Diabetes & Metabolism Journal

Volume 34(6); December 2010

Review

Triple Combination Therapy Using Metformin, Thiazolidinedione, and a GLP-1 Analog or DPP-IV Inhibitor in Patients with Type 2 Diabetes Mellitus: Sun Woo Kim; Korean Diabetes J. 2010;34(6):331-337. Published online December 31, 2010; DOI: https://doi.org/10.4093/kdj.2010.34.6.331

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Although there is no HbA1c threshold for cardiovascular risk, the American Diabetic Association-recommended goal of HbA1c < 7.0% appears to be unacceptably high. To achieve an optimal HbA1c level goal of 6.0% or less, a high dosage of sulfonylureas and insulin would be required; the trade-off would be the common adverse effects of hypoglycemia and weight gain. In contrast, hypoglycemia is uncommon with insulin sensitizers and GLP-1 analogs, allowing the physician to titrate these drugs to maximum dosage to reduce HbA1c levels below 6.0% and they have been shown to preserve β-cell function. Lastly, weight gain is common with sulfonylurea and insulin therapy, whereas GLP-1 analogs induce weight loss and offset the weight gain associated with TZDs. A treatment paradigm shift is recommended in which combination therapy is initiated with diet/exercise, metformin (which has antiatherogenic effects and improves hepatic insulin sensitivity), a TZD (which improves insulin sensitivity and preserves β-cell function with proven durability), and a GLP-1 analog (which improves β, α-cell function and promotes weight loss) or a dipeptidyl peptidase IV inhibitor in patients with type 2 diabetes mellitus.

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Phase III Study on Efficacy and Safety of Triple Combination (Exenatide/Metformin/Biphasic Insulin Aspart) Therapy for Type 2 Diabetes Mellitus
Ke Su, Chunmei Lv, Zongwen Ji, Yishu Wang, Haifeng Wang, Ying Bai, Yaping Liu
American Journal of Therapeutics.2018; 25(6): e609. CrossRef
A Case Report of Diabetes Mellitus with Herniated Intervertebral Lumbar Discs Improved by Korean Medicine Treatment
Dong-geun Han, A-ryun Choi, You-jin Jung, Ah-hyun Kang, Hye-jin Seo, Jae-yeon Sung, Hyung-chul Lee, Gook-hyun Eom, Woo-sub Song
The Journal of Internal Korean Medicine.2017; 38(5): 828. CrossRef
A crossover study of the combination therapy of metformin and exenatide or biphasic insulin aspart 30 in overweight or obese patients newly diagnosed with type 2 diabetes mellitus
Huibiao Quan, Huachuan Zhang, Weiping Wei, Tuanyu Fang, Daoxiong Chen, Kaining Chen
Experimental and Therapeutic Medicine.2017; 14(4): 3279. CrossRef
Gender-related different effects of a combined therapy of Exenatide and Metformin on overweight or obesity patients with type 2 diabetes mellitus
Huibiao Quan, Huachuan Zhang, Weiping Wei, Tuanyu Fang
Journal of Diabetes and its Complications.2016; 30(4): 686. CrossRef
Bioreducible polymers for therapeutic gene delivery
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Journal of Controlled Release.2014; 190: 424. CrossRef
Managing diabetes in Asia: Overcoming obstacles and the role of DPP-IV inhibitors
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Diabetes Research and Clinical Practice.2012; 95(2): 179. CrossRef

Editorial

Correlations of Glucose Levels in Interstitial Fluid Estimated by Continuous Glucose Monitoring Systems and Venous Plasma: Byung-Joon Kim; Korean Diabetes J. 2010;34(6):338-339. Published online December 31, 2010; DOI: https://doi.org/10.4093/kdj.2010.34.6.338

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Original Articles

The Small Rice Bowl-Based Meal Plan was Effective at Reducing Dietary Energy Intake, Body Weight, and Blood Glucose Levels in Korean Women with Type 2 Diabetes Mellitus: Hee Jung Ahn, Kyung Ah Han, Hwi Ryun Kwon, Kyung Wan Min; Korean Diabetes J. 2010;34(6):340-349. Published online December 31, 2010; DOI: https://doi.org/10.4093/kdj.2010.34.6.340

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Background

The typical Korean diet includes rice, which is usually served in a rice bowl. We investigated the effects of a meal plan using rice bowls of varying sizes on dietary energy intake (EI), body weight (BW), and blood glucose levels.

