A study on serum lipid and malondialdehyde levels among diabetic patients

Background: Elevated levels of lipid peroxide in diabetes mellitus may be due to the alteration of function of erythrocytes membrane. This inhibits the activity of superoxide dismutase enzyme leading to accumulation of superoxide radicals which cause the maximum lipid peroxidation and tissue damage in diabetes. The objectives was to study was done with the objectives of assessing the serum lipid and malondialdehyde levels among diabetic population and matched control group.Methods: This study was done among 50 NIDDM, 50 IDDM and 50 controls at Thanjavur Medical College, Tamil Nadu, India for a period of one year at the Department of Diabetology after getting the informed consent and IEC clearance. This study included all ambulatory NIDDM and IDDM patients without any complications. The following investigations like serum malondialdehyde, blood sugar, HBA1C, serum lipid profile, blood urea, serum creatinine, urine albumin and sugar were done by standardized procedures and reagents after getting the detailed history and examination.Results: Among NIDDM group 78% were between 6.4 to 8 categories whereas in IDDM group only 28% were in this 6.4 to 8 category (HBA1C). Comparison of serum MDA values among three groups were done by ANOVA with two groups separately and it was highly significant. Multiple comparison of mean difference of MDA and lipid values among all the three groups showed statistically significant results with p value at 0.05.Conclusions: Lipid profile is increased in poor glycemic controlled patients (both IDDM and NIDDM patients) and it is reflected in high serum malondialdehyde levels.

Neurophysiological Changes In Person With Insulin Dependent And Non Insulin Dependent Diabetes Mellitus

Background: Diabetes mellitus is a disease caused by an inability of the body to metabolize glucose properly. The prevalence of diabetes is rapidly rising all over the globe at an alarming rate. As Insulin and non-insulin dependent diabetes shows their effect on various physiological systems includes central, peripheral and autonomic nervous systems, musculoskeletal, cardiovascular and other vital systems. A common complications due to the IDDM and NIDDM includes peripheral neuropathy, retinopathy, nephropathy and vascular complication. Insulin and non-insulin dependent diabetes mellitus, both affect the peripheral nervous system significantly. Therefore we would like to find out neurophysiological changes on peripheral nervous systems between insulin and non-insulin dependent diabetes mellitus. Aim: To find out the Neuro-physiological changes between IDDM and NIDDM. Materials and Method: 120 individuals screened with SF36 (general health good and above) were included with age limit between 25 to 60 years. Those individuals having a history of hospitalization in last 1 year, acute fever, present history of radiculopathy and open wound were excluded. They were divided into 2 groups IDDM and NIDDM. For nerve conduction study–distal latency, amplitude and NCV of sensory and motor nerves were performed. Nerve conduction studies of common peroneal, tibial and sural nerves were examined in both groups. Latency, NCV and CMAP/SNAP were taken as outcome measures. Result and Discussion: Bio-statistical analysis has been done using Mann-Whitney test. Result suggest that there is a significant difference in Neurophysiological changes (p<0.05) between IDDM and NIDDM groups. Conclusion: In context to our study and neurophysiological findings, individuals with IDDM must be taken into consideration for promotion, prevention, and care as compared to NIDDM for secondary complications.

Novel heterozygous mutation of the IL2RA gene in one Chinese girl with immunodeficiency 41 with lymphoproliferation and autoimmunity and diabetes mellitus, insulin-dependent 10: One case report and literature review / 中华内分泌代谢杂志

Objective To report a case of immunodeficiency 41 with lymphoproliferation and autoimmunity (IMD41) and type 10 insulin-dependent diabetes mellitus(IDDM10), caused by mutations of the interleukin 2 receptor α(IL2RA)gene.Methods Clinical symptoms were colleted,while IL2RA gene was sequenced.Results Here we reported a girl of 7 years and 6 months old who came to our hospital presented with lymphadenovarix for 5 years,debilitation for 2 months and alternation of hyperglycemia and hypoglycemia for 20 days. She was subsequently diagnosed with fungal pneumonia and ANCA-associated vasculitis. All exons of IL2RA gene were sequenced. c.340C>T(p.Q114X,paternal,novel mutation),c.64G>A(p.E22X,maternal) were detected. After treatments of dihydrocortisone,voriconazole combined with diabetic diet plus raw cornstarch, the pulmonary lesions reduced, autoantibodies disappeared and the blood glucose returned to normal. Literature review suggested that totally 5 IL2RA gene mutation patients were reported, the major clinical features were recurrent infection(infection of lung, skin, gastrointestinal tract) and immune abnormalities ( such as lymph node disease, autoimmune disease, hepatosplenomegaly,and diabetes mellitus). Conclusion In cases of atypical clinical symptoms, whole exon sequencing helps early diagnosis.

