Treatment Options for Depression among Diabetic Patient, Focusing on Macronutrients  

PubMed Central

There is a bidirectional adverse association between diabetes and depression. The odds for experiencing depressive symptoms in diabetic patients are two times more than nondiabetic persons, and depression is an independent predictor for the onset of diabetes. However, depression has been approximately unrecognized and untreated in two-thirds of diabetic patients, which may lead to worsened diabetes complications. A cornerstone strategy for managing depression among diabetic patients is the use of diet to improve both health problems. Because of similar pathophysiology for chronic diseases and depression, it seems that similar dietary recommendations could be useful. However, few studies have been conducted among diabetic patients. Regarding the complications of diabetes such as renal diseases and coronary heart diseases, the proper range of various macronutrients should be clarified in depressed diabetic patients as well as the proper type of each macronutrient. In this paper, we reviewed the available data on the treatment of depression in diabetic patients. PMID:24199205

Azadbakht, Leila

2013-01-01

183

Effect of Japanese radish (Raphanus sativus) sprout (Kaiware-daikon) on carbohydrate and lipid metabolisms in normal and streptozotocin-induced diabetic rats.  

PubMed

No information is available about the effects of Japanese radish sprout (JRS) on diabetes. To clarify the effects, the influence of JRS on carbohydrate and lipid metabolisms was investigated in normal and streptozotocin-induced diabetic rats. The rats were fed a diet containing 0%, 2.5% or 5% of JRS ad libitum for 21 days. Compared with the corresponding control groups, the JRS-fed normal rats showed lower plasma levels of total cholesterol (TC), triglycerides (TG), phospholipids (PL), fructosamine, glucose and insulin and higher plasma levels of low-density lipoprotein-cholesterol, whereas the JRS-fed diabetic rats showed lower plasma levels of fructosamine, glucose and insulin without changes in the plasma lipid parameters. JRS also decreased the hepatic TC, TG and PL levels in the normal rats and the TG level in the diabetic rats. These results showed that JRS had a hypoglycemic activity in both the normal and diabetic rats and partly improved lipid metabolism in the normal rats. JRS has the potential to alleviate hyperglycemia in cases where diabetes is present and to serve in the primary prevention of diabetes mellitus. PMID:16557609

Taniguchi, Hironobu; Kobayashi-Hattori, Kazuo; Tenmyo, Chie; Kamei, Tomoko; Uda, Yasushi; Sugita-Konishi, Yoshiko; Oishi, Yuichi; Takita, Toshichika

2006-04-01

184

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. PMID:22970386

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

2012-01-01

185

Rates of Complications and Mortality in Older Diabetes Patients: The Diabetes and Aging Study  

PubMed Central

Importance In the coming decades, the population of older adults with diabetes is expected to grow substantially. Understanding the clinical course of diabetes in this population is critical for establishing evidence-based clinical practice recommendations, research priorities, allocating resources, and setting health policies. Objective Contrast rates of diabetes complications and mortality across age and diabetes duration categories. Design, Setting, Participants This cohort study (2004–2010) included 72,310 older (?60 years of age) patients with type 2 diabetes enrolled in a large, integrated healthcare delivery system. Incidence densities (events per 1000 person-years (pys)) were calculated for each age category (60s, 70s, 80+ years) and duration of diabetes (shorter: 0–9 years vs. longer: 10+ years). Main Outcome Measures Incident acute hyperglycemic events, acute hypoglycemic events (hypoglycemia), microvascular complications [end-stage renal disease (ESRD), peripheral vascular disease, lower extremity amputation, advanced eye disease], cardiovascular complications [coronary artery disease (CAD), cerebrovascular disease (CVD), congestive heart failure (CHF)], and all-cause mortality. Results Among older adults with diabetes of short duration, cardiovascular complications followed by hypoglycemia were the most common non-fatal complications. For example, among 70–79 year olds with short duration of diabetes, CAD and hypoglycemia rates were higher (11.5 and 5.0/1000 pys respectively), compared to ESRD (2.6/1000), amputation (1.3/1000), and acute hyperglycemic events (0.8/1000). We observed a similar pattern among subjects in the same age group with long diabetes duration where CAD and hypoglycemia had some of the highest incidence rates (19.0 and 15.9 /1000 pys respectively), compared to ESRD (7.6/1000), amputation (4.3/1000), and acute hyperglycemic events (1.8/1000). For a given age group, rates of each outcome, particularly hypoglycemia and microvascular complications, increased dramatically with longer duration. However, for a given duration of diabetes, rates of hypoglycemia, cardiovascular complications, and mortality increased steeply with advancing age, while rates of microvascular complications remained stable or declined. Conclusion Duration of diabetes and advancing age independently predict diabetes morbidity and mortality rates. As long-term survivorship with diabetes increases and as the population ages, more research and public health efforts to reduce hypoglycemia will be needed, to complement ongoing efforts to reduce cardiovascular and microvascular complications. PMID:24322595

Huang, Elbert S.; Laiteerapong, Neda; Liu, Jennifer Y.; John, Priya M.; Moffet, Howard H.; Karter, Andrew J.

2014-01-01

186

Asymmetric dimethylarginine (ADMA) in the aqueous humor of diabetic patients.  

PubMed

Asymmetric dimethylarginine (ADMA) is an endogenous NO synthase (NOS) inhibitor whose production is enhanced by oxidative stress. Recent studies have shown that ADMA may also directly stimulate the production of reactive oxygen species (ROS) by up-regulation of the renin-angiotensin system independently of NOS inhibition. In this study, to investigate the clinical association of ADMA with diabetic retinopathy, we evaluated the levels of ADMA and NO oxides (NO2- and NO3-) in serum and aqueous humor obtained during cataract surgery from non-diabetic subjects (n = 21) and diabetic patients (n = 17). We found that the ADMA existed in aqueous humor and its level was similar to that in serum. The ADMA levels in both serum and aqueous humor were higher in diabetic patients, especially those with severe retinopathy, than in the non-diabetic group (serum ADMA: 0.67 +/- 0.26 vs. 0.53 +/- 0.08 micromol/l, p<0.05; aqueous humor ADMA: 0.55 +/- 0.20 vs. 0.32 +/- 0.16 micromol/l, p<0.05). Also, the aqueous humor level of ADMA, but not the serum level, was correlated with HbA1c on analysis of all the patients (R = 0.33, p<0.05 by simple regression analysis). However, a correlation between the ADMA levels in serum and aqueous humor was not observed in either the non-diabetic group or the diabetic group. Furthermore, serum and aqueous humor levels of NOx did not differ between the two groups, and no correlation with ADMA levels was observed in either group. These results suggest that ROS production may be enhanced in the eyes of diabetics. Since ADMA may act to potentiate ROS production independently of its inhibition of NOS, further investigation is required to clarify the possible contribution of ADMA to the development or progression of retinopathy. PMID:17379959

Sugai, Motohiko; Ohta, Akio; Ogata, Yuji; Nakanishi, Minoru; Ueno, Satoki; Kawata, Takehiro; Saito, Nobuhiko; Tanaka, Yasushi

2007-04-01

187

Long-term outcome of immunosuppressive therapy for Japanese patients with lower-risk myelodysplastic syndromes.  

PubMed

To investigate the long-term usefulness of immunosuppressive therapy (IST) for Japanese patients with lower-risk myelodysplastic syndromes, we retrospectively analyzed 29 MDS patients who were treated with cyclosporine A alone or with anti-thymocyte globulin at a single institute in Japan. A total of 58.6 % of patients showed hematological response to IST. Overall survival of all patients was 74.5 % at 5 years and 48.3 % at 10 years. The major adverse event was the elevation of creatinine level (grade 1 and 2). Eleven patients were still on IST at the time of analysis with, at least, some clinical benefits. Pneumonia was the most frequent cause of death (eight of 12 deaths), followed by bleeding (three of 12); most of the patients who died were non-responders. The presence of paroxysmal nocturnal hemoglobinuria-type cells was significantly associated with both response to IST and long-term survival by univariate analysis. The 10-year overall survival of responders (72.2 %) was significantly superior to that of non-responders (15.6 %, P < 0.0001). These results suggest that IST using cyclosporine A provides long-term benefit for Japanese patients with lower-risk MDS. PMID:24254637

Hata, Tomoko; Tsushima, Hideki; Baba, Maki; Imaizumi, Yoshitaka; Taguchi, Jun; Imanishi, Daisuke; Nagai, Kazuhiro; Tomonaga, Masao; Miyazaki, Yasushi

2013-12-01

188

Re-amputation after minor foot amputation in diabetic patients: Risk factors leading to limb loss  

PubMed Central

Burn injury in diabetic patients has been a recent topic of interest in published studies. Previous studies have shown increased complications in diabetic patients compared with nondiabetic controls who have sustained these injuries. A paucity of research has been devoted to foot-specific diabetic burn injury. We present a case series evaluating the mechanisms and complications of diabetic foot burns. PMID:23419696

Nerone, Vincent S.; Springer, Kevin D.; Atway, Said

2014-01-01

189

Prevalence of microalbuminuria, arterial hypertension, retinopathy, and neuropathy in patients with insulin dependent diabetes  

Microsoft Academic Search

Diabetic nephropathy is the main cause of the increased morbidity and mortality in patients with insulin dependent diabetes. The prevalence of microalbuminuria was determined in adults with insulin dependent diabetes of five or more years' duration that had started before the age of 41. All eligible patients (n=982) attending a diabetes clinic were asked to collect a 24 hour urine

Hans-Henrik Parving; Eva Hommel; Elisabeth Mathiesen; Peter Skøtt; Berit Edsberg; Mogens Bahnsen; Mogens Lauritzen; Philip Hougaard; Erik Lauritzen

1988-01-01

190

Diabetic Retinopathy and Endothelial Dysfunction in Patients with Type 2 Diabetes Mellitus  

PubMed Central

Background We investigated the relationship between endothelial dysfunction and diabetic retinopathy (DR) in patients with type 2 diabetes. Methods We used a cross-sectional design to examine 167 patients with type 2 diabetes mellitus. All patients underwent biochemical and ophthalmological examination. We assessed endothelial dysfunction by a flow-mediated vasodilation method of the brachial artery. Changes in vasodilation (flow-mediated vasodilatation, %FMD) were expressed as percent change over baseline values. Results The mean±standard deviation of patient age was 54.1±8.6 years. The %FMD was significantly lower in patients with DR than without DR. The prevalence of retinopathy decreased across increasing tertiles of %FMD. After adjusting for patients' age, sex, diabetes duration, use of insulin, use of antihypertensive, antiplatelet, and lipid lowering medications, systolic blood pressure, fasting plasma glucose, 2-hour plasma glucose, glycated hemoglobin, and urinary albumin excretion, participants with a reduced %FMD were more likely to have DR (odds ratio, 11.819; 95% confidence interval, 2.201 to 63.461; P=0.004, comparing the lowest and highest tertiles of %FMD). Conclusion Endothelial dysfunction was associated with DR, which was most apparent when the endothelial dysfunction was severe. Our study provides insights into the possible mechanism of the influence of endothelial dysfunction on the development of DR. PMID:23991404

Yun, Jae-Seung; Ko, Seung-Hyun; Kim, Ji-Hoon; Moon, Kun-Woong; Park, Yong-Moon; Yoo, Ki-Dong

2013-01-01

191

Patient Complexity and Diabetes Quality of Care in Rural Settings  

PubMed Central

Purpose Even though pay-for-performance programs are being rapidly implemented, little is known about how patient complexity affects practice-level performance assessment in rural settings. We sought to determine the association between patient complexity and practice-level performance in the rural United States. Basic procedures Using baseline data from a trial aimed at improving diabetes care, we determined factors associated with a practice’s proportion of patients having controlled diabetes (hemoglobin A1c ?7%): patient socioeconomic factors, clinical factors, difficulty with self-testing of blood glucose, and difficulty with keeping appointments. We used linear regression to adjust the practice-level proportion with A1c controlled for these factors. We compared practice rankings using observed and expected performance and classified practices into hypothetical pay-for-performance categories. Main Findings Rural primary care practices (n = 135) in 11 southeastern states provided information for 1641 patients with diabetes. For practices in the best quartile of observed control, 76.1% of patients had controlled diabetes vs 19.3% of patients in the worst quartile. After controlling for other variables, proportions of diabetes control were 10% lower in those practices whose patients had the greatest difficulty with either self testing or appointment keeping (p < .05 for both). Practice rankings based on observed and expected proportion of A1c control showed only moderate agreement in pay-for-performance categories (? = 0.47; 95% confidence interval, 0.32–0.56; p < .001). Principal Conclusions Basing public reporting and resource allocation on quality assessment that does not account for patient characteristics may further harm this vulnerable group of patients and physicians. PMID:21671526

Salanitro, Amanda H.; Safford, Monika M.; Houston, Thomas K.; Williams, Jessica H.; Ovalle, Fernando; Payne-Foster, Pamela; Allison, Jeroan J.; Estrada, Carlos A.

2011-01-01

192

Glycemic control in non-diabetic critically ill patients  

PubMed Central

Hyperglycemia is a common and costly health care problem in hospitalized patients. In hospital hyperglycemia is defined as any glucose value >7.8 mmol/l (140 mg/dl). Hyperglycemia is present in 40% of critically ill patients and in up to 80% of patients after cardiac surgery, with ~ 80% of ICU patients with hyperglycemia having no history of diabetes prior to admission. The risk of hospital complications relates to the severity of hyperglycemia, with a higher risk observed in patients without a history of diabetes compared to those with known diabetes. Improvement in glycemic control reduces hospital complications and mortality; however, the ideal glycemic target has not been determined. A target glucose level between 7.8 and 10.0 mmol/l (140 and 180 mg/dl) is recommended for the majority of ICU patients. This review aims to present updated recommendations for the inpatient management of hyperglycemia in critically ill patients with and without a history of diabetes. PMID:21925080

Farrokhi, Farnoosh; Smiley, Dawn; Umpierrez, Guillermo E.

2013-01-01

193

Angina and exertional myocardial ischemia in diabetic and nondiabetic patients: assessment by exercise thallium scintigraphy  

SciTech Connect

Patients with diabetes mellitus and coronary artery disease are thought to have painless myocardial ischemia more often than patients without diabetes. We studied 50 consecutive patients with diabetes and 50 consecutive patients without diabetes, all with ischemia, on exercise thallium scintigraphy to show the reliability of angina as a marker for exertional ischemia. The two groups had similar clinical characteristics, treadmill test results, and extent of infarction and ischemia, but only 7 patients with diabetes compared with 17 patients without diabetes had angina during exertional ischemia. In diabetic patients the extent of retinopathy, nephropathy, or peripheral neuropathy was similar in patients with and without angina. Angina is an unreliable index of myocardial ischemia in diabetic patients with coronary artery disease. Given the increased cardiac morbidity and mortality in such patients, periodic objective assessments of the extent of ischemia are warranted.

Nesto, R.W.; Phillips, R.T.; Kett, K.G.; Hill, T.; Perper, E.; Young, E.; Leland, O.S. Jr.

1988-02-01

194

Hyperbaric oxygen therapy decreases QT dispersion in diabetic patients.  

PubMed

Diabetes mellitus is frequently associated with the malignant ventricular arrhythmias and sudden death. The QT dispersion is the difference between the longest and shortest QT interval calculated from the standard 12-lead electrocardiogram. The QT dispersion is suggested as an index of myocardial electrical activity. An increase in QT dispersion is associated with the malignant ventricular arrhythmias and sudden cardiac death. Diabetic patients receive hyperbaric oxygen (HBO) therapy for non-healing lower extremity ulcers. The aim of this study was to determine the effect of HBO therapy on QT dispersion in diabetic patients. Thirty diabetic patients (18 male and 12 female, 59.9 +/- 10 years), who were planning to undergo ten sessions of HBO therapy in two weeks for non-healing lower extremity ulcers, were consecutively enrolled into the study. The 12-lead resting electrocardiography recordings were taken before the first HBO therapy and after the 10th HBO-therapy session. QT intervals were measured on electrocardiogram. QT intervals were corrected for heart rate by using Bazett's formula (corrected QT [QTc] = QT/ radical R - R [seconds]). QTc dispersion was significantly decreased from 59.8 +/- 17.4 msec to 52.2 +/- 15.5 msec after ten sessions of HBO therapy (p < 0.05). However, maximum QTc, minimum QTc and mean QTc did not change significantly after HBO therapy. We have concluded that HBO therapy may reduce the risk of malignant ventricular arrhythmia and sudden cardiac death in diabetic patients when applied repetitively. PMID:18509242

Kardesoglu, Ejder; Aparci, Mustafa; Uzun, Gunalp; Suleymanoglu, Selami; Uz, Omer; Onem, Yalcin; Ay, Hakan; Kucukardali, Yasar; Ozkan, Sezai

2008-05-01

195

Health coaching in diabetes: empowering patients to self-manage.  

PubMed

To effectively manage diabetes mellitus, patients must adhere to treatment recommendations and healthy lifestyle behaviors, but research shows many patients do not do this. Education is effective when combined with self-management support but peer-support programs do not lead to lasting changes. Health coaching, or professional support, can be highly effective if it focuses on developing self-efficacy and skills such as goal-setting, problem-solving and managing cognitive and emotional barriers. This overview discusses the benefits of patient self-management for chronic conditions such as diabetes, core competencies for health coaching, theoretical bases and principles of health coaching interventions, delivery methods and the evidence that health coaching works for diabetes self-management. PMID:24070747

Wong-Rieger, Durhane; Rieger, Francis P

2013-02-01

196

Bevacizumab in Japanese patients with malignant glioma: from basic research to clinical trial  

PubMed Central

An antiangiogenic approach is especially suitable for the treatment of malignant gliomas. Recently, two large clinical trials in newly diagnosed glioblastoma (the Avastin in Glioblastoma study and Radiation Therapy Oncology Group 0825 study) showed a 3- to 4-month prolongation of progression-free survival (PFS) with bevacizumab, but no significant effect on overall survival (OS). Japan is the first, and so far only, country to approve the use of bevacizumab in newly diagnosed glioblastoma in combination with radiotherapy and temozolomide chemotherapy. The drug is also approved for use as monotherapy for recurrent glioblastoma and certain other types of high-grade glioma after previous therapy. The effectiveness of bevacizumab on Japanese malignant glioma patients was reviewed. The Phase II clinical trial demonstrated that the PFS with bevacizumab alone was 34% at 6 months and 3.3 months at median for 32 patients with recurrent malignant gliomas. In the Avastin in Glioblastoma study, 44 Japanese patients were registered from Japan. PFS and OS for bevacizumab combined with standard temozolomide and radiotherapy were 12.2 months and 29.2 months at median, respectively, for the patients with newly diagnosed glioblastoma. PFS and OS tended to be longer for those treated with bevacizumab than for those not treated with the drug. In addition, biomarkers of bevacizumab effectiveness were investigated in Japanese patients. Vascular endothelial growth factor concentration, matrix metalloproteinase 9 activities in urine, and apparent diffusion coefficient values on magnetic resonance imaging may be biomarkers that predict patient prognosis. Finally, novel experiments for vascular endothelial growth factor antibody action were described; these include the induction of glioma cell apoptosis, an antibody treatment failure model, and a study of the synergistic effect with chemotherapeutic agents.

Takano, Shingo; Ishikawa, Eiichi; Nakai, Kei; Matsuda, Masahide; Masumoto, Tomohiko; Yamamoto, Tetsuya; Matsumura, Akira

2014-01-01

197

Clinical features of axillary osmidrosis: a retrospective chart review of 723 Japanese patients.  

PubMed

Axillary osmidrosis often disturbs a person's social life, particularly in Asian countries. However, the clinical aspects of this condition have not been well documented in the English-language published work. This study aimed to provide information on the features of axillary osmidrosis, with a particular focus on sex differences. A retrospective review was made of the charts for 723 Japanese patients (492 female, 231 male). The mean age at initial presentation (29.1 years) was nearly the same for males and females. Almost all patients (96.1%) had wet earwax, which was extremely high compared to its frequency in the general Japanese population. An association with hyperhidrosis was seen in 61.8% of these patients. Subjective odor levels in female patients were significantly lower than those in males (P < 0.001). A positive family history was more frequent for females than for males (P < 0.001), and prior treatment history was also more frequent for females than for males (P < 0.015). Most patients (86.6%) had received some treatments in our clinic. There were significantly fewer females who underwent surgical treatments compared to males (P = 0.026), as females preferred less invasive techniques (P < 0.001). Several features, including male/female ratios, and associations of wet earwax and hyperhidrosis, corresponded to previously reported data on axillary osmidrosis. Female patients were more concerned with axillary odor than males, and females had a tendency for polysurgery. PMID:23451913

Morioka, Daichi; Ohkubo, Fumio; Amikura, Yoshiyasu

2013-05-01

198

Environmental Lead Exposure Accelerates Progressive Diabetic Nephropathy in Type II Diabetic Patients  

PubMed Central

Whether environmental lead exposure has a long-term effect on progressive diabetic nephropathy in type II diabetic patients remains unclear. A total of 107 type II diabetic patients with stage 3 diabetic nephropathy (estimated glomerular filtration rate (eGFR) range, 30–60?mL/min/1.73?m2) with normal body lead burden (BLB) (<600??g/72?hr in EDTA mobilization tests) and no history of exposure to lead were prospectively followed for 2 years. Patients were divided into high-normal BLB (>80??g) and low-normal BLB (<80??g) groups. The primary outcome was a 2-fold increase in the initial creatinine levels, long-term dialysis, or death. The secondary outcome was a change in eGFR over time. Forty-five patients reached the primary outcome within 2 years. Although there were no differences in baseline data and renal function, progressive nephropathy was slower in the low-normal BLB group than that in the high-normal BLB group. During the study period, we demonstrated that each 100??g increment in BLB and each 10??g increment in blood lead levels could decrease GFR by 2.2?mL/min/1.72?m2 and 3.0?mL/min/1.72?m2 (P = 0.005), respectively, as estimated by generalized equations. Moreover, BLB was associated with increased risk of achieving primary outcome. Environmental exposure to lead may have a long-term effect on progressive diabetic nephropathy in type II diabetic patients. PMID:23555094

Huang, Wen-Hung; Lin, Ja-Liang; Lin-Tan, Dan-Tzu; Hsu, Ching-Wei; Chen, Kuan-Hsing; Yen, Tzung-Hai

2013-01-01

199

Diabetic Foot: Infections and Outcomes in Iranian Admitted Patients  

PubMed Central

Background: Diabetes mellitus (along with its complications) has become a global problem. Diabetic foot infection, among the most common complications, is responsible for 40 to 50% of foot amputations. Antibiotic-resistant microorganisms, however, have compromised empiric therapy in the infected patients. Objectives: The current study aimed to determine the most common microorganisms involved in diabetic foot infection in order to minimize the failure of antibiotic therapy and the risk of developing complications. Patients and Methods: All patients with diabetic foot infection admitted to the infectious diseases, surgery and endocrinology wards of two teaching hospitals from 2007 to 2010 (n = 196) were recruited. In this retrospective study, demographic characteristics, type of lesions, history of hospitalization/antibiotic therapy, isolated microorganisms, clinical complications, administered treatment (medical or surgical) and outcome were recorded. Results: Patients’ mean age was 60.84 (± 10.30) years. Totally, 113 (57.65%) of the patients were male and 83 (42.35%) were female. According to Wagner’s grading, deep ulcers with/without osteomyelitis accounted for the majority of lesions. A single microorganism was isolated (most common: Escherichia coli, Staphylococcus aureus and Klebsiella spp.) from 81 of the patients (80.20%); while for the remaining polymicrobial infection was reported. Isolated pathogens showed no significant correlation with duration of diabetes, type of the lesions (P = 0.13) and history of hospitalization (P = 0.61). The majority of patients (n = 118, 60.20%) were treated surgically; however 11 patients expired due to sepsis. Amputation (most common at toes and below the knee) was performed for 89 patients (45.40%). The response rate to medical treatment was 31.6% for single-pathogen and 10% for polymicrobial infection (with a 30% mortality rate). Conclusions: Physicians are recommended to take microbiological cultures before starting empirical therapy recommended to cover Gram-negative microorganisms in order to lower the risk of antibiotic resistance. PMID:25368803

Hadadi, Azar; Omdeh Ghiasi, Houra; Hajiabdolbaghi, Mahboubeh; Zandekarimi, Majid; Hamidian, Reza

2014-01-01

200

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. PMID:21110860

2010-01-01

201

The well-being and treatment satisfaction of diabetic patients in primary care  

Microsoft Academic Search

BACKGROUND: The quality of life in patients with diabetes is reduced and emotional coping with the disease has great impact on patient well-being. OBJECTIVES: The aim of this study was to assess the psychological well-being and treatment satisfaction in patients with type 2 diabetes mellitus in primary care. STUDY DESIGN AND SETTING: Patients (n = 112) with type 2 diabetes

Esra Saatci; Gulruh Tahmiscioglu; Nafiz Bozdemir; Ersin Akpinar; Sevgi Ozcan; Hatice Kurdak

2010-01-01

202

The Kabuki (Niikawa-Kuroki) syndrome: further delineation of the phenotype in 29 non-Japanese patients.  

PubMed

The Kabuki (Niikawa-Kuroki) syndrome was reported in 1981 by Niikawa et al. and Kuroki et al. in a total of ten unrelated Japanese children with a characteristic array of multiple congenital anomalies and mental retardation. The syndrome is characterized by a distinct face, mild to moderate mental retardation, postnatal growth retardation, dermatoglyphic and skeletal abnormalities. In Japan, the syndrome appears to have an incidence of about 1:32,000 newborns. Outside of Japan, a growing number of patients have been recognized. Clinical data are presented on 29 Caucasian patients; the patients were diagnosed over a relatively short period of time, indicating that the incidence outside of Japan is probably not lower than in Japan. A literature review of 89 patients (60 Japanese and 29 non-Japanese) is given. In 66% of the non-Japanese patients serious neurological problems were present, most notably hypotonia and feeding problems (which were not only related to the cleft palate); this was not reported in the Japanese patients. Inheritance is not clear. Most patients are isolated, sex-ratio is equal. The syndrome can be recognized in patients with cleft (lip/)palate, with mild to moderate developmental delay and in young children with hypotonia and/or feeding problems. In counselling parents, the designation "Kabuki" syndrome seems to be more appropriate than "Kabuki make-up" syndrome. PMID:8088300

Schrander-Stumpel, C; Meinecke, P; Wilson, G; Gillessen-Kaesbach, G; Tinschert, S; König, R; Philip, N; Rizzo, R; Schrander, J; Pfeiffer, L

1994-06-01

203

Assessing the nutritional needs of the geriatric patient with diabetes.  

PubMed

The 1994 Nutrition Guidelines reinforce that all nutritional plans for people with diabetes should be individualized, which is particularly important and necessary for elderly patients. The geriatric population poses many unique challenges to the healthcare professional due to physiological changes and many other risk factors that affect nutritional status either directly or indirectly. A thorough nutritional assessment that includes an evaluation of the potential nutritional risk factors described in this article can help in developing an effective and realistic nutritional plan for achieving and maintaining good blood glucose control and good nutritional status in geriatric patients with diabetes. PMID:9526323

Stanley, K

1998-01-01

204

[Aspects of perioperative care in patients with diabetes].  

PubMed

Diabetes is a common disease in Germany. Due to diabetes-associated end-organ disease, such as large and small vessel disease and neuropathy, diabetic patients require more intense anesthesia care during the perioperative phase. An in-depth and comprehensive medical history focusing on hemodynamic alterations, gastroparesis, neuropathy and stiff joint syndrome is a cornerstone of perioperative care and may affect outcome of diabetes patients more than specific anesthetic medications or the anesthetic procedure. Intraoperative anesthetic care needs to focus on preservation of hemodynamic stability, perioperative infection control and maintenance of glucose homeostasis. Whereas some years ago strict glucose control by aggressive insulin therapy was adamantly advocated, the results of recent studies have put the risk of such therapeutic algorithms into perspective. Therefore, optimized perioperative care of diabetic patients consists of setting a predefined targeted blood glucose level, evidence-based therapeutic approaches to reach that goal and finally adequate and continuous monitoring and amendment of the therapeutic approach if required. PMID:23086337

Pestel, G; Closhen, D; Zimmermann, A; Werner, C; Weber, M M

2013-01-01

205

Oral magnesium supplementation in type II diabetic patients  

PubMed Central

Background: Magnesium is the second most abundant intracellular cation. It plays an important role in insulin homeostasis and glucose metabolism through multiple enzymatic reactions. With increasing data on magnesium deficiency in diabetic patients and epidemiological studies demonstrating magnesium deficiency as a risk factor for diabetes, it is logical to search for its possible beneficial effects on diabetes control and prevention. We aimed to determine whether oral magnesium supplementation improves metabolic control, lipid profile and blood pressure in patients with type II diabetes. Methods: Fifty four patients with type II diabetes were included in a randomized double blind placebocontrolled clinical trial.Patients received either placebo or 300 mg elemental magnesium (as magnesium sulfate -MgSo4-) daily, for 3 months. Metabolic control, lipid profile, blood pressure, magnesium status, hepatic enzymes, hemoglobin concentration, and anthropometric indices were determined in the beginning and at the end of the study. Results: Daily administration of 300 mg elemental magnesium for 3 months, significantly improved fasting blood glucose (183.9±15.43 to 125.8±6.52 vs. 196.5±28.12 to 136.5±7.94, p< 0.0001), 2-hour post prandial glucose (239.1±74.75 to 189.1±60mg/dl vs. 246.4±97.37 to 247.8±86.74mg/dl, p< 0.01), lipid profile, blood pressure and hepatic enzymes. Conclusion: Oral magnesium supplementation with proper dosage has beneficial effects on blood glucose, lipid profile, and blood pressure in patients with type II diabetes.

Solati, Mehrdad; Ouspid, Elham; Hosseini, Saeedeh; Soltani, Nepton; Keshavarz, Mansoor; Dehghani, Mohsen

2014-01-01

206

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

207

A review of anti-hypertension therapies in diabetic patients.  