Methods

Forty-two obese women with type 2 diabetes mellitus were randomly assigned to use either a 200 mL small rice bowl (SB), a 380 mL regular rice bowl (RB), or to a control group (C). Both intervention groups were asked to reduce their EI by 500 kcal/day for 12 weeks and simple instructions for using the assigned bowl were provided. Dietary EI and proportion of macronutrients (PMN) were estimated from 3-day dietary records.

Results

Reduction of EI was more prominent in the SB group compared to the RB and C group, although EI decreased significantly from baseline in all groups. Carbohydrate and fat intakes of the SB group were decreased greater than those of the RB and C group. However, changes in PMN were not significant across the 3 groups. Reduction of BW and HbA1c levels in the SB group was more prominent compared to the C group. Although, BW and HbA1c were decreased significantly from baseline in both bowl groups. There was no statistical difference between the two groups.

Conclusion

The small rice bowl-based meal plan was effective at reducing EI, BW, and blood glucose levels, and the observed reductions in EI, carbohydrate, and fat intake were greater than those of the regular rice bowl-based meal plan.

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M. Angeles Vargas-Alvarez, Santiago Navas-Carretero, Luigi Palla, J. Alfredo Martínez, Eva Almiron-Roig
Nutrients.2021; 13(6): 1978. CrossRef
Do adults draw differently-sized meals on larger or smaller plates? Examining plate size in a community sample
David Sharp, Jeffery Sobal, Elaine Wethington
Food Quality and Preference.2019; 74: 72. CrossRef
Use and effectiveness of behavioural economics in interventions for lifestyle risk factors of non-communicable diseases: a systematic review with policy implications
Oana M Blaga, Livia Vasilescu, Razvan M Chereches
Perspectives in Public Health.2018; 138(2): 100. CrossRef
Whether Smaller Plates Reduce Consumption Depends on Who's Serving and Who's Looking: A Meta-Analysis
Stephen S. Holden, Natalina Zlatevska, Chris Dubelaar
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Portion, package or tableware size for changing selection and consumption of food, alcohol and tobacco
Gareth J Hollands, Ian Shemilt, Theresa M Marteau, Susan A Jebb, Hannah B Lewis, Yinghui Wei, Julian P T Higgins, David Ogilvie
Cochrane Database of Systematic Reviews.2015;[Epub] CrossRef

The Correlation and Accuracy of Glucose Levels between Interstitial Fluid and Venous Plasma by Continuous Glucose Monitoring System: Young Ha Baek, Heung Yong Jin, Kyung Ae Lee, Seon Mee Kang, Woong Ji Kim, Min Gul Kim, Ji Hyun Park, Soo Wan Chae, Hong Sun Baek, Tae Sun Park; Korean Diabetes J. 2010;34(6):350-358. Published online December 31, 2010; DOI: https://doi.org/10.4093/kdj.2010.34.6.350

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Background

Clinical experience with the continuous glucose monitoring systems (CGMS) is limited in Korea. The objective of this study is to evaluate the accuracy of the CGMS and the correlation between interstitial fluid and venous plasma glucose level in Korean healthy male subjects.

Methods

Thirty-two subjects were served with glucose solution contained same amount of test food's carbohydrate and test foods after separate overnight fasts. CGMS was performed over 3 days during hopitalization for each subjects. Venous plasma glucose measurements were carried out during 4 hours (0, 0.25, 0.5, 0.75, 1, 2, 4 hours) just before and after glucose solution and test food load. The performance of the CGMS was evaluated by comparing its readings to those obtained at the same time by the hexokinase method using the auto biochemistry machine (Hitachi 7600-110). Also, correlations between glucose recorded with CGMS and venous plasma glucose value were examined.

Results

CGMS slightly underestimated the glucose value as compared with the venous plasma glucose level (16.3 ± 22.2 mg/dL). Correlation between CGMS and venous plasma glucose values throughout sensor lifetime is 0.73 (regression analysis: slope = 1.08, intercept = 8.38 mg/dL). Sensor sensitivity can deteriorate over time, with correlations between venous blood glucose and CGMS values dropping from 0.77 during 1st day to 0.65 during 2nd and 3rd day.

