It was recently reported that lactate acts as a metabolic mediator and rises in the diabetic state, but the physiological effects are as yet poorly understood. The objective of the current study was to evaluate the significance of serum lactate elevation in type 2 diabetes mellitus (T2DM) patients. Fasting serum lactate levels, hematological and inflammatory serum markers and anthropometric parameters, obtained employing bioelectric impedance analysis, were measured in 103 patients with T2DM. Statistically significant correlations of serum lactate levels with C-reactive peptide, insulin, aspartate aminotransferase, alanine aminotransferase (ALT), serum lipids, total bilirubin, adiponectin, homeostasis model assessment-insulin resistance, body weight, body mass index and body fat (weight or percentage of subcutaneous fat, visceral fat or total body fat), but neither fasting plasma glucose nor HbA1c, were detected. Stepwise regression analysis showed ALT to be independently positively associated with total bilirubin, while being negatively associated with serum lactate levels. Furthermore, serum lactate levels were significantly higher in patients with ALT-predominant liver dysfunction. We found fasting serum lactate elevation in T2DM patients to be associated with the serum levels of ALT and total bilirubin independently of blood glucose control. UMIN clinical trials registry (UMIN000029178).

Aims:We aimed to assess the relationships between lower urinary tract symptoms (LUTS) and various parameters including diabetes complications in patients with type 2 diabetes. Methods:In this single-center cross-sectional study, we enrolled 404 patients hospitalized for diabetes. We ultimately analyzed data from 160 patients. To evaluate LUTS, the International Prostate Symptom Score and overactive bladder symptom score were used. The identified relationships were then analyzed considering parameters such as age, sex, body mass index (BMI), HbA1c, creatinine, and urinary albumin excretion. Results:The prevalences of overactive bladder (OAB), storage symptoms and voiding symptoms were 21.9%, 63.8%, and 39.4%, respectively. In multivariate logistic regression analysis, the coefficient of variation of the R-R interval, indicating autonomic neuropathy, correlated negatively with OAB, while BMI and duration of diabetes correlated positively with storage symptoms. A history of cerebrovascular disease correlated significantly with voiding symptoms in multivariate logistic analysis. Conclusions:Our analysis of diabetic patients with LUTS revealed differences in the characteristics of storage and voiding symptoms. These findings provide evidence that the features of LUTS associated with diabetes may have different pathogenic origins. J. Med. Invest. 71 : 237-245, August, 2024

To explore the relationship between mealtime delays of up to 3 h and subsequent glucose fluctuations, healthy young adults were allocated to three delayed dinnertimes in randomized order. Participants consumed test meals for lunch and dinner. After assessing the glucose responses using intermittently scanned continuous glucose monitoring devices (isCGM), the peak glucose elevation, and incremental area under the curve (iAUC) of postprandial glucose during certain intervals increased significantly when the time between lunch and dinner was delayed by 1 h or more. Our results support the importance of improving irregular mealtime habits, such as late eating. We investigated the relationship between mealtime delays of up to 3 hours and subsequent glucose fluctuations in healthy young adults. After assessing glucose responses using intermittently scanned continuous glucose monitoring devices (isCGM), the peak glucose elevation, and incremental area under the curve (iAUC) of postprandial glucose during certain intervals increased significantly when the time between lunch and dinner was delayed by 1 h or more. Our findings support the importance of improving irregular mealtime habits, such as late eating.image

Aims: Several studies have suggested diabetes to possibly be associated with muscle atrophy, that is, so‐called sarcopenia, in seniors. The association between grip strength and disease states has not yet been examined in a large‐scale general population study. Therefore, we conducted a large‐scale analysis of the relationship between grip strength and glucose tolerance in Japanese subjects aged ≥65 years receiving health check‐ups. Methods: We collected data from 22,717 subjects who underwent medical check‐ups. After excluding subjects who did not meet the criteria, data from 15,529 subjects who underwent the grip strength measurement were analyzed. The subjects were divided into three groups according to anthropometric and biochemical data, including glucose tolerance status. Baseline characteristics, including grip strength, were compared among the three groups. Regression analysis was performed to investigate the association between grip strength and glucose tolerance status. Results: For males, median grip strength was significantly lower in the group with diabetes (36.0 kg) than in those with prediabetes (37.0 kg) or normal glucose tolerance (37.3 kg). According to logistic regression analysis, higher grip strength was associated with lower odds of diabetes (OR = 0.959, 95% CI: 0.949–0.968 vs normal, OR = 0.968, 95% CI: 0.957–0.979 vs prediabetes) or prediabetes (OR = 0.990, 95% CI: 0.981–0.999 vs normal) for males, while not reaching statistical significance for females. Conclusions: Diabetes is associated with lower grip strength in Japanese males aged ≥65 years.

The aim:Pancreatic cancer, a rapidly progressive malignancy, is often diagnosed in patients with diabetes. The incidence of pancreatic cancer has risen dramatically over recent decades. Early diagnosis of this malignancy is generally difficult because the symptoms do not become apparent until the disease has progressed, generally leading to a poor outcome. To achieve earlier diagnosis, we analyzed the clinical characteristics of pancreatic cancer patients showing deterioration of plasma glucose levels while hospitalized. Method:Thirty-six cases were divided into 2 groups;those diagnosed with diabetes more than a year prior to identification of pancreatic cancer and diabetes secondary to pancreatic cancer. These 2 groups were further subdivided according to the tumor site (head or body/tail), allowing analysis of 4 subgroups. Anthropometric measurements, laboratory values were determined. Results:Both groups with diabetes lost at least 4 kg and showed HbA1c deterioration of at least 1% within 5 months of the pancreatic cancer diagnosis. The post-meal elevation of serum C-peptide immunoreactivity (CPR) was significantly decreased in the group with cancer of the pancreatic head, and this was unrelated to tumor size. Conclusion:Characteristically, pancreatic head cancer was associated with decreased endogenous insulin secretion as compared to body/tail cancer. J. Med. Invest. 70 : 350-354, August, 2023

Meal skipping has become increasingly common in modern society due to changes in lifestyle. While the adverse effects of skipping breakfast on postprandial glucose levels have been well established, less is known about the impact of skipping lunch or dinner on these levels. The aim of this study is to determine the effect of skipping breakfast, lunch, and dinner consecutively on postprandial glucose levels in healthy subjects. Thirteen healthy young adults were enrolled and instructed to consume meals freely at designated times while maintaining detailed food intake records. Participants then followed a controlled protocol in which one of the three meals was skipped for two consecutive days in a specified order, with interstitial glucose continuously monitored. Skipping lunch on both days significantly increased postprandial glucose levels at the subsequent dinner by 1.6 mmol/L compared to when lunch was consumed and breakfast was skipped (p < 0.001). In contrast, skipping dinner or breakfast did not result in significant changes in postprandial glucose levels at the following meal. We thus observed skipping each of these three meals to have different effects on subsequent postprandial blood glucose levels in the healthy subjects. Most notably, skipping lunch leads to increased postprandial blood glucose levels at dinner.