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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.

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

2013-01-01

2

Epitope analysis of GAD65 autoantibodies in Japanese patients with autoimmune diabetes.  

PubMed

Type 1 diabetes is an organ-specific autoimmune disease characterized by T cell-mediated destruction of pancreatic beta cells. In Japanese population, the incidence of type 1 diabetes in children is very low compared to European countries. However, there are more patients with type 1 diabetes in adults, including latent autoimmune diabetes in adults (LADA). The circulating autoantibodies to multiple islet autoantigens including GAD, insulin, and IA-2 are the important immunological features of type 1 diabetes. The prevalences of anti-islet autoantibodies in patients with Japanese type 1 diabetes are 60-70% for GAD autoantibodies, 45-50% for insulin autoantibodies (IAA), and 60-65% for IA-2 autoantibodies at disease onset, which are similar to those reported in Caucasian patients. With combinatorial analysis of these autoantibodies, 90% of patients express at least one of these autoantibodies and are classified as type 1A diabetes. Although the majority of patients with type 1 diabetes are young, lean, and ketosis-prone, there are a number of patients with type 1 diabetes initially diagnosed as having type 2 diabetes at disease onset called LADA. These patients with LADA often progress toward an insulin-deficient state within several years after diagnosis. High levels of GAD autoantibodies have a high predictive value for future insulin deficiency in LADA. Further, epitope analysis of GAD65 autoantibodies may be helpful to predict future insulin dependency in LADA patients. In conclusion, Japanese patients with type 1 diabetes are clinically heterogeneous and the determination of immunological features are helpful to clarify the characteristics of the Japanese type 1 diabetic syndrome. PMID:14679108

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

2003-11-01

3

Aldose reductase C-106T gene polymorphism is associated with diabetic retinopathy in Japanese patients with type 2 diabetes.  

PubMed

It is likely that the C allele of the polymorphism at position -106 in the promoter of aldose reductase gene, which codes a rate-limiting enzyme of the polyol pathway, is a susceptibility allele for diabetic retinopathy in Japanese type 2 diabetic patients. PMID:21420193

Katakami, N; Kaneto, H; Takahara, M; Matsuoka, T A; Imamura, K; Ishibashi, F; Kanda, T; Kawai, K; Osonoi, T; Matsuhisa, M; Kashiwagi, A; Kawamori, R; Shimomura, I; Yamasaki, Y

2011-06-01

4

Metabolic syndrome, insulin resistance, and atherosclerosis in Japanese type 2 diabetic patients  

Microsoft Academic Search

The aim of the present study was to investigate the relationships between metabolic syndrome and atherosclerosis in 57 Japanese type 2 diabetic patients. Metabolic syndrome was diagnosed based on the criteria raised by the Japan Internal Medicine Society. Insulin resistance was estimated by the insulin resistance index of homeostasis model assessment. Ultrasonographically measured carotid atherosclerosis, brachial-ankle pulse wave velocity (ba-PWV),

Ataru Taniguchi; Mitsuo Fukushima; Akira Kuroe; Kenji Sakaguchi; Hiroko Hashimoto; Ikuko Yoshioka; Naomi Kitatani; Tomoko Tsuji; Michihiro Ohya; Minako Ohgushi; Shoichiro Nagasaka; Okihisa Isogai; Yoshikatsu Nakai; Nobuya Inagaki; Yutaka Seino

2007-01-01

5

Efficacy and safety of modified Yale insulin infusion protocol in Japanese diabetic patients after open-heart surgery  

Microsoft Academic Search

To our knowledge, there is currently no insulin infusion protocol for critically ill patients especially designed for Asian diabetics although many such protocols are used in Western countries. In this study, we modified the Yale insulin infusion protocol taking into consideration the characteristics of Japanese diabetics and hospital environment. We tested the modified protocol in 40 type 2 diabetic patients

Motoyuki Tamaki; Tomoaki Shimizu; Akio Kanazawa; Yoshifumi Tamura; Ayame Hanzawa; Chie Ebato; Chiharu Itou; Eisuke Yasunari; Haruna Sanke; Hiroko Abe; Junko Kawai; Kaede Okayama; Kazuhisa Matsumoto; Koji Komiya; Minako Kawaguchi; Noriko Inagaki; Takahiro Watanabe; Yoshie Kanazawa; Takahisa Hirose; Ryuzo Kawamori; Hirotaka Watada

2008-01-01

6

Investigation of clinical factors associated with development of chronic kidney disease and eGFR decline in Japanese patients with type 2 diabetes mellitus  

Microsoft Academic Search

Introduction The aim of our study was to investigate clinical factors associated with the development of chronic kidney disease (CKD) in Japanese type 2 diabetes patients diagnosed by the new equation established by the Japanese Society of Nephrology. Materials and methods We analyzed data collected from 653 Japanese patients with type 2 diabetes who were followed at Juntendo University Hospital

Koji Komiya; Akio Kanazawa; Tomoaki Shimizu; Risako Yamamoto; Takahisa Hirose; Ryuzo Kawamori; Hirotaka Watada

2010-01-01

7

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

PubMed Central

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

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

2013-01-01

8

Gender differences in the incidence and progression of diabetic retinopathy among Japanese patients with type 2 diabetes mellitus: a clinic-based retrospective longitudinal study.  

PubMed

A clinic-based retrospective longitudinal study conducted for 5.8 ± 2.5 years, including 383 (M/F 245/138) Japanese patients with type 2 diabetes mellitus showed that females exhibit a significantly higher prevalence of proliferative diabetic retinopathy (DR) at baseline and that female gender is an independent risk factor for the development of DR. PMID:24503044

Kajiwara, A; Miyagawa, H; Saruwatari, J; Kita, A; Sakata, M; Kawata, Y; Oniki, K; Yoshida, A; Jinnouchi, H; Nakagawa, K

2014-03-01

9

Differing effects of liraglutide on gastric emptying in Japanese patients with type 2 diabetes.  

PubMed

This study was performed to clarify the influence of liraglutide on gastric emptying in Japanese patients with type 2 diabetes. In 16 patients, the [(13) C]-acetate breath test was performed to compare gastric emptying before and after liraglutide treatment. We found two patterns of response, with gastric emptying being delayed by liraglutide in seven patients (delayers) and not delayed in nine patients (non-delayers). The mean increase of the maximum gastric emptying time was 31 ± 4?min (p?patients can be classified as delayers or non-delayers. PMID:24320758

Nagai, Y; Hashimoto, E; Oikawa, R; Asai, S; Terashima, Y; Nakamura, Y; Sasaki, Y; Tsukiyama, H; Fukuda, H; Ohshige, T; Kato, H; Ohta, A; Tanaka, Y

2014-06-01

10

Effect of metformin on hepatic glucose production in Japanese patients with type 2 diabetes mellitus.  

PubMed

We investigated the effect of metformin on hepatic glucose production and peripheral glucose uptake in Asian patients with type 2 diabetes mellitus. We recruited ten Japanese patients whose fasting glucose levels remained poorly controlled under meal-time injection of short-acting insulin. Metformin was added to their insulin therapy, and both hepatic glucose production and peripheral glucose uptake were assessed before and one week after metformin treatment, with the use of stable isotope [6,6-˛H?] glucose. Metformin was titrated to a maximum dose of 500 mg. As a result, fasting glucose levels and hepatic glucose production were significantly improved after the metformin treatment (p < 0.01 and 0.02), whereas their peripheral glucose uptake was not significantly changed (p = 0.63). Furthermore, the change of fasting glucose levels was significantly correlated with that of hepatic glucose production, whose coefficient ? was 0.76 (p = 0.01). On the other hand, there was no significant correlation between the change of fasting glucose levels and that of peripheral glucose uptake (p = 0.43). In conclusion, low dose of metformin significantly reduced hepatic glucose production in Japanese patients with type 2 diabetes mellitus. The efficacy of metformin on correcting fasting hyperglycemia was strongly associated with reduced hepatic glucose production, rather than ameliorated peripheral glucose uptake. PMID:22673502

Takahara, Mitsuyoshi; Kaneto, Hideaki; Katakami, Naoto; Matsuhisa, Munehide; Shimomura, Iichiro

2012-09-30

11

Mitochondrial diabetes mellitus: Prevalence and clinical characterization of diabetes due to mitochondrial tRNA LeU(UUR) gene mutation in Japanese patients  

Microsoft Academic Search

Summary  Mutations in the mitochondrial gene were recently identified in a large pedigree of diabetes mellitus and deafness. As the\\u000a mitochondrial gene is maternally inherited, Japanese diabetic patients whose mothers were also diabetic were screened, using\\u000a peripheral leucocytes, for an A to G transition at nucleotide pair 3243 of the mitochondrial gene, a tRNALeu(UUR) mutation. This mutation was identified in four

H. Katagiri; I. Asano; H. Ishihara; K. Inukai; M. Anai; Y. Yazaki; Y. Oka; T. Yamanouchi; K. Isukuda; M. Kikuchi; H. itaoka; N. Ohsawa

1994-01-01

12

Prevalence of metabolic syndrome in Japanese type 2 diabetic patients and its significance for chronic vascular complications.  

PubMed

Prevalence of metabolic syndrome (MetS) in type 2 diabetes and its association with vascular complications were studied in 637 Japanese type 2 diabetic patients. MetS was diagnosed using criteria proposed by the Japanese study group for the definition of MetS in 2005. The prevalence of MetS in patients studied was higher in males (45.9%) than females (28.0%). The prevalence of MetS was 53.0% in males and 35.4% in females in patients with duration of less than 10 years, and decreased with an increase in duration. Upon comparing patients groups complicated with and without MetS, we determined the MetS group had significantly higher levels of fasting serum C-peptide and high-sensitivity C-reactive protein, and a significantly lower level of serum adiponectin. However, the prevalence of coronary heart disease, brain infarction, or peripheral arterial disease was not significantly different between these groups. On the other hand, the prevalence of microangiopathy in the group with MetS was significantly higher than in that without MetS, and became significantly higher along with an increase in duration. This study clarifies the prevalence of MetS in Japanese type 2 diabetic patients, and suggests that MetS is associated with microangiopathy rather than macroangiopathy in Japanese type 2 diabetic patients. PMID:17933413

Shimajiri, Yoshinori; Tsunoda, Keiko; Furuta, Machi; Kadoya, Yoshiki; Yamada, Shyoichi; Nanjo, Kishio; Sanke, Tokio

2008-02-01

13

Attenuated metabolic effect of waist measurement in Japanese female patients with type 2 diabetes mellitus.  

PubMed

Waist circumference (WC) was measured in 200 Japanese patients with type 2 diabetes mellitus (T2DM: male 106, female 94, mean age 61 years old) who had been admitted in our hospital, and relationship with various risk factors to predict future cardiovascular disease (CVD) was analyzed. There was a positive and statistically significant trend in WC levels with an increasing number of CVD risk factors in male patients, whereas no significant trend of WC was observed in female patients. The receiver operator characteristic (ROC) curve for WC to predict the presence of two or more risk factors of CVD depicted greater area under the curve in male patients (0.732) than that in female patients (0.571). Apart from positive correlation with fasting serum C-peptide (S-CPR) and log-transformed high-sensitivity C-reactive protein (log HS-CRP) in both genders, WC was positively correlated with log-transformed triglyceride (log TG), systolic and diastolic blood pressure (SBP and DBP) and negatively with HDL-cholesterol (HDL-C) in male patients, whereas it was negatively correlated with HbA1c and fasting plasma glucose (FPG) in female patients. The change of WC after administration (DeltaWC) was correlated with DeltaS-CPR, DeltaLDL-C, DeltaSBP and DeltaDBP in male patients, while no relationship was observed in female patients. In conclusion, WC is a reliable marker to predict future CVD events at least in Japanese male, but not female patients with T2DM. PMID:18786739

Tajiri, Yuji; Takei, Ryoko; Mimura, Kazuo; Umeda, Fumio

2008-10-01

14

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.

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

15

Effects of exenatide on metabolic parameters/control in obese Japanese patients with type 2 diabetes.  

PubMed

The effects of exenatide on glycemic control, lipid metabolism, blood pressure, and gastrointestinal symptoms were investigated in obese Japanese patients with type 2 diabetes mellitus. Twenty-six outpatients were enrolled and administered 5 ?g of exenatide twice daily. If there was insufficient weight loss and/or insufficient improvement in glycemic control, the dose was increased to 10 ?g twice daily. Follow-up was continued until the 12(th) week of administration. Hemoglobin A1c, glycoalbumin, fasting plasma glucose, body weight, fasting serum C-peptide, serum lipids, blood pressure, and pulse rate were measured before and after the observation period. In the initial phase of exenatide therapy, each patient received a diary to record gastrointestinal symptoms. During treatment with exenatide, hemoglobin A1c decreased significantly and serum C-peptide increased significantly. Body weight, low-density lipoprotein cholesterol, and systolic blood pressure decreased significantly. Nausea was the most frequent gastrointestinal symptom and occurred in 16 patients. Its onset was noted at a mean of 1.7 h after injection, the mean duration was 1.1 h, and it continued for a mean of 9.3 days after the initiation of administration. Patients with nausea showed a significant decrease in hemoglobin Alc, glycoalbumin, or body weight compared with those without nausea. These findings suggest that a more marked improvement in metabolic parameters by exenatide can be partly dependent on the manifestation of gastrointestinal symptoms. PMID:24452017

Tokuda, Masaru; Katsuno, Tomoyuki; Ochi, Fumihiro; Miyakoshi, Kana; Kusunoki, Yoshiki; Murai, Kazuki; Miuchi, Masayuki; Hamaguchi, Tomoya; Miyagawa, Jun-Ichiro; Namba, Mitsuyoshi

2014-04-29

16

Mitochondrial haplogroups associated with Japanese centenarians, Alzheimer's patients, Parkinson's patients, type 2 diabetic patients and healthy non-obese young males  

Microsoft Academic Search

The relationships between five classes of Japanese people (i.e., 96 centenarians, 96 Alzheimer's disease (AD) patients, 96 Parkinson's disease (PD) patients, 96 type 2 diabetic (T2D) patients, and 96 healthy non-obese young males) and their mitochondrial single nucleotide polymorphism (mtSNP) frequencies at individual mtDNA positions of the entire mitochondrial genome were examined using the radial basis function (RBF) network and

Shigeru Takasaki

2009-01-01

17

Post-prandial hyperglycemia is an important predictor of the incidence of diabetic microangiopathy in Japanese type 2 diabetic patients  

Microsoft Academic Search

Diabetic microangiopathy is often observed in diabetic patients, but there is little evidence regarding the relationship between post-prandial glycemia or insulinemia and the incidence of diabetic microangiopathy. In this study, to elucidate the relationship between post-prandial glycemia (or insulinemia) and diabetic microangiopathy, we performed a cross-sectional study of 232 subjects with type 2 diabetes mellitus who were not being treated

Toshihiko Shiraiwa; Hideaki Kaneto; Takeshi Miyatsuka; Ken Kato; Kaoru Yamamoto; Ayaha Kawashima; Tsutomu Kanda; Masaaki Suzuki; Eiichi Imano; Munehide Matsuhisa; Masatsugu Hori; Yoshimitsu Yamasaki

2005-01-01

18

Impact of Leisure-Time Physical Activity on Glycemic Control and Cardiovascular Risk Factors in Japanese Patients with Type 2 Diabetes Mellitus: The Fukuoka Diabetes Registry  

PubMed Central

Aims/hypothesis The effects of leisure-time physical activity (LTPA) on glycemia and cardiovascular risk factors are not fully understood in Asian type 2 diabetic patients, who are typically non-obese. We studied associations between LTPA and glycemia and cardiovascular risk factors in Japanese type 2 diabetic patients. Methods A total of 4,870 Japanese type 2 diabetic patients aged ?20 years were divided into eight groups according to their LTPA. We investigated associations between the amount and intensity levels of physical activity (PA) and glycemic control, insulin sensitivity, cardiovascular risk factors, and low-grade systemic inflammation in a cross-sectional study. Results LTPA was dose-dependently associated with body mass index (BMI), waist circumference, hemoglobin A1c (HbA1c), fasting plasma glucose, homeostasis model assessment of insulin resistance, triglyceride, high density lipoprotein cholesterol, high sensitivity C-reactive protein, and prevalence of metabolic syndrome, but not with blood pressure, low density lipoprotein cholesterol or adiponectin. The amount of PA required to lower HbA1c was greater than that required to improve cardiovascular risk factors. LTPA was inversely associated with HbA1c in non-obese participants but not in obese participants after multivariate adjustments for age, sex, duration of diabetes, current smoking, current drinking, energy intake, cardiovascular diseases, depressive symptoms, and treatment of diabetes. Higher-intensity LTPA, not lower-intensity LTPA was associated with HbA1c after multivariate adjustments with further adjustment including BMI. Conclusions/interpretation LTPA was dose-dependently associated with better glycemic control and amelioration of some cardiovascular risk factors in Japanese type 2 diabetic patients. In addition, increased higher-intensity LTPA may be appropriate for glycemic control.

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

2014-01-01

19

GAD65 Autoantibody Responses in Japanese Latent Autoimmune Diabetes in Adult Patients  

PubMed Central

OBJECTIVE—To determine whether development of insulin requirement in patients with latent autoimmune diabetes in adults (LADA) is accompanied with the emergence of a type 1 diabetes–like autoimmune response. RESEARCH DESIGN AND METHODS—We correlated ?-cell–specific autoimmunity reflected in autoantibodies to the 65-kDa isoform of GAD (GAD65) with insulin requirement. We determined GAD65Ab epitope specificities in type 1 diabetic patients, LADA patients without insulin requirement (nonprogressed), and LADA patients that had developed insulin requirement (progressed). RESULTS—Recognition of a type 1 diabetes–specific GAD65Ab epitope was more pronounced in type 1 diabetic patients than in nonprogressed (P < 0.001) or progressed (P < 0.01) LADA patients, with no significant differences between the two LADA cohorts. These differences were particularly pronounced in samples with GAD65Ab titers <1,000 units/ml, with no differences in epitope specificities in samples with higher GAD65Ab titers. Disease duration (initial diabetes diagnosis until sample collection or development of insulin requirement) in nonprogressed and progressed LADA patients, respectively, was not correlated with epitope specificity, suggesting lack of epitope maturation. This was supported by epitope analyses of longitudinal samples from LADA patients during progression to insulin requirement. CONCLUSIONS—First, the GAD65Ab-specific autoimmune reaction in type 1 diabetic patients with low and moderate GAD65Ab titers differs from that in LADA patients, irrespective of insulin requirement. Second, the GAD65Ab-specific autoimmune response in LADA patients does not change after their initial diabetes diagnosis. Finally, LADA patients with high GAD65Ab titers resemble type 1 diabetic patients in their GAD65Ab epitope specificity.

Maruyama, Taro; Oak, Shilpa; Shimada, Akira; Hampe, Christiane S.

2008-01-01

20

High prevalence of peripheral arterial disease diagnosed by low ankle–brachial index in Japanese patients with diabetes: The Kyushu Prevention Study for Atherosclerosis  

Microsoft Academic Search

We examined the prevalence of peripheral arterial disease (PAD) in Japanese diabetic patients with ankle–brachial index (ABI). Outpatients with diabetes (n=4249) who were regularly visiting Kyushu University Hospital, its 17 related hospitals, Ryukyu University Hospital and its 6 related hospitals were enrolled in the Kyushu Prevention Study for Atherosclerosis from 2001 to 2003. At baseline, ABI was measured using a

Yasutaka Maeda; Toyoshi Inoguchi; Hirotaka Tsubouchi; Fumi Sawada; Shuji Sasaki; Masakazu Fujii; Ryoko Saito; Toshihiko Yanase; Michio Shimabukuro; Hajime Nawata; Ryoichi Takayanagi

2008-01-01

21

Relationship between Stage of Diabetic Retinopathy and Pulse Wave Velocity in Japanese Patients with Type 2 Diabetes  

PubMed Central

Objectives. We investigated the relationship between the stage of diabetic retinopathy and pulse wave velocity (PWV). Methods. This was a cross-sectional study of 689 patients (406 men and 283 women) with type 2 diabetes who were admitted to our hospital from 2004 to 2007. Brachial-ankle pulse wave velocity (baPWV) was measured by an arterial pressure measurement device as PWV/ABI. Diagnosis of diabetic retinopathy was made by ophthalmologists based on the Davis classification: no diabetic retinopathy (NDR), simple retinopathy (SDR), pre-proliferative retinopathy (pre-PDR), and proliferative retinopathy (PDR). Results. There was a significant difference in PWV between patients without diabetic retinopathy (1657.0 ± 417.9?m/s (mean?±?SD)) and with diabetic retinopathy (1847.1 ± 423.9?m/s) (P < 0.001). In addition, the stage of diabetic retinopathy was associated with aortic PWV (1657.0 ± 417.9?m/s in NDR (n = 420), 1819.4 ± 430.3?m/s in SDR (n = 152), 1862.1 ± 394.0?m/s in pre-PDR (n = 54), and 1901.1 ± 433.5?m/s in PDR (n = 63) (P < 0.001)). Conclusions. In patients with diabetic retinopathy, even in those with SDR, PWV was higher than that in patients without diabetic retinopathy. Physicians should therefore pay attention to the value of PWV and macroangiopathy regardless of the stage of diabetic retinopathy.

Tanaka, Kumiko; Kawai, Toshihide; Saisho, Yoshifumi; Harada, Kana; Satoh, Yuka; Kobayashi, Kaori; Mizushima, Kei; Abe, Takayuki; Itoh, Hiroshi

2013-01-01

22

High prevalence of mitochondrial diabetes mellitus in Japanese patients with major risk factors  

Microsoft Academic Search

To identify diabetes mellitus caused by the mitochondrial gene substitution at genomic nucleotide pair 3243 (M3243A ? G) we selected 87 diabetic patients with high risk factors such as maternal inheritance and hearing loss. Total DNA was extracted from peripheral leukocytes, and mitochondrial DNA fragments containing M3243A ? G were amplified by polymerase chain reaction (PCR). The amplified fragments were

M. Fukui; K. Nakano; H. Obayashi; Y. Kitagawa; N. Nakamura; H. Mori; S. Kajiyama; S. Wada; M. Fujii; K. Yoshimori; T. Kanaitsuka; H. Shigeta; M. Kondo

1997-01-01

23

Monocyte chemoattractant protein-1 (MCP-1) gene polymorphism as a potential risk factor for diabetic retinopathy in Japanese patients with type 2 diabetes.  

PubMed

We examined the association between diabetic retinopathy and monocyte chemoattractant protein (MCP)-1 A-2518G polymorphism in 3802 Japanese type 2 diabetic subjects. The prevalence of diabetic retinopathy was higher as the number of G alleles increased, suggesting that the G allele of this polymorphism is a susceptibility allele for diabetic retinopathy. PMID:20488574

Katakami, Naoto; Matsuhisa, Munehide; Kaneto, Hideaki; Matsuoka, Taka-aki; Imamura, Kenichi; Ishibashi, Fukashi; Kanda, Tsutomu; Kawai, Koichi; Osonoi, Takeshi; Kashiwagi, Atsunori; Kawamori, Ryuzo; Shimomura, Iichiro; Yamasaki, Yoshimitsu

2010-07-01

24

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

Microsoft Academic Search

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

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

2002-01-01

25

Short-term effects of liraglutide on visceral fat adiposity, appetite, and food preference: a pilot study of obese Japanese patients with type 2 diabetes  

PubMed Central

Background To examine the effects of liraglutide, a glucagon-like peptide-1 (GLP-1) analogue, on visceral fat adiposity, appetite, food preference, and biomarkers of cardiovascular system in Japanese patients with type 2 diabetes. Methods The study subjects were 20 inpatients with type 2 diabetes treated with liraglutide [age; 61.2 ± 14.0 years, duration of diabetes; 16.9 ± 6.6 years, glycated hemoglobin (HbA1c); 9.1 ± 1.2%, body mass index (BMI); 28.3 ± 5.2 kg/m2, mean ± SD]. After improvement in glycemic control by insulin or oral glucose-lowering agents, patients were switched to liraglutide. We assessed the estimated visceral fat area (eVFA) by abdominal bioelectrical impedance analysis, glycemic control by the 75-g oral glucose tolerance test (OGTT) and eating behavior by the Japan Society for the Study of Obesity questionnaire. Results Treatment with liraglutide (dose range: 0.3 to 0.9 mg/day) for 20.0 ± 6.4 days significantly reduced waist circumference, waist/hip ratio, eVFA. It also significantly improved the scores of eating behavior, food preference and the urge for fat intake and tended to reduce scores for sense of hunger. Liraglutide increased serum C-peptide immunoreactivity and disposition index. Conclusions Short-term treatment with liraglutide improved visceral fat adiposity, appetite, food preference and the urge for fat intake in obese Japanese patients with type 2 diabetes.

2011-01-01

26

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

27

Predictors of coronary heart disease in Japanese patients with type 2 diabetes: Screening for coronary artery stenosis using multidetector computed tomography.  

PubMed

Aims/Introduction:? Multidetector computed tomography (MDCT) coronary angiography has been applied as a tool for non-invasive evaluation of the coronary arteries. The purpose of the present study was to evaluate the effectiveness of MDCT in screening for coronary artery disease (CAD), and to identify the indications for screening in diabetes patients with CAD. Materials and Methods:? The study population consisted of 52 Japanese type 2 diabetes patients who underwent examination with a 64-slice MDCT scanner, electrocardiogram (ECG), echocardiography and ultrasonographic scanning of the carotid arteries. Regression analysis was carried out to assess the correlation between MDCT results and CAD risk factors. Results:? Stenosis of the coronary artery was detected in 19/52 patients. Of the 19 patients, 7 patients had no symptoms, including chest pain, and no ischemic changes in ECG. Significant differences between patients with stenosis and those without stenosis were detected by mean IMT (1.21 vs 0.95?mm), and duration of diabetes (20 vs 13?years). Two-tailed ?(2)-test showed that a duration of diabetes of more than 20?years (odds ratio 6.222) and more than 1.1?mm of mean-IMT (odds ratio 4.600) significantly correlated with the stenosis. Conclusions:? It was shown that MDCT is useful in detecting coronary artery stenosis in diabetic patients without symptoms of CAD or ECG abnormality, and the predictors of CAD are mean IMT and duration of diabetes. It is recommended that patients with more than 1.1?mm mean IMT at the carotid artery and/or more than 20?years duration of diabetes should be screened for CAD by carrying out MDCT. PMID:24843408

Nishioka, Hiroko; Furukawa, Noboru; Shimoda, Seiya; Nishida, Kenro; Nakaura, Takeshi; Maeda, Takako; Goto, Rieko; Miyamura, Nobuhiro; Awai, Kazuo; Yamashita, Yasuyuki; Araki, Eiichi

2010-04-22

28

A randomized dose-finding study demonstrating the efficacy and tolerability of albiglutide in Japanese patients with type 2 diabetes mellitus.  

PubMed

Abstract Objective: To investigate the optimal dosage/regimen and to evaluate the efficacy and safety of albiglutide in Japanese patients with type 2 diabetes mellitus. Research design and methods: This was a randomized, double-blind, placebo-controlled, multicenter, parallel-group, dose-ranging, superiority study in Japanese patients with type 2 diabetes mellitus. Patients (n?=?215) who were treatment naive or washed out of one oral antidiabetic drug were randomized to placebo or albiglutide 15?mg weekly, 30?mg weekly, or 30?mg every other week (biweekly). Clinical trial registration: NCT01098461. Main outcome measures: The primary end point was the change from baseline in HbA1c at week 16, measured using the Japan Diabetes Society standardization scheme and presented here using the National Glycohemoglobin Standardization Program equivalents. Other measures of efficacy as well as safety and population pharmacokinetics and pharmacokinetics/pharmacodynamics of albiglutide were assessed. Results: Baseline HbA1c was 8.53%. There was a statistically significant difference between each albiglutide treatment group and placebo for change from baseline in HbA1c at week 16, with treatment effects of -0.89% for 15?mg weekly, -1.55% for 30?mg weekly, and -1.10% for 30?mg biweekly (P?patients in the 30?mg weekly albiglutide group compared with 6.0% and 0% of patients in the placebo group achieved HbA1c <7.4% and <6.9%, respectively. No serious adverse events were related to study therapy; no deaths occurred. Nasopharyngitis was the most frequently reported adverse event in all treatment groups (n?=?43 [20.3%]). Conclusions: Albiglutide exhibited therapeutic hypoglycemic effects with good tolerability among Japanese patients with type 2 diabetes mellitus; the 30?mg weekly dose was the most efficacious in this study. The 16 week duration of the study prevents generalizing these conclusions to longer treatment periods. PMID:24552155

Seino, Yutaka; Inagaki, Nobuya; Miyahara, Hajime; Okuda, Inaha; Bush, Mark; Ye, June; Holland, M Claire; Johnson, Susan; Lewis, Eric; Nakajima, Hiromu

2014-06-01

29

A pilot three-month sitagliptin treatment increases serum adiponectin level in Japanese patients with type 2 diabetes mellitus- a randomized controlled trial START-J study  

PubMed Central

Background The dipeptidyl-peptidase-IV (DPP-4) inhibitors, including sitagliptin, are used for the treatment of type 2 diabetes mellitus (T2DM). Adiponectin, an adipocyte-derived circulating protein, has anti-atherosclerotic and anti-diabetic properties and is effectively elevated in bloodstream by thiazolidinediones, an insulin sensitizer. However, the effect of sitagliptin treatment on serum adiponectin level in T2DM has not fully elucidated in Japanese T2DM patients. The aim of the present study was to examine the effect of sitagliptin treatment on serum adiponectin levels in T2DM subjects. Methods Twenty-six consecutive Japanese T2DM outpatients were recruited between April 2011 and March 2013, and randomized into the control (conventional treatment, n?=?10) group and sitagliptin treatment group (n?=?16). Serum adiponectin was measured by enzyme-linked immunosorbent assay. Results Indices of glycemic control, such as hemoglobin A1c, glycated albumin, and 1.5-anhydro-D-glucitol, were significantly improved after the three-month treatment in both the control and sitagliptin groups. Serum adiponectin level was significantly increased in sitagliptin group from 6.7?±?0.8 to 7.4?±?1.0 ?g/mL without change of body mass index (p?=?0.034), while serum adiponectin level was not altered in the control group (p?=?0.601). Conclusion In Japanese T2DM patients, serum adiponectin level was elevated by three-month treatment with sitagliptin without change of body weight. Trial registration UMIN000004721

2014-01-01

30

Efficacy and safety of luseogliflozin monotherapy in Japanese patients with type 2 diabetes mellitus: a 12-week, randomized, placebo-controlled, phase II study.  

PubMed

Abstract Objective: Luseogliflozin is a novel sodium glucose cotransporter 2 inhibitor for type 2 diabetes mellitus (T2DM) treatment. An exploratory Phase II study was conducted to assess the efficacy and safety of several doses of luseogliflozin in Japanese T2DM patients. Patients and methods: Japanese T2DM patients aged 20-74 years with hemoglobin A1c (HbA1c) of 6.9-10.5%, fasting plasma glucose (FPG) ?126?mg/dL and on diet therapy were randomized in a double-blind manner to receive luseogliflozin (0.5, 2.5, or 5?mg) or placebo once daily for 12 weeks (n?=?61, 61, 61, and 56, respectively). The primary endpoint was the change in HbA1c from baseline to end of treatment. Other endpoints included FPG, 2?h postprandial plasma glucose (PPG) in a meal tolerance test (MTT), and body weight. Drug safety was also assessed. Trial registration: Japan Pharmaceutical Information Center (identifier: JapicCTI-090908). Results: Changes in HbA1c from baseline to end of treatment were -0.36, -0.62, and -0.75% in the 0.5, 2.5, and 5?mg luseogliflozin groups, respectively, versus +0.06% in the placebo group (all P?Japanese T2DM patients over the 12-week treatment period. PMID:24597840

Seino, Yutaka; Sasaki, Takashi; Fukatsu, Atsushi; Sakai, Soichi; Samukawa, Yoshishige

2014-07-01

31

Diagnostic significance of antibodies to glutamic acid decarboxylase in Japanese diabetic patients with secondary oral hypoglycemic agents failure.  

PubMed

Some non-insulin-dependent diabetes mellitus (NIDDM) patients are positive for antibodies to glutamic acid decarboxylase (anti-GAD), and they tend to develop insulin deficiency. The aim of this study was to evaluate the prevalence of anti-GAD in NIDDM with secondary failure of sulfonylurea agents (NIDDM-SF) and to investigate the diagnostic significance of seropositivity for anti-GAD in NIDDM-SF patients by evaluating human leukocyte antigen (HLA)-DRB1 alleles concurrently. The prevalence of anti-GAD in NIDDM-SF, NIDDM, and new-onset (within 1 year after onset) insulin-dependent diabetes mellitus (IDDM) was 9.3% (39/420), 3.1% (12/392), and 65.0% (13/20), respectively. Pancreatic beta cell function deteriorated in NIDDM-SF patients positive for anti-GAD. HLA-DRB1 allele typing revealed that NIDDM-SF patients positive for anti-GAD were significantly associated with DRB1*0901 (RR = 2.81, P < 0.01), which is one of the susceptible alleles to IDDM. Shorter interval before development of secondary failure and insulin deficiency were significantly associated with the presence of DRB1*0901 (P < 0.05) in NIDDM-SF patients positive for anti-GAD. In conclusion, nearly 10% of NIDDM-SF patients are positive for anti-GAD, suggesting that an autoimmune mechanism might play an important role in the pathogenesis of NIDDM-SF patients. In addition, a combination of serological marker (anti-GAD) and genetic marker (HLA-DRB1) is useful for predicting clinical course of NIDDM patients with secondary failure of sulfonylurea agents. PMID:9344701

Fukui, M; Nakano, K; Maruya, E; Saji, H; Ohta, K; Ohta, M; Obayashi, H; Mori, H; Kajiyama, S; Wada, S; Shigeta, H; Kitagawa, Y; Nakamura, N; Kondo, M

1997-11-01

32

Dose-finding study of luseogliflozin in Japanese patients with type 2 diabetes mellitus: a 12-week, randomized, double-blind, placebo-controlled, phase II study.  

PubMed

Abstract Objectives: Luseogliflozin is a selective sodium glucose cotransporter 2 inhibitor under development for the treatment of type 2 diabetes mellitus (T2DM). This phase II study was conducted to confirm the efficacy and safety of luseogliflozin monotherapy at doses of up to 10?mg in Japanese patients with T2DM. Patients and methods: Patients with hemoglobin A1c (HbA1c) of 6.9-10.5% on diet therapy were randomized in a double-blind manner to treatment with 1, 2.5, 5, or 10?mg luseogliflozin or placebo for 12 weeks (n?=?56, 56, 54, 58, and 58, respectively). Trial registration: Japan Pharmaceutical Information Center (identifier: Japic CTI-101191). Main outcome measures: The primary endpoint was the change in HbA1c from baseline to the end of treatment. Other endpoints included fasting plasma glucose (FPG), postprandial plasma glucose (PPG) and body weight. Adverse events were recorded throughout the study. Results: HbA1c decreased significantly at the end of treatment in the 1, 2.5, 5, and 10?mg luseogliflozin groups compared with placebo (-0.29, -0.39, -0.46, and -0.43%, respectively, versus +0.22%; all P?Japanese patients with T2DM, luseogliflozin was well tolerated, improved glycemic control, and reduced body weight over 12 weeks of treatment at all tested doses. Doses of ?2.5?mg achieved similar improvements in glycemic control. PMID:24673496

Seino, Yutaka; Sasaki, Takashi; Fukatsu, Atsushi; Ubukata, Michito; Sakai, Soichi; Samukawa, Yoshishige

2014-07-01

33

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.

Kaku, Kohei; Araki, Takahiro; Yoshinaka, Ryoji

2013-01-01

34

Islet cell antibodies in the Japanese population and subjects with Type 1 (insulin-dependent) diabetes  

Microsoft Academic Search

Summary  Islet cell antibodies were studied in 1,112 non-diabetic adults, 473 normal school children and 162 Type 1 (insulin-dependent)\\u000a diabetic patients in a Japanese population. The prevalence of islet cell antibodies was 0.5%, 0.4% and 32%, respectively.\\u000a Most islet cell antibodies positive subjects with Type 1 diabetes had short duration of the disease. No patients who had over\\u000a 10 years from

K. Notsu; N. Oka; N. Nabeya; S. Kuno; T. Sakurami

1985-01-01

35

Early and late onset side effects of short-acting insulin analogue in seven Japanese diabetic patients.  

PubMed

Short-acting insulin analogue has previously shown to be equal to short-acting human regular insulin regarding in vitro characteristics, immunogenicity, and safety. But in the present study, we experienced seven patients who had mild to moderate side effects due to short-acting insulin analogue. These side effects could be divided into two types based on the appearance time; one with early onset and the other with late onset. Early onset side effects include rash, disturbances in walking and general fatigue that can not be explained by the swing in glucose levels. These symptoms appeared 2-3 days after the use of short-acting insulin analogue and disappeared several hours after switching short-acting human regular insulin. The late onset side effect is bilateral leg edema, which appeared 1-2 months after the induction of short-acting insulin analogue and disappeared after several hours by changing to short-acting human regular insulin. We should monitor the early and late onset side effects as diligently as possible when we use short-acting insulin analogue on diabetic patients. PMID:17306902

Kuroe, Akira; Taniuguchi, Ataru; Fukushima, Mitsuo; Nakai, Yoshikatsu; Ohgushi, Minako; Ohya, Michihiro; Seino, Yutaka

2007-09-01

36

Ankle brachial pressure index and carotid intima-media thickness as atherosclerosis markers in Japanese diabetics  

Microsoft Academic Search

The aim of this study was to assess the clinical significance of ankle brachial pressure index (ABI) and carotid intima-media thickness (IMT) in Japanese patients with type 2 diabetes. ABI and ultrasonographic carotid IMT measurements were made in 1311 patients and the relationships between ABI, IMT, and cardiovascular diseases were examined. Patients were assigned to one of three groups depending

Chisa Hayashi; Osamu Ogawa; Sayaka Kubo; Naomi Mitsuhashi; Tomio Onuma; Ryuzo Kawamori

2004-01-01

37

Efficacy and safety of luseogliflozin as monotherapy in Japanese patients with type 2 diabetes mellitus: a randomized, double-blind, placebo-controlled, phase 3 study.  

PubMed

Abstract Objective: Luseogliflozin - a novel, orally bioavailable, 1-thio-d-glucitol derivative and a selective sodium glucose cotransporter 2 inhibitor - has shown efficacy and tolerability in previous phase 2 studies. This phase 3, randomized, double-blind, placebo-controlled, comparative study aimed to confirm the superiority of 24 week luseogliflozin 2.5?mg monotherapy over placebo in reducing hemoglobin A1c (HbA1c) levels in Japanese patients with type 2 diabetes mellitus (T2DM). Methods: Patients with HbA1c levels of 6.9%-10.5% were randomized to receive luseogliflozin 2.5?mg or placebo once daily for 24 weeks (n?=?79 in each group). The primary endpoint was change from baseline in HbA1c at end of treatment. Secondary endpoints included change from baseline in fasting plasma glucose (FPG) and postprandial plasma glucose (PPG) following a meal tolerance test, body weight, and abdominal circumference. Safety assessments included adverse events (AEs), clinical laboratory tests, and vital signs. Results: At the end of treatment, HbA1c was significantly decreased from baseline in the luseogliflozin 2.5?mg group (-0.63%) versus the placebo group (0.13%), with a between-group difference of -0.75% (p?Japanese patients with T2DM. Clinical trial registration: JapicCTI-111661. PMID:24708292

Seino, Yutaka; Sasaki, Takashi; Fukatsu, Atsushi; Ubukata, Michito; Sakai, Soichi; Samukawa, Yoshishige

2014-07-01

38

Is Type 1 diabetes in the Japanese population the same as among Caucasians?  