Conclusion

The accuracy of data provided by CGMS may be less than expected. CGMS sensor sensitivity is decreased with the passage of time. But, from this study, CGMS can be used for glucose variability tendency monitoring conveniently to the Korean.

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Li Yan, Qiang Li, Qingbo Guan, Mingsong Han, Yu Zhao, Junfei Fang, Jiajun Zhao
International Journal of Diabetes in Developing Countries.2023; 43(4): 551. CrossRef
Correlation between short- and mid-term hemoglobin A1c and glycemic control determined by continuous glucose monitoring
Jen-Hung Huang, Yung-Kuo Lin, Ting-Wei Lee, Han-Wen Liu, Yu-Mei Chien, Yu-Chun Hsueh, Ting-I Lee, Yi-Jen Chen
Diabetology & Metabolic Syndrome.2021;[Epub] CrossRef
Accuracy of Flash Glucose Monitoring During Postprandial Rest and Different Walking Conditions in Overweight or Obese Young Adults
Xiaoyuan Zhang, Fenghua Sun, Waris Wongpipit, Wendy Y. J. Huang, Stephen H. S. Wong
Frontiers in Physiology.2021;[Epub] CrossRef
The MEDGICarb-Study: Design of a multi-center randomized controlled trial to determine the differential health-promoting effects of low- and high-glycemic index Mediterranean-style eating patterns
Robert E. Bergia, Izabela Biskup, Rosalba Giacco, Giuseppina Costabile, Savanna Gray, Amy Wright, Marilena Vitale, Wayne W. Campbell, Rikard Landberg, Gabriele Riccardi
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A genetic programming-based regression for extrapolating a blood glucose-dynamics model from interstitial glucose measurements and their first derivatives
I. De Falco, A. Della Cioppa, A. Giugliano, A. Marcelli, T. Koutny, M. Krcma, U. Scafuri, E. Tarantino
Applied Soft Computing.2019; 77: 316. CrossRef
Genetic Programming-based induction of a glucose-dynamics model for telemedicine
Ivanoe De Falco, Antonio Della Cioppa, Tomas Koutny, Michal Krcma, Umberto Scafuri, Ernesto Tarantino
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Dachao Li, Qingmei Xu, Yu Liu, Ridong Wang, Kexin Xu, Haixia Yu
Measurement Science and Technology.2017; 28(11): 115701. CrossRef
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Akua Amankwaah, R. Sayer, Amy Wright, Ningning Chen, Megan McCrory, Wayne Campbell
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Sajina Shakya, Yan Wang, Judith A. Mack, Edward V. Maytin
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Niclas Abrahamsson, Britt Edén Engström, Magnus Sundbom, F Anders Karlsson
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The use of reinforcement learning algorithms to meet the challenges of an artificial pancreas
Melanie K Bothe, Luke Dickens, Katrin Reichel, Arn Tellmann, Björn Ellger, Martin Westphal, Ahmed A Faisal
Expert Review of Medical Devices.2013; 10(5): 661. CrossRef
Continuous glucose monitoring: current clinical use
Hun‐Sung Kim, Jeong‐Ah Shin, Jin‐Sun Chang, Jae‐Hyoung Cho, Ho‐Young Son, Kun‐Ho Yoon
Diabetes/Metabolism Research and Reviews.2012; 28(s2): 73. CrossRef
Correlations of Glucose Levels in Interstitial Fluid Estimated by Continuous Glucose Monitoring Systems and Venous Plasma
Byung-Joon Kim
Korean Diabetes Journal.2010; 34(6): 338. CrossRef

A Retrospective Study on the Efficacy of a Ten-Milligram Dosage of Atorvastatin for Treatment of Hypercholesterolemia in Type 2 Diabetes Mellitus Patients: Dong Kyun Kim, Sa Rah Lee, Min Sik Kim, Suk Hyang Bae, Jin Yeon Hwang, Jung-Min Kim, Sung Hwan Suh, Hye-Jeong Lee, Mi Kyoung Park, Duk Kyu Kim; Korean Diabetes J. 2010;34(6):359-367. Published online December 31, 2010; DOI: https://doi.org/10.4093/kdj.2010.34.6.359

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Background

There have been few clinical studies on 10 mg atorvastatin as a starting dosage for treatment of hypercholesterolemia in type 2 diabetes mellitus (T2DM) patients. This retrospective study aims to evaluate the efficacy of 10 mg dosage of atorvastatin in clinical setting.

