CLINICAL STUDIES ON THE COMPLICATION OF DIABETES MELLITUS IN ACUTE MYOCARDIAL INFARCTION

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  • KOJIMA Kikuko
    The 3rd Department of Internal Medicine, School of Medicine, Showa University
  • FUJIMAKI Tadao
    The 3rd Department of Internal Medicine, School of Medicine, Showa University
  • SHIOHARA Yasuhiko
    The 3rd Department of Internal Medicine, School of Medicine, Showa University
  • KOBAYASHI Masaki
    The 3rd Department of Internal Medicine, School of Medicine, Showa University
  • IGARASHI Hiroshi
    The 3rd Department of Internal Medicine, School of Medicine, Showa University
  • HASEGAWA Takeshi
    The 3rd Department of Internal Medicine, School of Medicine, Showa University

Bibliographic Information

Other Title
  • 心筋梗塞症における糖尿病の研究
  • 心筋梗塞症における糖尿病の研究--臨床症状と経静脈性ブドウ糖負荷試験による検討
  • シンキン コウソクショウ ニ オケル トウニョウビョウ ノ ケンキュウ リンシ
  • —WITH SPECIAL REFERENCE TO CLINICAL SYMPTOMS AND INTRAVENOUS GLUCOSE TOLERANCE TEST—
  • ―臨床症状と経静脈性ブドウ糖負荷試験による検討―

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Abstract

Three hundreds and nine patients (male 234, female 75) with acute myocardial infarction were divided into two groups of diabetes and non-diabetes for comparative studies on their clinical features. Intravenous tolerance tests were performed on 39 patients in the acute stage of myocardial infarction for evaluation of glucose tolerance.<BR>The complication of diabetes mellitus was seen in 32.4 percent of all of the infarcted patients, and this value was almost the same either in male or in female patients. In the female infarcted patients, the olders were more frequently affected by diabetes mellitus than the youngers. Twelve percent of the diabetic group had painless infarction and this was significantly higher compared with that of the non-diabetic group. 43.5 percent of the diabetic female patients showed atypical symptoms such as painless attacks. Among the diabetic group under the age of 60, 25.8 percent had initiated the disease with atypical symptoms including painless infarction. Complications with congestive heart failure were found in many of the female diabetic group, as high as 43.4 percent in Killip III and IV groups. And the younger diabetic patients had the higher incidence of congestive heart failure compared to the non-diabetic group. In the diabetic group, 73.3 percent of the deaths were due to congestive heart failure in the acute stage.<BR>The intravenous glucose tolerance test exhibited that the blood sugar levels both before and after loading were higher in the diabetic group than in the non-diabetic group, while the K-value (glucose disappearance rate) was significantly lower in the diabetic group than in the non-diabetic group. With Fisher's discriminate function, the K-value was better than the blood sugar itself. When the discriminate function due to the K-value was established, the critical value was 0.85. With the K-value, diagnosis of diabetes mellitus will be in more possible than 80 percent of the cases in the acute stage of myocardial infarction.

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