- A Case of Diabetic Ketoacidosis in Gestational Diabetes Mellitus.
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Myung Hwan Kim, Eui Dal Jung, Seung Pyo Hong, Gyu Hwan Bae, Sun Young Ahn, Eon Ju Jeon, Seong Yeon Hong, Ji Hyun Lee, Ho Sang Son
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Korean Diabetes J. 2007;31(4):368-371. Published online July 1, 2007
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DOI: https://doi.org/10.4093/jkda.2007.31.4.368
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- Gestational diabetes mellitus (GDM) is defined as glucose intolerance of variant severity with onset or first recognition during present pregnancy. Recently the prevalence of GDM in Korean has reported as 1.7~4.0%. Diabetic ketoacidosis is a serious metabolic complication of diabetes with high mortality if undetected. Its occurrence is very rare in gestational diabetes patients, but is harmful to fetal and maternal health. A 26 years-old pregnant woman was admitted at 37 weeks gestation because of progressive generalized weakness, anorexia and weight loss. Initial physical examination reveals that she had been dehydrated, and blood pressure 130/80 mmHg, pulse rate 100/min, respiratory rate 20/min, and body temperature was 36.9 degrees C. Serum glucose was 545 mg/dL, pH 7.282, HCO3- 10.5 mmol/L, urine ketone 3+, urine glucose 2+ when initial laboratory work was done. She was treated with intravenous fluid and insulin under the impression of diabetic ketoacidosis. Her delivery was performed after 24 hours from admission because of suggestive fetal distress. After recovery, she is being treated with insulin at outpatient department. We experienced a appropriately treated case of diabetic ketoacidosis in pregnant woman with GDM, and report it with a literature review.
- Microarray Analysis of Short Heterodimer Partner (SHP)-induced Changes in Gene Expression in INS-1 Cells.
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Eui Dal Jung, Ji Hyun Lee, Won Gu Jang, Jung Guk Kim, Bo Wan Kim, In Kyu Lee
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Korean Diabetes J. 2007;31(3):193-199. Published online May 1, 2007
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DOI: https://doi.org/10.4093/jkda.2007.31.3.193
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- BACKGROUND
Nuclear receptors are involved in the cell growth, development, differentiation, and metabolism. The orphan nuclear receptor SHP which lacks a DNA-binding domain is a negative regulator of nuclear receptor signaling pathways. In pancreas, SHP regulate transcriptional activity of HNF3 and HNF4 through binding them and BETA2 which is involved in beta cell differentiation and insulin production. Here, we examined transcriptional activity changes of genes expressed in beta cell when SHP was overexpressed. METHOD: INS-1 cells of passage number 24 - 30 were prepared. Affimetrix DNA chip was used to examine gene expression in INS-1 cell when SHP was overexpressed. INS-1 cells were infected with adenovirus-SHP to overexpress SHP. To confirm the result of DNA chip, we used real time RT-PCR. RESULT: When SHP was overexpressed by adenovirus-SHP transfection, FXR, Transforming growth factor, beta 2, fructose-1,6-bisphosphatase 2, bone morphogenetic protein 4 genes expression were increased. Contrarily, Activating transcription factor 2, Glycogen synthase kinase 3 alpha, Nur 77, fibroblast growth factor 14 genes expression were decreased. We confirmed DNA microarray analysis by real time RT-PCR. FXR, tribbles homolog 3 (Drosophila), fructose-1,6-bisphosphatase 2, CD36 genes expression were increased in real time RT-PCR. Nur 77 and cAMP response element modulator genes expression were decreased in real time RT-PCR. CONCLUSION: we identified several genes which expression are regulated by SHP in pancreas beta cell. These results help to explain how SHP act in the various metabolism of pancreas beta cell.
- The Thickness of Carotid Artery Intima-Media Thickness in Hypertriglyceridemic Hyperapo B Type 2 Diabetes.
