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Biomedical subjects

Kunio Yamanouchi

Publications and source records attributed to Kunio Yamanouchi.

5 recordsLinked to original sources

Prevalence of diabetes mellitus in Japanese patients infected chronically with hepatitis C virus.

BACKGROUND: To examine the relationship between hepatitis C virus (HCV) infection and diabetes mellitus (DM) in Japanese populations, a retrospective study was done in 866 patients with chronic viral disease. METHODS: The present study included 707 HCV-infected and 159 hepatitis B virus (HBV)-infected patients. The prevalences of HBV- and HCV-related cirrhosis were 32% and 33%, respectively. A case-control study was also conducted to determine the seroprevalence of HCV infection in a cohort of 459 diabetics. RESULTS: The prevalence of DM was higher in HCV-infected patients (20.9%; P < 0.02) than in HBV-infected subjects (11.9%). In the cirrhotic patients, DM was observed in 30.8% of the subjects with HCV compared with 11.8% of those with HBV ( P < 0.01). Multivariate analysis revealed that the major independent variables associated with type II DM were male sex (odds ratio, 1.54; p = 0.020) and cirrhosis (odds ratio, 1.97; P = 0.0007). The relative odds of the development of DM were calculated to be 3.2 times higher in HCV-infected cirrhotic patients than in HBV-infected ones. In the case-control study of the diabetic cohort, 10.5% of patients were infected with HCV compared with 1.1% with HBV ( P < 0.0001). The results indicate that HCV infection is closely associated with DM, compared with HBV infection. Cirrhosis was an independent risk factor for DM. CONCLUSIONS: Taken together, the findings indicate that cirrhosis appears to be a more important predictor of glucose intolerance than HCV infection, and the combination of both factors increases the risk of DM in our populations.

Adult↗

Subjective health values of individuals with diabetes in Japan: comparison of utility values with the SF-36 scores.

To investigate the characteristics of utility values for current health states and the Medical Outcome Study Short Form 36 (SF-36) scores in terms of patients' preferences, we performed the utility assessment using the visual analog scale (VAS) and the standard gamble (SG) techniques, and the SF-36 questionnaires on 68 hospitalized individuals with diabetes. Sixty patients responded appropriately. The SG value, 0.93 +/- 0.12 (mean +/- S.D.), was significantly higher than the VAS value, 0.65 +/- 0.21 (P<0.001). A tendency for the SF-36 subscale scores to decrease compared to national normative data for Japan was observed. Diabetic conditions such as glycated hemoglobin level and daily insulin injection were not significant predictors of either utility or SF-36 scores, while diabetic complications affected two subscales of the SF-36. The VAS values were somewhat related to the SF-36 subscale scores but the SG values had no relation to any SF-36 scores. These results suggest the difficulty of estimating the subjective health values of the patients only through the traditional clinical indicators and the SF-36 scores.

Attitude to Health↗

The effect of walking before and after breakfast on blood glucose levels in patients with type 1 diabetes treated with intensive insulin therapy.

OBJECTIVE: We examined the effect of walking at different timing on carbohydrate metabolism in patients with type 1 diabetes. SUBJECTS AND METHODS: Subjects included six non-obese patients treated with intensive insulin therapy. The blood glucose profile was determined with and without walking for 30 min before (ExBM) or after (ExAM) breakfast. RESULTS: Mean blood glucose values at 07:00 h in the control, ExBM, and ExAM were 9.0, 8.0, 8.8 mM, respectively. Glucose levels gradually increased after meals up to 13.6, 15.0, and 15.3 mM, respectively, at 09:00 h (0.5 h after meals). At 09:30 h, glucose levels significantly fell to 11.0 mM during walking in the ExAM (P=0.039 vs 09:00 h values). The area under blood glucose response curve was significantly lower only in the ExAM when compared with that in the control (P=0.043) (11.8, 17.8. and 3.8 h mM in the control, ExBM and ExAM, respectively). CONCLUSION: These results might suggest that walking after meals improves glycemic control in patients with type 1 diabetes being treated with intensive insulin therapy consisting of the basal-bolus (NPH-human regular) insulin regimen.

3-Hydroxybutyric Acid↗