Study of significance of glycosylated hemoglobin in diabetic patient.

Background: Investigation of the structure and biosynthesis of glycosylated Hemoglobin (HbA1c) in the past decade have provided a means to objectively access the average level of glycemia in diabetic patient. The use of Glycosylated hemoglobin level as integrated index of long term blood glucose level, represent a significant tool in our research and therapeutic armamentarium. In this study, we have estimated glycosylated Hemoglobin (HbA1c) in diabetic and non diabetic person and its relationship with fasting and post prandial blood sugar levels. Materials and methods: In present study, Glycosylated hemoglobin levels were estimated by using cation exchange resin method. The study was conducted from November 2012 to October 2014. Measurement of total HbA1c and blood sugar were carried out at Diabetic research laboratory, Tertiary care centre, Teaching Institute. 110 Non diabetic persons studied as a control, which were proved to be Non diabetic from history, FBS, PPBS, Urine sugar. Persons with family history of diabetes were not included in control group (Group: X). 350 diabetic patients which included new and old cases, IDDM and NIDDM cases, complicated and non complicated cases, among them 241 were having NIDDM and 109 were having IDDM type of diabetes (Group: Y+Z). All cases thoroughly studied and details about personal data, history, clinical examination, laboratory investigations, complication of diabetes and type of treatment were noted. Results: In IDDM, there was higher value of mean GHb (13.13%), than in NIDDM (mean GHB 11.89%). Patients having Insulin therapy had higher value of GHb (13.08%) than with on oral hypoglycemic agents (11.91%) and patients on dietary modification had level 9.44%. There was no Modi D, Rathod GB, Delwadia KN, Goswami HM. Study of significance of glycosylated hemoglobin in diabetic patient. IAIM, 2016; 3(4): 1-10. Page 2 significant difference in GHb among patients with complication (12.26%) and patients without complications (12.29%). Conclusion: Glycosylated hemoglobin assay defines an end point as the fuel of diabetic therapy and provides a powerful stimulus to the patients to improve their compliance. Glycosylated hemoglobin assay may provide an alternative method of screening for diabetes.

Evaluation of effect of aqueous extract of Enicostemma littorale Blume in streptozotocin-induced type 1 diabetic rats.

The present investigation was undertaken to standardize and study the dose-dependent effect of three weeks treatment with hot and cold aqueous extract of E. littorale (0.5, 1 and 2 g/kg, po) on streptozotocin (STZ) induced type I diabetic (confirmed by histopathology) rats (45 mg/kg, iv single dose). Treatment of rats with STZ produced cardinal signs of diabetes-mellitus like a significant loss of body weight, polyuria and polydipsia. There was also a significant increase in fasting blood glucose levels and AUCglucose associated with decrease in insulin levels and AUCinsulin in STZ-diabetic rats. Treatment with E. littorale hot extract (1 and 2 g/kg) significantly reduced the elevated food intake and water intake, glucose and AUCglucose levels of diabetic rats. There was also a significant increase in serum cholesterol, serum triglyceride in the STZ diabetic rats. Treatment with E. littorale hot extract (1 and 2 g/kg) significantly decreased all these elevated levels in diabetic rats. Hot aqueous extract of E. littorale at 0.5 g/kg produced a significant decrease in serum glucose and triglycerides. At this doses serum cholesterol and AUCglucose were not found to be altered significantly.TLC finger-print profiles were established for the aqueous extract using HPTLC. Swertiamarin, which was used as a chemical marker, was found to be one of the major components in the hot extract while it was absent in cold extract. The results suggest that E. littorale possesses potential antidiabetic activity and improves lipid profile at a small dose of 0.5 g/kg.

