Diabetes & Metabolism Journal

Kwan Woo Lee (Lee KW)

16 Articles

Effect of Valsartan on Blood Pressure and Urinary Albumin Excretion in Hypertensive Type 2 Diabetic Patients: An Open-Label, Multicenter Study.: Se Jun Park, Dae Jung Kim, Hae Jin Kim, Soo Yeon Park, Ji A Seo, Nan Hee Kim, Sung Hee Choi, Soo Lim, Hak Chul Jang, Seung Hyun Ko, Ki Ho Song, Yu Bae Ahn, Soo Kyoung Kim, Yong Wook Cho, Jun Goo Kang, Sung Hee Ihm, Cheol Young Park, Sung Woo Park, Dong Hyun Shin, Yong Hyun Kim, Kwan Woo Lee; Korean Diabetes J. 2008;32(6):513-521. Published online December 1, 2008; DOI: https://doi.org/10.4093/kdj.2008.32.6.513

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Abstract PDF: BACKGROUND
Activation of renin-angiotensin system (RAS) has been an important mechanism of microvascular and macrovascular complications in diabetic patients. It has been reported that RAS blockades reduce the development and progression of diabetic nephropathy. The aim of this study was to evaluate whether valsartan, an angiotensin II receptor blocker (ARB), reduced blood pressure and urinary albumin excretion rate (UAER) in hypertensive type 2 diabetic patients. METHOD: Three hundred forty-seven hypertensive type 2 diabetic patients who had not taken angiotensin converting enzyme inhibitors or ARB for 6 months prior to this study were enrolled. We measured blood pressure and UAER before and after 24 weeks of valsartan treatment. RESULT: Baseline mean systolic and diastolic blood pressure was 143 +/- 15 and 87 +/- 11 mmHg, respectively and the median albumin excretion rate was 27 ug/mg. Reduction in systolic and diastolic blood pressure was 16 mmHg/10 mmHg and the median UAER was 19.3 ug/mg after 24 weeks (P < 0.01, respectively). When we divided the subjects into three groups according to the UAER (normoalbuminuria, microalbuminuria and macroalbuminuria), significant changes were reported in the microalbuminuria and the macroalbuminuria groups. Thirty-eight (42%) patients with microalbuminuria improved to normoalbuminuria and twelve (41%) patients with macroalbuminuria improved to microalbuminuria. We found an association between the improvement of blood pressure and UAER (R = 0.165, P = 0.015). CONCLUSION: We concluded that valsartan reduces urinary albumin excretion and blood pressure in hypertensive type 2 diabetic patients.

An Analysis of Medical Costs of Diabetic Patients in a University Hospital (1996~2005).: Ki Hong Chun, Kwan Woo Lee, Dae Jung Kim, Hae Jin Kim, Kyung Won Paek, Soo Jin Lee; Korean Diabetes J. 2008;32(4):366-376. Published online August 1, 2008; DOI: https://doi.org/10.4093/kdj.2008.32.4.366

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BACKGROUND
The aim of this research was to find out the costs of diabetes, as research in a prospective cohort study looking into the development of diabetic complications followed by treatment intervention by a medical institution. The research compared the changes in medical costs by following-up on the treatment details of diagnosed diabetes for the last 10 years in a university hospital. METHODS: The research used data of outpatient, inpatient, pharmaceutical and total medical costs, from 1996 to 2005, of individual patients who were diagnosed with diabetic patients, to analyze the outpatient and inpatient total medical cost changes over the years. RESULTS: After antidiabetic drug, in the case of outpatient treatment, pharmaceutical costs increased on average by about 25,000 won a month for diabetic patients without complications and by 35,000 won for diabetic patients with microvascular complications. Outpatient medical costs were affected after drug treatment by as much of an increase as created by the pharmaceutical costs. The total medical costs, that is the sum of inpatient and outpatient costs, decreased by 30~40% compared to that before drug treatment. In the case of total medical cost, MI or ESRD cost 2~3 times more in pharmaceutical costs than before the development of complications. The total medical costs of diabetic patients with CVA, MI and ESRD complications increased in the first year after development of the complication, and this was followed by a decrease in the next year, showing a tendency to remain constant with no increase or decrease over subsequent years. This means that the total medical costs of patients with complications remain continuously large throughout the life of the diagnosed patient. CONCLUSION: For diabetic patients, pharmaceutical costs are the most important factor in determining outpatient medical costs.

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Outcome Research in Diabetes
Kwan Woo Lee
Journal of Korean Diabetes.2011; 12(1): 2. CrossRef
Costs of Diabetes Mellitus in Korea
Kwan Woo Lee
Diabetes & Metabolism Journal.2011; 35(6): 567. CrossRef

Clinical Characteristics and Direct Medical Costs of Type 2 Diabetic Patients.: Eun Joon Moon, Young Eun Jo, Tae Chin Park, Yun Kyung Kim, Sun Hye Jung, Hae Jin Kim, Dae Jung Kim, Yoon Sok Chung, Kwan Woo Lee; Korean Diabetes J. 2008;32(4):358-365. Published online August 1, 2008; DOI: https://doi.org/10.4093/kdj.2008.32.4.358

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Abstract PDF

BACKGROUND
Type 2 diabetes mellitus is an expensive chronic metabolic disorder and its prevalence has been increasing rapidly in South Korea, owing to a westernized lifestyle. We analyzed the annual direct medical costs attributable to type 2 diabetes and its chronic complications in Korea retrospectively. METHODS: We randomly selected 1,051 patients with type 2 diabetes who visited Ajou University Hospital as an outpatient in 2005. Clinical characteristics, duration of diabetes, and microvascular and macrovascular complications were assessed from a medical chart review. The annual direct medical costs included insurance covered and uncovered medical costs. RESULTS: Of the 1,051 patients with type 2 diabetes, 48.2% had at least one microvascular complication, 5.6% had at least one macrovascular complication, and 12.4% of the patients had both microvascular and macrovascular complications. The average annual direct medical cost was found to be 3,348,488won per patient. In patients with microvascular complications, the total cost of management was increased 1.4 times compared to those without complications. Direct medical costs for patients with macrovascular complications were 2.1-fold as high as patients with no complications. Those patients with both microvascular and macrovascular complications, increased costs by 3.1-fold over those without complications. CONCLUSION: Chronic complications have a substantial impact on the direct medical costs of type 2 diabetes. The prevention of chronic diabetic complications will not only influence the mortality and morbidity of patients with type 2 diabetes, but also potentially reduce medical costs.