PubMed

In the Japanese population, the incidence of type 1 diabetes is as low as approximately 2 cases/year/100,000 children, which is much lower compared to that in countries with populations predominantly of Caucasian origin. However, the prevalences of anti-islet autoantibodies in patients with Japanese type 1 diabetes are 60-70% for GAD autoantibodies, 45-50% for insulin autoantibodies (IAA), and 60-65% for IA-2 autoantibodies at disease onset, which are similar to those reported in Caucasian patients. With combinatorial analysis of these autoantibodies, 90% of patients express at least one of these autoantibodies and are classified as type 1A diabetics. There is a significant number of patients with latent autoimmune diabetes in adults (LADA) in Japan, and a high level of GAD autoantibodies has a high predictive value for future insulin deficiency in such patients. Recently, it has been reported that a group of extremely rapid-onset patients presented with diabetic ketoacidosis and a low HbA1c level, called fulminant diabetes mellitus. Although they had severe hyperglycemia, these individuals lacked the expression of anti-islet autoantibodies. With a nationwide survey, it was documented that fulminant type 1 diabetes accounts for approximately 20% of the ketosis-onset patients with type 1 diabetes in Japan. It is currently unknown whether the pathogenesis of fulminant type 1 diabetes is associated with autoimmune response to pancreatic islet beta cells. Japanese patients with type 1 diabetes are clinically heterogeneous, and further investigations are required to clarify the underlying pathogenesis for each subgroup of type 1 diabetes. PMID:15699499

Kawasaki, Eiji; Eguchi, Katsumi

2004-12-01

39

Baseline and 1-year interim follow-up assessment of Japanese patients initiating insulin therapy who were enrolled in the cardiovascular risk evaluation in people with type 2 diabetes on insulin therapy study: an international, multicenter, observational study  

PubMed Central

Background The Cardiovascular Risk Evaluation in people with type 2 Diabetes on Insulin Therapy (CREDIT) study is an international, multicenter, observational study designed to assess metabolic parameters and cardiovascular risk of patients with type 2 diabetes mellitus (T2DM) on insulin therapy. The present report summarizes results at baseline and 1-year follow-up for the cohort of Japanese patients. Methods Male and female patients (n?=?511), aged >40 years, with T2DM for >1 year, treated with insulin therapy for ?1 month and <6 months were eligible for participation in the study. Glycemic and lipid parameters, duration of diabetes, diabetic complications, oral antidiabetic medications, and all hypoglycemic episodes were recorded. Effectiveness was assessed based on changes in clinical parameters and attainment of target HbA1c levels. Safety was evaluated based on episodes of hypoglycemia and weight gain. Results At baseline, the mean?±?SD duration of diabetes was 11.8?±?8.8 years. Microvascular and macrovascular diabetic complications were present in 83.4% and 25.1% of patients, respectively. At the 1-year follow-up, significant improvements were observed in mean HbA1c (10.3?±?2.0% vs. 7.5?±?1.3%, P?patients at the 1-year follow-up. Glycemic control tended to be better in patients with lower baseline HbA1c levels (P?Patients with a shorter duration of diabetes were more likely to achieve glycemic control and discontinue insulin for diabetes control at the 1-year follow-up (P?patients over 6 to 12 months. Conclusions Our results suggest that insulin treatment is an effective and safe therapeutic option in Japanese patients with T2DM, and earlier insulin initiation might be associated with better glycemic control.

2013-01-01

40

Investigation of the mode of inheritance of insulin-dependent diabetes mellitus in Japanese subjects.  

PubMed Central

Previous studies have shown that insulin-dependent diabetes mellitus is positively associated with HLA-DR4 and HLA-DR9 in Japanese populations. It was proposed that susceptibility to the disease is determined by a single HLA allele associated with both DR4 and DR9. DR genotypes in a Japanese population with insulin-dependent diabetes mellitus were determined by DRB/DQB RFLP analysis. A single disease-susceptibility-allele model was tested by the antigen-genotype-frequency-among-patients method. Recessive and additive inheritance of a single susceptibility allele were rejected. The DR9-associated disease-susceptibility allele in Japanese subjects is distinct from both the DR3- and DR4-associated susceptibility alleles in white Caucasians. The data suggest further complexity in the inheritance of HLA-associated susceptibility to insulin-dependent diabetes mellitus.

Jenkins, D; Penny, M A; Uchigata, Y; Jacobs, K H; Mijovic, C H; Hirata, Y; Otani, T; Fletcher, J; Bradwell, A R; Barnett, A H

1992-01-01

41

Burns in diabetic patients  

PubMed Central

CONTEXT AND AIMS: Diabetic burn patients comprise a significant population in burn centers. The purpose of this study was to determine the demographic characteristics of diabetic burn patients. MATERIALS AND METHODS: Prospective data were collected on 94 diabetic burn patients between March 20, 2000 and March 20, 2006. Of 3062 burns patients, 94 (3.1%) had diabetes; these patients were compared with 2968 nondiabetic patients with burns. Statistical analysis was performed using the statistical analysis software SPSS 10.05. Differences between the two groups were evaluated using Student's t-test and the chi square test. P < 0.05 was considered as significant. RESULTS: The major mechanism of injury for the diabetic patients was scalding and flame burns, as was also the case in the nondiabetic burn patients. The diabetic burn patients were significantly older, with a lower percentage of total burn surface area (TBSA) than the nondiabetic burn population. There was significant difference between the diabetic and nondiabetic patients in terms of frequency of infection. No difference in mortality rate between diabetic and nondiabetic burn patients was observed. The most common organism in diabetic and nondiabetic burn patients was methicillin-resistant staphylococcus. Increasing %TBSA burn and the presence of inhalation injury are significantly associated with increased mortality following burn injury. CONCLUSIONS: Diabetics have a higher propensity for infection. Education for diabetic patients must include caution about potential burn mishaps and the complications that may ensue from burns.

Maghsoudi, Hemmat; Aghamohammadzadeh, Naser; Khalili, Nasim

2008-01-01

42

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

Microsoft Academic Search

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

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

2004-01-01

43

Characteristics of reporting diabetes mellitus research results in Japanese newspapers.  

PubMed

This study aims to characterize the coverage of research on diabetes mellitus by Japanese newspapers. Newspaper articles with the key words diabetes mellitus, diabetes disease, or blood sugar in the headline were selected from four major Japanese newspapers for the period 1988-2007 using the ELNET database and coded by two researchers. Of 152 newspaper articles examined, 92 (60.5%) were based on journal articles, and published in English. The remaining 60 (39.5 %) were based on academic meetings, of which 51 (85.0%) were conducted in Japan. Seventy-two articles covered non-human studies (47.4%), but only 26 used a word such as animal, mouse, or cell in the headline to describe the study subjects. Publications in countries where the native language is not English may have language and geographical barriers that affect the reporting of research results. PMID:20103945

Akamatsu, Rie; Naito, Mariko; Nakayama, Takeo

2009-04-01

44

Type 1 (insulin-dependent) diabetes in Japanese children is not a uniform disease  

Microsoft Academic Search

Summary  The initial course of Type 1 (insulin-dependent) diabetes mellitus was studied in two groups of Japanese children, i. e. 21 patients with abrupt onset (Group A) and 19 patients detected by urine glucose screening at school with minimal or no symptoms (Group B). There was no statistical difference in mean age at diagnosis between Group A and B (11±3 years

T. Urakami; Y. Miyamoto; H. Fujita; T. Kitagawa

1989-01-01

45

Clinical features of diabetes mellitus with the mitochondrial DNA 3243 (A–G) mutation in Japanese: Maternal inheritance and mitochondria-related complications  

Microsoft Academic Search

Diabetes mellitus with the mitochondrial DNA 3243(A–G) mutation is reported to represent 0.5–2.8% of the general diabetic population. Since the characterization of diabetes with the mutation is still incomplete, we undertook a nation-wide case-finding study of genetically defined patients using questionnaires in Japan. One hundred and thirteen Japanese diabetic patients with the mutation were registered and analyzed. The patients had

Susumu Suzuki; Yoshitomo Oka; Takashi Kadowaki; Azuma Kanatsuka; Takeshi Kuzuya; Masashi Kobayashi; Tokio Sanke; Yutaka Seino; Kishio Nanjo

2003-01-01

46

Efficacy and safety of the dipeptidyl peptidase-4 inhibitor sitagliptin compared with ?-glucosidase inhibitor in Japanese patients with type 2 diabetes inadequately controlled on sulfonylurea alone (SUCCESS-2): a multicenter, randomized, open-label, non-inferiority trial.  

PubMed

We assessed the efficacy and safety of sitagliptin compared with ?-glucosidase inhibitor (?GI) in 120 of Japanese patients with type 2 diabetes mellitus (T2DM) inadequately controlled on stable ?2?mg/day glimepiride alone [mean hemoglobin A1c (HbA1c) 7.7%] by the randomized, active-controlled, non-inferiority trial. Patients were randomly assigned to receive additional sitagliptin or ?GI for 24?weeks. The primary endpoint was change in HbA1c from baseline to week 12. After 12?weeks, sitagliptin reduced HbA1c by -0.44% (p?Japanese T2DM patients receiving glimepiride alone, and well tolerated with minimum risk of gastrointestinal symptoms and hypoglycaemia. PMID:24447683

Kobayashi, K; Yokoh, H; Sato, Y; Takemoto, M; Uchida, D; Kanatsuka, A; Kuribayashi, N; Terano, T; Hashimoto, N; Sakurai, K; Hanaoka, H; Ishikawa, K; Onishi, S; Yokote, K

2014-08-01

47

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

Microsoft Academic Search

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

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

1992-01-01

48

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

Microsoft Academic Search

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

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

1995-01-01

49

Lower beta cell function relates to sustained higher glycated albumin to glycated hemoglobin ratio in Japanese patients with type 2 diabetes.  

PubMed

The aim of this study was to clarify the relationship between baseline beta cell function and future glycated albumin (GA) to glycated hemoglobin ratio (GA/HbA1c) in patients with type 2 diabetes. In our retrospective cohort, 210 type 2 diabetic patients who had been admitted to our hospital and in whom HbA1c and GA had been measured at baseline and 2 years after admission were included in this study. Baseline beta cell function was assessed by postprandial C-peptide immunoreactivity index (PCPRI) during admission. With intensification of treatment during admission, HbA1c and GA were significantly decreased 1 year and 2 years after admission. While baseline HbA1c was not significantly correlated with HbA1c after 2 years, baseline GA/HbA1c was strongly correlated with GA/HbA1c after 2 years (r = 0.575, P <0.001). When the patients were divided into two groups according to median PCPRI, patients with low PCPRI showed higher GA/HbA1c both at baseline and after 2 years compared to those with high PCPRI. There was a significant negative correlation between PCPRI and GA/HbA1c after 2 years (r = -0.379, P <0.001). Multiple regression analysis revealed that PCPRI was an independent predictor of GA/HbA1c after 2 years. In conclusion, our findings suggest that lower beta cell function is associated with sustained higher GA/HbA1c ratio in patients with type 2 diabetes. PMID:24212881

Saisho, Yoshifumi; Tanaka, Kumiko; Abe, Takayuki; Kawai, Toshihide; Itoh, Hiroshi

2014-01-01

50

Associations Between Diabetes, Leanness, and the Risk of Death in the Japanese General Population  

PubMed Central

OBJECTIVE To examine the BMI-stratified associations between diabetes and the risks of all-cause death, cardiovascular disease (CVD) death, and cancer death. RESEARCH DESIGN AND METHODS Using a prospective study with 12 rural Japanese general populations (n = 3,641, mean age, 53.7 years; 33.5% men), we examined the associations between diabetes and the risk of all-cause death, CVD death, and cancer death. We also examined the effects of BMI and age on such associations. RESULTS During an average duration of 10.2 years (37,278 person-years), 240 deaths occurred (54 deaths from CVD, 101 from cancer, and 85 from other causes). Cox regression analysis showed leanness (defined as the lowest quartile of entire BMI; mean, 19.5 kg/m2), but not obesity (BMI ?25 kg/m2), and diabetes were independently associated with an increased risk of all-cause death (hazard ratio [HR] 1.70 and 1.65, respectively; both P < 0.01.). Stratification with cause-specific deaths showed that leanness and obesity were associated with CVD death (HR 3.77 and 2.94, respectively), whereas diabetes was associated with cancer death (HR 1.87; all P < 0.05). The increased risk of all-cause death in diabetes was substantially higher in lean subjects aged <65 years (HR 3.4) or those aged ?65 years (HR 4.2), whereas the risk in obese diabetes patients was significant only in subjects aged <65 years (HR 2.32; all P < 0.05). CONCLUSIONS Among the Japanese general population, diabetes confers an increased risk of all-cause death. Particular attention must be paid to the pronounced high mortality in diabetes accompanied with leanness, regardless of age.

Yano, Yuichiro; Kario, Kazuomi; Ishikawa, Shizukiyo; Ojima, Toshiyuki; Gotoh, Tadao; Kayaba, Kazunori; Tsutsumi, Akizumi; Shimada, Kazuyuki; Nakamura, Yosikazu; Kajii, Eiji

2013-01-01

51

Add-on therapy with the DPP-4 inhibitor sitagliptin improves glycemic control in insulin-treated Japanese patients with type 2 diabetes mellitus.  

PubMed

The effect of add-on therapy with sitagliptin on glycemic control was prospectively investigated in patients with type 2 diabetes mellitus (T2DM) receiving insulin alone or insulin combined with oral antidiabetic drugs. Seventy-one patients were evaluated (38 men and 33 women aged 63.9 ± 10.2 years). They were divided into three groups, which were 45 patients receiving premixed insulin twice daily, 15 patients receiving multiple daily insulin injections, and 11 patients receiving basal insulin with oral antidiabetic drugs (basal insulin therapy). Concomitant oral drugs included sulfonylureas, ?-glucosidase inhibitors and metformin. The hemoglobin A1c (HbA1c) of all patients improved significantly from 8.1 ± 1.2% to 7.6 ± 1.1% after 12 weeks of add-on therapy with sitagliptin (p<0.01), and the insulin dosage was reduced from 27.3 ± 15.8 U/day to 24.5 ± 16.5 U/day (p<0.001). Body weight did not change after the start of concomitant therapy and severe hypoglycemia was not observed. The baseline HbA1c and glycated albumin levels were identified as factors that predicted the response to add-on therapy with sitagliptin. These findings suggest that add-on therapy with sitagliptin can be expected to achieve improvement of poor glycemic control irrespective of a patient's demographic profile. Stratified analysis based on the insulin regimen revealed a stronger antidiabetic effect and a high efficacy of sitagliptin when it was added to basal insulin therapy. The results of this investigation confirmed that add-on therapy with sitagliptin to various insulin regimens could improve glycemic control without severe hypoglycemia and/or weight gain. PMID:23386390

Katsuno, Tomoyuki; Ikeda, Hiroki; Ida, Kenichi; Miyagawa, Jun-Ichiro; Namba, Mitsuyoshi

2013-01-01

52

Clinicopathological study of Japanese patients with genetic iron overload syndromes.  

PubMed

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

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

2012-09-01

53

Comparison of Effects of Olmesartan and Telmisartan on Blood Pressure and Metabolic Parameters in Japanese Early-Stage Type2 Diabetics with Hypertension  

Microsoft Academic Search

Angiotensin II type-1 receptor blockers (ARBs) are regarded as first-line treatments for type-2 diabetes with hypertension. Despite the availability of various types of ARBs, there are no comparative studies of their effects on patients with diabetes. In this open-label prospective crossover study, we compared the effects of olmesartan (20 mg\\/day) and telmisartan (40 mg\\/day). Twenty Japanese early-stage type-2 diabetes patients

Shiho Nakayama; Hirotaka Watada; Tomoya Mita; Fuki Ikeda; Tomoaki Shimizu; Hiroshi Uchino; Yoshio Fujitani; Takahisa hirose; Ryuzo kawamori

2008-01-01

54

IgG1 is the dominant subclass of antibody against glutamic acid decarboxylase among type 1 diabetes in Japanese.  

PubMed

Autoantibody against glutamic acid decarboxylase (GADA) is a highly sensitive predictor of insulin-dependency in adult diabetic patients as well as young individuals. A considerable number of diabetics who do not reach the insulin-dependent stage have this antibody. Recently, type 1 diabetes has been thought to be caused by T helper 1 (Thl)-type autoimmunity based on studies in non-obese diabetic mice, but it is still difficult to investigate antigen-specific T-cell function in human type 1 diabetes. We therefore assessed an IgG subclass assay for GADA, which should reflect T-helper function against GAD. Sera from 14 type 1 diabetic patients positive for GADA by radioligand binding assay were tested for the IgG subclass of GADA. The assay was based on an enzyme-linked immunosorbent assay, which showed a good correlation with radioligand binding assay. The sera of all but one of the 14 type 1 diabetic patients (93%) were positive for the IgG1 subclass of GADA. The IgG2 and IgG3 subclasses of GADA were also detected in one diabetic patient each who were also positive for IgG1. The IgG4 subclass was not detected in any of the sera we tested. We concluded that IgG1 is the dominant subclass of GADA in Japanese type 1 diabetic patients. PMID:10811294

Kasuga, A; Shimada, A; Ozawa, Y; Maruyama, T; Oya, K; Saruta, T

2000-02-01

55

Type 2 (non-insulin-dependent) diabetes mellitus associated with a mutation of the glucokinase gene in a Japanese family  

Microsoft Academic Search

Summary  Mutations were screened for in the glucokinase gene of 25 Japanese patients with Type 2 (non-insulin-dependent) diabetes mellitus. Each exon was scanned by electrophoresis of enzymatically amplified DNA segments under non-denaturing conditions and variants were sequenced. A variant pattern was detected in exon 5 of one patient. Direct sequencing of this exon revealed a single nucleotide substitution in codon 188

F. Shimada; H. Makino; N. Hashimoto; M. Taira; S. Seino; G. I. Bell; A. Kanatsuka; S. Yoshida

1993-01-01

56

cblb Gene Analysis in Japanese Type 1 Diabetes with Younger Age of Onset  

PubMed Central

To clarify the contribution of Cblb to the development of type1 diabetes (T1D), we investigated Japanese younger-onset T1D patients. We sequenced the cblb gene in 10 T1D patients and screened the identified mutations in 109 Japanese T1D patients and 100 normal subjects. In addition to four previously reported synonymous single nucleotide polymorphisms (SNPs), we identified two novel nonsynonymous variants (786 C>T (A155V) and 1718 A>G (N466D)). The A155V mutation was found in one subject with Basedow’s disease whose mother also carried both the mutation and Basedow’s disease. The N466D mutation was found in 6 T1D cases including a subject who was classified as fulminant T1D. We found no significant differences in the allele frequency of these SNPs among T1D and control subjects, suggesting that the contribution of cblb to the genetic susceptibility to T1D might not be high for Japanese younger–onset T1D.

Matsuda, Junko; Yokota, Ichiro

2008-01-01

57

Efficacy and safety of canagliflozin monotherapy in Japanese patients with type 2 diabetes inadequately controlled with diet and exercise: a 24-week, randomized, double-blind, placebo-controlled, Phase III study.  

PubMed

Objective: To examine the efficacy and safety of canagliflozin monotherapy, a sodium/glucose co-transporter 2 inhibitor, in Japanese type 2 diabetes patients. Methods: In this double-blind, multi-centre Phase III study, patients aged ? 20 years with hemoglobin A1c (HbA1c) 7.0 - 10.0% on diet/exercise therapy alone received placebo or canagliflozin (100 or 200 mg) once daily for 24 weeks. The main outcome measure was the change in HbA1c from baseline to Week 24. Results: The changes in HbA1c (-0.74 and -0.76 vs + 0.29%), fasting plasma glucose (1 mg/dl = 0.0555 mmol/l; -31.6 and -31.9 vs + 3.7 mg/dl), 2-h plasma glucose after 75-g glucose load (-84.9 and -79.0 vs -0.5 mg/dl), body weight (percent change: -3.76 and -4.02 vs -0.76%) and systolic blood pressure (-7.88 and -6.24 vs -2.72 mmHg) were significantly greater with 100 and 200 mg canagliflozin than with placebo (all, p < 0.05). Genital infections in females (6.5, 6.3 and 0%) and asymptomatic hypoglycemia (4.4, 5.6 and 2.2%), but not symptomatic hypoglycemia (2.2, 1.1 and 1.1%), were more frequent in the 100- and 200-mg groups than in the placebo group. Conclusion: Canagliflozin significantly improved glycemic control and was well tolerated. PMID:25010793

Inagaki, Nobuya; Kondo, Kazuoki; Yoshinari, Toru; Takahashi, Nahoko; Susuta, Yutaka; Kuki, Hideki

2014-08-01

58

Hemoglobin maintenance and dosing strategies using intravenous continuous erythropoietin receptor activator in Japanese hemodialysis patients.  

PubMed

Methoxy polyethylene glycol-epoetin beta, a continuous erythropoietin receptor activator (CERA), is reported to be effective in managing renal anemia but there is little data about CERA in Japan. This study aimed to ascertain the effects of CERA in Japanese hemodialysis patients and the appropriate starting dose of CERA when switching from other erythropoiesis-stimulating agents. We switched 61 stable hemodialysis patients to 4-weekly intravenous CERA, from either epoetin beta (rHuEPO) or darbepoetin alpha (DA). When determining the initial dose of CERA, we used guidelines recommended by the Japanese supplier for switching from rHuEPO, but for DA we based the CERA dose on European reports, because no Japanese guidelines exist. Fifty-two patients completed the 28-week study. Hemoglobin was maintained within the target range (10.0-12.0?g/dL). The required CERA dose decreased over the 28 weeks. The hemoglobin level and CERA dose stabilized faster when switching from DA. CERA showed similar efficacy in diabetic and non-diabetic patients. The effect of CERA is similar regardless of whether patients switch from low- or high-dose erythropoiesis-stimulating agents. In conclusion, CERA is effective for Japanese hemodialysis patients at a lower dose than expected. PMID:24107278

Hirai, Takayuki; Nishizawa, Yoshiko; Nakazono, Hiroshi; Asai, Mariko; Yamashita, Hideki; Sasaki, Ayako; Yamashita, Tetsumasa; Yamashita, Kazuomi; Shigemoto, Kenichiro; Harada, Satoru; Mizuiri, Sonoo

2013-10-01

59

Antiproteinuric effect of candesartan cilexetil in Japanese subjects with type 2 diabetes and nephropathy  

Microsoft Academic Search

The effect of the angiotensin II receptor blocker, candesartan cilexetil, on proteinuria was examined in a prospective, multicenter, randomized, double-blind study in Japanese subjects with type 2 diabetes. This study enrolled diabetic subjects with confirmed proteinuria into four groups for 12 weeks of treatment with placebo or candesartan cilexetil 2, 4, or 8mg. The contribution of the angiotensin converting enzyme

Masakazu Haneda; Ryuichi Kikkawa; Hideto Sakai; Ryuzo Kawamori

2004-01-01

60

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

National Technical Information Service (NTIS)

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

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

1988-01-01

61

Two Japanese Patients with Gitelman Syndrome  

PubMed Central

Gitelman syndrome (GS) is a renal tubular disorder characterized by hypokalemia, hypomagnesemia, metabolic alkalosis and hypocalciuria due to defective tubular reabsorption of magnesium and potassium. This disease is caused by mutations of the thiazide-sensitive Na-Cl cotransporter (NCCT) gene, SLC12A3. Manifestations of GS are heterogeneous, from asymptomatic to mild symptoms of cramps and easy fatigue, to tetany and paralysis. Polydipsia, polyuria, and nocturia are also frequent in GS patients. Here we describe two Japanese patients with GS followed as nocturnal enuresis. In the first patient, occasional muscle cramps, easy fatigue and headache led to the diagnosis of GS. The parents of this patient reported that he had been affected by polydipsia and polyuria, especially nocturnal enuresis from early childhood. The second patient was referred to our clinic because of muscular weakness and cramps. He had a past history of transient muscle weakness and muscle cramps. He had also suffered from nocturnal enuresis since 3 yr of age. Laboratory findings of these patients were consistent with those of GS. Sequencing analysis of the SLC12A3 gene from two patients showed four mutations, which were previously reported. In our two patients, their manifestations had been underestimated and the correct diagnosis was delayed. GS is generally likely to be benign, however signs of GS are found in early childhood. Especially, we must recognize that nocturnal enuresis is frequent in symptoms of GS.

Tajima, Toshihiro; Tabata, Yuichi; Tao, Kayoko; Yokota, Ichiro; Takahashi, Yutaka

2006-01-01

62

Rheumatic manifestations in diabetic patients  

PubMed Central

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

Serban, AL; Udrea, GF

2012-01-01

63

A study to survey susceptible genetic factors responsible for troglitazone-associated hepatotoxicity in Japanese patients with type 2 diabetes mellitus  

Microsoft Academic Search

Background and objective: Troglitazone is a 2,4-thiazolidinedione antidiabetic agent with insulin-sensitizing activities. This agent had been used efficiently in a large number of patients but was withdrawn from the market in March 2000 because of its association with idiosyncratic hepatotoxicity. To address the susceptible genetic factors responsible for the hepatotoxicity associated with this agent, we performed a genetic polymorphic analysis

Ichiro Watanabe; Aiko Tomita; Miho Shimizu; Mie Sugawara; Hiroaki Yasumo; Ryuta Koishi; Tohru Takahashi; Kaoru Miyoshi; Kouichi Nakamura; Takashi Izumi; Yasuyuki Matsushita; Hidehiko Furukawa; Hideyuki Haruyama; Teiichiro Koga

2003-01-01

64

The diabetic patient in Ramadan  

PubMed Central

During the month of Ramadan, all healthy, adult Muslims are required to fast from dawn to sunset. Fasting during Ramadan involves abstaining from food, water, beverages, smoking, oral drugs, and sexual intercourse. Although the Quran exempts chronically ill from fasting, many Muslims with diabetes still fast during Ramadan. Patients with diabetes who fast during the month of Ramadan can have acute complications. The risk of complications in fasting individuals with diabetes increases with longer periods of fasting. All patients with diabetes who wish to fast during Ramadan should be prepared by undergoing a medical assessment and engaging in a structured education program to undertake the fast as safely as possible. Although some guidelines do exist, there is an overwhelming need for better designed clinical trials which could provide us with evidence-based information and guidance in the management of patients with diabetes fasting Ramadan.

Chamsi-Pasha, Hassan; Aljabri, Khalid S.

2014-01-01

65

The A3 allele of the HLA-DQA1 locus is associated with susceptibility to type 1 diabetes in Japanese.  

PubMed Central

Analysis of the frequencies of class II HLA-DR and HLA-DQ alleles by serological and DNA typing in 49 Japanese patients with type 1 (insulin-dependent) diabetes and 31 Japanese controls indicates the following. (i) Susceptibility is more strongly associated with the HLA-DQ subregion than with the HLA-DR subregion. (ii) Of the class II alleles detected, the A3 allele of the DQA1 locus was the most strongly associated with disease. Ninety-six percent of the patients were positive for the A3 allele compared to 53% of the controls (P = 0.001; relative risk = 19.7; confidence limits = 3.72-188.64). (iii) The DQw8 allele of the DQB1 locus, which is associated with susceptibility to type 1 diabetes in Caucasians and Blacks, was not increased in frequency in Japanese patients (22%) versus controls (19%). (iv) Asp-57-encoding DQB1 alleles are associated with reduced susceptibility to type 1 diabetes in Caucasians. The major predisposing haplotypes in Japanese are DR4 and DR9. By DNA sequence analysis, both of these Japanese haplotypes have Asp-57-encoding DQB1 alleles. Oligonucleotide dot blot analysis showed that all, except 1, of the 49 Japanese patients and all of the 31 controls have at least one Asp-57-encoding DQB1 allele. In addition, 40% of the patients were homozygous for Asp-57-encoding DQB1 alleles versus 35% of the controls. The high frequencies of Asp-57-encoding DQB1 alleles in this ethnic group may account for the rarity of type 1 diabetes in Japan.

Todd, J A; Fukui, Y; Kitagawa, T; Sasazuki, T

1990-01-01

66

Calcaneal Fractures in Diabetic Patients  

Microsoft Academic Search

We would like to present 23 calcaneal fractures in 22 patients of whom 21 had type I diabetes mellitus. There appear to be three basic fracture types: (1) a superiorly displaced extra-articular avulsion fracture of the posterior calcaneus (or Iowa fracture), which occurred in 12 patients (five men, seven women); (2) a mid-calcaneal compression fracture in six patients (four men,

Laura J Hedlund; Daniel D Maki; Harry J Griffiths

1998-01-01

67

Insomnia in Diabetic Hemodialysis Patients  

Microsoft Academic Search

Background: Insomnia is one of the most common problems in dialysis patients, and likely to contribute impairment in quality of life, which has a positive correlation with patients’ survival. In diabetic patients, morbidity and mortality are substantially higher than in the nondiabetic counterparts, and also the incidence of sleep disturbances. However, there is no means to predict sleep disturbance in

Sang-Youb Han; Jong-Woo Yoon; Sang-Kyung Jo; Jin-Ho Shin; Chol Shin; Jung-Bok Lee; Dae-Ryong Cha; Won-Yong Cho; Heui-Jung Pyo; Hyoung-Kyu Kim; Kyu-Bec Lee; Hyang Kim; Kyung-Wook Kim; Yong-Seop Kim; Jeong-Ho Lee; Sang-Eun Park; Chang-Soo Kim; Kyeong-So Wea; Kyung-Shik Oh; Tae-See Chung; Sang-Yeol Suh

2002-01-01

68

Management of hypertension in patients with diabetes.  

PubMed

Mortality from cardiovascular disease is 2 to 4 times higher in patients with type 2 diabetes compared with patients with similar demographic characteristics but without diabetes. The management of hypertension in patients with diabetes is as important as glucose control in the prevention of long-term diabetes complications. This article discusses the incidence of hypertension in diabetes, the impact of hypertension on the development of long-term complications, diagnosis of hypertension in patients with diabetes, blood pressure goals, the treatment of hypertension in patients with diabetes, and antihypertension medications. PMID:23410647

Levesque, Celia M

2013-03-01

69

Association of Cardiorespiratory Fitness and Overweight with Risk of Type 2 Diabetes in Japanese Men  

PubMed Central

Objective Existing evidence is limited on what extent fitness can counterbalance type 2 diabetes mellitus (T2DM) risk associated with obesity. We investigated the joint association of weight status and estimated VO2max, a marker of fitness, with the risk of developing T2DM among Japanese men using haemoglobin A1c and fasting glucose criterion. Methods The present study included 3,523 male employees aged 18–61 years without diabetes who provided health check-up and fitness data in Japan in 2003–2005. We calculated hazard ratios and 95% confidence intervals for incident diabetes using the Cox regression model. Results During a mean follow-up of 6.0 years, 199 men developed diabetes. Multivariable-adjusted hazard ratios (95% confidence interval) of diabetes were 1.00 (reference), 1.44 (1.01–2.07), and 1.48 (1.03–2.13) for the highest through the lowest tertile of fitness (P for trend ?=?0.04). Additional adjustment for body mass index largely attenuated the association of fitness with diabetes. Joint analysis showed that adjusted hazard ratios of diabetes were 1.00, 1.32, 2.94, and 1.83 in normal weight high-fit men, normal weight low-fit men, overweight high-fit men, and overweight low-fit men, respectively. Conclusion The results suggest that weight control is more important than fitness in prevention of type 2 diabetes in Japanese men.

Kuwahara, Keisuke; Uehara, Akihiko; Kurotani, Kayo; Pham, Ngoc Minh; Nanri, Akiko; Yamamoto, Makoto; Mizoue, Tetsuya

2014-01-01

70

Safety and effectiveness of adalimumab in Japanese rheumatoid arthritis patients: Postmarketing surveillance report of 7740 patients.  

PubMed

Abstract Objectives. To confirm the safety and effectiveness of adalimumab and to evaluate the influence of the concomitant use of methotrexate (MTX). Methods. Postmarketing surveillance of 7740 Japanese rheumatoid arthritis (RA) patients was performed. All patients who received adalimumab in the registration period were followed for 28 weeks after starting treatment for safety and 24 weeks for effectiveness. Effectiveness was measured by duration of morning stiffness, swollen and tender joint counts (28 joints), patient global assessment of disease activity, erythrocyte sedimentation rate and serum C-reactive protein. Results. Comparable rates of adverse drug reactions (ADRs) were reported in this study and in the interim analysis. Age, pulmonary disease history or comorbidity, co-existing diabetes mellitus, concomitant MTX at doses of > 8 mg/week and concomitant glucocorticoids at doses of > 5 mg/day were risk factors for infections. All mean values of effectiveness measurements improved. Relatively lower disease activity at baseline, biologic-naďve, concomitant MTX use and early RA stage/low functional class were background factors contributing to the effectiveness. The combination of adalimumab with MTX improved the response to adalimumab treatment. Conclusion. Adalimumab, especially with concomitant use of MTX, provided significant improvement in disease activity, without any unexpected ADRs in Japanese RA patients. PMID:24252049

Koike, Takao; Harigai, Masayoshi; Ishiguro, Naoki; Inokuma, Shigeko; Takei, Syuji; Takeuchi, Tsutomu; Yamanaka, Hisashi; Haruna, Shigenori; Ushida, Naoko; Kawana, Katsuyoshi; Tanaka, Yoshiya

2014-05-01

71

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.

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

2013-01-01

72

Rosuvastatin in Diabetic Hemodialysis Patients  

PubMed Central

A randomized, placebo-controlled trial in diabetic patients receiving hemodialysis showed no effect of atorvastatin on a composite cardiovascular endpoint, but analysis of the component cardiac endpoints suggested that atorvastatin may significantly reduce risk. Because the AURORA (A Study to Evaluate the Use of Rosuvastatin in Subjects on Regular Hemodialysis: An Assessment of Survival and Cardiovascular Events) trial included patients with and without diabetes, we conducted a post hoc analysis to determine whether rosuvastatin might reduce the risk of cardiac events in diabetic patients receiving hemodialysis. Among the 731 participants with diabetes, traditional risk factors such as LDL-C, smoking, and BP did not associate with cardiac events (cardiac death and nonfatal myocardial infarction). At baseline, only age and high-sensitivity C-reactive protein were independent risk factors for cardiac events. Assignment to rosuvastatin associated with a nonsignificant 16.2% reduction in risk for the AURORA trial's composite primary endpoint of cardiac death, nonfatal MI, or fatal or nonfatal stroke (HR 0.84; 95% CI 0.65 to 1.07). There was no difference in overall stroke, but the rosuvastatin group had more hemorrhagic strokes than the placebo group (12 versus two strokes, respectively; HR, 5.21; 95% CI 1.17 to 23.27). Rosuvastatin treatment significantly reduced the rates of cardiac events by 32% among patients with diabetes (HR 0.68; 95% CI 0.51 to 0.90). In conclusion, among hemodialysis patients with diabetes mellitus, rosuvastatin might reduce the risk of fatal and nonfatal cardiac events.

Holme, Ingar; Schmieder, Roland E.; Jardine, Alan G.; Zannad, Faiez; Norby, Gudrun E.; Fellstrom, Bengt C.

2011-01-01

73

Diabetic retinopathy is associated with insulin resistance and cardiovascular autonomic dysfunction in type 2 diabetic patients.  

PubMed

Diabetic retinopathy (DR) and cardiovascular autonomic dysfunction are associated with high mortality in type 2 diabetic patients. This preliminary study was therefore designed to test the hypothesis that DR is associated with insulin resistance and cardiovascular autonomic dysfunction in type 2 diabetic patients without insulin treatment. Seventy persons were diagnosed to have type 2 diabetes in the examination from June 2004 to May 2006. The study group consisted of 29 type 2 diabetic patients with DR (age: 58+/-6 years, mean+/-s.d.) and 41 type 2 diabetic patients with no DR (NDR) (n=41, 58+/-5 years). Cardiovascular autonomic function was assessed by baroreflex sensitivity (BRS), heart rate variability, plasma norepinephrine concentration and cardiac (123)I-metaiodobenzylguanidine (MIBG) scintigraphic findings. DR patients had lower BRS, early and delayed (123)I-MIBG myocardial uptake values and higher percent washout rate (WR) of (123)I-MIBG than the NDR patients. With respect to metabolic findings, DR patients had higher fasting plasma insulin concentration (P<0.0001) and higher homeostasis model assessment (HOMA) index (P<0.00001) than the NDR patients. Multiple logistic regression analysis revealed that the presence of DR was independently predicted by HOMA index and the percent WR of (123)I-MIBG (P<0.01 and P<0.05, respectively). Our results suggest that DR is associated with depressed cardiovascular autonomic function and insulin resistance and that HOMA index and the percent WR of (123)I-MIBG are independently associated with DR in Japanese patients with type 2 diabetes mellitus. PMID:19262488

Anan, Futoshi; Takayuki, Masaki; Takahashi, Naohiko; Nakagawa, Mikiko; Eshima, Nobuoki; Saikawa, Tetsunori; Yoshimatsu, Hironobu

2009-04-01

74

Management of necrotizing fasciitis in diabetic patients  

Microsoft Academic Search

Necrotizing fasciitis is a life-threatening condition in diabetic patients; its management and salvage of the patient is a formidable challenge. Diabetes mellitus is one of the serious conditions associated with necrotizing fasciitis. It is a disorder that primarily affects the microvascular circulation.We review our experience and present our approach to necrotizing fasciitis in patients with diabetes mellitus. All cases of

Ali Gürlek; Cemal F?rat; Ay?e Ersöz Öztürk; Nezih Alaybeyo?lu; Alpay Fariz; Serkan Aslan

2007-01-01

75

Angiotensin converting enzyme gene polymorphism and renal artery resistance in patients with insulin dependent diabetes mellitus  

Microsoft Academic Search

The present study was carried out to elucidate whether renal hemodynamic changes are associated with angiotensin converting enzyme (ACE) gene polymorphism in patients with insulin dependent diabetes mellitus (IDDM). We studied 32 Japanese patients with IDDM (aged 15 ± 3 years in mean ± SD) without renal failure or retinopathy. Renal hemodynamics were examined by duplex Doppler sonography and arterial

Shinya Fukumoto; Eiji Ishimura; Masayuki Hosoi; Takahiko Kawagishi; Tomoyuki Kawamura; Gen Isshiki; Yoshiki Nishizawa; Hirotoshi Morii

1996-01-01

76

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.

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

77

A novel missense mutation (Asn 5 ?Ile) in lecithin: cholesterol acyltransferase (LCAT) gene in a Japanese patient with LCAT deficiency  

Microsoft Academic Search

We identified a novel missense mutation in the lecithin: cholesterol acyltransferase gene in a new case of lecithin:cholesterol\\u000a acyltransferase (LCAT) deficiency. The patient was a 64-year-old diabetic Japanese male who showed an extremely low level\\u000a of serum high-density lipoprotein-cholesterol, corneal opacities, anemia, and proteinuria. Both the patient's LCAT activity\\u000a and mass were markedly low. DNA sequence analysis of the LCAT

M. Okubo; Y. Aoyama; H. Shio; J. J. Albers; T. Murase

1996-01-01

78

Family history of cancer in Japanese gastric cancer patients  

Microsoft Academic Search

The aim of this study was to evaluate the family history of cancer in Japanese gastric cancer patients and to investigate\\u000a the clinicopathological features of gastric cancer patients with and without a family history of cancer. Four hundred and\\u000a forty gastric cancer patients were enrolled in this study. The family history (first- and second-degree relatives) was investigated.\\u000a The 440 patients

Kentaro Kawasaki; Kiyonori Kanemitsu; Takashi Yasuda; Takashi Kamigaki; Daisuke Kuroda; Yoshikazu Kuroda

2007-01-01

79

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).

2014-01-01

80

Hyperuricemia Is Independently Associated with Coronary Heart Disease and Renal Dysfunction in Patients with Type 2 Diabetes Mellitus  

Microsoft Academic Search

AimsTo investigate the relationship between hyperuricemia (HUA) and the clinical backgrounds in Japanese patients with type 2 diabetes mellitus.MethodsAfter a cross-sectional study evaluating the association of HUA with the clinical characteristics in 1,213 patients with type 2 diabetes mellitus, the estimated glomerular filtration rate (eGFR) and the incidence of diabetic macroangiopathies was investigated in a prospective observational study in 1,073

Hiroyuki Ito; Mariko Abe; Mizuo Mifune; Koshiro Oshikiri; Shinichi Antoku; Yuichiro Takeuchi; Michiko Togane

2011-01-01

81

Anemia affects the quality of life of Japanese cancer patients.  

PubMed

The Functional Assessment of Cancer Therapy-Anemia (FACT-An) was developed to measure the effect of anemia on quality of life (QOL) in cancer patients. We have previously validated the Japanese version of the FACT-An in Japanese cancer patients receiving chemotherapy, hormone therapy, or radiation therapy. That analysis was limited to evaluating the relationship between QOL scores and hemoglobin (Hb) levels. In this study, the data were further analyzed in order to identify factors that affect QOL. The mean Hb level of the patients was unchanged over three months. Patient age, Eastern Oncology Group Performance Status (ECOG-PS) score, Hb level, and the type of treatment method received were each predictive factors of a patient's FACT-An score at baseline, while the patient's Hb level at three months and whether the patient had received a blood transfusion were both predictive factors of a patient's FACT-An score at three months. Anemia consistently negatively affected the QOL of cancer patients measured over a three-month period. These results confirm the clinical effectiveness of the FACT-An as a tool to assess anemia-related QOL in Japanese cancer patients. PMID:23564569

Wasada, Izumi; Eguchi, Hisae; Kurita, Maya; Kudo, Shitomi; Shishida, Tomoko; Mishima, Yaeko; Saito, Yuko; Ushiorozawa, Nobuko; Seto, Takashi; Shimozuma, Kojiro; Morita, Satoshi; Saito, Mari; Yokomizo, Yuki; Ishizawa, Kenichi; Ohashi, Yasuo; Eguchi, Kenji

2013-04-01

82

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.

2014-01-01

83

Effects of sitagliptin or mitiglinide as an add-on to acarbose on daily blood glucose fluctuations measured by 72 h subcutaneous continuous glucose monitoring in Japanese patients with type 2 diabetes: a prospective randomized study.  