PubMed

The objective of this study was to review published articles on the issues surrounding tight blood pressure control in hypertensive diabetics. Relevant medical subject headings (MeSH) terms and keywords to review scientific literatures were developed. These MeSH terms were used to generate MEDLINE searches that focused on English-language, peer-reviewed scientific literature. In reviewing the exceptionally large body of research literature in anti-hypertension therapies in diabetic patients , the review focused on outcomes of importance to patients and effects of sufficient magnitude to warrant changes in medical practice ("patient oriented evidence that matters" [POEMs]). Patient-oriented outcomes include not only mortality but also other outcomes that affect patients' lives and well-being. Studies of physiological end points (diseaseoriented evidence [DOEs]) were used to address questions where POEMs were not available Treatment of hypertension in diabetic patients provides dramatic beneficial outcomes. Target diastolic BP of < 80 mmHg appears optimal; and systolic targets of 130 mmHg or less are also reasonable. Studies that compare drug classes do not suggest obviously superior agents. However, it is reasonable to conclude that ACEIs, thiazide diuretics and angiotension II receptor blockers may be the preferred first-line agents for treatment of hypertension in diabetes. ACEIs, ARBs and low dose thiazide diuretics may be the first line treatments although other agents are usually necessary and goals may not be achieved even with three or four agents. Aggressive blood pressure control may be the most important factor in preventing adverse outcomes in hypertensive patients with diabetes. PMID:24825981

Ogochukwu, Adibe Maxwell; Victoria, Ukwe Chinwe

2010-06-01

208

[Prevalence of left ventricular hypertrophy in diabetic patients].  

PubMed

In order to establish the prevalence of left ventricular hypertrophy (LVH) in patients with type 2 diabetes mellitus, (DM) a cross-sectional study was conducted in these patients studying their anthropometric characteristics, blood pressure and metabolic control. To evaluate the presence of LVH, a trans-thoracic echocardiogram was used. The study included 91 patients, finding a 63.7% prevalence of HVI, with women being more affected than men (p=0.001). Additionally, 46.2% of patients were found to have diastolic dysfunction of the left ventricle. We conclude that there is an important prevalence of LVH in diabetic patients without defined causes of hypertrophy. There was no association with sex, metabolic control, BMI and time of diagnosis. PMID:23612816

Valarezo-Sevilla, Diego; Pazmiño-Martínez, Armín; Morales-Mora, Nidya

2013-03-01

209

Diabetes barriers and self-care management: the patient perspective.  

PubMed

For those individuals diagnosed with diabetes, the challenge is how to cope and manage the many aspects of their lives. The aim of this qualitative synthesis was to evaluate research studies for findings and then synthesize patients' experiences within the context of diabetes self-care while facing daily barriers. A total of 95 findings from 21 studies were categorized via like themes. These themes were further analyzed and aggregated to represent an interpretive meta-synthesis via a rigorous methodological protocol as described by Pearson, Robertson-Malt, and Rittinmeyer and the Joanna Briggs Institute. Meta-synthesized findings suggest that patients "avoid and hinder self-management" as well as "desire self-care and living life." Clinicians can improve interactions and potentiate understanding when the therapeutic approach is about the person living with diabetes as opposed to clinical control. PMID:24443416

Stiffler, Deborah; Cullen, Deborah; Luna, Gaye

2014-12-01

210

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

211

DIABETES  

PubMed Central

Limited options for clinical management of patients with juvenile-onset diabetes mellitus call for a novel therapeutic paradigm. Two innovative studies support endoplasmic reticulum as an emerging target for combating both autoimmune and heritable forms of this disease. PMID:24393784

Urano, Fumihiko

2014-01-01

212

Serum chromogranin A is a useful marker for Japanese patients with pancreatic neuroendocrine tumors.  

PubMed

Although chromogranin A (CGA) is a useful marker for pancreatic neuroendocrine tumors (pNET) in the West, its usefulness in Japanese populations is unclear. To assess this, we evaluated the serum CGA levels in 189 patients with various pancreatic diseases, including proven pNET (n = 69), pancreatic cancer (PC) (n = 50), chronic pancreatitis (CP) (n = 50) and autoimmune pancreatitis (AIP) (n = 20), and 112 normal controls (controls) using an ELISA kit. The mean CGA level of patients with pNET was significantly higher than any of the other groups (407.8 ± 984.6 ng/mL [pNET] vs 91.8 ± 101.8 ng/mL [PC], 93.6 ± 57.5 ng/mL [CP], 69.9 ± 52.4 ng/mL [AIP] and 62.5 ± 48.3 ng/mL [controls]). Limiting the analysis to patients not using proton pump inhibitors (PPI), the CGA level of patients with PC or CP was not significantly different compared with the controls. Discriminant analysis revealed that the best cut-off value of CGA to distinguish patients with pNET from the controls was 78.7 ng/mL, with a sensitivity and specificity of 53.6% and 78.6%, respectively. In patients with pNET, significant factors associating with elevated CGA levels were tumor classification, tumor size, and the presence of liver metastases in univariate analysis as well as PPI use and the presence of liver metastases in multivariate analysis. We show that CGA is a useful marker for diagnosing pNET in Japanese populations and for distinguishing patients with pNET from patients with other pancreatic diseases. The increased use of CGA in Japan will likely be a helpful tool in managing these patients, as found in the West. PMID:25220535

Hijioka, Masayuki; Ito, Tetsuhide; Igarashi, Hisato; Fujimori, Nao; Lee, Lingaku; Nakamura, Taichi; Jensen, Robert T; Takayanagi, Ryoichi

2014-11-01

213

Impact of obesity on the efficacy of ustekinumab in Japanese patients with psoriasis: a retrospective cohort study of 111 patients.  

PubMed

Obesity is thought to be involved in the pathogenesis of psoriasis, although its impact on the therapeutic response to systemic treatments remains unclear. The aim of this study was to examine the association of body mass index (BMI) with the efficacy of ustekinumab in Japanese patients with psoriasis. Clinical data from a cohort of 111 Japanese patients treated with ustekinumab 45 mg between July 2011 and March 2014 were retrospectively evaluated. The measured outcome was improvement in the psoriasis area and severity index (PASI) score at week 16. Patients with BMI ? 25 and BMI < 25 had comparable rates of ?50 and 75 % improvement in PASI (PASI-50 and PASI-75, respectively), whereas patients with BMI ? 25 had significantly lower PASI-90 and PASI-100 response rates. Patients with BMI ? 25 also showed significantly lower percent reduction in PASI than those with BMI < 25 at week 16 (85 vs. 74 %, P < 0.004). BMI was negatively correlated with percent reduction in PASI, whereas body weight was not. These results show that a higher BMI, but not body weight, is associated with lower effectiveness of ustekinumab for psoriasis. BMI ? 25 could therefore be a negative predictor of achieving PASI-90 and PASI-100 in patients with psoriasis when starting ustekinumab. PMID:25193345

Yanaba, Koichi; Umezawa, Yoshinori; Ito, Toshihiro; Hayashi, Mitsuha; Kikuchi, Sota; Fukuchi, Osamu; Saeki, Hidehisa; Nakagawa, Hidemi

2014-12-01

214

Impulsive disorders in Japanese adult patients with obsessive-compulsive disorder.  

PubMed

In this study, we sought to characterize obsessive-compulsive disorder (OCD) patients with impulsive features, and to determine whether they constitute a distinct subtype of OCD. Therefore we systematically assessed impulse control disorders and other impulsive conditions categorized as obsessive-compulsive spectrum disorders (OCSDs) in 153 Japanese adult patients with OCD. Forty-five subjects (29%) had concurrent impulsive disorders, and they were differentiated from other OCD patients on a range of demographic features (e.g., younger age at onset), and clinical features (e.g., pervasive and severe psychopathology, and poor treatment outcome). However, on logistic regression, none of these variables predicted comorbid impulsivity. The findings appear to support the argument that OCD patients with impulsive features constitute a subtype of OCD. However, further research is necessary to determine whether impulsivity should be conceptualized as lying on a spectrum with compulsivity or as a dimension that is orthogonal to compulsivity. PMID:15714194

Matsunaga, Hisato; Kiriike, Nobuo; Matsui, Tokuzo; Oya, Kenzo; Okino, Kenya; Stein, Dan J

2005-01-01

215

Options for diabetic patients with chronic heel ulcers  

Microsoft Academic Search

The presence of a heel ulcer in the diabetic patient is usually due to neuropathy, vasculopathy, or both. Diagnostic testing including noninvasive assessment by nerve conduction velocity and Doppler pressure measurements can provide the basis for subsequent treatment. The diagnosis of osteomyelitis is assisted by plain radiographs, isotope definition, and\\/or magnetic resonance imaging (MRI). The loss of the calcaneus may

John J Cevera; Laura L Bolton; Morris D Kerstein

1997-01-01

216

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

217

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

218

Laser refractive surgery in diabetic patients: a review of the literature  

PubMed Central

Background The purpose of this study was to evaluate the current recommendations regarding laser refractive surgery in patients with diabetes mellitus and to assess whether these patients make appropriate candidates for laser vision correction. Methods A literature search was conducted to identify current research on the ocular complications of diabetes and original publications on laser refractive surgery in diabetic patients. Results Diabetes was associated with several ocular complications. Initially the US Food and Drug Administration listed these complications as justification to advise against refractive surgery in patients with diabetes. However, recent studies on laser in situ keratomileusis in diabetic patients indicate that this procedure may be safe in diabetic patients with very well controlled systemic disease and no ocular manifestations. Conclusion Laser refractive surgery may be performed safely in a very selected group of patients with diabetes. PMID:23152656

Spadea, Leopoldo; Paroli, Maria Pia

2012-01-01

219

Is there a lesser hyperparathyroidism in diabetic patients with chronic renal failure?  

PubMed

Diabetic patients on dialysis have lower levels of parathyroid hormone (PTH); however, there is no data regarding PTH levels with different degrees of chronic renal failure (CRF). We compared 58 diabetic patients with different degrees of CRF with 268 non-diabetic patients with CRF (serum creatinine >1.2 mg/dl). In both groups, we investigated the main biochemical parameters together with plasma calcium, phosphorus, magnesium, PTH and calcitriol. Diabetic patients showed lower levels of PTH than non-diabetics (P=0.003). The differences were observed in patients with creatinine clearance <70ml/min. We also observed differences in phosphorus, magnesium and tubular resorption of phosphate. In the group of diabetic patients, serum glucose correlated inversely with PTH. Our study suggests that poor control of diabetes (hyperglycaemia) may play a role in the pathogenesis of the hypoparathyroidism observed in patients with diabetes and CRF. PMID:9568813

Martínez, I; Saracho, R; Moina, I; Montenegro, J; Llach, F

1998-01-01

220

Prescribing pattern and efficacy of anti-diabetic drugs in maintaining optimal glycemic levels in diabetic patients  

PubMed Central

Context: Despite the availability of efficacious anti-diabetic drugs, which act by different mechanisms to reduce the blood-glucose, the majority of people with diabetes on anti-diabetic drug therapy, have poor glycemic control and diabetic vascular complications. Aim and Objectives: The aim was to study the prescribing pattern and efficacy of anti-diabetic drugs in maintaining optimal glycemic levels in diabetic patients attending tertiary care teaching hospital in Navi Mumbai. Materials and Methods: A prospective, cross-sectional, observational survey was carried out in 100 patients of diabetes mellitus attending diabetes outpatient/medicine outpatient departments, to assess their prescribing pattern of anti-diabetic drugs, and their blood-glucose level was measured by Accu-Chek Active glucometer to determine their glycemic control. Results: Average number of anti-diabetic drugs per prescription was 1.4. Sulfonylureas were the most commonly prescribed class, but metformin (biguanide) was the commonest prescribed individual drug among oral hypoglycemic agents (OHA). Fixed dose combination of biguanide and sulfonylurea was prescribed commonly. Monotherapy dominated over polytherapy and there was a higher percentage of use of insulin in Type 2 diabetics. Only 41% of patients on anti-diabetic therapy had optimal glycemic control. The association between anti-diabetic therapy along with lifestyle modification and glycemic control was statistically significant (P = 0.0011). Conclusions: OHAs still dominate the prescribing pattern, but there was a shifting trend toward the use of insulin preparations in the management of Type 2 diabetes mellitus. In achieving optimal glycemic control, the efficacy of the anti-diabetic drugs was only 41%; therefore intensification of current drug treatment as well as planning multiple drug interventions with lifestyle modification is necessary.

Agarwal, Akshay A.; Jadhav, Pradeep R.; Deshmukh, Yeshwant A.

2014-01-01

221

Biophoton emission from blood serum of diabetic patients  

NASA Astrophysics Data System (ADS)

The concept that free radicals mediate vascular abnormalities in diabetes has been debated. This study examines the relationship between serum free radical activity and glycaemic regulation. A cross-sectional assessment is presented of the chemiluminescence of blood serum, long term glycaemic control (HbAlc, fructosamine) and blood glucose concentrations in patients with type-1 (n equals 114) and patients with type-2 (n equals 112) diabetes. The average value of serum chemiluminescence of type-1 patients is higher than that of type-2 patients (p equals 0.014). Spectral analysis suggests that different sources of free radical activity are responsible in different ratios for chemiluminescence in type-1 and type-2 sera. Serum chemiluminescence values of type-1 patients strongly correspond with blood glucose levels (p < 0.001). Chemiluminescence values were higher, although not significant (p equals 0.082) in the 'poorly' controlled group characterized by high values of HbAlc and/or fructosamine in comparision with the group of 'good' glycaemic control with lower values of HbAlc and/or fructosamine. Serum chemeluminescence values of type-2 patients neither correspond to their long tern glycaemic status nor to their blood glucose levels. It is concluded that changes in glucose metabolism and changes in chemiluminescence are coordinated for type-1 but not for type-2 patients. This strongly indicates the relevance of ther free radical connection to diabetes type-1 complications.

Van Wijk, R.; Wiegant, F. A. C.; Popp, Fritz A.; Storms, G. E. M. G.

1994-12-01

222

Effect of Ayurvedic management in 130 patients of diabetic nephropathy  

PubMed Central

Diabetic nephropathy is a specific form of renal disease. It is a major cause of renal insufficiency and ultimately of death. The present study has been carried out to prove the efficacy of Ayurvedic drugs in the management of diabetic nephropathy, which can be helpful in reducing the need of dialysis and avoiding or delaying renal transplantation. A total of 130 patients of this disease were treated in IPD (Group A) and OPD (Group B). Ayurvedic formulations including Gokshuradi Guggulu, Bhumyamalaki, Vasa and Shilajatvadi Vati were given to all the patients for 2 months. Group A patients were given special planned food. Results were analyzed statistically using “t” test. In group A patients, highly significant reduction was found in the values of serum creatinine, blood urea and urinary excretion of albumin. Marked improvement was found in the patients’ general physical well-being, together with reduction in symptoms, in group A patients. This shows the importance of Pathyapathya in Ayurvedic management of the disease. This management may bring some new hope to the patients of diabetic nephropathy, which usually terminates to chronic renal failure and ultimately to death. Further studies are being carried out in this regard. PMID:22131758

Patel, Kalapi; Gupta, S. N.; Shah, Namrata

2011-01-01

223

A Model-Based Approach to Synthesizing Insulin Infusion Pump Usage Parameters for Diabetic Patients  

E-print Network

A Model-Based Approach to Synthesizing Insulin Infusion Pump Usage Parameters for Diabetic Patients used by type-1 diabetic patients to control their blood glucose levels. The amounts of insulin. INTRODUCTION Insulin infusion pumps are commonly used by type-1 diabetic patients to control their blood

Sankaranarayanan, Sriram

224

Relationship Between Diurnal Blood Pressure Variation and Diurnal Blood Glucose Levels in Type 2 Diabetic Patients  

Microsoft Academic Search

Background: Hypertension and hyperglycemia are established risk factors for progression of microangiopathies and macroangiopathies in type 2 diabetes mellitus. Cardiovascular risk is even more increased in diabetic patients with nocturnal nondipping or postprandial hyperglycemia. We therefore investigated the relationship between diurnal hyperglycemia and diurnal blood pressure (BP) variation in patients.Methods: One hundred seven hypertensive type 2 diabetic patients received a

Frank Pistrosch; Eva Reissmann; Jan Wildbrett; Carsta Koehler; Markolf Hanefeld

2007-01-01

225

Nutritional status in patients with diabetes and chronic kidney disease: a prospective study1-3  

Microsoft Academic Search

Background: A poor nutritional status reduces the life expectancy of diabetes patients undergoing hemodialysis. Objective: The study objective was to specify the nutritional out- come in patients with chronic kidney disease (CKD) and well- controlled diabetes. Design: Forty-five diabetes patients with CKD were enrolled in a cooperative-care program designed to control glucose, blood pres- sure, LDL cholesterol, and the albumin

Christelle Raffaitin; Catherine Lasseur; Philippe Chauveau; Nicole Barthe; Henri Gin; Christian Combe; Vincent Rigalleau

226

BENEFITS OF RENIN ANGIOTENSIN SYSTEM INHIBITORS IN HYPERTENSIVE PATIENTS WITH DIABETES MELLITUS  

Microsoft Academic Search

ABSTRACT ABSTRACT ABSTRACT ABSTRACT Hypertension is an extremely common diabetes comorbidity, affecting approximately 20 to 60% of diabetic patients. Hypertension further increases the risk for both micro- and macrovascular complications in diabetes. Activation of the renin-angiotensin system (RAS) plays an important role in the pathogenesis of hypertension, atherosclerosis, heart failure, diabetic and hypertensive nephropathy. Angiotensin II (AT II), the active

Romulus Timar; Viorel Serban; Laura Diaconu; Adrian Vlad

2004-01-01

227

SNP-based analysis of the HLA locus in Japanese multiple sclerosis patients.  

PubMed

Although several major histocompatibility complex (MHC)-wide single-nucleotide polymorphism (SNP) studies have been performed in populations of European descent, none have been performed in Asian populations. The objective of this study was to identify human leukocyte antigen (HLA) loci associated with multiple sclerosis (MS) in a Japanese population genotyped for 3534 MHC region SNPs. Using a logistic regression model, two SNPs (MHC Class III SNP rs422951 in the NOTCH4 gene and MHC Class II SNP rs3997849, susceptible alleles A and G, respectively) were independently associated with MS susceptibility (204 patients; 280 controls), two (MHC Class II SNP rs660895 and MHC Class I SNP rs2269704 in the NRM gene, susceptible alleles G and G, respectively) with aquaporin-4- (AQP4-) MS susceptibility (149 patients; 280 controls) and a single SNP (MHC Class II SNP rs1694112, susceptible allele G) was significant when contrasting AQP4+ against AQP4- patients. Haplotype analysis revealed a large susceptible association, likely DRB1*04 or a locus included in the DRB1*04 haplotype, with AQP4- MS, which excluded DRB1*15:01. This study is the largest study of the HLA's contribution to MS in Japanese individuals. PMID:21654846

McElroy, J P; Isobe, N; Gourraud, P A; Caillier, S J; Matsushita, T; Kohriyama, T; Miyamoto, K; Nakatsuji, Y; Miki, T; Hauser, S L; Oksenberg, J R; Kira, J

2011-10-01

228

Electronic orthotics shoe: preventing ulceration in diabetic patients.  

PubMed

The improvement in processor performance through continuous breakthroughs in transistor technology has resulted in the proliferation of lightweight embedded systems. Advances in wireless technology and embedded systems have enabled remote healthcare and telemedicine. Continuous and real-time monitoring can discretely analyze how a patient's lifestyle affects his/her physiological conditions and if additional symptoms occur under various stimuli. Diabetes is one of most difficult challenges facing the healthcare industry today. One of the primary afflictions of diabetic patients is peripheral neuropathy (loss of sensation in the foot). As a direct result of this condition, the likelihood of ulcer increases which in many cases leads to to amputation. We have developed a wireless electronic orthotics composed of lightweight embedded systems and non-invasive sensors which can be used by diabetic patients suffering from peripheral neuropathy. Our proposed system monitors feet motion and pressure distribution beneath the feet in real-time and classifies the state of the patient. The proposed system detects the conditions that could potentially cause a foot ulcer. This system enables a continuous feedback mechanism for instance in case of an undesired behavior or condition a preemptive message wirelessly to the patient and the patient's caregiver. PMID:19162769

Dabiri, Foad; Vahdatpour, Alireza; Noshadi, Hyduke; Hagopian, Hagop; Sarrafzadeh, Majid

2008-01-01

229

The 5-Year Onset and Regression of Diabetic Retinopathy in Chinese Type 2 Diabetes Patients  

PubMed Central

Purpose To determine the rate and risk factors of diabetic retinopathy (DR) onset and regression in Chinese type 2 diabetes mellitus patients. Methods This is a 5-year community-based prospective study. The demographic information, systemic examination results and ophthalmological test results of each participant were collected. The study outcomes were DR incidence, defined as the onset of DR in at least one eye, and DR regression, defined as full regression from existing DR to no retinopathy without invasive treatments. The associations between each potential risk factor and the outcomes were studied. Results In total, 778 participants were enrolled. There were 322 patients without DR at baseline, of which 151 participants developed DR during follow-up (DR incidence rate?=?46.89%). Baseline hyperglycemia and high blood pressure were two independent risk factors associated with DR incidence. Among the 456 participants with existing DR at entry, 110 fully recovered after 5 years (DR regression rate?=?24.12%). Low baseline glucose and low serum triglyceride were two independent factors associated with DR regression. Conclusions DR incidence occurred more frequently in patients with hyperglycemia and high blood pressure. DR regression occurred mostly in patients with lower glucose and lower serum triglyceride levels among Chinese type 2 diabetes patients. PMID:25402474

Jin, Peiyao; Peng, Jinjuan; Zou, Haidong; Wang, Weiwei; Fu, Jiong; Shen, Binjie; Bai, Xuelin; Xu, Xun; Zhang, Xi

2014-01-01

230

Chronic ulcers: MATRIDERM® system in smoker, cardiopathic, and diabetic patients  

PubMed Central

Diabetic ulcers and pressure ulcers represent a more frequent cause of chronic wounds in aging populations. It is estimated that approximately 15% of the diabetic population will develop diabetic ulcers during their life and over half of these patients develop an infection, often osteomyelitis, with 20% requiring amputation. The authors report a case of a 65-year-old woman affected by a post-traumatic loss of substance due to road accidents with soft tissue exposure (comprising muscle tendon) of the left knee combined with the fracture of the right fibula previously subjected to surgery and reconstruction of muscle tendon. The patient was affected by diabetes type II, hypertension, and ischemic heart disease. In 2008, she underwent a double bypass surgery and coronary angioplasty. Initially, the patient was treated with cycles of advanced dressings, with fibrinolytic ointments, hydrocolloid, and subsequently, when the bottom began granulated with fibrinolytic and idrocellulosa, Hydrofibra-Ag, and Ag-alginate, three times a week for 30 days. In the second step, the authors decided to treat the ulcer with the MATRIDERM system and auto skin graft. Following the first treatment, 7 days after the procedure, the authors found the reduction of the loss of substance until its complete closure. The wound’s infection was evaluated by a buffer negative confirmation performed every 2 weeks four times. We obtained decrease of limb edema and full functional rehabilitation. The skin appeared renovated, with volume restoration and an improvement of the texture. PMID:24020011

Gentile, Pietro; Agovino, Annarita; Migner, Alessia; Orlandi, Fabrizio; Delogu, Pamela; Cervelli, Valerio

2013-01-01

231

Subclinical Ulnar Neuropathy at the Elbow in Diabetic Patients  

PubMed Central

Objective To demonstrate the prevalence and characteristics of subclinical ulnar neuropathy at the elbow in diabetic patients. Methods One hundred and five patients with diabetes mellitus were recruited for the study of ulnar nerve conduction analysis. Clinical and demographic characteristics were assessed. Electrodiagnosis of ulnar neuropathy at the elbow was based on the criteria of the American Association of Neuromuscular & Electrodiagnostic Medicine (AANEM1 and AANEM2). The inching test of the ulnar motor nerve was additionally performed to localize the lesion. Results The duration of diabetes, the existence of diabetic polyneuropathy (DPN) symptoms, the duration of symptoms, and HbA1C showed significantly larger values in the DPN group (p<0.05). Ulnar neuropathy at the elbow was more common in the DPN group. There was a statistically significant difference in the number of cases that met the three diagnostic criteria between the no DPN group and the DPN group. The most common location for ulnar mononeuropathy at the elbow was the retrocondylar groove. Conclusion Ulnar neuropathy at the elbow is more common in patients with DPN. If the conduction velocities of both the elbow and forearm segments are decreased to less than 50 m/s, it may be useful to apply the AANEM2 criteria and inching test to diagnose ulnar neuropathy. PMID:24639928

Jang, Ji Eun; Kim, Yun Tae; Park, Byung Kyu; Cheong, In Yae

2014-01-01

232

[Plausible solution to prevent major amputation in diabetic foot patients].  

PubMed

Diabetes mellitus is one of the leading public health problems in the world. Complications of diabetes mellitus include cardiovascular diseases, retinopathy, neuropathy and diabetic foot, which can in turn lead to lower extremity amputations. This is the main cause of mortality and the biggest expenditure for health system. Treatment is long and frustrating for the patient and also for medical staff. Amputations are becoming more frequent, while the quality of life after amputation is greatly reduced. Healing of postoperative infection is long lasting and demands a lot of hard work from the surgeon and the rest of medical staff, while causing severe suffering for the patient. Progression of infection increases mortality. Negative pressure therapy after minor foot amputations greatly reduces healing time. Negative Pressure Wound Therapy (NPWT) was applied after surgical treatment. All necrotic tissue and fibrin deposits were removed. Initial therapy was administered continuously with 125 mm Hg of vacuum. The NPWT was continued intermittently. Additionally, all patients underwent additional hyperbaric treatment and local hemoglobin administration. In conclusion, in all cases presented, combined NPWT, hyperbaric and topical hemoglobin therapy proved to be a highly effective therapeutic option in preventing pending major amputation following minor diabetic foot amputation. PMID:25326996

Laginja, Stanislava; Seremet, Jasmina; Spehar, Branka; Marinovi?, Marin

2014-10-01

233

Morningness-eveningness questionnaire score and metabolic parameters in patients with type 2 diabetes mellitus.  

PubMed

"Morningness" and "Eveningness" represent lifestyle patterns including sleep-wake patterns. Although previous studies described a relationship between the morningness-eveningness trait and glycemic control in patients with type 2 diabetes mellitus (T2DM), the mechanism underlying this association remains unknown. The study participants comprised 725 Japanese T2DM outpatients free of history of cardiovascular diseases. Various lifestyles were analyzed using self-reported questionnaires, including morningness-eveningness questionnaire (MEQ). The relationships between morningness-eveningness trait and various biochemical parameters were investigated by linear regression analysis and logistic regression analysis. We classified the study patients into three groups, morning type (n?=?117), neither type (n?=?424) and evening type (n?=?184). Subjects of the evening type had high levels of alanine aminotransferase, triglyceride, fasting blood glucose and HbA1c and low high-density lipoprotein-cholesterol level in a model adjusted for age and gender. Furthermore, multivariate analysis showed that the evening type was associated with high HbA1c and estimated glomerular filtration rate even after adjustment for other lifestyle factors known to affect metabolic control. The results suggest that T2DM patients with eveningness trait are under inadequate metabolic control independent of other lifestyle factors. Thus, the evening trait of T2DM patients represents an important target for intervention to ensure appropriate metabolic function. PMID:25102425

Osonoi, Yusuke; Mita, Tomoya; Osonoi, Takeshi; Saito, Miyoko; Tamasawa, Atsuko; Nakayama, Shiho; Someya, Yuki; Ishida, Hidenori; Kanazawa, Akio; Gosho, Masahiko; Fujitani, Yoshio; Watada, Hirotaka

2014-11-01

234

Effect of diabetic duration on serum concentrations of endogenous inhibitor of nitric oxide synthase in patients and rats with diabetes.  

