- Effects of 'Ubiquitous Healthcare' on the Ability of Self-Management in Elderly Diabetic Patients.
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Sung Hoon Yu, Sun Hee Kim, So Yeon Kim, Sung Hee Choi, Soo Lim, Yoon Seok Chang, Hak Jong Lee, Young Joo Park, Hak Chul Jang
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Korean Diabetes J. 2009;33(1):58-64. Published online February 1, 2009
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DOI: https://doi.org/10.4093/kdj.2009.33.1.58
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- BACKGROUND
The need for a new healthcare system is growing due to the paradigm shift from health supervision to health maintenance. Previously, we performed a pilot study that examined the effectiveness of a ubiquitous healthcare (U-healthcare) diabetes management program which consists of self-monitoring of blood glucose (SMBG) and mobile phone services for elderly patients with type 2 diabetes mellitus. In this study, we investigated the effect of a diabetes management program using U-healthcare based on the self-care skills of elderly patients with diabetes mellitus. METHODS: From July to October 2005, 17 patients were recruited and provided with a blood glucometer with the ZigBee module and a mobile phone. In addition, the patients' understanding of diabetes self-care skills was examined at the beginning and end of the study. At the end of the study, we determined the level of patient satisfaction regarding U-healthcare services. RESULTS: The patients' test scores on their understanding of diabetes mellitus improved from 57.2 +/- 20.7 to 72.7 +/- 13.4%. Specifically, patient knowledge of the basic principles for a proper diabetic diet (52.9% vs. 82.4%, P = 0.046), foods that influence blood sugar level (41.2% vs. 76.5%, P = 0.007) and the influence of beverage choice (41.2% vs. 64.7%, P = 0.007), all increased. In addition, a significant increase in knowledge of living standards regarding diabetes mellitus was observed (64.7% vs. 88.2%, P = 0.0032). CONCLUSION: We conclude that the U-healthcare incorporating SMBG could be promising, as it improves self-management skills of diabetes mellitus patients, as well as their understanding of the disease.
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- Self-management of Chronic Conditions Using mHealth Interventions in Korea: A Systematic Review
Jae Yoon Yi, Yujin Kim, Yoon-Min Cho, Hongsoo Kim Healthcare Informatics Research.2018; 24(3): 187. CrossRef - Effectiveness of the Smart Care Service for Diabetes Management
Young-Soon Chung, Yongsuk Kim, Chang Hee Lee Healthcare Informatics Research.2014; 20(4): 288. CrossRef - Ubiquitous Healthcare Service Has the Persistent Benefit on Glycemic Control and Body Weight in Older Adults With Diabetes
Seon Mee Kang, Min Joo Kim, Hwa Young Ahn, Ji Won Yoon, Min Kyong Moon, Hye Seung Jung, Sung Hee Choi, Soo Lim, Kyong Soo Park, Hak C. Jang Diabetes Care.2012; 35(3): e19. CrossRef - Improved Glycemic Control Without Hypoglycemia in Elderly Diabetic Patients Using the Ubiquitous Healthcare Service, a New Medical Information System
Soo Lim, Seon Mee Kang, Hayley Shin, Hak Jong Lee, Ji Won Yoon, Sung Hoon Yu, So-Youn Kim, Soo Young Yoo, Hye Seung Jung, Kyong Soo Park, Jun Oh Ryu, Hak C. Jang Diabetes Care.2011; 34(2): 308. CrossRef - A Survey on Ubiquitous Healthcare Service Demand among Diabetic Patients
Soo Lim, So-Youn Kim, Jung Im Kim, Min Kyung Kwon, Sei Jin Min, Soo Young Yoo, Seon Mee Kang, Hong Il Kim, Hye Seung Jung, Kyong Soo Park, Jun Oh Ryu, Hayley Shin, Hak Chul Jang Diabetes & Metabolism Journal.2011; 35(1): 50. CrossRef
- Association between Apolipoprotein E Polymorphism and Type 2 Diabetes in Subjects Aged 65 or Over.