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Ji Hyun Lee, Duck Soo Chung
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Korean Diabetes J. 2005;29(1):57-64. Published online January 1, 2005
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- BACKGROUND
Atherosclerotic diseases such as cardiovascular disease and cerebrovascular disease are major causes of diabetes mellitus-related morbidity and mortality. The frequency of macrovascular disease in type 2 diabetic patients varies geographically, and this suggests that factors other than diabetes play an important role in the pathogenesis of their vascular disease. One such factor may be the dyslipoproteinemias that are common in diabetic patients. There were many studies showing that hypertriglyceridemia with an elevated apolipoprotein B (apo B) level was associated with an increased risk for coronary disease in type 2 diabetes patients. Meanwhile, an increase in the intima-media thickness (IMT) of the carotid artery has been previously reported in patients with type 2 diabetes, and this is related to the atherosclerotic risk factors. The aim of this study was to evaluate the relationship between the carotid artery IMT and lipoprotein and apolipoprotein, and we also wanted to assess the role of hypertriglyceridemic hyperapo B for the cardiovascular risk factors in the type 2 diabetic patients. METHODS: The carotid artery IMT was measured using high resolution B-mode ultrasono graphy in 117 type 2 diabetes. At the same time, we analyzed the patients characteristics including height, weight, body mass index, blood pressure, duration of diabetes and history of hypertension. Laboratory parameters such as fasting blood glucose, HbA1c, total cholesterol, triglyceride, LDL-cholesterol, HDL-cholesterol, apolipoprotein A and B were included in this study. We defined hypertrigl yceridemic hyperapo B as when the triglyceride level was over 1.7 mmol/L and the apolipoprotein B level was over 1.20 g/L. RESULTS: Thirty-three patients (28%) were classified as having hypertriglyceridemic hyperapo B. Age (r = 348, P = 0.001), duration of diabetes (r = 0.438, P = 0.001), hypertension (P = 0.001), and LDL-cholesterol (r = 0.225, P = 0.018) were statistically significant for the carotid artery IMT values in diabetic patients. However, there were no correlations between carotid artery IMT and total cholesterol, triglyceride, HDL- cholesterol, and apolipoprotein A and B. Upon multiple regression analysis, age, duration of diabetes and LDL-cholesterol were statistically significant for the carotid artery IMT values in diabetic patients (R2 = 0.296). Hypertriglyceridemic hyperapo B diabetic patients didn't have higher carotid artery IMT values than the other patients. CONCLUSION: The increment of carotid artery IMT is affected by age, blood pressure, duration of diabetes and LDL-cholesterol. However, our study did not show any association between carotid artery IMT and hypertriglyceridemic hyperapo B
- The Correlation Between Femoral Artery Intima-Media Thickness (IMT) and Atherosclerotic Risk Factors in Type 2 Diabetes Mellitus Patients.
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Ji Hyun Lee, Ho Sang Shon, Duck Soo Chung
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Korean Diabetes J. 2003;27(6):467-475. Published online December 1, 2003
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- BACKGROUND
High resolution B-Mode ultrasound is increasingly used in epidemiological and clinical research to noninvasively study the atherosclerotic process in the carotid artery. An increase in the intimamedia thickness (IMT) of the carotid artery has previously been reported in patients with diabetes, compared with a control group, and is related to atherosclerotic risk factors. There have been few reports on the relationship between the IMT of the femoral artery, another large artery, and atherosclerotic risk factors in diabetic patients. The aim of the present investigation was to evaluate the relationship between the femoral artery IMT and the atherosclerotic risk factors in type 2 diabetics, and to assess if such a measurement might provide further information on the extent of the atherosclerotic disease in these patients. METHODS: The carotid and femoral IMT were measured using high resolution B-mode ultrasonography in 55 type 2 diabetes patients and 25 age- and sex-matched control subjects. The femoral artery was examined distal to the inguinal ligament, at the site the artery divides into the superficial femoral and the profound femoral arteries. At the same time, patient's characteristics, including height, weight, body mass index, blood pressure, duration of diabetes and histories of hypertension and smoking, were analyzed. Examinations of the laboratory parameters, such as serum glucose, HbA1C, lipid profile, blood urea nitrogen and serum creatinine, were included in this study. RESULTS: The carotid and femoral IMT values were significantly increased in the type 2 diabetes patients compared with the control subjects. There was a significant relationship between the IMT values of the two arteries in the diabetic patients (r=0.419, p< 0.001). In a simple regression analysis, age (r=0.534, p=0.001), systolic blood pressure (r=0.499, p=0.001), diastolic blood pressure (r=0.350, p=0.003), high density lipoprotein cholesterol (r=-0.262, p=0.037) and the serum creatinine level (r=0.280, p=0.020) were statistically significant for the femoral artery IMT value. In a multiple regression analysis, age, smoking and systolic blood pressure were statistically significant for the femoral artery IMT values in diabetic patients (R2=0.379). CONCLUSION: The femoral IMT values were significantly increased in the type 2 diabetes patients. Increases in the IMT of the femoral artery are affected by the atherosclerotic risk factors; age, smoking and blood pressure. Therefore, it is suggest that measurement of the femoral IMT, using high resolution B-mode ultrasonography, is also a useful method for the detection of macrovascular complications in type 2 diabetes patients.
- A Case of Interstitial Deletion [del(6)(q21q23)] with type 2 diabetes Mellitus and Mental Retardation.
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Ye Dal Jung, Sun Joo Cho, Hak Jun Kim, Wern Chan Yoon, Dong Geun Yeo, Jeong Ki Park, Ji Hyun Lee, Ho Sang Shon
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Korean Diabetes J. 2000;24(2):281-284. Published online January 1, 2001
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- Chromosomal abnormalities such as Klinefelter syndrome, Down syndrome, Turner syndrome, Prader-Willi, Bardet-Biedl syndrome were associated with diabetes mellitus. Over 30 cases of interstitial deletions of the long arm of chromosome 6 with vastly variable breakpoints and clinical features have been reported in the literature, The clinical findings varies and most often includes mental retardation, microcephaly, and craniofacial anomalies. We report a case of interstitial deletion (del(6)(q21q23)) with type 2 diabetes mellitus and mental retardation.
- The Difference of Intrarenal Hemodynamics in Type 2 Diabetic Nephropathy.