Selenoprotein S1: A novel inflammatory gene / 中南大学学报(医学版)

Selenoprotein S1 (SEPS1) , a novel gene involved in the stress response of endoplasmic reticulum and inflammation control. Recent results provide a direct mechanistic link between SEPS1 and the production of inflammatory cytokines, suggesting SEPS1 may play a major role in the mediation of inflammation in IDDM and some other immunological disorders.

The effects of interleukin-6 on the development of autoimmune diabetes in NOD mouse / 中国药理学通报

AIM To investigate the anti-inflammatory properties of IL-6 on the development of IDDM(insulin dependent diabetes mellitus) in NOD mouse. METHODS IL-6 was administered exogenously in female NOD mice (spontaneous model) and cyclophosphamide-treated NOD mice (accelerated model) respectively. During the study period, the mice were evaluated for development of diabetes once a week. At the end of experiment, 8 euglycosuria mice from each group were sacrificed for histoimmunological analysis, and the production of TNF-? and IFN-? from spleen lymphoid cells were detected. RESULTS The incidence of IDDM in spontaneous model(33%) were significantly reduced after 12 weeks of treatment. TNF-?(P

Frequencies and Risk Factors for Microvascular Complications in Patients with Type 1 Diabetes Mellitus / 대한소아내분비학회지

PURPOSE: This study was undertaken to identify the frequencies and the risk factors of microvascular complications in subjects with type 1 diabetes mellitus METHODS: The frequencies and their relation to risk factors of microvascular complications were analyzed in 29 type 1 diabetes mellitus subjects with duration of disease more than 5 years. Microvascular disease was defined as the presence of either retinopathy, microalbuminuria or neuropathy. RESULTS: The overall prevalence rate of microvascular disease was 8/29(27.6%). Retinopathy has developed in 3 patients(10.3%), microalbuminuria in 7 patients(24.0 %) and neuropathy in 5 patients(17.2%). The mean HbA1C was significantly higher in the patients with microvascular complications(11.6+/-.2% in microvascular complication group vs 9.3+/-.6% in control group). CONCLUSION: In childhood onset type 1 diabetes mellitus, poor glycemic control is an important risk factor for microvascular complications.

An approach to the treatment of the hypoglycemia dropped after meal

BACKGROUND: Many patients with type I Diabetes Melitus treated by insulin therapy were observed their blood sugar dropped even after meal. The ecology and treatment for this phenomenon was unknown. A clinical research making an approach to treat this phenomenon is inevitable. METHODS: 9 patients whose blood sugar dropped right after meal (from 15 minutes to 1 hour) were selected among 58 IDDM(Insulin Dependant Diabetes Mellitus) patients admitted in Daejon Sungsim Hospital from March 1999 to Feb. 2000. The subjects were consist of 6 female and 3male, average age was 57.2. Blood samples were taken from their capillaries and measured by Super Glucocard II glucometer. Insulin was injected 30 minutes before breakfast and 50% glucose 30 ml was taken orally 15 minutes after the insulin injection. Breakfast was taken 15 minutes after the glucose taken. Bolld sugar was measured 15, 20, 25, 30, 35, 40, 45, 50, 55, 60, 120 minutes and 2 hours after a breakfast. RESULTS: Though average blood sugar dropped after breakfast was 44.5 mg/dl, average blood sugar after taken 50% glucose 30 ml was 114.1 mg/dl. 2 patients had good effect among 3 male patients and every 6 female patients had good effect. CONCLUSION: Taking 50% glucose 30 ml was in oral 15 minutes after insulin injection improved the IDDM patient's blood sugar drop right after meal.

Prevention of overt diabetes and insulitis by BCG administration in the NOD mice of the breast-fed period / 대한해부학회지

By the concept that IDDM (insulin-dependent diabetes mellitus) is one of the autoimmune diseases, several immune suppressive drugs and immune modulators including BCG have been used to suppress the occurrence of IDDM. A data reported that BCG has different effects for prevention of diabetes according to the timing of drug administration. This study was performed to examine the preventive effect of diabetes development and insulitis by administering BCG at breast-fed period. NOD (non-obese diabetic) mice were divided into three groups: Group I, II, III were injected by BCG on the first day, eighth day, and twenty second day of life respectively. The later BCG was injected, the smaller occurrence of diabetes and the lower severity of insulitis were.