PubMed

Objective: Postprandial hyperglycemia and blood glucose fluctuations increase the risk of macroangiopathy in patients with type 2 diabetes mellitus (T2DM). However, few studies have examined the effects of oral hypoglycemic drugs on blood glucose fluctuations in daily life. Methods: Twenty-nine T2DM patients treated with acarbose were randomized to receive either sitagliptin (14 patients) or mitiglinide (15 patients) together with acarbose for 4 weeks. Patients were then switched to a combination of 10 mg mitiglinide and 0.2 mg voglibose for 4 weeks. All patients wore a continuous glucose monitoring (CGM) device for 5 - 7 days in week 3 of each treatment period. Results: The percentage of blood glucose levels in the hyperglycemic range, blood glucose indices derived from 24-h CGM profiles and the glycemic parameters (HbA1c, glycated albumin and fasting plasma glucose) were significantly improved by adding sitagliptin or mitiglinide to ongoing acarbose therapy. These parameters also tended to improve in the mitiglinide/voglibose combination period. Conclusion: Daily blood glucose fluctuations were significantly improved by adding sitagliptin or mitiglinide to acarbose, and improved after switching to the mitiglinide/voglibose combination. Larger controlled studies are needed to verify the effects of adding sitagliptin or mitiglinide to acarbose on glucose fluctuations. PMID:24866329

Osonoi, Takeshi; Saito, Miyoko; Tamasawa, Atsuko; Ishida, Hidenori; Osonoi, Yusuke

2014-07-01

84

Identifying risk factors for clinically significant diabetic macula edema in patients with type 2 diabetes mellitus.  

PubMed

It is known that clinic blood pressure (BP), gender, cigarette smoking, dyslipidemia, anemia and thiazolidenediones (TZD) treatment are predictors for clinically significant diabetic macula edema (CSDME). We examined a most risky factor for CSDME in Japanese patients with type 2 diabetes mellitus (T2DM) and diabetic retinopathy (DR) confirmed using optical coherence tomography by multiple regression analysis (MRA). As the risk factors, wakening-up BP was added to such factors. Seven diabetic Japanese patients with CSDME (group 1) and 124 subjects without CSDME (group 2) assonated with DR using optical coherence tomography were studied. The durations of T2DM in groups 1 and 2 were 15±10 years and 20±15 years, respectively. There was no statistically difference in means of gender, duration, age, body mass index (BMI), HbA1c, TC, LDL and TC/HDL, serum creatinine, urinary albumin excretion rate, and clinic BP between two groups. Morning systolic home BP (MSHBP), cigarette smoking and foveal thickness were significantly (p<0.001) higher in group 1 than group 2, whereas visual acuity was significantly (p<0.00?) lower in group 1 than in group 2. The patients in both groups had received various kinds of drugs for hyperglycemia, hypertension and others. There were no significant differences in the variables in both groups. MRA revealed that MSHBP, cigarette smoking and pioglitazone as TZD treatment were significantly positive predictors for CSDME, while BMI had a significantly negative predictor. Other variables were not significantly correlated to CSDME. The review summarizes a multiple regression analysis revealed that MSHBP makes an addition to predictive factors for CSDME among risk factors reported previously in patient with T2DM. PMID:23363297

Kamoi, Kyuzi; Takeda, Keiji; Hashimoto, Kaoru; Tanaka, Reiko; Okuyama, Shinya

2013-05-01

85

Association between aldehyde dehydrogenase 2 polymorphisms and the incidence of diabetic retinopathy among Japanese subjects with type 2 diabetes mellitus  

PubMed Central

Background Mitochondrial aldehyde dehydrogenase 2 (ALDH2) detoxifies reactive aldehydes in the micro- and macrovasculature. These substrates, including methylglyoxal and 4-hydroxynonenal formed from glucose and lipids, cause protein carbonylation and mitochondrial dysfunction, forming advanced glycation end products (AGEs). The present study aimed to confirm the association between the inactive ALDH2*2 allele and diabetic retinopathy (DR). Methods A retrospective longitudinal analysis was conducted, among 234 Japanese patients with type 2 diabetes mellitus (DM) (156 males and 78 females) who had no DR signs at baseline and were treated for more than half a year. The ALDH2*1/*2 alleles were determined using a real-time TaqMan allelic discrimination assay. Multivariate-adjusted hazard ratios (HRs) and 95% confidential intervals (CIs) for the cumulative incidence of the development of DR were examined using a Cox proportional hazard model, taking drinking habits and the serum ?-glutamyltransferase (GGT) level into consideration. Results The frequency of the ALDH2*2 allele was 22.3%. Fifty-two subjects cumulatively developed DR during the follow-up period of 5.5?±?2.5 years. The ALDH2*2 allele carriers had a significantly higher incidence of DR than the non-carriers (HR: 1.92; P?=?0.02). The incidence of DR was significantly higher in the drinkers with the ALDH2*2 allele than in those with the ALDH2*1/*1 genotype (HR: 2.61; P?=?0.03), while the incidence of DR in the non-drinkers did not differ significantly between the ALDH2 genotype groups (P?>?0.05). The incidence of DR was significantly higher in the ALDH2*2 allele carriers with a high GGT level than in the non-carriers with a high or low GGT level (HR: 2.45; P?=?0.03; and HR: 2.63; P?=?0.03, respectively). Conclusions To the best of our knowledge, this is the first report of a significant association between the ALDH2*2 allele and the incidence of DR. These findings provide additional evidence that ALDH2 protects both microvasculature and macrovasculature against reactive aldehydes generated under conditions of sustained oxidative stress, although further investigations in larger cohorts are needed to verify the results.

2013-01-01

86

Retinopathy in Patients with Diabetic Ophthalmoplegia  

Microsoft Academic Search

Purpose: To compare patients with palsy of the 3rd, 4th or 6th cranial nerve due to diabetes mellitus (DM) with controls matched for age, sex and disease duration in terms of the presence and severity of diabetic retinopathy. Patients and Method: Thirty-three diabetic patients with cranial nerve palsies and 33 age- and sex-matched controls with the same duration of disease

Golge Acaroglu; Arsen Akinci; Orhan Zilelioglu

2008-01-01

87

Health and Diabetes Self-efficacy: A Study of Diabetic and Non-diabetic Free Clinic Patients and Family Members.  

PubMed

Free clinics across the country provide free or reduced fee healthcare to individuals who lack access to primary care and are socio-economically disadvantaged. This study examined perceived health status among diabetic and non-diabetic free clinic patients and family members of the patients. Diabetes self-efficacy among diabetic free clinic patients was also investigated with the goal of developing appropriate diabetes health education programs to promote diabetes self-management. English or Spanish speaking patients and family members (N = 365) aged 18 years or older completed a self-administered survey. Physical and mental health and diabetes self-efficacy were measured using standardized instruments. Diabetic free clinic patients reported poorer physical and mental health and higher levels of dysfunction compared to non-diabetic free clinic patients and family members. Having a family history of diabetes and using emergency room or urgent care services were significant factors that affected health and dysfunction among diabetic and non-diabetes free clinic patients and family members. Diabetic free clinic patients need to receive services not only for diabetes, but also for overall health and dysfunction issues. Diabetes educational programs for free clinic patients should include a component to increase diabetes empowerment as well as the knowledge of treatment and management of diabetes. Non-diabetic patients and family members who have a family history of diabetes should also participate in diabetes education. Family members of free clinic patients need help to support a diabetic family member or with diabetes prevention. PMID:24496670

Kamimura, Akiko; Christensen, Nancy; Myers, Kyl; Nourian, Maziar M; Ashby, Jeanie; Greenwood, Jessica L J; Reel, Justine J

2014-08-01

88

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.

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

2012-01-01

89

CUTANEOUS DISORDERS IN 500 DIABETIC PATIENTS ATTENDING DIABETIC CLINIC  

PubMed Central

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

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

2011-01-01

90

Familial mediterranean Fever: genotype-phenotype correlations in Japanese patients.  

PubMed

Familial Mediterranean fever (FMF) is an autoinflammatory disease caused by MEditerranean FeVer gene (MEFV) mutations. In Japan, patients with FMF have been previously reported, including a mild or incomplete form. Several factors are presumed to contribute to the variable penetrance and to the phenotypic variability of FMF. We conducted the current study to investigate the correlation of variable clinical presentations and MEFV genotypic distributions in Japanese FMF patients.We analyzed demographic, clinical, and genetic data for 311 FMF patients enrolled in the study. Clinically, we classified FMF into 2 phenotypes: 1) the "typical" form of FMF, and 2) the "atypical" form of FMF according to the Tel Hashomer criteria. Patients with the typical FMF phenotype had a higher frequency of febrile episodes, a shorter duration of febrile attacks, more frequent thoracic pain, abdominal pain, a family history of FMF, and MEFV exon 10 mutations. Conversely, patients with the atypical FMF phenotype had a lower frequency of fever episodes and more frequent arthritis in atypical distribution, myalgia, and MEFV exon 3 mutations. Multivariate analysis showed that the variable associated with typical FMF presentation was the presence of MEFV exon 10 mutations. Typical FMF phenotype frequencies were decreased in patients carrying 2 or a single low-penetrance mutations compared with those carrying 2 or a single high-penetrance mutations (M694I), with an opposite trend for the atypical FMF phenotype. In addition, patients having more than 2 MEFV mutations had a younger disease onset and a higher prevalence of thoracic pain than those carrying a single or no mutations. Thus, MEFV exon 10 mutations are associated with the more typical FMF phenotype. In contrast, more than half of the Japanese FMF patients without MEFV exon 10 mutations presented with an atypical FMF phenotype, indicating that Japanese FMF patients tend to be divided into 2 phenotypes by a variation of MEFV mutations. PMID:24797171

Migita, Kiyoshi; Agematsu, Kazunaga; Yazaki, Masahide; Nonaka, Fumiaki; Nakamura, Akinori; Toma, Tomoko; Kishida, Dai; Uehara, Ritei; Nakamura, Yoshikazu; Jiuchi, Yuka; Masumoto, Junya; Furukawa, Hiroshi; Ida, Hiroaki; Terai, Chihiro; Nakashima, Yoshikazu; Kawakami, Atsushi; Nakamura, Tadashi; Eguchi, Katsumi; Yasunami, Michio; Yachie, Akihiro

2014-05-01

91

Prediction of systemic exposure to cyclosporine in Japanese pediatric patients  

Microsoft Academic Search

The monitoring of the blood concentration at 2 h (C2) after the oral administration of a cyclosporine (CsA) microemulsion was reconfirmed to be useful for the prediction of systemic exposure, the area under the blood concentration–time curve from 0 to 4 h (AUC0–4), in a group of Japanese patients, consisting of 33 children aged 5–15 years and 19 young adults aged 16–27 years, with

Toshiyuki Sakaeda; Kazumoto Iijima; Kandai Nozu; Tsutomu Nakamura; Yuka Moriya; Mika Nishikawa; Atsushi Wada; Noboru Okamura; Masafumi Matsuo; Katsuhiko Okumura

2006-01-01

92

Serum chromium levels in Egyptian diabetic patients  

Microsoft Academic Search

A direct association between trace elements and human disease has been observed. The alteration of chromium metabolism has\\u000a been observed in diabetic patients. The aim of this study was to investigate any association between serum chromium levels\\u000a and diabetes mellitus in the Egyptian population. Thirty patients with type 2 diabetes were compared to 20 healthy age- and\\u000a sex-matched control subjects

Asmaa Ismail Ahmed; Manal Mahmoud Helal

93

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

94

A Single Nucleotide Polymorphism within DUSP9 Is Associated with Susceptibility to Type 2 Diabetes in a Japanese Population  

PubMed Central

Aims The DUSP9 locus on chromosome X was identified as a susceptibility locus for type 2 diabetes in a meta-analysis of European genome-wide association studies (GWAS), and GWAS in South Asian populations identified 6 additional single nucleotide polymorphism (SNP) loci for type 2 diabetes. However, the association of these loci with type 2 diabetes have not been examined in the Japanese. We performed a replication study to investigate the association of these 7 susceptibility loci with type 2 diabetes in the Japanese population. Methods We genotyped 11,319 Japanese participants (8,318 with type 2 diabetes and 3,001 controls) for each of the 7 SNPs–rs5945326 near DUSP9, rs3923113 near GRB14, rs16861329 in ST6GAL1, rs1802295 in VPS26A, rs7178572 in HMG20A, rs2028299 near AP3S2, and rs4812829 in HNF4A–and examined the association of each of these 7 SNPs with type 2 diabetes by using logistic regression analysis. Results All SNPs had the same direction of effect (odds ratio [OR]>1.0) as in the original reports. One SNP, rs5945326 near DUSP9, was significantly associated with type 2 diabetes at a genome-wide significance level (p?=?2.21×10?8; OR 1.39, 95% confidence interval [CI]: 1.24?1.56). The 6 SNPs derived from South Asian GWAS were not significantly associated with type 2 diabetes in the Japanese population by themselves (p?0.007). However, a genetic risk score constructed from 6 South Asian GWAS derived SNPs was significantly associated with Japanese type 2 diabetes (p?=?8.69×10?4, OR ?=?1.06. 95% CI; 1.03?1.10). Conclusions/interpretation These results indicate that the DUSP9 locus is a common susceptibility locus for type 2 diabetes across different ethnicities, and 6 loci identified in South Asian GWAS also have significant effect on susceptibility to Japanese type 2 diabetes.

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

2012-01-01

95

Diabetes patient management by pharmacists during Ramadan  

PubMed Central

Background Many Muslim diabetes patients choose to participate in Ramadan despite medical advice to the contrary. This study aims to describe Qatar pharmacists’ practice, knowledge, and attitudes towards guiding diabetes medication management during Ramadan. Methods A cross-sectional descriptive study was performed among a convenience sample of 580 Qatar pharmacists. A web-based questionnaire was systematically developed following comprehensive literature review and structured according to 4 main domains: subject demographics; diabetes patient care experiences; knowledge of appropriate patient care during Ramadan fasting; and attitudes towards potential pharmacist responsibilities in this regard. Results In the 3 months prior to Ramadan (July 2012), 178 (31%) pharmacists responded to the survey. Ambulatory (103, 58%) and inpatient practices (72, 41%) were similarly represented. One-third of pharmacists reported at least weekly interaction with diabetes patients during Ramadan. The most popular resources for management advice were the internet (94, 53%) and practice guidelines (80, 45%); however only 20% were aware of and had read the American Diabetes Association Ramadan consensus document. Pharmacist knowledge scores of appropriate care was overall fair (99, 57%). Pharmacists identified several barriers to participating in diabetes management including workload and lack of private counseling areas, but expressed attitudes consistent with a desire to assume greater roles in advising fasting diabetes patients. Conclusion Qatar pharmacists face several practical barriers to guiding diabetes patient self-management during Ramadan, but are motivated to assume a greater role in such care. Educational programs are necessary to improve pharmacist knowledge in the provision of accurate patient advice.

2014-01-01

96

Hypothyroidism Complicating Nephropathy in a Diabetes Patient  

PubMed Central

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

Veerappan, Ilangovan; Abraham, Anila; Hariharan, Somasundaram

2012-01-01

97

Alexithymia among elderly patients with diabetes  

PubMed Central

Objective: To determine alexithymic characteristics and affecting factors in the elderly with diabetes mellitus. Methods: This study was planned as a cross-sectional and descriptive study and was conducted in a state Hospital with 120 elderly patients with diabetes. Data were collected using a personal information form and the Toronto Alexithymia Scale. Results: Alexithymia was found in 75.8% of the elderly with diabetes mellitus. It was determined that patients experienced higher than average difficulty in describing and identifying feelings. They also had more externally-oriented thinking styles. Patients’ income levels, family structure and illness duration affected their manifestation of alexithymic characteristics. Conclusion: Majority of elderly patients with diabetes exhibited alexithymic characteristics. However, these were not shown to be associated with sex, age, marital, educational or professional status. In addition, no connection was found between alexithymia and glycosylated hemoglobin (HbA1c), body mass index (BMI), postprandial glucose (PBG), and the treatment and complications of diabetes mellitus.

Hintistan, Sevilay; Cilingir, Dilek; Birinci, Nermin

2013-01-01

98

Second opinion behaviour among Japanese primary care patients.  

PubMed Central

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

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

1999-01-01

99

HLA antigens in Japanese patients with myasthenia gravis.  

PubMed Central

HLA antigens in 104 Japanese patients and 41 families with myasthenia gravis (MG) were investigated. The frequencies of DR9 and DRw13 were significantly increased in the patients who developed MG before 3 yr of age. The DQw3 antigen was positive for all the patients that developed MG before 15 yr with only one exception. All the examined cases that developed MG before 3 yr (including this DQw3 negative patient) had the same DQA and DQB DNA restriction fragments. These HLA frequencies decreased as the age of onset increased, and no significant association was observed in adult-onset MG. No patients had B8, DR3, and DQw2. The relative risk was higher for the DR9/DRw13 heterozygotes (37.4) than for DR9 (16.4) or DRw13 (7.1) in the childhood-onset MG. Statistical analysis suggested that DR9 and DRw13 (or DQw1 and DQw3) act synergistically in the disease development. Family study revealed diverse DR9 haplotypes. The most frequent DRw13 haplotype was Bw44-BFF-C4A3B1-DRw13-DQw1, which may be evolutionarily related to the caucasian B8-DR3-DQw2 haplotype. These results showed that MG in early childhood in Japanese individuals is genetically different from that in adulthood and that in caucasians. Images

Matsuki, K; Juji, T; Tokunaga, K; Takamizawa, M; Maeda, H; Soda, M; Nomura, Y; Segawa, M

1990-01-01

100

elation plasma levels CRP IL-6 fibrinogen stroke type neurological empowerment diabetic non-diabetic acute stroke patients 62-nd Scientific Sessions American Diabetes Association San Francisco Diabetes  

EPA Pesticide Factsheets

Did you mean elation plasma levels CRP IL-6 fibrinogen stroke type neurological empowerment diabetic non-diabetic acute stroke patients 62-nd Scientific Sessions American Diabetes Association San Francisco Diabetes ?

101

Population pharmacokinetic analysis of fexofenadine in Japanese pediatric patients.  

PubMed

A population pharmacokinetic analysis was conducted to characterize the pharmacokinetics of fexofenadine in Japanese pediatric patients (6 months through 16 years) with perennial allergic rhinitis or atopic dermatitis. The dataset was composed of 515 patients (including 109 adults), for a total of 1,080 concentration-time points. The analysis was performed with NONMEM using the SAEM method. Several structural models and residual error models were evaluated. The relationship between the individual estimates and the potential covariates was then investigated: demographic and pathophysiologic characteristics were tested as potential model covariates (forward selection method). The qualification of the model was performed using visual predictive check and bootstrap. A two-compartment disposition model with first-order absorption best fitted the data. The inter-individual variability was modeled through an exponential error model for all parameters (except for ka for which no inter-individual term could be estimated), while a proportional error model was used to model the residual variability. The final model included two covariates on elimination clearance and one on the intercompartmental clearance. CL/F was related to BSA and patient's age (expressed in months) Q/F was also related to BSA. Once the model was correctly qualified, exposure parameters such as Cmax and AUC? were computed and compared between each age sub-group and between Japanese and Caucasians patients. These comparisons did not reveal any major difference (less than 50 %) between subgroups. PMID:24633780

Martinez, Jean-Marie; Khier, Sonia; Morita, Shigemichi; Rauch, Clémence; Fabre, David

2014-04-01

102

Serum magnesium in hospital admitted diabetic patients.  

PubMed

Magnesium depletion has a negative impact on glucose homeostasis and insulin sensitivity in diabetic patients. Low plasma magnesium concentration is a highly specific indicator of poor magnesium status. This case control study was conducted in Mymensingh Medical College Hospital, Bangladesh, from May 2011 to April 2012. This study was done to assess the serum magnesium level in diabetic and non-diabetic patients and to find out the association between serum magnesium, blood glucose and duration of diabetes mellitus. Serum magnesium concentrations were determined in 50 diabetics and 50 age and sex matched non-diabetic patients or attendants for controls. Among the case and control group 32 were male and 18 were female. Mean age of control group was 54.42±2.33 and study group was 55.78±2.43 years. Duration of diabetes of case group in which 50% of patients have diabetes for up to 4 years, 18% of patients have diabetes for 5-9 years, 5% of patients have for 10-14 years and 2% of patients have diabetes for 15 years and above. Serum magnesium concentrations below the normal reference range for study group was 44% and control group was 6%. The mean serum magnesium level of study group was 0.70±0.01mmol/L and that of control group was 0.83±0.02mmol/L. So, the difference in serum magnesium level between two groups were statistically highly significant (p = 0.001). Correlation between FBS and SML of study group, which is negative (r = - 0.182). There is opposite relation among the characteristics as r is negative. And also correlation between 2HAFB and SML of study group, which is negative (r = - 0.06). There is opposite relation among the characteristics as r is negative. PMID:24584369

Azad, K M; Sutradhar, S R; Khan, N A; Haque, M F; Sumon, S M; Barman, T K; Islam, M Z; Haque, M R; Pandit, H; Ahmed, S

2014-01-01

103

Mucormycosis in a diabetic ketoacidosis patient  

PubMed Central

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

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

2013-01-01

104

Lipid control in patients with diabetes mellitus  

Microsoft Academic Search

Patients with diabetes mellitus are at increased risk of cardiovascular disease (CVD). Dyslipidemia, an important component of the insulin resistance syndrome and type 2 diabetes, is strongly related to CVD risk and is open to therapeutic intervention. Statins have proved to be safe, very-well tolerated, and highly effective in reducing the levels of LDL cholesterol and apolipoprotein B. Primary and

D. John Betteridge

2011-01-01

105

Effectiveness of LAGB on Obese Diabetic Patients  

Microsoft Academic Search

Background: Obesity, and therefore diabetes, is an ever growing problem in worldwide healthcare. As weight loss is critical in controlling blood sugar levels, more patients are turning to bariatric surgery after failing conventional weight loss methods. Gastric bypass, as the most commonly performed bariatric surgery, has been shown to be effective in glycemic control and even diabetes resolution. Laparoscopic adjustable

Kathryn M. Mayhew

2009-01-01

106

Endocrinological Characteristics of 25 Japanese Patients with CHARGE Syndrome  

PubMed Central

Abstract CHARGE syndrome is a congenital disorder caused by mutation of the chromodomain helicase DNA binding protein 7 (CHD7) gene and is characterized by multiple anomalies including ocular coloboma, heart defects, choanal atresia, retarded growth and development, genital and/or urological abnormalities, ear anomalies, and hearing loss. In the present study, 76% of subjects had some type of endocrine disorder: short stature (72%), hypogonadotropic hypogonadism (60%), hypothyroidism (16%), and combined hypopituitarism (8%). A mutation in CHD7 was found in 80% of subjects. Here, we report the phenotypic spectrum of 25 Japanese patients with CHARGE syndrome, including their endocrinological features.

Shoji, Yasuko; Ida, Shinobu; Etani, Yuri; Yamada, Hiroyuki; Kayatani, Futoshi; Suzuki, Yasuhiro; Kosaki, Kenjiro; Okamoto, Nobuhiko

2014-01-01

107

Endocrinological Characteristics of 25 Japanese Patients with CHARGE Syndrome.  

PubMed

CHARGE syndrome is a congenital disorder caused by mutation of the chromodomain helicase DNA binding protein 7 (CHD7) gene and is characterized by multiple anomalies including ocular coloboma, heart defects, choanal atresia, retarded growth and development, genital and/or urological abnormalities, ear anomalies, and hearing loss. In the present study, 76% of subjects had some type of endocrine disorder: short stature (72%), hypogonadotropic hypogonadism (60%), hypothyroidism (16%), and combined hypopituitarism (8%). A mutation in CHD7 was found in 80% of subjects. Here, we report the phenotypic spectrum of 25 Japanese patients with CHARGE syndrome, including their endocrinological features. PMID:24790386

Shoji, Yasuko; Ida, Shinobu; Etani, Yuri; Yamada, Hiroyuki; Kayatani, Futoshi; Suzuki, Yasuhiro; Kosaki, Kenjiro; Okamoto, Nobuhiko

2014-04-01

108

Carotid stenosis and peripheral artery disease in Japanese patients with coronary artery disease undergoing coronary artery bypass grafting.  

PubMed

The combination of a change in lifestyle toward Western habits and an aging society, has led to a steady increase in the incidence of atherosclerotic diseases in the Japanese population. Coronary artery disease (CAD), carotid stenosis (CS), and peripheral artery disease (PAD) are major manifestations of generalized atherosclerosis and increase the risk of cardiovascular events. However, the incidence of CS and PAD in Japanese patients with CAD is not well known, so the present study investigated this in 380 consecutive patients with CAD undergoing elective coronary aorta bypass grafting (CABG) at Kishiwada Tokushukai Hospital between October 1999 and October 2001. The coexistence of CS and PAD in all patients was preoperatively evaluated by duplex ultrasonography and the ankle - brachial index (ABI). The average age of the study population was 66.09.1 years (range, 42-87). The number of male patients was 293 (77.1%). The incidence of CS was 13.7% and 15.3% for PAD. Multivariate logistic regression analysis demonstrated that no particular traditional atherosclerotic risk factor, such as hypertension, hyperlipidemia, diabetes mellitus, and smoking, was able to predict either CS or PAD, but CS and PAD were independent predictors of each other. The results of the study suggest that CS and PAD were not only highly prevalent but also strongly associated with each other in this cohort of CAD patients. Accordingly, extracoronary atherosclerotic disease should be assessed in Japanese CAD patients. PMID:14639014

Kawarada, Osami; Yokoi, Yoshiaki; Morioka, Nobuyuki; Nakata, Shinji; Higashiue, Shinichi; Mori, Toshifumi; Iwahashi, Masahiro; Hatada, Atsutoshi

2003-12-01

109

Replication study for the association of TCF7L2 with susceptibility to type 2 diabetes in a Japanese population  

Microsoft Academic Search

Aims\\/hypothesis  The transcription factor 7-like 2 gene (TCF7L2) has been shown to be strongly associated with an increased risk of type 2 diabetes in white populations. To further investigate\\u000a the involvement of TCF7L2 in conferring susceptibility to type 2 diabetes, we examined the association of TCF7L2 polymorphisms with type 2 diabetes in a Japanese population.\\u000a \\u000a \\u000a \\u000a Subjects and methods  We analysed four SNPs

T. Hayashi; Y. Iwamoto; K. Kaku; H. Hirose; S. Maeda

2007-01-01

110

Dental implant treatment in diabetic patients.  

PubMed

The purpose of the present study was twofold: (1) to investigate how many diabetic patients and types of cases that are treated with dental implants in our clinic; and (2) assess the outcome of such treatment. Medical records from 782 patients were examined in patients treated by the Brĺnemark method for partial or total edentulism with implant supported bridges. From these records, 25 patients (3.2%) with diabetes before implant treatment (136 implants) were identified and further studied with respect to age, gender, type of diabetes, treated jaw, degree of edentulism, bone graft, implant survival, periimplant inflammation, bleeding on probing, and radiographic bone loss. Furthermore, the patients' opinion about the outcome of the treatment was registered. The implant success rate was 96.3% during the healing period and 94.1% 1 year after surgery. Of all 38 bridges, one was lost. Few complications occurred and all patients, except for one, were satisfied with the treatment. Today, diabetic patients are being treated successfully for all types of edentulism, including bone-grafting treatment. Diabetics that undergo dental implant treatment do not encounter a higher failure rate than the normal population, if the diabetics' plasma glucose level is normal or close to normal as assessed by personal interviews. PMID:12271564

Farzad, Payam; Andersson, Lars; Nyberg, Jan

2002-01-01

111

Performance Monitoring of Diabetic Patient Systems.  

National Technical Information Service (NTIS)

The minimum variance performance measure is applied to two diabetic patient models under simulated fault scenarios. The Bergman Model and the Automated Insulin Dosage Advisor (AIDA), are controlled in the Internal Model Control (IMC) framework to achieve ...

C. L. Owens, F. J. Doyle

2001-01-01

112

Bidirectional Screening of Tuberculosis Patients for Diabetes Mellitus and Diabetes Patients for Tuberculosis  

PubMed Central

To assess the feasibility and results of screening diabetes mellitus (DM) patients for tuberculosis (TB) and TB patients for DM within the routine health care setting. Prospective observational study carried out within the Diabetes Centre and Pulmonary Medicine Department from February 2012 to September 2012. The screening for active TB in DM and DM in TB patients is followed as per the guidelines of the Revised National Tuberculosis Control Programme and national programmes in India. Total of 307 patients diagnosed with TB during the study period. Among the TB patients 9.77% were smokers, 19.54% were known cases diabetes, and 15.96% were newly diagnosed cases of diabetes. Total of 4,118 diabetes patients were screened for TB in which 111 patients found to have TB. The strengths of this study are that we implemented screening within the routine health system. It is feasible to screen DM patients for TB resulting in high rates of TB detection.

Mahishale, Vinay K.; Hiremath, Murigendra B.

2013-01-01

113

Insulin use in elderly diabetic patients  

PubMed Central

The prevalence of type 2 diabetes is increasing among older adults as is their diabetes-related mortality rate. Studies suggest that tighter glucose control reduces complications in elderly patients. However, too low a glycosylated hemoglobin (HbA1c) value is associated with increased hypoglycemia. Moreover, the appropriateness of most clinical trial data and standards of care related to diabetes management in elderly patients is questionable given their heterogeneity. Having guidelines to safely achieve glycemic control in elderly patients is crucial. One of the biggest challenges in achieving tighter control is predicting when peak insulin action will occur. The clinician’s options have increased with new insulin analogs that physiologically match the insulin peaks of the normal glycemic state, enabling patients to achieve the tighter diabetes control in a potentially safer way. We discuss the function of insulin in managing diabetes and how the new insulin analogs modify that state. We offer some practical considerations for individualizing treatment for elderly patients with diabetes, including how to incorporate these agents into current regimens using several methods to help match carbohydrate intake with insulin requirements. Summarizing guidelines that focus on elderly patients hopefully will help reduce crises and complications in this growing segment of the population.

Ober, Scott K; Watts, Sharon; Lawrence, Renee H

2006-01-01

114

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

115

Lack of association between IL10 polymorphisms and sarcoidosis in Japanese patients  

PubMed Central

Purpose To investigate whether interleukin 10 (IL10) gene polymorphisms are associated with the development of sarcoidosis in Japanese patients. Methods Two hundred and eighty-eight Japanese sarcoidosis patients and 310 Japanese healthy controls were recruited. We genotyped 9 single-nucleotide polymorphisms in IL10 and assessed the allelic diversity between cases and controls. Results No significant differences in the frequency of IL10 alleles, genotypes, and haplotypes in the sarcoidosis cases compared to the controls were detected. Conclusions Our results suggest that IL10 polymorphisms are not significantly related to the pathogenesis of sarcoidosis in the Japanese population.

Meguro, Akira; Ota, Masao; Ishihara, Mami; Uemoto, Riyo; Ito, Haruyasu; Okada, Eiichi; Namba, Kenichi; Kitaichi, Nobuyoshi; Morimoto, Shin-ichiro; Kaburaki, Toshikatsu; Ando, Yasutaka; Takenaka, Shinobu; Yuasa, Takenosuke; Ohno, Shigeaki; Inoko, Hidetoshi; Mizuki, Nobuhisa

2012-01-01

116

Prognosis of Elderly Japanese Patients Aged >=80 Years Undergoing Hemodialysis  

PubMed Central

Although the number of elderly patients requiring dialysis has increased, data regarding the prognosis of elderly patients undergoing hemodialysis are limited. In the present study, prognosis in Japanese hemodialysis patients aged ?80 years was evaluated. From January 1988 to July 2013, 1144 consecutive patients with end-stage renal disease required renal replacement therapy at our institution; of these, 141 were aged ?80 years. These patients' charts were retrospectively reviewed for relevant clinical variables and survival time. The life expectancies table from the National Vital Statistics database was used, and prognostic factors were assessed by multivariate analysis. In total, 107 deaths (76%) were recorded during the study period. The median survival time and estimated life-shortening period in the patients were 2.6 years and ?5.3 years, respectively. Eastern Cooperative Oncology Group Performance Status and hemoglobin level were revealed as prognostic factors in the multivariate analysis. Estimates of prognosis and prognostic factors may provide useful information for physicians as well as elderly patients with end-stage kidney disease.

Hatakeyama, Shingo; Murasawa, Hiromi; Hamano, Itsuto; Kusaka, Ayumu; Oikawa, Masaaki; Noro, Daisuke; Hagiwara, Kazuhisa; Yoneyama, Takahiro; Hashimoto, Yasuhiro; Koie, Takuya; Saitoh, Hisao; Funyu, Tomihisa; Ohyama, Chikara

2013-01-01

117

Prognosis of elderly Japanese patients aged ?80 years undergoing hemodialysis.  

PubMed

Although the number of elderly patients requiring dialysis has increased, data regarding the prognosis of elderly patients undergoing hemodialysis are limited. In the present study, prognosis in Japanese hemodialysis patients aged ?80 years was evaluated. From January 1988 to July 2013, 1144 consecutive patients with end-stage renal disease required renal replacement therapy at our institution; of these, 141 were aged ?80 years. These patients' charts were retrospectively reviewed for relevant clinical variables and survival time. The life expectancies table from the National Vital Statistics database was used, and prognostic factors were assessed by multivariate analysis. In total, 107 deaths (76%) were recorded during the study period. The median survival time and estimated life-shortening period in the patients were 2.6 years and -5.3 years, respectively. Eastern Cooperative Oncology Group Performance Status and hemoglobin level were revealed as prognostic factors in the multivariate analysis. Estimates of prognosis and prognostic factors may provide useful information for physicians as well as elderly patients with end-stage kidney disease. PMID:24228012

Hatakeyama, Shingo; Murasawa, Hiromi; Hamano, Itsuto; Kusaka, Ayumu; Narita, Takuma; Oikawa, Masaaki; Noro, Daisuke; Hagiwara, Kazuhisa; Ishimura, Hirofumi; Yoneyama, Takahiro; Hashimoto, Yasuhiro; Koie, Takuya; Saitoh, Hisao; Funyu, Tomihisa; Ohyama, Chikara

2013-01-01

118

Detecting gene mutations in Japanese Alzheimer's patients by semiconductor sequencing.  

PubMed

Alzheimer's disease (AD) is the most common form of dementia. To date, several genes have been identified as the cause of AD, including PSEN1, PSEN2, and APP. The association between APOE and late-onset AD has also been reported. We here used a bench top next-generation sequencer, which uses an integrated semiconductor device, detects hydrogen ions, and operates at a high-speed using nonoptical technology. We examined 45 Japanese AD patients with positive family histories, and 29 sporadic patients with early onset (<60-year-old). Causative mutations were detected in 5 patients in the familial group (11%). Three patients had a known heterozygous missense mutation in the PSEN1 gene (p.H163R). Two patients from 1 family had a novel heterozygous missense mutation in the PSEN1 gene (p.F386L). In the early onset group, 1 patient carrying homozygous APOE?4 had a novel heterozygous missense mutation in the PSEN2 gene (p.T421M). Approximately 43% patients were APOE?4 positive in our study. This new sequencing technology is useful for detecting genetic variations in familial AD. PMID:24559647

Yagi, Ryoichi; Miyamoto, Ryosuke; Morino, Hiroyuki; Izumi, Yuishin; Kuramochi, Masahito; Kurashige, Takashi; Maruyama, Hirofumi; Mizuno, Noriyoshi; Kurihara, Hidemi; Kawakami, Hideshi

2014-07-01

119

Medicare Coverage for Patients With Diabetes  

PubMed Central

The prevalence of diabetes in the U.S. Medicare population is growing at an alarming rate. From 1980 to 2004, the number of people aged 65 or older with diagnosed diabetes increased from 2.3 million to 5.8 million. According to the Centers for Medicare and Medicaid (CMS), 32% of Medicare spending is attributed to the diabetes population. Since its inception, Medicare has expanded medical coverage of monitoring devices, screening tests and visits, educational efforts, and preventive medical services for its diabetic enrollees. However, oral antidiabetic agents and insulin were excluded from reimbursement. In 2003, Congress passed the Medicare Modernization Act that includes a drug benefit to be administered either through Medicare Advantage drug plans or privately sponsored prescription drug plans for implementation in January 2006. In this article we highlight key patient and drug plan characteristics and resources that providers may focus upon to assist their patients choose a coverage plan. Using a case example, we illustrate the variable financial impact the adoption of Medicare part D may have on beneficiaries with diabetes due to their economic status. We further discuss the potential consequences the legislation will have on diabetic patients enrolled in Medicare, their providers, prescribing strategies, and the diabetes market.

Ashkenazy, R; Abrahamson, MJ

2006-01-01

120

[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

121

Comparison of Mortality between Japanese Peritoneal Dialysis and Hemodialysis Patients: A 5-Year Multicenter Follow-Up Study  

PubMed Central

To examine the relationship between dialysis modality and prognosis in Japanese patients, we conducted a prospective multicenter observational study. We recruited 83 background-matched peritoneal dialysis (PD) and 83 hemodialysis (HD) patients (average age, 64.9 years; men, 53.6%; diabetic patients, 22.9%; median duration of dialysis, 48 months in all patients) and followed them for 5 years. During the follow-up period, 27 PD patients (16 cardiovascular and 11 non-cardiovascular deaths) and 27 HD patients died (14 cardiovascular and 13 non-cardiovascular deaths). There were 8 PD patients switched to HD, and 6 PD patients received renal transplantation. Kaplan-Meier analysis revealed that the crude survival rate was not significantly different at the end of 5 years (PD 67.5% versus 67.5%, log-rank P = 0.719). The difference in cardiovascular and non-cardiovascular mortalities between PD and HD was not statistically significant. Multivariate Cox analysis showed that the independent predictors for death were age and serum albumin levels, but not the dialysis modality. This study showed that the overall mortality was not significantly different between PD and HD patients, which suggests that dialysis modality might not be an independent factor for survival in Japanese patients.

Suzuki, Kazuko; Konta, Tsuneo; Ichikawa, Kazunobu; Ikeda, Ami; Niino, Hiroki; Hoshikawa, Masato; Takahashi, Toshiyuki; Abiko, Hiroshi; Ito, Minoru; Masakane, Ikuto; Matsunaga, Tomohito; Kudo, Kosuke; Sato, Hiroko; Degawa, Noriyuki; Kubota, Isao

2012-01-01

122

JAMA Patient Page: Starting Insulin Treatment for Diabetes  

MedlinePLUS

... rights reserved. JAMA PATIENT PAGE| Diabetes Care Starting Insulin Treatment for Diabetes In people with type 2 diabetes, the body does not use insulin properly and, over time, cannot make enough insulin. ...

123

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

Microsoft Academic Search

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

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

124

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

PubMed Central

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

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

2012-01-01

125

Prescribing Exercise for Patients with Diabetes  

Microsoft Academic Search

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

Dalynn T. Badenhop

126

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

PubMed

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

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

2013-04-01

127

Magnesium utilization survey in selected patients with diabetes  

Microsoft Academic Search

Patients with diabetes mellitus were surveyed to determine magnesium utilization and supplementation patterns and the extent to which these patterns correlate with American Diabetes Association (ADA) consensus panel recommendations. Participating ADA member physicians were asked to enroll five or more patients with insulin-dependent diabetes mellitus (IDDM, or type I diabetes) or non—insulin-dependent diabetes mellitus (NIDDM, or type II diabetes) who

Alan J. Garber

1996-01-01

128

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

129

A crossover study of rosuvastatin and pitavastatin in patients with type 2 diabetes  

Microsoft Academic Search

Introduction  The effects of a low dose of rosuvastatin (ROS) and pitavastatin (PIT) on lipid profiles and inflammation markers were assessed\\u000a in subjects with type 2 diabetes mellitus.\\u000a \\u000a \\u000a \\u000a \\u000a Methods  A total of 90 Japanese type 2 diabetes patients with hyperlipidemia (low-density lipoprotein cholesterol [LDL-C] ?140 mg\\/dL)\\u000a were enrolled in this study. They were randomly assigned to four groups with open-label treatment with

Kazunori Yanagi; Tsuyoshi Monden; Shiori Ikeda; Mihoko Matsumura; Kikuo Kasai

2011-01-01

130

Gait problems in diabetic neuropathic patients  

Microsoft Academic Search

Objective: To examine whether a reduced peripheral sensibility caused by diabetic neuropathy increases the attentional demands necessary for controlling and regulating gait.Design: Nonrandomized control trial.Setting: University motor performance laboratory.Subjects: Twelve diabetic patients with peripheral neuropathy and 7 control subjects, all volunteers.Interventions: All subjects first performed a control seated reaction time task. For the walking task, auditory stimuli were randomly presented

Richard Courtemanche; Normand Teasdale; Pierre Boucher; Michelle Fleury; Yves Lajoie; Chantal Bard

1996-01-01

131

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

132

Technology and the diabetic patient  

Microsoft Academic Search

Diabetes is conventionally treated by one or two daily subcutaneous injections of insulin. Although controlling the acute\\u000a symptoms of the disease, this regimen is unable to achieve and maintain long term metabolic near normalisation. It is this\\u000a chronic metabolic disorder which is probably the cause of the several serious tissue complications affecting the eyes kidney's\\u000a nerves and blood vessels of

J. C. Pickup; D. Rothwell

1984-01-01

133

Alterations in Integrin Expression in Peripheral Blood Cells of Type II Diabetic Patients with Diabetic Retinopathy  

Microsoft Academic Search

Background: To determine the expression of 2 integrins in the peripheral blood of type II diabetic patients with diabetic retinopathy compared with healthy age-matched subjects and to examine whether patients with more severe retinopathy express higher levels of 2 integrins in the peripheral blood. Methods: This study was carried out with 3 groups of subjects: (1) type II diabetic patients

Ruey-Ching Shyu; Shou-Teng Shang; Jy-Been Liang; Cheng-Jong Chang; Jiann-Torng Chen

2004-01-01

134

Both glimepiride and high-dose metformin are important for sustained glucose lowering in Japanese type 2 diabetes patients on glimepiride-sitagliptin-metformin therapy: subanalysis of a single-center, open-label, randomized study.  