Methods

One hundred five enrolled patients with high levels of low density lipoprotein cholesterol (LDL-C, > 100 mg/dL) took 10 mg atorvastatin. After 6 months, they were divided into 'Responder group' (LDL-C < 100 mg/dL) and 'Non-responder group' (LDL-C ≥ 100 mg/dL), and the response rate was calculated. Thereafter, we subdivided the 'Responder group' into Maintenance (10 mg), Reduced dosage (5 mg), and Discontinuance group (0 mg). The 'Non-Responder group' was subdivided into Maintenance (10 mg) and Double dosage group (20 mg). After consecutive 6 months, the response rates of each 10 mg Maintenance groups were compared to those of the other groups, respectively.

Results

Following the first 6 months, the response rate of 10 mg fixed dosage was 74.3%. In the 'Responder group', response rates of 10 mg, 5 mg and Discontinuance groups following 6 months were 52.6%, 53.1%, and 12.5%, respectively. In the 'Non-responder group', response rates of 10 mg and 20 mg groups were 28.6% and 50.0%. Baseline LDL-C levels and body mass index (BMI) of 'Responder group' were significantly lower than those of 'Non-responder group' (P = 0.004, respectively).

Conclusion

Hypercholesterolemia treatment with 10 mg, fixed dosage of atorvastatin was effective in three quarters of the subjects during the first 6-month treatment; however, a significant number of patients with high LDL-C levels and/or BMI require higher starting and maintenance dosage.

Citations

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Preparation and Release Behavior of Atorvastatin Calcuim - Encapsulated Polyoxalate Microspheres
Cheon Jung Lee, Su Young Kim, Hyun Gu Lee, Jaewon Yang, Jin Young Park, Se Rom Cha, Dong-Kwon Lim, Dongwon Lee, Gilson Khang
Polymer Korea.2014; 38(5): 656. CrossRef
A Retrospective Study on the Efficacy of a Ten-Milligram Dosage of Atorvastatin for Treatment of Hypercholesterolemia in Type 2 Diabetes Mellitus Patients (Korean Diabetes J 2010;34:359-67)
Eun-Jung Rhee
Diabetes & Metabolism Journal.2011; 35(1): 86. CrossRef
Response: A Retrospective Study on the Efficacy of a Ten-Milligram Dosage of Atorvastatin for Treatment of Hypercholesterolemia in Type 2 Diabetes Mellitus Patients (Korean Diabetes J 2010;34:359-67)
Dong Kyun Kim, Sa Rah Lee, Min Sik Kim, Suk Hyang Bae, Jin Yeon Hwang, Jung-Min Kim, Sung Hwan Suh, Hye-Jeong Lee, Mi Kyoung Park, Duk Kyu Kim
Diabetes & Metabolism Journal.2011; 35(1): 88. CrossRef

R1467H Variants of Rho Guanine Nucleotide Exchange Factor 11 (ARHGEF11) are Associated with Type 2 Diabetes Mellitus in Koreans: Qing Song Jin, So Hun Kim, Shan-Ji Piao, Hyun Ae Lim, Seung Youn Lee, Seong Bin Hong, Yong Seong Kim, Hun-Jae Lee, Moonsuk Nam; Korean Diabetes J. 2010;34(6):368-373. Published online December 31, 2010; DOI: https://doi.org/10.4093/kdj.2010.34.6.368

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Background

The human Rho guanine nucleotide exchange factor 11 (ARHGEF11) functions as an activator of Rho GTPases and is thought to influence insulin signaling. The R1467H variant of ARHGEF11 has been reported to be associated with susceptibility to type 2 diabetes mellitus (T2DM) in Western populations.

Methods

We investigated the effects of the R1467H variant on susceptibility to T2DM as well as related traits in a Korean population. We genotyped the R1467H (rs945508) of ARHGEF11 in 689 unrelated T2DM patients and 249 non-diabetic individuals and compared the clinical and biochemical characteristics according to different alleles.

