@article{oai:niigata-u.repo.nii.ac.jp:00023450,
 author = {津田, 晶子 and 中村, 宏志 and 高木, 顕 and 伊藤, 正毅 and 涌井, 一郎},
 issue = {6},
 journal = {新潟医学会雑誌, 新潟医学会雑誌},
 month = {Jun},
 note = {To elucidate a major factor for poor glycemic control in insulin dependent DM (IDDM) with conventional insulin therapy (CIT), urinary C-peptide excretion (UCPR) was determined as a maker of residual cell function. UCPR was less than 2μg/day in 31 out of 33 unstable DM and more than 2μg/day in 5 out of 6 stable DM. The finding suggested that residual B cell function may play an important role in stability of glycemic control in CIT. The M-value and the SD of 10 serial measured fasting blood glucose (SD of 10 FBG) were remarkably improved with CSII in 28 patients without residual cell function. But in 7 out of 28 cases, these two markers were not improved inspite of CSII therapy. There is a positive correlation between SD of 10 FBG under CSII therapy and duration of diabetes (r=0.67). Diabetic complications especially autonomic neuropathy were more advanced in CSII-unstable group (SD of 10 FBG>50) than CSII-stable group. There are no differences in insulin antibody binding %, subcutaneous insulin absorption and gastric emptying time between two groups. Thus, autonomic neuropathy may be a major factor for instability of glycemic control in CSII therapy. 13 CSII-stable patients were treated with intensive conventional therapy (ICT). The deterioration were seen in the M-value during 2 days and the SD of 10 FBG. More variable fasting blood glucose levels and higher pre dinner blood glucose levels were detected in ICT unstable group than in ICT stable group. Free-IRI levels at fasting and afternoon were lower in ICT unstable group. Free-IRI profile after subcutaneous injection of NPH insulin decreased faster in ICT unstable group than in ICT stable group. Faster decreasing Free-IRI levels is considered as a cause of the unstability under ICT. As Total IRI levels and insulin antibody binding were higher in ICT stable group than ICT unstable group, insulin antibody may have a beneficial effect in stability of glycemic control in ICT through gradual dissociation of insulin from insulin antibody.},
 pages = {331--343},
 title = {5) 不安定型糖尿病の成因と治療(シンポジウム 糖尿病の合併症と治療に関する最近の進歩, 第426回新潟医学会)},
 volume = {102},
 year = {1988}
}