The Clinical and Immunogenetic Characteristics of Adult - Onset Insulin - Dependent Diabetes Mellitus in Korea / 대한내과학회지

Insulin-dependent diabetes mellitus (IDDM) is an autoimmune disease occurring among genetically susceptible individuals. Although the HLA class II genes and immunological abnormalities are clearly associated with IDDM in all racial groups, there are considerable variations in associated genotypes and prevalence of autoantibodies. Especially, it seems that adult-onset IDDM is somewhat different from childhood-onset IDDM in clinical and immunogenetic aspect. In order to determine the characteristics of the immunogenetic patterns and to use these results as an early diagnostic tool and a guideline of the therapeutic plan in Korean adult- onset IDDM, we investigated the clinical and immunogenetic characteristics in adult-onset IDDM patients. METHODS: We investigated the clinical and biochemical characteristics, and measured anti-GAD antibody by immunoradiometric assay or immunoprecipitation after in vitro translation of human GAD cDNA and IA-2 antibody by immunoprecipitaion after in vitro translation of human IA-2cDNA. The distribution of HLA-DR serotypes by lymphocyte microcytotoxicity method, HLA-DQA1 genotypes by restriction fragment length polymorphism and HLA-DQB1 genotypes by dot-blotting analysis using sequence specific oligonucleotide probe were analysed in 233 IDDM patients and controls. RESULTS: 1) Adult-onset patients had more preserved beta cell functions and slowly evolving form of clinical pattern rather than childhood-onset cases. 2) Each prevalences of anti-GAD and IA-2 antibody were 64% and 14.4% in adult-onset patients. Among them, the group with DR9-DQ9 had higher prevalence of antiGAD antibody rather than DR4-DQ4 group. 3) There were increased frequencies of HLA-DR4 and -DR9 in adult-onset patients. Considering the frequency of HLA-DQA1 and -DQB1 and the distribution of DQ heterodimers, they had no significantly increased genotypes or haplotypes. But childhood-onset cases had high frequencies in HLA DR3, -DR4, -DR9 serotypes and DQA1*0301, DQA1*0501, DQB1*0201 genotypes. CONCLUSION: Korean adult-onset IDDM patients have relatively higher prevalence of anti-GAD antibody implicating autoimmune pathogenesis. HLA genetic markers in adult-onset IDDM were somewhat different from those in childhood-onset cases. This pathogenetic heterogenesity according to age of onset may be due to the influences of other genetic markers and environmental factors involved in the etiology of Korean IDDM.

Prevalence of Autoimmune Antibodies in Type I Diabetic Children and Their Siblings / 대한소아내분비학회지

