Diabetes & Metabolism Journal

Volume 31(5); September 2007

Review

Non-drug Intervention in Lipid Management: Dietary Portfolio.: In Ju Kim; Korean Diabetes J. 2007;31(5):377-382. Published online September 1, 2007; DOI: https://doi.org/10.4093/jkda.2007.31.5.377

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Abstract PDF: Non-Pharmaceutical interventions are essential in lipid management. The NCEP recommends the following three tiered approach to lipid management: 1. Institution of therapeutic lifestyle changes (TLC); 2. Use of non-drug adjuncts, including viscous fibers and plant sterol/stanol products; and 3. Drug therapy when required to reach treatment goals. Even though non-drug approaches often receive minimal attention in clinical practice, the efficacy of non-drug therapies is not so small. Non-drug adjuncts are known to reduce LDL cholesterol as follows: 12.5% for 45 g of soy protein/d; 6% to 7% for 9 to 10 g of psyllium/d, with smaller reductions for other viscous fibers; 10% for 1 to 2 g of plant sterols/d and 1% for 10 g almonds/d. Recently, combining these foods in a single dietary portfolio decreased LDL cholesterol and CRP similarly to the extent which achieved by a usual dose of a statin. This dietary portfolio can be regarded as an effective non-drug approach to reduce the risk of cardiovascular disease.

Original Articles

Cytoprotective Effect by Antioxidant Activity of Quercetin in INS-1 Cell Line.: Min Jeong Kwon, Hye Sook Jung, Mi Kyung Kim, Seong Hoon Kang, Gwang Wook Seo, Jae Kwang Song, Tae Yeon Yoon, Min Kyeong Jeon, Tae Hwan Ha, Chang Shin Yoon, Mi Kyung Kim, Woo Je Lee, Jeong Hyun Noh, Soo Kyung Kwon, Dong Joon Kim, Kyung Soo Koh, Byung Doo Rhee, Kyung Ho Lim, Soon Hee Lee, Jeong Hyun Park; Korean Diabetes J. 2007;31(5):383-390. Published online September 1, 2007; DOI: https://doi.org/10.4093/jkda.2007.31.5.383

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Abstract PDF

BACKGROUND
Oxidative stress is induced under diabetic conditions and causes various forms of tissue damages in the patients with diabetes. Recently, pancreatic beta cells are regarded as a putative target of oxidative stress-induced tissue damage, and this seems to explain in part the progressive deterioration of beta cell function in type 2 diabetes. The aim of this study was to examine the potential of Quercetin (QE) to protect INS-1 cells from the H2O2-induced oxidative stress and the effects of QE on the glucose-stimulated insulin secretion in INS-1 cells. METHODS: To study the cell viability, cells were incubated with H2O2 and/or QE at the various concentrations. To confirm the protective effect by QE in response to H2O2, the levels of antioxidant enzymes were assessed by RT-PCR and Western blot, and glutathione peroxidase activities were quantified by spectrophotometrical method. Glucose-stimulated insulin secretion (GSIS) was measured by ELISA. RESULTS: Cell incubations were performed with 80 microM of H2O2 for 5 hours to induce 40 - 50% of cell death. QE gradually showed protective effect (IC50 = 50 microM) in dose-dependent manner. Superoxide dismutase (SOD) mRNA level in H2O2 + QE group was increased as compared to H2O2 group, but catalase did not changed. And the QE recruited glutathione peroxidase activity against H2O2-induced oxidative injuries in INS-1 cells. CONCLUSION: In conclusion, these findings suggest that QE might have protective effect on beta cells by ameliorating oxidative stress and preserving insulin secretory function.