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Importance of family history of diabetes in computing a diabetes risk score in Korean prediabetic population
Morena Ustulin, Sang Youl Rhee, Suk Chon, Kyu Keung Ahn, Ji Eun Lim, Bermseok Oh, Sung-Hoon Kim, Sei Hyun Baik, Yongsoo Park, Moon Suk Nam, Kwan Woo Lee, Young Seol Kim, Jeong-Taek Woo
Scientific Reports.2018;[Epub] CrossRef
Features of Long-Standing Korean Type 2 Diabetes Mellitus Patients with Diabetic Retinopathy: A Study Based on Standardized Clinical Data
Sejeong Park, Sang Youl Rhee, Su Jin Jeong, Kiyoung Kim, Suk Chon, Seung-Young Yu, Jeong-Taek Woo
Diabetes & Metabolism Journal.2017; 41(5): 393. CrossRef
Association between Sleep Duration and Impaired Fasting Glucose in Korean Adults: Results from the Korean National Health and Nutrition Examination Survey 2011–2012
Cho-Rong Kim, Yun-Mi Song, Jin-Young Shin, Wook Gim
Korean Journal of Family Medicine.2016; 37(1): 51. CrossRef
Trends in the Diabetes Epidemic in Korea
Kyoung Hwa Ha, Dae Jung Kim
Endocrinology and Metabolism.2015; 30(2): 142. CrossRef
Economic Evaluation of Diabetes Education
Jin-Won Noh, Young Dae Kwon, Jin-Hee Jung, Kang Hee Sim, Hee-Sook Kim, Minjae Choi, Jumin Park
The Journal of Korean Diabetes.2015; 16(4): 293. CrossRef
Association between diabetes-related factors and clinical periodontal parameters in type-2 diabetes mellitus
Eun-Kyong Kim, Sang Gyu Lee, Youn-Hee Choi, Kyu-Chang Won, Jun Sung Moon, Anwar T Merchant, Hee-Kyung Lee
BMC Oral Health.2013;[Epub] CrossRef
Cytoprotective Effect of Ethanol Extract from Maesil (Prunus mume Sieb. et Zucc.) on Alloxan-induced Oxidative Damage in Pancreatic-cell, HIT-T15
In-Hye Kim, Jong-Bae Kim, Kang-Jin Cho, Jae-Hyun Kim, Ae-Son Om
Korean Journal of Plant Resources.2012; 25(2): 184. CrossRef
The Protective Effects of Chrysanthemum cornarium L. var. spatiosum Extract on HIT-T15 Pancreatic β-Cells against Alloxan-induced Oxidative Stress
In-Hye Kim, Kang-Jin Cho, Jeong-Sook Ko, Jae-Hyun Kim, Ae-Son Om
The Korean Journal of Food And Nutrition.2012; 25(1): 123. CrossRef
Outcome Research in Diabetes
Kwan Woo Lee
Journal of Korean Diabetes.2011; 12(1): 2. CrossRef
Costs of Diabetes Mellitus in Korea
Kwan Woo Lee
Diabetes & Metabolism Journal.2011; 35(6): 567. CrossRef
The Epidemiology of Diabetes in Korea
Dae Jung Kim
Diabetes & Metabolism Journal.2011; 35(4): 303. CrossRef
The Hypoglycemic Effect of Complex of Chinese Traditional Herbs (CTH) and Macelignan in Type 2 Diabetic Animal Model

Journal of Life Science.2010; 20(7): 1113. CrossRef
Epidemiologic Characteristics of Diabetes Mellitus in Korea: Current Status of Diabetic Patients Using Korean Health Insurance Database
Ie Byung Park, Sei Hyun Baik
Korean Diabetes Journal.2009; 33(5): 357. CrossRef
Management of Diabetic Mellitus in Low-income Rural Patients
Hye-Yeon Kim, Woo-Jun Yun, Min-Ho Shin, Sun-Seong Kweon, Hye-Ran Ahn, Seong-Woo Choi, Young-Hoon Lee, Dong-Hyeok Cho, Jung-Ae Rhee
Journal of Preventive Medicine and Public Health.2009; 42(5): 315. CrossRef
Prevalence of Pancreatic Cancer in Diabetics and Clinical Characteristics of Diabetes-associated with Pancreatic Cancer - Comparison between Diabetes with and without Pancreatic Cancer -
Seung Goun Hong, Jae Seon Kim, Sung Joo Jung, Moon Kyung Joo, Beom Jae Lee, Jong Eun Yeon, Jong-Jae Park, Kwan Soo Byun, Young-Tae Bak
The Korean Journal of Gastroenterology.2009; 54(3): 167. CrossRef

A Study on Resistance in Type 2 Diabetic Patient Against Commencement of Insulin Treatment.: Sun Hwa Hong, Mi Jin Kim, Sung Gab Noh, Dae Won Suh, Suk Jung Youn, Kwan Woo Lee, Ho Chae Lee, Yang Soo Chung, Hong Ryang Chung, Hyuk Sang Kwon, Bong Yun Cha, Ho Young Son, Kun Ho Yoon; Korean Diabetes J. 2008;32(3):269-279. Published online June 1, 2008; DOI: https://doi.org/10.4093/kdj.2008.32.3.269

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Abstract PDF

BACKGROUND
To achieve tight glycemic control in the poorly controlled type 2 diabetic patients with oral hypoglycemic agent, it maybe beneficial to initiate insulin treatment at the early stage. Many patients with type 2 diabetes are often reluctant to begin insulin therapy despite poor glycemic control with oral hypoglycemic agents, this little known phenomenon, often termed 'psychological insulin resistance (PIR)'. This study investigates psychological insulin resistance in Korean patients with type 2 diabetes. METHOD: This study examined a total of 76 type 2 diabetic patients with poor glycemic control during period of April to July 2006. Through questionnaire and telephone survey, total 24 questions were asked about various attitudes on insulin therapy including psychological barriers and patients' acceptance of this treatment. Subjects were asked to allocate points in 5-point scale (from 5 points for 'very true' to 1 point for 'very untrue'). RESULTS: The means of psychological rejection, injection-related anxiety and fear of insulin side effects such as hypoglycemia and weight gain were 3.65 +/- 0.92, 3.17 +/- 0.98 and 2.8 +/- 1.02, respectively. Unwillingness was common in insulin therapy, 67% of patient rejected or was unwilling to take insulin. Main reasons of patients most frequently endorsed beginning insulin indicate that disease is worsening, permanence (once you start insulin you can never quit) and sense of personal failure. Furthermore, study indicates that patients' reasons for avoiding insulin therapy were mainly psychological rejection, which extended far beyond a simple injection related anxiety. CONCLUSION: PIR was psychological reluctance rather than injection related anxiety. To overcome these psychological barriers to insulin treatment, it is necessary to address appropriate diabetes education including training and counseling with excellent interactive communications between patients and clinicians.