PubMed

Abstract Background: In a previous single-center, open-label randomized 3-month study of triple oral antidiabetes drug (OAD) therapy, we investigated factors affecting the glycemic control afforded by sitagliptin, high-dose metformin, and low-dose glimepiride. Patients were prospectively assigned to either Group 1 (50% reduction in metformin) or Group 2 (discontinuation of glimepiride) and compared. The results showed that the glycated hemoglobin (HbA1c) levels of patients in Group 2 deteriorated more than those in Group 1, whereas HbA1c levels were maintained in some patients in both groups. Materials and Methods: To determine the factors associated with maintenance of HbA1c under this triple OAD regimen, data from the prospective study were further analyzed. Results: In both Groups 1 and 2, the baseline HbA1c level was higher in patients with HbA1c ?7.0% after 3 months of treatment than those with an HbA1c level of <7.0%. A generalized linear model revealed that high-dose metformin was associated with a deterioration of HbA1c levels in Group 2. Conclusions: Together, the findings indicate that glimepiride and high-dose metformin are important for sustained glycemic control in triple OAD therapy with sitagliptin, metformin, and sulfonylurea. PMID:24528246

Arai, Keiko; Maeda, Hajime; Shirabe, Shin-Ichiro; Yamamoto, Ritsuko; Kumakura, Atsushi; Yamauchi, Mikio; Hirao, Tetsuyuki; Hirao, Setsuko; Hirao, Koichi

2014-07-01

135

Criterion and Construct Validity of the CogState Schizophrenia Battery in Japanese Patients with Schizophrenia  

PubMed Central

Background The CogState Schizophrenia Battery (CSB), a computerized cognitive battery, covers all the same cognitive domains as the Measurement and Treatment Research to Improve Cognition in Schizophrenia (MATRICS) Consensus Cognitive Battery but is briefer to conduct. The aim of the present study was to evaluate the criterion and construct validity of the Japanese language version of the CSB (CSB-J) in Japanese patients with schizophrenia. Methodology/Principal Findings Forty Japanese patients with schizophrenia and 40 Japanese healthy controls with matching age, gender, and premorbid intelligence quotient were enrolled. The CSB-J and the Brief Assessment of Cognition in Schizophrenia, Japanese-language version (BACS-J) were performed once. The structure of the CSB-J was also evaluated by a factor analysis. Similar to the BACS-J, the CSB-J was sensitive to cognitive impairment in Japanese patients with schizophrenia. Furthermore, there was a significant positive correlation between the CSB-J composite score and the BACS-J composite score. A factor analysis showed a three-factor model consisting of memory, speed, and social cognition factors. Conclusions/Significance This study suggests that the CSB-J is a useful and rapid automatically administered computerized battery for assessing broad cognitive domains in Japanese patients with schizophrenia.

Yoshida, Taisuke; Eguchi, Satoshi; Lin, Crystal; Yoshida, Sumiko; Ishikawa, Masanori; Higuchi, Yuko; Seo, Tomonori; Ueoka, Yoshinori; Tomotake, Masahito; Kaneda, Yasuhiro; Darby, David; Maruff, Paul; Iyo, Masaomi; Kasai, Kiyoto; Higuchi, Teruhiko; Sumiyoshi, Tomiki; Ohmori, Tetsuro; Takahashi, Kiyohisa; Hashimoto, Kenji

2011-01-01

136

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; Lefčbvre, C

2014-08-01

137

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

138

Treatment of Patients With Diabetic Gastroparesis  

PubMed Central

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

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

2010-01-01

139

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.

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

2014-01-01

140

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

141

Continuous Glucose Monitoring For Patients with Diabetes  

PubMed Central

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

2011-01-01

142

Relatively Small Birth Size and Accelerated Early Growth of Japanese Type 1 Diabetic Children with Younger Onset  

PubMed Central

We investigated the changes of anthropometrical parameters in Japanese children with type 1 diabetes (T1DM) from birth to the onset of diabetes. One-hundred ninety-nine children (79 males and 120 females) diagnosed between 0–16 yr of age during the period between 1990 and 2003 were the subjects of this study. The subjects were categorized into 3 groups according to onset age (0–5 yr; n=74, 5–10 yr; n=61, 10–16 yr; n=64). At birth, the younger onset (<5) group had significant lower height and weight standard deviation score (SDS) compared with the older onset (5?) group (p=0.01 and p=0.02, respectively). When the changes in height SDS from birth to onset were compared, height SDS at onset were significantly greater than those at birth in the younger onset group (p<0.001). However, no significant difference was observed in the other groups (p=0.95 and p=0.39). These results suggest that relatively small size at birth and accelerated growth after birth until the onset of diabetes may be a characteristic of Japanese T1DM children with younger onset and may further support the hypothesis that emphasizes accelerated growth and subsequent insulin resistance as a cause of earlier onset of T1DM.

Kotani, Yumiko; Yokota, Ichiro; Kagami, Shoji; Amemiya, Shin; Matsuura, Nobuo; Sasaki, Nozomu

2006-01-01

143

Kidney transplant in diabetic patients: modalities, indications and results  

Microsoft Academic Search

BACKGROUND: Diabetes is a disease of increasing worldwide prevalence and is the main cause of chronic renal failure. Type 1 diabetic patients with chronic renal failure have the following therapy options: kidney transplant from a living donor, pancreas after kidney transplant, simultaneous pancreas-kidney transplant, or awaiting a deceased donor kidney transplant. For type 2 diabetic patients, only kidney transplant from

Érika B Rangel; Joăo R de Sá; Cláudio S Melaragno; Adriano M Gonzalez; Marcelo M Linhares; Alcides Salzedas; José O Medina-Pestana

2009-01-01

144

Treatment of dyslipidemia in patients with type 2 diabetes  

Microsoft Academic Search

Type 2 diabetes is associated with significant cardiovascular morbidity and mortality. Although low-density lipoprotein cholesterol levels may be normal in patients with type 2 diabetes, insulin resistance drives a number of changes in lipid metabolism and lipoprotein composition that render low-density lipoprotein cholesterol and other lipoproteins more pathogenic than species found in patients without type 2 diabetes. Dyslipidemia, which affects

Krishnaswami Vijayaraghavan

2010-01-01

145

Detection of variants in the mitochondrial glycerophosphate dehydrogenase gene in Japanese NIDDM patients  

Microsoft Academic Search

Summary   Mitochondrial FAD-linked glycerophosphate dehydrogenase (mGPDH) is thought to be an important factor for glucose sensing\\u000a in pancreatic beta cells. To evaluate the significance of the mGPDH gene in the development of non-insulin-dependent diabetes\\u000a mellitus (NIDDM), we set up primers and conditions for polymerase chain reaction (PCR) amplification of the coding exons and\\u000a flanking regions. Screening of 100 Japanese NIDDM

Y. Takeuchi; A. Matsutani; Y. Oka

1997-01-01

146

Medial arterial calcification in the feet of diabetic patients and matched non-diabetic control subjects  

Microsoft Academic Search

Summary  The prevalence and distribution of medial arterial calcification was assessed in the feet of four subject groups; 54 neuropathic diabetic patients with previous foot ulceration (U), median age 60.5 (50.5–67 interquartile range) years, duration of diabetes 19.5 (9.9–29.9) years; 40 neuropathic diabetic patients without a foot ulcer history (N), age 68 (62–73) years, duration of diabetes 14.0 (8.0–28.0) years; 43

M. J. Young; J. E. Adams; G. F. Anderson; A. J. M. Boulton; P. R. Cavanagh

1993-01-01

147

Partnering with diabetes educators to improve patient outcomes  

PubMed Central

Diabetes is a chronic, progressive disease that affects millions worldwide. The paradigm of diabetes management has shifted to focus on empowering the person with diabetes to manage the disease successfully and to improve their quality of life. Diabetes self-management education is a collaborative process through which people with diabetes gain the knowledge and skills needed to modify their behavior and to self-manage successfully the disease and its related conditions. Diabetes educators are health care professionals who apply in-depth knowledge and skills in the biological and social sciences, communication, counseling, and pedagogy to enable patients to manage daily and future challenges. Diabetes educators are integral in providing individualized education and promoting behavior change, using a framework of seven self-care behaviors known as the AADE7 Self-Care Behaviors™, developed by the American Association of Diabetes Educators. The iterative process of promoting behavior change includes assessment, goal setting, planning, implementation, evaluation, and documentation. Diabetes educators work as part of the patient’s health care team to engage with the patient in informed, shared decision making. The increasing prevalence of diabetes and the growing focus on its prevention require strategies for providing people with knowledge, skills, and strategies they need and can use. The diabetes educator is the logical facilitator of change. Access to diabetes education is critically important; incorporating diabetes educators into more and varied practice settings will serve to improve clinical and quality of life outcomes for persons with diabetes.

Burke, Sandra D; Sherr, Dawn; Lipman, Ruth D

2014-01-01

148

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

National Technical Information Service (NTIS)

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

2004-01-01

149

Increased serum resistin levels in patients with type 2 diabetes are not linked with markers of insulin resistance and adiposity.  

PubMed

The role of resistin in human biology remains uncertain. We measured serum resistin levels in Japanese patients with (n=111) and without (n=98) type 2 diabetes mellitus and investigated the significance of this hormone in the pathophysiology of diabetes. The levels of serum adiponectin and leptin were also measured. Resistin levels were increased significantly in patients with type 2 diabetes compared with non-diabetic subjects (24.7+/-2.6 vs. 15.0+/-1.2 ng/ml, p=0.0013). However, there was no correlation in either patient group between serum resistin levels and markers of insulin resistance, obesity or hyperlipidaemia. These results were in direct contrast to the data of leptin or adiponectin, both of which were closely related to these clinical markers of diabetes. Multivariate regression analysis on the combined data of the two groups demonstrated that the presence of diabetes and HDL cholesterol levels were significant predictors of serum resistin levels (diabetes: beta=0.159, p=0.035; HDL: beta=-0.172, p=0.039). No correlation was observed between C-reactive protein and resistin adjusted for BMI. Taken together, these findings demonstrate that serum resistin levels are increased in patients with type 2 diabetes, but this increase is not linked to markers of insulin resistance or adiposity. Further studies are necessary to elucidate the significance of serum resistin concentration in human pathophysiology. PMID:15944845

Hasegawa, G; Ohta, M; Ichida, Y; Obayashi, H; Shigeta, M; Yamasaki, M; Fukui, M; Yoshikawa, T; Nakamura, N

2005-06-01

150

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

151

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

PubMed Central

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

2013-01-01

152

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

153

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.

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

2011-01-01

154

Nonmydriatic retinal color photography in young Indian diabetic patients.  

PubMed

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

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

1993-05-01

155

Dipstick urinalysis for diabetes screening in TB patients  

PubMed Central

Introduction Diabetes knowledge among TB patients can contribute to improved TB treatment outcomes, but lack of diabetes diagnosis awareness is a limitation in developing countries. Given its low cost, the sensitivity of urine glucose dipsticks for diabetes screening in TB patients was assessed. Methods Glycosuria was assessed in 90 newly diagnosed TB patients (38 with diabetes) in south Texas, USA (n = 20) and northeast Mexico (n = 70) during January 2009–December 2010. Results Glycosuria was detected in 65% of the diabetic patients with chronic hyperglycemia (positive predictive value 91%, negative predictive value 84%). Conclusion We propose that TB clinics with limited budgets where portable glucometers may not be available conduct universal screening for diabetes with urine dipsticks. This could be followed by blood glucose or HbA1c testing in the subset of patients requiring confirmation or higher sensitivity assessment, to improve the comanagement of TB and diabetes.

Restrepo, Blanca I.; Pino, Paula A.; Zarate, Izelda; Mora-Guzman, Francisco

2013-01-01

156

Frequency of odontogenic periradicular lesions in diabetic patients  

PubMed Central

Background: Diabetic patients are more prone to oral infections and periradicular lesions due to changes in their immune system and qualitative and quantitative changes in normal flora of their mouth. The aim of this study was to evaluate the frequency of periradicular lesions in diabetic patients in Babol, North of Iran. Methods: From October 2011 to March 2012, 135 diabetic patients who referred to the Iranian Diabetes Society - Babol Branch and Endocrinology Clinic of Babol University of Medical Sciences were studied. The demographic features as well as the duration of the diagnosis of diabetes (> 48 months was called long term and < 48 months short term) is the quality of control of their diabetes. For all the patients, panoramic and periapical radiography were performed for the presence of any radicular radiolucent lesions. Vitality test has been done for the recorded teeth except for the root treated ones and periodontal involvement necrotic teeth. The data were collected and analyzed. Results: Periradicular lesions were seen on 90.37% of the patients. The frequency of periradicular lesions in long term patients was 85 (94.4%) and in short term was 37 (82.2%) (p=0.023). The mean of teeth with periradicular lesions in long and short term diabetic patients was 2.63±2.23 and 2.11±1.79, respectively (p=0.174). Conclusion: The results show that the frequency of periradicular lesions in diabetic patients is higher in long-term diabetic patients than the short-term diabetic patients.

Mesgarani, Abbas; Haghanifar, Sina; Eshkevari, Narges; Ehsani, Maryam; Khafri, Soraya; Nafarzade, Shima; Damankesh, Zahra

2014-01-01

157

[Treatment of diabetes mellitus in dialysis patients].  

PubMed

Diabetes mellitus is a key cause of chronic kidney disease (CKD) in developed contries. Disorders of glucose metabolism regulation in CKD are explained by insulin resistance, decreased insulin clearance, weak hormonal response to hypoglycemia. These disturbances appear in inhibition of glomerular filtration rate under 60 ml/min. Hemodialysis treatment raises the risk of hypoglycemic conditions due to glucose elimination from blood circulation during the sessions and improvement of sensitivity to insulin. Use of glucose-containing solutions for dialysis, step-by-step achievement of normoglycemia, monitoring of blood glucose during dialysis sessions are recommended for reducing the risk of hypoglycemic conditions in DM patients on dialysis. Insulin is the most common preparation in the treatment with use of hemodialysis in diabetics. Tiasolidindions (pioglitason, rosiglitason) and analogues of dipeptidilpeptidase of type IV (sitagliptin, saxagliptin) can be administered in type 2 diabetics without insulin insufficiency. As solutions for peritoneal dialysis contain glucose, such dialysis may entail such metabolic complications as fat accumulation, metabolic syndrome. Intraperitoneal introduction of insulin allows avoiding hyperinsulinemia and in some cases to decrease the risk of hypoglycemia. Side effects of intraperitoneal insulin administration are significant absorption of insulin on the surface of the systems for intraperitoneal dialysis, higher rate of peritonitis, subcapsular hepatic steatosis. In the absence of controlled studies the mode of insulin administration in patients on peritoneal dialysis should be chosen individually basing on potential risk and benefit for the patient and experience of the dialysis center. It should be remembered that adequate sugar-reducing treatment is necessary for prevention of complications and prolongation of survival of diabetics on dialysis. PMID:22416450

Bondar', I A; Klimontov, V V

2011-01-01

158

Benefits of coronary revascularisation in diabetic and non-diabetic patients with ischaemic cardiomyopathy: Role of myocardial viability  

Microsoft Academic Search

Background: Diabetes mellitus in patients with coronary artery disease is associated with poor outcome. In this study, the relation between myocardial viability, diabetes, coronary revascularisation and outcome was evaluated. Methods: 129 patients (31 diabetic, 98 non-diabetic) with ischaemic cardiomyopathy underwent dobutamine stress echocardiography to assess myocardial viability. Patients with 4 viable segments were defined as viable and patients with <4

Vittoria Rizzello; Don Poldermans; Elena Biagini; Arend F. L. Schinkel; Eric Boersma; Abdou Elhendy; Fabiola B. Sozzi; Alexander Maat; Jos R. T. C. Roelandt; Jeroen J. Bax

2006-01-01

159

Trastuzumab emtansine in the treatment of HER2-positive metastatic breast cancer in Japanese patients  

PubMed Central

Anti-HER2 agents, such as trastuzumab, lapatinib, trastuzumab emtansine (T-DM1), and pertuzumab, are standard agents in the treatment of breast cancer overexpressing the human epidermal growth factor receptor 2 (HER2). Trastuzumab is the first approved HER2-targeted agent. Subsequent developments include agents with different mechanisms. In this paper, we review the results of clinical trials of T-DM1, a new anti-HER2 agent, with a focus on Japanese patients with breast cancer. On the basis of results from a Phase I study (JO22591), the maximum tolerated dose was determined to be 3.6 mg/kg every 3 weeks for both Japanese and western patients. In a Phase II study (JO22997), the overall response rate was 38.4% (90% confidence interval 28.8–48.6). T-DM1 was well tolerated in Japanese patients; however, the incidence of grade 3 or 4 thrombocytopenia was higher than that observed in earlier western studies, but was not associated with clinically important symptoms. Pharmacokinetic parameters for T-DM1 and its metabolites were consistent with those reported previously from a Phase I or II study in non-Japanese patients, and the data obtained showed no suggestion of ethnic differences. Several Phase III studies of T-DM1 are ongoing throughout the world, including in Japanese patients with breast cancer.

Sawaki, Masataka

2014-01-01

160

Recurrent multifocal diabetic myonecrosis: a cause of severe extremity pain in a diabetic patient  

PubMed Central

We detail the unusual occurrence of successive episodes of diabetic myonecrosis in both lower and upper limbs in a young woman with diabetic end organ dysfunction. We highlight the importance of recognising this as a differential diagnosis for acute limb pain in diabetic patients and advocate conservative measures for successful treatment and return to function.

Welck, MJ; Balaji, V; Jennings, R; Goodier, WD

2013-01-01

161

Automatic Exudates Detection on Thai Diabetic Retinopathy Patients' Retinal Images  

Microsoft Academic Search

Diabetic retinopathy is a complication of diabetes that is caused by changes in the blood vessels of the retina. The symptom can blur or distort the patient's vision and are mainly cause of blindness. Exudates are one of the primary signs of diabetic retinopathy. Detection of exudates by ophthalmologists normally required pupil dilation using chemical solution which takes time and

Akara Sopharak; Bunyarit Uyyanonvara

2006-01-01

162

Food Recommendation System Using Clustering Analysis for Diabetic Patients  

Microsoft Academic Search

Food and nutrition are a key to have good health. They are important for everyone to maintain a healthy diet especially for diabetic patients who have several limitations. Nutrition therapy is a major solution to prevent, manage and control diabetes by managing the nutrition based on the belief that food provides vital medicine and maintains a good health. Typically, diabetic

Maiyaporn Phanich; P. Pholkul; S. Phimoltares

2010-01-01

163

Psychological Adjustment and Neuropsychological Performance in Diabetic Patients.  

ERIC Educational Resources Information Center

Compared diabetic (N=39) with nondiabetic chronic illness patients (N=20) and healthy controls (N=24). The chronic illness and the diabetic groups had significant elevations on the Hypochondriasis, Depression, and Hysteria scales of the Feschingbauer Abbreviated MMPI. For diabetics, results demonstrated a negligible effect of poor adjustment on…

Skenazy, Judy A.; Bigler, Erin D.

1985-01-01

164

Impact of advances in diabetes care on dental treatment of the diabetic patient.  

PubMed

In medicine and dentistry, studies are published periodically that have a potentially wide-ranging impact on patient health and management. One such study is the Diabetes Control and Complications Trial (DCCT), which offers new hope for millions of individuals with diabetes and has begun to significantly alter medical management of these patients. Advances in the medical treatment of diabetes require a heightened awareness by dental practitioners of the various treatment regimens of their patients with diabetes, especially because of potential complications associated with diabetes care. Intensive medical treatment with oral agents and exogenous insulin injection promises to decrease the long-term risks of major complications of diabetes, but these treatments increase the risk of medical emergencies, especially hypoglycemia. This article reviews the findings of the DCCT, diabetes treatment regimens that might be encountered in a dental practice, and potential alterations to dental treatment protocols. PMID:9533351

Mealey, B L

1998-01-01

165

Serum uric acid and risk for development of hypertension and impaired fasting glucose or Type II diabetes in Japanese male office workers  

Microsoft Academic Search

We examined the association of serum uric acid (SUA) with development of hypertension (blood pressure = 140\\/90 mmHg and\\/or medication for hypertension) and impaired fasting glucose (IFG) (a fasting plasma glucose level 6.1–6.9 mmol\\/l) or Type II (non-insulin-dependent) diabetes (a fasting plasma glucose level = 7.0 mmol\\/l and\\/or medication for diabetes) over a 6-year follow-up among 2310 Japanese male office

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

2003-01-01

166

Evaluation of New Japanese Diagnostic Criteria for Disseminated Intravascular Coagulation in Critically Ill Patients  

Microsoft Academic Search

New Japanese diagnostic criteria were prepared for disseminated intravascular coagulation (DIC) in critically ill patients and their usefulness was compared with the criteria of the International Society of Thrombosis and Haemostasis (ISTH) and those of the Japan Ministry of Health and Welfare (JMHW). In a retrospective study of patients with platelet counts of less than 150 × 103\\/mL, 52 cases

Satoshi Gando; Hideo Wada; Hidesaku Asakura; Toshiaki Iba; Yutaka Eguchi; Kohji Okamoto; Yasuhiro Ohtomo; Kazuo Kawasugi; Shin Koga; Kazuhide Koseki; Hajime Tsuji; Toshihiko Mayumi; Atsuo Murata; Masao Nakagawa; Shigeatu Endo

2005-01-01

167

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.

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

168

Volume Control in Diabetic and Nondiabetic Peritoneal Dialysis Patients  

Microsoft Academic Search

Diabetic patients especially the elderly have higher mortality on peritoneal dialysis treatment as compared to nondiabetic\\u000a patients. As fluid overload is an important contributor for the high dropout rate in peritoneal dialysis therapy, the present\\u000a study tried to compare the fluid status in diabetic and non-diabetic peritoneal dialysis patients and to investigate the effect\\u000a of salt and water restriction on

Hong-bing Gan; Meng-hua Chen; Bengt Lindholm; Tao Wang

2005-01-01

169

Molecular characterization of galactokinase deficiency in Japanese patients  

Microsoft Academic Search

Galactokinase (GALK) deficiency is an autosomal recessive disorder, which causes cataract formation in children not maintained\\u000a on a lactose-free diet. We characterized the human GALK gene by screening a Japanese genomic DNA phage library, and found that several nucleotides in the 5?-untranslated region\\u000a and introns 1, 2, and 5 in our GALK genomic analysis differed from published data. A 20-bp

Minoru Asada; Yoshiyuki Okano; Takuji Imamura; Itsujin Suyama; Yutaka Hase; Gen Isshiki

1999-01-01

170

Neurohormonal profile of patients with heart failure and diabetes  

PubMed Central

Background. Neurohormonal activation is generally recognised to play an important role in the pathophysiology, prognosis and treatment of chronic heart failure (HF). While the number of patients with diabetes increases, little if anything is known about neurohormonal activation in HF patients with diabetes. Methods. The study population consisted of 371 patients with advanced HF who were enrolled in a multicentre survival trial. Ten different plasma neurohormones were measured (noradrenaline, adrenaline, dopamine, aldosterone, renin, endothelin, atrial natriuretic peptide [ANP], N-terminal (pro)ANP, brain natriuretic peptide [BNP] and N-terminal (pro)BNP. Comparisons were made between patients with diabetes (n=81) and those without (n=290). Results. At baseline, the two groups were comparable regarding age (mean 68 years), left ventricular ejection fraction (23%), severity and aetiology of HF, while body weight was higher in those with diabetes (77.4 vs. 74.2 kg, p=0.04). Most plasma neurohormones were similar between groups, but patients with diabetes had higher values of BNP (94 vs. 47 pmol/l, p=0.03), while a similar trend was observed for N-terminal (pro)BNP (750 vs. 554 pmol/l, p=0.10). During almost five years of follow-up, 51/81 patients with diabetes died (63%), as compared with 144 of 290 non-diabetic patients (50%) who died (p=0.046). Natriuretic peptides and noradrenaline were the most powerful predictors of mortality in both diabetic and non-diabetic HF patients. Conclusion. HF patients with diabetes have higher (N-terminal (pro)) BNP levels than non-diabetic patients, while other neurohormones are generally similar. Natriuretic peptides are also good prognostic markers in diabetic HF patients. (Neth Heart J 2010;18:190–6.20428417) PMID:20428417

van der Horst, I.C.C.; de Boer, R.A.; Hillege, H.L.; Boomsma, F.; Voors, A.A.; van Veldhuisen, D.J.

2010-01-01

171

Characterization of the calcaneal fat pad in diabetic and non-diabetic patients using magnetic resonance imaging  

Microsoft Academic Search

It is well known that diabetic patients have a high incidence of foot ulceration. The purpose of this study was to determine whether magnetic resonance (MR) imaging can detect changes in the composition of the calcaneal fat pad in diabetic feet. MR data were collected in vitro from amputated specimens (eight from diabetic patients and eight from non-diabetic patients) as

Patricia F Kao; Brian L Davis; Peter A Hardy

1999-01-01

172

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.

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

1990-01-01

173

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

PubMed Central

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

Rodbard, Helena W.

2008-01-01

174

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

175

[Relation between oral health conditions and diabetes mellitus in a japanese population from Bauru-SP-Brazil].  

PubMed

The aim of this cross-sectional study was to determine the oral health condition in a Japanese population aged 40 to 79, in Bauru, Brazil as well as its association with the occurrence of diabetes mellitus and impaired glucose tolerance. It involved 530 subjects, from both sexes. All persons of first generation (Issei) and a random sample of one third of second generation (Nisei) were submitted to a home interview. A clinical examination, oral glucose tolerance test, and examination of oral health conditions took place at the Hospital of Rehabilitation of Craniofacial Anomaly - USP. The data were processed by Epi-Info program and 22.9% of the individuals presented diabetes mellitus (group I), 15.1% impaired glucose tolerance (group II), and 61.9% were considered normoglycemics (group III). The percentage of edentulous subjects was 45.9% for the total sample, and values of 58.4%, 46.7%, and 41.2% were observed for groups I, II, and III, respectively. Among the edentulous subjects, no one showed necessity of making a total prothesis. These data indicate that tooth loss showed significant association with the occurrence of diabetes mellitus, but there was no significant association with glucose intolerance. PMID:21409334

Tomita, Nilce Emy; Chinellato, Luiz Eduardo Montenegro; Franco, Laércio Joel; Iunes, Magid; Freitas, José Alberto de Souza; Lopes, Eymar Sampaio

2003-03-01

176

Anti-Tribbles Homolog 2 Autoantibodies in Japanese Patients with Narcolepsy  

PubMed Central

Study Objectives: Narcolepsy is a sleep disorder characterized by excessive daytime sleepiness and cataplexy. The association with human leukocyte antigen (HLA)-DQB1*0602 and T-cell receptor alpha locus suggests that autoimmunity plays a role in narcolepsy. A recent study reported an increased prevalence of autoantibodies against Tribbles homolog 2 (TRIB2) in patients with narcolepsy. To replicate this finding, we examined anti-TRIB2 autoantibodies in Japanese patients with narcolepsy. Design: We examined anti-TRIB2 autoantibodies against a full-length [35S]-labeled TRIB2 antigen in Japanese patients with narcolepsy-cataplexy (n = 88), narcolepsy without cataplexy (n = 18), and idiopathic hypersomnia with long sleep time (n = 11). The results were compared to Japanese healthy controls (n = 87). Thirty-seven healthy control subjects were positive for HLA-DRB1*1501-DQB1*0602. We also examined autoantibodies against another Tribbles homolog, TRIB3, as an experimental control. Measurements and Results: Autoantibodies against TRIB2 were found in 26.1% of patients with narcolepsy-cataplexy, a significantly higher prevalence than the 2.3% in healthy controls. We found that anti-TRIB3 autoantibodies were rare in patients with narcolepsy and showed no association with anti-TRIB2 indices. No significant correlation was found between anti-TRIB2 positivity and clinical information. Conclusions: We confirmed the higher prevalence and specificity of anti-TRIB2 autoantibodies in Japanese patients with narcolepsy-cataplexy. This suggests a subgroup within narcolepsy-cataplexy might be affected by an anti-TRIB2 autoantibody-mediated autoimmune mechanism. Citation: Toyoda H; Tanaka S; Miyagawa T; Honda Y; Tokunaga K; Honda M. Anti-Tribbles homolog 2 autoantibodies in Japanese patients with narcolepsy. SLEEP 2010;33(7):875-878.

Toyoda, Hiromi; Tanaka, Susumu; Miyagawa, Taku; Honda, Yutaka; Tokunaga, Katsushi; Honda, Makoto

2010-01-01

177

Thyroid gland diseases in adult patients with diabetes mellitus.  

PubMed

This review concerns the relation between most frequent thyroid gland diseases and diabetes mellitus in adult patients. Special attention is paid to autoimmune thyroiditis, Graves' disease, thyroid autoimmunity in pregnant diabetic women, and iodine metabolism. We focused on mechanisms leading to coexistence of both endocrine disorders, and on distinctions in the prevalence, diagnosis, clinical course and treatment of thyroid diseases in diabetic patients. The prevalence of thyroid diseases in diabetic patients is 2-3 times higher than in nondiabetic subjects; it raises with age, and is strongly influenced by female gender and autoimmune diabetes. Clinical relevance of thyroid diseases, especially in diabetic patients, significantly increases if it is associated with deteriorated function, which always cause a number problems with metabolic compensation of diabetes. Most serious consequences are increased frequency of hypoglycaemia in hypothyroidism and development of potentially life-threatening ketoacidosis in thyrotoxicosis. In spite of that, little attention is paid to the diagnosis of thyroid diseases in diabetics, as they are diagnosed in only about half of the patients. At the end, we provide recommendations for the thyroid disease screening and diagnosis in patients with diabetes mellitus based on our experience. PMID:16319810

Vondra, K; Vrbikova, J; Dvorakova, K

2005-12-01

178

Identification of Autoantibody-Negative Autoimmune Type 2 Diabetic Patients  

PubMed Central

OBJECTIVE Islet autoimmunity has long been recognized in the pathogenesis of type 1 diabetes and is becoming increasingly acknowledged as a component in the pathogenesis of type 2 diabetes. Islet reactive T cells and autoantibodies have been demonstrated in type 1 diabetes, whereas islet autoimmunity in type 2 diabetes has been limited to islet autoantibodies. In this study, we investigated whether islet reactive T cells might also be present in type 2 diabetic patients and how islet reactive T cells correlate with ?-cell function. RESEARCH DESIGN AND METHODS Adult phenotypic type 2 diabetic patients (n = 36) were screened for islet reactive T-cell responses using cellular immunoblotting and five islet autoantibodies (islet cell antibody, GADA, insulin autoantibody, insulinoma-associated protein-2 autoantibody, and zinc transporter autoantibody). RESULTS We identified four subgroups of adult phenotypic type 2 diabetic patients based on their immunological status (Ab?T?, Ab+T?, Ab?T+, and Ab+T+). The Ab?T+ type 2 diabetic patients demonstrated T-cell responses similar to those of the Ab+T+ type 2 diabetic patients. Data were adjusted for BMI, insulin resistance, and duration of diabetes. Significant differences (P < 0.02) were observed among groups for fasting and glucagon-stimulated C-peptide responses. T-cell responses to islet proteins were also demonstrated to fluctuate less than autoantibody responses. CONCLUSIONS We have identified a group of adult autoimmune phenotypic type 2 diabetic patients who are Ab?T+ and thus would not be detected using autoantibody testing alone. We conclude that islet autoimmunity may be more prevalent in adult phenotypic type 2 diabetic patients than previously estimated.

Brooks-Worrell, Barbara M.; Reichow, Jessica L.; Goel, Amit; Ismail, Heba; Palmer, Jerry P.

2011-01-01

179

Difficulties of Diabetic Patients in Learning about Their Illness.  

ERIC Educational Resources Information Center

Examines the difficulties experienced by diabetic patients in learning about their illness. Diabetic people (N=138) were questioned by means of a closed answer questionnaire. Results reveal that patients easily acquired manual skills, yet numerous learning difficulties were associated with the skills required to solve problems and make decisions,…

Bonnet, Caroline; Gagnayre, Remi; d'Ivernois, Jean Francois

2001-01-01

180

Anaemia and kidney dysfunction in Caribbean Type 2 diabetic patients  

Microsoft Academic Search

BACKGROUND: Anaemia has been shown in previous studies to be a risk factor for cardiovascular disease in diabetic patients with chronic kidney disorder. This study was aimed to assess the prevalence of anaemia and kidney dysfunction in Caribbean type 2 diabetic patients that have been previously shown to have a high prevalence of the metabolic syndrome. METHODS: 155 type 2

Chidum E Ezenwaka; Altheia Jones-LeCointe; Emeka Nwagbara; Dawn Seales; Fidelis Okali

2008-01-01

181

Insulin Infusion Improves Neutrophil Function in Diabetic Cardiac Surgery Patients  

Microsoft Academic Search

Diabetic patients are at increased risk of wound infec- tion after major surgery, but the effect of perioperative glucose control on postoperative wound infection rates after surgery is uncertain. We tested the effect of an in- sulin infusion on perioperative neutrophil function in diabetic patients scheduled for coronary artery bypass surgery. Participants (n 5 26) were randomly allocated to receive

Athos J. Rassias; Charles A. S. Marrin; Janice Arruda; Patricia Kate Whalen; Michael Beach; Mark P. Yeager

1999-01-01

182

Regular physical exercise in patients with type II diabetes mellitus  

Microsoft Academic Search

It is widely accepted that regular physical exercise helps diabetic patients control blood glucose, reduce cardiovascular risk factors, and prevent other related complications. In spite of the undoubted benefits of regular physical exercise, diabetic patients with chronic complications should be aware of potential hazards of practicing exercise. To avoid some harmful consequences of acute exercise, it is necessary to adopt

C. Nakhanakhup; P. Moungmee; H. J. Appell; J. A. Duarte

2006-01-01

183

Identification of patients at risk for diabetic foot  

Microsoft Academic Search

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

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

2001-01-01

184

Stress echocardiography for risk assessment of diabetic patients  

PubMed Central

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

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

2004-01-01

185

Barriers to diabetes management: Patient and provider factors  

Microsoft Academic Search

Despite significant advances in diagnosis and treatment, the persistence of inadequate metabolic control continues. Poor glycemic control may be reflected by both the failure of diabetes self-management by patients as well as inadequate intervention strategies by clinicians. The purpose of this systematic review is to summarize existing knowledge regarding various barriers of diabetes management from the perspectives of both patients

Soohyun Nam; Catherine Chesla; Nancy A. Stotts; Lisa Kroon; Susan L. Janson

2011-01-01

186

Prognostic value of exercise echocardiography in diabetic patients  

Microsoft Academic Search

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

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

2009-01-01

187

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

188

The serum vaspin levels are reduced in Japanese chronic hemodialysis patients  

PubMed Central

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

2012-01-01

189

Patient Beliefs and Sense of Control Among Spanish-Speaking Patients with Diabetes in Northeast Colorado  

Microsoft Academic Search

Purpose Latinos have higher diabetes prevalence and complication rates with lower use of self-management compared to other populations.\\u000a This study evaluated perceived barriers to diabetes control among Spanish-speaking only patients in rural Colorado. Methods Thirty-five Spanish-speaking patients with diabetes were randomly sampled and interviewed about their attitudes and beliefs\\u000a concerning diabetes, self-management activities, and the care they received. Results Patients

Loretta V. Sullivan; Paul Hicks; Gilda Salazar; C. Kelet Robinson

2010-01-01

190

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.

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

191

Association of the TNFa13 microsatellite with systemic sclerosis in Japanese patients  

PubMed Central

OBJECTIVES—To elucidate the contribution of microsatellite polymorphisms of TNFa and TNFb alleles to the pathogenesis of systemic sclerosis (SSc) by comparing the allele distribution among populations with different HLA susceptibility genes in SSc.?METHODS—TNFa and TNFb microsatellite polymorphisms were determined by PCR in 54 Japanese and 50 German SSc patients and in normal controls. HLA-DR genotyping was carried out by PCR-SSCP.?RESULTS—The frequency of TNFa13 was significantly increased in Japanese SSc (p=0.011, OR=8.53, 95% confidence intervals (95%CI)=2.46, 32.51, and p<1.0 × 10E-5, OR=10.35, 95%CI=4.88, 22.09) and SSc with antitopoisomerase I antibody (a-Scl-70) (p=0.021, OR=33.25, 95%CI=3.39, 800.76, and p<1.0 × 10E-5, OR=24.42, 95%CI=8.40, 72.83), compared with the German patient group and German controls, respectively. This increase was not only attributable to a higher prevalence of TNFa13 in Japanese compared with Germans (p=0.005, OR=3.55, 95%CI=1.60, 7.85) but was also caused by an increase in SSc, especially in the a-Scl-70 positive patients (p=0.028, OR=6.88, 95%CI=1.16, 22.60) compared with Japanese controls. TNFa13 was positively in linkage disequilibrium with HLA-DRB1*1502 (LD=0.053, t=2.69). Association analysis indicated that both TNFa13 and DRB1*1502 might have comparable probabilities of being susceptibility factors for SSc with a-Scl-70 in Japanese. Prevalences of TNFa6 and 13 were significantly increased and prevalences of TNFa2, and 7 were significantly decreased in Japanese controls as compared with German controls.?CONCLUSION—TNFa13 is a genetic marker for SSc with a-Scl-70 in Japanese patients. Various differences in the prevalences of TNFa alleles between Japanese and German controls were established.??

Takeuchi, F.; Nabeta, H.; Fussel, M.; Conrad, K.; Frank, K.

2000-01-01

192

Glycemic control in diabetic dialysis patients and the burnt-out diabetes phenomenon.  

PubMed

Diabetes mellitus (DM) is the most common cause of end-stage kidney disease and a major risk of morbidity and mortality. It is not clear whether medical management of DM has any significant beneficial effect on clinical outcomes at the end-stage of diabetic nephropathy with full-blown micro- and macro-angiopathic complications. Both loss of kidney function and dialysis treatment interfere with glucose homeostasis and confound glycemic control. Given the unique nature of uremic milieu and dialysis therapy related alterations, there have been some debates about reliance on the conventional measures of glycemic control, in particular the clinical relevance of hemoglobin A1c and its recommended target range of <7 % in diabetic dialysis patients. Moreover, a so-called burnt-out diabetes phenomenon has been described, in that many diabetic dialysis patients experience frequent hypoglycemic episodes prompting cessation of their anti-diabetic therapies transiently or even permanently. By reviewing the recent literature we argue that the use of A1c for management of diabetic dialysis patients should be encouraged if appropriate target ranges specific for these patients (e.g. 6 to 8 %) are used. We also argue that "burnt-out diabetes" is a true biologic phenomenon and highly prevalent in dialysis patients with established history and end-stage diabetic nephropathy and explore the role of protein-energy wasting to this end. Similarly, the J- or U-shaped associations between A1c or blood glucose concentrations and mortality are likely biologically plausible phenomena that should be taken into consideration in the management of diabetic dialysis patients to avoid hypoglycemia and its fatal consequences in diabetic dialysis patients. PMID:22638938

Park, Jongha; Lertdumrongluk, Paungpaga; Molnar, Miklos Z; Kovesdy, Csaba P; Kalantar-Zadeh, Kamyar

2012-08-01

193

Ocular Disease, Knowledge, and Technology Applications in Patients with Diabetes  

PubMed Central

An estimated 25.8 million children and adults in the United States, approximately 8.3% of the population, have diabetes. Diabetes prevalence varies by race and ethnicity. African Americans have the highest prevalence (12.6%), followed closely by Hispanics (11.8%), Asian Americans (8.4%), and Whites (7.1%). The purpose of this article is to discuss the ocular complications of diabetes, the cultural and racial differences in diabetes knowledge, and the role of telemedicine as a means to reach the undeserved who are at risk of complications. Information on the pathophysiology of ocular disease in patients with diabetes and the role of telemedicine in diabetes care was derived from a literature review. National Institutes of Health (NIH) on-line resources were queried to present data on the racial and cultural understandings of diabetes and diabetes-related complications. The microvascular ocular complications of diabetes are discussed for retinopathy, cataracts, glaucoma and ocular surface disease. Racial and cultural differences in knowledge of recommended self-care practices are presented. These differences in part, may explain health disparities and the increased risk of diabetes and its complications in rural minority communities. Finally, advances in telemedicine technology are discussed that show improvements in metabolic control and cardiovascular risk in adults with type 2 diabetes. Improving provider and patient understanding of diabetes complications may improve management and self care practices that are important for diabetes control. Telemedicine may improve access to diabetes specialists and may improve self-management education and diabetes control particularly in rural and underserved communities.

