- Complications
- Non-Alcoholic Fatty Liver Disease with Sarcopenia and Carotid Plaque Progression Risk in Patients with Type 2 Diabetes Mellitus
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Yongin Cho, Hye-Sun Park, Byung Wook Huh, Yong-ho Lee, Seong Ha Seo, Da Hea Seo, Seong Hee Ahn, Seongbin Hong, So Hun Kim
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Diabetes Metab J. 2023;47(2):232-241. Published online January 19, 2023
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DOI: https://doi.org/10.4093/dmj.2021.0355
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- Background
We aimed to evaluate whether non-alcoholic fatty liver disease (NAFLD) with or without sarcopenia is associated with progression of carotid atherosclerosis in patients with type 2 diabetes mellitus (T2DM).
Methods We investigated 852 T2DM patients who underwent abdominal ultrasonography, bioelectrical impedance analysis, and carotid artery ultrasonography at baseline and repeated carotid ultrasonography after 6 to 8 years. NAFLD was confirmed by abdominal ultrasonography, and sarcopenia was defined as a sex-specific skeletal muscle mass index (SMI) value <2 standard deviations below the mean for healthy young adults. SMI was calculated by dividing the sum of appendicular skeletal mass by body weight. We investigated the association between NAFLD with or without sarcopenia and the progression of carotid atherosclerosis.
Results Of the 852 patients, 333 (39.1%) were classified as NAFLD without sarcopenia, 66 (7.7%) were classified as sarcopenia without NAFLD, and 123 (14.4%) had NAFLD with sarcopenia at baseline. After 6 to 8 years, patients with both NAFLD and sarcopenia had a higher risk of atherosclerosis progression (adjusted odds ratio, 2.20; P<0.009) than controls without NAFLD and sarcopenia. When a subgroup analysis was performed on only patients with NAFLD, female sex, absence of central obesity, and non-obesity were significant factors related to increased risk of plaque progression risk in sarcopenic patients.
Conclusion NAFLD with sarcopenia was significantly associated with the progression of carotid atherosclerosis in T2DM patients.
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Alejandra Calderón, Cristina Arteaga, Elizabeth Quiroga, Lisbeth Reales, Marcelo Pilamunga, Fernanda Marizande, Alberto Bustillos Salud, Ciencia y Tecnología.2025;[Epub] CrossRef - Impact of steatotic liver disease subtypes, sarcopenia, and fibrosis on all-cause and cause-specific mortality: a 15.7-year cohort study
Yebei Liang, Xiaoqi Ye, Min Pan, Yijun Chen, Yeqing Yuan, Li Luo BMC Gastroenterology.2025;[Epub] CrossRef - Sarcopenia and non-alcoholic fatty liver disease - complex pathogenetic relationships
V. A. Akhmedov, V. S. Marinenko Experimental and Clinical Gastroenterology.2025; (9): 110. CrossRef - Metabolic-associated fatty liver disease and sarcopenia: A double whammy
Aditya Viswanath, Sherouk Fouda, Cornelius James Fernandez, Joseph M Pappachan World Journal of Hepatology.2024; 16(2): 152. CrossRef - Prevalence and outcome of sarcopenia in non-alcoholic fatty liver disease
Suprabhat Giri, Prajna Anirvan, Sumaswi Angadi, Ankita Singh, Anurag Lavekar World Journal of Gastrointestinal Pathophysiology.2024;[Epub] CrossRef - Association between non-alcoholic fatty liver disease and risk of sarcopenia: a systematic review and meta-analysis
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Sanshiro Nakao, Daiji Ngayama, Chiaki Nakaseko, Naomi Shimizu Journal of Chemotherapy.2024; : 1. CrossRef - Clinical Characteristics of Sarcopenia in Nonalcoholic Fatty Liver Disease: A Systemic Scoping Review
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Yu. G. Samoilova, M. V. Matveeva, E. A. Khoroshunova, D. V. Podchinenova, L. L. Maksimova, G. G. Gorbach, A. B. Trivozhenko, V. A. Avkhimenko Cardiovascular Therapy and Prevention.2023; 23(1): 3655. CrossRef
- Complications
- Advanced Liver Fibrosis Is Associated with Chronic Kidney Disease in Patients with Type 2 Diabetes Mellitus and Nonalcoholic Fatty Liver Disease
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Da Hea Seo, Young Ju Suh, Yongin Cho, Seong Hee Ahn, Seongha Seo, Seongbin Hong, Yong-ho Lee, Young Ju Choi, Eunjig Lee, So Hun Kim
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Diabetes Metab J. 2022;46(4):630-639. Published online January 26, 2022
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DOI: https://doi.org/10.4093/dmj.2021.0130
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- Background
Nonalcoholic fatty liver disease (NAFLD) is associated with chronic kidney disease (CKD). However, the causal relationship between NAFLD and CKD is uncertain, particularly in patients with type 2 diabetes mellitus (T2DM). We aimed to investigate the association between the presence and severity of NAFLD and incident CKD in patients with T2DM.