Citations

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Anti-diabetic effects of Allium tuberosum rottler extracts and lactic acid bacteria fermented extracts in type 2 diabetic mice model
Bae Jin Kim, Seung Kyeung Jo, Yoo Seok Jeong, Hee Kyoung Jung
Korean Journal of Food Preservation.2015; 22(1): 134. CrossRef
Protective Effects of Sasa Borealis Leaves Extract on High Glucose-Induced Oxidative Stress in Human Umbilical Vein Endothelial Cells
Ji-Young Hwang, Ji-Sook Han
Journal of the Korean Society of Food Science and Nutrition.2010; 39(12): 1753. CrossRef

Therapeutic Efficacy of Combined Therapy with Once Daily Insulin Glargine and Once Daily Glimepiride in Korean Type 2 Diabetic Patients.: Ji Young Park, Hyo Jeong Kim, Bo Kyung Koo, Hyun Jin Kim, Gang Seo Pak, Kyung Ah Han, Kyung Wan Min, Eung Jin Kim; Korean Diabetes J. 2007;31(5):391-401. Published online September 1, 2007; DOI: https://doi.org/10.4093/jkda.2007.31.5.391

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Abstract PDF: BACKGROUND
Once daily injection and 24 hour lasting glucose lowering effect of insulin glargine had recently changed a perception about the early insulin treatment of type 2 diabetic patients. This study was performed to investigate therapeutic efficacy of combined therapy with insulin glargine and glimepiride in Korean type 2 diabetic patients, who had received oral hypoglycemic agents (OHA) or conventional insulin therapy. METHODS: Total of 192 patients who needed to change the previous therapy because of uncontrolled diabetes or hypoglycemia were included and followed for about 6 months. Two groups of prior treatment modality were analyzed; OHA group (n = 54, 28.1%), conventional insulin therapy group in combination with or without OHA group (n = 138, 71.9%). The primary end point was changes in HbA1c according to baseline characteristics such as prior treatment modality, HbA1C, c-peptide, duration of diabetes mellitus, body mass index and prior used conventional insulin doses. Secondary end point was the dose conversion ratio of insulin glargine to prior used insulin in patients who had one or two insulin therapy. We also evaluated the level of the patients' satisfaction on the glucose lowering effects and the convenience for use of device. RESULTS: The differences of HbA1c according to prior treatment groups were -0.78 +/- 1.76 % in OHA group and 0.07 +/- 1.44 % in conventional insulin group with or without OHA group. The HbA1c improved better when baseline HbA1c was higher than 9%, c-peptide was higher than 0.6 ng/mL, duration of diabetes was shorter than 15 years, BMI was lower than 30 kg/m2 and prior conventional insulin dose was less than 30 IU. However, those effects were attenuated in subjects having duration of diabetes longer than 16 years, BMI higher than 30 kg/m2 and prior insulin dose more than 40 IU. Dose conversion ratio of the insulin glargine to prior insulin was 0.78 +/- 0.30 and showed a tendency to increase in patients who have prior insulin dose more than 40 IU. The scores of the patients' subjective satisfaction on insulin glargine were all high, irrespective of the changes of HbA1c. CONCLUSIONS: Once daily injection of insulin glargine and oral ingestion of glimepiride can be recommended as one of starting insulin regimen for patients who are not adequately controlled by OHA alone or as once daily regimen for whom treated with one or two conventional insulin therapy.

Antibodies to GAD and ICA in Type 2 DM with Secondary Failure of Oral Hypoglycemic Therapy.: Jung Hyun Oh, Ji Sung Yoon, Kyu Chang Won, Hyoung Woo Lee; Korean Diabetes J. 2007;31(5):402-409. Published online September 1, 2007; DOI: https://doi.org/10.4093/jkda.2007.31.5.402