Threatt, Jennifer; Williamson, Jennifer Faye; Huynh, Kyle; Davis, Richard M.

2013-01-01

194

Ocular disease, knowledge and technology applications in patients with diabetes.  

PubMed

An estimated 25.8 million children and adults in the United States, approximately 8.3% of the population, have diabetes. Diabetes prevalence varies by race and ethnicity. African Americans have the highest prevalence (12.6%), followed closely by Hispanics (11.8%), Asian Americans (8.4%) and whites (7.1%). The purpose of this article was to discuss the ocular complications of diabetes, the cultural and racial differences in diabetes knowledge and the role of telemedicine as a means to reach the undeserved who are at risk of complications. Information on the pathophysiology of ocular disease in patients with diabetes and the role of telemedicine in diabetes care was derived from a literature review. National Institutes of Health online resources were queried to present data on the racial and cultural understandings of diabetes and diabetes-related complications. The microvascular ocular complications of diabetes are discussed for retinopathy, cataracts, glaucoma and ocular surface disease. Racial and cultural differences in knowledge of recommended self-care practices are presented. These differences, in part, may explain health disparities and the increased risk of diabetes and its complications in rural minority communities. Finally, advances in telemedicine technology are discussed that show improvements in metabolic control and cardiovascular risk in adults with type 2 diabetes. Improving provider and patient understanding of diabetes complications may improve management and self-care practices that are important for diabetes control. Telemedicine may improve access to diabetes specialists and may improve self-management education and diabetes control particularly in rural and underserved communities. PMID:23531956

Threatt, Jennifer; Williamson, Jennifer F; Huynh, Kyle; Davis, Richard M

2013-04-01

195

Diabetes Attitude Scale: Validation in Type-2 Diabetes Patients in Multiple Centers in China  

PubMed Central

Objective The aim of the paper is to report the development and psychometric testing of Diabetes Attitude Scale. Method A prospective study was performed. The cultural equivalency and content validity of the Diabetes Attitude Scale were determined by panels of endocrinologists, physiologists, nurses and dieticians. An accurate and usable translation was obtained for each of five subscales examining attitudes on need for special training, the seriousness of type-2 diabetes, the need for controlling the condition, its psychosocial impact and the degree of autonomy given to patients in decision making. The validation was derived from 5961 patients with type-2 diabetes, recruited from 50 centers in 29 provinces throughout China between March 1st and September 30th, 2010. Results The modified Diabetes Attitude Scale showed an acceptable level of internal consistency. The strength of the inter-correlations among the domains of five subscales suggests that the instrument measures related but separate domains of patients' attitudes toward diabetes. Moreover, the test-retest intraclass correlation coefficients were high enough to support the stability of the Chinese version of the third version of the scale. Conclusions The psychometric properties of the Chinese version of Diabetes Attitude Scale demonstrated satisfactory validity and reliability and appeared to effectively evaluate attitudes toward diabetes in patients with type-2 diabetes.

Lou, Qingqing; Chen, Yufeng; Guo, Xiaohui; Yuan, Li; Chen, Tao; Wang, Chun; Shen, Li; Sun, Zilin; Zhao, Fang; Dai, Xia; Huang, Jin; Yang, Huiying

2014-01-01

196

Intraocular matrix metalloproteinase 2 and 9 in patients with diabetes mellitus with and without diabetic retinopathy  

PubMed Central

Introduction We aimed to investigate activities of metalloproteinases 2 (MMP-2) and MMP-9 in aqueous humour of patients with diabetes mellitus with various stages of diabetic retinopathy. Material and methods We included 36 samples of aqueous humour of patients suffering from diabetes mellitus, undergoing routine cataract surgery. Seven of them suffered from proliferative diabetic retinopathy (PDR), 3 had diabetic maculopathy and the remaining 26 had background or minimal background retinopathy only. Metalloproteinases 2 and MMP-9 activities in aqueous humour were measured by gelatin zymography combined with the densitometric imaging system. Total protein content in aqueous humour samples was also assessed. Results Metalloproteinases 2 activities were present in almost all samples of aqueous humour (32 of 36) and were 2.6-fold higher in patients who suffered from diabetic ocular complications (p < 0.0001). Activities of MMP-2 correlated well with the duration of the disease (correlation = 0.37, p = 0.03) and tended to correlate with total protein levels in aqueous humour (correlation = 0.43, p = 0.06). Metalloproteinases 9 activities were observed only in 2 of 7 patients with proliferative diabetic disease and the enzyme was absent from aqueous humour samples of patients without proliferative retinopathy. Conclusions Increased activities of MMP-2 in aqueous humour of patients with PDR may be related to the disease process and support the hypothesis that MMP-2 may be of particular importance in diabetic retinal neovascularization. MMP-9 may be activated at a certain disease stage only.

Naduk-Kik, Julia; Hrabec, Zbigniew; Gos, Roman; Hrabec, Elzbieta

2010-01-01

197

Disordered eating behaviors in type 1 diabetic patients  

PubMed Central

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

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

2011-01-01

198

Ambulatory blood pressure in microalbuminuric type 1 diabetic patients  

Microsoft Academic Search

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

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

1992-01-01

199

JAMA Patient Page: Weight and Diabetes  

MedlinePLUS

... known as “adult-onset” diabetes, usually develops in adulthood but can also occur in overweight children. Family history of diabetes and excess weight, especially weight carried around the middle, are strong risk factors for developing type 2 ...

200

Daytime sleepiness in Japanese patients with multiple system atrophy: prevalence and determinants  

PubMed Central

Background The recent SLEEMSA study that evaluated excessive daytime sleepiness (EDS) in Caucasian patients with multiple system atrophy (MSA) demonstrated that EDS was more frequent in patients (28%) than in healthy subjects (2%). However, the prevalence and determinants of EDS in other ethnic populations have not been reported to date. Methods We performed a single-hospital prospective study on patients with probable MSA. To ascertain the prevalence and determinants of EDS in Japanese MSA patients, we assessed the patients’ degree of daytime sleepiness by using the Japanese version of the Epworth Sleepiness Scale (ESS). In addition, we investigated the effects of sleep-disordered breathing (SDB) and abnormal periodic leg movements in sleep (PLMS), which were measured by polysomnography, on the patients’ ESS scores. Results A total of 25 patients with probable MSA (21 patients with cerebellar MSA and 4 patients with parkinsonian MSA) were included in this study. All patients underwent standard polysomnography. The mean ESS score was 6.2 ± 0.9, and EDS was identified in 24% of the patients. SDB and abnormal PLMS were identified in 24 (96%) and 11 (44%) patients, respectively. The prevalences of EDS in patients with SDB and abnormal PLMS were 25% and 18%, respectively. No correlations were observed between ESS scores and the parameters of SDB or abnormal PLMS. Conclusions The frequency of EDS in Japanese patients with MSA was similar to that in Caucasian MSA patients. SDB and abnormal PLMS were frequently observed in MSA patients, although the severities of these factors were not correlated with EDS. Further investigations using objective sleep tests need to be performed.

2012-01-01

201

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

PubMed

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

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

2008-12-01

202

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.

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

2007-01-01

203

[Nursing diagnoses for diabetic patients using insulin].  

PubMed

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

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

2008-01-01

204

Kidney transplant in diabetic patients: modalities, indications and results  

PubMed Central

Background Diabetes is a disease of increasing worldwide prevalence and is the main cause of chronic renal failure. Type 1 diabetic patients with chronic renal failure have the following therapy options: kidney transplant from a living donor, pancreas after kidney transplant, simultaneous pancreas-kidney transplant, or awaiting a deceased donor kidney transplant. For type 2 diabetic patients, only kidney transplant from deceased or living donors are recommended. Patient survival after kidney transplant has been improving for all age ranges in comparison to the dialysis therapy. The main causes of mortality after transplant are cardiovascular and cerebrovascular events, infections and neoplasias. Five-year patient survival for type 2 diabetic patients is lower than the non-diabetics' because they are older and have higher body mass index on the occasion of the transplant and both pre- and posttransplant cardiovascular diseases prevalences. The increased postransplant cardiovascular mortality in these patients is attributed to the presence of well-known risk factors, such as insulin resistance, higher triglycerides values, lower HDL-cholesterol values, abnormalities in fibrinolysis and coagulation and endothelial dysfunction. In type 1 diabetic patients, simultaneous pancreas-kidney transplant is associated with lower prevalence of vascular diseases, including acute myocardial infarction, stroke and amputation in comparison to isolated kidney transplant and dialysis therapy. Conclusion Type 1 and 2 diabetic patients present higher survival rates after transplant in comparison to the dialysis therapy, although the prevalence of cardiovascular events and infectious complications remain higher than in the general population.

Rangel, Erika B; de Sa, Joao R; Melaragno, Claudio S; Gonzalez, Adriano M; Linhares, Marcelo M; Salzedas, Alcides; Medina-Pestana, Jose O

2009-01-01

205

Genetic alterations in the JAG1 gene in Japanese patients with Alagille syndrome  

Microsoft Academic Search

Alagille syndrome (AGS) is a congenital anomaly syndrome that affects liver, heart, pulmonary artery, eyes, face, and skeleton.\\u000a Recently, mutations of the JAG1 gene, which encodes a ligand for the Notch receptor, have been identified in AGS patients. We investigated the JAG1 gene for genetic alterations in eight Japanese AGS patients, using fluorescence in situ hybridization (FISH), single strand\\u000a conformation

Yoshihiro Onouchi; Hiroki Kurahashi; Hitoshi Tajiri; Shinobu Ida; Shintaro Okada; Yusuke Nakamura; Yusuke Nakamura

1999-01-01

206

Fibroblasts as Target and Effector Cells in Japanese Patients with Sarcoidosis  

Microsoft Academic Search

.   Fibroblasts play a crucial role in progressive lung fibrosis, acting not only as target cells but also as effector cells.\\u000a To clarify these functions in sarcoidosis, lung fibroblasts from Japanese sarcoid patients were studied for their proliferative\\u000a capacity and cytokine productivity. Fibroblasts were cultured from transbronchial lung biopsy specimens from seven patients\\u000a with sarcoidosis. As a comparison, fibroblasts from

R. Tamura; A. Sato; K. Chida; H. Suganuma

1998-01-01

207

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

208

Abdominal Pathology in Patients With Diabetes Ketoacidosis.  

PubMed

INTRODUCTION: The objective is to describe the incidence and nature of significant abdominal pathologies in patients with diabetes ketoacidosis (DKA) and abdominal pain. METHODS: Retrospective chart review (N = 86) of patients with DKA from January 1, 2005, to January 31, 2010, was performed. Data included demographics, comorbidities, compliance, chief complaints and physical findings, blood count, metabolic profile, lactic acid, glycosylated hemoglobin (HbA1C), amylase, lipase, anion gap, arterial gases, imaging and final diagnosis. Continuous variables were described as mean ± standard deviation and compared with the Student's t test. Categorical variables were expressed as percentages (%) and compared with the Mantel-Haenszel ? test. Univariate analysis was conducted among patients with and without significant abdominal pain and also with and without significant abdominal pathology. Two lipase strata were created at 400 U. Multivariate model to identify limits (confidence interval) of the estimated risk imposed by the predictor found significant in univariate analysis. A P value of ?0.05 was considered significant. Stat View 5.0 (SAS Institute, Cary, NC) was used for the statistical analysis. RESULTS: In patients with abdominal pain, 17% had significant abdominal pathology mainly acute pancreatitis (AP). Serum amylase and lipase level were found to be an indicator of significant underlying pathology (both P values ?0.001). The logistic model created showed that patients with lipase level ?400 U have a 7% increased risk of having AP with confidence interval of 0.01 to 0.6. CONCLUSIONS: Patients with DKA and abdominal pain with lipase >400 U have an increased risk of significant underlying abdominal pathology (AP). PMID:22270401

Pant, Nicole; Kadaria, Dipen; Murillo, Luis C; Yataco, Jose C; Headley, Arthur S; Freire, Amado X

2012-01-20

209

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

PubMed Central

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

Tayek, Chandler J; Tayek, John A

2012-01-01

210

Comparison of the pharmacokinetics of S-1, an oral anticancer agent, in Western and Japanese patients  

PubMed Central

Objective S-1 is an oral anticancer agent combining tegafur (FT), a prodrug of 5-fluorouracil (5-FU), with potassium oxonate (oteracil) and gimeracil (CDHP) respectively to mitigate gastrointestinal toxicity and increase the half-life of 5-FU. This article presents a population pharmacokinetic analysis of these four compounds in Western cancer patients. The second objective was to compare the pharmacokinetics of S-1 in Western and Japanese patients. Methods A single dose (25–45mg/m2) of S-1 was administered to 60 patients. In each patient, 6 concentrations of FT, 5-FU, oteracil and CDHP were measured over 24hr. Using NONMEM, oteracil and CDHP were analysed separately, and the individual estimates of CDHP parameters were included in the joint analysis of FT and 5-FU. We used validation techniques to assess differences between the two populations, and finally we compared the exposures in Western and Japanese patients using simulations. Results A compartmental model describing the PK of the 4 compounds was developed. The influence of CDHP on the elimination of 5-FU was well described by an enzymatic inhibition model. The model provided a good fit for all compounds. The pharmacokinetics for 5-FU and oteracil were similar between Western and Japanese patients, but apparent differences in exposure to 5-FU resulted from different total doses due to different body sizes.

Comets, Emmanuelle; Ikeda, Kazumasa; Hoff, Paulo; Fumoleau, Pierre; Wanders, Jantien; Tanigawara, Yusuke

2003-01-01

211

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

PubMed

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

Tamamaki, Kinko; Nishio, Hisahide

2013-01-01

212

Prognostic Significance of Pre-treatment Neutrophil: Lymphocyte Ratio in Japanese Patients with Breast Cancer.  

PubMed

Background: The neutrophil:lymphocyte ratio (NLR) has been reported to reflect systemic inflammation and to have independent prognostic value for patients with various cancers. In this study, we analyzed the association between NLR and clinicopathological factors and verified the significance of NLR as a prognostic factor for Japanese patients with breast cancer. Patients and Methods: A total of 167 Japanese female patients with stage I-III breast cancer were retrospectively recruited into this study. Associations with clinicopathological factors and NLR were assessed, and disease-free survival and breast cancer-specific survival were estimated. Results: In multivariate analysis, lymph node metastases and NLR were significantly associated with disease-free survival and breast cancer-specific survival. NLR was significantly higher in patients with lower body-mass index. Conclusion: Preoperative NLR may be an independent prognostic factor for survival in Japanese patients with breast cancer. Reduction of body mass index has been implicated in NLR elevation, particularly in postmenopausal women. PMID:24982408

Nakano, Kiichiroh; Hosoda, Mitsuchika; Yamamoto, Mitsugu; Yamashita, Hiroko

2014-07-01

213

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

Microsoft Academic Search

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

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

2011-01-01

214

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

PubMed

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

Rodbard, Helena W

2008-01-01

215

Predictive properties of plasma amino Acid profile for cardiovascular disease in patients with type 2 diabetes.  

PubMed

Prevention of cardiovascular disease (CVD) is an important therapeutic object of diabetes care. This study assessed whether an index based on plasma free amino acid (PFAA) profiles could predict the onset of CVD in diabetic patients. The baseline concentrations of 31 PFAAs were measured with high-performance liquid chromatography-electrospray ionization-mass spectrometry in 385 Japanese patients with type 2 diabetes registered in 2001 for our prospective observational follow-up study. During 10 years of follow-up, 63 patients developed cardiovascular composite endpoints (myocardial infarction, angina pectoris, worsening of heart failure and stroke). Using the PFAA profiles and clinical information, an index (CVD-AI) consisting of six amino acids to predict the onset of any endpoints was retrospectively constructed. CVD-AI levels were significantly higher in patients who did than did not develop CVD. The area under the receiver-operator characteristic curve of CVD-AI (0.72 [95% confidence interval (CI): 0.64-0.79]) showed equal or slightly better discriminatory capacity than urinary albumin excretion rate (0.69 [95% CI: 0.62-0.77]) on predicting endpoints. A multivariate Cox proportional hazards regression analysis showed that the high level of CVD-AI was identified as an independent risk factor for CVD (adjusted hazard ratio: 2.86 [95% CI: 1.57-5.19]). This predictive effect of CVD-AI was observed even in patients with normoalbuminuria, as well as those with albuminuria. In conclusion, these results suggest that CVD-AI based on PFAA profiles is useful for identifying diabetic patients at risk for CVD regardless of the degree of albuminuria, or for improving the discriminative capability by combining it with albuminuria. PMID:24971671

Kume, Shinji; Araki, Shin-Ichi; Ono, Nobukazu; Shinhara, Atsuko; Muramatsu, Takahiko; Araki, Hisazumi; Isshiki, Keiji; Nakamura, Kazuki; Miyano, Hiroshi; Koya, Daisuke; Haneda, Masakazu; Ugi, Satoshi; Kawai, Hiromichi; Kashiwagi, Atsunori; Uzu, Takashi; Maegawa, Hiroshi

2014-01-01

216

Predictive Properties of Plasma Amino Acid Profile for Cardiovascular Disease in Patients with Type 2 Diabetes  

PubMed Central

Prevention of cardiovascular disease (CVD) is an important therapeutic object of diabetes care. This study assessed whether an index based on plasma free amino acid (PFAA) profiles could predict the onset of CVD in diabetic patients. The baseline concentrations of 31 PFAAs were measured with high-performance liquid chromatography-electrospray ionization-mass spectrometry in 385 Japanese patients with type 2 diabetes registered in 2001 for our prospective observational follow-up study. During 10 years of follow-up, 63 patients developed cardiovascular composite endpoints (myocardial infarction, angina pectoris, worsening of heart failure and stroke). Using the PFAA profiles and clinical information, an index (CVD-AI) consisting of six amino acids to predict the onset of any endpoints was retrospectively constructed. CVD-AI levels were significantly higher in patients who did than did not develop CVD. The area under the receiver-operator characteristic curve of CVD-AI (0.72 [95% confidence interval (CI): 0.64–0.79]) showed equal or slightly better discriminatory capacity than urinary albumin excretion rate (0.69 [95% CI: 0.62–0.77]) on predicting endpoints. A multivariate Cox proportional hazards regression analysis showed that the high level of CVD-AI was identified as an independent risk factor for CVD (adjusted hazard ratio: 2.86 [95% CI: 1.57–5.19]). This predictive effect of CVD-AI was observed even in patients with normoalbuminuria, as well as those with albuminuria. In conclusion, these results suggest that CVD-AI based on PFAA profiles is useful for identifying diabetic patients at risk for CVD regardless of the degree of albuminuria, or for improving the discriminative capability by combining it with albuminuria.

Kume, Shinji; Araki, Shin-ichi; Ono, Nobukazu; Shinhara, Atsuko; Muramatsu, Takahiko; Araki, Hisazumi; Isshiki, Keiji; Nakamura, Kazuki; Miyano, Hiroshi; Koya, Daisuke; Haneda, Masakazu; Ugi, Satoshi; Kawai, Hiromichi; Kashiwagi, Atsunori; Uzu, Takashi; Maegawa, Hiroshi

2014-01-01

217

Long-term beneficial effect of ACE inhibition on diabetic nephropathy in normotensive type 1 diabetic patients  

Microsoft Academic Search

Long-term beneficial effect of ACE inhibition on diabetic nephropathy in normotensive type 1 diabetic patients.BackgroundThe purpose of this study was to assess whether long-term (8 years) inhibition of angiotensin-converting enzyme (ACE) protects kidney function in normotensive type 1 diabetic patients with diabetic nephropathy.MethodsWe performed an open randomized follow-up study of normotensive type 1 diabetics with nephropathy either treated (N =

Hans-Henrik Parving; Eva Hommel; Berit Ruud Jensen; Henrik Post Hansen

2001-01-01

218

Correlation between Microalbuminuria and Hypertension in Type 2 Diabetic Patients  

PubMed Central

Background: Hypertension is commonly found in patients with Diabetic Kidney Disease (DKD). Microalbuminuria is the first clinical sign of involvement of kidneys in patients with type 2 diabetes. Uncontrolled hypertension induces a higher risk of cardiovascular events, including death, increasing proteinuria and progression to kidney disease. Objectives: To determine the correlation between microalbuminuria and hypertension and their association with other risk factors in type 2 diabetic patients. Methods: One hundred and thirteen type 2 diabetic patients attending the diabetic clinic of Shaikh Zayed Postgraduate Medical Institute, Lahore, Pakistan were screened for microalbuminuria and raised blood pressure. The study was conducted from November 2012 to June 2013. Results: Patients were divided into two groups. Group 1, those with normoalbuminuria (n=63) and Group 2, those having microalbuminuria (n=50). Group 2 patients showed higher blood pressure values as compared to Group 1. The results were statistically significant and showed poor glycemic control as a contributing risk factor. Conclusion: The study concluded that there is high frequency of hypertension among type 2 diabetics but still much higher among those having microalbuminuria. So, early recognition of renal dysfunction through detection of microalbuminuria and to start treatment without any delay will confer future protection from end stage renal disease as well as hypertension and its complications in type 2 diabetic patients.

Ali, Alia; Taj, Azeem; Amin, Muhammad Joher; Iqbal, Farrukh; Iqbal, Zafar

2014-01-01

219

[Experience with chronic hemodialysis in diabetic patients with kidney failure].  

PubMed

Between 1978 and 1992, 534 patients--including 35 (25 IDDM and 10 NIDDM) diabetics--were accepted to chronic hemodialysis (HD) at our Dialysis Center. The 1-year cumulative survival rate (CSR) was significantly lower in diabetic vs. non-diabetic group (66 +/- 8% vs. 78 +/- 2%), p < 0.05). At the onset of diabetes the mean age of IDDM patients vs. NIDDM patients was 18.2 +/- 2.7 years vs. 51.3 +/- 3.1 years, respectively. At the beginning of HD treatment the mean age of IDDM patients vs. NIDDM patients was 38 +/- 2.4 years vs. 58.3 +/- 2.6 years. In IDDM group until the start of HD treatment the mean duration of diabetes was 20 +/- 1.3 years and it did not depend on the quality of preuraemic metabolic control (p = 0.825); mean duration of diabetes until their death was 22.5 +/- 1.3 years. Mean age of IDDM and NIDDM patients at their death was 38.8 +/- 3 years and 60.5 +/- 3.7 years. Average duration of HD treatment was 16 +/- 2.5 months in IDDM group and 21.5 +/- 5.8 months in NIDDM group. Major causes of death were cardiovascular complications of diabetes (39%) and infections (33%). We found no difference in CSR related to gender, age, type of diabetes, quality of metabolic control during the HD treatment, but CSR was significantly higher in patients with good metabolic control from the onset of diabetes (1-year CSR of adequately vs. poorly controlled diabetics: 80% vs. 62%, p < 0.05).(ABSTRACT TRUNCATED AT 250 WORDS) PMID:8532324

Brázda, E; Makó, J; Jansen, J

1995-12-10

220

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. (PsycINFO Database Record (c) 2014 APA, all rights reserved). PMID:24219020

Shirotsuki, Kentaro; Kodama, Yoshio; Nomura, Shinobu

2014-05-01

221

A keratin K10 gene mutation in a Japanese patient with epidermolytic hyperkeratosis.  

PubMed

Epidermolytic hyperkeratosis (EHK), or bullous congenital ichthyosiform erythroderma, is characterized by generalized erythroderma, ichthyosiform skin and blistering, and is caused by an aberration of the keratin intermediate filaments. In this study, we examined keratin K10 and 1 gene mutations in a Japanese EHK patient who had severe ichthyosiform erythroderma at birth and developed subsequent blistering. The patient had a G to A transition at codon 156 of the keratin K10 gene, which resulted in an arginine (Arg)-->histidine (His) substitution in the helix initiation peptide of the highly-conserved 1A domain in keratin K10. This is the first mutation report of a Japanese patient with EHK, although the position and mode of the mutation identified here did not differ from those in reported Western cases. PMID:9184002

Nomura, K; Meng, X; Umeki, K; Tamai, K; Sawamura, D; Hashimoto, I; Kikuchi, T

1997-03-01

222

Familial Mediterranean fever in three Japanese patients, and a comparison of the frequency of MEFV gene mutations in Japanese and Mediterranean populations  

Microsoft Academic Search

We report on three Japanese patients (two families) with familial Mediterranean fever (FMF), a rare disease in the Far East.\\u000a Two of the patients (siblings with definite FMF) were heterozygous for both E148Q and M694I, and the remaining patient (with probable FMF and no family history of the disease) was heterozygous for both P369S and R408Q. Although the M694I mutation

Tomoko Sugiura; Yasushi Kawaguchi; Satoru Fujikawa; Yukiko Hirano; Toru Igarashi; Manabu Kawamoto; Kae Takagi; Masako Hara; Naoyuki Kamatani

2008-01-01

223

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.

Casqueiro, Juliana; Casqueiro, Janine; Alves, Cresio

2012-01-01

224

Benign migratory glossitis in patients with juvenile diabetes.  

PubMed

The prevalence of tissue type HLA-B15 has been shown to be higher in atopic patients with benign migratory glossitis and in patients with insulin-dependent diabetes mellitus than it is in the general population. Despite this apparent link, the possible relationship between benign migratory glossitis and insulin-dependent diabetes mellitus does not appear to have been investigated previously. This study of 87 diabetic patients and 105 age- and sex-matched nondiabetic control subjects revealed a fourfold increase in the prevalence of benign migratory glossitis in the diabetic group. These results suggest that benign migratory glossitis may be linked to diabetes mellitus and that further investigation of this association is warranted. PMID:3468467

Wysocki, G P; Daley, T D

1987-01-01

225

Clinical and MRI study of brain stem and cerebellar involvement in Japanese patients with multiple sclerosis  

PubMed Central

OBJECTIVES—To investigate the clinical and MRI features of brain stem and cerebellar lesions in Japanese patients with multiple sclerosis.?METHODS—A retrospective study of 66 consecutive Japanese patients with multiple sclerosis (42 women and 24 men) was done by reviewing the medical records and MRI films. Forty nine patients were diagnosed as having clinically definite multiple sclerosis and 17 patients as having clinically probable multiple sclerosis according to Poser's criteria. Prevalence rates of each brain stem and cerebellar manifestation and frequency and distribution of MRI lesions in these patients were studied.?RESULTS—Forty three patients (65%) had one or more infratentorial manifestations. Cranial nerves were clinically involved in 28 patients (42%), and most of the lesions were identified by MRI. Among them, manifestations of facial, trigeminal, and abducens nerves were relatively common. Cerebellar ataxia was found in 20 patients (30%). The MRI study showed that the lesions responsible for ataxia in these patients were mainly found in the cerebellar peduncles, but cerebellar hemispheric lesions were detected in only four patients (6.4%).?CONCLUSION—The low frequency (6.4%) of the cerebellar MRI lesions in these patients is in sharp contrast with the figures reported for white patients with multiple sclerosis (50%-90%). Racial and genetic differences may have an influence on the susceptibility of each part of the CNS to demyelination in multiple sclerosis.??

Nakashima, I.; Fujihara, K.; Okita, N.; Takase, S.; Itoyama, Y.

1999-01-01

226

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

PubMed Central

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

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

2010-01-01

227

Diabetic ketoacidosis associated with olanzapine in an adolescent patient  

Microsoft Academic Search

Olanzapine (Zyprexa) is an atypical neuroleptic used in adult and pediatric patients for the management of schizophrenia. Common side effects include increased appetite and weight gain. An uncommon but severe adverse effect is the development of diabetic ketoacidosis, reported until now only in adults. We report a case of acute onset diabetic ketoacidosis presenting in a 16-year-old girl during olanzapine

Karin A. Selva; Susan Marie Scott

2001-01-01

228

The health status of diabetic patients receiving orthotic therapy  

Microsoft Academic Search

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

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

2000-01-01

229

Serologic Detection of Anti Toxoplasma gondii Infection in Diabetic Patients  

PubMed Central

Background Toxoplasmosis is caused by the Toxoplasma gondii parasite. The parasite is intracellular and can result in severe complications leading to death in immuno-deficient patients in particular. Diabetes is an important factor that increases susceptibility and risk of various infections in the host. Objectives The present study focused on the serologic detection of Toxoplasma gondii infection in diabetic patients. Materials and Methods Through a case-control study, overall 184 serum samples including 91 from diabetic cases and 93 from healthy non-diabetic controls were investigated. Cases and controls were matched for age and gender. Serum samples were tested for sugar by an enzymatic method, and IgG antibodies were tested against Toxoplasma gondii by ELISA method. Results The prevalence of IgG antibodies against Toxoplasma gondii in diabetic patients and healthy controls were 60.43% and 38% respectively. Risk of toxoplasmosis infection in diabetic patients with was two folds higher than healthy controls (RR = 2.21, 95% CI; 1.6 – 3.7, P = 0.001). Conclusions Diabetes may be caused by Toxoplasma gondii. Presence of T. gondii in the pancreas at the same time could directly undermines the pancreas cells. When ? cells are destroyed, insulin secretion would then be affected. Probably the destruction of T. gondii affects nervous system and damages pancreatic cells leading to increased risk of diabetes.

Shirbazou, Shahnaz; Delpisheh, Ali; Mokhetari, Rahim; Tavakoli, Ghafor

2013-01-01

230

Non-diabetic renal disease in patients with non-insulin dependent diabetes mellitus.  

PubMed

The diagnosis of diabetic nephropathy (DN) is almost always based on clinical grounds. The diagnosis is supported by a long history of diabetes, evidence of target organ damage and proteinuria preceding azotemia. The validity of this clinical approach is well established in insulin dependent diabetes mellitus but not in non-insulin dependent diabetes mellitus (NIDDM). It is thus important to determine which patients with NIDDM accompanied by non-diabetic renal disease (NDRD) should have a biopsy. However, factors clinically associated with NDRD in patients with NIDDM remain unclear. Therefore we reviewed clinical data, laboratory data and renal biopsies from 22 NIDDM patients who underwent renal biopsy between 1992 and 1998 in Wonju Christian Hospital. From this data, we identified important features that would discriminate between DN and NDRD. There were 8 women and 14 men. Age ranged from 33 to 68 (51.2 +/- 10.7) years. The duration of diabetes at biopsy ranged from 0 to 13 (4.2 +/- 4.2) years. Nephrotic syndrome was present in 13 patients. The patients with NDRD (n = 14) and DN (n = 8) had comparable 24-hour proteinuria, 24-hour albuminuria, creatinine clearance, serum creatinine, albumin, as well as incidences of neuropathy and hypertension. The significant factors that predict the NDRD included a short duration of the diabetes mellitus, the presence of dysmorphic red blood cells in urine, the absence of retinopathy and HbA1c below 9% (p < 0.05, respectively). NDRD included IgA nephropathy (n = 6), minimal change disease (n = 3), membranous nephropathy (n = 3), membranous lupus nephritis (n = 1) and acute interstitial nephritis (n = 1). Multiple logistic regression analysis revealed that the short duration of DM and the absence of retinopathy were factors significantly associated with NDRD. In summary, when there is a short duration of diabetes mellitus, or an absence of retinopathy seen in patients with NIDDM, then renal biopsy in diabetic patients aids in the detection of NDRD. PMID:10487133

Lee, E Y; Chung, C H; Choi, S O

1999-08-01

231

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

PubMed Central

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

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

2012-01-01

232

Determinants of sexual dysfunction among clinically diagnosed diabetic patients  

Microsoft Academic Search

Background  Diabetes mellitus is a chronic disease that can result in various medical, psychological and sexual dysfunctions (SD) if not\\u000a properly managed. SD in men is a common under-appreciated complication of diabetes. This study assessed the prevalence and\\u000a determinants of SD among diabetic patients in Tema, Greater Accra Region of Ghana.\\u000a \\u000a \\u000a \\u000a \\u000a Method  Sexual functioning was determined in 300 consecutive diabetic men (age

William KBA Owiredu; Nafiu Amidu; Huseini Alidu; Charity Sarpong; Christian K Gyasi-Sarpong

2011-01-01

233

Intervention with Delivery of Diabetic Meals Improves Glycemic Control in Patients with Type 2 Diabetes Mellitus  

PubMed Central

The aim of this study was to investigate the effects of a diabetic meal delivery system on glycemic control over a 12 month period in patients with type 2 diabetes. A total of 77 patients with type 2 diabetes were assigned randomly into three dietary intervention groups: group M, diabetic meal delivery; group D, individual dietary counseling; and group C, conventional dietary education. In group M, HbA1c levels decreased significantly from 8.2 ± 1.2% to 7.4 ± 0.8% after 12 months (p<0.05), while in group D, HbA1c levels decreased significantly throughout the entire 12 month period, from 8.5 ± 1.7% at baseline to 7.4 ± 1.1% at the endpoint. Similarly, fasting blood glucose (FBG) levels decreased significantly between 1 and 12 months in group M (p<0.05), and decreased significantly during the entire 12 month period in group D (p<0.01). There were no significant changes in either HbA1c or FBG levels in group C. This study provides evidence that intervention with delivery of diabetic meals to patients with type 2 diabetes can be equally effective for achieving glycemic control as individual dietary counselling by a dietitian. Diabetic meal delivery can therefore be used successfully to provide diabetes education to outpatients.

Imai, Saeko; Kozai, Hana; Matsuda, Mikuko; Hasegawa, Goji; Obayashi, Hiroshi; Togawa, Chikako; Yamamura, Toyomi; Watanabe, Kanji; Miyatani, Syuichi; Yoshikawa, Toshikazu; Kajiyama, Shizuo

2008-01-01

234

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

Microsoft Academic Search

This study was designed to investigate the effect of diabetic duration on serum concentrations of endogenous inhibitor of nitric oxide synthase NG, NG-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

Yan Xiong; Minxiang Lei; Sihai Fu; Yunfeng Fu

2005-01-01

235

Approach to the Patient with Gestational Diabetes after Delivery  

PubMed Central

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

Page, Kathleen A.

2011-01-01

236

Observations of glomerular epithelial cell structure in patients with type I diabetes mellitus  

Microsoft Academic Search

Observations of glomerular epithelial cell structure in patients with type I diabetes mellitus. Overt proteinuria is a hallmark of diabetic nephropathy while microalbuminuria is thought to be a predictor of later onset of diabetic nephropathy. Yet the mechanisms for abnormal urinary protein leak in diabetes have not been defined. We studied 28 patients with type I diabetes for 7 to

Eileen N Ellis; Michael W Steffes; Blanche Chavers; S Michael Mauer

1987-01-01

237

Exon 3 of tyrosine hydroxylase gene: lack of association with Japanese schizophrenic patients.  

PubMed

Tyrosine hydroxylase (TH) is the rate-limiting enzyme in dopamine (DA) biosynthesis. Exon 3 of the human TH gene encodes the sequence from Ser31 to Glu104 of type 1 enzyme, which contains the critical parts for regulation of the catalytic activity. The amino acid residues Gly36-Arg37-Arg38 were identified as a key sequence for DA to exert its inhibitory effect on catalytic activity. Therefore, we screened the nucleotide sequences of exon 3 from 201 Japanese patients with schizophrenia to explain the elevation in the synaptic or presynaptic DA concentrations in the schizophrenic brain, based on the hypothesis that any mutation changing the amino acid sequence Gly36-Arg37-Arg38 would result in the elevation of DA synthesis, due to a reduced inhibitory effect of DA on the catalytic activity. However, no mutated sequences of exon 3 and both exon-intron boundaries were detected in any of the patients examined. Polymorphisms generating Val81 and Met81 were compared of the distributions of genotype and allele between the patients and 175 Japanese healthy controls, which did not suggest an association between the polymorphism and schizophrenia. These results indicate that exon 3 of the human TH gene lacks association with schizophrenia in Japanese patients. PMID:11326301

Ota, M; Nakashima, A; Ikemoto, K; Nojima, S; Tanaka, M; Okuda, M; Koga, H; Mori, K; Kaneko, Y S; Fujiwara, K; Yamamoto, H; Nagatsu, T; Ota, A

2001-05-01

238

[Diabetes mellitus and osteoporosis. Therapeutic strategy for osteoporosis in patients with diabetes mellitus].  

PubMed

Patients with either type 1 or type 2 diabetes mellitus (DM) are predisposed to fragile fracture. In particular, although bone mineral density in patients with type 2 DM is somewhat higher than control subjects, diabetic patients are more likely to break a bone. Because the number of elderly patients with DM is getting larger, it is necessary to prevent fracture in those. Unfortunately, substantial randomized control trials are yet to be done in patients with DM to clarify if anti-osteoporotic drugs are effective to prevent fractures. According to post-hoc analyses of pivotal clinical studies of alendronate and raloxifene, best available clinical data at the present time, those anti-osteoporotic drugs seem to be equally effective in diabetic patients to controls. We are now waiting for evidence of effects of teriparatide and other drugs on patients with DM. PMID:22932297

Takeuchi, Yasuhiro

2012-09-01

239

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

Microsoft Academic Search

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

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

2002-01-01

240

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.

Urano, Fumihiko

2014-01-01

241

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.

2013-01-01

242

Pancreatic beta-cell function and insulin sensitivity in japanese subjects with impaired glucose tolerance and newly diagnosed type 2 diabetes mellitus  

Microsoft Academic Search

To clarify whether pancreatic beta-cell function and\\/or insulin resistance contributes to development of glucose intolerance in Japanese subjects, we investigated 551 subjects who underwent a 75-g oral glucose tolerance test (OGTT). Subjects were divided into 3 groups: normal glucose tolerance (NGT, n [equals] 238), impaired glucose tolerance (IGT, n [equals] 211), and newly diagnosed type 2 diabetes mellitus (n [equals

Masao Kanauchi; Mikane Nakajima; Yoshihiko Saito; Kimiko Kanauchi

2003-01-01

243

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

244

Retinopathy and microalbuminuria in type II diabetic patients  

PubMed Central

Background The aim of this study was to identify risk factors for the development of retinopathy and microalbuminuria and their correlation in type II diabetic patients. Methods In this cross-sectional study 590 patients suffering from diabetis type II were examined. Fundoscopy was performed by practising ophthalmologist. The ratio of urinary albumin to creatinine was assessed by clinitek 100 (Bayer corporation–USA). HbA1C, height and weight also were measured. Results The overall prevalence of retinopathy was 39.3% (232 patients), 5.4% of which showed to be prolifrative diabetic retinopathy (PDR). The diabetic retinopathy had significant inverse correlation with body mass index (BMI) (P = 0.02). HbA1C was higher in patients with PDR (mean = 10.5%) than in patients with no signs of retinopathy (mean = 9.5%) and this difference was statistically significant (P = 0.001). The prevalence of microalbuminuria was 25.9% while 14.5% of the patients revealed to have macroalbuminuria. As expected, diabetic retinopathy and renal involvement were highly positively correlated. (P = 0.001). Conclusion Microalbuminuria is associated with diabetic retinopathy in type II diabetic patients and is a reliable marker of retinopathy.

Manaviat, Masoud R; Afkhami, Mohammad; Shoja, Mohammad R

2004-01-01

245

Retinal haemodynamics in patients with early diabetes mellitus.  

PubMed Central

AIMS/BACKGROUND: The retinal circulation was investigated in a group of 19 patients with insulin dependent diabetes mellitus with less than 4 years of disease duration and no evidence of diabetic retinopathy. Results of these patients were compared with those of 16 age-matched normal controls. METHODS: Venous diameter (D) was measured from monochromatic fundus photographs. Maximum erythrocyte velocity (Vmax) was assessed by bidirectional laser Doppler velocimetry in the major retinal veins of one eye of each subject. Total volumetric blood flow rate (QT) was calculated by adding the flow rates of the major retinal veins. RESULTS: Average QT was 12% larger than normal in diabetic patients (one tailed, non-paired Student's t test, p < 0.05). A statistically significant correlation was observed between QT and disease duration (r = 0.35, p < 0.04). Patients with longer disease duration tended to have somewhat larger QT. The average retinal vascular regulatory responses to hyperoxia were not significantly different from normal in diabetic patients. In these patients, however, higher blood glucose levels were associated with decreased regulatory responses to hyperoxia. CONCLUSIONS: Patients with diabetes mellitus of relatively short duration have mildly increased QT, suggesting that increased blood flow may play an early role in the development of diabetic retinal microangiopathy.

Grunwald, J E; DuPont, J; Riva, C E

1996-01-01

246

Staff Manual for Teaching Patients about Diabetes Mellitus.  

National Technical Information Service (NTIS)

Guidelines for teaching patients about diabetes mellitus are provided for use by hospital staff. The guidelines were developed by the Center for Health Promotion of the American Hospital Association in cooperation with numerous organizations and individua...

J. E. Espenshade

1979-01-01

247

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

MedlinePLUS

... Child Health and Human Development (NICHD) has been working to answer these types of questions through research and clinical practice to improve the health of mothers, children, and families. Managing Gestational Diabetes: A Patient's ...