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Using Motivational Interviewing to Overcome Psychological Insulin Resistance
Sung-Chul Lim
The Journal of Korean Diabetes.2023; 24(4): 227. CrossRef
Psychological Insulin Resistance: Key Factors and Intervention
Yeon Jeong Jang
The Journal of Korean Diabetes.2021; 22(3): 192. CrossRef
Factors influencing psychological insulin resistance in type 2 diabetes patients
Ji Hyeon Yu, Hye Young Kim, Sung Reul Kim, Eun Ko, Heung Yong Jin
International Journal of Nursing Practice.2019;[Epub] CrossRef
Development of a Psychological Insulin Resistance Scale for Korean Patients with Diabetes
Youngshin Song, Younghee Jeon, Jeonghwa Cho, Bohyun Kim
Journal of Korean Academy of Nursing.2016; 46(6): 813. CrossRef
Patients' perspectives on taking insulin in diabetes - Perspectives of convergence
Youngshin Song, Eunkyong Ah
Journal of Digital Convergence.2016; 14(12): 283. CrossRef
Concept Analysis for Psychological Insulin Resistance in Korean People with Diabetes
Youngshin Song
Journal of Korean Academy of Nursing.2016; 46(3): 443. CrossRef
New Insulin Injection Recommendations
Min Jeong Gu
The Journal of Korean Diabetes.2016; 17(4): 261. CrossRef
Glucose, Blood Pressure, and Lipid Control in Korean Adults with Diagnosed Diabetes
Sun-Joo Boo
Korean Journal of Adult Nursing.2012; 24(4): 406. CrossRef

Direct Medical Costs of Type 2 Diabetic Patients in the Tertiary Hospital.: Joo An Hwang, Tae Chin Park, Sun Hye Jung, Hae Jin Kim, Dae Jung Kim, So Hun Kim, Moon Suk Nam, Tae Hyun Kim, Moon Kyu Lee, Kwan Woo Lee; Korean Diabetes J. 2008;32(3):259-268. Published online June 1, 2008; DOI: https://doi.org/10.4093/kdj.2008.32.3.259

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Abstract PDF

BACKGROUND
Type 2 diabetes mellitus is a common, chronic and costly disease. Its prevalence is rapidly increasing worldwide. Diabetes has big economic burden mainly because of its chronic complications. We analyzed the annual direct medical costs of type 2 diabetic patients, including the costs associated with its complications in Korea retrospectively. METHODS: We enrolled 531 type 2 diabetic patients who had been treated in the 3 Tertiary Hospital in 2005. Clinical characteristics, duration of diabetes, modality of glycemic control, and presence of microvascular and macrovascular complications were assessed by the review of medical records. The annual direct medical costs were assessed using the hospital electronic database and included insurance covered and uncovered medical costs. RESULTS: The annual direct medical costs of type 2 diabetic patients without any complications was 1,184,563 won (95% CI for mean: 973,006~1,396,121 won). Compared to diabetic patients without complications, annual total medical costs increased 4.7-fold, 10.7-fold, and 8.8-fold in patients with microvascular complications, macrovascular complications and both complications, respectively. Hospitalization costs largely increased by 78.7-fold and 61.0-fold in patients with macrovascular complications and both complications, respectively. Major complications to increase medical costs were kidney transplantation (23.1-fold), dialysis (21.0-fold), PTCA or CABG (12.4-fold), and leg amputation (11.8-fold). The total medical costs dramatically increased according to the stage of diabetic retinopathy and nephropathy. CONCLUSION: Diabetic complications have a substantial impact on the direct medical costs of type 2 diabetic patients. The prevention of diabetic complications will benefit the patients as well as the overall healthcare expenditures.

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Policy Proposals for Infection Control in Patients with Chronic Wounds
Kyung-Chul Moon, Donghyeok Shin, Kyu-Won Baek, Changsik John Pak, Young-Joon Jun
Journal of Wound Management and Research.2022; 18(3): 249. CrossRef
Effects of Co‐administration of Sulfonylureas and Antimicrobial Drugs on Hypoglycemia in Patients with Type 2 Diabetes Using a Case‐Crossover Design
Sera Lee, Miyoung Ock, Hun‐Sung Kim, Hyunah Kim
Pharmacotherapy: The Journal of Human Pharmacology and Drug Therapy.2020; 40(9): 902. CrossRef
The effect of continuity of care on the incidence of end-stage renal disease in patients with newly detected type 2 diabetic nephropathy: a retrospective cohort study
Yun Jung Jang, Yoon Soo Choy, Chung Mo Nam, Ki Tae Moon, Eun-Cheol Park
BMC Nephrology.2018;[Epub] CrossRef
Social Welfare Information for Patients with Diabetes Mellitus
Jea Yeon Lee
The Journal of Korean Diabetes.2016; 17(2): 117. CrossRef
Hypoglycemia and Health Costs
Yong-ho Lee, Gyuri Kim, Eun Seok Kang
The Journal of Korean Diabetes.2016; 17(1): 11. CrossRef
Outcome Research in Diabetes
Kwan Woo Lee
Journal of Korean Diabetes.2011; 12(1): 2. CrossRef
Costs of Diabetes Mellitus in Korea
Kwan Woo Lee
Diabetes & Metabolism Journal.2011; 35(6): 567. CrossRef
How Much Amount of Socioeconomic Loss Is Caused by Digestive Diseases?
Kyung Sik Park
The Korean Journal of Gastroenterology.2011; 58(6): 297. CrossRef