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Ji Hyun Lee, Ye Dal Jung, Ho Sang Shon, Ki Sung Ahn, Duck Soo Chung
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Korean Diabetes J. 1999;23(6):822-830. Published online January 1, 2001
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- BACKGROUND
Diabetic nephropathy is a major microvascular complication in diabetic patients. No single etiologic factor has been identified to explain the development of diabetic nephropathy. Genetic factors, poor glycemic control, increased intra-glomerular pressure, systemic hypertension, and altered intrarenal hemodynamics may be contributed to the pathogenesis of diabetic nephropathy. Intrarenal duplex Doppler sonography can provide physiologic information reflecting the status of renal vascular resistance. Recently, there were some reports that obstructive renal disease and renal allograft rejection patients has altered intrarenal hemodynamics. So we investigate intrarenal hemo- dynamic abnormalities in diabetic patients with nephropathy and analyze the factors associated with increased intrarenal resistance METHODS: The patients were divided into the three groups. According to the levels of 24-hour urinary albumin excretion(UAE), group 1 (UAE<30mg/day, normoalbuminuria), group 2 (30 mg/day
- Angiotensin 1 Converting Enzyme ( ACE ) Gene Polymorphism According to Micro- and Mocro - angiopathy in non-insulin Dependent Diabetes Mellitus.
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Moon Suk Nam, Hyun Chul Lee, Ji Hyun Lee, Bong Soo Cha, Su Youn Nam, Young Duk Song, Sung Kil Lim, Kyung Rae Kim, Kap Bum Huh
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Korean Diabetes J. 1997;21(4):397-405. Published online January 1, 2001
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- BACKGROUND
Chronic micro- and macro-angiopathy in diabetes are clinically significant complications that affect both quality and length of life in diabetic patients. Angiotensin 1 converting enzyme (ACE) is of key importance in regulating systemic and renal circulation by converting angiotensin-1 into -2 and inactivating bradykinin, Recent reports suggest that the ACE gene polymorphism is associated with susceptibility to micro- and macro-angiopathy in diabetes. But the results are diffetent according to the type of diabetes and complication. METHODS: We investigated the alleles of the ACE gene and measured the ACE activity in the 169 cases of non-insulin dependent diabetic patients and in the 95 cases of controls matched with age and BMI. RESULTS: The measured ACE activity was well correlated with the count of D allele. We found no differences of ACE alleles between in diabetes and control. No association was found between ACE gene polymorphism and diabetic microangiopathy(retinopathy or nephropathy). But DD genotypes (homozy-gotes for the deletion polymorphism) and D allele were found more frequently in diabetic patients with coronary artery obstructive diseases than in patients without coronary artery obstructive diseases in coronary angiography. CONCLUSION: These data indicate that ACE gene polymorphism in non-insulin dependent diabetes is associated with coronary artery obstructive diseases, but not with chronic microangiopathy.
- Relationship between Angiotensin I Converting Enzyme Gene Polymorphism and Vascular complications in Non-Insulin Dependent Diabetic Patients.
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Byoung Gue Na, Tae Geun Oh, Sang Moo Jung, Sang Woo Oh, Jae Hong Choi, Ji Hyun Lee, Seong Su Koong, Seung Taik Kim
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Korean Diabetes J. 1997;21(2):138-146. Published online January 1, 2001
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- No abstract available.
- Thebeta3-adrenergic Receptor Gene Polymorphism in Non-Insulin Dependent Diabetes Mellitus.
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Ji Hyun Lee, Hai Ri Li, Sang Won Lee, Su Youn Nam, Young Jun Won, Bong Soo Cha, Moon Suk Nam, Young Duk Song, Eun Jig Lee, Sung Kil Lim, Kyung Rae Kim, Hyun Chul Lee, Kap Bum Huh
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Korean Diabetes J. 1997;21(2):130-137. Published online January 1, 2001
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- BACKGROUND
The B3-adrenergic receptor, located mainly in adipose tissue, is known to be involved in the regulation of lipolysis and thermogenesis. Recently studies have shown that the B3-adrenergic receptor gene polymorphism is associated with Non-Insulin Dependent Diabetes Mellitus(NIDDM) and insulin resistance. We investigated the relationship between the B3-adrenergic receptor gene polymorphism and the cli!ical and biochemical features of NIDDM patients. METHODS: Anthropometeric and biochemi al characteristics were determined for 134 NIDDM subjects and 30 nondiabetic controls. All subjects were genotyped for the 0-adrenergic receptor gene mutation using restriction fragment length polymorphism assay. RESULTS: The allelic frequency of the mutated allele was similar in NIDDM subjects and nondiabetic controls(11%, 12% respectively). There was no difference in the Arg64 allelic frequency of the B3-adrenergic receptor gene according to the onset age of diabetes. In diabetic group, the clinical and biochemical characteristics were not statistically different between the B3-adrenergic receptor gene mutation and nonmutation group. In control group, also no clinical differences were found between mutation and non-mutation group. When comparing frequency of obesity according to the B3-adrenergic receptor gene mutation in diabetic patients, we did not find the difference between the two groups. CONCLUSION: These results suggest that the b3-adrenergic receptor gene is not a major determinant for the development of obesity and NIDDM in Korea.
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