PubMed

This study was designed to investigate the effect of diabetic duration on serum concentrations of endogenous inhibitor of nitric oxide synthase N(G), N(G)-asymmetric dimethylarginine (ADMA) in patients and rats with diabetes, and to determine whether elevated endogenous ADMA is implicated in endothelial dysfunction or macroangiopathy in diabetes. Experimental diabetic model was induced by a single intraperitoneal injection of streptozotocin to male Sprague-Dawley rats and fed for 2-, 4- and 8-week, respectively. Type 2 diabetic patients with different diabetic duration were recruited from Xiangya Hospital. Plasma glucose and serum ADMA levels were measured in both patients and rats. Moreover, endothelium-dependent relaxation of thoracic aortas and some parameters of metabolic control were examined in rats. Serum ADMA concentrations were significantly elevated in type 2 diabetic patients compared with healthy subjects (3.44 +/- 0.40 vs 1.08 +/- 0.14 micromol/L, n = 50 in diabetic patients and n = 40 in healthy subjects, P < 0.01). The serum levels of ADMA in patients with macroangiopathy were higher than the patients without macroangiopathy (P < 0.01). But no difference was observed in serum ADMA concentrations between groups of patients with different diabetic duration. Similarly, serum levels of ADMA in diabetic rats were also significantly elevated at 2-week duration compared with duration-matched control (3.71 +/- 0.20 vs 1.04 +/- 0.23 micromol/L, n = 5 approximately 6, P < 0.01). This elevation of ADMA was retained to 4- and 8-week (3.54 +/- 0.76 vs 0.95 +/- 0.06 micromol/L for 4-week, 3.21 +/- 0.50 vs 1.03 +/- 0. 09 micromol/L for 8-week, n = 5 approximately 6, all P < 0.01) and remained unchanged among three diabetic groups. The elevation of ADMA was accompanied by impairment of endothelium-dependent relaxation and poor metabolic control in diabetic rat. These results first reveal that the extent of elevation in serum ADMA in both rats and patients with diabetes is not proportion with the length of their diabetic duration but rather with the metabolic control of this disease. Elevated endogenous ADMA may be implicated in diabetes-induced endothelial dysfunction and macroangiopathy. This study is helpful to prevention and treatment of diabetic-induced endothelial dysfunction or macroangiopathy. PMID:15862600

Xiong, Yan; Lei, Minxiang; Fu, Sihai; Fu, Yunfeng

2005-05-27

235

Is increased colon subepithelial collagen layer thickness in diabetic patients related to collagenous colitis? An immunohistochemical study  

Microsoft Academic Search

In this study, we evaluated immunohistochemically whether increased thickness of the colon subepithelial collagen layer in diabetic patients relates to collagenous colitis.A total of 100 patients (25 in each group) were included in this study. There were diabetic patients with chronic diarrhea in the first group, diabetic patients without chronic diarrhea in the second group, non-diabetic patients with chronic diarrhea

Aydin Unal; Kadri Guven; Alper Yurci; Edip Torun; Sebnem Gursoy; Mevlut Baskol; Figen Ozturk; Vedat Arsav

2008-01-01

236

A 15-year follow-up study of patients with non-insulin-dependent diabetes mellitus (NIDDM) in Osaka, Japan. Factors predictive of the prognosis of diabetic patients  

Microsoft Academic Search

Risk factors related to the prognosis of diabetic patients were studied in a follow-up study of 1939 patients with non-insulin-dependent diabetes mellitus (NIDDM) for a mean observation period of 15 years at our institute. Age at entry into the study was the most powerful risk factor related to the survival of diabetic patients in this study. Moreover, the risk of

Akira Sasaki; Masuko Uehara; Naruto Horiuchi; Kyoichi Hasegawa; Takao Shimizu

1997-01-01

237

Plasma amino acid profiles are associated with insulin, C-peptide and adiponectin levels in type 2 diabetic patients  

PubMed Central

Objectives: Plasma-free amino acid (PFAA) profiles have been associated with a future risk of developing diabetes or cardiovascular disease in nondiabetic subjects. These PFAA alterations might predominantly result from the metabolic shift caused by insulin resistance and visceral fat deposition. The variety of PFAA profiles within diabetic subjects is not well researched. In this study, we focused on type 2 diabetic subjects and examined the association between PFAA profiles and insulin- and glucose-related variables. Methods: Fifty-one Japanese subjects diagnosed with type 2 diabetes were recruited from an outpatient clinic. The plasma concentrations of 21 amino acids; glucose-related markers including glucose, hemoglobin A1c (HbA1c), glycoalbumin and 1,5-anhydroglucitol; insulin-related markers including insulin, C-peptide, and the homeostasis model assessment of insulin resistance; and adipocytokines including adiponectin and leptin were determined. The association of PFAA and other metabolic profiles were analyzed, and stratified analyses of the PFAAs and clinical characteristics were performed according to the fasting plasma insulin and HbA1c levels. In addition, the PFAA indices that correlate to visceral fat obesity were evaluated. Results: Although strong correlations between PFAAs and glucose-related markers were not observed, several amino acids (branched-chain amino acids, tryptophan, alanine, tyrosine, glutamate and proline) and PFAA indices that evaluate visceral obesity were highly correlated with insulin-related markers and adiponectin (P<0.001). In the group of diabetic patients with hyperinsulinemia, the amino acid levels were significantly increased, which generally demonstrated good concordance with insulin-related markers and adiponectin levels. Conclusions: The PFAA profiles in diabetic patients were strongly associated with hyperinsulinemia and hypoadiponectinemia, which might become risk evaluation factors for the development of cardiovascular diseases. PMID:25177913

Nakamura, H; Jinzu, H; Nagao, K; Noguchi, Y; Shimba, N; Miyano, H; Watanabe, T; Iseki, K

2014-01-01

238

Variations in the core promoter/pre-core region in HBV genotype C in Japanese and Northern Vietnamese patients.  

PubMed

Hepatitis B virus (HBV) subgenotypes Cs (C1) and Ce (C2) are common in East Asia. To investigate the genomic difference of HBV genotype C between two separated regions, 50 subgenotype Cs-infected Vietnamese and 70 subgenotype Ce-infected Japanese patients were enrolled for analysis. The patients were categorized to either a hepatocellular carcinoma group (HCC) or a non-HCC group including liver cirrhosis, chronic hepatitis, and asymptomatic carriers. HBV serology, HBV-DNA level, and variations in core promoter/pre-core region were examined. Phylogenetic analysis based on the full genome sequences and nucleotide sequences partly in the S gene and in the P gene revealed that all Japanese strains (70/70) were subgenotype Ce, and nearly all of the Vietnamese strains (50/51) were subgenotype Cs, excluding one subgenotype C5. C1858 and G1775 were common in the Vietnamese (64% and 40%) but not in the Japanese (0%). The prevalence of C/A1753 in Vietnamese was higher than that in the Japanese (32% vs. 17.1%), however the frequency of A1896 in the Japanese was significantly higher (32.9% vs. 12%, P < 0.05). Most of the Vietnamese patients with HCC had a high level of HBV-DNA, the Japanese HCC had a relatively low level. In the Vietnamese, C/A1753 and C1858 were associated closely with T1762A1764, higher HBV-DNA levels and higher HCC incidence. The multivariate analysis revealed that male, T1653 and C/A1753 were independent risk factors for HCC. The subgenotypes and unique mutations of HBV genotype C in the Vietnamese and Japanese differed, and C/A1753 and C1858 variants might play a role in the pathogenesis of liver disease in Vietnamese patients. PMID:17607788

Truong, Bui Xuan; Yano, Yoshihiko; Seo, Yasushi; Phuong, Tran Minh; Tanaka, Yasuhito; Kato, Hirotaka; Miki, Akira; Utsumi, Takako; Azuma, Takeshi; Trach, Nguyen Khanh; Mizokami, Masashi; Hayashi, Yoshitake; Kasuga, Masato

2007-09-01

239

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

240

Investigation on Carbohydrate Counting Method in Type 1 Diabetic Patients  

PubMed Central

Objective. The results from Diabetes Control and Complications Trial (DCCT) have propounded the importance of the approach of treatment by medical nutrition when treating diabetes mellitus (DM). During this study, we tried to inquire carbohydrate (Kh) count method's positive effects on the type 1 DM treatment's success as well as on the life quality of the patients. Methods. 22 of 37 type 1 DM patients who applied to Eski?ehir Osmangazi University, Faculty of Medicine Hospital, Department of Endocrinology and Metabolism, had been treated by Kh count method and 15 of them are treated by multiple dosage intensive insulin treatment with applying standard diabetic diet as a control group and both of groups were under close follow-up for 6 months. Required approval was taken from the Ethical Committee of Eski?ehir Osmangazi University, Medical Faculty, as well as informed consent from the patients. The body weight of patients who are treated by carbohydrate count method and multiple dosage intensive insulin treatment during the study beginning and after 6-month term, body mass index, and body compositions are analyzed. A short life quality and medical research survey applied. At statistical analysis, t-test, chi-squared test, and Mann-Whitney U test were used. Results. There had been no significant change determined at glycemic control indicators between the Kh counting group and the standard diabetic diet and multiple dosage insulin treatment group in our study. Conclusion. As a result, Kh counting method which offers a flexible nutrition plan to diabetic individuals is a functional method. PMID:25202704

Son, Osman; Efe, Belgin; Son, Nazan Erenoglu; Akalin, Aysen; Kebapci, Nur

2014-01-01

241

Effect of azilsartan versus candesartan on morning blood pressure surges in Japanese patients with essential hypertension  

PubMed Central

Morning blood pressure (BP) surge is reported as a risk factor for cardiovascular events and end-organ damage independent of the 24-h BP level. Controlling morning BP surge is therefore important to help prevent onset of cardiovascular disease. We compared the efficacy of azilsartan and candesartan in controlling morning systolic BP (SBP) surges by analyzing relevant ambulatory BP monitoring data in patients with/without baseline BP surges. As part of a 16-week randomized, double-blind study of azilsartan (20–40 mg once daily) and candesartan (8–12 mg once daily) in Japanese patients with essential hypertension, an exploratory analysis was carried out using ambulatory BP monitoring at baseline and week 14. The effects of study drugs on morning BP surges, including sleep trough surge (early morning SBP minus the lowest night-time SBP) and prewaking surge (early morning SBP minus SBP before awakening), were evaluated. Patients with sleep trough surge of at least 35 mmHg were defined by the presence of a morning BP surge (the ‘surge group’). Sleep trough surge and prewaking surge data were available at both baseline and week 14 in 548 patients, 147 of whom (azilsartan 76; candesartan 71) had a baseline morning BP surge. In surge group patients, azilsartan significantly reduced both the sleep trough surge and the prewaking surge at week 14 compared with candesartan (least squares means of the between-group differences ?5.8 mmHg, P=0.0395; and ?5.7 mmHg, P=0.0228, respectively). Once-daily azilsartan improved sleep trough surge and prewaking surge to a greater extent than candesartan in Japanese patients with grade I–II essential hypertension. PMID:24710336

Kario, Kazuomi; Enya, Kazuaki; Sugiura, Kenkichi; Ikeda, Yoshinori

2014-01-01

242

MRI appearance of the pancreas in patients with cystic fibrosis: a comparison of pancreas volume in diabetic and non-diabetic patients  

PubMed Central

We investigated differences in the volume of the pancreas in cystic fibrosis (CF) patients with and without diabetes using MRI to study the natural history of CF-related diabetes (CFRD). We investigated 29 pancreas-insufficient adult CF patients, 13 with CFRD and 16 without diabetes. Patients with CFRD were receiving insulin therapy at the time of study. None of the non-diabetic CF patients had evidence of impaired glucose tolerance. Pancreas volume was estimated by MRI scans using T1 weighted fat-suppression sequences and assessed by an examiner who was unaware of the patientsdiabetes status. Pancreas volume of CF patients was measured and subsequently compared with that of non-CF age-matched Type 1 diabetes (T1DM) patients and healthy controls previously investigated. The two CF groups were matched for age and gender. There were no differences in spirometry values, body mass index or pancreatic exocrine function. The pancreas was visible by MRI in only 3 of 13 (23.1%) patients with CFRD and in 5 of 16 (31.3%) patients without diabetes (p-value = 0.7). In total, the pancreas was not detected by MRI as an anatomical entity in 21 of 29 (72.4%) CF patients, irrespective of their diabetes status. When comparing the four study groups, the pancreas was significantly smaller in CF patients than in T1DM patients and healthy controls. PMID:20965902

Sequeiros, I M; Hester, K; Callaway, M; Williams, A; Garland, Z; Powell, T; Wong, F S; Jarad, N A

2010-01-01

243

Improving Diabetes Management With a Patient Portal: Qualitative Study of a Diabetes Self-Management Portal  

PubMed Central

Background Effective management and care of diabetes is crucial to reducing associated risks such as heart disease and kidney failure. With increasing access and use of the Internet, online chronic disease management is being explored as a means of providing patients with support and the necessary tools to monitor and manage their disease. Objective The objective of our study was to evaluate the experience of patients and providers using an online diabetes management portal for patients. Methods Participants were recruited from a large sample population of 887 for a follow-up questionnaire to be completed after 6 months of using the patient portal. Participants were presented with the option to participate in an additional interview and, if the participant agreed, a time and date was scheduled for the interview. A 5-item, open-ended questionnaire was used to capture providers' opinions of the patient portal. Providers included general practitioners (GPs), nurses, nurse practitioners (NPs), dieticians, diabetes educators (DECs), and other clinical staff. Results A total of 854 patients were consented for the questionnaire. Seventeen (8 male, 9 female) patients agreed to participate in a telephone interview. Sixty-four health care providers completed the five open-ended questions; however, an average of 48.2 responses were recorded per question. Four major themes were identified and will be discussed in this paper. These themes have been classified as: facilitators of disease management, barriers to portal use, patient-provider communication and relationship, and recommendations for portal improvements. Conclusions This qualitative study shows that online chronic disease management portals increase patient access to information and engagement in their health care, but improvements in the portal itself may improve usability and reduce attrition. Furthermore, this study identifies a grey area that exists in the roles that GPs and AHPs should play in the facilitation of online disease management. PMID:23195925

Dupak, Kourtney; Kuehner, Zachary; Leonard, Kevin; Lovrics, Emily; Picton, Peter; Seto, Emily; Cafazzo, Joe

2012-01-01

244

[Sulodexid and nephrotic syndrome in patients with diabetic nephropathy].  

PubMed

Diabetic nephropathy (DN) is the most serious, life limited complication of both types of diabetes mellitus. Therefore the early identification and intensive treatment of DN is very important. DN involves the thickening of glomerular basement membrane (GBM) and the depletion of glycosaminoglycan (GAG) in the GBM with resultant diminution in the physiological electrostatic charge barrier. Additional mechanism in pathophysiology of DN is mesangial expansion. Sulodexide is glycosaminoglycan mixture of heparansulfate and dermatan sulfate. We present a 71-year old patient with severe nephrotic syndrome, probably caused by DN. AS patient refused renal biopsy, exact diagnosis of DN could not be confirmed. Since 2000 our patient was treated with sulodexide. More pronounced decrease of proteinuria was proved 1.5 year after the begin of this treatment (from 10.37 g/d to 4.8 g/d) and after 3 years was proteinuria negative. PMID:21695933

Valociková, I

2011-05-01

245

Pudendal neuropathy in diabetic patients with faecal incontinence.  

PubMed

To investigate the pathophysiology of faecal incontinence in diabetes mellitus, two groups of diabetic patients were studied: 14 subjects (7 females and 7 males, mean age 57 +/- 9 years) with faecal incontinence (Group A) and 15 subjects (6 females and 9 males, mean age 54.7 +/- 8 years) without faecal incontinence but affected by somatic peripheral neuropathy. A third group (C) of 10 healthy volunteers was used as controls. All subjects underwent electroneurographic evaluation of peripheral neuropathy, pudendal nerve terminal motor latency, anorectal manometry and rectal sensitivity tests. All the patients of group A had somatic peripheral neuropathy. Maximum squeeze pressure was lower in A compared to C (P < 0.025) and sustained for a shorter period in A compared with B (P < 0.0005) and C (P < 0.0005). All rectal sensitivity thresholds were higher in A compared with B and C. Pudendal Nerve Terminal Motor Latency was prolonged in 93% of patients studied in group A and in 73% of patients in group B (A vs B P < 0.005), with a significant difference in comparison with C: A vs C P < 0.0005, B vs C P < 0.005. Our findings suggest that somatic neuropathy plays an important role in faecal incontinence in diabetic patients, combined with sensation threshold impairment as a feature of an autonomic involvement. PMID:8064189

Pinna Pintor, M; Zara, G P; Falletto, E; Monge, L; Demattei, M; Carta, Q; Masenti, E

1994-05-01

246

Salivary-type amylase producing lung cancers examined clinically and pathologically in 260 Japanese patients of lung lobectomy or segmentectomy  

Microsoft Academic Search

The causative mechanisms of lung cancers producing salivary-type amylase (S-Amy) were hypothesized from clinical and pathological\\u000a analysis of lung cancers. A total of 260 Japanese patients who received lung lobectomy or segmentectomy during the last 4 years\\u000a at Hamamatsu University Hospital, Japan, were objective patients in this study. Among the 260 patients, 212 patients were\\u000a operated on for lung cancers. Of

Tadako Nakatsuji

2008-01-01

247

Cardiac autonomic neuropathy in patients with diabetes mellitus.  

PubMed

Cardiac autonomic neuropathy (CAN) is an often overlooked and common complication of diabetes mellitus. CAN is associated with increased cardiovascular morbidity and mortality. The pathogenesis of CAN is complex and involves a cascade of pathways activated by hyperglycaemia resulting in neuronal ischaemia and cellular death. In addition, autoimmune and genetic factors are involved in the development of CAN. CAN might be subclinical for several years until the patient develops resting tachycardia, exercise intolerance, postural hypotension, cardiac dysfunction and diabetic cardiomyopathy. During its sub-clinical phase, heart rate variability that is influenced by the balance between parasympathetic and sympathetic tones can help in detecting CAN before the disease is symptomatic. Newer imaging techniques (such as scintigraphy) have allowed earlier detection of CAN in the pre-clinical phase and allowed better assessment of the sympathetic nervous system. One of the main difficulties in CAN research is the lack of a universally accepted definition of CAN; however, the Toronto Consensus Panel on Diabetic Neuropathy has recently issued guidance for the diagnosis and staging of CAN, and also proposed screening for CAN in patients with diabetes mellitus. A major challenge, however, is the lack of specific treatment to slow the progression or prevent the development of CAN. Lifestyle changes, improved metabolic control might prevent or slow the progression of CAN. Reversal will require combination of these treatments with new targeted therapeutic approaches. The aim of this article is to review the latest evidence regarding the epidemiology, pathogenesis, manifestations, diagnosis and treatment for CAN. PMID:24567799

Dimitropoulos, Gerasimos; Tahrani, Abd A; Stevens, Martin J

2014-02-15

248

Proteinuria in type 2 diabetic patients with renal impairment: the changing face of diabetic nephropathy.  

PubMed

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 ACEi and/or ARB at the time of screening was recorded in 951 patients. 22% of patients had significant renal impairment with a PCR at screening of <500 mg/g. Therapy with ACEi and/or ARB at the time of screening was recorded in 94%, where prior medication data was available. In patients with type 2 DN and advanced renal impairment, levels of proteinuria below that which traditionally defines overt diabetic nephropathy, are found in more than one fifth of patients. We suggest that the high prevalence of ACEi and ARB usage in patients with type 2 DN may be effecting the traditional clinical paradigm of type 2 DN. PMID:21293156

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

2011-01-01

249

Comparison of diabetes patients with "demyelinating" diabetic sensorimotor polyneuropathy to those diagnosed with CIDP  

PubMed Central

Background We have previously identified a subset of diabetic sensorimotor polyneuropathy (DSP) patients with probable demyelination related to poor glycemic control. We aimed to determine whether the clinical characteristics and electrodiagnostic classification of nerve injury in diabetes patients with “demyelinating” DSP (D-DSP) differed from those diagnosed with chronic inflammatory demyelinating polyneuropathy (CIDP) (CIDP + diabetes mellitus [DM]). Methods D-DSP (56) and CIDP + DM (67) subjects underwent clinical examination and nerve conduction studies (NCS), and were compared using analysis of variance, contingency tables, and Kruskal–Wallis analyses. Results Of the 123 subjects with a mean age of 60.5 ± 15.6 years and mean hemoglobin A1c (HbA1c) of 8.2 ± 2.2%, 54% had CIDP + DM and 46% had D-DSP. CIDP + DM subjects were older (P = 0.0003), had shorter duration of diabetes (P = 0.005), and more severe neuropathy as indicated by Toronto Clinical Neuropathy Score (TCNS) (P = 0.003), deep tendon reflexes (P = 0.02), and vibration perception thresholds (VPT) (P = 0.01, P = 0.02). The mean HbA1c value for D-DSP subjects (8.9 ± 2.3%) was higher than in CIDP + DM subjects (7.7 ± 2.0%, P = 0.02). Conclusions The clinical phenotype and electrophysiological profile of CIDP + DM patients is marked by more severe neuropathy and better glycemic control than in patients with D-DSP. These findings indicate that these two conditions – despite similarities in their electrophysiological pattern of demyelination – likely differ in etiology. PMID:24363969

Dunnigan, Samantha K; Ebadi, Hamid; Breiner, Ari; Katzberg, Hans D; Lovblom, Leif E; Perkins, Bruce A; Bril, Vera

2013-01-01

250

Adherence to therapies in patients with type 2 diabetes.  

PubMed

Adherence to therapy is defined as the extent to which a person's behavior in taking medication, following a diet, and/or executing lifestyle changes, corresponds with agreed recommendations from a healthcare provider. Patients presenting with type 2 diabetes mellitus are initially encouraged to maintain a healthy diet and exercise regimen, followed by early medication that generally includes one or more oral hypoglycemic agents and later may include an injectable treatment. To prevent the complications associated with type 2 diabetes, therapy frequently also includes medications for control of blood pressure, dyslipidemia and other disorders, since patients often have more than three or four chronic conditions. Despite the benefits of therapy, studies have indicated that recommended glycemic goals are achieved by less than 50% of patients, which may be associated with decreased adherence to therapies. As a result, hyperglycemia and long-term complications increase morbidity and premature mortality, and lead to increased costs to health services. Reasons for nonadherence are multifactorial and difficult to identify. They include age, information, perception and duration of disease, complexity of dosing regimen, polytherapy, psychological factors, safety, tolerability and cost. Various measures to increase patient satisfaction and increase adherence in type 2 diabetes have been investigated. These include reducing the complexity of therapy by fixed-dose combination pills and less frequent dosing regimens, using medications that are associated with fewer adverse events (hypoglycemia or weight gain), educational initiatives with improved patient-healthcare provider communication, reminder systems and social support to help reduce costs. In the current narrative review, factors that influence adherence to different therapies for type 2 diabetes are discussed, along with outcomes of poor adherence, the economic impact of nonadherence, and strategies aimed at improving adherence. PMID:23990497

García-Pérez, Luis-Emilio; Alvarez, María; Dilla, Tatiana; Gil-Guillén, Vicente; Orozco-Beltrán, Domingo

2013-12-01

251

Emphysematous pyelonephritis in a diabetic patient with obstructed kidney.  

PubMed

Emphysematous pyelonephritis (EPN) is an acute, rare, inflammatory disease, which typically occurs in patients who suffer from diabetes mellitus. We report the case of a patient who was admitted to the Department of Urology with septic signs, in whom, after performing computed tomography, the diagnosis of EPN was established. The patient underwent organ-preserving treatment, which consisted of pyelolithotomy with nephrostomy, and the insertion of a double J catheter into the left ureter. The importance of the classification of EPN is also discussed. The need for individualized procedures is highlighted. PMID:25147731

Kutwin, Piotr; Konecki, Tomasz; Jab?onowski, Zbigniew

2014-01-01

252

Serum magnesium concentrations in type 1 diabetic patients: Relation to early atherosclerosis  

Microsoft Academic Search

Hypomagnesemia and sub-clinical atherosclerosis are common in type 1 diabetic patients, and are especially common in poorly controlled and chronically treated diabetics. The aim of this study was to evaluate the relationships between serum magnesium (Mg) and intima-media thickness (IMT), and functions of common carotid artery (CCA), accepted as markers of early carotid atherosclerosis in type 1 diabetic patients. Serum

Mehmet Emre Atabek; Selim Kurtoglu; Ozgur Pirgon; Murat Baykara

2006-01-01

253

Correlates of venous catecholamine concentrations in patients with type 1 diabetes during a cold pressor test  

Microsoft Academic Search

In some patients with type 1 diabetes, various physiologic reactions during a cold pressor test (CPT) are impaired. Whether this is caused by diabetic autonomic neuropathy, disturbed secretion of catecholamines, or disturbed blood glucose control is unknown. The authors, therefore, performed CPTs in patients with type 1 diabetes and in control subjects. They measured blood glucose concentrations, insulin concentrations, cardiac

Dieter Luft; Christine Maisch; Valerie Hofmann-Kriick; Mahmoud Radjaipour; Hans-Ulrich Häring

2000-01-01

254

Measuring and Improving Preventive Care for Patients With Diabetes in Primary Health Centers  

Microsoft Academic Search

Diabetes care among medically underserved patients is suboptimal. Few studies, however, have described successful strategies to improve diabetes care in these patient populations. To address this issue, 4 Montana community health centers and 1 urban Indian health center implemented quality improvement efforts along with an office-based electronic system for monitoring diabetes care. After a median of 17 months follow-up, preventive

Todd S. Harwell; Janet M. McDowall; Dorothy Gohdes; Steven D. Helgerson

2002-01-01

255

Smart Home-based Health Platform for Behavioral Monitoring and Alteration of Diabetes Patients  

E-print Network

. The architecture can be used to monitor the activity, diet, and exercise compliance of diabetes patients plan and exercise program, losing excess weight, and taking oral medication. Many people with diabetesSmart Home-based Health Platform for Behavioral Monitoring and Alteration of Diabetes Patients

Cook, Diane J.

256

[Domestic practice of antihypertensive treatment of diabetic hypertensive patients].  

PubMed

Diabetes mellitus as comorbidity is present in 20-25% of patients suffering from high blood pressure. Because simultaneous presence of these two diseases results in a significant increase of cardiovascular risk, various guidelines focus greatly on the anti-hyperintensive treatment of patients with diabetes. Combined drug therapy is usually required to achieve the blood pressure target value of <140/85 mmHg defined for patients with diabetes, which must be based on angiotensin converting enzyme-inhibitors or angiotensin receptor blockers. These can be/must be combined with low dose, primarily thiazid-like diuretics, calcium channel blockers with neutral metabolic effect, and further options include the addition of beta blockers, imidazolin-l-receptor antagonists, or alpha-1-adrenoreceptor blockers. Evidence-based guidelines are obviously present in local practice. Although most of the patients receive angiotensin converting enzyme-inhibitor+indapamid or angiotensin converting enzyme-inhibitor+calcium channel blocker combined therapy with favorable metabolic effects, yet the use of angiotensin converting enzyme-inhibitors containing hidrochlorotiazide having diabetogenic potencial, and angiotensin receptor blocker fixed combinations is still widespread. Similarly, interesting therapeutic practice can be observed with the use of less differentiated beta blockers, where the 3rd generation carvediolol and nebivolol are still in minority. Orv. Hetil., 2014, 155(43), 1695-1700. PMID:25327459

Szentes, Veronika; Kovács, Gabriella; Dézsi, Csaba András

2014-10-01

257

Two heterozygous mutations of the AMH gene in a Japanese patient with persistent Müllerian duct syndrome.  

PubMed

Abstract Persistent Müllerian duct syndrome (PMDS) is an autosomal recessive disorder of sex development (DSD) characterized by the presence of Müllerian duct derivatives in 46, XY phenotypic males. To date, more than 50 different mutations of the anti-Müllerian hormone gene (AMH) have been reported. Here, we report two novel mutations of AMH in a Japanese patient with PMDS. A 1-year-old male presented with bilateral cryptorchidism and normal male external genitalia. A laparoscopic surgery revealed a uterus and fallopian tubes. Serum AMH was very low. The patient's elder brother was also diagnosed as having PMDS at another hospital. Genetic analysis of AMH showed two novel mutations of p.N486T and p.V527L. Given that these two amino acids are well conserved among different species of AMH, the substitution of two amino acids might affect the normal function of AMH. In conclusion, PMDS should be included in differential diagnoses of cryptorchidism. PMID:25026127

Morikawa, Shuntaro; Moriya, Kimihiko; Ishizu, Katsura; Tajima, Toshihiro

2014-11-01

258

Clinical and radiological features of Japanese patients with a severe phenotype due to CASK mutations.  

PubMed

Heterozygous loss of function mutations of CASK at Xp11.4 in females cause severe intellectual disability (ID) and microcephaly with pontine and cerebellar hypoplasia (MICPCH). However, the longitudinal clinical and radiological course of affected patients, including patterns of postnatal growth, has not been described. Neurodevelopmental and imaging information was retrospectively accrued for 16 Japanese (15 female and 1 male) patients with ID and MICPCH associated with CASK mutations. All records were analyzed; patient age ranged from 2 to 16 years at the time of the most recent examinations. The growth pattern, neurological development, neurological signs/symptoms, and facial features were similar in the 15 female patients. Their head circumference at birth was within the normal range in about half, and their height and weight were frequently normal. This was followed by early development of severe microcephaly and postnatal growth retardation. The patients acquired head control almost normally between 3 and 6 months, followed by motor delay. More than half of the female patients had epilepsy. Their MRIs showed microcephaly, brainstem, and cerebellar hypoplasia in early infancy, and a normal or large appearing corpus callosum. The male patient showed a more severe clinical phenotype. These uniform clinical and radiological features should facilitate an early diagnosis and be useful for medical care of females with ID and MICPCH associated with CASK mutations. PMID:23165780

Takanashi, Jun-ichi; Okamoto, Nobuhiko; Yamamoto, Yuto; Hayashi, Shin; Arai, Hiroshi; Takahashi, Yukitoshi; Maruyama, Koichi; Mizuno, Seiji; Shimakawa, Shuichi; Ono, Hiroaki; Oyanagi, Reiki; Kubo, Satomi; Barkovich, A James; Inazawa, Johji

2012-12-01

259

The self-aware diabetic patient software agent model.  