Clinical Characteristics of Korean Type 2 Diabetic Patients According to Insulin Secretion and Insulin Resistance.: Kyoung Eun Song, Dae Jung Kim, Ji Won Park, Hong Keun Cho, Kwan Woo Lee, Kap Bum Huh; Korean Diabetes J. 2007;31(2):123-129. Published online March 1, 2007; DOI: https://doi.org/10.4093/jkda.2007.31.2.123

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Abstract PDF

BACKGROUND
Korean type 2 diabetic patients are known to differ from western diabetes because of their unique characteristics, such as non-obese but centrally obese anthropometry and relatively more insulin secretory defects than insulin resistance compared to western diabetic patients. METHODS: We recruited 1,646 diabetic patients in the present study and excluded the 45 patients with fasting C-peptide < 0.20 nmol/L. We had assessed insulin secretion by fasting serum C-peptide level and insulin resistance by short insulin tolerance test (Kitt ; rate constant for plasma glucose disappearance, %/min) in the private diabetes clinic. The insulin secretory defect was divided by severe (C-peptide < 0.37 nmol/L), moderate (C-peptide 0.37~0.56 nmol/L), and normal (C-peptide > or = 0.57 nmol/L) group. The insulin resistance was divided by insulin resistant (IR) (Kitt < 2.5 %/min) and insulin sensitive (IS) (Kitt > or = 2.5 %/min) group. RESULTS: We analysed the data of 1,601 type 2 diabetic patients (831 men and 770 women, age 56.5 +/- 10.8 years, duration of diabetes 9.6 +/- 7.3 years). The prevalence of BMI > or = 25.0 kg/m2 is 42.5% and BMI > or = 23.0 kg/m2 is 70.2%. The prevalence of abdominal obesity (waist > or = 90 cm in men and 80 cm in women) is 45.2% (36.0% and 55.2%, respectively in men and women). Fasting C-peptide level is 0.64 +/- 0.29 nmol/L and Kitt value is 2.03 +/- 0.96%/min. According to fasting C-peptide level, the degree of insulin secretory defect were severe (13.1%), moderate (33.0%) and normal (53.9%). According to Kitt value, the IR group is 70.6% and the IS group is 29.4%. CONCLUSION: Obese type 2 diabetes is markedly increasing in Korea. Therefore, the major problem in Korean type 2 diabetic patients is being changed into insulin resistance instead of insulin secretory defect.

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Effect of Euonymus alatus Extracts on Diabetes Related Markers in Pancreatic β-Cells and C57BL/Ksj-db/db Mice
Ye Rin Kim, Eun-young Kim, Seong Uk Lee, Young Wan Kim, Yoon Hee Kim
Journal of the Korean Society of Food Science and Nutrition.2022; 51(9): 894. CrossRef
Effect of Nutrition Counseling by Nutrition Care Process on Diet Therapy Practice and Glycemic Control in Type 2 Diabetic Patients
Tae-Jeong Bae, Na-Eun Jeon, Soo-Kyong Choi, Jung-Sook Seo
Korean Journal of Community Nutrition.2020; 25(3): 214. CrossRef
Calpain-10 and Adiponectin Gene Polymorphisms in Korean Type 2 Diabetes Patients
Ji Sun Nam, Jung Woo Han, Sang Bae Lee, Ji Hong You, Min Jin Kim, Shinae Kang, Jong Suk Park, Chul Woo Ahn
Endocrinology and Metabolism.2018; 33(3): 364. CrossRef
Obesity and Insulin Resistance According to Age in Newly Diagnosed Type 2 Diabetes Patients in Korea
Ju Won Lee, Nam Kyu Kim, Hyun Joon Park, Jun Yeob Lee, Seon Yoon Choi, Eun Mi Lee, So Young Ock, Su Kyoung Kwon, Young Sik Choi, Bu Kyung Kim
Kosin Medical Journal.2016; 31(2): 157. CrossRef
The Insulin Resistance but Not the Insulin Secretion Parameters Have Changed in the Korean Population during the Last Decade
Hae Kyung Yang, Jin Hee Lee, In-Young Choi, Hyuk Sang Kwon, Jeong Ah Shin, Seung Hee Jeong, Seung-Hwan Lee, Jae Hyoung Cho, Ho Young Son, Kun Ho Yoon
Diabetes & Metabolism Journal.2015; 39(2): 117. CrossRef
The Effects of Low-Calorie Diets on Abdominal Visceral Fat, Muscle Mass, and Dietary Quality in Obese Type 2 Diabetic Subjects (Korean Diabetes J 2009;33:526-36)
Hee-Jung Ahn, Kyung-Wan Min
Korean Diabetes Journal.2010; 34(1): 68. CrossRef
Effects ofSasa BorealisLeaf Extract on the Glucose Tolerance of Major Foods for Carbohydrate
Eun-Kyoung Yun, Young-Ran Heo, Hyeon-Sook Lim
The Korean Journal of Nutrition.2010; 43(3): 215. CrossRef
The Effects of Low-Calorie Diets on Abdominal Visceral Fat, Muscle Mass, and Dietary Quality in Obese Type 2 Diabetic Subjects (Korean Diabetes J 2009;33:526-36)
Won-Young Lee
Korean Diabetes Journal.2010; 34(1): 66. CrossRef
Anti-GAD Antibody in Patients with Adult-Onset Diabetes in Korea
Eun-Gyoung Hong
Korean Diabetes Journal.2009; 33(1): 13. CrossRef
Hypoglycemic effect of Chlorella vulgaris intake in type 2 diabetic Goto-Kakizaki and normal Wistar rats
Hyejin Jeong, Hye Jin Kwon, Mi Kyung Kim
Nutrition Research and Practice.2009; 3(1): 23. CrossRef