248

T cell gene expression profiling identifies distinct subgroups of Japanese multiple sclerosis patients  

Microsoft Academic Search

To clarify the molecular background underlying the heterogeneity of multiple sclerosis (MS), we characterized the gene expression profile of peripheral blood CD3+ T cells isolated from MS and healthy control (CN) subjects by using a cDNA microarray. Among 1258 cDNAs on the array, 286 genes were expressed differentially between 72 untreated Japanese MS patients and 22 age- and sex-matched CN

Jun-ichi Satoh; Megumi Nakanishi; Fumiko Koike; Hiroyuki Onoue; Toshimasa Aranami; Toshiyuki Yamamoto; Mitsuru Kawai; Seiji Kikuchi; Kyouichi Nomura; Kazumasa Yokoyama; Kohei Ota; Toshiro Saito; Masayuki Ohta; Sachiko Miyake; Takashi Kanda; Toshiyuki Fukazawa; Takashi Yamamura

2006-01-01

249

Diagnosis of Alexander disease in a Japanese patient by molecular genetic analysis  

Microsoft Academic Search

Alexander disease is a leukodystrophy that is neuropathologically characterized by the presence of numerous Rosenthal fibers\\u000a in astrocytes. Recently, mutations in the gene encoding glial fibrillary acidic protein (GFAP) were identified in patients\\u000a with Alexander disease. We sequenced the GFAP gene of a Japanese girl who presented with typical symptoms of Alexander disease but in whom the diagnosis was not

Naohide Shiroma; Naomi Kanazawa; Mina Izumi; Kenji Sugai; Michio Fukumizu; Masayuki Sasaki; Shigeru Hanaoka; Makiko Kaga; Seiichi Tsujino

2001-01-01

250

VKORC1 gene variations are the major contributors of variation in warfarin dose in Japanese patients  

Microsoft Academic Search

Objectives: To compare the genetic and clinical factors that cause large interpatient variability and ethnic differences in warfarin efficacy, we investigated variations of the VKORC1, CYP2C9, and CYP2C19 genes in Japanese subjects. Furthermore, we evaluated the genetic variations and clinical data as contributors of variation in warfarin maintenance dose.Methods: Gene variations of VKORC1, CYP2C9, and CYP2C19 in 125 patients treated

Kyoko Obayashi; Katsunori Nakamura; Junichi Kawana; Hiroyasu Ogata; Kazuhiko Hanada; Masahiko Kurabayashi; Akira Hasegawa; Koujirou Yamamoto; Ryuya Horiuchi

2006-01-01

251

Hemichorea-Hemiballism with a Diabetic Patient  

PubMed Central

Chorea and ballism are movement disorders that result from a variety of conditions. They are an uncommon manifestation of diabetes mellitus. We report a 52-year-old diabetic man who presented with acute onset chorea-ballism with a putaminal high-signal-intensity lesion on T1-weighted magnetic resonance imaging (MRI).

Kim, Yoo Hwan; Kim, Ju Yeon; Seok, Hung Youl; Koh, Seong-Beom

2010-01-01

252

Association of adiponectin with cardiovascular events in diabetic and non-diabetic hemodialysis patients.  

PubMed

Adiponectin is a novel collagen-like protein synthesized by white adipose tissue. Its levels are decreased in obesity, type-2 diabetes and insulin-resistant states, and are increased in chronic renal failure. It has anti-inflammatory and anti-atherogenic properties. This study was planned to evaluate the levels of adiponectin in uremic patients with and without diabetes and to find any relationship between adiponectin levels and some cardiovascular risk factors, and to determine the possible predictive value of adiponectin for cardiovascular complications (CVC). The study included 100 subjects, 20 of them were healthy subjects and served as the control group (group I), 40 were uremic non-diabetic patients (group II) (half of them were without CVC, group IIA, and the other half were patients with CVC, group IIB) and, lastly, 40 uremic diabetic patients (group III) (half of them were without CVC, group IIIA, and the other half were patients with CVC, group IIIB). All subjects were subjected to complete clinical examination, including determination of mean arterial blood pressure (MABP), body mass index (BMI), waist to hip ratio, routine laboratory investigations, fasting plasma glucose, fasting plasma insulin, lipid profile (cholesterol, TG, LDL, HDL), determination of insulin resistance by homeostasis model assessment index (HOMA-IR) and estimation of serum levels of adiponectin. There was a significant increase in serum adiponectin levels in all the uremic patients (group II and group III) when compared with the control (group I) group, P <0.01; also, serum adiponectin levels were significantly decreased in uremic diabetic patients (group III) when compared with uremic non-diabetic patients (group II), P <0.01; but this was still higher than in the controls. The patients with CVC, whether uremic non-diabetic (group IIB) or uremic diabetic (group IIIB), had a significant decrease in serum adiponectin levels when compared with patients without CVC (group IIA and group IIIA), P <0.01. Serum adiponectin has a significant positive correlation with HDL and a significant negative correlation with MABP, BMI, plasma insulin, HOMA-IR, LDL, TG and cholesterol in all the patients. Therefore, it can be concluded that adiponectin levels in uremic patients, whether diabetic or non-diabetic, may be a good indicator of cardiovascular disease risk. PMID:22805386

Elokely, Amir; Shoukry, Amira; Ghonemy, Tarek A; Atia, Mrwan; Amr, Ghada

2012-07-01

253

Pyuric diabetic patients: A tertiary centre experience from Karachi  

PubMed Central

Objectives: (1) To determine frequency of urinary tract infection among pyuric diabetic patients. (2) To determine sterile pyuria frequency among pyuric diabetic patients. (3) To determine factors predisposing to urinary tract infection. Methods: This is a non randomized, prospective observational study done in tertiary care set up of Dow University of Health Sciences, Karachi. Data collection done from June 2013 till August 2013. Sampling was done by convenient method, sample size of 97. Inclusion criteria was all adult (above 16) patients with diabetes mellitus and pyuria (more than 4 pus cells /HPF) whose urine culture report was also available. Verbal consent was sought from patients. All data was collected on a Performa. Data was maintained and analyzed on SPSS version 16. Results: Total number of pyuric diabetic patients in study was 97. Frequency of Urinary tract infection was 59/97 (60.82%), prevalence of culture negative sterile pyuria was found 38/97 (39.17%). Urinary tract infection was found to be more in females with lower urinary tract symptoms and flank pains. Stone disease, obstructed pelvicalyceal system, proteinuria, high serum creatinine and positive nitrites were found more in culture positive patients than in culture negative pyuric patients. Conclusions: Pyuric diabetic patients in our study population were found to have culture positive UTI in 60.82% and culture negative sterile pyuria among 39.17% of patients. UTI was found more in females, in symptomatic patient and with abnormal urinary tract anatomy and function.

Mamun Mahmud, Huma; Qureshi, Sobia; Kumar, Darshan; Farman, Syed

2014-01-01

254

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

PubMed

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

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

2013-01-01

255

Do all patients with type 2 diabetes need breakfast?  

Microsoft Academic Search

Objectives:To evaluate if an improved daily glycemic profile could be achieved in patients with type 2 diabetes by withholding breakfast, but maintaining the same total daily intake of calorie and the same composition of carbohydrates, fat and protein.Methods:Thirteen type 2 diabetic patients participated in this randomized crossover study. Following an initial fasting night the study consisted of 4 consecutive days.

T Parkner; J K Nielsen; T D Sandahl; B M Bibby; B S Jensen; J S Christiansen

2011-01-01

256

Lower Extremity Arterial Reconstruction in Patients With Diabetes Mellitus  

Microsoft Academic Search

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

Kakra Hughes; David Campbell; Frank B. Pomposelli Jr

257

Detection of isopropyl alcohol in a patient with diabetic ketoacidosis  

Microsoft Academic Search

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

Alan E Jones; Richard L Summers

2000-01-01

258

Japanese and American ALS patient preferences regarding TIV (tracheostomy with invasive ventilation): A cross-national survey.  

PubMed

Abstract Substantial disparities in TIV utilization rates among ALS patients have been observed, with rates in Japan far exceeding rates in the United States. Our objective was to elicit national preferences and their determinants. We predicted more Japanese than American patients would desire TIV, as would sicker patients, those already using non-invasive interventions, and those with more positive mood and outlook. Patients were enrolled in five U.S. states and six Japanese regions. Eligible patients completed surveys during clinic visits (U.S.) or at home (Japan). Survey responses were in multiple-choice format and took about 15 min to complete. One hundred and fifty-six Americans and 66 Japanese patients participated. Contrary to expectations, Japanese patients were more likely to oppose TIV, as were those on 24-h NIV and patients who knew someone using TIV. Most Japanese and American patients with advanced respiratory impairment were undecided or opposed to TIV, while nearly 20% in both countries were in favor. Finally, patients who favored TIV or who were undecided had more energy, greater wish to live, and more sense of control over ALS management. In conclusion, factors other than patient preferences, such as neurologist preferences, caregiver attitudes and perhaps lack of advance planning, may influence probability of TIV utilization. PMID:24720451

Rabkin, Judith; Ogino, Mieko; Goetz, Raymond; McElhiney, Martin; Hupf, Jonathan; Heitzman, Daragh; Heiman-Patterson, Terry; Miller, Robert; Katz, Jonathan; Lomen-Hoerth, Catherine; Imai, Takashi; Atsuta, Naoki; Morita, Mitsuya; Tateishi, Takahisa; Matsumura, Tsuyoshi; Mitsumoto, Hiroshi

2014-06-01

259

[A diabetic patient with asymptomatic multiple arterial disease].  

PubMed

The authors present the case of a 73-year-old diabetic woman who was referred to hospital because of the suspicion of lower limb peripheral arterial stenosis. During evaluations signs of the subclavian artery occlusion were found. In addition to diabetes, the patient had several risk factors revealed by medical history. Subclavian artery occlusion was solved by angiography guided stenting, and angiography also showed the presence of abnormalities in renal arteries. This case draws the attention to the importance of screening old diabetic patients for arterial stenosis and the importance of accurate risk factor assessment. PMID:22961418

Bényi, Zoltán; Nagy, György; Nyirati, Gábor; Szentpétery, László; Vallus, Gábor

2012-09-16

260

Discontinuation of imatinib in Japanese patients with chronic myeloid leukemia  

PubMed Central

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

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

2012-01-01

261

Diabetes and cancer (2): evaluating the impact of diabetes on mortality in patients with cancer.  

PubMed

In this paper we address methodological aspects of aetiological importance in the link between diabetes and mortality in patients with cancer. We identified nine key points on the cancer pathway at which confounding may arise-cancer screening use, stage at diagnosis, cancer treatment selection, cancer treatment complications and failures, peri-treatment mortality, competing risks for long-term mortality, effects of type 2 diabetes on anti-cancer therapies, effects of glucose-lowering treatments on cancer outcome and differences in tumour biology. Two types of mortality studies were identified: (1) inception cohort studies that evaluate the effect of baseline diabetes on cancer-related mortality in general populations, and (2) cohorts of patients with a cancer diagnosis and pre-existing type 2 diabetes. We demonstrate, with multiple examples from the literature, that pre-existing diabetes affects presentation, cancer treatment, and outcome of several common cancer types, often to varying extents. Diabetes is associated with increased all-cause mortality in cancer patients, but the evidence that it influences cancer-specific mortality is inconsistent. In the absence of data that address the potential biases and confounders outlined in the above framework, we caution against the reporting of cancer-related mortality as a main endpoint in analyses determining the impact of diabetes and glucose-lowering medications on risk of cancer. PMID:22476948

Renehan, A G; Yeh, H-C; Johnson, J A; Wild, S H; Gale, E A M; Mřller, H

2012-06-01

262

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

263

Lipoprotein(a) Serum Levels in Diabetic Patients with Retinopathy  

PubMed Central

Background. Atherogenic lipoproteins, such as total cholesterol, LDL cholesterol, oxidized low density lipoprotein, and triglycerides, are associated with progression of retinopathy. Aim. To evaluate the relationship between lipoprotein(a) and retinopathy in patients with type 2 diabetes mellitus. Materials and Methods. We enrolled 145 diabetic consecutive patients (82 females, 63 males; mean age 66.8 ± 12 years, mean duration of diabetes 9.4 ± 6.8 years). Presence and severity of retinopathy were evaluated. Serum lipid profile, including Lp(a) level, was assessed. Results. High Lp(a) levels have been observed in 54 (78.3%) subjects and normal levels in 13 (18.85%) subjects as regards diabetic patients with retinopathy. Lp(a) levels were high in 15 subjects (21.75%) and normal in 63 subjects (91.35%) as regards patients without retinopathy. Conclusions. Lp(a) levels are increased in a significant percentage of patients with retinopathy compared to diabetic patients without retinopathy. The impact of Lp(a) levels on diabetic retinopathy needs to be further investigated.

Malaguarnera, Giulia; Gagliano, Caterina; Vacante, Marco; Malaguarnera, Michele; Leonardi, Daniela Giovanna; Motta, Massimo; Drago, Filippo; Avitabile, Teresio

2013-01-01

264

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

265

Predicting Perioperative Venous Thromboembolism in Japanese Gynecological Patients  

PubMed Central

Objective To develop a convenient screening method that can predict perioperative venous thromboembolism (VTE) and identify patients at risk of fatal perioperative pulmonary embolism (PE). Methods Patients hospitalized for gynecological abdominal surgery (n?=?183) underwent hematology tests and multidetector computed tomography (MDCT) to detect VTE. All statistical analyses were carried out using the SPSS software program (PASWV19.0J) Results The following risk factors for VTE were identified by univariate analysis: plasmin-alpha2-plasmin inhibitor complex (PIC), thrombin-antithrombin III complex (TAT), and prolonged immobility (all p<0.001); age, neoadjuvant chemotherapy (NAC), malignancy, hypertension, past history of VTE, and hormone therapy (all p<0.01); and hemoglobin, transverse tumor diameter, ovarian disease, and menopause (all p<0.05). Multivariate analysis using these factors revealed that PIC, age, and transverse tumor diameter were significant independent determinants of the risk of VTE. We then calculated the incidence rate of perioperative VTE using PIC and transverse tumor diameter in patient groups stratified by age. In patients aged?40 years, PIC ?1.3 µg/mL and a transverse tumor diameter ?10 cm identified the high-risk group for VTE with an accuracy of 93.6%. For patients in their 50 s, PIC ?1.3 µg/mL identified a high risk of VTE with an accuracy of 78.2%. In patients aged ?60 years, a transverse tumor diameter ?15 cm (irrespective of PIC) or PIC ?1.3 µg/mL identified the high-risk group with an accuracy of 82.4%. Conclusions We propose new screening criteria for VTE risk that are based on PIC, transverse tumor diameter, and age. Our findings suggest the usefulness of these criteria for predicting the risk of perioperative VTE and for identifying patients with a high risk of fatal perioperative PE.

Ikeda, Masae; Kan-no, Hidetoshi; Hayashi, Masaru; Tsukada, Hitomi; Shida, Masako; Hirasawa, Takeshi; Muramatsu, Toshinari; Ogushi, Yoichi; Mikami, Mikio

2014-01-01

266

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

PubMed Central

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

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

2013-01-01

267

Family issues and family functioning of Japanese outpatients with type 2 diabetes: a cross-sectional study  

PubMed Central

Background Previous studies confirmed that the control of diabetes is related to family functioning, but the validity of the tools used to assess family functioning in these studies is questionable. Few studies have focused on family issues. In this study, we used a new assessment tool to evaluate family functioning and family issues of patients with type 2 diabetes. Methods A cross-sectional questionnaire was given to outpatients with type 2 diabetes at a community hospital in Aichi, Japan, between August 2001 and March 2002. First, the patients were asked to answer FACESKGIV-16, which measures cohesion and adaptability, questions regarding family issues, daily lifestyle, and HAD. Physical and serological data were measured. Family functioning, family issues, and relationships between each parameter and family functioning or family issues were analyzed. Results Of the 133 participants, 121 (33.3%) had some sort of family issue. Family issues included “Health problems of family members” (40.9%), “Family life cycle issues” (22.7%), and others. The best fit multiple regression model (Adjusted R2: 0.494, p?=?0.020) included Plasma Glucose as an independent variable, and the squared value of cohesion score, depression score of HAD, Total calorie intake, Exercise time, Housekeeping time, and BMI were dependent variables. The results show that extremes of family cohesion with either too many or too few issues related to family functioning are correlated with the plasma glucose level. Conclusions Family issues were common among patients with type 2 diabetes, and the extremes of family cohesion were associated with the glucose level, in contrast to the common wisdom that a well balanced family leads to good control of diabetes.

2013-01-01

268

Knowledge of diabetes and its associated ocular manifestations by diabetic patients: A study at Korle-Bu Teaching Hospital, Ghana  

PubMed Central

Background: Diabetes mellitus is a significant cause of visual impairment, hence adequate knowledge on this condition and its ocular manifestations is of immense importance to diabetic patients. Aim: To assess the knowledge of diabetic patients on the disorder and its ocular manifestations, and their attitude towards ocular examinations. Materials and Methods: A cross-sectional survey involving the use of a structured interview was conducted among diabetic patients attending the Diabetic Clinic of the Korle-Bu Teaching Hospital. Using Fishers Exact Chi-square (?2) and Odds Ratios (ORs), data obtained was analyzed. Results: Only 103 (26.4%) patients knew the type of diabetes mellitus they were suffering from. Knowledge on ocular effects of diabetes mellitus was low and only 15 (3.8%) knew that it could affect the ocular refraction with no patient mentioning that diabetes mellitus could cause cataract or diabetic retinopathy. Attitude to routine eye examination was poor. As much as 135 (34.6%) had never had an eye examination since being diagnosed of diabetes. Knowledge of the type of diabetes mellitus the individual had or any ocular complication of this disorder was significantly related (OR: 4.22; P < 0.001 and OR: 2.55; P < 0.001) respectively to their attitude to seeking eye care. Conclusion: Diabetic patients’ knowledge on diabetes mellitus and its ocular manifestations, and the attitude of diabetic patients towards eye examination were poor. Intensive health education by diabetes care givers and leaders of the Ghana Diabetic Association for diabetic patient is therefore required to improve attitude towards eye care to prevent visual impairment.

Ovenseri-Ogbomo, Godwin O.; Abokyi, Samuel; Koffuor, G. A.; Abokyi, Eric

2013-01-01

269

Heart Failure and Diabetes The Effect of Diabetes on Outcomes of Patients With Advanced Heart Failure in the BEST Trial  

Microsoft Academic Search

OBJECTIVES This was a retrospective analysis to determine the effect of diabetes on outcome in patients with advanced heart failure (HF), and to determine the effect of beta-blockade in patients with HF with and without diabetes mellitus. BACKGROUND In chronic HF the impact on clinical outcomes and therapeutic response of the prevalent comorbid condition diabetes mellitus has not been extensively

Michael Domanski; Heidi Krause-Steinrauf; Prakash Deedwania; Dean Follmann; Jalal K. Ghali; Edward Gilbert; Steven Haffner; Richard Katz; JoAnn Lindenfeld; Brian D. Lowes; Wade Martin; Frank McGrew; Michael R. Bristow

270

Associated factors for falls and fear of falling in Japanese patients with rheumatoid arthritis.  

PubMed

The objective of this is to determine factors associated with falls in Japanese patients with rheumatoid arthritis (RA). Among the patients who participated in a single-institute-based prospective observational cohort study of patients with RA, namely, Institute of Rheumatology Rheumatoid Arthritis, 4,996 (male 765, female 4231, median age 60 years) responded to questions related to falls during the previous 6 months in April or May 2008. Logistic regression was used to determine the association between variables and falls. Five hundred and five (10.1%), 110 (2.2%), and 958 patients (19.2%) reported at least one fall, multiple falls, and fear of falling, respectively. Those who fell tended to report incident fractures during the same 6 months compared to those who did not (14.7% versus 1.1%, P < 0.001). In multivariate models, Japanese health assessment questionnaire (HAQ) scores (odds ratios (OR) 1.52, 2.49, and 3.88), tender joint counts (OR 1.39, 1.72, and 1.36), patient-reported visual analog scale for general health (OR 1.08, 1.16, and 1.20), and body mass index (OR 1.05, 1.08, and 1.04) were associated (P < 0.05) with at least one fall, multiple falls, and fear of falling, respectively. Other clinical variables and medications were also associated with falls and fear of falling. HAQ disability score, tender joint counts, and impaired general health appear to be associated with falls in Japanese patients with RA, as previously reported for patients of other ethnicities. PMID:19618097

Furuya, Takefumi; Yamagiwa, Kiyotaka; Ikai, Tetsuo; Inoue, Eisuke; Taniguchi, Atuo; Momohara, Shigeki; Yamanaka, Hisashi

2009-11-01

271

Pre and post-operative needs of patients with diabetes.  

PubMed

The incidence of diabetes is rising rapidly and individuals with the condition often have complex comorbidities, which may increase the need for surgical procedures such as amputation and cardiac, renal and eye surgery. Patients with diabetes undergoing surgery may have specific needs, particularly in relation to blood glucose control, and healthcare professionals need to be able to assess and manage these individuals to ensure optimum surgical outcomes. This article considers the potential effects of anaesthesia and surgery on blood glucose control. Diabetes-related complications, particularly signs and symptoms, and effects of these complications on patient safety during surgery are discussed. Specific pre and post-operative care of patients with type land type 2 diabetes is described, with reference to nil-by-mouth practices, blood glucose control, and post-operative infection and pain. PMID:23248951

Holt, Paula

272

Bone and wound healing in the diabetic patient.  

PubMed

Impaired soft tissue regeneration and delayed osseous healing are known complications associated with diabetes mellitus with regard to orthopedic surgery, making the management and treatment of diabetic patients undergoing foot and ankle surgery more complex and difficult. At the moment several options are available to address the known issues that complicate the clinical outcomes in these high-risk patients. Using a multifaceted approach, with close attention to intraoperative and perioperative considerations including modification of surgical technique to supplement fixation, local application of orthobiologics, tight glycemic control, administration of supplementary oxygen, and biophysical stimulation via low-intensity pulsed ultrasound and electrical bone stimulation, the impediments associated with diabetic healing can potentially be overcome, to yield improved clinical results for diabetic patients after acute or elective foot and ankle surgery. PMID:20682414

Mehta, Siddhant K; Breitbart, Eric A; Berberian, Wayne S; Liporace, Frank A; Lin, Sheldon S

2010-09-01

273

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

274

Prevalence of amiodarone-induced thyrotoxicosis and associated risk factors in Japanese patients.  

PubMed

Amiodarone is a widely used agent for life-threatening arrhythmias. Although amiodarone-induced thyrotoxicosis (AIT) is a major adverse effect that can cause recurrence of arrhythmias and exacerbation of heart failure, risk factors for AIT among amiodarone-treated Japanese patients have not been elucidated. Here, we investigated the prevalence and predictive factors for AIT. The study subjects were 225 patients treated with amiodarone between 2008 and 2012, who were euthyroid before amiodarone therapy. All patients with AIT were diagnosed by measurement of thyroid hormones and ultrasonography. Among the 225 subjects, 13 patients (5.8%) developed AIT and all the patients were classified as Type 2 AIT. Baseline features of patients with AIT were not different from those who did not develop AIT, except for age (AIT, 55.1 ± 13.8, non-AIT, 68.1 ± 12.0 years, P < 0.001). Multivariate analyses using the Cox proportional hazard model identified age as the sole determinant of AIT (hazard ratio: 0.927, 95% confidence interval: 0.891-0.964). Receiver operating characteristic curve analysis identified age of 63.5 years as the cutoff value for AIT with sensitivity of 70.3% and specificity of 69.2%. In summary, this study showed that the prevalence of AIT is 5.8% in Japanese patients treated with amiodarone and that young age is a risk factor for AIT. PMID:25053942

Uchida, Toyoyoshi; Kasai, Takatoshi; Takagi, Atsutoshi; Sekita, Gaku; Komiya, Koji; Takeno, Kageumi; Shigihara, Nayumi; Shimada, Kazunori; Miyauchi, Katsumi; Fujitani, Yoshio; Daida, Hiroyuki; Watada, Hirotaka

2014-01-01

275

Prevalence of Amiodarone-Induced Thyrotoxicosis and Associated Risk Factors in Japanese Patients  

PubMed Central

Amiodarone is a widely used agent for life-threatening arrhythmias. Although amiodarone-induced thyrotoxicosis (AIT) is a major adverse effect that can cause recurrence of arrhythmias and exacerbation of heart failure, risk factors for AIT among amiodarone-treated Japanese patients have not been elucidated. Here, we investigated the prevalence and predictive factors for AIT. The study subjects were 225 patients treated with amiodarone between 2008 and 2012, who were euthyroid before amiodarone therapy. All patients with AIT were diagnosed by measurement of thyroid hormones and ultrasonography. Among the 225 subjects, 13 patients (5.8%) developed AIT and all the patients were classified as Type 2 AIT. Baseline features of patients with AIT were not different from those who did not develop AIT, except for age (AIT, 55.1 ± 13.8, non-AIT, 68.1 ± 12.0 years, P < 0.001). Multivariate analyses using the Cox proportional hazard model identified age as the sole determinant of AIT (hazard ratio: 0.927, 95% confidence interval: 0.891–0.964). Receiver operating characteristic curve analysis identified age of 63.5 years as the cutoff value for AIT with sensitivity of 70.3% and specificity of 69.2%. In summary, this study showed that the prevalence of AIT is 5.8% in Japanese patients treated with amiodarone and that young age is a risk factor for AIT.

Uchida, Toyoyoshi; Takagi, Atsutoshi; Sekita, Gaku; Komiya, Koji; Takeno, Kageumi; Shigihara, Nayumi; Shimada, Kazunori; Miyauchi, Katsumi; Fujitani, Yoshio; Daida, Hiroyuki; Watada, Hirotaka

2014-01-01

276

Increased Circulating Betatrophin Concentrations in Patients with Type 2 Diabetes  

PubMed Central

Betatrophin has recently been described as a key hormone to stimulate beta-cell mass expansion in response to insulin resistance and obesity in mice. The finding has generated an interest in the development of antidiabetic drugs with betatrophin as the active component. However, the circulating levels of betatrophin in patients with type 2 diabetes are not well known. Betatrophin concentrations in plasma of 27 type 2 diabetes patients and 18 gender-, age-, and BMI-matched controls were measured. Study participants were characterized with regard to BMI, waist and hip circumference, blood pressure, and fasting plasma blood lipids, creatinine, glucose, HbA1c, and C-peptide. HOMA2 indices were calculated. Betatrophin was 40% higher in patients with type 2 diabetes (893 ± 80 versus 639 ± 66?pg/mL). Betatrophin positively correlated with age in the controls and with HbA1c in the type 2 diabetes patients. All study participants were insulin resistant with mean HOMA2B IR in both groups exceeding 2 and HOMA2%S < 50%. Control individuals had impaired fasting glucose concentrations. In this report on betatrophin concentrations in type 2 diabetes and insulin resistance, elevated betatrophin levels were measured in the patients with type 2 diabetes. Future studies are clearly needed to delineate the exact role, if any, of betatrophin in regulating human beta-cell mass.

2014-01-01

277

Treatment of dyslipidemia in patients with type 2 diabetes  

PubMed Central

Type 2 diabetes is associated with significant cardiovascular morbidity and mortality. Although low-density lipoprotein cholesterol levels may be normal in patients with type 2 diabetes, insulin resistance drives a number of changes in lipid metabolism and lipoprotein composition that render low-density lipoprotein cholesterol and other lipoproteins more pathogenic than species found in patients without type 2 diabetes. Dyslipidemia, which affects almost 50% of patients with type 2 diabetes, is a cardiovascular risk factor characterized by elevated triglyceride levels, low high-density lipoprotein cholesterol levels, and a preponderance of small, dense, low-density lipoprotein particles. Early, aggressive pharmacological management is advocated to reduce low-density lipoprotein cholesterol levels, regardless of baseline levels. A number of lipid-lowering agents, including statins, fibrates, niacin, and bile acid sequestrants, are available to target normalization of the entire lipid profile. Despite use of combination and high-dose lipid-lowering agents, many patients with type 2 diabetes do not achieve lipid targets. This review outlines the characteristics and prevalence of dyslipidemia in patients with type 2 diabetes and discusses strategies that may reduce the risk of cardiovascular disease in this population.

2010-01-01

278

Lipoprotein(a) and cardiovascular disease in diabetic patients  

PubMed Central

Lipoprotein(a) (Lp[a]) is a LDL-like particle consisting of an ApoA moiety linked to one molecule of ApoB100. Recent data from large-scale prospective studies and genetic association studies provide highly suggestive evidence for a potentially causal role of Lp(a) in affecting risk of cardiovascular disease (CVD) in general populations. Patients with Type 2 diabetes display clustered metabolic abnormalities and elevated risk of CVD. Lower plasma Lp(a) levels were observed in diabetic patients in several recent studies. Epidemiology studies of Lp(a) and CVD risk in diabetic patients generated inconsistent results. We recently found that Lp(a)-related genetic markers did not predict CVD in two diabetic cohorts. The current data suggest that Lp(a) may differentially affect cardiovascular risk in diabetic patients and in the general population. More prospective studies, Mendelian randomization analysis and functional studies are needed to clarify the causal relationship of Lp(a) and CVD in diabetic patients.

Qi, Qibin; Qi, Lu

2012-01-01

279

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

280

Serum levels of insulin-binding antibodies in diabetic patients treated with monocomponent insulin  

Microsoft Academic Search

Summary  Levels of insulin binding immunoglobulin G (IgG) were determined by the method of Christiansen in diabetic patients divided into the following groups: 1. recently diagnosed diabetics, treated from the beginning with monocomponent (MC) pork insulin (12 patients); 2. diabetics treated from the beginning with several times recrystallized monospecies (MS) pork insulin (6 patients), and 3. diabetics previously treated for long

A. Czy?yk; J. ?awecki; H. Rogala; E. Miedzi?ska; A. Popik-Hankiewicz

1974-01-01

281

Highly variable gastric emptying in patients with insulin dependent diabetes mellitus  

Microsoft Academic Search

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

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

1995-01-01

282

Prevalence of lean type 2 diabetes mellitus in recently diagnosed type 2 diabetes mellitus patients  

PubMed Central

Introduction: Obesity has always been thought to be a risk factor for diabetes; however, some studies in India have reported that even lean people are prone to diabetes. We conducted this study to see if this holds true for this part of the country. Objectives: To determine the prevalence of lean type 2 diabetes mellitus (DM) in recently diagnosed type 2 DM in Manipur. Materials and Methods: All recently diagnosed type 2 DM patients, within a period of 24 weeks, who attended the endocrine clinic of RIMS from Jan to Dec 2012 are included in the study. Exclusion criteria are patients with chronic diseases. Results: Out of the 181 recently diagnosed diabetics 3.9% had a BMI of <19 kg/m2 of which five are females (5.4% of female patients) and two are males (2.2% of male patients). Mean age of Lean diabetics is 54.86 ± 15.32, mean fasting glucose is 212 ± 105.5 mg% and mean postprandial glucose is 351.57 ± 167.79 mg%. DM complications were observed in 28.6% of the Lean diabetics. Conclusion: Our study shows a low prevalence rate of Lean DM in recently diagnosed type 2 DM.

Chaudhary, Prateek; Laloo, Demitrost; Salam, Ranabir

2013-01-01

283

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

PubMed Central

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

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

2012-01-01

284

Cellular Basis of Diabetic Nephropathy: V. Endoglin Expression Levels and Diabetic Nephropathy Risk in Patients with Type 1 Diabetes  

PubMed Central

Endoglin is an accessory receptor molecule that, in association with transforming growth factor ? (TGF-?) family receptors types I and II, binds TGF-?1, TGF-?3, activin A, bone morphogenetic protein (BMP)-2 and BMP-7, regulating TGF-? dependent cellular responses. Relevant to diabetic nephropathy, endoglin, expressed in vascular endothelial and smooth muscle cells, fibroblasts, and mesangial cells, negatively regulates extracellular matrix (ECM). The aim of this study was to evaluate endoglin expression in cultured skin fibroblasts from patients with type 1 diabetes with and without diabetic nephropathy. Kidney and skin biopsies were performed in 125 type 1 diabetic patients. The 20 with the fastest rate of mesangial expansion (estimated by electron microscopy) and proteinuria (“fast-track”) and the 20 with the slowest rate and normoalbuminuria (“slow-track”), along with 20 controls were studied. Endoglin mRNA expression was assessed by microarray and QRT-PCR and protein expression by Western blot. Age and sex distribution were similar among groups. Diabetes duration was similar (20±8 vs. 24±7 years), HbA1c lower (8.4±1.2 vs. 9.4±1.5%), and glomerular filtration rate higher (115±13 vs. 72±20 ml/min/1.73m2) in “slow-track” vs. “fast-track” patients. Microarray endoglin mRNA expression levels were higher in “slow-track” (1516.0±349.9) than “fast-track” patients (1211.0±274.9; p=0.008) or controls (1223.1±422.9; p=0.018). This was confirmed by QRT-PCR. Endoglin protein expression levels correlated with microarray (r=0.59; p=0.044) and QRT-PCR (r=0.61; p=0.034) endoglin mRNA expression. These studies are compatible with the hypothesis that “slow-track” type 1 diabetic patients, strongly protected from diabetic nephropathy, have distinct cellular behaviors that may be associated with reduced ECM production.

Alvarez-Munoz, Patricia; Mauer, Michael; Kim, Youngki; Rich, Stephen S.; Miller, Michael E.; Russell, Gregory B.; Lopez-Novoa, Jose M.; Caramori, M. Luiza

2013-01-01

285

Evaluation of PTPN22 polymorphisms and Vogt-Koyanagi-Harada disease in Japanese patients  

PubMed Central

Purpose Vogt-Koyanagi-Harada (VKH) disease is an autoimmune disorder against melanocytes. Polymorphisms of the protein tyrosine phosphatase non-receptor 22 gene (PTPN22) have recently been reported to be associated with susceptibility to several autoimmune diseases. In this study, genetic susceptibility to VKH disease was investigated by screening for single nucleotide polymorphisms (SNPs) of PTPN22. Methods A total of 167 Japanese patients with VKH disease and 188 healthy Japanese controls were genotyped by direct sequencing methods for six SNPs (rs3811021, rs1217413, rs1237682, rs3761935, rs3789608, and rs2243471) of PTPN22 including the uncoding exons. Results The six SNPs in PTPN22 showed no significant association with susceptibility to VKH disease or its ocular, neurologic, or dermatological manifestation. Conclusions Further studies are needed to clarify the genetic mechanisms underlying VKH disease.

Kitaichi, Nobuyoshi; Katsuyama, Yoshihiko; Yoshida, Kazuhiko; Miura, Toshie; Ota, Masao; Asukata, Yuri; Inoko, Hidetoshi; Mizuki, Nobuhisa; Ishida, Susumu; Ohno, Shigeaki

2009-01-01

286

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.

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

2013-01-01

287

Thyroid Cancer Risk Is Not Increased in Diabetic Patients  

PubMed Central

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

Tseng, Chin-Hsiao

2012-01-01

288

Changes of total antioxidant capacity and total oxidant status of aqueous humor in diabetes patients and correlations with diabetic retinopathy  

PubMed Central

AIM To measure changes of total oxidant status (TOS) and total antioxidant capacity (TAC) of aqueous humor (AH) in diabetic retinopathy (DR) patients, and to determine if there were any differences in TOS and TAC of AH in diabetic patients without retinopathy compared with non-diabetic patients. METHODS One hundred and three eyes of 103 patients who were enrolled for cataract surgery were included in this study. Patients were grouped according to presence of diabetes and stage of DR. Prior to cataract surgery, 0.1mL to 0.2mL of AH was aspirated and analyzed for TAC and TOS level using a colorimetric method. RESULTS TOS levels were highest among proliferative diabetic retinopathy (PDR) patients and lowest in patients with only cataracts. Results were statistically significant between all groups (P<0.05). Whereas result between diabetic without retinopathy patients and non-proliferative diabetic retinopathy (NPDR) patients was not statistically significant (P=0.757). TAC levels were highest in patients with only cataract and lowest among PDR patients and results were statistically significant between all groups (P<0.05). CONCLUSION Aqueous humor TAC levels are low in diabetic patients and reduced further in DR patients, TOS levels are increased in diabetic patients and this is exacerbated in DR patients.

Beyazy?ld?z, Emrullah; Cankaya, Ali Bulent; Ergan, Esra; Anayol, Mustafa Alparslan; Ozdamar, Yasemin; Sezer, Sevilay; T?rh?s, Mehmet Hakan; Y?lmazbas, Pelin; Ozturk, Faruk

2013-01-01

289

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

PubMed Central

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.

Rochester, Charmaine D; Akiyode, Oluwaranti

2014-01-01

290

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

291

Radial augmentation index and diabetic complications in patients with type 2 diabetes mellitus  

Microsoft Academic Search

Background  Increased arterial stiffness is associated with cardiovascular diseases. Aortic augmentation index (AI) depends on arterial\\u000a stiffness, although its relation with diabetic complications was not fully understood. Using radial AI as a surrogate index\\u000a for aortic AI, we studied the relationship between radial AI and diabetic micro- and macroangiopathy in patients with type\\u000a 2 diabetes mellitus.\\u000a \\u000a \\u000a \\u000a \\u000a Methods  Radial and carotid AIs were

S. Morimoto; M. Iwase; Y. Kikuchi; T. Ohkuma; H. Fujii; Y. Hirakawa; Y. Doi

292

Glomerular size-and charge selectivity in Type 2 (non-insulin-dependent) diabetic patients with diabetic nephropathy  

Microsoft Academic Search

Summary  In an attempt to evaluate the mechanisms of proteinuria in diabetic kidney disease, we measured the renal clearances of albumin,\\u000a total IgG, and IgG4 in 20 male Type 2 (non-insulin-dependent) diabetic patients with diabetic glomerulosclerosis (biopsy proven),\\u000a in 10 male Type 2 diabetic patients without nephropathy (urinary albumin excretion rate < 30 mg\\/24 h), and in 10 healthy male\\u000a subjects.

M.-A. Gall; P. Rossing; A. Kofoed-Enevoldsen; F. S. Nielsen; H.-H. Parving

1994-01-01

293

High incidence of periodontitis in Japanese patients with abdominal aortic aneurysm.  

PubMed

Periodontitis is known to be a risk factor for abdominal aortic aneurysm (AAA). However, the influence of periodontitis on AAA in Japanese patients has not yet been elucidated. The aim of this clinical investigation was to assess the relationship between periodontal bacterial burden in AAA patients.We studied 12 AAA patients and 24 age- and sex-matched non-AAA cardiovascular patients. We examined periodontitis and the presence of the periodontal pathogens Porphyromonas gingivalis, Aggregatibacter actinomycetemcomitans, and Prevotella intermedia in oral samples using polymerase chain reaction assays.We found that the AAA patients had deeper pocket depth compared to the non-AAA patients (3.53 ± 0.38 mm versus 2.67 ± 0.17 mm, P < 0.05). However, the populations of periodontal bacteria were comparable between the two groups. Periodontitis may have a greater effect on aneurysm progression compared to other cardiovascular diseases. PMID:24806388

Suzuki, Jun-Ichi; Aoyama, Norio; Aoki, Mieko; Tada, Yuko; Wakayama, Kouji; Akazawa, Hiroshi; Shigematsu, Kunihiro; Hoshina, Katsuyuki; Izumi, Yuichi; Komuro, Issei; Miyata, Tetsuro; Hirata, Yasunobu; Isobe, Mitsuaki

2014-05-26

294

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

295

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

296

Skin rash by gefitinib is a sign of favorable outcomes for patients of advanced lung adenocarcinoma in Japanese patients.  

PubMed

Skin rash is one of the notorious adverse events of gefitinib as well as other epidermal growth factor receptor tyrosine kinase inhibitors. The differences of response rate and frequency of adverse events between ethnic groups are well known. Some reports demonstrated the correlation between development of rash and efficacy in Caucasian patients treated with erlotinib, gefitinib or cetuximab. We analyzed clinical course of Japanese patients of lung adenocarcinoma in order to assess the relation between adverse events and efficacy of gefitinib. Between January 2008 and June 2012, 24 Japanese patients administered gefitinib 250 mg daily. The adverse events were evaluated in accordance with Common Terminology Criteria For Adverse Events v4.0 (CTCAE). Objective response to gefitinib was evaluated with using computed tomography every 1-2 months. The relationship between each adverse event and objective response was examined by chi-square test. The Log-rank Test was used to assess the relationship between the presence of skin rash and overall survival. Twenty four patients with a median age of 67 years (range 55-89) entered were 16 female and 8 male patients; the pathological diagnosis of all patients was adenocarcinoma. Skin rash in CTCAE occurred in 10. The objective response and overall survival among the patients with skin rash was significantly superior to the patients without skin rash. Skin rash by gefitinib correlates with improved clinical outcomes among advanced lung adenocarcinoma patients. PMID:23420789

Sugiura, Yasoo; Nemoto, Etsuo; Kawai, Osamu; Ohkubo, Yasuyuki; Fusegawa, Hisae; Kaseda, Shizuka

2013-12-01

297

Renoprotective effects of angiotensin II receptor blockade in type 1 diabetic patients with diabetic nephropathy  

Microsoft Academic Search

Renoprotective effects of angiotensin II receptor blockade in type 1 diabetic patients with diabetic nephropathy.BackgroundAngiotensin I-converting enzyme (ACE) inhibitors reduce angiotensin II formation and induce bradykinin accumulation. Animal studies suggest that bradykinin may play a role for the effects of ACE inhibition on blood pressure and kidney function. Therefore, we compared the renal and hemodynamic effects of specific intervention in

Steen Andersen; Lise Tarnow; Peter Rossing; Birgitte V Hansen; Hans-Henrik Parving

2000-01-01

298

Functional outcome of elderly hip fracture patients: does diabetes matter?  