Methods In this longitudinal cohort study of patients with T2DM, 3,188 patients with preserved renal function were followed up for the occurrence of incident CKD. NAFLD was defined as the presence of hepatic steatosis on ultrasonography, without any other causes of chronic liver disease. Advanced liver fibrosis of NAFLD was defined as a fibrosis-4 index ≥2.67. CKD was defined as an estimated glomerular filtration rate <60 mL/min/1.73 m2.
Results At baseline, 1,729 (54.2%) patients had NAFLD, of whom 94 (5.4%) had advanced liver fibrosis. During the follow-up of 8.3±3.6 years, 472 (14.8%) patients developed incident CKD: 220 (15.1%) in the non-NAFLD group, 231 (14.1%) in the NAFLD without advanced fibrosis group and 28 (31.1%) in the NAFLD with advanced fibrosis group. There was no increased risk of incident CKD in the NAFLD group compared to the non-NAFLD group (P=0.435). However, among patients with NAFLD, advanced liver fibrosis was associated with an increased risk of CKD (adjusted hazard ratio, 1.75; 95% confidence interval, 1.15 to 2.66; P=0.009).
Conclusion Advanced liver fibrosis in patients with NAFLD is independently associated with an increased risk of incident CKD in patients with T2DM.
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Verena Damiani, Alessia Lamolinara, Ilaria Cicalini, Maria Concetta Cufaro, Francesco Del Pizzo, Federica Di Marco, Piero Del Boccio, Beatrice Dufrusine, Michael Hahne, Rossano Lattanzio, Damiana Pieragostino, Manuela Iezzi, Massimo Federici, Maria Cateri Molecular Metabolism.2023; 74: 101752. CrossRef - Utility of non-invasive liver fibrosis markers to predict the incidence of chronic kidney disease (CKD): A systematic review, meta-analysis, and meta-regression
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- Guideline/Fact Sheet
- Diabetes Fact Sheets in Korea, 2020: An Appraisal of Current Status
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Chan-Hee Jung, Jang Won Son, Shinae Kang, Won Jun Kim, Hun-Sung Kim, Hae Soon Kim, Mihae Seo, Hye-Jung Shin, Seong-Su Lee, Su Jin Jeong, Yongin Cho, Seung Jin Han, Hyang Mi Jang, Mira Rho, Shinbi Lee, Mihyun Koo, Been Yoo, Jung-Wha Moon, Hye Young Lee, Jae-Seung Yun, Sun Young Kim, Sung Rae Kim, In-Kyung Jeong, Ji-Oh Mok, Kun Ho Yoon
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Diabetes Metab J. 2021;45(1):1-10. Published online January 13, 2021
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DOI: https://doi.org/10.4093/dmj.2020.0254
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- Background
This study aimed to investigate the recent prevalence, management, and comorbidities of diabetes among Korean adults aged ≥30 years by analyzing nationally representative data.
Methods This study used data from the Korea National Health and Nutrition Examination Survey from 2016 to 2018, and the percentage and total number of people ≥30 years of age with diabetes and impaired fasting glucose (IFG) were estimated.