PubMed

This work presents a self-aware diabetic patient software agent for representing a human diabetic patient. To develop a 24h, stochastic and self-aware patient agent, we extend the original seminal work of Ackerman et al. [1] in creating a mathematical model of human blood glucose levels in three aspects. (1) We incorporate the stochastic and unpredictable effects of daily living. (2) The Ackerman model is extended into the period of night-time. (3) Patients' awareness of their own conditions is incorporated. Simulation results are quantitatively assessed to demonstrate the effectiveness of lifestyle management, such as adjusting the amount of food consumed, meal schedule, intensity of exercise and level of medication. In this work we show through the simulation that the average blood glucose can be reduced by as much as 51% due to careful lifestyle management. Self monitoring blood glucose is also quantitatively evaluated. The simulation results show that the average blood glucose is further dropped by 25% with the assistance of blood glucose samples. In addition, the blood glucose is perfectly controlled in the target range during the simulation period as a result of joint efforts of lifestyle management and self monitoring blood glucose. This study focuses on demonstrating how human patients' behavior, specifically lifestyle and self monitoring of blood glucose, affects blood glucose controls on a daily basis. This work does not focus on the insulin-glucose interaction of an individual human patient. Our conclusion is that this self-aware patient agent model is capable of adequately representing diabetic patients and of evaluating their dynamic behaviors. It can also be incorporated into a multi-agent system by introducing other healthcare components so that more interesting insights such as the healthcare quality, cost and performance can be observed. PMID:24209935

Wang, Zhanle; Paranjape, Raman

2013-11-01

260

Molecular and Clinical Studies in 138 Japanese Patients with Silver-Russell Syndrome  

PubMed Central

Background Recent studies have revealed relative frequency and characteristic phenotype of two major causative factors for Silver-Russell syndrome (SRS), i.e. epimutation of the H19-differentially methylated region (DMR) and uniparental maternal disomy 7 (upd(7)mat), as well as multilocus methylation abnormalities and positive correlation between methylation index and body and placental sizes in H19-DMR epimutation. Furthermore, rare genomic alterations have been found in a few of patients with idiopathic SRS. Here, we performed molecular and clinical findings in 138 Japanese SRS patients, and examined these matters. Methodology/Principal Findings We identified H19-DMR epimutation in cases 1–43 (group 1), upd(7)mat in cases 44–52 (group 2), and neither H19-DMR epimutation nor upd(7)mat in cases 53–138 (group 3). Multilocus analysis revealed hyper- or hypomethylated DMRs in 2.4% of examined DMRs in group 1; in particular, an extremely hypomethylated ARHI-DMR was identified in case 13. Oligonucleotide array comparative genomic hybridization identified a ?3.86 Mb deletion at chromosome 17q24 in case 73. Epigenotype-phenotype analysis revealed that group 1 had more reduced birth length and weight, more preserved birth occipitofrontal circumference (OFC), more frequent body asymmetry and brachydactyly, and less frequent speech delay than group 2. The degree of placental hypoplasia was similar between the two groups. In group 1, the methylation index for the H19-DMR was positively correlated with birth length and weight, present height and weight, and placental weight, but with neither birth nor present OFC. Conclusions/Significance The results are grossly consistent with the previously reported data, although the frequency of epimutations is lower in the Japanese SRS patients than in the Western European SRS patients. Furthermore, the results provide useful information regarding placental hypoplasia in SRS, clinical phenotypes of the hypomethylated ARHI-DMR, and underlying causative factors for idiopathic SRS. PMID:23533668

Fuke, Tomoko; Mizuno, Seiji; Nagai, Toshiro; Hasegawa, Tomonobu; Horikawa, Reiko; Miyoshi, Yoko; Muroya, Koji; Kondoh, Tatsuro; Numakura, Chikahiko; Sato, Seiji; Nakabayashi, Kazuhiko; Tayama, Chiharu; Hata, Kenichiro; Sano, Shinichiro; Matsubara, Keiko; Kagami, Masayo; Yamazawa, Kazuki; Ogata, Tsutomu

2013-01-01

261

Lifestyle intervention for type 2 diabetes patients - trial protocol of The Copenhagen Type 2 Diabetes Rehabilitation Project  

PubMed Central

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 a new group-based lifestyle rehabilitation programme in a Health Care Centre in primary care. Methods/Design The group-based diabetes rehabilitation programme consists of empowerment-based education, supervised exercise and dietary intervention. The effectiveness of this multi-disciplinary intervention is compared with conventional individual counselling in a Diabetes Outpatient Clinic and evaluated in a prospective and randomized controlled trial. During the recruitment period of 18 months 180 type 2 diabetes patients will be randomized to the intervention group and the control group. Effects on glycaemic control, quality of life, self-rated diabetes symptoms, body composition, blood pressure, lipids, insulin resistance, beta-cell function and physical fitness will be examined after 6, 12 and 24 months. Discussion The Copenhagen Type 2 Diabetes Rehabilitation Project evaluates a multi-disciplinary non-pharmacological intervention programme in a primary care setting and provides important information about how to organize non-pharmacological care for type 2 diabetes patients. Trail Registration ClinicalTrials.gov registration number: NCT00284609. PMID:19480671

Vadstrup, Eva S; Fr?lich, Anne; Perrild, Hans; Borg, Eva; R?der, Michael

2009-01-01

262

Potentially functional variants in the core nucleotide excision repair genes predict survival in Japanese gastric cancer patients.  

PubMed

Functional genetic variants of DNA repair genes may alter the host DNA repair capacity, and thus influence efficiency of therapies. We genotyped eight potentially functional single nucleotide polymorphisms (SNPs) in genes (i.e. ERCC1, XPA, XPC, XPD and XPG) involved in the nucleotide excision repair (NER) pathway in 496 Japanese gastric cancer patients, and assessed overall survival and recurrence-free survival. The combined effects of risk genotypes of these eight SNPs in Japanese patients were further replicated in 356 North-American gastric cancer patients. In Japanese patients, we found that the XPC rs2228000 TT genotype was associated with shorter overall survival [hazards ratio (HR) = 1.75, 95% confidence interval (95% CI) = 1.07-2.86] and recurrence-free survival (HR = 2.17, 95% CI = 1.19-3.95), compared with CC/CT genotypes, and the XPG rs17655 CC genotype was associated with shorter overall survival (HR = 1.60, 95% CI = 1.08-2.36), compared with GG/CG genotypes. The number of observed risk genotypes in the combined analysis was associated with shorter overall survival and recurrence-free survival in a dose-response manner (P(trend) = 0.006 and P(trend) < 0.000) in Japanese patients; specifically, compared with those with ?1 risk genotypes, those with ?2 risk genotypes showed markedly shorter overall survival (HR = 1.79, 95% CI = 1.18-2.70) and recurrence-free survival (HR = 2.80, 95% CI = 1.66-4.73). The association between ?2 risk genotypes and shorter overall survival was not significant (HR = 1.26, 95% CI = 0.82-1.94) in North-American patients, but the trends were similar in these two groups of patients. These data show that functional SNPs in NER core genes may impact survival in Japanese gastric cancer patients. PMID:24990617

Li, Yangkai; Liu, Zhensheng; Liu, Hongliang; Wang, Li-E; Onodera, Hisashi; Suzuki, Akihiro; Suzuki, Koyu; Wadhwa, Roopma; Elimova, Elena; Sudo, Kazuki; Shiozaki, Hironari; Estrella, Jeannelyn; Lee, Ju-Seog; Song, Shumei; Tan, Dongfeng; Ajani, Jaffer A; Wei, Qingyi

2014-09-01

263

EM clustering analysis of diabetes patients basic diagnosis index.  

PubMed

Cluster analysis can group similar instances into same group and different instances into different groups. It assigns classes to samples without known the classes in advance. EM clustering algorithm can find number of distributions of generating data and build "mixture models". It identifies groups that are either overlapping or varying sizes and shapes. In this project, by using EM in Weka system, diabetes patient basic diagnosis index data have been analyzed for clustering. PMID:16779444

Wu, Cai; Steinbauer, Jeffrey R; Kuo, Grace M

2005-01-01

264

Evaluation of immunological parameters in diabetic patients: are these patients immunodeficient?  

PubMed

It has been widely thought that diabetic patients are prone to infections due to hyperglycemia induced immunodeficiency; the present study was designed to examine this opinion. In diabetic patients and normal control groups T-cell reactivity to hsp-60 molecule, tetanus toxoid recall antigen (TT) and phytohemagglutinin-A (PHA) mitogen were evaluated The number of circulating IFN-?, IL-10 and IL-13 cytokine producing cells stimulated with above antigens or mitogen as well as the serum levels of Th1/Th2 type cytokines were determined. Total serum immunoglobulins (IgG, IgA, IgM), C3, C4 and CH50 were also measured. Diabetic patients showed a positive circulating T-cell reactivity to human recombinant hsp60 However, this reactivity was significantly lower in comparison to control group (p<0.001). All other examined factors were not significantly different between diabetic and normal subjects except for the number of IFN-? and IL-13 producing cells in response to PHA stimulation, which was higher in control gtroup (p=0.006, 0.018, respectively). The mean serum concentration of IgA in diabetic patients was 245.86 ± 115.05 mg/dl versus 192.96 ± 105.33 mg/dl in healthy control group (p<0.018). We were not able to demonstrate any substantial mitigation in cellular arms of immune reaction to some prominent T-cell antigens and mitogens, as well as, in main parameters of humoral immunity of diabetic patients, thus, the common notion of believing that patients with diabetes suffering from immunodeficiency should be revised. It is much more appropriate that "altered immunity" is applied instead of "immunodeficiency" to explain the immunity condition in this group of patients. PMID:24338256

Moazezi, Zoleikha; Hosseinian, Azam; Ahmad Moazam, Ensiyeh; Eslami, Mohamed Bagher; Mosavi, Ezatollah; Akhavan-Niaki, Haleh; Bijani, Ali; Schloot, Nanette; Mostafazadeh, Amrollah

2014-04-01

265

Patient safety education at Japanese medical schools: results of a nationwide survey  

PubMed Central

Background Patient safety education, including error prevention strategies and management of adverse events, has become a topic of worldwide concern. The importance of the patient safety is also recognized in Japan following two serious medical accidents in 1999. Furthermore, educational curriculum guideline revisions in 2008 by relevant the Ministry of Education includes patient safety as part of the core medical curriculum. However, little is known about the patient safety education in Japanese medical schools partly because a comprehensive study has not yet been conducted in this field. Therefore, we have conducted a nationwide survey in order to clarify the current status of patient safety education at medical schools in Japan. Results Response rate was 60.0% (n?=?48/80). Ninety-eight-percent of respondents (n?=?47/48) reported integration of patient safety education into their curricula. Thirty-nine percent reported devoting less than five hours to the topic. All schools that teach patient safety reported use of lecture based teaching methods while few used alternative methods, such as role-playing or in-hospital training. Topics related to medical error theory and legal ramifications of error are widely taught while practical topics related to error analysis such as root cause analysis are less often covered. Conclusions Based on responses to our survey, most Japanese medical schools have incorporated the topic of patient safety into their curricula. However, the number of hours devoted to the patient safety education is far from the sufficient level with forty percent of medical schools that devote five hours or less to it. In addition, most medical schools employ only the lecture based learning, lacking diversity in teaching methods. Although most medical schools cover basic error theory, error analysis is taught at fewer schools. We still need to make improvements to our medical safety curricula. We believe that this study has the implications for the rest of the world as a model of what is possible and a sounding board for what topics might be important. PMID:22574712

2012-01-01

266

Reversal of the Symptoms of Diabetic Neuropathy through Correction of Vitamin D Deficiency in a Type 1 Diabetic Patient  

PubMed Central

Vitamin D deficiency has been associated with both type 1 and type 2 diabetes as well as both the microvascular and macrovascular complications of diabetes. Vitamin D deficiency has been shown to be more common in diabetic patients who have symptoms of distal symmetrical polyneuropathy. In addition, vitamin D deficiency has been associated with a lower pain threshold which increases when vitamin D deficiency is corrected. Herein, I describe a type 1 diabetic patient with neuropathic symptoms so severe that he could not work and for which he needed narcotics for pain management and whose symptoms improved dramatically with correction of the vitamin D deficiency. To my knowledge, this is the first report of an improvement in severe symptoms of diabetic neuropathy with correction of vitamin D deficiency in a single patient. PMID:23304571

Bell, David S. H.

2012-01-01

267

How does anger coping style affect glycemic control in diabetes patients?  

Microsoft Academic Search

Background: Although various forms of anger have been found to influence the psychological and physical health in many chronic illness\\u000a populations, little is known about the effects of anger in diabetes patients. Purpose: Associations between anger coping style, diabetes-related psychological distress, and glycosylated hemoglobin (HbA1c) were\\u000a examined in 100 diabetes patients. Method: Participants completed the Problem Areas in Diabetes and

Joyce P. Yi; Jean C. Yi; Peter P. Vitaliano; Katie Weinger

2008-01-01

268

Attainment of Canadian Diabetes Association recommended targets in patients with type 2 diabetes  

PubMed Central

OBJECTIVE To examine the degree to which targets for diabetes (blood pressure [BP], glycated hemoglobin [HbA1c], and low-density lipoprotein cholesterol [LDL-C]) are achieved in family practices and how these results compare with family physicians’ perceptions of how well targets are being achieved. DESIGN Chart audit and physician survey. SETTING Newfoundland and Labrador. PARTICIPANTS Patients with type 2 diabetes and their family physicians. INTERVENTIONS The charts of 20 patients with type 2 diabetes were randomly chosen from each of 8 family physician practices in St John’s, Nfld, and data were abstracted. All family physicians in the province were surveyed using a modified Dillman method. MAIN OUTCOME MEASURES The most recent HbA1c, LDL-C, and BP measurements listed in each audited chart; surveyed family physicians’ knowledge of the recommended targets for HbA1c, LDL-C, and BP and their estimates of what percentage of their patients were at those recommended targets. RESULTS The chart audit revealed that 20.6% of patients were at the recommended target for BP, 48.1% were at the recommended target for HbA1c, and 17.5% were at the recommended target for LDL-C. When targets were examined collectively, only 2.5% of patients were achieving targets in all 3 areas. The survey found that most family physicians were aware of the recommended targets for BP, LDL-C, and HbA1c. However, their estimates of the percentages of patients in their practices achieving these targets appeared high (59.3% for BP, 58.2% for HbA1c, and 48.4% for LDL-C) compared with the results of the chart audit. CONCLUSION The findings of the chart audit are consistent with other published reports, which have illustrated that a large majority of patients with diabetes fall short of reaching recommended targets for BP, blood glucose, and lipid levels. Although family physicians are knowledgeable about recommended targets, there is a gap between knowledge and clinical outcomes. The reasons for this are likely multifactorial. Further investigation is needed to better understand this phenomenon as well as to understand the foundation for physicians’ optimistic estimates of how many of their patients with diabates were reaching target values. PMID:20090056

McCrate, Farah; Godwin, Marshall; Murphy, Laura

2010-01-01

269

Tissue Doppler imaging for the detection and quantitation of myocardial dysfunction in patients with type 2 diabetes mellitus  

Microsoft Academic Search

The prevalence of type 2 diabetes mellitus is rapidly increasing. Myocardial dysfunction may be a consequence of diabetic cardiomyopathy and it contributes to the poor prognosis of diabetic patients.Aims This study was designed to test whether tissue Doppler imaging might be a suitable tool for early detection of myocardial dysfunction in diabetic patients.Methods Forty-three diabetic patients and 33 non-diabetic controls,

Helene Von Bibra; Inga S Thrainsdottir; Alexander Hansen; Vasilios Dounis; Klas Malmberg; Lars Rydén

2005-01-01

270

Pharmacokinetics of Rifabutin in Japanese HIV-Infected Patients with or without Antiretroviral Therapy  

PubMed Central

Objective Based on drug-drug interaction, dose reduction of rifabutin is recommended when co-administered with HIV protease inhibitors for human immunodeficiency virus (HIV)-associated mycobacterial infection. The aim of this study was to compare the pharmacokinetics of rifabutin administered at 300 mg/day alone to that at 150 mg every other day combined with lopinavir-ritonavir in Japanese patients with HIV/mycobacterium co-infection. Methods Plasma concentrations of rifabutin and its biologically active metabolite, 25-O-desacetyl rifabutin were measured in 16 cases with HIV-mycobacterial coinfection. Nine were treated with 300 mg/day rifabutin and 7 with 150 mg rifabutin every other day combined with lopinavir-ritonavir antiretroviral therapy (ART). Samples were collected at a median of 15 days (range, 5–63) of rifabutin use. Results The mean Cmax and AUC0–24 of rifabutin in patients on rifabutin 150 mg every other day were 36% and 26% lower than on 300 mg/day rifabutin, while the mean Cmax and AUC0–24 of 25–O-desacetyl rifabutin were 186% and 152% higher, respectively. The plasma concentrations of rifabutin plus its metabolite were similar between the groups within the first 24 hours, but it remained low during subsequent 24 to 48 hours under rifabutin 150 mg alternate day dosing. Conclusion Rifabutin dose of 150 mg every other day combined with lopinavir-ritonavir seems to be associated with lower exposure to rifabutin and its metabolite compared with rifabutin 300 mg/day alone in Japanese patients. Further studies are needed to establish the optimal rifabutin dose during ART. The results highlight the importance of monitoring rifabutin plasma concentration during ART. Trial registration UMIN-CTR (https://upload.umin.ac.jp/cgi-open-bin/ctr/ctr.cgi?function=search&action=input&language=E) UMIN000001102 PMID:23940604

Tanuma, Junko; Sano, Kazumi; Teruya, Katsuji; Watanabe, Koji; Aoki, Takahiro; Honda, Haruhito; Yazaki, Hirohisa; Tsukada, Kunihisa; Gatanaga, Hiroyuki; Kikuchi, Yoshimi; Oka, Shinichi

2013-01-01

271

Changes of tear film and tear secretion after phacoemulsification in diabetic patients  

PubMed Central

Objective: To evaluate tear film stability and tear secretion in patients with diabetes after phacoemulsification. Methods: Twenty-five diabetic cataract patients and 20 age-matched non-diabetic cataract patients as control underwent phacoemulsification. Tear film break-up time (TFBUT), Schirmer I test (SIT), corneal fluorescein staining, and dry eye symptoms were measured pre- and postoperatively. Results: Diabetics had a decreased preoperative TFBUT and SIT. TFBUT was reduced on Day 1 and recovered on Day 180 postoperatively in both groups. SIT was increased after phacoemulsification, but returned to preoperative levels by Day 180 in non-diabetics, whereas it was lower than preoperative level in diabetics. Positive corneal fluorescein staining was elevated in both groups, and returned to preoperative levels only in controls. Dry eye symptoms were similar to fluorescein staining in both groups. Conclusion: Tear secretion was reduced in diabetic cataract patients after phacoemulsification, which worsened dry eye symptoms and predisposed those patients to ocular damage. PMID:18381808

Liu, Xi; Gu, Yang-shun; Xu, Ye-sheng

2008-01-01

272

Ocular Factors Relevant to Keratoepitheliopathy in Glaucoma Patients With and Without Diabetes Mellitus  

Microsoft Academic Search

Purpose: To examine the effect of diabetes mellitus on the keratoepitheliopathy in glaucoma patients with and without diabetes mellitus who were treated with anti-glaucoma eye drops.Methods: The presence and severity of keratoepitheliopathy was investigated in the eyes of 36 glaucoma patients with diabetes mellitus and 47 nondiabetic patients who had glaucoma. All the patients had used anti-glaucoma eye drops. The

Kenji Inoue; Kazuko Okugawa; Satoshi Kato; Yuji Inoue; Tetsuro Oshika; Shiro Amano

2003-01-01

273

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

274

Change of aging males' symptoms (AMS) rating scale in Japanese late-onset hypogonadism (LOH) patients administered androgen replacement therapy  

Microsoft Academic Search

BackgroundWe examined changes in the Aging Males' Symptoms (AMS) rating scale in Japanese late-onset hypogonadism (LOH) patients during the administration of androgen replacement therapy (ART), and evaluated whether the AMS rating scale is a useful tool for the diagnosis of LOH or the determination of ART efficacy.

Hisanori Taniguchi; Gen Kawa; Hidefumi Kinoshita; Tadashi Matsuda

2011-01-01

275

Circulating antibodies to -enolase and phospholipase A2 receptor and composition of glomerular deposits in Japanese patients with primary or  

E-print Network

deposits in Japanese patients with primary or secondary membranous nephropathy Yukihiro Kimura1 , Hiroyuki 1 Division of Nephrology and Rheumatology, Department of Internal Medicine, Aichi Medical University­Hôpitaux de Paris (AP-HP), Tenon Hospital, Paris, France ; 3 Department of Internal Medicine, Kawana Hospital

Boyer, Edmond

276

Diabetes, Insulin Resistance, and Dementia Among HIV-1-Infected Patients  

PubMed Central

Objectives: Metabolic complications have been associated with HIV-1 infection and with long-term use of antiretroviral (ARV) medications. In some studies, such complications have been linked to cardiovascular events, yet limited data exist concerning metabolic complications and dementia. The objective of this study was to examine the relationship between HIV-associated dementia (HAD) and diabetes among patients with HIV-1 infection. Design: Cross-sectional analysis of entry data for a longitudinal cohort study. Methods: A total of 203 participants who were enrolled in the Hawaii Aging with HIV Cohort between October 2001 and November 2003 served as the study population. Research case definitions of HAD were determined in consensus conferences by a panel that included neurologists, neuropsychologists, and a geriatrician. Diabetes was determined by self-report or a fasting glucose level >125 mg/dL. Results: Participants' ages ranged between 20–76 years at enrollment with approximately one-half aged ?50 years. After adjustment for important covariates including age, education, ethnicity, CD4 lymphocyte count, duration of HIV infection, and protease inhibitor–based ARV therapy, we found a statistically significant association of diabetes with HAD (odds ratio 5.43, 1.66–17.70). A significant association remained after adjustment for other vascular risk factors. Among participants without diabetes, fasting glucose levels were higher with increasing impairment category. Conclusions: Within the Hawaii Aging with HIV Cohort, a longitudinal study enriched with older HIV-1–infected individuals, diabetes is associated with prevalent dementia. This finding is not fully explained by age or coexisting vascular risk factors. Evaluation of underlying mechanisms is warranted. PMID:15608521

Shikuma, Cecilia M.; Shiramizu, Bruce T.; Williams, Andrew E.; Watters, Michael R.; Poff, Pamela W.; Grove, John S.; Selnes, Ola A.; Sacktor, Ned C.

2006-01-01

277

[Factors influencing homocysteineamia in type 2 diabetic patients].  

PubMed

Previous studies have suggested that hyperhomocysteinaemia (Hcy) could be a strong and independent cardiovascular risk factor. Many factors could influence the serum concentration of Hcy such as vitamin B 12, folic acid, renal failure, hypothyroid status, ovarian failure and cancers. So the aim of our study was to evaluate the prevalence of hyperhomocysteinaemia among 54 type 2 diabetic patients and to study, its relationship with vitamin B12, folic acid and Metformin. Were excluded all patients with an evident cause of hyperhomocysteinaemia. Mean age of patients was 52.8 years. Mean Hcy was 11.7 + 6.9 micromol/l. The prevalence of hyperhomocysteinaemia was 27.8% in our group. There were eight (14%) patients with vitamin B12 deficiency and three among them had hyperhomocysteinaemia. There was no folic acid deficiency and no relationship with Metformin treatment. We suggest a wide screening of hyperhomocysteinaemia in type 2 diabetic patients and folic acid or vitamin B12 supplements if necessary. PMID:16915776

Essais, Olfa; Bouzid, Chiraz; Ouni, Zied; Ibrahim, Hazard; Ouertani, Haroun; Machghoul, Salem; Zidi, Borni

2006-05-01

278

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 PMID:21235825

2011-01-01

279

Nocturnal blood pressure fall as predictor of diabetic nephropathy in hypertensive patients with type 2 diabetes  

PubMed Central

Background Hypertensive patients with reduced blood pressure fall (BPF) at night are at higher risk of cardiovascular events (CVE). Methods We evaluated in hypertensive diabetic patients, if a reduced nocturnal BPF can precedes the development of diabetic nephropathy (DN). We followed 70 patients with normal urinary albumin excretion (UAE) for two years. We performed 24-hours ambulatory BP monitoring in baseline and at the end of the study. Results Fourteen (20%) patients (GI) developed DN (N = 11) and/or CVE (n = 4). Compared to the remaining 56 patients (GII) in baseline, GI had similar diurnal systolic (SBP) and diastolic BP (DBP), but higher nocturnal SBP (138 ± 15 vs 129 ± 16 mmHg; p < 0.05) and DBP (83 ± 12 vs 75 ± 11 mmHg; p < 0,05). Basal nocturnal SBP correlated with occurrence of DN and CVE (R = 0.26; P < 0.05) and with UAE at the end of the study (r = 0.3; p < 0.05). Basal BPF (%) correlated with final UAE (r = -0.31; p < 0.05). In patients who developed DN, reductions occurred in nocturnal systolic BPF (12 ± 5 vs 3 ± 6%, p < 0,01) and diastolic BPF (15 ± 8 vs 4 ± 10%, p < 0,01) while no changes were observed in diurnal SBP (153 ± 17 vs 156 ± 16 mmHg, NS) and DBP (91 ± 9 vs 90 ± 7 mmHg, NS). Patients with final UAE < 20 ?g/min, had no changes in nocturnal and diurnal BP. Conclusions Our results suggests that elevations in nocturnal BP precedes DN and increases the risk to develop CVE in hypertensive patients with T2DM. PMID:20704750

2010-01-01

280

Clinical management of concurrent diabetes and tuberculosis and the implications for patient services.  

PubMed

Diabetes triples the risk for active tuberculosis, thus the increasing burden of type 2 diabetes will help to sustain the present tuberculosis epidemic. Recommendations have been made for bidirectional screening, but evidence is scarce about the performance of specific tuberculosis tests in individuals with diabetes, specific diabetes tests in patients with tuberculosis, and screening and preventive therapy for latent tuberculosis infections in individuals with diabetes. Clinical management of patients with both diseases can be difficult. Tuberculosis patients with diabetes have a lower concentration of tuberculosis drugs and a higher risk of drug toxicity than tuberculosis patients without diabetes. Good glycaemic control, which reduces long-term diabetes complications and could also improve tuberculosis treatment outcomes, is hampered by chronic inflammation, drug-drug interactions, suboptimum adherence to drug treatments, and other factors. Besides drug treatments for tuberculosis and diabetes, other interventions, such as education, intensive monitoring, and lifestyle interventions, might be needed, especially for patients with newly diagnosed diabetes or those who need insulin. From a health systems point of view, delivery of optimum care and integration of services for tuberculosis and diabetes is a huge challenge in many countries. Experience from the combined tuberculosis and HIV/AIDS epidemic could serve as an example, but more studies are needed that include economic assessments of recommended screening and systems to manage concurrent tuberculosis and diabetes. PMID:25194887

Riza, Anca Lelia; Pearson, Fiona; Ugarte-Gil, Cesar; Alisjahbana, Bachti; van de Vijver, Steven; Panduru, Nicolae M; Hill, Philip C; Ruslami, Rovina; Moore, David; Aarnoutse, Rob; Critchley, Julia A; van Crevel, Reinout

2014-09-01

281

[Diagnosis of diabetic autonomic neuropathy in young patients with diabetes mellitus type 1].  