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Abstract PDF

BACKGROUND
Secondary failure of oral hypoglycemic agents is defined as that blood glucose is no longer controlled with sulfonylurea after a proven period of good glycemic control. There are many causes of secondary failure, including that drug problem, acute illnesses, inappropriate drug dosages, oxidative stress & glucose toxicity of beta-cell, etc. And many studies have suggested role of immunologic process such as islet cell antibody (ICA) and/or glutamic acid decarboxylase antibody (GADA) for the causes of secondary failure. So we evaluated the prevalence of ICA & GADA in type 2 diabetes with secondary failure of oral hypoglycemic agents and the pathogenesis of the secondary failure. METHODS: We studied 267 patients with type 2 diabetes. We regarded 84 patients who could not control HbA1c less than 8% after good glycemic control for at least 1 year as secondary failure group (group 1) and regarded the other 183 patients as group 2. We measured GADA in both group, and measured the prevalence of GADA and ICA in secondary failure group who were especially divided into obese group and nonobese group according to BMI and were divided into insulin deficiency group and noninsulin deficiency group according to fasting C-peptide level. RESULTS: The prevalence of GADA in all subjects was 4.1%, which was 9.5% in group 1 and 1.6% in group 2 (P < 0.05). Among 35 patients of the group 1 who could be checked ICA, the prevalence of GADA & ICA were 33% & 25% in insulin deficiency group and 4.3% & 0% in non-insulin deficiency group, respectively (P < 0.05). The prevalence of GADA & ICA were none in obese group and 33.3% & 20% in nonobese group, respectively (P < 0.05). The prevalence of GADA & ICA were 36.4% & 27.3% in nonobese and insulin deficiency, 4.2% & 0% in obese and non-insulin deficiency. CONCLUSION: We suggest that autoimmune mechanism is associated with increased risk for secondary failure of oral hypoglycemic agents in type 2 diabetes, so the measurement of GADA and ICA could help to predict the potential risk and insulin treatment.

Citations

Citations to this article as recorded by

Recent information on test utilization and intraindividual change in anti-glutamic acid decarboxylase antibody in Korea: a retrospective study
Rihwa Choi, Wonseo Park, Gayoung Chun, Jiwon Lee, Sang Gon Lee, Eun Hee Lee
BMJ Open Diabetes Research & Care.2022; 10(3): e002739. CrossRef
Latent Autoimmune Diabetes in Adults: Autoimmune Diabetes in Adults with Slowly Progressive β-cell Failure
Hannah Seok, Byung Wan Lee
Diabetes & Metabolism Journal.2012; 36(2): 116. CrossRef
Prevalence and Clinical Characteristics of Recently Diagnosed Type 2 Diabetes Patients with Positive Anti-Glutamic Acid Decarboxylase Antibody
Yul Hwangbo, Jin Taek Kim, Eun Ky Kim, Ah Reum Khang, Tae Jung Oh, Hak Chul Jang, Kyong Soo Park, Seong Yeon Kim, Hong Kyu Lee, Young Min Cho
Diabetes & Metabolism Journal.2012; 36(2): 136. CrossRef
Anti-GAD Antibody in Patients with Adult-Onset Diabetes in Korea
Eun-Gyoung Hong
Korean Diabetes Journal.2009; 33(1): 13. CrossRef
Chronic Complications in Adult Diabetic Patients with and without GAD Antibody
Jin Ook Chung, Dong Hyeok Cho, Dong Jin Chung, Min Young Chung
Korean Diabetes Journal.2009; 33(2): 124. CrossRef

Validation Studies

Transcription Factor Profile by Degenerate RT-PCR/SSCP: Application in 3T3-L1 Adipocyte Treated with TNF-alpha.: Yoo Lee Kim, Sang Hwa Lee, Young Kil Choi, Seo Yoon Chang, Yun Soo Kim, Soo Kyung Kim, Seok Won Park, Won Kun Park, Yong Wook Cho, Sang Jong Lee; Korean Diabetes J. 2007;31(5):410-420. Published online September 1, 2007; DOI: https://doi.org/10.4093/jkda.2007.31.5.410