Results In 2018, 13.8% of Korean adults aged ≥30 years had diabetes, and adults aged ≥65 years showed a prevalence rate of 28%. The prevalence of IFG was 26.9% in adults aged ≥30 years. From 2016 to 2018, 35% of the subjects with diabetes were not aware of their condition. Regarding comorbidities, 53.2% and 61.3% were obese and hypertensive, respectively, and 72% had hypercholesterolemia as defined by low-density lipoprotein cholesterol (LDL-C) ≥100 mg/dL in people with diabetes. Of the subjects with diabetes, 43.7% had both hypertension and hypercholesterolemia. With regard to glycemic control, only 28.3% reached the target level of <6.5%. Moreover, only 11.5% of subjects with diabetes met all three targets of glycosylated hemoglobin, blood pressure, and LDL-C. The percentage of energy intake from carbohydrates was higher in diabetes patients than in those without diabetes, while that from protein and fat was lower in subjects with diabetes.
Conclusion The high prevalence and low control rate of diabetes and its comorbidities in Korean adults were confirmed. More stringent efforts are needed to improve the comprehensive management of diabetes to reduce diabetes-related morbidity and mortality.
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- Early Development of Bidirectional Associations between Sleep Disturbance and Diabetes
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Yongin Cho
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Diabetes Metab J. 2020;44(5):668-670. Published online October 21, 2020
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DOI: https://doi.org/10.4093/dmj.2020.0198
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J. Ildefonzo Arocha Rodulfo, Gestne Aure Fariñez, Fernando Carrera Clínica e Investigación en Arteriosclerosis.2024; 36(1): 38. CrossRef - Sleep and cardiometabolic risk. Narrative revision
J. Ildefonzo Arocha Rodulfo, Gestne Aure Fariñez, Fernando Carrera Clínica e Investigación en Arteriosclerosis (English Edition).2024; 36(1): 38. CrossRef - Sleep problems and their predictors in community-dwelling older adults with diabetes in India: Evidence from the Longitudinal Ageing Study in India
Vansh Maheshwari, Saurav Basu Sleep Medicine: X.2024; 7: 100108. CrossRef - Latent Profile Analysis of Sleep Quality in Pregnant Women With Gestational Diabetes Mellitus and Its Influencing Factors
Yanxia Chen, Hui Wang, Yiling Yang, Jiale Li, Tingyu Luo, Huixin Wei, Fengxiang Wei, Weiqiang Chen Western Journal of Nursing Research.2024; 46(12): 970. CrossRef - Understanding the relationship between sleep and quality of life in type 2 diabetes: A systematic review of the literature
Bróna Laverty, Sreelakshmi Puthezhath Jayanandan, Sinéad Smyth Journal of Health Psychology.2023; 28(8): 693. CrossRef - Impact of Retirement on Sleep Problems Among Older Workers and Their Partners
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- Corrigenda: Table Correction. Nonalcoholic Fatty Liver Disease in Diabetes. Part I: Epidemiology and Diagnosis
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Yong-ho Lee, Yongin Cho, Byung-Wan Lee, Cheol-Young Park, Dae Ho Lee, Bong-Soo Cha, Eun-Jung Rhee
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Diabetes Metab J. 2019;43(5):731-731. Published online October 24, 2019
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DOI: https://doi.org/10.4093/dmj.2019.0188
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Corrects: Diabetes Metab J 2019;43(1):31
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- Association of statins with nonalcoholic fatty liver disease in patients with diabetes
Raj Shah, Alexander Kong, Silvio De Melo, Moheb Boktor, Richard Henriquez, Amar Mandalia, Hrishikesh Samant, Carlos A. Alvarez, Ishak A. Mansi Journal of Investigative Medicine.2024; 72(6): 497. CrossRef - Comparing the Risk of Poor Outcomes Among Hepatitis C–Infected, Cured, and Never-Infected Controls
Varun Saxena, Weilu Wu, Sreepriya Balasubramanian, Nizar Mukhtar, Suk I. Seo, Joanna B. Ready, Brock A. MacDonald, Julie A. Schmittdiel Gastro Hep Advances.2024; 3(6): 871. CrossRef
- Clinical Diabetes & Therapeutics
- Effectiveness of Exercise Intervention in Reducing Body Weight and Glycosylated Hemoglobin Levels in Patients with Type 2 Diabetes Mellitus in Korea: A Systematic Review and Meta-Analysis