Comparison of the Efficacy and Safety of Glimepiride/Metformin Fixed Combination Versus Free Combination in Patients with Type 2 Diabetes: Multicenter, Randomized, Controlled Trial.: Seung Hwan Lee, In Kyu Lee, Sei Hyun Baik, Dong Seop Choi, Kyong Soo Park, Ki Ho Song, Kwan Woo Lee, Bong Soo Cha, Chul Woo Ahn, Hyoung Woo Lee, Choon Hee Chung, Moon Suk Nam, Hong Sun Baek, Yong Ki Kim, Hyo Young Rhim, Ho Young Son; Korean Diabetes J. 2006;30(6):466-475. Published online November 1, 2006; DOI: https://doi.org/10.4093/jkda.2006.30.6.466

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Abstract PDF

BACKGROUND
Failure to manage diabetes mellitus receiving monotherapy increases as the duration of the disease is protracted, and in many cases it becomes inevitable to introduce combined therapies. However, compliance of the patients tends to decrease. We conducted a clinical study to compare the efficacy and safety of preconstituted and fixed combination therapy of glimepiride plus metformin to those of free combination therapy. METHODS: Two hundred and thirteen patients with type 2 diabetes who had been diagnosed at least six months ago were randomly assigned either to a fixed group or a free group. The initial dosage was chosen according to the previous treatment history and then adjusted every two weeks following a predefined titration algorithm to meet the target mean fasting glucose levels (140 mg/dL). The medications were given for 16 weeks. The primary endpoint was the change in HbA1c level from baseline to week 16. Various parameters were checked as secondary outcome measures and safety criteria. RESULTS: HbA1c level of the fixed group and the free group decreased by 1.09% and 1.08%, respectively. The 95% CI of the changes' difference between the two groups (-0.21%, +0.19%) was within the predefined equivalence interval (-0.5%, +0.5%). Secondary outcome measures (the changes of fasting and postprandial plasma glucose level, response rate and compliance) and safety criteria (frequency of hypoglycemia and adverse reactions) were similar between the two groups. CONCLUSION: Fixed combination of glimepiride/metformin is as effective and safe therapy as free combination in type 2 diabetes patients.

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Efficacy and safety of glimepiride/metformin sustained release once daily vs. glimepiride/metformin twice daily in patients with type 2 diabetes
Y.-C. Hwang, M. Kang, C. W. Ahn, J. S. Park, S. H. Baik, D. J. Chung, H. C. Jang, K.-A. Kim, I.-K. Lee, K. W. Min, M. Nam, T. S. Park, S. M. Son, Y.-A. Sung, J.-T. Woo, K. S. Park, M.-K. Lee
International Journal of Clinical Practice.2013; 67(3): 236. CrossRef
Pharmacokinetic comparison of a new glimepiride 1-mg + metformin 500-mg combination tablet formulation and a glimepiride 2-mg + metformin 500-mg combination tablet formulation: A single-dose, randomized, open-label, two-period, two-way crossover study in
Bo-Hyung Kim, Kwang-Hee Shin, JaeWoo Kim, Kyoung Soo Lim, Kyu-pyo Kim, Jung-Ryul Kim, Joo-Youn Cho, Sang-Goo Shin, In-Jin Jang, Kyung-Sang Yu
Clinical Therapeutics.2009; 31(11): 2755. CrossRef

Efficacy Evaluation of Atorvastatin in Korean Hyperlipidemic Patients with Type 2 Diabetes Mellitus.: Dong Seop Choi, Duk Kyu Kim, Doo Man Kim, Seong Yeon Kim, Moon Suk Nam, Yong Soo Park, Ho Sang Shon, Chul Woo Ahn, Kwan Woo Lee, Ki Up Lee, Moon Kyu Lee, Choon Hee Chung, Bong Yeon Cha; Korean Diabetes J. 2006;30(4):292-302. Published online July 1, 2006; DOI: https://doi.org/10.4093/jkda.2006.30.4.292

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BACKGROUND
NCEP ATP III Guideline recommends aggressive treatments of diabetic dyslipidemia, recognizing diabetes mellitus as CHD risk equivalents. This study was conducted to evaluate the effectiveness and safety of atorvastatin in hyperlipidemic patients with Type 2 diabetes mellitus through post-marketing drug use investigation of atorvastatin. METHODS: An open, multi-center, non-comparison, titrated dosage study was conducted in hyperlipidemic patients, who were treated with atorvastatin at first visiting hospitals from Mar. 2004 to Sep. 2004. 96 endocrinologists participated from 66 centers in this study. Total 2,182 hyperlipidemic patients were enrolled and 1,514 patients among them were accompanied by diabetes mellitus. Efficacy was evaluated at later than 4-week treatment by % change of total cholesterol, triglycerides, HDL-cholesterol and LDL-cholesterol from baseline. Percent of patients reaching LDL-cholesterol level less than 100 mg/dL was also analyzed. The adverse events incidence and abnormalities of clinical laboratory values were evaluated for safety monitoring. RESULTS: Total cholesterol, triglycerides, and LDL-cholesterol level were reduced by 26.6%, 12.0%, and 34.8%, respectively, in diabetic hyperlipidemic patients after atorvastatin treatment. The patients with LDL-cholesterol level of less than 100 mg/dL were increased from 2.8% to 52.6%. Atorvastatin was considered to be safe because adverse drug reactions were reported in 32 patients (1.5%) of total 2,182 patients. CONCLUSION: Atorvastatin was effective and safe in hyperlipidemic patients with type 2 diabetes mellitus.

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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
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 Journal.2010; 34(6): 359. CrossRef
The Association of Plasma HDL-Cholesterol Level with Cardiovascular Disease Related Factors in Korean Type 2 Diabetic Patients
Hye Sook Hong, Jong Suk Park, Han Kyoung Ryu, Wha Young Kim
Korean Diabetes Journal.2008; 32(3): 215. CrossRef

Resurvey of Alternative Medicine in Korean Type 2 Diabetes Mellitus after 10Years.: Kyung Wook Lee, Seong Bin Hong, Kee Young Min, Seung Yong Lee, Moonsuk Nam, Yong Seong Kim, Chul Woo Ahn, Bong Soo Cha, Kyung Rae Kim, Hyun Chul Lee, Kwan Woo Lee, Tae Sun Park; Korean Diabetes J. 2005;29(3):231-238. Published online May 1, 2005