PubMed

The purpose of this study was to investigate whether diabetes mellitus may affect the functional outcome of hip fractured patients. We studied 759 consecutive patients admitted for hip fracture rehabilitation, out of whom 18.2% were diabetics. The functional outcomes of diabetics and nondiabetics were assessed by the functional independence measurement scale (FIM) at admission and discharge. Data were analyzed by t-tests, Pearson correlation, and chi-square test as well as by multiple logistic regression analysis. Compared with nondiabetics, diabetic patients were slightly younger (p=0.003) and more hyperlipidemic (p=0.01), had a higher prevalence of previous stroke (p=0.03) and lower cognitive Mini-Mental State Examination (MMSE) scores (p=0.007). Absolute and relative FIM parameters, at admission and discharge, were similar in both groups. A multiple logistic regression analysis showed that diabetes was independently, and inversely, associated with male gender [odds ratio (OR), 2.11 (95% CI, 1.41-3.18)] and higher admission motor-FIM [OR, 1.05 (95% CI, 1.03-1.07)], whereas higher cognitive scores upon admission emerged as being "protective" for being in the motor-FIM gain <20 [OR, 0.94 (95% CI, 0.91-0.97)]. However, diabetes was not associated with any of the parameters indicating unsuccessful rehabilitation. The findings suggest that there is no difference in the functional outcome of diabetic and nondiabetic patients, presenting for rehabilitation after surgery of hip fractures. Diabetes should not be considered as adversely affecting rehabilitation of such patients. PMID:16359740

Mizrahi, E H; Fleissig, Y; Arad, M; Adunsky, A

2006-01-01

299

Results of the DCCT trial. Implications for managing our patients with diabetes.  

PubMed Central

Results of the Diabetes Control and Complications Trial (DDCT) suggest that intensive therapy can prevent or delay the microvascular complications of diabetes. This article critically appraises evidence from the DCCT and other prospective trials and concludes that the successful results for persons with insulin-dependent diabetes cannot be generalized to most family practice diabetes patients, who have non-insulin-dependent diabetes.

Worrall, G.

1994-01-01

300

The association of patient trust and self-care among patients with diabetes mellitus  

PubMed Central

Background Diabetes requires significant alterations to lifestyle and completion of self management tasks to obtain good control of disease. The objective of this study was to determine if patient trust is associated with reduced difficulty and hassles in altering lifestyle and completing self care tasks. Methods A cross-sectional telephone survey and medical record review was performed to measure patient trust and difficulty in completing diabetes tasks among 320 medically underserved patients attending diabetes programs in rural North Carolina, USA. Diabetes tasks were measured three ways: perceived hassles of diabetic care activities, difficulty in completing diabetes-related care activities, and a global assessment of overall ability to complete diabetes care activities. The association of patient trust with self-management was examined after controlling for patient demographics, physical functioning, mental health and co-morbidities. Results Level of patient trust was high (median 22, possible max 25). Higher trust levels were associated with lower levels of hassles (p = 0.006) and lower difficulty in completing care activities (p = 0.001). Patients with higher trust had better global assessments of overall ability to complete diabetes care activities (p < 0.0001). Conclusion Higher patient trust in physicians is associated with reduced difficulty in completing disease specific tasks by patients. Further studies are needed to determine the causal relationship of this association, the effect of trust on other outcomes, and the potential modifiability of trust

Bonds, Denise E; Camacho, Fabian; Bell, Ronny A; Duren-Winfield, Vanessa T; Anderson, Roger T; Goff, David C

2004-01-01

301

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.

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

2012-01-01

302

An Exploration of Barriers to Insulin Initiation for Physicians in Japan: Findings from the Diabetes Attitudes, Wishes and Needs (DAWN) JAPAN Study  

Microsoft Academic Search

ObjectiveInsulin is recommended as an appropriate treatment in type 2 diabetes patients with suboptimal glycemic control; however, its initiation is often delayed. We therefore conducted the DAWN (Diabetes Attitudes, Wishes and Needs) JAPAN study in an attempt to identify specific patient- and physician-related factors which contribute to delay of insulin initiation among Japanese patients with diabetes. In this report, we

Hitoshi Ishii; Yasuhiko Iwamoto; Naoko Tajima

2012-01-01

303

Morganella morganii-associated arthritis in a diabetic patient.  

PubMed

This case report involves a 60-year-old diabetic man who developed septic arthritis as a result of the pathogen Morganella morganii. The patient had complaints of elevated body temperature, malaise, rigors and pain in the left knee, despite no history of trauma. On examination of the knee, erythema, warmth, tenderness and swelling was observed. Arthrocentesis performed on his left knee indicated the presence of straw-coloured, cloudy fluid without crystals. Bacterial identification based on biochemical and automated methods indicated the growth of M morganii. M morganii was also isolated sedimentafrom the exudate of a diabetic ulcer in the left foot, with antibiotic susceptibilities identical to those from the knee effusion. This case indicates that M morganii may be considered as a possible cause of septic arthritis in diabetic patients, especially those with diabetic foot infections. PMID:18327547

Cetin, Meryem; Ocak, Sabahattin; Kuvandik, Guven; Aslan, Bahadir; Temiz, Muhyittin; Aslan, Ahmet

2008-03-01

304

Budd-Chiari syndrome in a patient of diabetic ketoacidosis  

PubMed Central

We report a rare case of Budd-Chiari syndrome developing in a patient undergoing treatment for diabetic ketoacidosis. A 27-year-old female presented with newly detected Type 1 diabetes with sepsis in ketoacidosis. During the process of treatment, she developed pain abdomen, ascites, and pedal edema. Investigations revealed an alteration of liver function and imaging characteristics of acute on chronic Budd–Chiari syndrome. All known etiological factors for Budd–Chiari syndrome were negative. Diabetic ketoacidosis, being a severely dehydrated state often associated with sepsis, may precipitate an acute presentation of previously asymptomatic Budd–Chiari syndrome.

Dasgupta, Arundhati; Saikia, Uma Kaimal; Sharma, Dipti; Choudhury, Bikash

2012-01-01

305

Visual outcome in Japanese patients with Acanthamoeba keratitis  

PubMed Central

Purpose To identify prognostic factors affecting visual outcome in Acanthamoeba keratitis (AK) treated with topical chlorhexidine gluconate (CHG). Methods A total of 35 eyes in 34 patients with AK were treated with 0.02% topical CHG. Patients were divided into two groups according to the final visual outcome: Group 1, final visual acuity (VA) of 20/25 or greater (22 eyes); Group 2, less than 20/25 (13 eyes). We compared these groups and evaluated the effectiveness of topical CHG compared with outcomes in previous reports. Results Ring infiltrate was observed more often in Group 2 (4.5% vs 61.5%, OR 33.6, 95% confidence interval (CI) 3.4–333.9, P<0.01). The duration between onset and diagnosis of AK was significantly longer (24.9 days vs 48.4 days, OR 1.03, 95% CI 1.00–1.06, P=0.04) and VA at initial examination (log MAR) significantly lower (0.47 vs 1.59, OR 25.5, 95% CI 3.4–186.7, P<0.01) in Group 2 (visual outcome <20/25). Multivariate analysis revealed that only VA at initial examination was independently associated with worse visual outcome (adjusted OR 24.5, 95% CI 1.9–312.6, P=0.01). Seventeen (85.0%) of the 20 eyes diagnosed within 1 month and 24 (82.8%) of 29 eyes diagnosed within 2 months achieved a VA of 20/40 or greater. Conclusion VA at initial examination was the most predictive factors for final visual outcome in AK. Topical CHG was comparably effective to other treatments, including polyhexamethyl biguanide and propamidine isethionate.

Yamazoe, K; Yamamoto, Y; Shimazaki-Den, S; Shimazaki, J

2012-01-01

306

[Diabetes].  

PubMed

The new recommendations on the pharmacological treatment of type 2 diabetes have introduced two important changes. The first is to have common strategies between European and American diabetes societies. The second, which is certainly the most significant, is to develop a patient centred approach suggesting therapies that take into account the patient's preferences and use of decision support tools. The individual approach integrates six factors: the capacity and motivation of the patient to manage his illness and its treatment, the risks of hypoglycemia, the life expectancy, the presence of co-morbidities and vascular complications, as well as the financial resources of the patient and the healthcare system. Treatment guidelines for cardiovascular risk reduction in diabetic remains the last point to develop. PMID:23409644

Ruiz, J

2013-01-16

307

Surface dyslexia in a Japanese patient with semantic dementia: evidence for similarity-based orthography-to-phonology translation  

Microsoft Academic Search

We studied the reading performance of a Japanese-speaking patient, TI, with bilateral but asymmetrical (left more than right) temporal-lobe atrophy, severe anomia, and poor word comprehension. Most Japanese kanji characters correspond to several different legitimate pronunciations in different contexts, with varying degrees of correspondence consistency. TI made many errors in reading aloud words that violate statistically typical character-sound correspondences, especially

Takao Fushimi; Kenjiro Komori; Manabu Ikeda; Karalyn Patterson; Mutsuo Ijuin; Hirotaka Tanabe

2003-01-01

308

Iris and periocular adverse reactions to bimatoprost in Japanese patients with glaucoma or ocular hypertension  

PubMed Central

Purpose To prospectively investigate adverse reactions to bimatoprost in Japanese patients with glaucoma or ocular hypertension. We also examined patient attitudes to adverse reactions via a questionnaire. Methods Fifty-two Japanese patients with glaucoma or ocular hypertension were enrolled. Iridial, eyelid, and eyelash photographs were taken before and at 6 months after bimatoprost treatment. Increase in eyelid pigmentation, iridial pigmentation, eyelash growth and bristle, and vellus hair of the lid was assessed from the photographs. Questionnaires completed by patients provided insight into their subjective judgment of adverse reactions. Results Increase in eyelash bristle (53.8%), iris pigmentation (50.0%), eyelash growth (46.2%), vellus hair of the lid (40.4%), and eyelid pigmentation (7.7%) was evident after bimatoprost treatment. The objective and subjective assessments were in agreement in terms of increase in eyelash bristle, eyelash growth, and increase in vellus hair of the lid. Conclusion Most patients were conscious of these adverse reactions. Before administering bimatoprost, sufficient explanation of potential adverse reactions should be provided; after initiating treatment, careful observation is required.

Inoue, Kenji; Shiokawa, Minako; Sugahara, Michitaka; Higa, Risako; Wakakura, Masato; Tomita, Goji

2012-01-01

309

Impact of disease severity on work productivity and activity impairment in Japanese patients with atopic dermatitis.  

PubMed

Atopic dermatitis (AD) is a common inflammatory skin disease that is characterized by chronic and persisting pruritic and eczematous lesions. There has been no study of work productivity and activity in AD patients in relation to disease severity. The purpose of this study was to examine the impact of disease severity on work productivity and activity impairment (WPAI) in adult AD patients using the Japanese version of the questionnaire. Data were collected from 112 AD patients who visited the Jikei University Hospital. Outcomes as measured by the questionnaire included employment status, total work productivity impairment (TWPI) and total activity impairment (TAI). We investigated the correlation between TWPI or TAI scores and severity scoring of AD (SCORAD) for disease severity and dermatology life quality index (DLQI) for quality of life impairment. Both TWPI and TAI scores were significantly correlated with the SCORAD and DLQI scores (P < 0.001), indicating disease severity is significantly associated with WPAI in Japanese adult AD patients. Further studies are necessary to evaluate the effects of treatments on WPAI for severe AD patients. PMID:23834561

Yano, Chizuko; Saeki, Hidehisa; Ishiji, Takaoki; Ishiuji, Yozo; Sato, Junko; Tofuku, Yukari; Nakagawa, Hidemi

2013-09-01

310

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

PubMed Central

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 increased in ACA positive SSc patients compared with ACA negative SSc patients (36% versus 13%; p = 0.02, odds ratio = 4.0, 95% confidence interval 1.1 to 13.9), but the association of ACA with a polar amino acid at position 26 in the DQB1 beta 1 domain, which was demonstrated in white North Americans, was not observed in Japanese. The DRB1*0101, *0405, and *1302 alleles were associated with high ACA titres, whereas DRB1*1502 was associated with low ACA titres and a low frequency of centromere protein C (CENP-C) reactivity. CONCLUSIONS--These results suggest that the ACA response is associated with multiple HLA class II genes and that ACA positive SSc patients are heterogeneous in terms of immunogenetic background.

Kuwana, M; Okano, Y; Kaburaki, J; Inoko, H

1995-01-01

311

The health behaviour of Black insulin dependent diabetic patients.  

PubMed

This descriptive retrospective study explores the perceptions and experiences relating to their disease of 20 adult Black insulin-dependent diabetic clients in terms of Cox's Interaction Model of Client Health Behaviour. Cognitive and affective responses were investigated by means of structured interviews. Questionnaires completed by 30 registered nurses examined by their impressions of diabetic patients' motivation and levels of satisfaction with their care. Findings are discussed and recommendations made. PMID:1845618

Xaba, G L; Dewar, S R

1991-08-01

312

Progression of nephropathy in type 2 diabetic patients  

Microsoft Academic Search

Progression of nephropathy in type 2 diabetic patients.BackgroundNephropathy in type 2 diabetes is the single most common cause of end-stage renal disease (ESRD), but the decline in kidney function varies considerably between individuals, and determinants of renal function loss, early in the course of renal disease, have not been clearly identified.MethodsIn a prospective observational study, we followed 227 (60 female)

KASPER ROSSING; PER K CHRISTENSEN; PETER HOVIND; LISE TARNOW; PETER ROSSING; HANS-HENRIK PARVING

2004-01-01

313

Pure apraxic agraphia with abnormal writing stroke sequences: report of a Japanese patient with a left superior parietal haemorrhage  

Microsoft Academic Search

A 67 year old Japanese male patient had pure agraphia after a haemorrhage in the left superior parietal lobule. He developed difficulty in letter formation but showed no linguistic errors, consistent with the criteria of apraxic agraphia. He manifested a selective disorder of sequencing writing strokes, although he was able to orally state the correct sequences. The patient’s complete recovery

Mika Otsuki; Yoshiaki Soma; Toshiko Arai; Atsuko Otsuka; Shoji Tsuji

1999-01-01

314

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

PubMed Central

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

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

2012-01-01

315

[JMIC-B study and its sub-analyses: effect of nifedipine in Japanese hypertensive patients with coronary artery disease].  

PubMed

It is thought that coronary artery spasm is involved in the pathogenesis of coronary artery disease in a large proportion of Japanese patients. However, large-scale trial data in Japanese patients were lacking. The JMIC-B (Japan Multicenter Investigation for Cardiovascular Diseases-B) study conducted for Japanese hypertensive patients with coronary artery disease, compared the incidence of cardiac events (cardiac death or sudden death, myocardial infarction, hospitalization for angina pectoris or heart failure, serious arrhythmia, and coronary interventions) in patients receiving twice-daily nifedipine or an angiotensin-converting enzyme (ACE) inhibitor (enalapril, lisinopril or imidapril). There was a similar incidence of cardiac events in both treatment groups but exacerbation of angina pectoris in patients with a history of myocardial infarction was lower with nifedipine. Nifedipine appeared to be better than ACE inhibitor in inhibiting the progression of coronary atherosclerosis and the development of coronary artery stenosis as evidenced by quantitative coronary angiogram (QCA) analysis. PMID:18200776

Yui, Yoshiki

2006-01-01

316

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.

Xia, Jianfei; Wang, Zonghua; Zhang, Feifei

2014-01-01

317

Body mass index and retinopathy in type 1 diabetic patients.  

PubMed

Aim. To investigate whether body mass index (BMI) independently or in correlation with other risk factors is associated with diabetic retinopathy (DR) progression. Methods. The study included 176 patients with type 1 diabetes divided into three groups according to DR status: group 1 (no retinopathy; n = 86), group 2 (mild/moderate nonproliferative DR; n = 33), and group 3 (severe/very severe NPDR or proliferative DR; n = 57). Results. A significant deterioration of HbA1c, an increase in total cholesterol, systolic, diastolic blood pressure, and diabetic nephropathy with the progression of retinopathy were found. DR progression was correlated with diabetes duration, HbA1c, hypertension, total cholesterol, and the presence of nephropathy. In patients without nephropathy, statistical analyses showed that progression of retinopathy increased significantly with higher BMI (gr. 1: 24.03?±?3.52, gr. 2: 25.36?±?3.44, gr. 3: 26.93?±?3.24; P < 0.01). A positive correlation between BMI and a significant deterioration of HbA1c, an increase in cholesterol, triglycerides, and hypertension was observed. Conclusion. BMI in correlation with HbA1c, cholesterol, and hypertension appears to be associated with the progression of DR in type 1 diabetic patients without nephropathy. However, additional studies are required to investigate the pathogenic role of obesity and weight loss in retinal diabetic complications particularly relating to nephropathy. PMID:24696683

Kaštelan, Snježana; Salopek Rabati?, Jasminka; Tomi?, Martina; Gverovi? Antunica, Antonela; Ljubi?, Spomenka; Kaštelan, Helena; Novak, Branko; Oreškovi?, Darko

2014-01-01

318

Body Mass Index and Retinopathy in Type 1 Diabetic Patients  

PubMed Central

Aim. To investigate whether body mass index (BMI) independently or in correlation with other risk factors is associated with diabetic retinopathy (DR) progression. Methods. The study included 176 patients with type 1 diabetes divided into three groups according to DR status: group 1 (no retinopathy; n = 86), group 2 (mild/moderate nonproliferative DR; n = 33), and group 3 (severe/very severe NPDR or proliferative DR; n = 57). Results. A significant deterioration of HbA1c, an increase in total cholesterol, systolic, diastolic blood pressure, and diabetic nephropathy with the progression of retinopathy were found. DR progression was correlated with diabetes duration, HbA1c, hypertension, total cholesterol, and the presence of nephropathy. In patients without nephropathy, statistical analyses showed that progression of retinopathy increased significantly with higher BMI (gr. 1: 24.03?±?3.52, gr. 2: 25.36?±?3.44, gr. 3: 26.93?±?3.24; P < 0.01). A positive correlation between BMI and a significant deterioration of HbA1c, an increase in cholesterol, triglycerides, and hypertension was observed. Conclusion. BMI in correlation with HbA1c, cholesterol, and hypertension appears to be associated with the progression of DR in type 1 diabetic patients without nephropathy. However, additional studies are required to investigate the pathogenic role of obesity and weight loss in retinal diabetic complications particularly relating to nephropathy.

Kastelan, Snjezana; Salopek Rabatic, Jasminka; Tomic, Martina; Gverovic Antunica, Antonela; Ljubic, Spomenka; Kastelan, Helena; Oreskovic, Darko

2014-01-01

319

Transplantation of porcine fetal pancreas to diabetic patients.  

PubMed

Transplantation of fetal porcine islet-like cell clusters (ICC) reverses diabetes in experimental animals. We have now transplanted porcine ICC to ten insulin-dependent diabetic kidney-transplant patients. All patients received standard immunosuppression and, at ICC transplantation, antithymocyte globulin or 15-deoxyspergualin. ICC were injected intraportally or placed under the kidney capsule of the renal graft. Four patients excreted small amounts of porcine C-peptide in urine for 200-400 days. In one renal-graft biopsy specimen, morphologically intact epithelial cells stained positively for insulin and glucagon in the subcapsular space. We conclude that porcine pancreatic endocrine tissue can survive in the human body. PMID:7968077

Groth, C G; Korsgren, O; Tibell, A; Tollemar, J; Möller, E; Bolinder, J; Ostman, J; Reinholt, F P; Hellerström, C; Andersson, A

1994-11-19

320

Identifying patients at risk of type 2 diabetes.  

PubMed

At present there are nearly 3 million people with diabetes in the UK. It is predicted that this number will almost double by 2025. Nine out of ten of these individuals will have type 2 diabetes. It is estimated that one in seven adults have impaired glucose regulation and up to 12% of these will develop type 2 diabetes each year. The impact of obesity on the development of type 2 diabetes cannot be overemphasised, with a 1 kg/m2 increase in BMI raising the risk of impaired fasting glycaemia by 9.5% and of developing new-onset type 2 diabetes by 8.4%. A 1 cm increase in waist circumference increases the risks by 3.2% and 3.5% respectively. NICE advises using a validated risk assessment tool to identify patients at risk of diabetes. Risk factors used by such tools include: age; ethnicity; weight; first-degree relative with type 2 diabetes; low birthweight and sedentary lifestyle. Certain comorbidities increase the risk of type 2 diabetes, these include: cardiovascular and cerebrovascular disease; polycystic ovary syndrome; a history of gestational diabetes; and mental health problems. The initial screening blood test could be a fasting plasma glucose, HbA1c, or an oral glucose tolerance test, according to WHO criteria. NICE recommends that high-risk patients should be offered a programme encouraging them to undertake a minimum of 150 minutes of moderate intensity physical activity a week, gradually lose weight to reach and maintain a BMI within the healthy range, increase consumption of whole grains, vegetables, and other foods that are high in dietary fibre, reduce the total amount of fat in their diet and eat less saturated fat. PMID:22988703

Savill, Peter

2012-01-01

321

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.

Azadbakht, Leila

2013-01-01

322

[Neuroprotector therapy of patients with decompensated diabetes mellitus type 1].  

PubMed

The influence of actovegin and reamberin on diabetic ketoacidotic crises has been studied on a group of 128 patients with severe diabetic ketoacidosis on the background of diabetes mellitus type 1 with disorders ranging from consciousness to coma or precoma states. Patients of group 1 received standard intensive therapy of diabetic ketoacidosis. In group 2, an intensive therapy for neuroprotection by actovegin was added. In group 3, patients received reamberin on the background of standard therapy. In group 4, the neuroprotective therapy using actovegin and reamberin was combined. The mental status was estimated upon recovery from coma, on 5th and 28th days from the beginning of treatment, by taking into consideration cognitive functions such as attention, memory, mentality. The results showed that the use of neuroprotective drugs, including the combination of actovegin and reamberin, allowed to the restore the compensatory-adaptive reaction of patients to ketoacidotic crisis, accelerate the restoration of consciousness within 19.2 +/- 3.8 h, restore the cognitive functions with exceeding norm for patients with diabetes mellitus in compensation stage and maintain their high level on 28th day after crisis. PMID:22379876

Kligunenko, E N; Sedinkin, V A

2011-01-01

323

Complications of ankle fracture in patients with diabetes.  

PubMed

Ankle fractures in patients with diabetes mellitus have long been recognized as a challenge to practicing clinicians. Complications of impaired wound healing, infection, malunion, delayed union, nonunion, and Charcot arthropathy are prevalent in this patient population. Controversy exists as to whether diabetic ankle fractures are best treated noninvasively or by open reduction and internal fixation. Patients with diabetes are at significant risk for soft-tissue complications. In addition, diabetic ankle fractures heal, but significant delays in bone healing exist. Also, Charcot ankle arthropathy occurs more commonly in patients who were initially undiagnosed and had a delay in immobilization and in patients treated nonsurgically for displaced ankle fractures. Several techniques have been described to minimize complications associated with diabetic ankle fractures (eg, rigid external fixation, use of Kirschner wires or Steinmann pins to increase rigidity). Regardless of the specifics of treatment, adherence to the basic principles of preoperative planning, meticulous soft-tissue management, and attention to stable, rigid fixation with prolonged, protected immobilization are paramount in minimizing problems and yielding good functional outcomes. PMID:18316714

Chaudhary, Saad B; Liporace, Frank A; Gandhi, Ankur; Donley, Brian G; Pinzur, Michael S; Lin, Sheldon S

2008-03-01

324

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.

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

2014-01-01

325

Basal Insulin Requirement Is ~30% of the Total Daily Insulin Dose in Type 1 Diabetic Patients Who Use the Insulin Pump  

PubMed Central

OBJECTIVE To investigate the basal insulin requirement in total daily insulin dose in Japanese type 1 diabetic patients who use the insulin pump. RESEARCH DESIGN AND METHODS The basal insulin requirement in 35 type 1 diabetic patients without detectable C-peptide using the insulin pump (Paradigm 712) was investigated during 2–3 weeks of hospitalization. The patients were served diabetic diets of 25–30 kcal/kg ideal body weight. Each meal omission was done to confirm stable blood glucose levels within 30 mg/dL variance until the next meal. Target blood glucose level was set at 100 mg/dL before each meal and 150 mg/dL at 2 h after each meal. RESULTS Total daily insulin dose was 31.6 ± 8.5 units, and total basal insulin requirement was 8.7 ± 2.9 units, which was 27.7 ± 6.9% of the total daily dose. CONCLUSIONS Basal insulin requirement is ?30% of the total daily dose in Japanese type 1 diabetic patients who use the insulin pump.

Kuroda, Akio; Kaneto, Hideaki; Yasuda, Tetsuyuki; Matsuhisa, Munehide; Miyashita, Kazuyuki; Fujiki, Noritaka; Fujisawa, Keiko; Yamamoto, Tsunehiko; Takahara, Mitsuyoshi; Sakamoto, Fumie; Matsuoka, Taka-aki; Shimomura, Iichiro

2011-01-01

326

Updated management of chronic kidney disease in patients with diabetes.  

PubMed

Chronic diseases, including chronic kidney disease (CKD), are the primary threat to global public health in the 21st century. Recently updated guidelines from the National Kidney Foundation's Kidney Disease Outcomes Quality Initiative provide patient care benchmarks that physician assistants can use when caring for patients with diabetes and CKD and developing clinical performance improvement plans. PMID:24819952

Hass, Virginia McCoy

2014-06-01

327

The management of diabetes in patients with advanced cancer  

Microsoft Academic Search

The management of diabetes mellitus is often complicated in patients with advanced cancer.Anorexia and nausea or vomiting make caloric intake erratic. The use of diabetogenic medications such as glucocorticoids can produce profound hyperglycemia. Many malignant tumors cause derangement in intermediary metabolism and abnormal glucose tolerance in up to one-third of patients. Both hyperglycemia and hypoglycemia impair the quality of life

Jane Poulson

1997-01-01

328

Burkholderia gladioli associated abscess in a type 1 diabetic patient.  

PubMed

Burkholderia gladioli, a bacterial pathogen, causes a variety of infectious ailments in immunocompromised individuals. We present a case report of foreign body associated Burkholderia gladioli related abscess in an immunocompetent type 1 diabetic patient. Relevant medical literature is reviewed to understand this unusual mode of presentation of this bacterium in our patient. PMID:18626540

Waseem, Mohiuddin; Al-Sherbeeni, Suphia; Al-Malki, Mussa H; Al-Ghamdi, Mubarak S

2008-07-01

329

XRCC3 Gene Polymorphism Is Associated with Survival in Japanese Lung Cancer Patients  

PubMed Central

We focused on OGG1 Ser326Cys, MUTYH Gln324His, APEX1 Asp148Glu, XRCC1 Arg399Gln, and XRCC3 Thr241Met and examined the relationship between the different genotypes and survival of Japanese lung cancer patients. A total of 99 Japanese lung cancer patients were recruited into our study. Clinical data were collected, and genotypes of the target genes were identified by polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP). Survival analysis to verify the impact of these gene polymorphisms on the clinical outcome of lung cancer showed that lung squamous cell carcinoma patients with the Thr/Met genotype at XRCC3 had a significantly shorter survival time than those with the Thr/Thr genotype (13 months versus 48 months; log-rank test, p < 0.0001). Cox regression analysis showed that the carriers of XRCC3 genotypes were at a significantly higher risk [adjusted hazard ratio (HR) = 9.35, 95% confidence interval (CI) = 2.52–34.68, p = 0.001; adjusted HR = 9.05, 95% CI = 1.89–44.39, p = 0.006]. Our results suggest that XRCC3 Thr241Met may act as a favorable prognostic indicator for lung squamous cell carcinoma patients.

Osawa, Kayo; Nakarai, Chiaki; Uchino, Kazuya; Yoshimura, Masahiro; Tsubota, Noriaki; Takahashi, Juro; Kido, Yoshiaki

2012-01-01

330

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

PubMed Central

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

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

2013-01-01

331

Yogic practice and diabetes mellitus in geriatric patients  

PubMed Central

Background: Stress has negative effect on health and type 2 diabetes patients may be at an increased risk. Abnormally high levels of free radicals and the simultaneous decline of antioxidant defense mechanisms can increase lipid peroxidation and insulin resistance. The objective of the present study was to demonstrate the efficacy of yogic practice in geriatric patients with type 2 diabetes mellitus and also to compare the efficacy with the state of glycaemic control. Materials and Methods: Seventy three (73) healthy elderly patients of type 2 diabetes mellitus in the age group of 60 to 70 years with a history of diabetes for 5 to 10 years and with poor glycaemic control (HbA1c >8 %) residing in Kozhikode district were recruited for the study. The subjects were divided into three groups according to their glycaemic control. Group I with HbA1c 8.6–9.7 %, group II with HbA1c 9.8–10.7 % and group III with HbA1c 10.8–12.7 %. Participants did yogic practice under the supervision of experienced trainer, daily 90 minutes and for three months. Biochemical estimation of HbA1c, glucose, lipid profile, cortisol, ferritin, malondialdehyde (MDA) and catalase activity were carried out on 0 day and 90th day. Seventy patients participated in a comparable control session. Results: The participants in the test group showed statistically significant (P < 0.001) decrease in glucose, HbA1c, lipids, cortisol, ferritin, MDA and significant increase in catalase activity after yogic practice. Conclusions: Yoga may improve risk profiles induced by stress in geriatric patients with type 2 diabetes and may have promise for the prevention or delay in diabetes complications. And at all stages of the disease a significant improvement can be achieved by yogic practice in geriatric diabetes.

Beena, Rani K; Sreekumaran, E

2013-01-01

332

Cortisol correlates with metabolic disturbances in a population study of type 2 diabetic patients  

Microsoft Academic Search

Objective: The prevalence of type 2 diabetes mellitus is increasing rapidly in industrialized countries, and adrenal glucocorticoids may intensify this disease. We sought to assess the relationship between diabetes-associated metabolic disturbances and cortisol concentrations in patients with type 2 diabetes. Design: We investigated 190 type 2 diabetic patients who volunteered from a population study of 12430 people in Luebeck and

Kerstin M Oltmanns; Baerbel Dodt; Bernd Schultes; Hans H Raspe; Ulrich Schweiger; Jan Born; Horst L Fehm; Achim Peters

2006-01-01

333

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

PubMed Central

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

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

2011-01-01

334

Homocysteine Serum Levels in Diabetic Patients with Non Proliferative, Proliferative and without Retinopathy  

PubMed Central

Homocysteine has been associated with extracellular matrix changes. The diabetic retinopathy is a neurovascular complication of diabetes mellitus and it is the leading cause of vision loss among working adults worldwide. In this study, we evaluate the role of homocysteine in diabetic retinopathy analyzing the plasma levels of homocysteine in 63 diabetic type 2 patients with nonproliferative retinopathy (NPDR), 62 patients with proliferative diabetic retinopathy (PDR), 50 healthy subjects used as control group, and 75 randomly selected patients.

Gagliano, Caterina; Giordano, Maria; Vacante, Marco; Caraci, Filippo; Drago, Filippo; Avitabile, Teresio; Motta, Massimo

2014-01-01

335

Homocysteine Serum Levels in Diabetic Patients with Non Proliferative, Proliferative and without Retinopathy.  

PubMed

Homocysteine has been associated with extracellular matrix changes. The diabetic retinopathy is a neurovascular complication of diabetes mellitus and it is the leading cause of vision loss among working adults worldwide. In this study, we evaluate the role of homocysteine in diabetic retinopathy analyzing the plasma levels of homocysteine in 63 diabetic type 2 patients with nonproliferative retinopathy (NPDR), 62 patients with proliferative diabetic retinopathy (PDR), 50 healthy subjects used as control group, and 75 randomly selected patients. PMID:24877066

Malaguarnera, Giulia; Gagliano, Caterina; Giordano, Maria; Salomone, Salvatore; Vacante, Marco; Bucolo, Claudio; Caraci, Filippo; Reibaldi, Michele; Drago, Filippo; Avitabile, Teresio; Motta, Massimo

2014-01-01

336

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

Microsoft Academic Search

BACKGROUND: Current guidelines recommend education, physical activity and changes in diet for type 2 diabetes patients, yet the composition and organization of non-pharmacological care are still controversial. Therefore, it is very important that programmes aiming to improve non-pharmacological treatment of type 2 diabetes are developed and evaluated. The Copenhagen Type 2 Diabetes Rehabilitation Project aims to evaluate the effectiveness of

Eva S Vadstrup; Anne Frřlich; Hans Perrild; Eva Borg; Michael Rřder

2009-01-01

337

Development of postpartum Graves' disease and type 1 diabetes after delivery in a patient with gestational diabetes.  

PubMed

Pregnancy and the postpartum period are associated with changes of the immune system. These changes might eventually result in autoimmune diseases, such as Graves' disease and type?1 diabetes mellitus, in the postpartum period. We describe a case of a patient with gestational diabetes who developed both Graves' disease and type?1 diabetes mellitus in the postpartum period. The pathology of gestational diabetes (GDM) is close to that of type?2 diabetes mellitus. However, the present case emphasizes the importance of screening and monitoring high-risk GDM patients for all available autoimmune antibodies throughout pregnancy and the postpartum period, as GDM has a risk of developing into type?1 diabetes and multiple autoimmune diseases. In addition, only Graves' disease was transient, whereas type?1 diabetes mellitus remained permanent in the present case. Thus, the present case shows etiological differences between these two autoimmune diseases. (J Diabetes Invest, doi: 10.1111/j.2040-1124.2010.00089.x,2011). PMID:24843507

Negishi, Mayumi; Shimomura, Kenju; Proks, Peter; Nakahara, Rieko; Murakami, Masami; Shimomura, Yohnosuke; Kobayashi, Isao

2011-08-01

338

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

339

Dietary glycemic index, glycemic load and incidence of type 2 diabetes in Japanese men and women: the Japan public health center-based prospective study  

PubMed Central

Background Japanese diets contain a relatively high amount of carbohydrates, and its high dietary glycemic index and glycemic load may raise the risk of diabetes in the Japanese population. The current study evaluated the associations between the dietary glycemic index, glycemic load, and the risk of type 2 diabetes in a population based cohort in Japan. Methods We observed 27,769 men and 36,864 women (45–75 y) who participated in the second survey of the Japan Public Health Center-based Prospective Study. The dietary glycemic index and glycemic load were estimated using a food-frequency questionnaire. The development of diabetes was reported in a questionnaire administered five years later, and the associations were analyzed using logistic regression after controlling for age, area, total energy intake, smoking status, family history of diabetes, physical activity, hypertension, BMI, alcohol intake, magnesium, calcium, dietary fiber and coffee intake, and occupation. Results The dietary glycemic load was positively associated with the risk of diabetes among women: the multivariable-adjusted odds ratio comparing the highest vs. the lowest quartile was 1.52 (95% CI, 1.13-2.04; P-trend?=?0.01). The association was implied to be stronger among women with BMI?diabetes among men with a high intake of total fat: the multivariable-adjusted odds ratio comparing the highest vs. the lowest quartile was 1.46 (95% CI, 0.94-2.28; P-trend?=?0.04). Among women with a high total fat intake, those in the first and second quartiles of the dietary glycemic index had a significant reduced risk of diabetes, compared with those in the first quartile who had a lower total fat level (multivariable-adjusted odds ratio?=?0.59 with 95% CI, 0.37-0.94, and odds ratio?=?0.63 with 95% CI, 0.40-0.998 respectively). Conclusions The population-based cohort study in Japan indicated that diets with a high dietary glycemic load increase the risk of type 2 diabetes among women. Total fat intake may modify the association between the dietary glycemic index and the risk of type 2 diabetes among men and women.

2013-01-01

340

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.

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

341

Sleep Disturbances and Glucoregulation in Patients with Type 2 Diabetes  

PubMed Central

We investigated the frequency of sleep disturbances and the association between sleep disturbances and glucoregulation in type 2 diabetic patients. The frequency of sleep disturbances in 614 type 2 diabetic patients was investigated using validated sleep questionnaires. There were 381 male and 233 female patients. The mean age was 59.7 ± 11.1 yr; the mean body mass index was 24.9 ± 4.4 kg/m2; the mean HbA1c was 7.8% ± 1.5%; and the mean duration of diabetes was 10.3 ± 8.4 yr. The questionnaires revealed insomnia in 48.2% of the patients while 8.5% reported excessive daytime sleepiness. A total of 49% of the patients was poor sleepers, while 28.5% had depression. Multivariate logistic regression analysis showed that there was no significant association between HbA1c and other sleep disturbances, such as poor sleep, insomnia, and short duration of sleep. Sleep disturbances were very common in patients with type 2 diabetes mellitus, whereas there was no association between poor or short sleep and glucoregulation. Awareness and identifying sleep complaints in such patients are necessary to improve their quality of daily life.

Cho, Eun-Hee; Lee, HeyJean; Ryu, Ohk Hyun; Choi, Moon Gi

2014-01-01

342

Proximal gastric motility in critically ill patients with type 2 diabetes mellitus  

PubMed Central

AIM: To investigate the proximal gastric motor response to duodenal nutrients in critically ill patients with long-standing type 2 diabetes mellitus. METHODS: Proximal gastric motility was assessed (using a barostat) in 10 critically ill patients with type 2 diabetes mellitus (59 ± 3 years) during two 60-min duodenal infusions of Ensure® (1 and 2 kcal/min), in random order, separated by 2 h fasting. Data were compared with 15 non-diabetic critically ill patients (48 ± 5 years) and 10 healthy volunteers (28 ± 3 years). RESULTS: Baseline proximal gastric volumes were similar between the three groups. In diabetic patients, proximal gastric relaxation during 1 kcal/min nutrient infusion was similar to non-diabetic patients and healthy controls. In contrast, relaxation during 2 kcal/min infusion was initially reduced in diabetic patients (p < 0.05) but increased to a level similar to healthy humans, unlike non-diabetic patients where relaxation was impaired throughout the infusion. Duodenal nutrient stimulation reduced the fundic wave frequency in a dose-dependent fashion in both the critically ill diabetic patients and healthy subjects, but not in critically ill patients without diabetes. Fundic wave frequency in diabetic patients and healthy subjects was greater than in non-diabetic patients. CONCLUSION: In patients with diabetes mellitus, proximal gastric motility is less disturbed than non-diabetic patients during critical illness, suggesting that these patients may not be at greater risk of delayed gastric emptying.

Nguyen, Nam Q; Fraser, Robert J; Bryant, Laura K; Chapman, Marianne; Holloway, Richard H

2007-01-01

343

Telemedicine in paediatric patients with poorly controlled type 1 diabetes.  

PubMed

We conducted a retrospective study of a telemedicine clinic for paediatric patients with poorly controlled type 1 diabetes. Thirty-one patients (mean age 12 years) were enrolled into the clinic. After an initial visit, a group messaging system was provided to allow communication with the diabetic team which consisted of a diabetic provider, diabetic educator, insulin pump trainer and dietician. Patients and parents were encouraged to make all contacts by electronic means. For urgent matters, direct paging access was provided to the diabetic team. Adjustments in insulin dosing were accomplished via automated web-based communication or email between patient and provider. Compared to baseline, the HbA1c levels were significantly lower at 3 months (9.1% vs. 11.1%, P < 0.05) and 6.5 months (9.5% vs. 11.1%, P < 0.05). There were no significant differences in HbA1c levels for different age categories, insulin delivery methods or number of telemedicine encounters. The study showed that while telemedicine was effective in lowering HbA1c levels, it did not achieve optimum control. PMID:23401606

Choi, Y Sammy; Berry-Cabán, Cristóbal; Nance, Julie

2013-06-01

344

Neonatal diabetes mellitus: patient report and review of the literature.  

PubMed

A female infant born at 33 weeks gestation to a gestationally diabetic mother developed apnea and respiratory distress at 6 hours of age. Laboratory investigation demonstrated persistent hyperglycemia, and the patient was treated with continuous intravenous and subsequent subcutaneous insulin therapy. Detailed laboratory investigation to reveal the etiology of hyperglycemia and further endocrine evaluation were not significant. The baby's insulin requirement has continued thereafter, and she is being followed up in an outpatient clinic still under insulin therapy at 18 months of age. Neonatal diabetes mellitus should be considered in the differential diagnosis of neonatal hyperglycemia, and it may develop in newborns born to diabetic mothers, as well as neonatal hypoglycemia. Insulin treatment with close blood glucose monitoring is essential as long as hyperglycemia persists since neonatal diabetes mellitus may be either transient or permanent and it is not possible to differentiate these two outcomes before 18 months of age. PMID:11327380

Sarici, S U; Alpay, F; Dündaryz, M R; Gyknay, E

2001-04-01

345

Thyroid disorders in patients of type 2 diabetes mellitus.  