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Ji-Eun Jang, Yongin Cho, Byung Wan Lee, Ein-Soon Shin, Sun Hee Lee
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Diabetes Metab J. 2019;43(3):302-318. Published online November 19, 2018
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DOI: https://doi.org/10.4093/dmj.2018.0062
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- Background
This study aimed to assess the effectiveness of exercise intervention in reducing body weight and glycosylated hemoglobin (HbA1c) level in patients with type 2 diabetes mellitus (T2DM) in Korea. MethodsCochrane, PubMed, Embase, KoreaMed, KMbase, NDSL, KCI, RISS, and DBpia databases were used to search randomized controlled trials and controlled clinical trials that compared exercise with non-exercise intervention among patients with non-insulin-treated T2DM in Korea. The effectiveness of exercise intervention was estimated by the mean difference in body weight changes and HbA1c level. Weighted mean difference (WMD) with its corresponding 95% confidence interval (CI) was used as the effect size. The pooled mean differences of outcomes were calculated using a random-effects model. ResultsWe identified 7,692 studies through literature search and selected 23 articles (723 participants). Compared with the control group, exercise intervention (17 studies) was associated with a significant decline in HbA1c level (WMD, −0.58%; 95% CI, −0.89 to −0.27; I2=73%). Although no significant effectiveness on body weight was observed, eight aerobic training studies showed a significant reduction in body weight (WMD, −2.25 kg; 95% CI, −4.36 to −0.13; I2=17%) in the subgroup analysis. ConclusionExercise significantly improves glycemic control; however, it does not significantly reduce body weight. Aerobic training can be beneficial for patients with non-insulin-treated T2DM in Korea.
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Atchara Meenasantirak, Chalee Siripitakchai, Natthawut Suriya Health Promotion Journal of Australia.2025;[Epub] CrossRef - Surface electromyography for characterizing neuromuscular changes in diabetic peripheral neuropathy
I. Junquera-Godoy, J.L. Martinez-De-Juan, G. González Lorente, J.M. Carot-Sierra, J. Gomis-Tena, J. Saiz, R. López Mateu, G.C. Mas Penalva, S.Garcia Blasco, E. Boix Carreño, E. Soler Climent, G. Prats-Boluda Journal of Electromyography and Kinesiology.2025; 82: 102991. CrossRef - Effect of low-volume combined aerobic and resistance high-intensity interval training on vascular health in people with type 2 diabetes: a randomised controlled trial
Emily R. Cox, Trishan Gajanand, Shelley E. Keating, Matthew D. Hordern, Nicola W. Burton, Daniel J. Green, Joyce S. Ramos, Maximiano V. Ramos, Robert G. Fassett, Stephen V. Cox, Jeff S. Coombes, Tom G. Bailey European Journal of Applied Physiology.2024; 124(9): 2819. CrossRef - 2023 Clinical Practice Guidelines for Diabetes Management in Korea: Full Version Recommendation of the Korean Diabetes Association
Jun Sung Moon, Shinae Kang, Jong Han Choi, Kyung Ae Lee, Joon Ho Moon, Suk Chon, Dae Jung Kim, Hyun Jin Kim, Ji A Seo, Mee Kyoung Kim, Jeong Hyun Lim, Yoon Ju Song, Ye Seul Yang, Jae Hyeon Kim, You-Bin Lee, Junghyun Noh, Kyu Yeon Hur, Jong Suk Park, Sang Diabetes & Metabolism Journal.2024; 48(4): 546. CrossRef - Exercise as a Therapeutic Intervention for Chronic Disease Management: A Comprehensive Review
Maryam Fairag, Saif A Alzahrani, Naif Alshehri, Arjwan O Alamoudi, Yazeed Alkheriji, Omar A Alzahrani, Abdulrahman M Alomari, Yahya A Alzahrani, Shahad Mohammed Alghamdi, Amer Fayraq Cureus.2024;[Epub] CrossRef - The anti-inflammatory effects of aerobic exercise training in patients with type 2 diabetes: A systematic review and meta-analysis
Georgia Papagianni, Chrystalla Panayiotou, Michail Vardas, Nikolaos Balaskas, Constantinos Antonopoulos, Dimitrios Tachmatzidis, Triantafyllos Didangelos, Vaia Lambadiari, Nikolaos P.E. Kadoglou Cytokine.2023; 164: 156157. CrossRef - Glucose Control in Korean Patients with Type 2 Diabetes Mellitus according to Body Mass Index
Ye-lim Shin, Heesoh Yoo, Joo Young Hong, Jooeun Kim, Kyung-do Han, Kyu-Na Lee, Yang-Hyun Kim Journal of Obesity & Metabolic Syndrome.2023; 32(1): 55. CrossRef - Exercise therapy for diabetes mellitus