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You Jin Lee, Hak Chul Jang, Eun Hye Kim, Hye Jin Kim, Seok Bum Lee, Sung Hee Choi, Soo Lim, Kyoung Un Park, Young Joo Park, Ki Woong Kim
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Korean Diabetes J. 2008;32(1):30-37. Published online February 1, 2008
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DOI: https://doi.org/10.4093/kdj.2008.32.1.30
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Abstract
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- BACKGROUND
Increased prevalence of diabetes in recent years is linked with increased cardiovascular morbidity and mortality. Apolipoprotein E (apo E) polymorphism is well known to be related to hyperlipidemia and coronary heart disease, but only a few studies investigated the association between apo E polymorphism and diabetes or insulin resistance. In Korea, two studies with relatively small subjects reported controversial results. Therefore, we investigated the association between apo E polymorphism and diabetes in elderly community population. METHODS: 982 elderly people aged 65 or over in Seongnam city were enrolled. We measured anthropometric variables and blood pressure and performed biochemical tests including fasting glucose, fasting insulin, HbA1c, and lipid profiles. Apo E polymorphism was determined by PCR-RFLP method. RESULTS: Frequencies of apo E isoforms and alleles were similar to those of other reports. Subjects with e4 allele had significantly higher total and LDL-cholesterol levels. However, there were no differences in cholesterol levels between normal subjects and diabetes. Diabetes was not related to apo E polymorphism. CONCLUSION: In Korean aged 65 or over, subjects with diabetes didn't have increased total or LDL-cholesterol, triglyceride, and decreased HDL-cholesterol levels. Diabetes and apo E polymorphism were not related.
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- Association of APOE genotype with lipid profiles and type 2 diabetes mellitus in a Korean population
Jung Yeon Seo, Byeong Ju Youn, Hyun Sub Cheong, Hyoung Doo Shin Genes & Genomics.2021; 43(7): 725. CrossRef - Sarcopenia, Frailty, and Diabetes in Older Adults
Hak Chul Jang Diabetes & Metabolism Journal.2016; 40(3): 182. CrossRef
- Genetic Association of Adiponectin Polymorphisms with Risk of Type 2 Diabetes Mellitus.
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Yun Yong Lee, Nam Seok Lee, Young Min Cho, Min Kyong Moon, Hye Seung Jung, Young Joo Park, Hong Je Park, Byoung Soo Youn, Hong Kyu Lee, Kyong Soo Park, Hyoung Doo Shin
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Korean Diabetes J. 2003;27(6):438-448. Published online December 1, 2003
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Adiponectin, an adipocyte-secreted protein, is known to modulate insulin sensitivity, glucose homeostasis and the development of atherosclerosis. Recently, several single nucleotide polymorphisms (SNPs) in the adiponectin gene have been reported to be associated with type 2 diabetes and components of the insulin resistance syndrome. METHODS: The frequencies of SNP T45G and G276T of the adiponectin gene was examined in 493 unrelated type 2 diabetic and 136 non-diabetic control Korean subjects. The clinical characteristics and plasma adiponectin levels of the subjects were compared within these genotypes. RESULTS: The T allele at SNP45 was significantly more frequent in the type 2 diabetes than in the control subjects (71.6 vs. 64.3%, p=0.013). The subjects with the G/G genotype of SNP45 were at reduced risk for type 2 diabetes (OR: 0.495, 95% CI 0.246-0.995, p=0.048) compared with those having the T/T genotype. However, there were no statistically significant differences in allele the frequencies (G frequency in the control vs. the diabetic group 73.9 vs. 68.9%, p=0.106) and genotype frequencies at SNP276 between groups. The subjects with the T/T genotype at SNP45 had higher a body mass index (24.6+/- 3.1 vs. 24.1+/-2.8 kg/m2, p=0.036) and serum triglyceride levels (2.03+/-1.31 vs. 1.87+/-1.38 mmol/1, p=0.041) than the T/G+G/G genotypes in the diabetic group. Those with the T/T genotype also had lower plasma adiponectin levels than those without T/T genotype at SNP45 in the control group (6.11+/-3.10 vs. 8.24+/-4.24 g/mL, p=0.043). There was a similar trend in diabetic group, but this did not reach statistical significance (4.32+/-2.81 vs. 4.96+/-3.26 g/mL, p=0.097). The SNP276 had no association with the clinical features of insulin resistance or plasma adiponectin level. CONCLUSION: The T/T genotype of SNP45 in the adiponectin gene was associated with a low adiponectin level, high body mass index, the serum triglyceride level and risk of type 2 diabetes mellitus. The SNP276 in the adiponectin gene may not be an important determinant of insulin resistance or type 2 diabetes in Korean subjects.
- Plasminogen Activator Inhibitor-1 (PAI-1)/tissue Plasminogen Activator (t-PA) Levels and PAI-1 4G/5G Promoter Polymorphism in Type 2 Diabetes with Microalbuminuria.