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Abstract PDF: BACKGROUND
Despite tremendous advances in modern medicine, the interest in alternative medicine, including those medicines used for the treatment of diabetes has intensified throughout the industrialized world. We conducted a clinical resurvey of the dlternative medicines used for diabetic treatment, and we compared the results with those from the previous survey. METHODS: From July through October 2004, a total of 1,233 type 2 diabetics attending diabetes clinics in five university hospitals were interviewed and asked 14 questions that were identical to those questions asked 10 years ago during the earlied study. RESULTS: On the average, the respondents, having an average age of 58.9+/-11.4years, suffered diabetes for 8.7+/-7.3years with 7.7+/-1.4% HbA1c. The percentage of patients who experienced using alternative medicine for diabetic treatment plummeted from 73.9% to 33.2% over the last 10 years. Herbal medicine maintained its high popularity with increase an being seen in supplementary food use. The average per-capita spending on alternative medicine changed from 520,000 Korea Won on five types of medicine in 1994 to 730,000 on two types of medicine in 2004. Regarding the information sources, the family and relatives topped the list again(70.3%). Information sources such as mass media almost doubled to 20.2%, and the internet accounted for 1.2% in 2004. The majority of the users said again in 2004 that the medicine was `inefficacious'(63.5%) but those who answered positively inched up by 3.1% from 14.5% in 1994. To the question if they would try a new alternative medicine, the majority answered negatively in 2004(43% of the experienced group, 52.3% of the inexperienced group), and this was unlike the results in 1994 when the positive responses prevailed(78.6% and 72.7% respectively). CONCLUSION: Alternative medicine use among the type 2 diabetic patients has declined in the last 10 years. The patients overall attitude toward alternative medicine has turned negative, and this is primarily attributable the to continuous, proper education by mass media and social groups

Effects of Nateglinide on the Control of Mealtime Glucose Excursions in Korean Patients with Type 2 Diabetes.: Hyeon Man Kim, Yoon Seok Chung, Kwan Woo Lee, Dae Jung Kim, Hyun Chul Lee, Dong Rim Kim, Dong Seop Choi, Eun Sook Oh, Moo Il Kang, Kwang Woo Lee, Chul Young Park, In Myung Yang, Jin Woo Kim, Young Seol Kim, Hyong Gi Jung; Korean Diabetes J. 2002;26(5):405-415. Published online October 1, 2002

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Abstract PDF: BACKGROUND
Nateglinide belong to a new family of insulin secretagogues that stimulate the early phase of insulin secretion. This study was designed to evaluate the efficacy and adverse effect of nateglinide in Korean type 2 diabetes patients, whose diabetes were inadequately controlled by medical nutrition therapy, focusing on the changes in mealtime glucose excursion (PBG), fasting blood glucose (FBG), glycated hemoglobin (HbA1c) and plasma insulin. SUBJECTS AND METHODS: This multicentered open-label trial was conducted on 66 Korean patients with type 2 diabetes mellitus. The subjects comprised of 36 males and 30 females, with a mean age, and duration of diabetes of 53.9+/-9.6(34~69) years and 39.5+/-44.0 months, respectively. The inclusion criteria were as follows: 1) FBG and PBG before the trial of 6.7~11.1 mmol/l and above 11.1 mmol/l, respectively, 2) changes of FBG and PBG during the 2-week-diet treatment of less than 1.7 mmol/l. PBG, FGB, HbA1c and plasma insulin levels were measured at weeks -2, 0, 2, 4, 8 and 12. Any adverse effects were noted during the study. The data were analyzed by the intent-to treat (ITT) and the per protocol (PP) methods. RESULTS: Nineteen cases were excluded due to protocol violation or withdrawal. The PBG level was significantly decreased during the study 13.7 2.6 mmol/l, before the trail to 9.6 2.8 mmol/l after (p=0.001) which was particularly marked during the first 2 weeks. The FBG, HbA1c and fasting plasma insulin levels were also significantly decreased, from 9.0+/-1.2 to 8.2+/-2.0 mmol/l, p=0.0063), from 8.0+/-1.3% to 7.0+/-1.1% (p=0.0001) and from 9.8 7.2 to 8.0 5.5 pmol/l (p<0.05), respectively. Three adverse events suggested the nateglinide-related diabetes was not serious. CONCLUSION: This study revealed that nateglinide could be used as an effective glucose-lowering agent, especially for the control of mealtime glucose excursion in Korean type 2 diabetes patients who were inadequately controlled by diet alone.

Chronic Diabetic Complications in the Insulin- Treated Animal Model of Type 2 Diabetes Mellitus.: Jee Won Park, Sung Kyu Lee, Hyo Jung Kim, Hae Lim Noh, Chang Young Hah, Su Jin Lee, Yoon Sok Chung, Kwan Woo Lee, Hyun Man Kim, Eun Ju Paek; Korean Diabetes J. 2001;25(3):200-210. Published online June 1, 2001

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Abstract PDF: BACKGROUND
Non-Insulin Dependent Diabetes Mellitus (NIDDM) is a characterized by insulin resistance and impairment of beta cell function. OLETF male rat usually developed NIDDM and obesity at 20 weeks old spontaneously. It is a metabolically characterized by insulin resistance in onset of early disease. However, body weight and insulin secretory function was gradually reduced during the diabetes developed. These characteristics of disease is similar to Korean type 2 diabetic patients. NIDDM patients in Korea are thought to be different from traditional NIDDM in western countries. They are non obese type and also has reduced insulin secretory function compared to western countries. These patients are not easily managed on diet and/or oral hypoglycemic agent. Reduced C-peptide and insulin concentrations in these patients are similar to patients with IDDM. In these patients, insulin therapy is effective to control glucose level. Therefore, we investigated the effect of insulin and oral hypoglycemic therapy to glucose control and severity of chronic complications in OLETF male rats of 6weeks (42 weeks old) and 14 weeks (50 weeks old) treated groups. MATERIAL AND METHODS: The OLETF male rats which are 36 weeks old is diagnosed to NIDDM. A total of 20 rats were stratified into the three groups: control group (n=3), OHA's group; rats treated by OHA's (n=3) and insulin group; rats treated with insulin (n=4). We evaluated anthropometry, fasting glucose and 75 gram OGATT, nerve conduction studies, sclerotic degree of kidney and thickness of carotid arteries at 42 and 50 weeks old. RESULTS: In the 42 weeks old groups (6 weeks treated group), there was a significant difference in weight gain in group 3 but no differences were observed in kidney tissue pathology and thickness of carotid arteries. In the 50 weeks old groups (14 weeks treated group), there were also no changes in the kidneys and arteries, but weight gain and peak amplitude in NCV was significantly higher in insulin - treated group. CONCLUSIONS: OLETF male rats as NIDDM animal mocel, with late stage diabetic complications show weight loss and decreased insulin secretory capacity. Insulin treated group shows improved blood glucose control. Also it showed improved severity of diabetic neuropathy.