Chaiho Jeong, Tae-Seo Sohn Journal of the Korean Medical Association.2023; 66(7): 427. CrossRef - Effects of an evidence‐based nursing intervention on prevention of anxiety and depression in the postpartum period
Jun Meng, Junying Du, Xiaoli Diao, Yingxia Zou Stress and Health.2022; 38(3): 435. CrossRef - Effect of exercise intervention dosage on reducing visceral adipose tissue: a systematic review and network meta-analysis of randomized controlled trials
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Jingxuan Lian, Jianfang Fu Frontiers in Endocrinology.2021;[Epub] CrossRef - Exercise Training: The Holistic Approach in Cardiovascular Prevention
Francesco Giallauria, Teresa Strisciuglio, Gianluigi Cuomo, Anna Di Lorenzo, Andrea D’Angelo, Mario Volpicelli, Raffaele Izzo, Maria Virginia Manzi, Emanuele Barbato, Carmine Morisco High Blood Pressure & Cardiovascular Prevention.2021; 28(6): 561. CrossRef - Effect of chronic High Intensity Interval Training on glycosylated haemoglobin in people with type 2 diabetes: a meta-analysis
María Cristina Arrieta-Leandro, Jessenia Hernández-Elizondo, Judith Jiménez-Díaz Human Movement.2021; 24(1): 32. CrossRef - Non-Alcoholic Fatty Liver Disease in Patients with Type 2 Diabetes Mellitus: A Position Statement of the Fatty Liver Research Group of the Korean Diabetes Association
Byung-Wan Lee, Yong-ho Lee, Cheol-Young Park, Eun-Jung Rhee, Won-Young Lee, Nan-Hee Kim, Kyung Mook Choi, Keun-Gyu Park, Yeon-Kyung Choi, Bong-Soo Cha, Dae Ho Lee Diabetes & Metabolism Journal.2020; 44(3): 382. CrossRef - Beneficial effect of anti-diabetic drugs for nonalcoholic fatty liver disease
Kyung-Soo Kim, Byung-Wan Lee Clinical and Molecular Hepatology.2020; 26(4): 430. CrossRef - Factors Influencing Glycemic Control among Type 2 Diabetes Mellitus Patients: The Sixth Korea National Health and Nutrition Examination Survey (2013~2015)
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- Predictors of the Therapeutic Efficacy and Consideration of the Best Combination Therapy of Sodium-Glucose Co-transporter 2 Inhibitors
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Ji-Yeon Lee, Yongin Cho, Minyoung Lee, You Jin Kim, Yong-ho Lee, Byung-Wan Lee, Bong-Soo Cha, Eun Seok Kang
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Diabetes Metab J. 2019;43(2):158-173. Published online January 25, 2019
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DOI: https://doi.org/10.4093/dmj.2018.0057
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7,569
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- Background
We investigated the predictive markers for the therapeutic efficacy and the best combination of sodium-glucose co-transporter 2 (SGLT2) inhibitors (empagliflozin, dapagliflozin, and ipragliflozin) therapy in patients with type 2 diabetes mellitus (T2DM). MethodsA total of 804 patients with T2DM who had taken SGLT2 inhibitor as monotherapy or an add-on therapy were analyzed. Multivariate regression analyses were performed to identify the predictors of SGLT2 inhibitor response including the classes of baseline anti-diabetic medications. ResultsAfter adjusting for age, sex, baseline body mass index (BMI), diabetes duration, duration of SGLT2 inhibitor use, initial glycosylated hemoglobin (HbA1c) level, estimated glomerular filtration rate (eGFR), and other anti-diabetic agent usage, multivariate analysis revealed that shorter diabetes duration, higher initial HbA1c and eGFR were associated with better glycemic response. However, baseline BMI was inversely correlated with glycemic status; lean subjects with well-controlled diabetes and obese subjects with inadequately controlled diabetes received more benefit from SGLT2 inhibitor treatment. In addition, dipeptidyl peptidase 4 (DPP4) inhibitor use was related to a greater reduction in HbA1c in patients with higher baseline HbA1c ≥7%. Sulfonylurea users experienced a larger change from baseline HbA1c but the significance was lost after adjustment for covariates and metformin and thiazolidinedione use did not affect the glycemic outcome. ConclusionA better response to SGLT2 inhibitors is expected in Korean T2DM patients who have higher baseline HbA1c and eGFR with a shorter diabetes duration. Moreover, the add-on of an SGLT2 inhibitor to a DPP4 inhibitor is likely to show the greatest glycemic response.