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Seong Hee Kwon, Young Joo Park, In Kyong Jeong, Jae Joon Koh, Kyong Soo Park, Seong Yeon Kim, Hong Kyu Lee
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Korean Diabetes J. 2003;27(3):186-198. Published online June 1, 2003
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Persistent microalbuminuria in diabetic patients is a risk factor of cardiovascular mortality. Increased plasma plasminogen activator inhibitor type-1 (PAI-1) levels have been observed in diabetic patients with overt nephropathy. However, there have been few studies on diabetic patients with microalbuminuria. The expression of PAI-1 may be influenced by the polymorphism of the PAI-1 genotype promoter. The aim of this study was to investigate the relationship between the plasma PAI-1/t-PA levels, polymorphism of the PAI-1 4G/5G promoter and microalbuminuria in type 2 diabetes. METHODS: The plasma PAI-1/t-PA levels and polymorphisms of the PAI-1 promoter were measured in type 2 diabetic patients without nephropathy (n=30), and with microalbuminuria (n=30) and overt proteinuria (n=20). The correlation between the amount of urinary albumin excretion and plasma PAI-1/t-PA levels were investigated using Pearson's correlation analyses. RESULTS: The plasma PAI-1/t-PA levels and polymorphisms of the PAI-1 promoter showed no significant difference between the three groups in relation to the urinary albumin excretion. There were no differences in the plasma PAI-1/t-PA levels between the genotypes of the polymorphism of the PAI-1 promoter. No association was found between the amount of urinary albumin excretion and the plasma PAI-1/t-PA levels and genotypes of the polymorphism of the PAI-1 promoter. CONCLUSION: These results show that there was no decrease in the fibrinolytic state in type 2 diabetics with microalbuminuria, compared to normoalbuminuria, which also suggest that polymorphisms of the PAI-1 4G/5G promoter do not affect the plasma PAI-1/t-PA levels in type 2 diabetic patients with microalbuminuria.
- Expression of ghrelin and its receptor according to feeding state in rats.
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Min Seon Kim, Cho Ya Yoon, Young Joo Park, Hyung Kyu Park, Chen Ji Jin, Kyong Han Park, Chan Soo Shin, Kyong Soo Park, Seong Youn Kim, Bo Youn Cho, Hong Kyu Lee
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Korean Diabetes J. 2002;26(3):169-178. Published online June 1, 2002
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Ghrelin is a newly discovered gut peptide, produced mainly in the stomach, which is secreted into the circulating blood and acts on the hypothalamus and the pituitary gland. Although ghrelin was originally identified as an endogenous growth hormone secretagogue, recent studies have suggested its role is in the regulation of food intake and energy homeostasis. The aim of this study was to investigate changes in the expression of ghrelin in the stomach, and of its receptors in the hypothalamus and the pituitary gland in relation to the feeding state. METHODS: Sprague Dawley male rats, divided into 3 groups, freely fed, fasted for 48 hrs and fasted for 48 hrs followed by feeding for 24 hrs, were investigated. The stomach fundus, the hypothalamus and the pituitary glands were collected. The gastric ghrelin mRNA expression was determined by Northern blot analysis and the ghrelin protein by immunohistochemistry. The ghrelin receptor mRNA levels in the hypothalamus and anterior pituitary gland were determined by real time PCR. RESULTS: The ghrelin mRNA levels in the stomach were increased by fasting but reduced again by allowing feeding. The number of ghrelin-immunoreactive gastric epithelial cells tended to increase with fasting. Moreover, the ghrelin receptor mRNA levels increased fold in the hypothalamus, and about 3 fold in the anterior pituitary gland harvested from the rats that had fasted for 48 hrs compared to those that were freely fed. CONCLUSION: Our data demonstrate that expression of both ghrelin in stomach and its receptor in target organs increased in the fasted state, which would be helpful for magnifying the orexigenic effect of ghrelin in the negative energy balance state. Dynamic changes in ghrelin and ghrelin receptor according to altered metabolic state may suggest a physiologic role of ghrelin in the regulation of energy homeostasis.
- Comparison of Clinical Characteristics of Impaired Fasting Glucose with Impaired Glucose Tolerance in Yonchon County.