Microvascular Complications and lts Relationship with Obesity in Outpatient Type 2 Diabetics.: Seong Kyu Lee, Bong Nam Chae, Eun Gyoung Hong, Hye Lim Noh, Hyeon Kyoung Cho, Yoon Jung Kim, Mi Deok Lee, Yoon Sok Chung, Kwan Woo Lee, Nam Han Cho, Hyeon Man Kim; Korean Diabetes J. 2000;24(1):60-70. Published online January 1, 2001

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Abstract PDF: BACKGROUND
Korean type 2 diabetic patients who are frequently non-obese, may be genetically different from Western type 2 diabetics who are frequently obese. Therefore, the diabetic complications of type 2 diabetes mellitus in Korea may be also different from those of Western countries. Until now, most studies reported in Korea did not analyse the microvascular complications of type 2 diabetes mellitus according to obesity, and also the criteria in the diagnosis of microvascular complications were different in each study. We investigated the microvascular complications and its relationship with obesity, in type 2 diabetic patients visiting an outpatient clinic. METHODS: The study subjects were type 2 diabetic patients visiting an outpatient clinic of Ajou University Hospital. We selected patients participating in a 75 g oral glucose tolerance test, retrospectively. Type 2 diabetes was diagnosed according to the WHO/NDDG classification of diabetes. Biochemical studies including lipid profile, plasma insulin and C-peptide levels were done. Anthropometric measurements were performed. Based on BMI (kg/m2), the patients were divided into the following groups: the lean group, whan the BMI was less than 20kg/m2; the ideal body weight (IBW) group, if the BMI was between 20 kg/m and 25 kg/m in women and 20kg/m and 27 kg/m in men; and the obese group, when the BMI was>25 kg/m in women and >27 kg/m2 in men. RESULTS: 1. Neuropathy (45.2%) was the most frequent among the microvascular complications, and the frequency of retinopathy was 15.1%, and that of nephropathy was 4.9k. Within 5 years of diabetes duration, the frequency of neuropathy, retinopathy, and nephropathy was 43.2%, 11.8%, and 2,9%, respectively. 2. Glycosylated hemoglobin (HbA1c) and fasting blood glucose levels were not different among the three groups. Beta cell function{delta(insulin 30min insulin Omin)/delta(glucose 30min - glucose Omin)} was the highest in the obese group, However, beta cell function(delta/delta G) divided by the basal insulin level, considered insulin resistance, was not different among the three groups. 3. Within 5 years of diabetes duration, retinopathy tended to be the most frequent in the lean group, whereas neuropathy tended to be the most frequent in the obese group, and body mass index influenced the retinopathy and neuropathy, statistically significantly. CONCLUSION: Diabetic neuropathy was the most frequent among microvascular complications of type 2 diabetes mellitus in our study subjects. At the time of presentation within 5 years of diabetes duration, the lean group of type 2 diabetics had a tendency of the more frequent retinopathy, the obese group had a tendency of the more frequent neuropathy. These results suggest that type 2 diabetes mellitus in Korea is also not a singie disease entity, as in Western countries and is a heterogenous group of disorders with a diversity of microvascular complications. However, the more studies about this will be required.

Efficacy and Safety of Glimepiride: A Novel Sulfonylurea Drug compared with Gliclazide in the Treatment of Type 2 Diabetes Mellitus: an Open , Randomized Comparative Multi - Center Clinical Study.: Sung Kwan Hong, Ki Up Lee, Yeon Sang Oh, Ho Young Son, Kwang Won Kim, Hyun Chul Lee, Kyung Rae Kim, Dong Seop Choi, Ie Byung Park, Young Seol Kim, Kwan Woo Lee, Hong Kyu Lee, Soon Hyun Shin; Korean Diabetes J. 1999;23(1):87-97. Published online January 1, 2001

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Abstract PDF: BACKGROUND
Glimepiride (HOE490, Amaryl (R)) is a new, third generation sulfonylurea, which binds to a different protein of the sulfonylurea receptor than other sulfonylureas. Although there have been many studies proving the efficacy of glimepiride on Caucasian diabetic patients, only a few studies are available on Asian diabetic patients. We performed an open, randomized, comparative multicenter clinical trial to assess the efficacy and safety of glimepiride in Korean type 2 diabetic patients. METHOD: We recruited 262 type 2 cliabetic patients at 12 different university hospitals whose blood glucose was not controlled effectively with diet alone. Patients were randomized to 1~2mg glimepiride or 40~80mg gliclazide depending on the fasting blood glucose level. Doses were increased stepwise, up to 8mg for glimepiride (once-daily) and 320mg for gliclazide (>80 mg as dividedose) respectively, until metabolic control (fasting blood glucose < 7.9 mmol/L) or maximum dose was achieved. The quality of rnetabolic control was assessed by fasting blood glucose and HbA 1c as primary variables. Insulin, C-peptide and weight were monitored as secondary variables. Safety was assessed by obtaining patient history and laboratory values of relevant variables. RESULTS: Of the 262 patients randomized to treatment, 160(61%) patients completed the 18-week study. The rate of successful blood glucose control (3.9

The Role of Insulin Secretion and Insulin Resistance in the Development of Korean Type 2 Diabetes Mellitus.: Bong Nam Chae, Seong Kyu Lee, Eun Gyoung Hong, Yoon Sok Chung, Kwan Woo Lee, Hyeon Man Kim; Korean Diabetes J. 1998;22(4):491-503. Published online January 1, 2001

