糖尿病患者の統計的観察および予後に関する臨床的研究
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Joslin reported that the clinical aspects of diabetes mellitus had been changed and the life expectancy of diabetics had been increased since the advent of insulin therapy, and after the Second World War these changes have been remarkable by the various factors, including the treatment of antibiotics and antidiabetic agents. For this reason, an attempt was made to study the recent statistical observation and the follow-up evaluation of diabetics admitted to our clinic from 1945 to 1960. (A) The results of statistical observation of 228 diabetic patients admitted during the past 16 years were as follows. a) The incidence of diabetes in the total admissions was 3.71 per cent, and it increased to between 4.81 and 7.83 per cent during the last seven years. b) The ratio of females to males was 1:1.78. c) The highest incidence according to age was in the fifth and sixth decades. d) The incidence of heredity was 20.7 per cent, which was twice as much before the W.W.II. e) When the diagnosis was made, 63.3 per cent of the cases had typical symptoms, 19.9 per cent atypical symptoms, and the rest, 16.8 per cent, were asymptomatic. The most frequent symptoms at onset were; 1) polydipsia, 2) polyuria, 3) general malaise, 4) loss of weight, and 6) polyphagia. f) At the time of adimission, 72.7 per cent of entire cases revealed a fasting blood sugar level of less than 200 mg % by Somogyi-Nelson method. g) Various complications occurred on 78.1 per cent of the cases, most of which were vascular in nature. h) Albuminuria was found in 26.0 per cent, hypertension in 41.3 per cent, diabetic retinopathy in 23.0 per cent, and retinal angiosclerosis in 25.2 per cent. i) Evidence of electrocardiographic myocardial damages was found in 43.5 per cent cf 69 cases. Patellar deep tendon reflex was absent in 30.6 per cent and diminished in 29.1 per cent of 134 cases. (B) The results of follow-up untill 1961 of 126 patients were as follows. a) Among 126 cases, 40 patients died, and the average age at death was 50.3 years and the average life expectancy from the onset to death was 8.8 years. b) The most frequent causes of deaths were; 1) cardio-renal-vascular diseases (32.5%), 2) infections (20.0%), 3) diabetic coma (10.0%), 4) cancer (10.0%), and 5) miscellaneous (27.5%). c) Eighty-six patients are still alive, but only 38.3 per cent of them consulted physicians at regular intervals after the discharge and some complications occurred on 46.5 per cent of them, chiefly vascular diseases being newly found. d) The prognosis of diabetics with one or more of albuminuria, hypertension and diabetic retinopathy was more unfavorable than those without them.
- 千葉大学の論文
- 1964-03-28
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