PubMed

Autonomic neuropathy, particularly cardiovascular autonomic neuropathy (CAN) is one of the complications of the diabetes mellitus both types. It leads to life comfort's declination but may also be the direct cause of death in diabetes mellitus patients. It seems that degree of metabolic control and duration of the disease is connected with prevalence and severity of CAN. The aim of our study was to assess cardiac autonomic function in young subjects suffered from insulin-dependent diabetes mellitus (IDDM) with relatively short duration time of the disease. We subdivided 25 (m-12, f-13) IDDM patients aged from 18 to 30 years: mean--26 +/- 38 years, with duration time of the disease up to 10 years, normotensive and without nephropathy and retinopathy. We created 25 healthy volunteers control group with similar age and sex. In all selected subjects full Ewing's battery tests were performed as well as the spectral analysis of power heart rate variability (HRV) was assessed with Finapress device (Ohmeda 2300) and automatically computed with special software. HRV in total spectrum power TP from 0.001-0.5 Hz, high frequency (HF) band from 0.15-0.3 Hz, low frequency (LF) band from 0.03-0.15 Hz and LF/HF ratio were examined both in supine and tilt. All assessed spectral values were significantly lower in IDDM patients then these in controls whereas LF/HF were respectively higher. Valsalva tests and deep breathing HR response tests were significantly differed among groups but within normal limits. We concluded that when spectral analyse was performed, in young IDDM patients with short duration time of the disease, impairment of cardiac autonomic function was observed. PMID:11291603

Burak, W; Grzeszczak, W; Bujak-Rosenbeiger, E

2000-01-01

282

Health-related quality of life in diabetic patients and controls without diabetes in refugee camps in the Gaza strip: a cross-sectional study  

Microsoft Academic Search

BACKGROUND: Prevalence of diabetes mellitus is increasing in developed and developing countries. Diabetes is known to strongly affect the health-related quality of life (HRQOL). HRQOL is also influenced by living conditions. We analysed the effects of having diabetes on HRQOL under the living conditions in refugee camps in the Gaza strip. METHODS: We studied a sample of 197 diabetic patients

Ashraf Eljedi; Rafael T Mikolajczyk; Alexander Kraemer; Ulrich Laaser

2006-01-01

283

Investigation of auditory thresholds in type 2 diabetic patients compared to non-diabetic cases  

PubMed Central

Background: Hearing loss is one of the common complaints of diabetics. The aim of this study was to evaluate the hearing status of diabetic patients in Babol, North of Iran. Methods: The hearing status of 50 type 2 diabetic patients (case group) and 50 healthy individuals (control group) were evaluated from October 2011 to September 2012. Audiometry was done with the frequencies of 250, 500, 1000, 2000, 4000, 6000, 8000 HZ and speech tests like SRT (speech reception threshold), SDS (speech discrimination score) were performed. The data were collected and analyzed. Results: The mean age of case group was 50.1±3 and in control group was 49.9±3.2 years. Hearing thresholds were 10.55.6, 10.76.1, 15.27.1, 169.6, 21.213.5, 26.416.5, 28.32 db in the right ear of the case group and 11.25.3, 9.74.9, 127.1, 14.29.4, 20.913.3, 25.115.6, 27.620.2 db in control group with different frequencies (p<0.05). Similar results were obtained in the left ear of both groups. The mean SRT in the right ear of the case group was 15.77.7 and control group was 9.24.8 and 13.56.9 in case and 9.14 in the left ear of case group (P=0.0001). SDS was 94.33.7 and in 96.23.3 in the right ear for the case and control group, respectively (P=0.0001). For the left ear, these values were 94.44.4 and 95.93.2, respectively (P=0.023). Conclusion: The results show that hearing loss in different frequencies and speech reception threshold were higher in diabetic group but speech discrimination score was higher in normal individuals. Audiological monitoring is recommended in diabetic patients during therapy. PMID:24778785

Kiakojouri, Keivan; Monadi, Mohsen; Sheikhzadeh, Mahboobeh; Taghinejad Omran, Pouria; Bayani, Mohammad Ali; Khafri, Soraya

2014-01-01

284

Clozapine-induced seizures, electroencephalography abnormalities, and clinical responses in Japanese patients with schizophrenia  

PubMed Central

Purpose We describe electroencephalography (EEG) abnormalities and seizures associated with clozapine treatment in Japanese patients with schizophrenia and retrospectively compare EEG results and total Positive and Negative Syndrome Scale (PANSS [T]) scores before and after treatment. Methods Twenty-six patients with treatment-resistant schizophrenia were enrolled in this study. EEG measurements were obtained prior to clozapine treatment and every 4 weeks thereafter. EEG measurements were also obtained at the time of seizure. After seizures or EEG abnormalities were noted, additional EEGs were performed every 2 weeks. PANSS (T) scores were used to determine clozapine treatment outcome. Results All 26 patients had normal baseline EEG measurements, and ten patients (38.5%) later manifested EEG abnormalities. The mean age was significantly lower than in the abnormal EEG group. Six patients (23.1%) experienced seizures. The mean dose of clozapine at the first occurrence of seizure was 383.3 mg/day. Five of six patients who experienced seizures in this study were successfully treated with valproate or lamotrigine without discontinuation of clozapine. The one patient who continued to experience seizures was successfully treated without antiepileptic drugs. The mean baseline PANSS (T) scores were not significantly different between the normal and abnormal EEG groups, but the mean score in the abnormal EEG group was significantly lower than that in the normal EEG group at the final follow-up (P=0.02). Conclusion EEG abnormalities may appear in younger patients, and our findings indicate that there is no need to discontinue clozapine when seizures occur. EEG abnormalities that appeared after clozapine treatment were associated with a good clinical response. PMID:25342906

Kikuchi, Yuka Sugawara; Sato, Wataru; Ataka, Keiichiro; Yagisawa, Kiwamu; Omori, Yuki; Kanbayashi, Takashi; Shimizu, Tetsuo

2014-01-01

285

Local effect of stereotactic body radiotherapy for primary and metastatic liver tumors in 130 Japanese patients  

PubMed Central

Background and aims Stereotactic body radiotherapy (SBRT) is a relatively new treatment for liver tumor. The outcomes of SBRT for liver tumor unfit for ablation and surgical resection were evaluated. Methods Liver tumor patients treated with SBRT in seven Japanese institutions were studied retrospectively. Patients given SBRT for liver tumor between 2004 and 2012 were collected. Patients treated with SBRT preceded by trans-arterial chemoembolization (TACE) were eligible. Seventy-nine patients with hepatocellular carcinoma (HCC) and 51 patients with metastatic liver tumor were collected. The median biologically effective dose (BED) (?/??=?10 Gy) was 96.3 Gy for patients with HCC and 105.6 Gy with metastatic liver tumor. Results The median follow-up time was 475.5 days in patients with HCC and 212.5 days with metastatic liver tumor. The 2-year local control rate (LCR) for HCC and metastatic liver tumor was 74.8%?±?6.3% and 64.2?±?9.5% (p?=?0.44). The LCR was not different between BED10???100 Gy and??30 mm vs. ? 30 mm (64% vs. 85%, p?=?0.040) in all 130 patients. No grade 3 laboratory toxicities in the acute, sub-acute and chronic phases were observed. Conclusions There was no difference in local control after SBRT in the range of median BED10 around 100 Gy for between HCC and metastatic liver tumor. SBRT is safe and might be an alternative method to resection and ablation. Summary There was no difference in local control after SBRT in the range of median BED10 around 100 Gy for between HCC and metastatic liver tumor and SBRT is safe and might be an alternative method to resection and ablation. PMID:24886477

2014-01-01

286

Determinants of sexual dysfunction among clinically diagnosed diabetic patients  

PubMed Central

Background Diabetes mellitus is a chronic disease that can result in various medical, psychological and sexual dysfunctions (SD) if not properly managed. SD in men is a common under-appreciated complication of diabetes. This study assessed the prevalence and determinants of SD among diabetic patients in Tema, Greater Accra Region of Ghana. Method Sexual functioning was determined in 300 consecutive diabetic men (age range: 18-82 years) visiting the diabetic clinic of Tema General Hospital with the Golombok Rust Inventory of Sexual Satisfaction (GRISS) questionnaire, between November, 2010 and March, 2011. In addition to the socio-demographic characteristics of the participants, the level of glycosylated haemoglobin, fasting blood sugar (FBS) and serum testosterone were assessed. All the men had a steady heterosexual relationship for at least 2 years before enrolment in the study. Results Out the 300 participants contacted, the response rate was 91.3% after 20 declined participation and 6 incomplete data were excluded All the respondents had at least basic education, 97.4% were married, 65.3% were known hypertensive, 3.3% smoked cigarettes, 27% took alcoholic beverages and 32.8% did some form of exercise. The 69.3% SD rate observed in this study appears to be related to infrequency (79.2%), non-sensuality (74.5%), dissatisfaction with sexual acts (71.9%), non-communication (70.8%) and impotence (67.9%). Other areas of sexual function, including premature ejaculation (56.6%) and avoidance (42.7%) were also substantially affected. However, severe SD was seen in only 4.7% of the studied population. The perceived "adequate", "desirable", "too short" and "too long intra-vaginal ejaculatory latency time (IELT) are 5-10, 5-10, 1-2 and 15-30 minutes respectively. Testosterone correlates negatively with glycated haemoglobin (HBA1c), FBS, perceived desirable, too short IELT, and weight as well as waist circumference. Conclusion SD rate from this study is high but similar to that reported among self-reported diabetic patients in Kumasi, Ghana and vary according to the condition and age. The determinants of SD from this study are income level, exercise, obesity, higher perception of "desirable" and "too short" IELT. PMID:21612653

2011-01-01

287

Efficacy of traditional and alternative sunitinib treatment schedules in Japanese patients with metastatic renal cell carcinoma.  

PubMed

We report the adverse events and efficacy of traditional (4 weeks on 2 weeks off) and alternative sunitinib treatment schedules for Japanese patients with metastatic renal cell carcinoma. We retrospectively investigated 54 patients who received sunitinib for metastatic renal cell carcinoma between May 2006 and June 2012: 32 received a traditional treatment schedule and 22 received an alternative schedule. According to the Memorial Sloan-Kettering Cancer Center risk classification, five patients had favorable prognoses, 42 had intermediate prognoses and seven had poor prognoses. The mean observation periods were 16.3 and 20 months for the traditional and alternative schedule groups, respectively. Adverse events were significantly less common in the alternative schedule group, including most high-grade events. In the traditional and alternative schedule groups, median times to failure were 4.1 and 11.6 months (P?=?0.040), median progression-free survival times were 4.1 and 11.3 ?months (P?=?0.031), and median overall survival times were 12.0 and 32.1?months (P?=?0.018), respectively. Each of these measures was better in the group of patients who received an alternative treatment schedule, suggesting that individualized changes to the sunitinib administration schedule can be effective. PMID:24930736

Ohzeki, Takayuki; Fukasawa, Satoshi; Komaru, Atsushi; Namekawa, Takeshi; Sato, Yosuke; Takagi, Kimiaki; Kobayashi, Masayuki; Uemura, Hirotsugu; Ichikawa, Tomohiko; Ueda, Takeshi

2014-10-01

288

Westernization of lifestyle markedly increases carotid intima-media wall thickness (IMT) in Japanese people  

Microsoft Academic Search

To illustrate the impact of westernization of lifestyle on the development of pre-clinical atherosclerosis in Japanese people, we compared risk factors for atherosclerosis such as serum lipids, blood pressure, BMI, insulin resistance, and smoking habits between non-diabetic native Japanese and non-diabetic Japanese Americans. Two hundred and twenty two non-diabetic Japanese Americans living in Hawaii and 271 non-diabetic Japanese living in

Hiroshi Watanabe; Kiminori Yamane; Rumi Fujikawa; Masamichi Okubo; Genshi Egusa; Nobuoki Kohno

2003-01-01

289

Vitamin D status of patients with type 2 diabetes and sputum positive pulmonary tuberculosis  

PubMed Central

Introduction: Vitamin D deficiency is expected to be higher in patients with diabetes and pulmonary tuberculosis (TB). Studies estimating prevalence in the subset of patients with both diabetes and pulmonary TB are scarce. Materials and Methods: A total of 155 subjects were recruited; 46 patients with type 2 diabetes, 39 non-diabetic healthy controls, 30 patients of pulmonary TB and 40 patients with both pulmonary TB and type 2 diabetes. Vitamin D level (25 OH vitamin D) levels were done for all the 4 groups. Results: Mean vitamin D levels were not different between groups with TB, diabetes mellitus or combination of both, but the prevalence of severe vitamin D deficiency was higher in the group with both diabetes and TB (45%) as compared with the group with only TB (26.66%) and diabetes (17.39%) and healthy controls (7.69%). Conclusion: The prevalence of patients with severe vitamin D deficiency is higher in patients with dual affection of TB and diabetes mellitus as compared with either disorder alone implying that patients with type 2 diabetes with the most severe vitamin D deficiency are the one of the most predisposed to pulmonary TB. PMID:24910835

Chaudhary, Sandeep; Thukral, Anubhav; Tiwari, Shalbha; Pratyush, Daliparthy D; Singh, Surya Kumar

2013-01-01

290

Patient-provider interaction from the perspectives of type 2 diabetes patients in Muscat, Oman: a qualitative study  

Microsoft Academic Search

BACKGROUND: Patients' expectations and perceptions of the medical encounter and interactions are important tools in diabetes management. Some problems regarding the interaction during encounters may be related to a lack of communication skills on the part of either the physician or the patient. This study aimed at exploring the perceptions of type 2 diabetes patients regarding the medical encounters and

Nadia Abdulhadi; Mohammed Al Shafaee; Solveig Freudenthal; Claes-Göran Östenson; Rolf Wahlström

2007-01-01

291

Highly variable gastric emptying in patients with insulin dependent diabetes mellitus.  

PubMed Central

Some diabetic patients--particularly those with nausea and vomiting--frequently have evidence of delayed gastric emptying while other diabetic patients may in fact exhibit accelerated gastric emptying. Whether the presence or absence of symptoms of upper gastrointestinal dysfunction correlated with objective measures of gastric emptying in insulin dependent diabetic subjects was investigated. Twenty one insulin dependent diabetic patients underwent a solid phase gastric emptying scintiscan using in vivo labelled chicken liver. Thirteen patients had symptoms suggestive of gastrointestinal dysfunction (nausea, vomiting, early satiety, or constipation), while eight patients had no gastrointestinal symptoms. Eleven patients had orthostatic hypotension. All patients had been diabetic since childhood or adolescence. As a group, the diabetic patients showed a half time (T50) of gastric emptying (mean (SD) 150.0 min (163.7) that was not significantly different from that of 12 healthy control subjects (148.1 min (62.4)). Those diabetic patients without gastrointestinal symptoms and without orthostatic hypotension, however, showed a gastric emptying half time (70.1 min (41.6)) that was significantly faster than that of the control subjects. Conversely, those diabetic patients with nausea, vomiting, and early satiety (or early satiety alone) showed T50 values that were significantly greater than those of the diabetic patients without these symptoms. No correlation was found between the T50 value and the duration of diabetes, the fasting blood glucose at the time of study, or the respiratory variation in heart rate (E:I ratio). These observations indicate that highly variable rates of gastric emptying occur in insulin dependent diabetic patients, and that accelerated gastric emptying may occur in diabetic patients who have no symptoms of gastrointestinal dysfunction. PMID:7672674

Nowak, T V; Johnson, C P; Kalbfleisch, J H; Roza, A M; Wood, C M; Weisbruch, J P; Soergel, K H

1995-01-01

292

Prevalence of Hypomagnesaemia among Obese Type 2 Diabetic Patients Attending the National Center for Diabetes, Endocrinology and Genetics (NCDEG)  

PubMed Central

Background: Some observations suggested that magnesium supplementation could be helpful in the treatment of diabetic patients by improving glycemic control and preventing the development of diabetes-related complications. Objectives: To estimate the prevalence of hypomagnesaemia among obese patients with type 2 diabetes attending the National Center for Diabetes, Endocrinology and Genetics (NCDEG) in Amman, Jordan. Patients and Methods: A cross-sectional study was carried out at the National Center for diabetes, Endocrinology and Genetics (NCDEG) in Amman-Jordan. A total of 1105 patients with type 2 diabetes (51.9% females and 48.1% males) who attended this center between first of October 2011and end of February 2012 were included in the study. The mean age and duration of diabetes were 57.1 years and 5.1 years, respectively and the mean value of HbA1c was 7.9%. Our study also performed a comparison of the prevalence of hypomagnesaemia between our studied sample and 3600 individuals enrolled in the National Vitamin D study completed in Jordan in 2009. The obtained data included patients’ age, gender, smoking history, HbA1c level, comorbid history including hypertension, dyslipidemia, and presence of neuropathy and retinopathy. Results: Out of 1105 patients with type 2 diabetes, 210 patients (19%) (95% CI, 16.8%-21.4%) were hypomagnesaemic. Female gender, hypertension, statin therapy, HbA1c between 7-7.9% or ? 9% and patients with diabetes duration more than five years were independent risk factors for hypomagnesaemia. No association between hypomagnesaemia and age distribution, smoking history, neuropathy and retinopathy was found. In comparison with individuals enrolled in the National Vitamin D study, diabetic patients in this study had a much higher prevalence of hypomagnesaemia (19% vs. 0.7%) with odd’s ratio of 32 (95% CI, 21-48.2). Conclusions: As the prevalence of hypomagnesaemia among patients with type 2 diabetes treated at the NCDEG was found to be 19% (95% CI, 16.8%-21.4%), we recommend periodic determination of magnesium level and appropriate magnesium replacement therapy particularly among the above defined groups.

Hyassat, Dana; Al Sitri, Ebtihaj; Batieha, Anwar; EL-Khateeb, Mohammed; Ajlouni, Kamel

2014-01-01

293

Determinants of vascular function in patients with type 2 diabetes  

PubMed Central

Background Type 2 diabetes mellitus (T2DM) is independently associated with an increased risk for cardiovascular diseases that is primarily due to the early development of advanced atherosclerotic vascular changes. The aim of our study was to investigate the predictors of vascular dysfunction in T2DM patients. Methods We studied 165 T2DM patients without known macrovascular or microvascular disease. Standard demographic (age, gender, cardiovascular risk factors, medications), clinical (body mass index, blood pressure) and laboratory (glucose, glycated hemoglobin, lipids, renal function) parameters were included in analyses. Brachial artery flow-mediated dilation (FMD), nitrate mediated dilation (NMD) and Carotid-Femoral Pulse Wave Velocity (PWV) were measured. Results Median age was 66 years and duration since T2DM diagnosis was 10 years, 70% were females and 79% hypertensives, while only 10% had a glycated hemoglobin <7%. FMD was positively associated with NMD (r 0.391, P?diabetes was the single independent predictor of FMD (? -0.40, P?=?0.003). Increased age and fasting glucose and the presence of hypertension were independent predictors of decreased NMD (P?patients, impairment of endothelium-dependent vasodilation was independently associated only with longer diabetes duration while no association with other established risk factors was found. Vascular smooth muscle dysfunction and increased arterial stiffness were more prominent in older T2DM patients with hypertension. Worse glycemic control was associated with impaired vascular smooth muscle function. PMID:23062182

2012-01-01

294

Family history, body mass index and survival in Japanese patients with stomach cancer: a prospective study.  

PubMed

Family history and nutritional status may affect the long-term prognosis of stomach cancer, but evidence is insufficient and inconsistent. To clarify the prognostic factors of stomach cancer, we conducted a prospective study of 1,033 Japanese patients with histologically confirmed stomach cancer who were admitted to a single hospital between 1997 and 2005. Family history of stomach cancer and pretreatment body mass index (BMI) were assessed using a self-administered questionnaire. Clinical data were retrieved from a hospital-based cancer registry. All patients were completely followed up until December, 2008. Hazard ratios (HRs) and 95% confidence intervals (CIs) were estimated according to family history in parents and siblings and BMI category. During a median follow-up of 5.3 years, 403 all-cause and 279 stomach cancer deaths were documented. Although no association with family history was observed in the patients overall, analysis according to age group found an increased risk of all-cause death associated with a history in first degree relatives (HR?=?1.61, 95% CI: 0.93-2.78, p?=?0.09) and with a parental history (HR?=?1.86, 95% CI: 1.06-3.26) among patients aged under 60 years at diagnosis. BMI was related to all-cause and stomach cancer death among patients aged 60 and over, showing a J-shaped pattern (HR of all-cause death?=?2.28 for BMI?patients, whereas nutritional status may be a prognostic factor in older patients. PMID:24890283

Minami, Yuko; Kawai, Masaaki; Fujiya, Tsuneaki; Suzuki, Masaki; Noguchi, Tetsuya; Yamanami, Hideaki; Kakugawa, Yoichiro; Nishino, Yoshikazu

2015-01-15

295

Dabigatran etexilate prevents venous thromboembolism after total knee arthroplasty in Japanese patients with a safety profile comparable to placebo.  

PubMed

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 and all-cause mortality; the primary safety end point was incidence of major, clinically relevant, and minor bleeding events. Total VTE and all-cause mortality were lower in patients receiving DAB (39.6%, 32.7%, and 24.0%) than placebo (56.4%). There was no difference in the incidence of major bleeding between the DAB and placebo groups. Overall, DAB reduced the incidence of VTE in Japanese patients undergoing TKA, with a comparable safety profile vs placebo. PMID:19854610

Fuji, Takeshi; Fuijita, Satoru; Ujihira, Toru; Sato, Toru

2010-12-01

296

Why does Japan have a high incidence of gastric cancer? Comparison of gastritis between UK and Japanese patients  

PubMed Central

Background and aims The incidence of gastric cancer in Japan is four times higher than in the UK. It usually arises in a stomach with corpus predominant or pangastritis that has undergone extensive atrophy and intestinal metaplasia. We hypothesised that a Japanese population would have a more severe gastritis with a corpus predominant or pangastritis pattern and a greater degree of atrophy and intestinal metaplasia than that found in the UK. To test this we designed a comparative trial. Methods A total of 252 age matched consecutive patients were recruited from the endoscopy services in Leeds and Tokyo. In each centre, 21 patients were prospectively selected from each decennial, between the ages of 20–80?years. All had epigastric discomfort as their predominant symptom. Patients with peptic ulcer, cancer, and oesophagitis were excluded. Five gastric biopsies were examined by two histopathologists using the updated Sydney system. Helicobacter pylori infection was assessed by histology and culture of biopsies and enzyme linked immunosorbent assay and immunoblot of plasma. Results Gastritis was found by both pathologists in 59 (47%) UK and 76 (60%) Japanese patients (?2 test, p?=?0.04). In those patients with gastritis, corpus predominant or pangastritis was commoner in the Japanese (63% Japan v 36% in the UK (?2 test, p?=?0.003) Atrophy and intestinal metaplasia were more extensive and severe (Mann?Whitney U test, p<0.001) and chronic inflammation and polymorph activity were also greater, especially in the corpus (Mann?Whitney U test, p<0.001). Fifty three of 59 UK gastritis patients (90%) and 67/76 (88%) (?2 test, p?=?1) Japanese gastritis patients were positive for H pylori. Using a previously described “gastric cancer risk index” among H pylori positive patients, there were significantly more Japanese than UK subjects with a “high risk” score. Conclusion In Japanese as opposed to English patients, gastritis is more prevalent and severe with more corpus predominant atrophy and intestinal metaplasia. These differences may partially explain the higher incidence of gastric cancer in Japan. PMID:16603635

Naylor, G M; Gotoda, T; Dixon, M; Shimoda, T; Gatta, L; Owen, R; Tompkins, D; Axon, A

2006-01-01

297

Bariatric surgery as metabolic surgery for diabetic patients.  

PubMed

The recent increase in the prevalence of obesity seems to be responsible for the increase in T2 Diabetes Mellitus (T2DM). At present around 50 % of T2DM patients are obese and this percentage appears set to increase in the near future. Successful management of T2DM in obese patients is a complicated task, as many parameters such as blood pressure, LDL-cholesterol levels have to be adequately controlled along with HbA1c levels. There is a substantial amount of evidence showing that bariatric surgery achieves long term remission of diabetes in the majority of obese patients and improves significantly comorbidities associated with DM such as dyslipidemia, hypertension, and obstructive sleep apnea. It seems that early surgical intervention before irreversible b-cell damage has occurred, increases the chances of long term T2DM resolution. However, at present a very small percentage (< 2%) of obese patients with T2DM is treated surgically. The present review focuses on the efficacy and safety of the main bariatric procedures. It also emphasizes the mechanism with which bariatric surgery exerts its therapeutic effect and on the long term results on T2DM remission. PMID:24040876

Kalyvas, Aristotelis V; Vlachos, Konstantinos; Abu-Amara, Mohammed; Sampalis, John S; Glantzounis, Georgios

2014-01-01

298

Are patients with diabetes mellitus satisfied with technologies used to assist with diabetes management and coping?: a structured review.  

PubMed

Abstract Modern technological devices supporting coping and management for patients with diabetes are increasingly popular and could be important healthcare tools. This review aimed to evaluate patient satisfaction and perceptions regarding these devices, examples of which include short message service reminder systems, online educational programs, and clinician-patient electronic communication. Therapy devices such as continuous glucose monitors and continuous subcutaneous insulin infusion pumps are not included in this review. Embase, Psychinfo, Medline, CINAHL, and gray literature databases were searched for "diabetes mellitus," "technical device," "patient satisfaction," and their synonyms. This review was carried out according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement guidelines. The search produced 1,902 studies, 26 of which were included in the review: type 1 diabetes mellitus (eight studies), type 2 diabetes mellitus (nine studies), and both (nine studies). High satisfaction was seen with almost all devices and correlated strongly with ease of use and improved diabetes management. Satisfaction was not affected by participant age, and the effect of diabetes type was not assessed. Web devices were reported as easiest to use. Increased support was valued and resulted from devices facilitating interaction with healthcare professionals (HCPs) or peers. Technical difficulties were barriers to both use and satisfaction. Overall, patients enjoyed supplementing their usual therapy with these devices. Perceived support from HCPs or peers formed an important aspect of patient satisfaction and should be considered for future interventions. PMID:25069057

Harrison, Samantha; Stadler, Marietta; Ismail, Khalida; Amiel, Stephanie; Herrmann-Werner, Anne

2014-11-01

299

Depression and compliance with treatment in a sample of Northland diabetes patients  

Microsoft Academic Search

Aim The purposes of the study were to compare self-ratings and clinicians' ratings of compliance with treatment for diabetes among New Zealand European and Maori diabetes patients living in Northland Province, New Zealand; and to examine the unique relationships of demographic factors, diabetic history, and depression to the ratings. Method A questionnaire containing demographic items, a depression inventory and a

Dave Clarke; Tanya Goosen

300

Insulin Therapy and Colorectal Cancer Risk Among Type 2 Diabetes Mellitus Patients  

E-print Network

Insulin Therapy and Colorectal Cancer Risk Among Type 2 Diabetes Mellitus Patients YU­XIAO YANG follow-up after the diabetes diagnosis as well as those insulin users who developed colorectal cancer after insulin ther- apy. The remaining insulin users and the noninsulin-using type 2 diabetic

Hennessy, Sean

301

Protein intake and blood glucose as modulators of GFR in hyperfiltering diabetic patients  

Microsoft Academic Search

Protein intake and blood glucose as modulators of GFR in hyperfiltering diabetic patients. Glomerular hyperfiltration has been claimed to be a risk factor for the development of diabetic nephropathy. Protein intake and hyperglycemia can both increase GFR in diabetic and normal subjects. Our study was designed to explore the relative importance of short-term changes in protein intake and glycemia on

Sharon L Jones; Panayotis Kontessis; Martin Wiseman; Rosemary Dodds; Emilio Bognetti; Jose Pinto; Giancarlo Viberti; G C Viberti

1992-01-01

302

Hypercoagulability and high lipoprotein(a) levels in patients with type II diabetes mellitus  

Microsoft Academic Search

Diabetes mellitus is associated with disturbances in hemostasis that could contribute to the development of diabetic vascular disease. We investigated the changes in parameters of blood coagulation and the fibrinolytic system and in plasma levels of lipoprotein(a) (Lp(a)) in 124 patients with type II diabetes mellitus and 44 healthy control subjects matched for age and body mass index (BMI) to

Eriko Morishita; Hidesaku Asakura; Hiroshi Jokaji; Masanori Saito; Chika Uotani; Ichiro Kumabashiri; Masahide Yamazaki; Keiji Aoshima; Takuma Hashimoto; Tamotsu Matsuda

1996-01-01

303

Hyperbaric Oxygen Therapy Facilitates Healing of Chronic Foot Ulcers in Patients With Diabetes  

Microsoft Academic Search

OBJECTIVE — Chronic diabetic foot ulcers are a source of major concern for both patients and health care systems. The aim of this study was to evaluate the effect of hyperbaric oxygen therapy (HBOT) in the management of chronic diabetic foot ulcers. RESEARCH DESIGN AND METHODS — The Hyperbaric Oxygen Therapy in Diabet- ics with Chronic Foot Ulcers (HODFU) study

MAGNUS LONDAHL; PER KATZMAN; ANDERS NILSSON; CHRISTER HAMMARLUND

2010-01-01

304

Clinical characteristics of hyperglycemic crises in patients without a history of diabetes  

PubMed Central

Aims/Introduction Hyperglycemic crises without a history of diabetes have not been well studied. We compared the clinical characteristics of patients with and without a history of diabetes, and evaluated the glycated hemoglobin levels. Materials and Methods Consecutive adult patients (aged >18 years) visiting the emergency department (ED) between January 2004 and December 2010 were enrolled if they met the criteria for a hyperglycemic crisis. Patients were separated into those without and those with a history of diabetes. The 30-day mortality was the primary end-point. Results We enrolled 295 patients who made 330 visits to the ED. Patients without a history of diabetes made up 24.5% (81/330) of the hyperglycemic crises. Patients without a history of diabetes were more prone than patients with a history of diabetes to be younger and male, and to have better consciousness and renal function, more significant diabetic signs and symptoms (e.g., thirst, polydipsia, polyuria and bodyweight loss), higher blood sugar, and less opportunity of infection and mortality. Most of the patients (93.8%, 76/81) had glycated hemoglobin of ?6.5%. Conclusions The present study delineates the clinical characteristics of patients with hyperglycemic crises, but without a history of diabetes. Most patients had glycated hemoglobin ?6.5%, which raises the argument of using this biomarker for routine screening of diabetes.

Chou, Willy; Chung, Min-Hsien; Wang, Hsien-Yi; Chen, Jiann-Hwa; Chen, Wei-Lung; Guo, How-Ran; Lin, Hung-Jung; Su, Shih-Bin; Huang, Chien-Cheng; Hsu, Chien-Chin

2014-01-01

305

Candidate gene association study for diabetic retinopathy in Chinese patients with type 2 diabetes  

PubMed Central

Purpose To investigate whether variants in a set of eight candidate genes are associated with diabetic retinopathy (DR) in a cohort of Chinese patients with type 2 diabetes mellitus (T2DM). Methods Case-control study. Patients with T2DM were recruited from the Desheng community in urban Beijing and assigned into a DR group or diabetic without retinopathy (DWR) group, based on the duration of diabetes and grading of fundus images. Twenty-six single-nucleotide polymorphisms (SNPs) within eight candidate genes, including PPAR?, vascular endothelial growth factor (VEGF) and its receptor kinase insert domain receptor (KDR), erythropoietin, aldose reductase, protein kinase C-?, angiotensin-converting enzyme, and intercellular adhesion molecule 1, were analyzed using the MassARRAY genotyping system. Results A total of 500 patients with T2DM (216 with DR and 284 with DWR) were enrolled in the study. Significant associations of DR were noted with genotypes of four SNPs—rs699947 (p<0.001), rs833061 (p=0.001), rs13207351 (p<0.001), and rs2146323 (p=0.006)—in the VEGF gene and one variant, rs2071559, in the KDR gene (p=0.034). After adjustment for covariates, significant association of DR remained with the homozygous genotype of the minor allele for the SNPs rs699947 (odds ratio [OR] = 3.54, 95% confidence interval [CI]: 1.12–11.19), rs833061 (OR = 3.72, 95% CI: 1.17–11.85), rs13207351 (OR = 3.76, 95% CI: 1.21–11.71), and rs2146323 (OR = 2.8, 95% CI: 1.46–5.37) in the VEGF gene as well as the SNP rs2071559 (OR = 1.62, 95% CI: 1.08–2.41) in the KDR gene. However, only rs699947 and rs13207351 in the VEGF gene remained statistically significant after Bonferroni correction. No associations were found in other genes tested. Conclusions These data expanded previous observations on the association of DR with variants in the VEGF gene in Chinese patients with T2DM. Moreover, a possible association between DR and KDR polymorphisms is suggested. PMID:24623964

Yang, Xiufen; Deng, Yu; Gu, Hong; Ren, Xuetao; Li, Na; Lim, Apiradee; Snellingen, Torkel; Liu, Xipu; Wang, Ningli

2014-01-01

306

Japanese cancer patient participation in and satisfaction with treatment-related decision-making: A qualitative study  

Microsoft Academic Search

BACKGROUND: Over the last decade, patient involvement in treatment-related decision-making has been widely advocated in Japan, where patient-physician encounters are still under the influence of the long-standing tradition of paternalism. Despite this profound change in clinical practice, studies investigating the actual preferences of Japanese people regarding involvement in treatment-related decision-making are limited. The main objectives of this study were to

Yoshiko Watanabe; Miyako Takahashi; Ichiro Kai

2008-01-01

307

Panitumumab in Japanese Patients with Unresectable Colorectal Cancer: A Post-marketing Surveillance Study of 3085 Patients  

PubMed Central

Objective Panitumumab was approved in Japan in April 2010 for the treatment of Kirsten rat sarcoma-2 virus oncogene wild-type unresectable and recurrent colorectal cancer. We conducted a post-marketing surveillance study to evaluate the safety and effectiveness of panitumumab. Methods After panitumumab was commercially available in Japan, all patients to be treated with panitumumab were enrolled. Data on baseline characteristics, treatment outcome, and incidence and severity of adverse drug reactions were collected. Results In total, 3091 patients were registered. In the safety analysis set (n = 3085), panitumumab was administered as monotherapy (40.7%) or combination therapy (59.4%). The median treatment duration was 113 days (range: 1–559 days), and 451 (14.6%) patients received panitumumab for ?10 months. The overall incidence rate of adverse drug reactions was 84.1%, and the most common adverse drug reaction was skin disorders (78.4%). The incidence rates (all grades) of interstitial lung disease, infusion reaction, electrolyte abnormalities and cardiac disorders were 1.3% (mortality rate: 0.6%), 1.5, 19.3 and 0.2%, respectively. The median survival time of patients treated with panitumumab monotherapy as the third-line, or later, therapy was 10.3 months. Conclusion This post-marketing survey in clinical practice confirmed the safety and effectiveness of panitumumab. The benefit/risk balance for panitumumab in Japanese patients with unresectable colorectal cancer remains favorable. PMID:24526771

Boku, Narikazu; Sugihara, Kenichi; Kitagawa, Yuko; Hatake, Kiyohiko; Gemma, Akihiko; Yamazaki, Naoya; Muro, Kei; Hamaguchi, Tetsuya; Yoshino, Takayuki; Yana, Ikuo; Ueno, Hiroshi; Ohtsu, Atsushi

2014-01-01

308

Pharmacokinetics of oxycodone after intravenous and subcutaneous administration in Japanese patients with cancer pain.  