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Abstract PDF: BACKGROUND
Several high-throughput gene analysis techniques - differential display PCR, suppression subtraction hybridization (SSH), serial analysis of gene expression (SAGE), and DNA microarray - have permitted transcriptome profiling to understand the molecular pathogenesis of multifactorial diseases. But these techniques are of no great utility regarding feasibility, reproducibility, cost, and the amount of material required for analysis. To establish more practical method for transcription factor transcriptome profiling, we combined degenerate reverse transcriptase-polymerase chain reaction (RT-PCR) and single strand conformational polymorphism (SSCP) technique. METHODS: We categorized 417 human/mouse transcription factor mRNA into 92 small groups according to homology with ClustalW method and established 92 degenerate RT-PCR including common motives of the 92 small groups with the software program of CODEHOP, Primer Premier, Amplify 1.2. Further analysis on the amplified PCR products was performed by SSCP. This system was applied for the evaluation of changes on transcription factor transcriptome of differentiated 3T3-L1 adipocyte treated with TNF-alpha. RESULTS: 82 groups and 52 groups showed amplification of PCR before and after TNF-alpha treatment respectively and 24 groups showed significant amplification difference after TNF-alpha treatment. After TNF-alpha treatment for 48 hours, mRNA expressions of group 7, 30, and 33 which include adipocyte related transcription factors such as CEBP-alpha, RXR-alpha, PPAR-gamma were downregulated and mRNA expression of group 8 including preadipocyte abundant CEBP-beta was upregulated. These results are largely concordant with the results analyzed by oligonucleotide microarray. Randomly selected single PCR bands of group 28 and 75 on agarose electrophoresis displayed additional multiple bands by SSCP and necessitated addition of this technique to degenerate RT-PCR for further analysis. CONCLUSION: It could be suggested that degenerate RT-PCR/SSCP is practical method and could be used as a screening test for transcriptome profiling of various disease states with further validation study.

Original Articles

The Association between Arterial Stiffness and Albuminuria in Type 2 Diabetes.: Seong Geun Lee, Yong Ki Kim, Seo Rin Kim, Yong Sung Ahn, Ji Hae Kwon, Yang Ho Kang, Suk Man Son, In Joo Kim, Ju Sung Kim; Korean Diabetes J. 2007;31(5):421-428. Published online September 1, 2007; DOI: https://doi.org/10.4093/jkda.2007.31.5.421

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Abstract PDF

BACKGROUND
Brachial ankle pulse wave velocity (BaPWV) and cardio ankle vascular index (CAVI), as indicators of arterial stiffness, are increased in type 2 diabetes. Albuminuria, as a cardiovascular risk factor in type 2 diabetes, can cause endothelial dysfunction and atherosclerosis, and these can increase arterial stiffness. So we investigated the hypothesis that increased albuminuria reflects increased BaPWV and CAVI in type 2 diabetes. METHODS: We retrospectively analyzed 106 patients (58 men and 48 women) with type 2 diabetes from March 2005 to September 2006. Urine albumin creatinine ratio (ACR) to evaluate urinary albumin excretion, BaPWV and CAVI were measured in all patients. RESULTS: All patients were divided 3 groups, normal group (ACR < 30 mg/g Cr., n = 31), microalbuminuria group(30 < or = ACR < or = 30 mg/g Cr., n = 42), proteinuria group(ACR > 300 mg/g Cr., n = 33). BaPWV and CAVI in microalbuminuria group and proteinuria group are faster than normal group. In bivariate correlation analysis, BaPWV was not associated with ACR, but CAVI was positively correlated to ACR (r = 0.285, P = 0.003). BaPWV was positively correlated to age, diabetes duration, body mass index, systolic blood pressure, diastolic pressure, pulse pressure and negatively correlated to glomerular filtration rate (GFR). CAVI was positively correlated to age, diabetes duration and negatively correlated to GFR. In multiple linear stepwise regression analysis, BaPWV was not associated with ACR, but ACR was independent predictor for CAVI (P = 0.002). CONCLUSION: In type 2 diabetes, albuminuria was independent predictor for indicators of arterial stiffness, especially CAVI.

