title: Impacts of the Great East Japan Earthquake on diabetic patients.
abstract: OBJECTIVE
  We investigated impacts of the Great East Japan Earthquake on diabetic patients and characterized those with disaster-susceptible diabetes.
  
  
  METHODS
  We enrolled 497 diabetic patients who had been followed at hospitals in devastated areas. We collected metabolic parameters prospectively, 1 and 3 months after the earthquake, and retrospectively for pre-earthquake time-points. Questionnaire surveys were carried out regarding earthquake-related damage and post-earthquake lifestyle alterations. Available data were analyzed to examine associations with post-earthquake glycosylated hemoglobin alterations.
  
  
  RESULTS
  The mean glycosylated hemoglobin level of the participants was not elevated at 1 month, and was significantly decreased at 3 months as compared with the pre-earthquake glycosylated hemoglobin. There were no significant differences in earthquake-related damage or lifestyle alterations between the improved and worsened glycemic control groups according to the data obtained from the questionnaire survey. As reported, fasting serum C-peptide levels were significantly lower in the worsened glycemic control group (P < 0.05). Notably, plasma noradrenaline levels were significantly higher in the worsened glycemic control group (P < 0.05). Furthermore, at 1 month after the earthquake, the plasma noradrenaline level was significantly higher in the low C-peptide group (fasting serum C-peptide <1.0 ng/mL) than in the high C-peptide group (fasting serum C-peptide ≥1.0 ng/mL), but this difference had disappeared by 3 months after the earthquake. These findings show that post-earthquake plasma noradrenaline levels were temporarily increased in the low C-peptide group.
  
  
  CONCLUSIONS
  Sympathetic nerve activation might be elicited more easily in subjects with lower endogenous insulin secretory capacity, and could be involved in the mechanism underlying post-earthquake worsening of glycemic control.
authors.affiliation: Department of Diabetes and Metabolism, Tohoku University Hospital Sendai, Miyagi, Japan.
authors.forename: Mamiko
authors.initials: M
authors.lastname: Tanaka
authors.affiliation: Department of Diabetes and Metabolism, Tohoku University Hospital Sendai, Miyagi, Japan.
authors.forename: Junta
authors.initials: J
authors.lastname: Imai
authors.affiliation: Department of Pharmacy, Tohoku University Hospital Sendai, Miyagi, Japan.
authors.forename: Michihiro
authors.initials: M
authors.lastname: Satoh
authors.affiliation: Department of Planning for Drug Development and Clinical Evaluation, Tohoku University Graduate School of Medicine and Pharmaceutical Sciences Sendai, Miyagi, Japan.
authors.forename: Takanao
authors.initials: T
authors.lastname: Hashimoto
authors.affiliation: Department of Diabetes and Metabolism, Tohoku University Hospital Sendai, Miyagi, Japan.
authors.forename: Tomohito
authors.initials: T
authors.lastname: Izumi
authors.affiliation: Department of Diabetes and Metabolism, Tohoku University Hospital Sendai, Miyagi, Japan.
authors.forename: Shojiro
authors.initials: S
authors.lastname: Sawada
authors.affiliation: Department of Diabetes and Metabolism, Tohoku University Hospital Sendai, Miyagi, Japan.
authors.forename: Kenji
authors.initials: K
authors.lastname: Uno
authors.affiliation: Department of Diabetes and Metabolism, Tohoku University Hospital Sendai, Miyagi, Japan.
authors.forename: Yutaka
authors.initials: Y
authors.lastname: Hasegawa
authors.affiliation: Department of Diabetes and Metabolism, Tohoku University Hospital Sendai, Miyagi, Japan.
authors.forename: Keizo
authors.initials: K
authors.lastname: Kaneko
authors.affiliation: Department of Diabetes and Metabolism, Tohoku University Hospital Sendai, Miyagi, Japan.
authors.forename: Tetsuya
authors.initials: T
authors.lastname: Yamada
authors.affiliation: Department of Diabetes and Metabolism, Iwate Medical University Hospital Morioka, Iwate, Japan.
authors.forename: Yasushi
authors.initials: Y
authors.lastname: Ishigaki
authors.affiliation: Department of Planning for Drug Development and Clinical Evaluation, Tohoku University Graduate School of Medicine and Pharmaceutical Sciences Sendai, Miyagi, Japan.
authors.forename: Yutaka
authors.initials: Y
authors.lastname: Imai
authors.affiliation: Department of Diabetes and Metabolism, Tohoku University Hospital Sendai, Miyagi, Japan.
authors.forename: Hideki
authors.initials: H
authors.lastname: Katagiri
keywords: Glycemic control; Natural disaster; Sympathetic activation