PubMed

The study was planned to assess the prevalence of thyroid disorders in type 2 diabetes in North Indian population and to correlate the serum insulin and glycosylated haemoglobin levels with thyroid hormones. It is a case control study. One hundred and twenty patients of type 2 diabetes were included in the study along with 117 adults of the same age group and normal glucose levels as controls. All blood samples were taken from subjects who fasted for at least 12 h before the blood collection. Glycosylated hemoglobin was determined by ion exchange chromatography and serum insulin and thyroid hormones were assessed through enzyme linked immunosorbent assay. Fasting blood glucose and glycosylated haemoglobin levels were significantly higher in diabetics showing a poor glucose control. Serum tri-iodothyronine values were significantly lower in diabetics. There was a significant correlation between glycosylated haemoglobin and thyroid hormones. There was no correlation between serum insulin and thyroid hormones. PMID:24426234

Uppal, Vibha; Vij, Chittranjan; Bedi, Gurdeep Kaur; Vij, Anil; Banerjee, Basu Dev

2013-10-01

346

Type 2 diabetes in Arab patients in Kuwait.  

PubMed

We describe the characteristics of 75 Arab Type 2 diabetic patients in Kuwait. Their age (+/- SD) at onset was 41 +/- 10 years, and fasting serum C-peptide concentration was 0.32 +/- 0.23 nmol/l (n = 51). Fifty-three percent (37/70) possessed HLA-DR3 or -DR4 epitopes, and 64% (47/73) had a family history of diabetes. Data review suggested that they could be segregated into two groups, those under 40 years old at onset (32 +/- 6 years, n = 37), and the remainder (48 +/- 6 years, n = 38) (p less than 0.001). Those in the former group had a significantly higher frequency of a family history of diabetes than those in the latter group (92% vs 38%, p less than 0.001) suggestive of a greater genetic influence on the development of Type 2 diabetes in those with early onset disease. PMID:2967143

Richens, E R; Abdella, N; Jayyab, A K; al-Saffar, M; Behbehani, K

1988-04-01

347

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

PubMed

We conducted a multicenter, open-label study to investigate the safety, efficacy, and pharmacokinetics of lenalidomide in Japanese patients with relapsed or refractory multiple myeloma The study was composed of the "monotherapy phase", a dose-escalation phase, to determine the tolerability to single agent lenalidomide and the "combination phase" to determine the safety and obtain preliminary data on the efficacy of lenalidomide plus dexamethasone. The primary end points were the tolerability to 25 mg lenalidomide and safety. Nine and six patients were enrolled in the monotherapy phase and the combination phase, respectively. Since 25 mg of monotherapy treatment did not satisfy the DLT criteria, this dose was employed in the combination phase. The major adverse event was myelosuppression. At the planned interim analysis (median study duration, 26.3 weeks), grade 3 or grade 4 neutropenia was observed with high frequency (66.7%). However, all adverse events observed were clinically manageable. In the combination cohort, the overall response rate (> or =PR) was 100%. The pharmacokinetics of lenalidomide showed rapid absorption and elimination after both single and multiple doses. In conclusion, 25 mg of lenalidomide was given safely as a single agent or in combination with dexamethasone in Japanese patients. The good efficacy of the combination therapy was also demonstrated in this study. PMID:20559759

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

2010-07-01

348

Cystoid macular oedema following cataract extraction in patients with diabetes.  

PubMed Central

The course of cystoid macular oedema (CMO) following extracapsular cataract extraction with posterior chamber intraocular lens implantation was prospectively studied in 44 eyes of 44 consecutive diabetic patients without preoperative CMO. In 50% of eyes CMO was observed 6 weeks after surgery and in 25% was still present at 1 year. The preoperative presence of diabetic retinopathy significantly affected the postoperative onset and persistence of CMO. CMO occurred postoperatively in only 32% of eyes without pre-existing diabetic retinopathy and in 81% of eyes with pre-existing diabetic retinopathy (p < 0.05). CMO persisted at 1 year after surgery in only 7% of eyes without pre-existing diabetic retinopathy and in 56% of eyes in which diabetic retinopathy persisted (p < 0.01). Angiographic CMO (that is, detectable only on fluorescein angiography) was more common than clinical CMO (detectable on ophthalmoscopic examination as well) in eyes with no pre-existing diabetic retinopathy, whereas clinical CMO was seen more often than angiographic CMO when diabetic retinopathy was present preoperatively (p < 0.01). The course and final visual outcome of angiographic CMO were more favourable than in clinical CMO. Final visual acuity of at least 6/12 was achieved in 86% of eyes with angiographic CMO and in only 33% of eyes with clinical CMO. On the basis of the above findings we believe that cataract extraction should not be recommended for eyes with pre-existing diabetic retinopathy until the vision has deteriorated to at least 6/30-6/60.

Pollack, A.; Leiba, H.; Bukelman, A.; Oliver, M.

1992-01-01

349

Status of Vitamin-D in diabetic patients  

PubMed Central

Background: Vitamin D (vit D) deficiency has been found to have an inverse relationship with the occurrence of type-2 diabetes mellitus (DM). The aim of this study was to assess the vit D level in type-2 diabetic patients. Methods: One hundred-twenty DM patients selected as case group and 120 healthy individuals as control group were investigated in this study from October 2011 to September 2012 in Shahid Beheshti and Ayatollah Rouhani teaching hospital in Babol, North of Iran. Both groups were matched regarding age and gender. Serum levels of 25(OH)-vitamin D were measured in both groups. The data were collected and analyzed. Results: The mean age of the case group was 51.2±7.98 and in control group was 50.6±7.73 years. The mean concentration of vit D in the case group was 18.7±10.2 and in the control group was 24.6±13.5 ng/dl (p=0.002). The mean concentration of vit D in male subjects in both groups were equal but in women with diabetes was lower than the healthy women (19.3±11.9 versus 27.03±10.28 ng/dl, respectively) (p=0.0001). In diabetic patient vit D level was deficient in 77 (64.2%), insufficient in 30 (25%) and sufficient in 13 (10.3%) patients. In the healthy group, these parameters were seen in 44 (36.6%), in 46 (38.4%) and in 30 (25%) patients. Conclusion: The results show that vit D concentration was significantly lower in diabetic patients than the healthy individuals. Although the mean concentration of vit D in males in both groups was equal but in the women with diabetes was lower than the healthy women.

Bayani, Mohammad Ali; Akbari, Rogheyeh; Banasaz, Bahar; Saeedi, Fayyaz

2014-01-01

350

Increased Mortality of Patients With Diabetes Reporting Severe Hypoglycemia  

PubMed Central

OBJECTIVE Hypoglycemia is a cause of significant morbidity among patients with diabetes and may be associated with greater risk of death. We conducted a retrospective study to determine whether patient self-report of severe hypoglycemia is associated with increased mortality. RESEARCH DESIGN AND METHODS Adult patients (N = 1,020) seen in a specialty diabetes clinic between August 2005 and July 2006 were questioned about frequency of hypoglycemia during a preencounter interview; 7 were lost to follow-up and excluded from analysis. Mild hypoglycemia was defined as symptoms managed without assistance, and severe hypoglycemia was defined as symptoms requiring external assistance. Mortality data, demographics, clinical characteristics, and Charlson comorbidity index (CCI) were obtained from the electronic medical record after 5 years. Patients were stratified by self-report of hypoglycemia at baseline, demographics were compared using the two-sample t test, and risk of death was expressed as odds ratio (95% CI). Associations were controlled for age, sex, diabetes type and duration, CCI, HbA1c, and report of severe hypoglycemia. RESULTS In total, 1,013 patients with type 1 (21.3%) and type 2 (78.7%) diabetes were questioned about hypoglycemia. Among these, 625 (61.7%) reported any hypoglycemia, and 76 (7.5%) reported severe hypoglycemia. After 5 years, patients who reported severe hypoglycemia had 3.4-fold higher mortality (95% CI 1.5–7.4; P = 0.005) compared with those who reported mild/no hypoglycemia. CONCLUSIONS Self-report of severe hypoglycemia is associated with 3.4-fold increased risk of death. Patient-reported outcomes, including patient-reported hypoglycemia, may therefore augment risk stratification and disease management of patients with diabetes.

McCoy, Rozalina G.; Van Houten, Holly K.; Ziegenfuss, Jeanette Y.; Shah, Nilay D.; Wermers, Robert A.; Smith, Steven A.

2012-01-01

351

Physical and sexual abuse histories in patients with eating disorders: a comparison of Japanese and American patients.  

PubMed

Physical and sexual abuse among patients with eating disorders has been a focus of attention in Western countries, however, there is no study comparing the incidence of these factors in Western and Asian countries. Japanese subjects consisted of 38 patients with anorexia nervosa restricting type (AN-R), 46 patients with anorexia nervosa binge eating/purging type (AN-BP), 76 patients with bulimia nervosa purging type (BN) and 99 controls. Subjects from the USA consisted of 29 AN-R, 34 AN-BP and 16 BN. The Physical and Sexual Abuse Questionnaire was administered to all subjects. Minor sexual abuse such as confronting exhibitionism or being fondled by a stranger tended to be more prevalent among Japanese subjects, while victimization by rape or incest was more prevalent among USA subjects. Conversely, physical abuse history was similarly distributed across each diagnostic subgroup in both countries. Events related to physical abuse, such as an abusive family background, may contribute whether eating disorder patients are restricting or bulimic and regardless of culture. PMID:11442883

Nagata, T; Kaye, W H; Kiriike, N; Rao, R; McConaha, C; Plotnicov, K H

2001-08-01

352

Limited Joint Mobility in Non–Insulin-Dependent Diabetic (NIDDM) Patients: Correlation to Control of Diabetes, Atherosclerotic Vascular Disease, and Other Diabetic Complications  

Microsoft Academic Search

This study examined the association between limited joint mobility (LJM) and diabetic control, atherosclerotic vascular disease and other diabetic complications in non–insulin-dependent diabetic (NIDDM) patients. LJM was studied in 139 [age (mean ± SD) 61.3 ± 12.3 years] NIDDM patients. Limitation of several joints was examined with a goniometer and LJM was classified by the Rosenbloom method. The NIDDM patients

Perttu E. T. Arkkila; Ilkka M. Kantola; Jorma S. A. Viikari

1997-01-01

353

Pulmonary multinodular mucormycosis in type 1 diabetic patient with diabetic ketoacidosis.  

PubMed

We report a case of pulmonary multinodular mucormycosis in a Type 1 diabetic patient with diabetic ketoacidosis. He had a history of 20-pack-year tobacco use. The initial chest roentgenogram and thorax tomography (after the treatment of diabetic ketoacidosis) revealed multiple nodular lesions with cavitation in the upper lobes of pulmonary parenchyma. Resection of three nodular lesion demonstrated cheesy necrotic mass in the cavitating lesions. The diagnosis of pulmonary multinodular mucormycosis was made depending on the histopathologic examination yielding nonseptated right angle branching-shaped hyphae typical of mucormycosis. The patient was started on liposomal amphotericin B and discharged at the sixth week of therapy with a scheduled therapy of amphotericin B. When he came back after 33 months, he was metabolically unregulated under the insulin therapy. He confessed that he had been smoking heroin besides tobacco for the last 5 years. A new thorax computerized tomography showed that pulmonary nodules were slightly regressed but not resolved. PMID:17505160

Kebapci, N; Efe, B; Alata?, F; Açikalin, M; Kiraz, N

2007-03-01

354

A phosphodiesterase inhibitor, cilostazol, prevents the onset of silent brain infarction in Japanese subjects with Type II diabetes  

Microsoft Academic Search

.\\u000a Aims\\/hypothesis:   This study aimed to evaluate the effect of a phosphodiesterase inhibitor, cilostazol, on the prevention of silent brain infarction\\u000a in diabetic patients without symptoms of vascular events. \\u000a \\u000a \\u000a \\u000a Methods:   A total of 89 subjects were allocated at random to the cilostazol group (n = 43) or the control group (n = 46). \\u000a \\u000a \\u000a \\u000a Results:   After the study period (3.2 ±

T. Shinoda-Tagawa; Y. Yamasaki; S. Yoshida; Y. Kajimoto; T. Tsujino; N. Hakui; M. Matsumoto; M. Hori

2002-01-01

355

Natural Antibodies to Human Retrovirus HTLV in a Cluster of Japanese Patients with Adult T Cell Leukemia  

Microsoft Academic Search

Human T cell lymphoma leukemia virus (HTLV) is a human retrovirus (RNA tumor virus) that was originally isolated from a few patients with leukemias or lymphomas involving mature T lymphocytes. Here we report that the serum of Japanese patients with adult T cell leukemia, but not the serum of tested normal donors, contains high titers of antibodies to HTLV. These

Marjorie Robert-Guroff; Yoshinobu Nakao; Kunihiro Notake; Yohei Ito; Ann Sliski; Robert C. Gallo

1982-01-01

356

Prevalence and risk factors for renal artery stenosis and chronic kidney disease in Japanese patients with peripheral arterial disease  

Microsoft Academic Search

The prevalence and risk factors for renal artery stenosis (RAS) and chronic kidney disease (CKD) are unclear in Japanese patients with peripheral arterial disease (PAD). To examine these issues, we performed renal angiography in 410 patients with PAD. Renal function and damage were assessed using the estimated glomerular filtration rate (eGFR) and urinary level of microalbumin (MA). Multiple logistic and

Michiko Endo; Hisao Kumakura; Hiroyoshi Kanai; Yoshihiro Araki; Shu Kasama; Hiroyuki Sumino; Shuichi Ichikawa; Masahiko Kurabayashi

2010-01-01

357

Clinical characteristics and prevalence of GB virus C, SEN virus, and HFE gene mutation in Japanese patients with nonalcoholic steatohepatitis  

Microsoft Academic Search

Background This study was carried out to clarify differences in clinical characteristics between fatty liver and nonalcoholic steatohepatitis in a Japanese population, and to assess the significance of GB virus C (GBV-C) infection, SEN virus (SENV) infection, and HFE gene mutation in the pathophysiology of these conditions. Methods Twenty patients with nonalcoholic steatohepatitis and 18 patients with simple steatosis were

Norihito Yamauchi; Yoshito Itoh; Yasuhito Tanaka; Masashi Mizokami; Masahito Minami; Atsuhiro Morita; Tetsuya Toyama; Kanji Yamaguchi; Hideki Fujii; Takeshi Okanoue

2004-01-01

358

Recurrent and progressive abdominal pain and enteritis in a Japanese patient with paroxysmal nocturnal hemoglobinuria.  

PubMed

This case report describes a young male patient with recurrent abdominal pain persisting for more than 16 months. Clinical investigations showed signs of inflammation and pancytopenia. A diagnosis of paroxysmal nocturnal hemoglobinuria (PNH) was made 9 months after the onset of the abdominal pain, following endoscopic examinations that revealed evidence of a previously unknown hemorrhage. Regular monitoring indicated that the abdominal pain was associated with elevations in lactate dehydrogenase, C-reactive proteins, and D-dimer levels. The patient started treatment with the complement inhibitor eculizumab shortly after it was approved for use in Japanese PNH patients with hemolysis. Resolution of the abdominal pain and normalization of clinical parameters were noted within 3 weeks from treatment initiation. PMID:24587926

Hino, Akihisa; Yamashita, Yukiko; Yamaguchi, Mitsuhiro; Azenishi, Yasuhiko

2014-01-01

359

Esophageal Capsule Endoscopy for Screening Esophageal Varices among Japanese Patients with Liver Cirrhosis  

PubMed Central

Purpose. Although esophageal capsule endoscopy (ECE) is reportedly useful in the diagnosis of esophageal varices (EV), few reports have described the benefits of this technique in Asian countries. The present paper evaluates the usefulness of ECE for diagnosing EV in Japanese patients with cirrhosis. Methods. We examined 29 patients with cirrhosis (20 males and 9 females; mean age 60 years; Child-Pugh classification A/B/C; 14/14/1) using ECE followed by esophagogastroduodenoscopy (EGD). High-risk EV were defined as F2 and/or RC2 and above. Results. The sensitivity and specificity of ECE for the diagnosis of high-risk EV were 92% and 80%, respectively. Conclusions. The findings showed that ECE is a highly sensitive method of diagnosing high-risk EV that requires endoscopic or pharmacological therapy. Thus, ECE might be a useful method for the screening and followup of EV in patients with cirrhosis.

Ishiguro, Haruya; Saito, Shoichi; Imazu, Hiroo; Aihara, Hiroyuki; Kato, Tomohiro; Tajiri, Hisao

2012-01-01

360

Recurrent Diabetic Ketoacidosis in Inner-City Minority Patients  

PubMed Central

OBJECTIVE To conduct a bedside study to determine the factors driving insulin noncompliance in inner-city patients with recurrent diabetic ketoacidosis (DKA). RESEARCH DESIGN AND METHODS We analyzed socioeconomic and psychological factors in 164 adult patients with DKA who were admitted to Grady Hospital between July 2007 and August 2010, including demographics, diabetes treatment, education, and mental illness. The Patient Health Questionnaire-9 and the Short Form-36 surveys were used to screen for depression and assess quality of life. RESULTS The average number of admissions was 4.5 ± 7 per patient. A total of 73 patients presented with first-time DKA, and 91 presented with recurrent DKA; 96% of patients were African American. Insulin discontinuation was the leading precipitating cause in 68% of patients; other causes were new-onset diabetes (10%), infection (15%), medical illness (4%), and undetermined causes (3%). Among those who stopped insulin, 32% gave no reasons for stopping, 27% reported lack of money to buy insulin, 19% felt sick, 15% were away from their supply, and 5% were stretching insulin. Compared with first-time DKA, those with recurrent episodes had longer duration of diabetes (P < 0.001), were a younger age at the onset of diabetes (P = 0.04), and had higher rates of depression (P = 0.04), alcohol (P = 0.047) and drug (P < 0.001) abuse, and homelessness (P = 0.005). There were no differences in quality-of-life scores, major psychiatric illnesses, or employment between groups. CONCLUSIONS Poor adherence to insulin therapy is the leading cause of recurrent DKA in inner-city patients. Several behavioral, socioeconomic, psychosocial, and educational factors contribute to poor compliance. The recognition of such factors and the institution of culturally appropriate interventions and education programs might reduce DKA recurrence in minority populations.

Randall, Lori; Begovic, Jovan; Hudson, Megan; Smiley, Dawn; Peng, Limin; Pitre, Njalalia; Umpierrez, Denise; Umpierrez, Guillermo

2011-01-01

361

Patterns of Antihypertensive Therapy Among Patients with Diabetes  

PubMed Central

Background Hypertension is extremely prevalent in patients with diabetes. Limited data exist on whether patterns of antihypertensive use in this population are consistent with evidence-based practice guidelines. Objective To evaluate utilization patterns of antihypertensive agents and blood pressure (BP) control among diabetic patients with hypertension. Design Retrospective cohort study. Patients/Participants In all, 9,975 patients with diabetes and hypertension as of March 2001 from an outpatient medical center of the Department of Veterans Affairs. Measures Proportions of use of 6 different antihypertensive drug classes were compared for all patients receiving 1, 2, 3, or 4 or more drugs, and separately among patients with and without coronary artery disease (CAD). Blood pressure control (<130/85 mmHg) was compared for untreated patients, those on monotherapy, and patients on multi-drug regimens. Results Over 60% of patients were receiving angiotensin-converting enzyme inhibitors (ACEI) or angiotensin receptor blocker (ARB), followed by diuretics (38.1%), calcium channel blockers (35.3%) and ?-blockers (28.5%) with 19.1% of patients untreated. Patients on monotherapy were mostly receiving ACEI/ARB (59.5%). The majority (70.7%) of treated patients were on multidrug regimens. In patients with CAD, ?-blocker and ACEI/ARB use was higher, and 70.5% of patients on single-drug regimens received either ACEI/ARB or ?-blockers. The proportions of patients not on medications, on monotherapy, or multidrug regimens achieving BP control were 23.4%, 27.4%, and 24.9%, respectively. Conclusions Patterns of anti-hypertensive therapy were generally consistent with evidence-based practice guidelines. Areas of improvement include increasing ACEI/ARB and diuretic use, decreasing the number of untreated patients, and increasing the proportion of patients with controlled BP in this population.

Johnson, Michael L; Singh, Hardeep

2005-01-01

362

Fasting Insulin Levels and Metabolic Risk Factors in Type 2 Diabetic Patients at the First Visit in Japan  

PubMed Central

OBJECTIVE To investigate the relationship between fasting insulin levels and metabolic risk factors (MRFs) in type 2 diabetic patients at the first clinic/hospital visit in Japan over the years 2000 to 2009. RESEARCH DESIGN AND METHODS In total, 4,798 drug-naive Japanese patients with type 2 diabetes were registered on their first clinic/hospital visits. Conventional clinical factors and fasting insulin levels were observed at baseline within the Japan Diabetes Clinical Data Management (JDDM) study between consecutive 2-year groups. Multiple linear regression analysis was performed using a model in which the dependent variable was fasting insulin values using various clinical explanatory variables. RESULTS Fasting insulin levels were found to be decreasing from 2000 to 2009. Multiple linear regression analysis with the fasting insulin levels as the dependent variable showed that waist circumference (WC), BMI, mean blood pressure, triglycerides, and HDL cholesterol were significant, with WC and BMI as the main factors. ANCOVA after adjustment for age and fasting plasma glucose clearly shows the decreasing trend in fasting insulin levels and the increasing trend in BMI. CONCLUSIONS During the 10-year observation period, the decreasing trend in fasting insulin was related to the slight increase in WC/BMI in type 2 diabetes. Low pancreatic ?-cell reserve on top of a lifestyle background might be dependent on an increase in MRFs.

Matsuba, Ikuro; Saito, Kazumi; Takai, Masahiko; Hirao, Koichi; Sone, Hirohito

2012-01-01

363

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

PubMed

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

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

2014-06-01

364

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.

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

2014-01-01

365

Diabetes care quality is highly correlated with patient panel characteristics  

PubMed Central

Introduction Health care reimbursement is increasingly based on quality. Little is known about how clinic-level patient characteristics affect quality performance, particularly in community health centers (CHCs). Methods Using electronic health record data for 4,019 diabetic patients from 23 CHC primary care clinics in the OCHIN practice-based research network, we calculated correlations between a clinic’s patient panel characteristics and delivery rates of diabetes preventive services in 2007. Using regression models, we estimated the proportion of clinic variability in clinics’ preventive services rates associated with the variability in the clinics’ patient panel characteristics. We also explored whether clinics’ performance rates were affected by how patient panel denominators were defined. Results Clinic rates of glycosylated hemoglobin testing, influenza immunizations, and lipid screening were positively associated with the percentage of patients with continuous health insurance coverage, and negatively associated with the percentage uninsured. Microalbumin screening rates were positively associated with the percentage of racial minorities in a clinic’s panel. Associations remained consistent with different panel denominators. Conclusions Clinic variability in delivery rates of preventive services correlates with differences in clinics’ patient panel characteristics, particularly the percentage of patients with continuous insurance coverage. Quality scores that do not account for these differences could create disincentives to diabetes care for vulnerable patients.

Bailey, Steffani; O'Malley, Jean P.; Gold, Rachel; Heintzman, John; Likumahuwa, Sonja; DeVoe, Jennifer E.

2014-01-01

366

A retrospective study of 231 Japanese vitiligo patients with special reference to phototherapy.  

PubMed

Although the outcomes of various treatment modalities for vitiligo have been studied extensively, the influence of the participant's characteristics on treatment response has not been thoroughly investigated. Therefore, we retrospectively investigated treatment effects and their association with clinical characteristics in Japanese patients with vitiligo. The charts of patients with vitiligo treated in our institution were reviewed. Clinical response was evaluated as a marked response rate, defined as repigmentation in >75% of the initial lesional area. 162 patients were treated with phototherapy, while 69 were treated with topical mono-therapy. The patients treated with phototherapy and those treated with both phototherapy and topical treatment demonstrated significantly higher clinical response rates compared to patients treated solely with topical mono-therapy (marked response rate: 19.1% vs. 5.8%, P<0.05; and 23.5% vs. 5.8%, P<0.01, respectively). Among the phototherapy-treated patients, younger subjects (?15 years old) were more responsive to phototherapy compared to older patients (37.0% vs. 15.6%; P=0.015). The disease subtypes did not affect treatment response. In conclusion, phototherapy appears to have a therapeutic effect superior to topical mono-therapy on both focal and generalized vitiligo, especially in younger patients. Thus, any type of psychosocially devastating lesions in a pediatric patient may be a good target for phototherapy. PMID:24813836

Yoshida, Akiko; Takagi, Atsushi; Ikejima, Ayako; Takenaka, Hiroshi; Fukai, Tatsuo; Ikeda, Shigaku

2014-04-01

367

Association of carboxylesterase 1A genotypes with irinotecan pharmacokinetics in Japanese cancer patients  

PubMed Central

AIMS Human carboxylesterase 1 (CES1) hydrolyzes irinotecan to produce an active metabolite SN-38 in the liver. The human CES1 gene family consists of two functional genes, CES1A1 (1A1) and CES1A2 (1A2), which are located tail-to-tail on chromosome 16q13-q22.1 (CES1A2-1A1). The pseudogene CES1A3 (1A3) and a chimeric CES1A1 variant (var1A1) are also found as polymorphic isoforms of 1A2 and 1A1, respectively. In this study, roles of CES1 genotypes and major SNPs in irinotecan pharmacokinetics were investigated in Japanese cancer patients. METHODS CES1A diplotypes [combinations of haplotypes A (1A3-1A1), B (1A2-1A1), C (1A3-var1A1) and D (1A2-var1A1)] and the major SNPs (?75T>G and ?30G>A in 1A1, and ?816A>C in 1A2 and 1A3) were determined in 177 Japanese cancer patients. Associations of CES1 genotypes, number of functional CES1 genes (1A1, 1A2 and var1A1) and major SNPs, with the AUC ratio of (SN-38 + SN-38G)/irinotecan, a parameter of in vivo CES activity, were analyzed for 58 patients treated with irinotecan monotherapy. RESULTS The median AUC ratio of patients having three or four functional CES1 genes (diplotypes A/B, A/D or B/C, C/D, B/B and B/D; n= 35) was 1.24-fold of that in patients with two functional CES1 genes (diplotypes A/A, A/C and C/C; n= 23) [median (25th–75th percentiles): 0.31 (0.25–0.38) vs. 0.25 (0.20–0.32), P= 0.0134]. No significant effects of var1A1 and the major SNPs examined were observed. CONCLUSION This study suggests a gene-dose effect of functional CES1A genes on SN-38 formation in irinotecan-treated Japanese cancer patients.

Sai, Kimie; Saito, Yoshiro; Tatewaki, Naoko; Hosokawa, Masakiyo; Kaniwa, Nahoko; Nishimaki-Mogami, Tomoko; Naito, Mikihiko; Sawada, Jun-ichi; Shirao, Kuniaki; Hamaguchi, Tetsuya; Yamamoto, Noboru; Kunitoh, Hideo; Tamura, Tomohide; Yamada, Yasuhide; Ohe, Yuichiro; Yoshida, Teruhiko; Minami, Hironobu; Ohtsu, Atsushi; Matsumura, Yasuhiro; Saijo, Nagahiro; Okuda, Haruhiro

2010-01-01

368

Insulin Therapy and Colorectal Adenomas in Patients with Diabetes Mellitus  

PubMed Central

Background Patients with type 2 diabetes mellitus (DM) are at increased risk for colorectal adenomas and cancer due to endogenous hyperinsulinemia. Exogenous insulin therapy has been associated with higher colorectal cancer incidence. The aim of this study was to evaluate the association between exogenous insulin therapy and adenoma formation, accounting for duration of therapy and location and stage of the adenoma. Methods We conducted a cross-sectional study of type 2 diabetic patients between the ages of 50 and 80 years who completed full colonoscopies. Cases were patients with any adenoma on index colonoscopy. Patients without any adenoma compose the control group. Multivariable logistic regression was used to calculate odds ratios (ORs) and associated confidence intervals (CIs). Results Compared to the controls, case patients (n=196) did not have a significantly increased odds of insulin exposure, when exposure was defined as ? 12 months of insulin use compared to no insulin. However, the odds of insulin exposure among the cases was significantly increased when exposure was defined as ? 18 months (OR 1.6, 95% CI 1.1–2.5), ? 24 months (OR 1.7, CI 1.1–2.6), and ?36 months (OR 2.0, 95% CI 1.2–3.4) of insulin use (test for trend p=0.05). A similar trend in insulin exposure was seen among type 2 diabetics with advanced adenomas. Adenoma location was not significantly affected by insulin therapy. Conclusions Chronic insulin therapy is associated with increased risk of colorectal adenomas in patients with type 2 diabetes. Impact Diabetes patients receiving insulin may need more stringent colon cancer screening.

Wong, Patricia; Weiner, Mark G.; Hwang, Wei-Ting; Yang, Yu-Xiao

2012-01-01

369

Camel milk: a possible boon for type 1 diabetic patients.  

PubMed

Poor nutrition in utero and in early life combined with over nutrition in later life may also play a role in epidemic of diabetes. The efficacy of camel milk consumption as an adjunct to routine diabetic management in type 1 diabetes is a approach showing new rays of hope to cope with this disorder by adding a food supplement with medicinal values. Research on the beneficial aspects of camel milk has been taking place in different corners of globe since last three decades. Continuous efforts to disclose the role of camel milk in diabetes has rendered it title of 'white gold'. Biochemical studies has revealed the components e.g. insulin like protein, lactoferrin, immunoglobulins are responsible for imparting camel milk the scientific weightage. In parallel, epidemiological surveys stating low prevalence of diabetes in communities consuming camel milk clearly indicate towards its hopeful role in maintaining hyperglycemia. This article shades light on camel milk production, composition, characteristics as well as it expresses positive effect of camel milk on blood glucose level, insulin dose, beta cell function. This review also compiles various epidemiological studies carried out to bring forth utility of camel milk suggesting it as a useful food supplement or alternative therapy for type 1 diabetic patients. PMID:24200025

Agrawal, R P; Tantia, P; Jain, S; Agrawal, R; Agrawal, V

2013-01-01

370

Partial central diabetes insipidus in patient with common variable immunodeficiency  

PubMed Central

Approximately 20% of patients with common variable immunodeficiency (CVID) have any autoimmune disease, as concurrent as prior to diagnosis, even during follow-up. In recent years, cases of CVID associated to endocrine autoimmune diseases have been reported. To our knowledge, no cases of CVID with diabetes insipidus has been reported previously. The authors present the case of a 37-year-old male, diagnosed of CVID, who had thirst, polyuria and nocturia for several years. After a water deprivation test and a complete resolution of patient’s symptoms with vasopressin (DDAVP) treatment, diagnosis of partial central diabetes insipidus was finally made. Patients diagnosed of CVID could develop water misbalance due to posterior hypophysis autoimmune disorder. A high index of clinical suspicion, an early diagnosis and treatment of these disease could avoid future complications and improve the quality of life of these patients.

Megias, Marta Cano; Matei, Ana Maria; Gonzalez Albarran, Olga; Perez Lopez, Gilberto

2012-01-01

371

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

372

Serum lipids and other risk factors for diabetic retinopathy in Chinese type 2 diabetic patients*  

PubMed Central

Objective: To investigate the association of serum lipids and other risk factors with diabetic retinopathy (DR) in Chinese type 2 diabetic patients. Methods: Five hundred and twenty-three type 2 diabetic patients underwent ophthalmic examination by experienced retinal specialists to assess their DR. Serum lipids, including triglycerides, total cholesterol, high density lipoprotein cholesterol (HDLC), and low density lipoprotein cholesterol (LDLC), were measured using Roche automated clinical chemistry analyzers. The concentration of very low density lipoprotein cholesterol (VLDLC) was calculated based on total cholesterol, HDLC and LDLC. Hyperlipidemia was defined as a total cholesterol concentration of 6.2 mmol/L or higher or the use of lipid-lowering medications. The association of risk factors with any DR or proliferative diabetic retinopathy (PDR) was assessed using the odds ratio (OR) and its 95% confidence interval (CI), calculated from logistic regression models. Results: In multivariate logistic regression models, hyperlipidemia (OR=2.39, 95% CI: 1.02–5.66), higher VLDLC (OR=1.59, 95% CI: 1.14–2.23), and higher triglyceride (OR=1.18, 95% CI: 1.03–1.37) were associated with increased risk of DR. A longer diabetic duration was associated with increased risk of DR (P<0.0001) and PDR (P=0.002) in a dose-response manner. Higher systolic blood pressure (P=0.02) and higher serum creatinine (P=0.01) were independently associated with increased risk of DR, and female gender was associated with increased risk of PDR (P=0.03). Conclusions: Among Chinese type 2 diabetic patients, hyperlipidemia, higher VLDLC, and higher triglyceride were independently associated with increased risk of DR, suggesting control of serum lipids may decrease the risk of DR.

Zhang, Hui-yan; Wang, Jian-yong; Ying, Gui-shuang; Shen, Li-ping; Zhang, Zhe

2013-01-01

373

Monocyte chemoattractant protein-1 A-2518G gene polymorphism and renal survival of Japanese patients with immunoglobulin A nephropathy  

Microsoft Academic Search

Background  Monocyte chemoattractant protein (MCP)-1 is closely related to the pathogenesis of the progression of various chronic renal\\u000a diseases, including IgA nephropathy (IgAN), through its chemoattractant effect on macrophages. However, the correlation of\\u000a MCP-1 gene polymorphism with the long-term prognosis of Japanese patients with IgAN has not been clearly determined yet.\\u000a \\u000a \\u000a \\u000a Methods  We investigated 277 Japanese patients diagnosed with IgAN based on

Honami Mori; Yoshikatsu Kaneko; Ichiei Narita; Shin Goto; Noriko Saito; Daisuke Kondo; Fuminori Sato; Junya Ajiro; Daisuke Saga; Asa Ogawa; Minoru Sakatsume; Mitsuhiro Ueno; Kaoru Tabei; Fumitake Gejyo

2005-01-01

374

Phase II study of docetaxel in patients with metastatic pancreatic cancer: a Japanese cooperative study  

PubMed Central

Docetaxel has been reported to show promising anti-tumour activity in pancreatic ductal cancer (PC). This study was conducted to evaluate the activity and toxicity of moderate-dose (60 mg m?2) docetaxel in Japanese chemo-naive patients with measurable metastatic PC. The patients had a performance status of 0–2. They received docetaxel intravenously over a 1- to 2-h period without any premedication for hypersensitivity reactions. This treatment was repeated every 3–4 weeks with dose adjustments based on the toxic effects observed. Twenty-one patients were eligible and treated with docetaxel. The median number of courses was 2 (range, 1–4). None of the patients achieved an objective response; seven showed no change and 13 showed progressive disease. In one patient, the response was not assessable because of early death. The median survival time for all patients was 118 days. The main grade 3–4 toxicities by patient were leucocytopenia (67%) and neutropenia (86%). Other grade 3–4 toxicities included anaemia (10%), thrombocytopenia (5%), nausea/vomiting (29%), anorexia (29%), GOT/GPT increase (10%), alkaline phosphatase increase (14%), malaise/fatigue (33%) and alopecia (24%). In conclusion, docetaxel, administered on this schedule, did not show significant anti-tumour activity in patients with metastatic PC. © 1999 Cancer Research Campaign

Okada, S; Sakata, Y; Matsuno, S; Kurihara, M; Sasaki, Y; Ohashi, Y; Taguchi, T

1999-01-01

375

Genetic and Infectious Profiles Influence Cerebrospinal Fluid IgG Abnormality in Japanese Multiple Sclerosis Patients  

PubMed Central

Background Abnormal intrathecal synthesis of IgG, reflected by cerebrospinal fluid (CSF) oligoclonal IgG bands (OBs) and increased IgG index, is much less frequently observed in Japanese multiple sclerosis (MS) cohorts compared with Western cohorts. We aimed to clarify whether genetic and common infectious backgrounds influence CSF IgG abnormality in Japanese MS patients. Methodology We analyzed HLA-DRB1 alleles, and IgG antibodies against Chlamydia pneumoniae, Helicobacter pylori, Epstein-Barr virus nuclear antigen (EBNA), and varicella zoster virus (VZV) in 94 patients with MS and 367 unrelated healthy controls (HCs). We defined CSF IgG abnormality as the presence of CSF OBs and/or increased IgG index (>0.658). Principal Findings CSF IgG abnormality was found in 59 of 94 (62.8%) MS patients. CSF IgG abnormality-positive patients had a significantly higher frequency of brain MRI lesions meeting the Barkhof criteria compared with abnormality-negative patients. Compared with HCs, CSF IgG abnormality-positive MS patients showed a significantly higher frequency of DRB1*1501, whereas CSF IgG abnormality-negative patients had a significantly higher frequency of DRB1*0405. CSF IgG abnormality-positive MS patients had a significantly higher frequency of anti-C. pneumoniae IgG antibodies compared with CSF IgG abnormality-negative MS patients, although there was no difference in the frequency of anti-C. pneumoniae IgG antibodies between HCs and total MS patients. Compared with HCs, anti-H. pylori IgG antibodies were detected significantly less frequently in the total MS patients, especially in CSF IgG abnormality-negative MS patients. The frequencies of antibodies against EBNA and VZV did not differ significantly among the groups. Conclusions CSF IgG abnormality is associated with Western MS-like brain MRI features. DRB1*1501 and C. pneumoniae infection confer CSF IgG abnormality, while DRB1*0405 and H. pylori infection are positively and negatively associated with CSF IgG abnormality-negative MS, respectively, suggesting that genetic and environmental factors differentially contribute to MS susceptibility according to the CSF IgG abnormality status.

Yoshimura, Satoshi; Isobe, Noriko; Matsushita, Takuya; Masaki, Katsuhisa; Sato, Shinya; Kawano, Yuji; Ochi, Hirofumi; Kira, Jun-ichi

2014-01-01

376

Diabetic retinopathy progression and visual outcome after phacoemulsification in South-Asian and Afro-Caribbean patients with diabetes  

Microsoft Academic Search

Purpose To determine diabetic retinopathy or maculopathy progression and visual outcome following phacoemulsification in South-Asian and Afro-Caribbean patients with diabetes.Methods Review of notes of patients with type II diabetes undergoing phacoemulsification by one surgeon. The inclusion criteria were: (a) South-Asian or Afro-Caribbean ethnicity, (b) monocular cases with a minimum postoperative follow-up of 6 months, and (c) binocular cases with an

S Chatterjee; V V Savant; P Stavrou

2004-01-01

377

Effects of gender, age, family support, and treatment on perceived stress and coping of patients with type 2 diabetes mellitus  

PubMed Central

Background We previously found that the empowerment of patients with type 2 diabetes mellitus can be strongly affected by gender and age in addition to self-managed diet and exercise behaviors and treatment. This study was to examine the effects of gender, age, family support, and treatment on the perceived stress and coping of patients with type 2 diabetes mellitus living with family. Methods A survey was conducted of 140 adults with type 2 diabetes mellitus who were living with family. There was no significant difference in hemoglobin A1c (HbA1c) between male and female. Perceived stress and coping were measured with the Japanese version of the Appraisal of Diabetes Scale and the Lazarus Type Stress Coping Inventory. Stepwise regression analysis and path analysis were performed to identify factors that affect the perceived stress and coping of patients. Results (1) Perceived stress and coping were strongly affected by gender. (2) Perceived stress and coping were affected by age for males, but perceived stress was not affected by age for females. However, females showed a greater “psychological impact of diabetes” than did males. Females aged between 50 and 69 years engaged in active problem solving, but awareness of diabetes was low. (3) Treatment regimens had an effect on HbA1c for both sexes, and diet therapy affected the awareness of diabetes of males and coping of females. (4) For females, “sense of self-control” was strongly associated with coping, and those who were living with non-spouse family members had a greater psychological impact of diabetes than those living with only their spouse. (5) For males, coping was strongly affected by living with their spouse. Conclusions The results suggest that perceived stress, coping, and diet regimen are deeply associated with gender and age and that a male with type 2 diabetes mellitus living with his spouse is strongly dependent on support from the spouse. It is important to take into account gender, age, and family environment to provide patients with an individualized approach to addressing perceived stress and to provide education program for coping that can maximize treatment and maintain better, continuous glycemic control.

2014-01-01

378

Pregnancy management of diabetic renal transplant patients.  

PubMed

Advances in medical care and options for medications for diabetic kidney transplant recipients have allowed for successful pregnancies to be carried to full term. End-stage renal disease leads to impaired fertility. Fertility is restored 1 to 6 months after a successful kidney transplant. Poor glycemic control near the conception period leads to a higher incidence of major fetal malformations and spontaneous abortion. Preconception counseling about risks of medications, control of comorbid conditions, stability of allograft function, and potential risks to mother, fetus, and allograft has to be done. Close and careful monitoring of mother, fetus, and allograft is important in ensuring a good outcome. PMID:23702116

Haider, Lalarukh; Adams, Nancy Day

2013-06-01

379

Management of Hypertriglyceridemia in the Diabetic Patient  

Microsoft Academic Search

The hypertriglyceridemia of diabetes can be classified into mild to moderate (triglycerides between 150–499 mg\\/dL) and severe\\u000a hypertriglyceridemia (triglycerides ?500 mg\\/dL). As in any other individuals with hypertriglyceridemia, secondary causes need\\u000a to be excluded. The management of severe hypertriglyceridemia (chylomicronemia syndrome) includes aggressive reduction of\\u000a triglycerides with intravenous insulin, fibrates, omega-3 fatty acids, and\\/or niacin therapy to avert t