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In Kyong Jeong, Min Kyong Moon, Sang Wan Kim, Young Joo Park, Sun Yuk Kim, Chan Soo Shin, Do Joon Park, Kyong Soo Park, Seong Yeon Kim, Bo Youn Cho, Noe Kyeong Kim, Hong Kyu Lee
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Korean Diabetes J. 2000;24(1):71-77. Published online January 1, 2001
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To compare the clinical characteristics of 1997 American Diabetes Association (ADA) impaired fasting glucose (IFG) based on fasting plasma glucose (FPG) with World Health Organization (WHO) impaired glucose tolerance (IGT) based on oral glucose tolerance test (OGTT) in a Korean population. METHODS: The analyses were based on the data of 2,251 subjects aged 30-80 years obtained from the surveys of Yonchon County in Korea in 1993, and the data of 1084 subjects participated in the follow-up survey in 1995. Prevalence of glucose tolerance categories was obtained by using WHO and ADA criteria, and the level of agreement was estimated by index. Cardiovascular risk profile and the incidence of diabetes based on the ADA criteria after 2 years were compared by focusing on the discordant ctiagnostic categories namely IGT/NFS in which the subjects were diagnosed as IGT by WHO criteria but normal fasting glucose(NFG) by ADA criteria and NGT/IFG diagnosed as normal glucose tolerance(NGT) by WHO but IFG by ADA. Results The ADA criteria failed to diagnose 69% of IGT patients, that is 62% of them were considered normal and 7% as diabetes. The overall agreement was poor (x statistics = 0.32, p<0.05). Subjects classified into IGT/NFG or NGT/IFG showed the worse cardiovascular risk profile and higher incidence of diabetes than NGT/NFG. Especially, subjects with NGT/IFG exhibited higher incidence of diabetes than those with IGT/NFG. CONCLUSION: Although IFG predicts subsequent development of diabetes much better than IGT, the vast majority of the subjects with IGT will be missed according to ADA criteria based on FPG only. Consequently FPG alone could be an inadequate substitute for the OGTT.
- Evaluation of Fasting Plasma Glucose to Diagnose Diabetes in Yonchon County.
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Young Joo Park, In Kyoung Chung, Chan Soo Shin, Kyong Soo Park, Seong Yeon Kim, Hong Kyu Lee, Sun Ja Kwon
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Korean Diabetes J. 1998;22(3):372-380. Published online January 1, 2001
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Recently, many studies were performed to evaluate the diagnostic value of fasting plasma glucose to diagnose diabetes, and the diagnostic criteria were revised by ADA in 1997 to avoid discrepancy between the fasting plasma glucose (FPG) and 2 hour post-load plasma glucose(2hPG) cutpoint values after 75g oral glucose loading and to alsc facilitate and encourage the use of test for diagnosing diabetes. This study was performed to assess the performance of different cutpoint of fasting plasma glucose in the diagnosis of diabetes and to compare the prevalence and incidence of diabetes using revised 1997 ADA FPG criterion with those using 1985 WHO criteria in Yonchon County of Korea. METHODS: Two thousand three hundred fifty-six subjects who participated in population based cross-sectional study in Yonchon County in 1993. We have also analysed the data from 1141 subjects who were non-diabetic in 1993 and participated in the follow-up survey in 1995. The relationship between FPG and 2hPG were determined using sensitivity, specificity and the prevalence of diabetes according to FPG and/or 2hPG values. We have determined the prevalence and the incidence of diabetes using the ADA criterion. RESULTS: Based on WHO criteria, a FPG of 6.1 mmol/L(110mg/dL) was determined to yield optimal sensitivity(83.6%) and specificity(82.4%), but it showed low positive predictive value(27.2%) and high prevalence(24.5%). The FPG cutpoint which showed same prevalence with the criterion ot the 2hPG >11.1mmol/L(87 in 2251) was 7.4mmol/L (133mg/dL, 87 in 2251), The crude prevalence of diabetes and impaired fasting glucose by ADA criterion were 9.6% and 14.9%, respectively, where as the crude prevalence of diabetes and IGT were 9.4% and 11.5% by WHO criteria. The crude incidence of diabetes was 5.1% as defined by ADA criterion and 34.4% of subjects who showed impaired fasting glucose in 1993 converted to diabetes in 1995, whereas the incidence was 2.5% by WHO criteria and 13% of IGT subjeets converted to diabetes in 2 years. Conclusions: The adequate cutpoint for FPG seems to lie between 6.1mmol/L and 7.4mmol/L. The 1997 ADA criterion of the FPG > 7.0mmol/L produced similar prevalence and higher incidence than those obtained from 1985 WHO criteria and the former seems to be better to detect the risk group who may progress to diabetes.
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