PubMed

ABSTRACT In Japan, Oxycodone hydrochloride injection formulation has been approved in 2012. However, its pharmacokinetics has been poorly studied. The aim of this study is to evaluate the pharmacokinetics of oxycodone after intravenous and subcutaneous administration of oxycodone hydrochloride injection in Japanese patients with cancer pain. Noncompartmental analysis and population pharmacokinetic analysis were performed. We conducted a multicenter open-label study of oxycodone hydrochloride administered as constant infusion with the dose titrated individually according to the pain intensity in patients with cancer pain. Pharmacokinetic parameters for plasma oxycodone and its metabolites were estimated using pharmacokinetics of oxycodone was evaluated using a total of 344 plasma concentrations obtained from 89 patients. The estimated geometric mean clearance (CL) of oxycodone was 24.3 L per hour after constant intravenous infusion and 29.5 L per hour after constant subcutaneous infusion, respectively. Population pharmacokinetic analysis indicated that body surface area was the influencing factor on CL and there were no pharmacokinetic differences for CL between intravenous and subcutaneous infusion. These results provide important information for the clinical use of oxycodone injection. PMID:25359452

Kokubun, Hideya; Yoshimoto, Tetsusuke; Hojo, Minoru; Fukumura, Kazuya; Matoba, Motohiro

2014-12-01

309

Relation of Diabetic Patients' Health-Related Control Appraisals and Physician–Patient Interpersonal Impacts to Patients' Metabolic Control and Satisfaction with Treatment  

Microsoft Academic Search

Desire for healthcare control, health locus of control, perceived control over diabetes, satisfaction with diabetes treatment, and general personality traits were assessed in 54 Type 1 and Type 2 diabetic patients of the same male endocrinologist during a regularly scheduled office visit. At the end of the consultation, both patients and the physician completed a measure describing the interpersonal impacts

Stephen M. Auerbach; John N. Clore; Donald J. Kiesler; Tamara Orr; Phillip O. Pegg; Ben G. Quick; Christopher Wagner

2002-01-01

310

Factors Increasing Physical Activity Levels in Diabetes Mellitus: A Survey of Patients after an Inpatient Diabetes Education Program  

PubMed Central

[Purpose] The aim of this study was to understand the factors involved in increasing physical activity levels in type 2 diabetes mellitus patients for improved glycemic control. [Subjects] The subjects were 101 type 2 diabetes mellitus patients who had completed an inpatient diabetes education program. [Methods] The survey evaluated physical activity levels on the basis of the International Physical Activity Questionnaire and a questionnaire listing physical and psychosocial factors. [Results] Four variables—participation or non-participation in farm work, presence or absence of a job, stage of change in attitude toward exercise behavior, and social support—accounted for 34% of physical activity levels in these diabetes mellitus patients. The Spearman’s rank correlation coefficient between physical activity level and HbA1c was ?0.31. [Conclusion] Intervention in terms of practical use of living environments, promotion of exercise behavior, and social support may be effective in helping to improve glycemic control. PMID:24926134

Murano, Isamu; Asakawa, Yasutsugu; Mizukami, Masafumi; Takihara, Jun; Shimizu, Kaoru; Imai, Taihei

2014-01-01

311

Inspiratory muscle weakness is associated with autonomic cardiovascular dysfunction in patients with type 2 diabetes mellitus  

Microsoft Academic Search

Introduction  Diabetic autonomic neuropathy is a complication of diabetes mellitus (DM) that can cause cardiovascular and respiratory abnormalities.\\u000a The association between respiratory muscle weakness and autonomic cardiovascular neuropathy has not yet been studied. The\\u000a aims of the present study were to assess respiratory muscle strength, pulmonary function, and heart rate (HR) variability\\u000a in diabetic patients with and without diabetic autonomic neuropathy.

Diogo Machado Kaminski; Beatriz D’Agord Schaan; Antônio Marcos Vargas da Silva; Pedro Paulo Soares; Rodrigo Della Méa Plentz; Pedro Dall’Ago

2011-01-01

312

Muscle performance and ankle joint mobility in long-term patients with diabetes  

Microsoft Academic Search

BACKGROUND: Long-term patients with diabetes and peripheral neuropathy show altered foot biomechanics and abnormal foot loading. This study aimed at assessing muscle performance and ankle mobility in such patients under controlled conditions. METHODS: Forty six long-term diabetes patients with (DN) and without (D) peripheral neuropathy, and 21 controls (C) were examined. Lower leg muscle performance and ankle mobility were assessed

Claudia Giacomozzi; Emanuela D'Ambrogi; Stefano Cesinaro; Velio Macellari; Luigi Uccioli

2008-01-01

313

A Holistic Approach to Enhance the Doctor-Patient Relationship for Diabetes Using Social Networking,  

E-print Network

.e. physicians and nurses) and patients with diabetes. With more than 23 million Americans suffering from) based on patient modeling that enhances the communication and relationship among health care providers are the challenges in the current relationship between a diabetic patient and his/her health care providers? 2) Can

Jannach, Dietmar

314

Estimation of renal function in patients with diabetes.  

PubMed

Diabetes is the leading cause of chronic kidney disease (CKD), which makes estimation of renal function crucial. Serum creatinine is not an ideal marker of glomerular filtration rate (GFR), which also depends on digestive absorption, and the production of creatinine in muscle and its tubular secretion. Formulas have been devised to estimate GFR from serum creatinine but, given the wide range of GFR, proteinuria, body mass index and specific influence of glycaemia on GFR, the uncertainty of these estimations is a particular concern for patients with diabetes. The most popular recommended formulas are the simple Cockcroft-Gault equation, which is inaccurate and biased, as it calculates clearance of creatinine in proportion to body weight, and the MDRD equation, which is more accurate, but systematically underestimates normal and high GFR, being established by a statistical analysis of results from renal-insufficient patients. This underestimation explains why the MDRD equation is repeatedly found to give a poor estimation of GFR in patients with recently diagnosed diabetes and is a poor tool for reflecting GFR decline when started from normal, as well as the source of unexpected results when applied to epidemiological studies with a 60mL/min/1.73m(2) threshold as the definition of CKD. The more recent creatinine-based formula, the Mayo Clinic Quadratic (MCQ) equation, and the Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) improve such underestimation, as both were derived from populations that included subjects with normal renal function. Determination of cystatin C is also promising, but needs standardisation. PMID:21680218

Rigalleau, V; Beauvieux, M-C; Gonzalez, C; Raffaitin, C; Lasseur, C; Combe, C; Chauveau, P; De la Faille, R; Rigothier, C; Barthe, N; Gin, H

2011-11-01

315

Efficacy of berberine in patients with type 2 diabetes mellitus.  

PubMed

Berberine has been shown to regulate glucose and lipid metabolism in vitro and in vivo. This pilot study was to determine the efficacy and safety of berberine in the treatment of type 2 diabetes mellitus patients. In study A, 36 adults with newly diagnosed type 2 diabetes mellitus were randomly assigned to treatment with berberine or metformin (0.5 g 3 times a day) in a 3-month trial. The hypoglycemic effect of berberine was similar to that of metformin. Significant decreases in hemoglobin A1c (from 9.5%+/-0.5% to 7.5%+/-0.4%, P<.01), fasting blood glucose (from 10.6+/-0.9 mmol/L to 6.9+/-0.5 mmol/L, P<.01), postprandial blood glucose (from 19.8+/-1.7 to 11.1+/-0.9 mmol/L, P<.01), and plasma triglycerides (from 1.13+/-0.13 to 0.89+/-0.03 mmol/L, P<.05) were observed in the berberine group. In study B, 48 adults with poorly controlled type 2 diabetes mellitus were treated supplemented with berberine in a 3-month trial. Berberine acted by lowering fasting blood glucose and postprandial blood glucose from 1 week to the end of the trial. Hemoglobin A1c decreased from 8.1%+/-0.2% to 7.3%+/-0.3% (P<.001). Fasting plasma insulin and homeostasis model assessment of insulin resistance index were reduced by 28.1% and 44.7% (P<.001), respectively. Total cholesterol and low-density lipoprotein cholesterol were decreased significantly as well. During the trial, 20 (34.5%) patients experienced transient gastrointestinal adverse effects. Functional liver or kidney damages were not observed for all patients. In conclusion, this pilot study indicates that berberine is a potent oral hypoglycemic agent with beneficial effects on lipid metabolism. PMID:18442638

Yin, Jun; Xing, Huili; Ye, Jianping

2008-05-01

316

Differences Between Diabetes Patients Who Are Interested or Not in the Use of a Patient Web Portal  

PubMed Central

Abstract Objective A patient Web portal allows patients to access their personal health record through the Internet. It may improve diabetes outcomes, but the adoption is unsatisfactory. We examined the differences between patients with and without a login in order to optimize its use. Patients and Methods A survey was conducted among patients from 62 general practices and one outpatient clinic that all use a diabetes Web portal. Between November 2011 and March 2012 questionnaires were sent to 1,500 patients with and 3,000 patients without a login. Patient groups were stratified according to type of diabetes. Demographic and diabetes-related variables were analyzed with multivariable regression analysis. Results The total response rate was 67%. Fewer than 50% of the patients did request a login. Among 128 patients with type 1 diabetes mellitus, those with a login (89.8%) were younger and more frequently treated by an internist. In 1,262 patients with type 2 diabetes mellitus, fewer patients had a log-in (41.0%), and the likelihood of having a login was independently associated with younger age, male gender, higher educational level, treatment by an internist, longer duration of diabetes, and polypharmacy (all P<0.001). Conclusions Patients with type 1 diabetes request a login more frequently than patients with type 2 diabetes, and patients with a login are strikingly different than patients without. The healthcare provider seems to play an important role in patients' Web utilization. Simply promoting use of electronic healthcare methods does not make sense. It is important to address disparities between patient groups to optimize the use of a Web portal. PMID:23777369

Dijkhorst-Oei, Lioe-Ting; Gorter, Kees J.; Beulens, Joline W.J.; Rutten, Guy E.H.M.

2013-01-01

317

[Intestinal strongyloidiasis in a psoriasis patient with diabetes].  

PubMed

This case study underlined the importance of parasitological examination before starting immunosuppressive treatment since a heavy burden of strongyloidiasis could lead to fatal infections. It represents the first strongyloidiasis from a patient with psoriasis and diabetes mellitus in this country. In the case, 59 years old female subject had psoriasis for six years and during the treatment with topical corticosteroid and anti-psorial medication, psoriatic lesions flared up. The patient had constipation and foul smelling stool complaints. Blood tests showed an increase in eosinophil and a decrease of vitamin B12 level. Stool examination indicated the presence of abundant amount of S. stercoralis larvae. The patient was given albendazole for two weeks. After treatment, the symptoms decreased and S. stercoralis larvae were not detected in stool. In this case, it was emphasized that the clinicians planning immunosuppressive regimens should bear in mind that parasitic examination could be present in the subjects. PMID:25016122

Iraz, Meryem; Karaman, Ulkü; Topukçu, Bu?çe; Doymaz, Mehmet Ziya

2014-06-01

318

Novel treatment approaches in hypertensive type 2 diabetic patients  

PubMed Central

Type 2 diabetes mellitus (T2DM) and hypertension represent two common conditions worldwide. Their frequent association with cardiovascular diseases makes management of hypertensive patients with T2DM an important clinical priority. Carvedilol and renal denervation are two promising choices to reduce plasma glucose levels and blood pressure in hypertensive patients with T2DM to reduce future complications and improve clinical outcomes and prognosis. Pathophysiological mechanisms of both options are under investigation, but one of the most accepted is an attenuation in sympathetic nervous system activity which lowers blood pressure and improves insulin sensitivity. Choice of these therapeutic approaches should be individualized based on specific characteristics of each patient. Further investigations are needed to determine when to consider their use in clinical practice. PMID:25126399

Castro Torres, Yaniel; Katholi, Richard E

2014-01-01

319

The management of type 2 diabetic patients with hypoglycaemic agents.  

PubMed

Type 2 Diabetes Mellitus (T2DM) is characterized by chronic hyperglycemia with disturbance in carbohydrate, lipid, and protein metabolism due to insulin resistance and beta cell dysfunction. Epidemiological studies have confirmed a global pandemic of T2DM, which has created an enormous burden on society, with regard to morbidity, mortality, and health care expenditures. Life style modifications are fundamental not only in early stages of disease management but need to be intensified as disease progresses. United Kingdom Prospective Diabetes Study (UKPDS) has demonstrated the progressive nature of T2DM, and as disease progresses, a combination agents-oral antidiabetic drugs (OAD) and insulin-are needed in order to maintain good sugar control. The general consensus of HbA1c target for most patients is less than 7%, and various guidelines and algorithms have provided guidance in patient management to keep patient at goal. As our understanding of pathophysiological defects advances, targeting treatment at underlying defects not only enables us to achieve HbA1c goal but also reduces morbidities, mortalities, and progression of the disease. Traditional oral agents like metformin and sulfonylureas have failed to arrest the progression of T2DM. New agents such as TZD, DPP-4 inhibitor, and SGLT-2 may increase our armamentariums against T2DM. PMID:22645689

Tsang, Man-Wo

2012-01-01

320

[Selective retina therapy in patients with diabetic maculopathy].  

PubMed

Selective Retina Therapy (SRT) is a new laser treatment that selectively targets the retinal pigmen epithelium (RPE). In this study, we treated 39 patients presenting with nonischemic, focal and focal-diffuse diabetic maculopathy with SRT. In the main. the results indicate that SRT had stabilizing effects on visual acuity, angiographic leakage, lipid exudation, and foveal retinal thickness. SRT is safe and is especially useful for treating pathologies that are located close to the fovea, which cannot be treated with conventional argon laser photocoagulation. PMID:16937095

Elsner, H; Klatt, C; Liew, S H M; Pörksen, E; Bunse, A; Rudolf, M; Brinkmann, R; Hamilton, R P; Birngruber, R; Laqua, H; Roider, J

2006-10-01

321

Onset of type 1 diabetes mellitus in two patients with maturity onset diabetes of the young.  

PubMed

The association between maturity onset diabetes of the young (MODY) and type 1 diabetes mellitus (T1DM) has been rarely described. We report two patients affected by MODY who developed T1DM. Case 1: a 4-yr-old girl referred for glycosuria presented hemoglobin A1c (HbA1c) of 6.6%. Islet cell antibodies (ICA) and anti-glutamic acid decarboxylase (GADA) were initially negative. As her father, uncle and grandmother showed mild hyperglycemia, they were screened for MODY 2. A novel mutation in glucokinase gene was found in the family. Few months later, her glycemic control worsened consistently and she required insulin treatment. A high titer of GADA and ICA was then detected. Six years afterwards insulin requirement is 0.8 U/kg and HbA1c 6.7%. Case 2: a 15-yr-old boy treated for growth hormone deficiency was found with a blood glucose level of 106 mg/dL. HbA1c was 7.2%, ICA and GADA were negative. Family history was positive for autoimmune diseases and type 2 diabetes mellitus. The patient was investigated for MODY 2 and MODY 3, and a mutation of hepatocyte nuclear factor-1 alpha gene was found. The same mutation was found in the mother who had never been referred for hyperglycemia. After 1 yr, due to an unjustified worsening of the metabolic control, autoimmunity was again investigated and a mild positivity was found. He then required insulin therapy and after 5 yr current HbA1c was 8.2%. The diagnosis of MODY does not exclude the risk of developing T1DM. Therefore autoimmunity should be investigated when ordinary treatments fail and metabolic control unexpectedly worsens. PMID:21696527

Maltoni, Giulio; Zucchini, Stefano; Scipione, Mirella; Mantovani, Vilma; Salardi, Silvana; Cicognani, Alessandro

2012-03-01

322

Reversible brain atrophy and cognitive impairment in an adolescent Japanese patient with primary adrenal Cushing's syndrome  

PubMed Central

Endogenous Cushing’s syndrome is an endocrine disease resulting from chronic exposure to excessive glucocorticoids produced in the adrenal cortex. Although the ultimate outcome remains uncertain, functional and morphological brain changes are not uncommon in patients with this syndrome, and generally persist even after resolution of hypercortisolemia. We present an adolescent patient with Cushing’s syndrome who exhibited cognitive impairment with brain atrophy. A 19-year-old Japanese male visited a local hospital following 5 days of behavioral abnormalities, such as money wasting or nighttime wandering. He had hypertension and a 1-year history of a rounded face. Magnetic resonance imaging (MRI) revealed apparently diffuse brain atrophy. Because of high random plasma cortisol levels (28.7 ?g/dL) at 10 AM, he was referred to our hospital in August 2011. Endocrinological testing showed adrenocorticotropic hormone-independent hypercortisolemia, and abdominal computed tomography demonstrated a 2.7 cm tumor in the left adrenal gland. The patient underwent left adrenalectomy in September 2011, and the diagnosis of cortisol-secreting adenoma was confirmed histologically. His hypertension and Cushingoid features regressed. Behavioral abnormalities were no longer observed, and he was classified as cured of his cognitive disturbance caused by Cushing’s syndrome in February 2012. MRI performed 8 months after surgery revealed reversal of brain atrophy, and his subsequent course has been uneventful. In summary, the young age at onset and the short duration of Cushing’s syndrome probably contributed to the rapid recovery of both cognitive dysfunction and brain atrophy in our patient. Cushing’s syndrome should be considered as a possible etiological factor in patients with cognitive impairment and brain atrophy that is atypical for their age.

Ohara, Nobumasa; Suzuki, Hiroshi; Suzuki, Akiko; Kaneko, Masanori; Ishizawa, Masahiro; Furukawa, Kazuo; Abe, Takahiro; Matsubayashi, Yasuhiro; Yamada, Takaho; Hanyu, Osamu; Shimohata, Takayoshi; Sone, Hirohito

2014-01-01

323

Phase I study of inotuzumab ozogamicin (CMC-544) in Japanese patients with follicular lymphoma pretreated with rituximab-based therapy.  

PubMed

Inotuzumab ozogamicin (CMC-544), an antibody-targeted chemotherapeutic agent composed of an anti-CD22 antibody conjugated to calicheamicin, a potent cytotoxic antibiotic, specifically targets the CD22 antigen present in >90% of B-lymphoid malignancies, rendering it useful for treating patients with B-cell non-Hodgkin lymphoma (B-NHL). This phase I study evaluated the safety, tolerability, efficacy, and pharmacokinetics of inotuzumab ozogamicin in Japanese patients. Eligible patients had relapsed or refractory CD22-positive B-NHL without major organ dysfunction. Inotuzumab ozogamicin was administered intravenously once every 28 days (dose escalation: 1.3 and 1.8 mg/m(2)). All 13 patients had follicular lymphoma, were previously treated with > or =1 rituximab-alone or rituximab-containing chemotherapy, and were enrolled into two dose cohorts (1.3 mg/m(2), three patients; 1.8 mg/m(2), 10 patients). No patient had dose-limiting toxicities, and the maximum tolerated dose, previously determined in non-Japanese patients (1.8 mg/m(2)), was confirmed. Drug-related adverse events (AEs) included thrombocytopenia (100%), leukopenia (92%), lymphopenia (85%), neutropenia (85%), elevated AST (85%), anorexia (85%), and nausea (77%). Grade 3/4 drug-related AEs in > or =15% patients were thrombocytopenia (54%), lymphopenia (31%), neutropenia (31%), and leukopenia (15%). The AUC and C(max) of inotuzumab ozogamicin increased dose-dependently with pharmacokinetic profiles similar to non-Japanese. Seven patients had complete response (CR, 54%) including unconfirmed CR, four patients had partial response (31%), and two patients had stable disease (15%). The overall response rate was 85% (11/13). Inotuzumab ozogamicin was well tolerated at doses up to 1.8 mg/m(2) and showed preliminary evidence of activity in relapsed or refractory follicular lymphoma pretreated with rituximab-containing therapy, warranting further investigations. This trial was registered in ClinicalTrials.gov (NCT00717925). PMID:20491780

Ogura, Michinori; Tobinai, Kensei; Hatake, Kiyohiko; Uchida, Toshiki; Kasai, Masanobu; Oyama, Takashi; Suzuki, Tatsuya; Kobayashi, Yukio; Watanabe, Takashi; Azuma, Teruhisa; Mori, Masakazu; Terui, Yasuhito; Yokoyama, Masahiro; Mishima, Yuko; Takahashi, Shunji; Ono, Chiho; Ohata, Junko

2010-08-01

324

Phase-1 study of abiraterone acetate in chemotherapy-naïve Japanese patients with castration-resistant prostate cancer.  

PubMed

Persistent androgen synthesis under castration status in adrenal gland, testes and tumor cells is thought to be one of the major causes of development and progression of castration-resistant prostate cancer (CRPC). Abiraterone acetate (AA), the prodrug of abiraterone, which is an inhibitor of androgen synthesis enzymes, was evaluated for pharmacokinetics, pharmacodynamics, preliminary efficacy and safety in Japanese patients with CRPC in a phase-1, open-label and dose-escalation study. Chemotherapy-naïve Japanese CRPC patients (N = 27) received one of four AA daily doses (250 mg [n = 9], 500 mg [n = 6], 1000 [1 h premeal] mg [n = 6] and 1000 [2 h postmeal] mg [n = 6]) continuously through 28-day treatment cycles. In the first cycle, AA monotherapy was given on days 1-7 for pharmacokinetics, and AA plus prednisone (5 mg twice daily) from days 8 to 28. Of 27 patients, 9 continued treatment with AA until the data cut-off date (18 July 2013). Over the evaluated dose range, plasma abiraterone concentrations increased with dose, with median tmax 2-3 h. At each dose level, mean serum corticosterone concentrations increased, while testosterone and dehydroepiandrosterone sulfate concentrations rapidly decreased following a single AA dose and were further reduced to near the quantification limit on day 8 regardless of the dose. At least 3 patients from each dose-group experienced ?50% prostate-specific antigen reduction, suggesting clinical benefit from AA in Japanese CRPC patients. AA was generally well-tolerated, and, therefore, the recommended AA dosage regimen in Japanese CRPC patients is 1000 mg oral dose under modified fasting conditions (at least 1 h premeal or 2 h postmeal). This study is registered at ClinicalTrials.gov: NCT01186484. PMID:25117615

Matsubara, Nobuaki; Uemura, Hiroji; Fukui, Iwao; Niwakawa, Masashi; Yamaguchi, Akito; Iizuka, Koho; Akaza, Hideyuki

2014-10-01

325

Impact of Long-Term Complications on Quality of Life in Patients with Type 2 Diabetes not Using Insulin  

Microsoft Academic Search

ObjectivesThe complications of diabetes have the potential to greatly impact the health-related quality of life (HRQOL) of patients with type 2 diabetes. The effect of diabetic complications on HRQOL was assessed in 1233 patients with type 2 diabetes who were not using insulin.

Adam Lloyd; William Sawyer; Patrick Hopkinson

2001-01-01

326

Prediction of 10-year coronary heart disease risk in Caribbean type 2 diabetic patients using the UKPDS risk engine  

Microsoft Academic Search

ObjectivePrimary prevention of Coronary Heart Disease (CHD) in diabetic patients should be based on absolute CHD risk calculation. This study was aimed to determine the levels of 10-year CHD risk in Caribbean type 2 diabetic patients using the diabetes specific United Kingdom Prospective Diabetes Study (UKPDS) risk engine calculator.

C. E. Ezenwaka; E. Nwagbara; D. Seales; F. Okali; S. Hussaini; Bn. Raja; A. Jones-LeCointe; H. Sell; H. Avci; J. Eckel

2009-01-01

327

Proteomic Biomarkers for Acute Interstitial Lung Disease in Gefitinib-Treated Japanese Lung Cancer Patients  

PubMed Central

Interstitial lung disease (ILD) events have been reported in Japanese non-small-cell lung cancer (NSCLC) patients receiving EGFR tyrosine kinase inhibitors. We investigated proteomic biomarkers for mechanistic insights and improved prediction of ILD. Blood plasma was collected from 43 gefitinib-treated NSCLC patients developing acute ILD (confirmed by blinded diagnostic review) and 123 randomly selected controls in a nested case-control study within a pharmacoepidemiological cohort study in Japan. We generated ?7 million tandem mass spectrometry (MS/MS) measurements with extensive quality control and validation, producing one of the largest proteomic lung cancer datasets to date, incorporating rigorous study design, phenotype definition, and evaluation of sample processing. After alignment, scaling, and measurement batch adjustment, we identified 41 peptide peaks representing 29 proteins best predicting ILD. Multivariate peptide, protein, and pathway modeling achieved ILD prediction comparable to previously identified clinical variables; combining the two provided some improvement. The acute phase response pathway was strongly represented (17 of 29 proteins, p?=?1.0×10?25), suggesting a key role with potential utility as a marker for increased risk of acute ILD events. Validation by Western blotting showed correlation for identified proteins, confirming that robust results can be generated from an MS/MS platform implementing strict quality control. PMID:21799770

Kawakami, Takao; Nagasaka, Keiko; Takami, Sachiko; Wada, Kazuya; Tu, Hsiao-Kun; Otsuji, Makiko; Kyono, Yutaka; Dobashi, Tae; Komatsu, Yasuhiko; Kihara, Makoto; Akimoto, Shingo; Peers, Ian S.; South, Marie C.; Higenbottam, Tim; Fukuoka, Masahiro; Nakata, Koichiro; Ohe, Yuichiro; Kudoh, Shoji; Clausen, Ib Groth; Nishimura, Toshihide; Marko-Varga, Gyorgy; Kato, Harubumi

2011-01-01

328

Detection of Mogibacterium timidum in subgingival biofilm of aggressive and non-diabetic and diabetic chronic periodontitis patients  

PubMed Central

The aim of the present study was to evaluate the frequency of detection of Mogibacterium timidum in subgingival samples of subjects with generalized aggressive periodontitis (GAgP) and uncontrolled diabetic and non-diabetic subjects with generalized chronic periodontitis (GChP). 48 patients with GAgP, 50 non-diabetic and 39 uncontrolled (glycated hemoglobin >7%) type 2 diabetic subjects with GChP were enrolled in this study. Subgingival biofilm were collected from deep pockets (probing depth > 7 mm). After DNA extraction, M. timidum was detected by Nested Polymerase Chain Reaction and chi-square test was used to data analysis (p>0.05). There were no differences in the frequency of detection of M. timidum between subjects with GAgP (35%) and non-diabetic subjects with GChP (40%) (p>0.05). The frequency of detection of M. timidum was significantly higher in deep pockets of diabetic subjects with GChP (56%) when compared to GAgP (p<0.05), but similar to non-diabetic subjects with GChP (p>0.05). The frequency of detection of M. timidum was higher in subjects GChP presenting uncontrolled type 2 diabetes mellitus, when compared to GAgP subjects. PMID:24031909

Casarin, Renato Correa Viana; Saito, Daniel; Santos, Vanessa Renata; Pimentel, Suzana Peres; Duarte, Poliana Mendes; Casati, Marcio Zaffalon; Goncalves, Reginaldo Bruno

2012-01-01

329

Pancreatic magnetic resonance imaging after manganese injection distinguishes type 2 diabetic and normoglycemic patients  

PubMed Central

A non-invasive method to image the mass and/or function of human pancreatic islets is needed to monitor the progression of diabetes, and the effect of therapeutic interventions. As yet, no method is available for this purpose, which could be applied to in situ human islets. Animal and in vitro studies have documented that manganese infusion could improve the magnetic resonance imaging (MRI) of the endocrine pancreas. Here, we have tested whether a similar approach could discriminate diabetic and non-diabetic patients. In vitro, human isolated islets readily incorporated manganese. In vivo, 243 manganese-enhanced magnetic resonance imaging (MEMRI) examinations were reviewed, including 41 examinations which were run on 24 patients with type 2 diabetes and 202 examinations which were run on 119 normoglycemic patients. The results show that MEMRI discriminates type 2 diabetics from non-diabetic patients, based on the signal enhancement of pancreas. PMID:22722479

Botsikas, Diomidis; Terraz, Sylvain; Vinet, Laurent; Lamprianou, Smaragda; Becker, Christoph; Bosco, Domenico; Meda, Paolo; Montet, Xavier

2012-01-01

330

[Magistral and intrarenal blood flow in type 2 diabetes mellitus patients with kidney lesions].  