Results

The H allele was significantly more frequent in T2DM cases than in controls (P = 0.037, 17.1% and 13.1%; respectively). H homozygocity was associated with a higher risk of T2DM compared to those with R/R or R/H genotype (odds ratio, 5.24; 95% confidence interval, 1.06 to 25.83; P = 0.042). The fasting plasma glucose, HbA1c, fasting insulin, HOMA2-IR and HOMA2-%β levels did not differ significantly between different genotypes.

Conclusion

Our study replicated associations of the ARHGEF11 polymorphism with increased risk of T2DM in a Korean population and thus supports previous data implicating a potential role of ARHGEF11 in the etiology of T2DM. Further studies revealing the underlying mechanism for this association are needed.

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Epigenetic alteration of Rho guanine nucleotide exchange Factor 11 (ARHGEF11) in cord blood samples in macrosomia exposed to intrauterine hyperglycemia
Jie Yan, Rina Su, Wanyi Zhang, Yumei Wei, Chen Wang, Li Lin, Hui Feng, Huixia Yang
The Journal of Maternal-Fetal & Neonatal Medicine.2021; 34(3): 422. CrossRef
Loss of Arhgef11 in the Dahl Salt-Sensitive Rat Protects Against Hypertension-Induced Renal Injury
Ashley C. Johnson, Wenjie Wu, Esinam M. Attipoe, Jennifer M. Sasser, Erin B. Taylor, Kurt C. Showmaker, Patrick B. Kyle, Merry L. Lindsey, Michael R. Garrett
Hypertension.2020; 75(4): 1012. CrossRef
Transgenerational Obesity and Alteration of ARHGEF11 in the Rat Liver Induced by Intrauterine Hyperglycemia
Wanyi Zhang, Rina Su, Hui Feng, Li Lin, Chen Wang, Huixia Yang
Journal of Diabetes Research.2019; 2019: 1. CrossRef
ARHGEF11 affecting the placental insulin signaling pathway in fetal macrosomia of normal glucose tolerance pregnant women
Wanyi Zhang, Rina Su, Li Lin, Huixia Yang
Placenta.2018; 63: 7. CrossRef
Genetic variants and clinical relevance associated with gestational diabetes mellitus in Chinese women: a case-control study
Jie Yan, Rina Su, Deng Ao, Yan Wang, Haijun Wang, Huixia Yang
The Journal of Maternal-Fetal & Neonatal Medicine.2018; 31(16): 2115. CrossRef
Human Rho Guanine Nucleotide Exchange Factor 11 (ARHGEF11) Regulates Dendritic Morphogenesis
Yutaka Mizuki, Manabu Takaki, Shinji Sakamoto, Sojiro Okamoto, Makiko Kishimoto, Yuko Okahisa, Masahiko Itoh, Norihito Yamada
International Journal of Molecular Sciences.2016; 18(1): 67. CrossRef
Allelic Variants in Arhgef11 via the Rho-Rock Pathway Are Linked to Epithelial–Mesenchymal Transition and Contributes to Kidney Injury in the Dahl Salt-Sensitive Rat
Zhen Jia, Ashley C. Johnson, Xuexiang Wang, Zibiao Guo, Albert W. Dreisbach, Jack R. Lewin, Patrick B. Kyle, Michael R. Garrett, Maria Pia Rastaldi
PLOS ONE.2015; 10(7): e0132553. CrossRef
The Rho-guanine nucleotide exchange factor PDZ-RhoGEF governs susceptibility to diet-induced obesity and type 2 diabetes
Ying-Ju Chang, Scott Pownall, Thomas E Jensen, Samar Mouaaz, Warren Foltz, Lily Zhou, Nicole Liadis, Minna Woo, Zhenyue Hao, Previn Dutt, Philip J Bilan, Amira Klip, Tak Mak, Vuk Stambolic
eLife.2015;[Epub] CrossRef
Human Rho guanine nucleotide exchange factor 11 gene is associated with schizophrenia in a Japanese population
Yutaka Mizuki, Manabu Takaki, Yuko Okahisa, Shinji Sakamoto, Masafumi Kodama, Hiroshi Ujike, Yosuke Uchitomi
Human Psychopharmacology: Clinical and Experimental.2014; 29(6): 552. CrossRef
Small G proteins and their regulators in cellular signalling
Roland Csépányi-Kömi, Magdolna Lévay, Erzsébet Ligeti
Molecular and Cellular Endocrinology.2012; 353(1-2): 10. CrossRef
The Duration of Sulfonylurea Treatment Is Associated withβ-Cell Dysfunction in Patients with Type 2 Diabetes Mellitus
Mi-Seon Shin, Jee Hee Yu, Chang Hee Jung, Jenie Yoonoo Hwang, Woo Je Lee, Min-Seon Kim, Joong-Yeol Park
Diabetes Technology & Therapeutics.2012; 14(11): 1033. CrossRef