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Kana N. Miyata, Chao-Sheng Lo, Shuiling Zhao, Min-Chun Liao, Yuchao Pang, Shiao-Ying Chang, Junzheng Peng, Matthias Kretzler, Janos G. Filep, Julie R. Ingelfinger, Shao-Ling Zhang, John S.D. Chan Clinical Science.2021; 135(7): 943. CrossRef - Sodium-Glucose Cotransporter-2 Inhibitor for Renal Function Preservation in Patients with Type 2 Diabetes Mellitus: A Korean Diabetes Association and Korean Society of Nephrology Consensus Statement
Tae Jung Oh, Ju-Young Moon, Kyu Yeon Hur, Seung Hyun Ko, Hyun Jung Kim, Taehee Kim, Dong Won Lee, Min Kyong Moon Diabetes & Metabolism Journal.2020; 44(4): 489. CrossRef - Differential indication for SGLT-2 inhibitors versus GLP-1 receptor agonists in patients with established atherosclerotic heart disease or at risk for congestive heart failure
Francesco Giorgino, Irene Caruso, Julia Moellmann, Michael Lehrke Metabolism.2020; 104: 154045. CrossRef - Clinical Predictors of the Hypoglycemic Effect of Sodium–Glucose Co-transporter-2 Inhibitors in Hyperuricemic Patients: A Retrospective Descriptive Observational Study
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- Nonalcoholic Fatty Liver Disease in Diabetes. Part I: Epidemiology and Diagnosis
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Yong-ho Lee, Yongin Cho, Byung-Wan Lee, Cheol-Young Park, Dae Ho Lee, Bong-Soo Cha, Eun-Jung Rhee
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Diabetes Metab J. 2019;43(1):31-45. Published online December 17, 2018
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DOI: https://doi.org/10.4093/dmj.2019.0011
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Correction in: Diabetes Metab J 2019;43(5):731
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Abstract
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Nonalcoholic fatty liver disease (NAFLD) and diabetes are common metabolic disorders whose prevalence rates are expected to rise worldwide, corresponding to aging and increasingly obese populations. Compared to the general population (around 25%), 50% to 70% of people with diabetes have NAFLD, and NAFLD severity (including fibrosis) tends to be worsened by the presence of diabetes. NAFLD is considered an emerging risk factor for type 2 diabetes mellitus and a contributor to the development of chronic diabetes-related complications. This reciprocal relationship demonstrates the importance of confirming suspected NAFLD in patients with diabetes. Due to the invasive nature of liver biopsy to assess NAFLD status, various alternative non-invasive modalities have been developed and validated. Here, we summarized the epidemiology of NAFLD in patients with diabetes and reviewed currently available imaging modalities and biomarker-based prediction models for their ability to detect liver steatosis and/or fibrosis.
