肺結核と糖尿病の合併

During the past 5 years 8 to 14 patients (1.01-1.85%) of 803 to 890 hospitalized pulmonary tuberculouss patients in our sanatorium had been combined with diabetes mellitus yearly. The percentage of this complication at the date of 1st July, 1964 was 2.9% (14 out of 479 patients). The yearly value of this percentage did not show a remarkable change and there was no difference with sex distinction.<br>In 21 of 26 pulmonary tuberculous patients with diabetes, the onset of diabetes was more than 30 years old; 7 of 26 patients (27%) had been suffering from diabetes before the onset of pulmonary tuberculosis (J group), 5 patients (19.2%) suffered from both diseases at the same year, and 14 patients of them (53.8%) suffered from pulmonary tuberculosis before development of diabetes (III group) . That the 3rd group has a majority in these patients is due to the insufficient urinalysis and to that the patients in this study were all admittedd in tuberculous sanatorium. In the 3rd group the onset of diabetes had not been related exactly with obesity nor antituberculous drugs.<br>The yearly percentage of the patients with occasional or renal glycosuria during the past 5 years was about zoo until 1962, but increased to about 5% in 1963. Of these actual 98 patients with occasional glycosuria, 8 cases had positive results more than twice and 16 cases revealed positive results only at the time of admission.<br>Among 476 pulmonary tuberculous patients without diabetes in July 1964, 41 patients (8.6%) were positive urine glucose 2 hours after breakfast by administration of antituberculous drugs; in 3 cases (0.6%) Nylander (+) and Tes-tape (+), in 27 cases (5.7%) Nylander (-) and Tes-tape (+) in 11 cases (2.396) Nylander (+) and Tes-tape (+). Of these 41 patients 21 cases did not become positive again by withdrawing of antituberculous drugs. The rest of 20 patients had positive urine glucose more than twice.<br>As a result of G. T. T. for these 20 patients, 3 cases were overt diabetes, 12 cases were suspected diabetes, and 6 cases were normal or with renal glycosuria. Of 12 suspected diabetes 4 cases showed oxyhyperglycemia. Of another 8 suspected diabetic, 5 cases revealed positive and 3 cases revealed negative results in consequence of P. G. T. T. Of these pulmonary tuberculoss patients with newly discovered diabetes, 2 cases were far advanced form and in another one diabetic became overt after thoracic surgery. Eight patients with P. G. T. T. showed mainly moderately advanced chest-roentgenogram.<br>We conclude 8 patients as subclinical diabetes (3 are latent chemical, 5 are chemical diabetes) i. e. as prediabetic state in a wide sense. Furthermore we believe that we have to consider the existence of these subclinical diabetic state during the treatment of pulmonary tuberculosis.