Effectiveness of metformin and lifestyle interventions as an initial treatment in Japanese patients with newly diagnosed type 2 diabetes : a prospective observational study

Although global guidelines recommend metformin and lifestyle interventions as an initial treatment in patients with newly diagnosed type 2 diabetes (T2DM), few reports exist about its effectiveness in Japanese patients. To examine its effectiveness, we performed a prospective observational study within a routine clinical setting. We provided metformin (≥1,500 mg/day) and lifestyle interventions to 23 patients with newly diagnosed T2DM (20 men and 3 women, mean age 53 years, mean body mass index [BMI] 25.7 kg/m2). After 16 weeks, HbA1c levels significantly decreased from 9.1±2.1% (mean±SD) to 6.6±0.8% (p<0.001). Thirteen patients (56.5%) achieved a target HbA1c<6.5%. We did not find a significant correlation between baseline BMI and the changes in HbA1c (ΔHbA1c) (r=-0.165, p=0.451). In contrast, we found a significant correlation between baseline fasting plasma glucose and ΔHbA1c (r=-0.755, p<0.001). Body weight decreased from 73.3±13.3 kg to 69.8±11.6 kg (p<0.001). Total cholesterol, low density lipoprotein-cholesterol, non-high density lipoprotein-cholesterol, and serum vitamin B-12 concentrations also significantly decreased. Adverse events included diarrhea (26.1%) and mild elevation of liver enzymes (8.7%). These results suggest that metformin and lifestyle interventions is effective and safe as an initial treatment in Japanese patients with newly diagnosed T2DM

Electron Spin Resonance Studies of Erythrocytes from Patients with Duchenne Muscular Dystrophy

The membrane organization of the erythrocytes from patients with Duchenne muscular dystrophy was studied by means of electron spin resonance. The fluidity of the membrane near the polar region of Duchenne muscular dystrophy erythrocytes was similar to that of normal erythrocytes. The membrane environment in the nonpolar region, however, was quite different from that of normal erythrocytes, judged by the spectra with 2-(14-carboxytetradecyl) - 2 - ethyl - 4,4 - dimethyl - 3 - oxazolidinyloxyl as probe. The temperature dependence of the ratio of the line height of central field to that at the low field showed two inflection points in normal erythrocytes at pH 7.4 (13.5°-16.5° and 37.5°-40.5°C, respectively) but the inflection point in the lower temperature range was not detected in Duchenne muscular dystrophy erythrocytes. When pH was varied, an abrupt decrease in the ratio was observed at pH 5.9-5.6 in normal erythrocytes whereas there was a gradual decrease over the range of pH from 6.6 to 5.0 in Duchenne muscular dystrophy erythrocytes. The rate of reduction of the radical 2-(3-carboxypropyl)-4,4-dimethyl-2-tridecyl-3-oxazolidinyloxyl by ascorbate in normal erythrocytes was faster than that in Duchenne muscular dystrophy erythrocytes. Treatment of both erythrocytes with phloretin markedly reduced the rate of reduction by ascorbate and eliminated the difference in the two types of erythrocyte. These results indicate that in Duchenne muscular dystrophy the erythrocyte membrane is involved as well as the muscle cell

男性化副腎皮質癌の1例

A 36-year-old woman who had experienced two pregnancies consulted our hospital, because of scant menses and virilization. A 24-hour excretion of 17-ketosteroids and 17-hydroxy-corticosteroids demonstrated a decrease in 11-hydroxylase. A computed tomogram showed a huge inhomogenous tumefaction in the left adrenal. Left selective renal angiography revealed a large adrenal tumefaction. Selective adrenal venous samplings revealed that testosterone and dehydroepiandrosterone (DHA) were produced in response to stimulation by 0.25 mg exogenous adrenocorticotropic hormone (ACTH). After left adrenalectomy was performed, a diagnosis of adrenocortical carcinoma was made by pathological examination. This is the first report of a patient with a virilizing adrenocortical carcinoma, which produced testosterone and DHA in response to exogenous ACTH stimulation

INTRODUCTION Effectiveness of metformin and lifestyle interventions as an initial treatment in Japanese patients with newly diagnosed type 2 diabetes : a prospective observational study

Optimal control of hyperglycemia and associated risk factors reduces the risk of diabetes-related complications. Metformin is the most widely prescribed biguanide, which lowers blood glucose level primarily through the inhibition of hepatic glucose production. The UK Prospective Diabetes study (UKPDS) showed that metformin reduces the risk of diabetesrelated endpoints, myocardial infarction, diabetesrelated death and all-cause mortality in overweight patients with newly diagnosed type 2 diabetes (1, 2). Moreover, recent observational studies reveal that body mass index (BMI) of patients is unlikely to influence the antihyperglycemic effect of metformi

X-ray analysis of bilirubin oxidase from Myrothecium verrucaria at 2.3 Å resolution using a twinned crystal

The crystal structure of bilirubin oxidase (BOD) from M. verrucaria has been determined at 2.3 Å resolution using a merohedrally twinned crystal. BOD has four copper-coordination sites that are almost identical to those of other multicopper oxidases and is also very similar to them in overall structure