PubMed

The study was conducted to investigate the main and intrarenal blood flow in type 2 diabetes mellitus patients with kidney lesions. Renal blood flow was estimated by Doppler ultrasonography at the level of the magistral and intrarenal arteries with assessment of speed and resistive indexes in 20 patients with pre-clinical stage of diabetic nephropathy, 45 with chronic pyelonephritis and diabetes mellitus. The control group consisted of 20 healthy individuals. Increase of intrarenal blood flow, against the background of increased vascular resistance in the magistral trunk and segmental renal artery was indicated in diabetic nephropathy. Decline of the main intrarenal blood flow to the level of the interlobar arteries on the background of increased renal vascular resistance was marked in patients with chronic pyelonephritis and type 2 diabetes mellitus. Renal hemodynamics disorders in patients with various kidney lesions and with type 2 diabetes mellitus were established. PMID:25341239

Amirkhanova, D; Turgunova, L; Laryushina, E; Alina, A

2014-09-01

331

Time trends of surgical treatment and the prognosis for Japanese patients with gastric cancer  

PubMed Central

The incidence of gastric cancer is much higher in Japan than in other countries even though diagnostics and treatments of such patients have improved. The objective of this study was to present an overview of the past, present and future of surgical treatment for our patients with gastric cancer. We analysed data on 2152 Japanese men and women with gastric cancer who underwent surgical resection from 1965 to 1995 at Kyushu University in Fukuoka, Japan, based on a univariate and the multivariate analysis. We focused on time trends of surgical treatment and the postoperative outcome. Over the years, there have been favourable changes in the numbers of patients with early gastric cancer. In all cases of gastric cancer, the rate of 18% in the first six year period (group 1) was 57% in the last 5 year period (group 6). Size of the tumour was smaller, well-differentiated tumour tissue was more common, and lymphatic involvement was less frequent. Lymph node metastasis, liver metastasis and peritoneal dissemination all decreased. Extensive lymph node dissection was more frequently done and the rate of curative resection (curability A and B) increased. With increases in identifying the early stage of cancer and better perioperative care, mortality rates 30 days after the surgery greatly decreased. Multivariate analysis revealed that the 10 factors of depth of invasion, lymph node metastasis, lymph node dissection, tumour size, liver metastasis, peritoneal dissemination, lymphatic invasion, vascular invasion, lesion in the whole stomach and lesion in the middle stomach were independent factors for determining the prognosis. Detection of the tumour in an early stage, standardized surgical treatment, including routine lymph node dissection, close follow-up schedules and better perioperative management are expected to increase survival time for patients with this malignancy. © 2000 Cancer Research Campaign PMID:10993643

Maehara, Y; Kakeji, Y; Oda, S; Takahashi, I; Akazawa, K; Sugimachi, K

2000-01-01

332

Fondaparinux prevents venous thromboembolism after joint replacement surgery in Japanese patients.  

PubMed

Venous thromboembolism (VTE) is an important complication of major orthopaedic surgery of the lower limbs. Fondaparinux, a synthetic pentasaccharide and highly selective inhibitor of activated Factor Xa, is the first in a new class of antithrombotic agents. To determine the optimal dose in Japanese patients, double-blind, placebo-controlled, dose-ranging studies of fondaparinux were conducted in patients undergoing total knee replacement (TKR) or total hip replacement (THR) surgery. Patients were randomly assigned to receive a once-daily subcutaneous injection of fondaparinux (0.75, 1.5, 2.5, or 3.0 mg) or placebo in Study 1 (TKR) and Study 2 (THR). In Study 1, the incidence of VTE was 65.3% in the placebo group and was 34.2%, 21.3%, 16.2%, and 9.5% in the groups receiving 0.75, 1.5, 2.5, and 3.0 mg fondaparinux respectively. In Study 2, the incidence of VTE was 33.8% in the placebo group and was 24.2%, 4.6%, 7.4%, and 14.4% in the 0.75, 1.5, 2.5, and 3.0 mg fondaparinux groups respectively. Dose-response effects were observed in both studies; however, no statistically significant differences in major bleeding events were found among any groups. Fondaparinux proved to be a potent anticoagulant with a favourable benefit-to-risk ratio in the prevention of VTE in these study patients. PMID:17468868

Fuji, Takeshi; Fujita, Satoru; Ochi, Takahiro

2008-08-01

333

Sensorineural deafness in patients of type 2 diabetes mellitus in uttar pradesh: a pilot study.  

PubMed

B/L symmetrical sensorineural hearing loss has long been associated with diabetes Mellitus. Microangiopathy associated with thickening of the basement membrane of small vessels has been implicated as a major source. This study was done to observe the predominant site of lesion whether cochlear or retrocochlear in patients of diabetic sensorineural hearing loss. This was a random study. Forty two patients with diabetic B/L symmetrical sensorineural hearing loss were selected in a tertiary referral centre. All the patients selected were of diabetic B/L symmetrical sensorineural hearing loss. The study was designed to show the predominant site of lesion whether cochlear or retrocochlear in patients of diabetes with or without noise exposure. The parameter for inferring blood sugar control was level of glycosylated haemoglobin (Hb1AC). The incidence of the classical symptoms of diabetes mellitus namely polyurea, polydypsia and polyphagia were seen in (40.8%) of patients. The present study was designed to show that even early diabetic patients without symptoms of hearing loss had mild bilaterally symmetrical purely sensorineural hearing loss (32.65%) signifying the diabetic hypoacusis is present significantly even in early aural symptomless diabetics. On follow up it was revealed that the hearing loss of these patients was irreversible. The predominant site of lesion was found to be cochlear by performing Chi Square test P < .05 and so this is applicable to the general population of Uttar Pradesh. PMID:24427709

Misra, Vilas; Agarwal, C G; Bhatia, N; Shukla, G K

2013-12-01

334

High-fibre diets for diabetic and hypertriglyceridemic patients.  

PubMed Central

Diets high in complex carbohydrate result in lower insulin requirements than the high-fat diets conventionally used to treat diabetes. Accompanying unacceptable increases in fasting triglyceride levels can be overcome by increasing the fibre content of the diet. In diabetics a diet providing 70% of energy from carbohydrate and containing 35 to 40 g of fibre per 1000 Cal will rapidly reduce the plasma glucose level and the requirement for insulin or sulfonylurea. It will also lower the serum cholesterol and triglyceride levels in individuals with hypertriglyceridemia. These improvements are maintained in patients following a modified high-carbohydrate, high-fibre diet providing 55% to 60% of energy by carbohydrate (75% of which is complex), 15% to 20% by protein and 20% to 30% by fat, with 25 g of plant fibre per 1000 Cal. With long-term use (for up to 48 months) of the maintenance diets patients maintained or corrected their body weight, and no nutritional deficiencies were observed. PMID:6256046

Anderson, J W

1980-01-01

335

Renal AA Amyloidosis in Patients with Type 2 Diabetes Mellitus  

PubMed Central

Background Type 2 diabetes mellitus (T2DM) is the leading cause of chronic kidney disease and a major cause of cardiovascular disease (CVD) mortality. Inflammation is closely involved in the pathogenesis of T2DM, and reactive amyloidosis occurs in the presence of chronic inflammation. We hypothesized that patients with T2DM may have a higher prevalence of renal AA amyloidosis (RAAA) and that this could contribute to worse atherosclerosis and CVD. Materials and Methods We analyzed 330 autopsy kidneys from patients with a previous T2DM diagnosis. The kidney tissue was evaluated in order to determine the presence of diabetic nephropathy and RAAA, and systemic vessels were evaluated for the presence of atherosclerosis. Results RAAA was detected in 9% of our study population and was associated with an increased risk for nodular sclerosis [OR (95% CI)] [11 (2.04-59.16)], for chronic ischemic cardiomyopathy [4.59 (2.02-10.42)], for myocardial infarction [3.41 (1.52-7.64)] as well as for aortic [4.75 (1.09-20.69)], coronary [3.22 (1.47-7.04)], and intrarenal atherosclerosis [3.84 (1.46-10.09)]. Conclusions RAAA is prevalent in T2DM and is associated with worse CVD and renal disease, likely because RAAA is a marker of severe chronic inflammation. PMID:25337080

Díez, Ramón; Madero, Magdalena; Gamba, Gerardo; Soriano, Juan; Soto, Virgilia

2014-01-01

336

In-patient management of diabetes: Controversies and guidelines  

PubMed Central

Hyperglycemia is associated with adverse outcomes in hospitalized patients with and without previously known diabetes. Some therapies that are used in the in-patient setting, including glucocorticoids, enteral and parenteral nutrition are associated with new onset hyperglycemia even in previously normoglycemic patients. Current guidelines advise that fasting and premeal blood glucose (BG) be maintained at < 140 mg/dl, with maximal random BG < 180 mg/dl in non-critically ill-patients. In critically ill-patients, intravenous (IV) insulin infusion therapy with BG targets of 140-180 effectively maintains glycemic control with a low risk for hypoglycemia. Protocols targeting “tight” glycemic control, defined as BG 80-110 mg/dl, are no longer recommended due to the high frequency of severe hypoglycemia. Rational use of basal bolus insulin (BBI) regimens in non-critical care and IV insulin infusions in critical care settings has been demonstrated to effectively achieve and maintain recommended BG targets with low risk for hypoglycemia. The safety of BBI relies upon provider awareness of prescribing recommendations for initiating and adjusting insulin regimens according to changes in overall clinical and nutritional status, as well as careful review of daily BG measurements. Smooth transition of care to the out-patient setting is facilitated by providing oral and written instructions regarding the timing and dosing of insulin as well as education in basic skills for home management. PMID:24910825

Korytkowski, Mary T.

2013-01-01

337

The impact of diabetic retinopathy: understanding the patient's perspective.  

PubMed

Understanding the impact of a condition from the patient's perspective is important, and different types of patient-reported outcomes or instruments are available to help with this. This review article summarises the current evidence on the impact of diabetic retinopathy (DR) and its associated vision impairment on patient-reported outcomes. We have included research that has used a range of outcome measures to assess the impact of DR on generic health-related quality of life, utility, vision-functioning and vision-specific quality of life. This review also offers clarification on frequently misused psychometric terminologies to help clinicians and researchers better understand the literature associated with patient-reported outcome research. Overall, the evidence suggests that DR, particularly in its vision-threatening stages, has a substantial, negative impact on the patient. However, our understanding of the impact of DR is currently restricted due to limitations inherent in currently available patient-reported outcome measures. We conclude by discussing potential directions for future research in this area, such as item banking and computer adaptive testing. PMID:20940313

Fenwick, E K; Pesudovs, K; Rees, G; Dirani, M; Kawasaki, R; Wong, T Y; Lamoureux, E L

2011-06-01

338

In-patient management of diabetes: Controversies and guidelines.  

PubMed

Hyperglycemia is associated with adverse outcomes in hospitalized patients with and without previously known diabetes. Some therapies that are used in the in-patient setting, including glucocorticoids, enteral and parenteral nutrition are associated with new onset hyperglycemia even in previously normoglycemic patients. Current guidelines advise that fasting and premeal blood glucose (BG) be maintained at < 140 mg/dl, with maximal random BG < 180 mg/dl in non-critically ill-patients. In critically ill-patients, intravenous (IV) insulin infusion therapy with BG targets of 140-180 effectively maintains glycemic control with a low risk for hypoglycemia. Protocols targeting "tight" glycemic control, defined as BG 80-110 mg/dl, are no longer recommended due to the high frequency of severe hypoglycemia. Rational use of basal bolus insulin (BBI) regimens in non-critical care and IV insulin infusions in critical care settings has been demonstrated to effectively achieve and maintain recommended BG targets with low risk for hypoglycemia. The safety of BBI relies upon provider awareness of prescribing recommendations for initiating and adjusting insulin regimens according to changes in overall clinical and nutritional status, as well as careful review of daily BG measurements. Smooth transition of care to the out-patient setting is facilitated by providing oral and written instructions regarding the timing and dosing of insulin as well as education in basic skills for home management. PMID:24910825

Korytkowski, Mary T

2013-12-01

339

Patient confidentiality, data security, and provider liabilities in diabetes management.  

PubMed

From inception, the electronic patient record has raised issues of data protection and patient confidentiality. These privacy issues have become more complicated with the introduction of electronic links to patient information held in databases sited on local and wide area networks. The first purpose of this paper is to review, from the provider's perspective, the issues surrounding patient confidentiality, data security, and consequential provider liabilities. The second is to propose possible immediate strategies and long-term solutions. Clinical procedures in diabetes practice create patient data from confidential information. This information is owned by the patient, received by the provider, enriched by a professional interpretation, and merged with other data into health records. Ownership, privacy, accountability, and responsibility issues are raised. Consequential data security and patient privacy are easily met by storage in a locked box or file cabinet. Conversion of such records into digital data in databases on local and wide area networks markedly increases the provider's exposure to liabilities. Current methods for securing remote data exist. These involve user authentication and secure transmission, but remote data storage is far less secure than a locked box. New tools for the secure storage of patient data are outlined. These involve encryption and decryption by the provider alone. A suite of computer protocols is presented that can restore security equivalent to a "locked box" and thus reduce liabilities for the provider. Providers should protect the privacy of their patients by encrypting all data that are stored in remote repositories. The tools to do this are urgently needed. A standardized digital protocol for verifying user identities, preserving patient confidentiality, and controlling data security by encryption will fully mitigate provider liabilities. Standardization and economies of scale promise future cost containment. PMID:14511418

Albisser, A Michael; Albisser, Jeremy B; Parker, Louise

2003-01-01

340

Assisting effects of lithium on hypoglycemic treatment in patients with diabetes  

Microsoft Academic Search

In this article, we report the assisting effect of lithium on hypoglycemic treatment in patients with diabetes. Thirty-eight\\u000a diabetic patients, 15 male and 23 female, aged 20–70 yr, 33 noninsulin-dependent diabetesmellitus (NIDDM) patients, and 5 insulin-dependent diabetesmellitus (IDDM) patients, were recruited in this study. Fasting and 1-h postprandial blood glucose (BG) profiles were undertaken from\\u000a three groups of patients with

Min Hu; Hanwen Wu; Chusheng Chao

1997-01-01

341

External validation of the UK Prospective Diabetes Study (UKPDS) risk engine in patients with type 2 diabetes  

Microsoft Academic Search

Aims\\/hypothesis  Treatment guidelines recommend the UK Prospective Diabetes Study (UKPDS) risk engine for predicting cardiovascular risk in\\u000a patients with type 2 diabetes, although validation studies showed moderate performance. The methods used in these validation\\u000a studies were diverse, however, and sometimes insufficient. Hence, we assessed the discrimination and calibration of the UKPDS\\u000a risk engine to predict 4, 5, 6 and 8 year cardiovascular

S. van Dieren; L. M. Peelen; U. Nöthlings; Y. T. van der Schouw; G. E. H. M. Rutten; A. M. W. Spijkerman; D. L. van der A; D. Sluik; H. Boeing; K. G. M. Moons; J. W. J. Beulens

2011-01-01

342

Diabetes, Prediabetes and the Survival of Nasopharyngeal Carcinoma: A Study of 5,860 Patients  

PubMed Central

Background The incidence of diabetes is increasing. But the impact of diabetes and prediabetes on survival of patients with nasopharyngeal carcinoma (NPC) has received little evaluation. Methods In a cohort of 5,860 patients, we compared the disease specific survival (DSS), locoregional relapse-free survival (LRFS) and distant metastasis-free survival (DMFS) of patients with diabetes, prediabetes and normoglycemia defined by pretreatment fasting plasma glucose (FPG) using Kaplan–Meier method, log-rank test and Cox proportional hazards model. Results Comparing to normoglycemic patients, the diabetic and the prediabetic were generally older, fatter, had hypertension, heart diseases and hyperlipaemia and usually received radiotherapy alone. But both the diabetic and the prediabetic had similar DSS, LRFS and DMFS to normoglycemic patients, even adjusting for such important factors as age, gender, smoking, drinking, hypertension, heart diseases, body mass index, hyperlipaemia, titer of VCA-IgA and EA-IgA, pathology, T-stage, N-stage, chemotherapy and radiotherapy (P>0.05 for all). Additionally, the findings remained unchanged in sensitivity analysis by excluding patients with known diabetes history and in subgroups of the various factors. Conclusions The diabetic and prediabetic NPC patients had similar survival to normoglycemic NPC patients. These data, in the largest reported cohort, are the first to evaluate the association between diabetes, prediabetes and the survival in NPC. The findings are relevant to patient management and provided evidence of the effect on this disease exerted by comorbidities. PMID:25350747

OuYang, Pu-Yun; Su, Zhen; Tang, Jie; Lan, Xiao-Wen; Mao, Yan-Ping

2014-01-01

343

Risk Factors for Cardiovascular Calcifications in Non-Diabetic Caucasian Haemodialysis Patients  

Microsoft Academic Search

Background\\/Aims: Dialysis patients display an increased mortality which is associated with cardiovascular calcifications. Diabetes mellitus and ethnicity are known factors that affect the extent of cardiovascular calcifications. However, most studies have investigated mixed cohorts with diabetics and\\/or mixed ethnicity. Methods: Cardiovascular calcifications were assessed in non-diabetic Caucasian haemodialysis patients by the semiquantitative Adragao calcification score (X-ray pelvis and hands) and

Georg Schlieper; Vincent Brandenburg; Zivka Djuric; Tatjana Damjanovic; Natasa Markovic; Leon Schurgers; Thilo Krüger; Ralf Westenfeld; Diana Ackermann; Angelika Haselhuhn; Sinisa Dimkovic; Markus Ketteler; Jürgen Floege; Nada Dimkovic

2009-01-01

344

Efficacy of Benfluorex in Combination With Sulfonylurea in Type 2 Diabetic Patients  

Microsoft Academic Search

OBJECTIVE — The aim of this study was to demonstrate the superiority of benfluorex over placebo as an add-on therapy in type 2 diabetic patients in whom diabetes is insufficiently controlled by sulfonylurea monotherapy and who have a limitation for the use of metformin. RESEARCH DESIGN AND METHODS — Type 2 diabetic patients with HbA1c (A1C) (7-10%) who were receiving

PHILIPPE MOULIN; MARIE ANDRE; HASAN ALAWI; LELITA C. DOS SANTOS; ABDUL K. KHALID; DRAGOMIR KOEV; RAY MOORE; VIOREL SERBAN; BRIGITTE PICANDET; MARIE FRANCILLARD

345

Effects of alcohol consumption on mortality in patients with Type 2 diabetes mellitus  

Microsoft Academic Search

Aims\\/hypothesis  Moderate alcohol intake has been associated with increased life expectancy due to reduced mortality from cardiovascular disease. We prospectively examined the effects of alcohol consumption on mortality in Type 2 diabetic patients in Switzerland.Methods  A total of 287 patients with Type 2 diabetes mellitus (125 women, 162 men), recruited in Switzerland for the WHO Multinational Study of Vascular Disease in Diabetes,

P. Diem; M. Deplazes; R. Fajfr; A. Bearth; B. Müller; E. R. Christ; A. Teuscher

2003-01-01

346

Stratified Patient-Centered Care in Type 2 Diabetes  

PubMed Central

OBJECTIVE Diabetes treatment should be effective and cost-effective. HbA1c-associated complications are costly. Would patient-centered care be more (cost-) effective if it was targeted to patients within specific HbA1c ranges? RESEARCH DESIGN AND METHODS This prospective, cluster-randomized, controlled trial involved 13 hospitals (clusters) in the Netherlands and 506 patients with type 2 diabetes randomized to patient-centered (n = 237) or usual care (controls) (n = 269). Primary outcomes were change in HbA1c and quality-adjusted life years (QALYs); costs and incremental costs (USD) after 1 year were secondary outcomes. We applied nonparametric bootstrapping and probabilistic modeling over a lifetime using a validated Dutch model. The baseline HbA1c strata were <7.0% (53 mmol/mol), 7.0–8.5%, and >8.5% (69 mmol/mol). RESULTS Patient-centered care was most effective and cost-effective in those with baseline HbA1c >8.5% (69 mmol/mol). After 1 year, the HbA1c reduction was 0.83% (95% CI 0.81–0.84%) (6.7 mmol/mol [6.5–6.8]), and the incremental cost-effectiveness ratio (ICER) was 261 USD (235–288) per QALY. Over a lifetime, 0.54 QALYs (0.30–0.78) were gained at a cost of 3,482 USD (2,706–4,258); ICER 6,443 USD/QALY (3,199–9,686). For baseline HbA1c 7.0–8.5% (53–69 mmol/mol), 0.24 QALY (0.07–0.41) was gained at a cost of 4,731 USD (4,259–5,205); ICER 20,086 USD (5,979–34,193). Care was not cost-effective for patients at a baseline HbA1c <7.0% (53 mmol/mol). CONCLUSIONS Patient-centered care is more valuable when targeted to patients with HbA1c >8.5% (69 mmol/mol), confirming clinical intuition. The findings support treatment in those with baseline HbA1c 7–8.5% (53–69 mmol/mol) and demonstrate little to no benefit among those with HbA1c <7% (53 mmol/mol). Further studies should assess different HbA1c strata and additional risk profiles to account for heterogeneity among patients. PMID:23949558

Slingerland, Annabelle S.; Herman, William H.; Redekop, William K.; Dijkstra, Rob F.; Jukema, J. Wouter; Niessen, Louis W.

2013-01-01

347

Patient-centered outcomes of a value-based insurance design program for patients with diabetes.  

PubMed

Value-based insurance design (VBID) initiatives have been associated with modest improvements in adherence based on evaluations of administrative claims data. The objective of this prospective cohort study was to report the patient-centered outcomes of a VBID program that eliminated co-payments for diabetes-related medications and supplies for employees and dependents with diabetes at a large health system. The authors compared self-reported values of medication adherence, cost-related nonadherence, health status, and out-of-pocket health care costs for patients before and 1 year after program implementation. Clinical metrics and satisfaction with the program also are reported. In all, 188 patients completed the follow-up evaluation. Overall, patients reported a significant reduction in monthly out-of-pocket costs (P<0.001), which corresponded to a significant reduction in cost-related nonadherence from 41% to 17.5% (P<0.001). Self-reported medication adherence increased for hyperglycemic medications (P=0.011), but there were no apparent changes in glycemic control. Overall, 89% of participants agreed that the program helped them take better care of their diabetes. The authors found that a VBID program for employees and dependents with diabetes was associated with self-reported reductions in cost-related nonadherence and improvements in medication adherence. Importantly, the program was associated with high levels of satisfaction among participants and strongly perceived by participants to facilitate medication utilization and self-management for diabetes. These findings suggest that VBID programs can accomplish the anticipated goals for medication utilization and are highly regarded by participants. Patient-centered outcomes should be included in VBID evaluations to allow decision makers to determine the true impact of VBID programs on participants. PMID:23405873

Elliott, Daniel J; Robinson, Edmondo J; Anthony, Karen B; Stillman, Paula L

2013-04-01

348

Clopidogrel for Atherothrombotic Event Management in Patients with Peripheral Arterial Disease (COOPER) Study: Safety and Efficacy of Clopidogrel versus Ticlopidine in Japanese Patients  

PubMed Central

Background: Peripheral arterial disease (PAD) has been recognized as an independent risk factor for vascular events and contributes to an adverse prognosis. Long-term administration of clopidogrel is recommended to prevent atherothrombotic events for patients with established PAD. We investigated the benefits of clopidogrel treatment in Japanese patients with PAD. Materials and Methods: COOPER (Clopidogrel for atherOthrombOtic event management in patients with PERipheral arterial disease) was a multicenter, randomized, double-blind study to evaluate the safety and efficacy of clopidogrel (75 mg/day) compared to ticlopidine (200 mg/day) in Japanese patients with PAD. The primary endpoint was the cumulative incidence of “safety events of interest” comprising clinically significant bleeding, blood disorders, hepatic dysfunction and other serious adverse events up to 12 weeks. The other safety events and vascular events were also assessed. Patients were followed up to 52 weeks. Results: A total of 431 patients with PAD were randomly assigned to receive either clopidogrel or ticlopidine. The cumulative incidences of “safety events of interest” at 12 weeks were 2.4% and 13.6% of patients who received clopidogrel and ticlopidine, respectively (adjusted hazard ratio, 0.161; 95% confidence interval, 0.062 to 0.416; p <0.0001). Bleeding and vascular events were similar in both groups. Conclusion: Clopidogrel demonstrated a favorable benefit/risk profile than ticlopidine in Japanese patients with PAD. (Trial registration: ClinicalTrials.gov, Identifier: NCT00862420) PMID:23555538

2012-01-01

349

Vitamin D Insufficiency Is Associated with Lower Physical Function in Patients with Heart Failure and Diabetes  

PubMed Central

Vitamin D deficiency is frequent among patients with heart failure (HF) and diabetes, disorders associated with exercise intolerance and muscle weakness. This study aims to search for associations between vitamin D sufficiency and physical function indexes in patients with HF and diabetes. A cross-sectional study of 146 HF patients, 39.7% with diabetes, at a Brazilian tertiary outpatient clinic was performed. Patients underwent clinical evaluation, 6-minute walk test (6?MWT), handgrip strength, physical activity level (IPAQ), and biochemical evaluations including serum 25-hydroxyvitamin D. Classification was done according to vitamin D status (?30?ng/dL, sufficient) and presence/absence of diabetes in vitamin sufficient, no diabetes (DS-C, n = 25), vitamin sufficient, diabetes (DS-DM, n = 18), vitamin deficient, no diabetes (DD-C, n = 63), and vitamin deficient, diabetes (DD-DM, n = 40). Patients age was 55.4 ± 8 yrs; 70.5% had vitamin D deficiency. Clinical characteristics were similar among groups. Total time expended in physical activity was similar among groups (P = 0.26). DS-C covered higher distances in the 6?MWT (392 ± 60 m) versus DD-DM (309 ± 116?m); P = 0.024. Handgrip strength was similar among groups but tended to lower levels in DD-DM (P = 0.074) even after being adjusted to physical activity (P = 0.069). Vitamin D deficiency can influence physical function in HF diabetic patients.

Lopes, M. R.; Ribeiro, Paula A. B.; Souza, Gabriela C.; Clausell, Nadine; Schaan, Beatriz D.

2014-01-01

350

Vitamin d insufficiency is associated with lower physical function in patients with heart failure and diabetes.  

PubMed

Vitamin D deficiency is frequent among patients with heart failure (HF) and diabetes, disorders associated with exercise intolerance and muscle weakness. This study aims to search for associations between vitamin D sufficiency and physical function indexes in patients with HF and diabetes. A cross-sectional study of 146 HF patients, 39.7% with diabetes, at a Brazilian tertiary outpatient clinic was performed. Patients underwent clinical evaluation, 6-minute walk test (6 MWT), handgrip strength, physical activity level (IPAQ), and biochemical evaluations including serum 25-hydroxyvitamin D. Classification was done according to vitamin D status (? 30 ng/dL, sufficient) and presence/absence of diabetes in vitamin sufficient, no diabetes (DS-C, n = 25), vitamin sufficient, diabetes (DS-DM, n = 18), vitamin deficient, no diabetes (DD-C, n = 63), and vitamin deficient, diabetes (DD-DM, n = 40). Patients age was 55.4 ± 8 yrs; 70.5% had vitamin D deficiency. Clinical characteristics were similar among groups. Total time expended in physical activity was similar among groups (P = 0.26). DS-C covered higher distances in the 6 MWT (392 ± 60 m) versus DD-DM (309 ± 116 m); P = 0.024. Handgrip strength was similar among groups but tended to lower levels in DD-DM (P = 0.074) even after being adjusted to physical activity (P = 0.069). Vitamin D deficiency can influence physical function in HF diabetic patients. PMID:25243195

Lopes, M R; Ribeiro, Paula A B; Ledur, Priscila; Souza, Gabriela C; Clausell, Nadine; Schaan, Beatriz D

2014-01-01

351

Acetylsalicylic Acid Resistance in Patients with Type 2 Diabetes Mellitus, Prediabetes & Non-Diabetic Coronary Artery Disease  

PubMed Central

Objective : Several studies have demonstrated the beneficial role of antiplatelet therapy with acetylsalicylic acid (ASA) at atherosclerotic vascular disease. Antiaggregant effect of ASA is not uniform in all patients. Purpose of the present study is to evaluate the prevalence of ASA resistance in patients with type 2 diabetes mellitus (T2DM), pre-diabetes and non-diabetic coronary artery disease (CAD). Methods: Effect of ASA was assessed using the platelet function analyzer (PFA-100) system. Resistance to ASA was defined as a normal collagen/epinephrine induced closure time after one week of ASA therapy. Patients with non-diabetic CAD, pre-diabetes and T2DM were compared. Results: ASA resistance was found in 26 (37.1%), 6 (17.6%) and 41 (26.5%) patients in the groups, respectively (p=0.154). ASA resistance was found to be significantly higher in men, smokers and insulin users, besides this it was found to be significantly lower in beta blocker (BB) users, angiotensin converting enzyme inhibitor (ACEI) users with univariate analysis. However insulin usage was found to be the single effective parameter on ASA resistance in multivariate analysis. Conclusion: There was no difference with regard to ASA resistance between groups. While ASA resistance was higher in men, smokers and insulin users, it was lower in patients using BBs and ACEIs. PMID:24948975

Cetin, Mustafa; Kiziltunc, Emrullah; Cetin, Zehra Guven; Cicekcioglu, Hulya; Sahin, Muslum; Isik, Serhat; Kurtul, Alparslan; Ornek, Ender; Ulusoy, Feridun Vasfi

2014-01-01

352

Differential expression of drug uptake and efflux transporters in Japanese patients with hepatocellular carcinoma.  