Background:Insulin dependent diabetes mellitus(IDDM) is known to be a disease characterized by a deficiency of insulin caused by destruction of the pancreatic beta-cells. It has been suggested that the clinical and immunological characteristics of IDDM in Korean are different from those of Caucasian. This study was undertaken to investigate the clinical characteristics and the prevalence of autoimmune markers in type I diabetic children and their prediabetic siblings in Korea. METHODS:Insulin autoantibody(IAA), antiglutamic acid decarboxylase(Anti-GAD) antibody, thyroid autoantibodies such as antithyroid antibody(ATA) and antimicrosomal antibody(AMA), and rheumatoid facter(RF) in 54 type I diabetic children have been measured. Diabetic autoimmune antibodies were also measured in 48 siblings. RESULTS: 1)Clinical characteristics of type I diabetic children were that age of onset was 8.6+/-4.4 years, duration of diabetes was 4.1+/-3.3 years. C-peptide at onset of diabetes was fasting 0.7+/-0.5ng/ml, and postprandial 1.2+/-0.5ng/ml, and HbA1c was 12.5+/-4.3%. 2)The positivity of IAA and anti-GAD antibody of type I diabetic children was 74% and 50% respectively. ATA and AMA positivity of type I diabetic children was 3.7% and 5.6%. however RF was not detected at all. Among the diabetic siblings, 48 persons for anti-GAD antibody, 21 for IAA, 27 for ICA were measured but 1 case was positive for IAA. 3)Clinical characteristics of type I diabetic children were not specific different between IAA and anti-GAD antibody positivity. But the mean age of onset of type I diabetic children was younger in case of both positivity of IAA and anti-GAD antibody than both negativity(7.8 vs 11.4 years old, P<0.05). 4)A case in whose brothers are diagnosed as IDDM has shown that autoantibody of elder brother was positive in both IAA and anti-GAD antibody, and younger brother was also strongly positive in IAA. Another case in whose sisters were IDDM, has shown that, while elder sister was positive in IAA, younger sister strongly positive in both IAA and anti-GAD antibody. 5)In a case of identical twin brother, the elder is type I diabetic child and the younger is normal, elder brother's onset of age was 6 years and 8 months old, and titer of anti-GAD antibody was measured as strong positive. Both ICA and anti- GAD antibody were negative in normal younger brother. First phase insulin release in IV GTT and the insulin levels in oral GTT showed reduction from the normal level in normal brother, and repeat check up showed normal ranges but on-going study is needed under observation. CONCLUSION: The prevalence of autoantibody positivity of type I diabetic children of Korea in this study were IAA 74%, and anti-GAD antibody 50%. Cases with both IAA and anti-GAD antibody positive were shown to be earlier onset. Though titers of auto-antibody in IDDM twins, brothers and sisters were strongly positive, auto-antibodies in siblings of IDDM patients were detected only one case with IAA positive(0.47%). We suggest that the pathogenesis of IDDM in Korean is different from foreign countries in terms of prevalence of autoimmune antibodies and more numbers of diabetic siblings should be tested for further study.

Caring Experience of Mothers with IDDM Children / 간호학회지

This study is to define the caring experience of mothers with insulin-dependent diabetes mellitus children, by finding core category, contextual factors, intervening factors, and the patterns of caring, and to develop a practice theory on it. Research method followed grounded theory methodology by Strauss and Corbin. Subjects were six mothers, whose children have had insulin-dependent diabetes mellitus for 4 months to 14 years by the interview time. They were selected by theoretical sampling. Data were collected from September, 1995 to January, 1996. Interview were done by long interview took 50 minutes to 2 hours. Content of interview was recorded and transcribed later. Based on the results of previous interview, content of next interview was planned until data reached to the saturation point. Results were as follows : One hundred and forty concepts were found. These concepts were grouped into thirty-three categories, and then to ten categories. Mothers with diabetic child were revealed to face "being overwhelmed by burden". Overwhelming by burden is found to be progressed through the cycle production-coping-decrease or in crease process. Mothers showed four patterns of adaptation in caring the diabetic children. 1) If mothers felt large amount of overwhelming by burden because of difficulty of caring and unsympathizing but they had sufficient support, no condition of the child, and their coping mechanism was positive, most of them overcome with strong will, but some fell into burnout. 2) If mothers felt large amount of overwhelming by burden because of difficulty of caring, unsympathizing, insufficient support, serious condition of the child, and their coping mechanism was negative, they fell into burnout by coping with feeling. 3) In mothers felt small amount of overwhelming by burden because of little difficulty of caring and sympathizing, sufficient support, no serious condition of the child, but their coping was negative, most of them fell into burnout by coping with feeling, but some overcome. 4) If mothers felt small amount of overwhelming by burden because of little difficulty of caring and unsympathizing, sufficient support, no serious condition of the child, and their coping was positive, they overcome with strong will. On the basis of the above result, in order to help mothers take good care of their children, nursing assesment and intervention on life readjustment, and getting support should be required. Especially, through understanding mothers' personalities, individual support consistent with each of them should be required. Therefore education, counseling, mutual support and exchange of information will have to be accomplished.

