(J Diabetes Invest, doi: 10.1111/j.2040‐1124.2012.00224.x, 2012)
Aims/Introduction: The Japanese Red Cross Society introduced measurement of glycated albumin (GA) for all blood donors as a glycemic control marker. The GA levels were examined by sex and age.Materials and Methods: GA was measured in 3.14 million blood donors who donated between April 2009 and March 2010. For the reference range for GA, values that were three times the reference range for glycated hemoglobin (Japan Diabetes Society value) were used. All donors were notified of their GA levels. For repeat donors, a comparison was made between the GA levels at the first and second donations to verify the GA change after notification.Results: The mean GA was significantly lower in males than in females in donors aged <60 years. The mean GAs of both sexes increased with age and reached the same level of 14.8% in their 60s. The percentage of donors with prediabetes/diabetes (GA ≥16.5%) was 2.8% in males and 2.3% in females. In the normal high group (15.6% ≤ GA < 16.5%), the mean GA at the second donation was lower by 0.20% than at the first donation. In 42.4% of these donors, GA decreased to the normal range at the second donation.Conclusions: Overall, 2.7% of otherwise healthy Japanese blood donors had a high GA (GA ≥16.5%). Donor blood screening for GA represents an effective measure to identify people at risk of diabetes. The decrease in the GA level after GA notification might indicate the potential usefulness of this strategy to improve glycemic control among people with high GA.
Somatostatin and its long-acting analogue octreotide have been used in various diarrheal disorders, including neoplastic and nonneoplastic diseases of the gastrointestinal tract. In two insulin-dependent diabetic patients with autonomic neuropathy and chronic steatorrheic diarrhea refractory to conventional medications, subcutaneous administration of octreotide markedly improved the volume and frequency of stools in both patients. This change was accompanied by a clear improvement in their rapid gastrointestinal tract transit times. The treatment also greatly improved their orthostatic hypotension. No adverse effects of octreotide were observed after treatment for 7 months in one patient and 2 months in the other.
The aim of this study was to determine the effect of angiotensin-converting-enzyme inhibitor, alacepril, on insulin sensitivity in patients with essential hypertension (EHT). Ten patients (5 men and 5 women) with EHT (3 with mild diabetes and 2 with borderline glucose tolerance) participated. We measured insulin sensitivity using the two-hour euglycemic-hyperinsulinemic clamp technique and plasma glucose and insulin responses to a 75 g oral glucose tolerance test (75 g OGTT) before and after 6-8 weeks of treatment with alacepril (dose, 50 mg/day). Glucose infusion rate (GIR) during the last 30 min of the clamp study increased from 5.83 +/- 0.70 to 6.59 +/- 0.65 mg per kilogram of body weight per minute (P < 0.05) after treatment with alacepril. The insulin-sensitivity index, which was calculated by dividing the GIR by the mean insulin concentration during the same period of the clamp, also increased from 5.91 +/- 0.66 to 7.20 +/- 0.90 (P < 0.05) after treatment with alacepril. Plasma glucose responses to a 75 g OGTT were changed from diabetic pattern to borderline pattern in two patients and from borderline pattern to normal pattern in one patient after treatment with alacepril. Body weight did not significantly change throughout the study in any of the patients studied. Our study demonstrated that alacepril significantly improves insulin sensitivity in patients with EHT.
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