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Abstract PDF: BACKGROUND
Impaired insulin secretinn, peripheral insulin resistance, a disproportionately elevated rate of hepatic glucose production and influence of inherited or enviromental factors contribute to the pathogenesis of type 2 diabetes mellitus(DM). But, which defect is primary is still controversial To determine whether insulin resistance or insulin deficiency is primary in the pathogenesis of type 2 DM, we studied normal glucose tolerant offsprings of type 2 diabetic patients. METHODS: 22 offsprings of type 2 diabetic patients with normal glucose tolerance, ranging in age from 20 to 40 years, and 17 control subjects in same age range who had no family history of diabetes, and 21 diabetic subjects were included. We performed 75 g oral glucose tolerance test, euglycemic hyper-insulinemic clamp test and hyperglycemic clamp test. RESULTS: With euglycemic clamp test, the values of peripheral insulin sensitivity, M, were 8.59+0.94 mg/kg/min in control group, 6.98+0.65 mg/kg/min in offspring group, and 5.19+0.89 mg/kg/min in diabetes group (P<0.05). Considering that lower limit of the normal range were 3.78 mg/kg/min in M and 3.10 mg/kg/min in M/I, the frequency of insulin resistance was 14.3% in the offspring group and 33.3 % in diabetes group. First and second phase insulin secretion during hyperglycemic clamp test were blunted in diabetes group. In the offspring group, first and second phase insulin secretion during hyperglycemic clamp test were increased greater than control group, though statistically insignificant. The mean first phase insulin secretion were 38.55+6.81 pU/mL in control group, 55.09+9.40 pU/mL in the offspring group and 6.02+0.98 pU/mL in diabetes group (P<0.05). The mean second phase insulin secretion were 65.11+15.5 pU/mL in control group, 90.25 + 11.9 pU/mL in the offspring group and 17.6 +2.71 pUmL in diabetes group(P<0,05). Considering that lower limit of the normal range were 19.5 pU/mL in the first phase insulin secretion and 26.1 pU/mL in the second phase insulin secretion, the frequency of impaired insulin secretion was 14.3 % in the offspring group and 100 % in diabetes group. There was an inverse relation between insulin resistance and insulin secretion in control subjects. But in the offspring group, this relation was absent. CONCLUSION: Our results show that both insulin resistance and impaired insulin secretion contribute to the development of type 2. DM in Koreans. In addifion, diabetic subjects had more severe impairment in insulin secretory capacity than insulin resistance.

Comparison of the New Diagnostic Criteria for Diabetes Mellitus Recommended by the Expert Committee of the American Diabetes Association with the Criteria by the NDDG or WHO in Koreans with Fasting Plasma Glucose between 110 and 139 mg / dL.: Yeo Joo Kim, Moon Suk Nam, Mi Rim Kim, Yong Seong Kim, Kwan Woo Lee, Hyeon Man Kim, Choon Hee Chung, Su Youn Nam, Bong Soo Cha, Kyung Rae Kim, Hyun Chul Lee, Sam Kweon, Yong Wook Cho, Kap Bum Huh; Korean Diabetes J. 1998;22(2):209-217. Published online January 1, 2001

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Abstract PDF: BACKGROUND
The current diagnostic criteria for diabetes mellitus announced by National Diabetes Data Group(NDDG) in 1979 were revised by Expert Committee of World Health Organization(WHO) in both 1980 and 1985. However, according to advancement in the knowledge of the etiology and pathogenesis of diabetes mellitus, the International Expert Committee working under the sponsorship of the American Diabetes Association(ADA) decided to adopt the resolution proposing that the criteria of fasting glucose level applied to diagnosis of diabetes mellitus should be lowered at the 57 ADA conference held in Boston, USA in June 1997(97 ADA). Hereupon, by comparing the diagnostic criteria of the former (NDDG/WHO) with the later, the authors have examined the usefulness of new diaignostic criteria, 97 ADA. METHOD: We collected the data from 13 university hospitals in Korea which contain the results of 75 gram oral glucose tolerance test(OGTT) for 532 Kareans between 110 and 139 mg/dL in fasting plasma glucose. We have then evaluated the results by classifying and comparing them in accordance with the criteria of NDDG/WHO and 97 ADA, respectively. RESULTS: 1. The number which tested for oral glucose tolerance was 532 and the majority of tests have been carried out between 110 and 119 mg/dL in fasting plasma glucose. 2. When we have classified the same results of OGTT by respective diagnostic criteria of NDDG/ WHO and 97 ADA, the NDDG/WHO have diagnosed 50.4%(268/532) of the total number of people as diabetes mellitus, while the '97 ADA has shown that only 33.1%(176/532) of it corresponded to the same diagnosis. On the other hand, the diagnosis rate of impaired fasting glucose(IFG) or impaired glucose tolerance(IGT) has shown 28.8~ 31.8%(NDDG/ WHO) and 66.9%(97 ADA), respectively. 3. Following the diagnostic criteria of the 97 ADA, we have separated the results into two groups which were above and below 126 mg/dL in fasting glucose. In addition, when we have again classified two groups by the criteria of the NDDG/WHO, the group above 126mg/dL in fasting glucose, which was all diagnosed as diabetes mellitus in 97 ADA has represented a ratio of 72.2%(127/176) in same diagnosis. However, within the group below 126mg/ dL, in fasting glucose being classitied as IFG in the 97 ADA, its diagnosis rate of diabetes mellitus has also shown 39.7%(141/356) applying to the criteria of the NDDG/WHO. CONCLUSION: The criteria of the 97 ADA can simply make a diagnosis of diabetes mellitus with fasting plasma glucose and additionally fmd out the IFG whose rate is 17.9 20% regarded as a normal condition by NDDG/WHO, whereas the existing criteria of the NDDG/WHO have to carry out the OGTT which is difficult in clinics. However, since among the patients ot 50.4% diagnosed as diabetes mellitus by NDDG/WHO, the 97 ADA classifies 17.3% of them as IFG, it is regarded that the need of OGTT for the diagnosis of diabetes mellitus can not be passed over in the future.

Fibroblast PC-1 mRNA Content, Body mass index and Insulin Sensitivity in Korean NIDDM Patients.: Deok Bae Park, Seong Kyu Lee, Young Goo Shin, Seong Keun Lee, Yoon Sok Chung, Kwan Woo Lee, Hyeon Man Kim; Korean Diabetes J. 1997;21(4):388-396. Published online January 1, 2001

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Abstract PDF: No abstract available.

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