Bone Mineral Density in Well Controlled IDDM / 대한소아내분비학회지

PURPOSE:Effects of IDDM on bone mineral metabolism are still in controversy. Some reported that bone mineral density in IDDM had inverse relationship with HbA1c, some reported that spine BMD was normal while femur BMD was decreased. Others reported that increased urinary calcium excretion in IDDM induced early trabecular bone mineral loss. We studied the correlation of BMD with diabetic control and body measurements. METHODS:In sixteen IDDM patients, using dual energy X-ray absorptiometry, BMD was measured in lumbar spine as trabecular bone and femur neck as cortical bone. Z-score of BMD was obtained by comparing age and sex matched control data. Correlations between BMD and diabetic control parameters (HbA1c, duration of IDDM) and body measurements were calculated. RESULTS:The body measurements were in normal range in all IDDM patients, the duration of IDDM was 38.4+/-24.0months, HbA1c was in good control state (7.69+/-1.53%), and urinary Ca/creatinine ratio was not increased. The Z-score of BMD was not decreased statistically (lumbar spine: -0.255, femur neck: -0.404), and the Z-score had no correlationship with body measurements and diabetic control parameters. CONCLUSIONS:In well controlled childhood IDDM, BMD was not decreased significantly.

Screening for Mitochondrial DNA Mutations of MELAS tRNA Leu(3243), MERRF tRNA Lys(8344) in Korean IDDM Patients / 대한소아내분비학회지

An A to G mutation at nucleotide 3243 or 8344 of the mitochondrial genome has been associated with insulin dependent diabetes mellitus(IDDM) and noninsulin dependent diabetes mellitus(NIDDM) in some patients whose family members are frequently affected in maternally inherited fashion. The hypothesis is entertained that defective oxidative phosphorylation system(OXPHOS) caused by mitochondrial DNA mutations would hamper the insulin secretion from pancreas beta islet cells, which requires large amount of ATP energy. Recently, a number of study have been reported to examine the frequecy of these mutations in diabetic populations. In this study, efforts have been directed to investigate the frequency of MELAS tRNALeu(3243) and MERRF tRNALys(8344) mutations in 53 Korean IDDM patients. Total genomic DNA extracted from patients' lymphocytes have been amplified using two sets of mitochondrial specific primers to cover the regions of nt 3243 or 8344. PCR-RFLP anlaysis using Apa I for MELAS(3243) or Ban II for MERRF(8344) were utilized to screen the presence of these mutations in 53 IDDM patients. Two positive controls have been directly sequenced to confirm the presence of these mutations. The results showed that none of IDDM patients(0/53) screened carried these mutations. In conclusion, mitochondrial DNA mutations of MELAS(3243) or MERRF(8344) may be very rare causative factor in developing IDDM, though a large number of IDDM patients are needed to be screened.

Serial Changes of Blood Glucose Levels in IDDM Patients Using Intermediate-acting Insulin only Therapy

PURPOSE: We investigated the clinical characteristics of IDDM patients, treated with NPH only, and evaluated current problems by measurement of serial blood glucose, insulin, C-peptide for 12 hours after administration of intermediate-acting insulin. METHODS: We studied 19 IDDM patients who had been diagnosed and followed up on a regular basis at Severance hospital. They were assigned into 2 groups, one(HbA1c high group) with HbA1c above 12%, the other(HbA1c low group) showing HbA1c below 12%. Their Heights, DM durations, HbA1c, basal C-peptides were primarily measured. Using continuous withdrawal pump, samples were taken every hour for 12 hours from 7:00 am. And serial blood glucose, insulin, C-peptide were assayed. RESULTS: 1) The mean HbA1c of the high group was 16.5+/-3.5% and that of the low group was 11.0+/-0.6%. There were no differences in clinical characteristics. 2) In HbA1c high group, fasting blood glucose, and mean blood glucose levels for 3hours were 156+/-85mg%, 284+/-125mg%(8,9,10am), 250+/-133mg% 11,12am,1pm), 252+/-122mg%(2,3,4pm), and 182+/-105 mg%(5,6,7pm), respectively. In low group, fasting blood glucose, and mean blood glucose levels for 3hours were 130+/-71mg%, 275+/-109 mg%(8,9,10am), 249+/-129mg%(11,12am,1pm), 231+/-81mg%(2,3,4pm), 158+/-62mg%(5,6,7pm), respectively. 3) Fasting blood insulin level was 51+/-47 U/l in high group, 62+/-62 U/l in low group. Thereafter low HbA1c group showed higher insulin levels than high HbA1c group. 4) Fasting blood C-peptide was 0.16+/-0.20 g/l in the high group, and 0.34+/-0.14 g/l in low group. Thereafter low group developed higher C-peptide responses than high group. The curve of C-peptide showed similar change of blood glucose, and maximal response followed 1-2 hours after maximal level of blood glucose. CONCLUSIONS: We concluded that short-acting insulin should be included for good control of blood glucose. Although fasting & dinner blood sugar seemed to be under fair control, intermediate-acting insulin used alone was not effective in preventing severe blood sugar elevation after morning meal.