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- The Effect of DPP-4 Inhibitors on Metabolic Parameters in Patients with Type 2 Diabetes
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Eun Yeong Choe, Yongin Cho, Younjeong Choi, Yujung Yun, Hye Jin Wang, Obin Kwon, Byung-Wan Lee, Chul Woo Ahn, Bong Soo Cha, Hyun Chul Lee, Eun Seok Kang
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Diabetes Metab J. 2014;38(3):211-219. Published online June 17, 2014
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DOI: https://doi.org/10.4093/dmj.2014.38.3.211
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- Background
We evaluated the effects of two dipeptidyl peptidase-4 (DPP-4) inhibitors, sitagliptin and vildagliptin, on metabolic parameters in patients with type 2 diabetes mellitus. MethodsA total of 170 type 2 diabetes patients treated with sitagliptin or vildagliptin for more than 24 weeks were selected. The patients were separated into two groups, sitagliptin (100 mg once daily, n=93) and vildagliptin (50 mg twice daily, n=77). We compared the effect of each DPP-4 inhibitor on metabolic parameters, including the fasting plasma glucose (FPG), postprandial glucose (PPG), glycated hemoglobin (HbA1c), and glycated albumin (GA) levels, and lipid parameters at baseline and after 24 weeks of treatment. ResultsThe HbA1c, FPG, and GA levels were similar between the two groups at baseline, but the sitagliptin group displayed a higher PPG level (P=0.03). After 24 weeks of treatment, all of the glucose-related parameters were significantly decreased in both groups (P=0.001). The levels of total cholesterol and triglycerides were only reduced in the vildagliptin group (P=0.001), although the sitagliptin group received a larger quantity of statins than the vildagliptin group (P=0.002).The mean change in the glucose- and lipid-related parameters after 24 weeks of treatment were not significantly different between the two groups (P=not significant). Neither sitagliptin nor vildagliptin treatment was associated with a reduction in the high sensitive C-reactive protein level (P=0.714). ConclusionVildagliptin and sitagliptin exert a similar effect on metabolic parameters, but vildagliptin exerts a more potent beneficial effect on lipid parameters.
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- Glycemic Effectiveness of Metformin-Based Dual-Combination Therapies with Sulphonylurea, Pioglitazone, or DPP4-Inhibitor in Drug-Naïve Korean Type 2 Diabetic Patients
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Young Ki Lee, Sun Ok Song, Kwang Joon Kim, Yongin Cho, Younjeong Choi, Yujung Yun, Byung-Wan Lee, Eun-Seok Kang, Bong Soo Cha, Hyun Chul Lee
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Diabetes Metab J. 2013;37(6):465-474. Published online December 12, 2013
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DOI: https://doi.org/10.4093/dmj.2013.37.6.465
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7,039
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- Background
This study compared the glycemic effectiveness of three metformin-based dual therapies according to baseline hemoglobin A1c (HbA1c) to evaluate the appropriateness of the guideline enforced by the National Health Insurance Corporation of Korea for initial medication of type 2 diabetes (T2D). MethodsThis prospective observational study was conducted across 24 weeks for drug-naïve Korean T2D patients with HbA1c greater than 7.5%. Subjects were first divided into three groups based on the agent combined with metformin (group 1, gliclazide-modified release or glimepiride; group 2, pioglitazone; group 3, sitagliptin). Subjects were also classified into three categories according to baseline HbA1c (category I, 7.5%≤HbA1c<9.0%; category II, 9.0%≤HbA1c<11.0%; category III, 11.0%≤HbA1c). ResultsAmong 116 subjects, 99 subjects completed the study, with 88 subjects maintaining the initial medication. While each of the metformin-based dual therapies showed a significant decrease in HbA1c (group 1, 8.9% to 6.4%; group 2, 9.0% to 6.6%; group 3, 9.3% to 6.3%; P<0.001 for each), there was no significant difference in the magnitude of HbA1c change among the groups. While the three HbA1c categories showed significantly different baseline HbA1c levels (8.2% vs. 9.9% vs. 11.9%; P<0.001), endpoint HbA1c was not different (6.4% vs. 6.6% vs. 6.0%; P=0.051). ConclusionThe three dual therapies using a combination of metformin and either sulfonylurea, pioglitazone, or sitagliptin showed similar glycemic effectiveness among drug-naïve Korean T2D patients. In addition, these regimens were similarly effective across a wide range of baseline HbA1c levels.
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