PubMed

Targeted chemotherapy for hepatocellular carcinoma (HCC) is impaired by intrinsic and/or acquired drug resistance. Because drugs used in HCC therapy (e.g., anthracyclines or the tyrosine kinase inhibitor sorafenib) are substrates of uptake and/or efflux transporters, variable expression of these transporters at the plasma membrane of tumor cells may contribute to drug resistance and subsequent clinical response. In this study, the variability of expression of uptake transporters [organic cation transporter (OCT) 1 and OCT3] and efflux transporters [multidrug resistance 1 (MDR1)/P-glycoprotein, multidrug resistance protein (MRP) 1, MRP2, and breast cancer resistance protein (BCRP)], selected for their implication in transporting drugs used in HCC therapy, was investigated. HCC and corresponding nontumor tissue samples were collected from 24 Japanese patients at the time of surgery. Protein expression was determined by immunohistochemistry. Expression data were correlated with clinicopathological characteristics and patients' outcome (median follow-up, 53 months). Generally, expression was highly variable among individual tumor samples. Yet median expression of OCT1, OCT3, and MDR1 in HCC was significantly lower (1.4-, 2.7-, and 2-fold, respectively) than in nontumor tissue, while expression of MRP2 persisted and BCRP showed a trend of increased levels in HCC. Patients with low BCRP expression had significantly shorter overall and recurrence-free survival times. Results suggest different expression patterns of drug transporters in HCC, which are associated only in part with clinicopathological characteristics. Detailed information on expression of drug transporters in HCC may be promising for individualization and optimization of drug therapy for liver cancer. PMID:25231932

Namisaki, Tadashi; Schaeffeler, Elke; Fukui, Hiroshi; Yoshiji, Hitoshi; Nakajima, Yoshiyuki; Fritz, Peter; Schwab, Matthias; Nies, Anne T

2014-12-01

353

Mucosal lesions may be a minor complication of SAPHO syndrome: a study of 11 Japanese patients with SAPHO syndrome  

Microsoft Academic Search

Since the term synovitis–acne–pustulosis–hyperostosis–osteitis (SAPHO) syndrome was proposed by Chamot et al. (Rev Rhum Mal\\u000a Osteoartic 54:187–196, 1987), clinical reviews concerning this syndrome have been mainly reported from Europe. We carried out a retrospective analysis\\u000a of 11 Japanese patients with SAPHO syndrome, and reviewed the clinical features of our series in comparison with those in\\u000a a European large case study.

Hiroki Yabe; Hisaji Ohshima; Yoji Takano; Takahiro Koyanagi; Hiroshi Usui; Kensuke Ochi; Michiya Kihara; Yukio Horiuchi

2010-01-01

354

Microalbuminuria Prevalence Study (MAPS) in hypertensive Patients with Type 2 Diabetes in Thailand  

Microsoft Academic Search

Background: Microalbuminuria represents the earliest clinical evidence of diabetic nephropathy, and is a marker of increased cardiovascular (CV) morbidity and mortality. Objectives: This analysis of Thai data from the Microalbuminuria Prevalence Study (MAPS) assessed the prevalence of macroalbuminuria and microalbuminuria in hypertensive patients with type 2 diabetes. Design: Cross-sectional clinic-based epidemiological study. Material and Method: A total of 100 patients

Peera Buranakitjaroen

355

Failure to control risk factors among patients with type 2 diabetes; experience from a Greek cohort.  

PubMed

We reviewed the records of 313 diabetic patients attending a diabetes clinic for at least two years. Despite improvements in the control rates of cardiovascular risk factors, only 8.9% of the patients reached all the metabolic target goals simultaneously at the end, indicating a gap between guidelines and clinical practice. PMID:19720571

Kollias, Anastasios; Bliziotis, Ioannis A; Xilomenos, Apostolos; Tolis, Apostolos

2009-11-01

356

Patients' experience with a diabetes support programme based on an interactive electronic medical record: qualitative study  

Microsoft Academic Search

Objective To describe the experiences of patients with type 2 diabetes in a web based disease management programme based on an interactive electronic medical record. Design Qualitative analysis of semistructured interviews with patients enrolled in a diabetes care module that included access to their electronic medical record, secure email, ability to upload blood glucose readings, an education site with endorsed

James D Ralston; Debra Revere; Lynne S Robins; Harold I Goldberg

2004-01-01

357

Outcome of Coronary Bypass Surgery Versus Coronary Angioplasty in Diabetic Patients With Multivessel Coronary Artery Disease  

Microsoft Academic Search

Objectives. This study sought to compare the outcome of percutaneous transluminal coronary angioplasty (PTCA) (n = 834) and coronary artery bypass graft surgery (CABG) (n = 1805) in diabetic patients with multivessel coronary disease from an observational database.Background. There is concern about selection of revascularization in diabetic patients with multivessel coronary artery disease.Methods. Data were collected prospectively and entered into

William S Weintraub; Bernardo Stein; Andrzej Kosinski; John S Douglas; Ziyad M. B Ghazzal; Ellis L Jones; Douglas C Morris; Robert A Guyton; Joseph M Craver; Spencer B King

1998-01-01

358

Diabetes Distress and Depressive Symptoms: A Dyadic Investigation of Older Patients and Their Spouses  

ERIC Educational Resources Information Center

In this dyadic study, we examined diabetes distress experienced by male and female patients and their spouses (N = 185 couples), and its association with depressive symptoms using the Actor-Partner Interdependence Model. Diabetes-related distress reported by both patients and spouses was associated with each partner's own depressive symptoms…

Franks, Melissa M.; Lucas, Todd; Stephens, Mary Ann Parris; Rook, Karen S.; Gonzalez, Richard

2010-01-01

359

Stabilized incidence of diabetic patients referred for renal replacement therapy in Denmark  

Microsoft Academic Search

Despite an improvement in diabetes care during the last 20 years, the number of diabetic patients starting renal replacement therapy (RRT) has continued to increase in the Western world. The aim was to study the incidence of patients starting RRT in Denmark from 1990 to 2004. Data were obtained from The Danish National Registry; Report on Dialysis and Transplantation, where

V R Sørensen; P M Hansen; J Heaf; B Feldt-Rasmussen

2006-01-01

360

Aerobic exercise in obese diabetic patients with chronic kidney disease: a randomized and controlled pilot study  

Microsoft Academic Search

BACKGROUND: Patients with obesity, diabetes, and chronic kidney disease (CKD) are generally physically inactive, have a high mortality rate, and may benefit from an exercise program. METHODS: We performed a 24-week randomized controlled feasibility study comparing aerobic exercise plus optimal medical management to medical management alone in patients with type 2 diabetes, obesity (body mass index [BMI] > 30 kg\\/m2),

David J Leehey; Irfan Moinuddin; Joseph P Bast; Shahzad Qureshi; Christine S Jelinek; Cheryl Cooper; Lonnie C Edwards; Bridget M Smith; Eileen G Collins

2009-01-01

361

A mysterious case of normalising blood sugar: insulinoma in a long-standing diabetic patient  

Microsoft Academic Search

We report a case of recurrent hypoglycaemia in a long-standing type 2 diabetic patient, despite dramatic reduction in her anti- diabetic therapy. Subsequent investigations revealed an insulinoma as the cause. This patient was treated medically with dia- zoxide therapy, as multiple co-morbidities were felt to preclude surgical intervention. Although insulinoma is rare in the elderly and exceedingly rare in the

MUHAMMAD FUAD HAMEED; GRAEME E. HOYLE; ZOE MUIR

362

Acarbose in the treatment of elderly patients with type 2 diabetes  

Microsoft Academic Search

Aims: To study the effect of acarbose, an ?-glucosidase inhibitor, on glycemic control in elderly patients with type 2 diabetes. Methods: Elderly patients with type 2 diabetes treated with diet alone were randomly treated in a double-blind fashion with placebo (n=99) or acarbose (n=93) for 12 months. Results: After 12 months of therapy, there was a statistically significant difference in

R. G Josse; J.-L Chiasson; E. A Ryan; D. C. W Lau; S. A Ross; J.-F Yale; L. A Leiter; P Maheux; D Tessier; T. M. S Wolever; H Gerstein; N. W Rodger; J. M Dornan; L. J Murphy; R Rabasa-Lhoret; G. S Meneilly

2003-01-01

363

Effect of sulphated glycosaminoglycans on albuminuria in patients with overt diabetic (type 1) nephropathy  

Microsoft Academic Search

Decreased expression of heparan sulphate has been shown in the glomerular basement membrane of patients with overt diabetic nephropathy. Low- molecular-weight heparin (LMWH) is a highly sulphated glycosaminoglycan with strong structural and functional similarities to heparan sulphate. In a first study, we set out to assess if LMWH could decrease the urinary albumin excretion rate (AER) in diabetic patients with

J. T. Tamsma; F. J. van der Woude; H. H. P. J. Lemkes

364

Managing Activity in Patients Who Have Diabetes. Practical Ways to Incorporate Exercise into Lifestyle.  

ERIC Educational Resources Information Center

Diabetes control involves the appropriate balance of exercise, diet, and medication. Regular exercise has many benefits for people with diabetes. Physicians can educate patients about ways to regulate and monitor blood glucose before, during, and after workouts. Patients need to understand the effects of exercise and diet on insulin requirements.…

Taunton, Jack E.; McCargar, Linda

1995-01-01

365

Neurohumoral control of gallbladder motility in healthy subjects and diabetic patients with or without autonomic neuropathy  

Microsoft Academic Search

Patients affected by diabetes mellitus are reported to have an increased incidence of gallbladder abnormalities. The pathophysiologic mechanisms for this phenomenon are unclear. In the present study ultrasonography was used to determine gallbladder emptying in response to a meal or separate cephalic or hormonal stimulation in 21 diabetic patients and 10 healthy subjects. Gallbladder emptying and refilling after a meal

Stefano Fiorucci; Rachele Bosso; Luciano Scionti; Silvana Disanto; Bruno Annibale; Gianfranco Delle Fave; Antonio Morelli

1990-01-01

366

Cutaneous Blood Flow and Peripheral Resistance in Type II Diabetes as Compared to Intermittent Claudication Patients  

Microsoft Academic Search

Insulin deficient, type I diabetic patients have reduced skin blood flow reserve. It is not known whether these skin perfusion abnormalities also exist in non-insulin dependent (type II) diabetic patients. An additional open question is whether the reduced skin blood flow is due to increased resistance of the cutaneous microvasculature or to decreased peripheral perfusion pressure due to increased atherosclerosis

Marc Rendell; Shikhar Saxena; Deepesh Shah

2003-01-01

367

Elderly patients with type 2 diabetes mellitus-the need for high-quality, inpatient diabetes care.  

PubMed

Elderly patients (aged > 70 years) with diabetes are at high risk of -hospitalization. We provide a detailed commentary about recent international clinical guidelines and a consensus statement devoted to elderly patients with type 2 diabetes mellitus in the context of hospitalization. In emergency departments, the 4 medication agents associated with the greatest number of patient adverse drug events are warfarin, oral glucose-lowering medications, insulin, and antiplatelet agents, all of which are commonly prescribed in older patients with diabetes. Comprehensive gerontological assessment, including review and, if indicated, discontinuation of all potentially unsafe or inappropriate patient medications should be done upstream to reduce the likelihood of adverse drugs events. Severe infections and ischemic heart disease are also frequent causes of acute admission into hospital in patients aged > 75 years. These patients are also likely to be malnourished and nutritional status should be monitored. Nutritional support, combined with specific products to avoid uncontrolled hyperglycemia must be implemented in patients at risk of malnutrition. Early exercise prescription may help patients maintain physical function and prevent the risk of falling. Clinical guidelines should be applied to achieve safe and effective patient target glucose levels. Insulin should be used earlier for its anabolic properties and patients closely monitored to reduce the risk of hypoglycemia and excessive hyperglycemia. The discharge plan needs to address full medical and social needs along with suitable follow-up to ensure a high level of patient safety. PMID:24145589

Bourdel-Marchasson, Isabelle; Sinclair, Alan

2013-01-01

368

Fetuin-A Levels Are Increased in Patients With Type 2 Diabetes and Peripheral Arterial Disease  

PubMed Central

OBJECTIVE Low levels of fetuin-A, a systemic calcification inhibitor, are linked to mortality in patients on dialysis. In contrast, elevated fetuin-A is associated with cardiovascular events in non-renal patients. We investigated fetuin-A in patients with type 2 diabetes and peripheral arterial disease (PAD). RESEARCH DESIGN AND METHODS We studied fetuin-A in 76 patients with PAD and normal glucose metabolism (NGM-PAD) and in 129 patients with PAD and type 2 diabetes (type 2 diabetes–PAD). Additionally, 40 patients with diabetes without any complications (type 2 diabetes–non-PAD) were examined. RESULTS Type 2 diabetes–PAD subjects (399 ± 155 ?g/ml) had significantly higher fetuin-A levels than type 2 diabetes–non-PAD subjects (247 ± 42; P < 0.001). In NGM-PAD subjects (376 ± 144), fetuin-A was significantly higher than in type 2 diabetes–non-PAD subjects (P < 0.001). Type 2 diabetes–PAD patients with mediasclerosis had lower fetuin-A than subjects without (P < 0.03). Regression analysis in type 2 diabetes–PAD subjects revealed that glycated A1C (P < 0.001) and mediasclerosis (P = 0.004) were the strongest predictors of fetuin-A. Multivariate regression revealed that a 1-SD increase in fetuin-A was associated with an odds ratio (OR) of 2.1 (95% CI 1.1–3.3; P < 0.001) for the prevalence of PAD and an OR of 1.4 (1.0–1.7, P = 0.039) for the prevalence of myocardial infarction. CONCLUSIONS In contrast to previous findings, fetuin-A was higher in type 2 diabetes–PAD patients than in type 2 diabetes–non-PAD patients. In NGM-PAD patients, fetuin-A was also higher than in type 2 diabetes–non-PAD patients. In type 2 diabetes–PAD patients, fetuin-A was inversely associated with mediasclerosis—the calcification process pathognomonic for diabetic PAD. This association persisted in multivariate regression, which is in line with the calcification inhibition in coronary heart or renal disease. PMID:20929991

Lorant, David Peter; Grujicic, Milan; Hoebaus, Clemens; Brix, Johanna-Maria; Hoellerl, Florian; Schernthaner, Guntram; Koppensteiner, Renate; Schernthaner, Gerit-Holger

2011-01-01

369

Relationship of flow rate, uric acid, peroxidase, and superoxide dismutase activity levels with complications in diabetic patients: can saliva be used to diagnose diabetes?  

PubMed

Can salivary free radicals and antioxidant parameters be useful in general diagnosis and evaluation of diabetes mellitus Type II (DM)? Serum and salivary redox state of 40 diabetes mellitus patients were examined and compared with 20 controls. The involvement of salivary gland in diabetes mellitus has been suggested based on salivary flow rate and compositional alterations. In addition, the redox state of saliva of diabetes mellitus patients is different than that of normoglycemic control human subjects. This observation unveils the opportunity to use noninvasive saliva-based diagnostics for diabetes mellitus patients. PMID:17511593

Zloczower, Moshe; Reznick, Abraham Z; Zouby, Rula Obeid; Nagler, Rafael M

2007-06-01

370

Efficacy and Safety of Axitinib Versus Sorafenib in Metastatic Renal Cell Carcinoma: Subgroup Analysis of Japanese Patients from the Global Randomized Phase 3 AXIS Trial  

PubMed Central

Objective Axitinib is a potent and selective second-generation inhibitor of vascular endothelial growth factor receptors 1, 2 and 3. The efficacy and safety of axitinib in Japanese patients with metastatic renal cell carcinoma were evaluated. Methods A subgroup analysis was conducted in Japanese patients enrolled in the randomized Phase III trial of axitinib versus sorafenib after failure of one prior systemic therapy for metastatic renal cell carcinoma. Results Twenty-five (of 361) and 29 (of 362) patients randomized to the axitinib and sorafenib arms, respectively, were Japanese and included in this analysis. Median progression-free survival in Japanese patients was 12.1 months (95% confidence interval 8.6 to not estimable) for axitinib and 4.9 months (95% confidence interval 2.8–6.6) for sorafenib (hazard ratio 0.390; 95% confidence interval 0.130–1.173; stratified one-sided P = 0.0401). The objective response rate was 52.0% for axitinib and 3.4% for sorafenib (P = 0.0001). The common all-causality adverse events (all grades) in Japanese patients were dysphonia (68%), hypertension (64%), hand–foot syndrome (64%) and diarrhea (56%) for axitinib, and hand–foot syndrome (86%), hypertension (62%) and diarrhea (52%) for sorafenib. The safety profiles of axitinib and sorafenib in Japanese patients were generally similar to those observed in the overall population, with the exceptions of higher incidences of hypertension, dysphonia, hand–foot syndrome, hypothyroidism and stomatitis. Conclusions Axitinib is efficacious and well tolerated in Japanese patients with previously treated metastatic renal cell carcinoma, consistent with the results in the overall population, providing a new targeted therapy for these Japanese patients. PMID:23630366

Ueda, Takeshi; Uemura, Hirotsugu; Tomita, Yoshihiko; Tsukamoto, Taiji; Kanayama, Hiroomi; Shinohara, Nobuo; Tarazi, Jamal; Chen, Connie; Kim, Sinil; Ozono, Seiichiro; Naito, Seiji; Akaza, Hideyuki

2013-01-01

371

Visual functions and disability in diabetic retinopathy patients  

PubMed Central

Purpose This study was undertaken to find correlations between visual functions and visual disabilities in patients with diabetic retinopathy. Method A cross-sectional study was carried out among 38 visually impaired diabetic retinopathy subjects at the Low Vision Clinic of B.P. Koirala Lions Centre for Ophthalmic Studies, Kathmandu. The subjects underwent assessment of distance and near visual acuity, objective and subjective refraction, contrast sensitivity, color vision, and central and peripheral visual fields. The visual disabilities of each subject in their daily lives were evaluated using a standard questionnaire. Multiple regression analysis between visual functions and visual disabilities index was assessed. Result The majority of subjects (42.1%) were of the age group 60–70 years. Best corrected visual acuity was found to be 0.73 ± 0.2 in the better eye and 0.93 ± 0.27 in the worse eye, which was significantly different at p = 0.002. Visual disability scores were significantly higher for legibility of letters (1.2 ± 0.3) and sentences (1.4 ± 0.4), and least for clothing (0.7 ± 0.3). Visual disability index for legibility of letters and sentences was significantly correlated with near visual acuity and peripheral visual field. Contrast sensitivity was also significantly correlated with the visual disability index, and total scores. Conclusion Impairment of near visual acuity, contrast sensitivity, and peripheral visual field correlated significantly with different types of visual disability. Hence, these clinical tests should be an integral part of the visual assessment of diabetic eyes. PMID:24646899

Shrestha, Gauri Shankar; Kaiti, Raju

2013-01-01

372

Pharmacokinetics of bosentan in routinely treated Japanese pediatric patients with pulmonary arterial hypertension.  

PubMed

We evaluated the pharmacokinetics of routinely administered bosentan in 46 Japanese pediatric patients with pulmonary arterial hypertension. Plasma samples were taken twice at times corresponding to the peak and trough concentrations following repetitive oral administration. The population pharmacokinetic parameters of bosentan were estimated by use of the NONMEM program, in which a one-compartment model with repetitive bolus dosing was parameterized in terms of the oral clearance (CL/F) and elimination rate constant (k). Polymorphisms of CYP3A5, SLCO1B1, SLCO1B3, and SLCO2B1 had no significant effect on the disposition of bosentan. In addition, the pharmacokinetics of bosentan was not altered by heart failure or coadministration of sildenafil. In contrast, weight (WT)-normalized values of CL/F were correlated negatively with age (AGE). The final population mean values of CL/F and k were estimated to be 0.409 · (1 - 0.0377 · (AGE - 3.81)) · WT L/h and 0.175 h(-1), respectively. PMID:21383523

Taguchi, Masato; Ichida, Fukiko; Hirono, Keiichi; Miyawaki, Toshio; Yoshimura, Naoki; Nakamura, Tsuneyuki; Akita, Chisato; Nakayama, Tomotaka; Saji, Tsutomu; Kato, Yuya; Horiuchi, Isao; Hashimoto, Yukiya

2011-06-01

373

Relationship among patients' perceived capacity for communication, health literacy, and diabetes self-care.  

PubMed

The mechanisms underlying the relations among health literacy, perceived capacity for communication, diabetes knowledge, and diabetes self-care are unclear. This study tested this relation using structural equation modeling with a sample of 137 Chinese patients 65 years of age or older with type 2 diabetes. The model showed that health literacy, knowledge, communication capacity, and diabetes self-care formed complex relations. After adjusting for age, education, and Chinese cultural influence, health literacy affected diabetes self-care indirectly through perceived capacity for communication (standardized estimate coefficient = .641, p < .001) but not diabetes knowledge. To enhance self-care, interventions should be tailored to increase patient health literacy and perceived capacity for communication with health care providers. Training should be provided to patients to enhance their communication abilities. PMID:25315591

Leung, Angela Yee Man; Cheung, Mike Kwun Ting; Chi, Iris

2014-10-01

374

Virological response and safety of 24-week telaprevir alone in Japanese patients infected with hepatitis C virus subtype 1b  

PubMed Central

Hepatitis C virus (HCV) subtype 1b, which infects approximately 70% of Japanese carriers, is likely to be more eradicable by a telaprevir regimen than subtype 1a because of the higher genetic barrier of Val36 and Arg155 substitutions. The aims of this exploratory study were to evaluate the virological response and safety of 24-week oral administration of telaprevir alone in chronic HCV subtype 1b infection. Fifteen treatment-naïve patients were treated with telaprevir 750 mg every 8 h for 24 weeks. All patients were Japanese whose median age was 58.0 years (range: 45–68), and six patients (40%) were men. Median baseline HCV RNA level was 6.80 log10 IU/mL (range: 3.55–7.10). The HCV RNA levels decreased to undetectable in five patients (33%) within 8 weeks. Three patients (20%) with negative HCV RNA by Week 4 achieved end of treatment response. One patient (7%) who achieved sustained virological response had a low baseline viraemia of 3.55 log10 IU/mL. Most of the adverse events including anaemia and skin disorders were mild to moderate. Developed variants were T54A and A156V/T/F/Y with or without secondary substitutions rather than V36M ± R155K. Telaprevir alone for 24 weeks in Japanese patients with HCV subtype 1b resulted in an sustained viral response rate of 7% (1/15) and was well tolerated for 24 weeks. These results will support the implementation of further studies on oral combination of telaprevir with other direct-acting antiviral agents in patients infected with HCV subtype 1b. PMID:23383655

Toyota, J; Ozeki, I; Karino, Y; Asahina, Y; Izumi, N; Takahashi, S; Kawakami, Y; Chayama, K; Kamiya, N; Aoki, K; Yamada, I; Suzuki, Y; Suzuki, F; Kumada, H

2013-01-01

375

Medical groups can reduce costs by investing in improved quality of care for patients with diabetes.  

PubMed

A major feature of many new contracts between providers and payers is shared savings programs, in which providers can earn a percentage of the savings if the cost of the care they provide is lower than the projected cost. Unless providers are also held accountable for meeting quality benchmarks, some observers fear that these programs could erode quality of care by rewarding only cost savings. We estimated the effects on Medicare expenditures of improving the quality of care for patients with diabetes. Analyzing 234 practices that provided care for 133,703 diabetic patients, we found a net savings of $51 per patient with diabetes per year for every one-percentage-point increase in a score of the quality of care. Cholesterol testing for all versus none of a practice's patients with diabetes, for example, was associated with a dramatic drop in avoidable hospitalizations. These results show that improving the quality of care for patients with diabetes does save money. PMID:22869662

Kralewski, John E; Dowd, Bryan E; Xu, Yi Wendy

2012-08-01

376

Diabetes management and self-care education for hospitalized patients with cancer.  

PubMed

Managing diabetes can be a daunting task for patients with cancer. Empowerment-based diabetes education and motivational interviewing are complementary approaches. Oncology nurses may feel unprepared to teach patients and their families about self-care for diabetes, but they provide individualized information on symptom management of cancer throughout hospitalization and at discharge. The essential self-care issues include food, exercise, medication, blood glucose monitoring, prevention, recognition and treatment of hypoglycemia and hyperglycemia, and when and how to get additional medical and educational support. This patient-centered model of diabetes education differs from the older "compliance" model that covers many universal rules for all patients, which are predetermined by the nurse. Informing nurses about their role in care of patients with cancer and diabetes is critical. PMID:19349267

Leak, Ashley; Davis, Ellen D; Houchin, Laura B; Mabrey, Melanie

2009-04-01

377

Diabetes Management and Self-Care Education for Hospitalized Patients With Cancer  

PubMed Central

Managing diabetes can be a daunting task for patients with cancer. Empowerment-based diabetes education and motivational interviewing are complementary approaches. Oncology nurses may feel unprepared to teach patients and their families about self-care for diabetes, but they provide individualized information on symptom management of cancer throughout hospitalization and at discharge. The essential self-care issues include food, exercise, medication, blood glucose monitoring, prevention, recognition and treatment of hypoglycemia and hyperglycemia, and when and how to get additional medical and educational support. This patient-centered model of diabetes education differs from the older “compliance” model that covers many universal rules for all patients, which are predetermined by the nurse. Informing nurses about their role in care of patients with cancer and diabetes is critical. PMID:19349267

Leak, Ashley; Davis, Ellen D.; Houchin, Laura B.; Mabrey, Melanie

2009-01-01

378

Comprehensive diabetes management program for poorly controlled Hispanic type 2 patients at a community health center.  

PubMed

Technology and improved care coordination models can help diabetes educators and providers meet national care standards and provide culturally sensitive diabetes education that may improve diabetes outcomes. The purpose of the study was to evaluate the clinical usefulness of a nurse-led diabetes care program (Comprehensive Diabetes Management Program, CDMP) for poorly controlled Hispanic type 2 diabetes (T2DM) patients in an urban community health center setting. Patients were randomized to the intervention condition (IC; n = 21) or an attention control condition (AC; n = 18). IC and AC conditions were compared on rates of adherence to national clinical practice guidelines (blood glucose, blood pressure, foot exam, eye exam), and levels of diabetes distress, depression, and treatment satisfaction. IC patients had a significant improvement in A1C from baseline to 12-month follow-up compared with AC (-1.6% ± 1.4% versus -0.6% ± 1.1%; P = .01). The proportion of IC patients meeting clinical goals at follow-up tended to be higher than AC for A1c (IC = 45%; AC = 28%), systolic blood pressure (IC = 55%; AC = 28%), eye screening (IC = 91%; AC = 78%), and foot screening, (IC = 86%; AC = 72%). Diabetes distress and treatment satisfaction also showed greater improvement for IC than AC (P = .05 and P = .06, respectively), with no differences for depression. The CDMP intervention was more effective than an attention control condition in helping patients meet evidence-based guidelines for diabetes care. PMID:21918206

Welch, Garry; Allen, Nancy A; Zagarins, Sofija E; Stamp, Kelly D; Bursell, Sven-Erik; Kedziora, Richard J

2011-01-01

379

Laser in-situ keratomileusis in patients with diabetes mellitus: a review of the literature  

PubMed Central

Purpose A growing number of diabetic patients request laser in situ keratomileusis (LASIK) for elective vision correction each year. While the United States Food and Drug Administration considers diabetes a relative contraindication to LASIK surgery, there are several reports in the literature of LASIK being performed safely in this patient population. The purpose of this review was to examine whether diabetes should still be considered a contraindication to LASIK surgery by reviewing the ocular and systemic complications of diabetes, and examining the existing data on the outcomes of LASIK in diabetic patients. Methods A literature review was conducted through PubMed, Medline, and Ovid to identify any study on LASIK surgery in patients with diabetes mellitus. This search was conducted without date restrictions. The search used the Medical Subject Headings (MeSH®) term LASIK linked by the word “and” to the following MeSH and natural language terms: diabetes, diabetes mellitus, systemic disease, and contraindications. Abstracts for all studies meeting initial search criteria were reviewed for relevance. There were no prospective clinical studies identified. Three retrospective studies were identified. Key sources from these papers were identified, reviewed, and included as appropriate. An additional literature search was conducted to identify any study of ocular surgery on patients with diabetes using the MeSH terms refractive surgery, photorefractive keratectomy, radial keratotomy, cataract surgery, vitrectomy, and iridectomy linked by the word “and” to the following MeSH terms: diabetes, diabetes mellitus, and systemic disease. This search was conducted without date restrictions. Abstracts of studies meeting the initial search criteria were reviewed and articles deemed relevant to the subject were included in this review. Conclusion LASIK may be safe in diabetic patients with tight glycemic control and no ocular or systemic complications. PMID:23109803

Simpson, Rachel G; Moshirfar, Majid; Edmonds, Jason N; Christiansen, Steven M

2012-01-01

380

Reduction of Melatonin Level in Patients with Type II Diabetes and Periodontal Diseases  

PubMed Central

Background and aims. Melatonin is a circulating hormone that is mainly released from the pineal gland. It possesses antioxidant, free-radical scavenging, and immune-enhancing properties. A growing number of studies reveal a complex role for melatonin in influencing various diseases, including diabetes and periodontal diseases. The aim of this study was to examine the possible links between salivary melatonin levels and type II diabetes and periodontal diseases. Materials and methods. A total of 30 type II diabetic patients, 30 patients with periodontal diseases, 30 type II diabetic patients with periodontal disease and 30 age- and BMI-matched controls were studied. The periodontal status was evaluated by the Community Periodontal Index (CPI). Salivary melatonin levels were determined by a commercial enzyme-linked immunosorbent assay (ELISA) kit. Results. The mean of salivary melatonin level was significantly lower in patients with either periodontitis or diabetes compared to healthy subjects (P < 0.05). Salivary melatonin concentration decreased in type II diabetic patients and periodontitis patients, and then decreased reaching the lowest levels in type II diabetic patients with periodontal disease. Conclusion. Based on the results of this study, it can probably be concluded that salivary level of melatonin has an important role in the pathogenesis of diabetes and periodontal diseases. It is also worth noting that this factor could probably be used as a pivotal biological marker in the diagnosis and possible treatment of these diseases, although further research is required to validate this hypothesis. PMID:25346835

Abdolsamadi, Hamidreza; Goodarzi, Mohammad Taghi; Ahmadi Motemayel, Fatemeh; Jazaeri, Mina; Feradmal, Javad; Zarabadi, Mahdiyeh; Hoseyni, Mostafa; Torkzaban, Parviz

2014-01-01