The Usefulness of an Accelerometer for Monitoring Total Energy Expenditure and Its Clinical Application for Predicting Body Weight Changes in Type 2 Diabetic Korean Women: Ji Yeon Jung, Kyung Ah Han, Hwi Ryun Kwon, Hee Jung Ahn, Jae Hyuk Lee, Kang Seo Park, Kyung Wan Min; Korean Diabetes J. 2010;34(6):374-383. Published online December 31, 2010; DOI: https://doi.org/10.4093/kdj.2010.34.6.374

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Background

The purpose of this study was to evaluate the usefulness of an accelerometer in predicting body weight (BW) change during a lifestyle intervention and to find out whether exercise or overall physical activity is associated with change in insulin sensitivity and body composition.

Methods

A total of 49 overweight (body mass index [BMI] ≥ 23 kg/m²) women with diabetes were enrolled and performed lifestyle intervention while monitoring BW, total energy expenditure (TEE) and physical activity energy expenditure (PAEE) using an accelerometer, and energy intake (EI) using a three-day dietary record at baseline and every 2 weeks for 12 weeks. We assessed body composition using bioimpedance analysis and compared the actual BW change to the predicted BW change, which was calculated from the energy deficit (ED) between EI and TEE (ED = EI-TEE).

Results

Mean age was 57.2 years, duration of diabetes was 8.0 years, and BMI was 27.8 kg/m². There was no significant difference between EI and TEE at baseline. For 12 weeks, the ED was 474.0 kcal·day^-1, which was significantly correlated with BW change (-3.1 kg) (r = 0.725, P < 0.001). However, the actual BW change was 50% lower than the predicted BW change. Both TEE and PAEE correlated with change in K_ITT (r = 0.334, P = 0.019; r = 0.358, P = 0.012, respectively), BMI (r = -0.395, P = 0.005; r = -0.347, P = 0.015, respectively), and fat mass (r = -0.383, P = 0.007; r = -0.395, P = 0.005, respectively), but only TEE correlated with fat free mass change (r = -0.314, P = 0.030).

Conclusion

The accelerometer appears to be a useful tool for measuring TEE under free-living conditions for both short- and long-term periods.

Citations

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Whether Smaller Plates Reduce Consumption Depends on Who’s Serving and Who’s Looking: A Meta-Analysis
Stephen S. Holden, Natalina Zlatevska, Chris Dubelaar
Journal of the Association for Consumer Research.2016; 1(1): 134. CrossRef

Letter

Bone Mineral Density in Prediabetic Men (Korean Diabetes J 2010;34:294-302): Chul-Hee Kim; Korean Diabetes J. 2010;34(6):384-385. Published online December 31, 2010; DOI: https://doi.org/10.4093/kdj.2010.34.6.384

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Yufang Liu, Sanbao Chai, Xiaomei Zhang
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Chi Chen, Qi Chen, Bin’en Nie, Haojie Zhang, Hualing Zhai, Li Zhao, Pu Xia, Yingli Lu, Ningjian Wang
Diabetes Care.2020; 43(5): 1008. CrossRef

Response

Bone Mineral Density in Prediabetic Men (Korean Diabetes J 2010;34:294-302): Ju Hee Lee, Hyun Jin Kim, Bon Jeong Ku; Korean Diabetes J. 2010;34(6):386-387. Published online December 31, 2010; DOI: https://doi.org/10.4093/kdj.2010.34.6.386

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