A Pediatric Case of MELAS Syndrome Associated with Insulin-dependent Diabetes Mellitus

MELAS(mitochondrial myopathy, encephalopathy, lactic acidosis, and sroke like episodes) is a major subgroup of heterogeneous mitochondrial encephalopathy. Recent advances in molecular genetics revealed specific mutations in the mitochondrial DNA causing MELAS. We described clinical and molecular genetic findings of a 13-year-old boy with MELAS syndrome associated IDDM(insulin dependent diabetes mellitus). For molecular genetic studies, DNAs from peripheral blood nucleated cells were used. And the A-->G substitution at the nt position 3,243 in the mitochodrial tRNAleu(UUR) gene in a heteroplasmic fashion was confirmed in the patient and his mother, which supporting maternal transmission. The mother had no neuromuscular syndromes but was diabetic. The islet cell antibody was abscent in both the patient and his mother, proving an indirect evidence of beta cell destruction was caused by the definite mitochondrial DNA itself. The association of MELAS syndrome and IDDM has been reported very rarely, and this is the first case report in Korea.

HLA Distribution in Korean Patients with Insulin-Dependent Diabetes Mellitus

The comparative frequency with which the human leukocyte antigen (HLA)-A, -B, -C and -DR were to be found in 54 insulin-dependent diabetes mellitus (IDDM) patients and 73 individuals unafflicted with diabetes in Korea was determined. There was no association between HLA-B8, -B15, or -Bw54 and IDDM. However, an increased frequency of HLA-B13 was found in a segment of the entire population and the entire population of patients: that group of patients in which the onset occurred before the age of 15 years(juvenile-onset IDDM) (p < .01) and that entire population of patients in which the onset found to be before the age of 30 years (entire IDDM) (p < .01). HLA-B35 was found to be significantly decreased in frequency only in the entire IDDM(p < .05). A significant increase in the frequency of HLA-DR4 was found in the entire IDDM patients; HLA-DR4 was found in 55.6% of the patients versus 31.5% of the controls. However, the negative correlation between HLA-DR2 and IDDM was statistically significant in those with juvenile-onset IDDM. It is concluded that the HLA pattern and its association witH IDDM in Korea would appear to be different from that in most other racial groups, including Caucasians, Japanese, and Chinese.

DETECTION OF IDDM SUSCEPTIBILITY IN SHANGHAI HANS WITH HLA-DQA, OLIGONUCLEOTIDE PROBES / 中华内分泌代谢杂志

With polymerase chain reaction and dot-blot hybridization with allele-specific oligonucleoade probes,we analyse DQA1 gene of 42 insulin-dependent diabetes mellitus (IDDM) and 40 normal controls (the Han nationality in Shanghai). We found that the frequency of DQA1 * 0301 and DQA1 * 0501 allele in IDDM patients was greatly increased, while the frequency of DQA1 * 0103 and DQA1 * 0201 allele was significantly decreased as compared with the controls. The result indicates the contribution of the DQA1 * 0301 and DQA1 * 0501 alleles to IDDM susceptibility in Han population in Shanghai. Our results also provide confirmation of the role of DQA1 * 0103 and DQA1 * 0201 to IDDM resistance in the same population.

OBSERVATION OF ELEVEN IMMUNOLOGIC INDEXES IN IDDM / 中华内分泌代谢杂志

To realize the immune dysfunction of IDDM, 11 immunologic indexes in 48 cases of IDDM and 36 normal controls were studied. ICA, ANA, TG, TM,,HLA-DR, CD4/CD8, RBC-CIC of 28 IDDM patients, whose course of diseasewas within 18months, were significantly higher than those of the normal controls (P