Citations

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Associations Between Cardio-Ankle Vascular Index and Microvascular Complications in Type 2 Diabetes Mellitus Patients
Kwang Joon Kim, Byung-Wan Lee, Hyun-min Kim, Joo Youn Shin, Eun Seok Kang, Bong Soo Cha, Eun Jig Lee, Sung-Kil Lim, Hyun Chul Lee
Journal of Atherosclerosis and Thrombosis.2011; 18(4): 328. CrossRef

Prevalence of Diabetic Retinopathy in Diabetics Who are Positive for GAD Autoantibody.: Seon Joong Moon, Chan Hee Lee, Jun Sung Moon, Hee Jung Moon, Ji Eun Lee, Kyung Ah Chun, Ji Sung Yoon, Ihn Ho Cho, Kyu Chang Won, Hyoung Woo Lee; Korean Diabetes J. 2007;31(5):429-434. Published online September 1, 2007; DOI: https://doi.org/10.4093/jkda.2007.31.5.429

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Abstract PDF

BACKGROUND
Diabetic retinopathy is a leading cause of adult blindness. Some patients show early development and progression of diabetic retinopathy despite of apparently good glycemic control. This is suggesting the involvement of other contributing factors. Recent studies have shown that retinopathy and GAD autoantibody (GADA) show an inverse relationship immunologically. This study is designed to investigate the clinical manifestation of diabetes who are positive for GADA and the relationship between GADA and diabetic retinopathy. METHODS: Type 1 diabetic patients & LADA patients who had visited Yeungnam university Medical Center from 1988 to 2005 were involved. We reviewed the pathologic and laboratory records of these patients and investigated the development of diabetic microvascular complications. RESULTS: Compared with patients who had GADA negative diabetes, patients with GADA positive diabetes had lower prevalence of diabetic retinopathy (GADA negative subject: 25.8% vs. GADA positive subject: 9.6%, P < 0.05). CONCLUSION: We confirmed that diabetic retinopathy and GADA showed an inverse relationship. It seems quite probable that GADA may contribute to the prevention of retinopathy. Further research should be needed concerning the effect of GADA on diabetic retinopathy.

Citations

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Chronic Complications in Adult Diabetic Patients with and without GAD Antibody
Jin Ook Chung, Dong Hyeok Cho, Dong Jin Chung, Min Young Chung
Korean Diabetes Journal.2009; 33(2): 124. CrossRef

The Relationship of Family Support with Blood Glucose Control in Elderly Type 2 Diabetic Patients.: Eun Suk Kim, Seong Jin Lee, Ohk Hyun Ryu, Jee Youn Lee, Hyun Suk Yun, Moon Gi Choi; Korean Diabetes J. 2007;31(5):435-443. Published online September 1, 2007; DOI: https://doi.org/10.4093/jkda.2007.31.5.435

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Abstract PDF

BACKGROUND
With the extension of human life span, the prevalence of diabetes in elderly population is increasing. The glycemic control is also important in elderly diabetics because the life expectancy in elderly is steadily increased. In this study, we investigated the role of family support on glycemic control in elderly type diabetic patients. METHODS: This study was conducted with 126 type 2 diabetic patients over 60 years of age who were enrolled between March and December, 2005. The data for glycemic control, family characteristics, and family support were collected by structured questionnaire, personal interview, and medical record review. We used total supportive index scores to evaluate family support. We evaluated the relationship between family support and glycemic control. RESULTS: Fasting plasma glucose was positively correlated with duration of diabetes (r = 0.277, P = 0.003). Postprandial 2 hour plasma glucose was negatively correlated with monthly incomes (r = -0.357, P = 0.002), assessment support (r = -0.201, P = 0.029). Hemoglobin A1c was positively correlated with duration with diabetes (r = 0.294, P = 0.002) and insulin use (r = 0.259, P = 0.004), but it was negatively correlated with diabetic self-management education (r = -0.190, P = 0.036). Adjusted for age, sex, duration of diabetes, and monthly incomes, there were no significant associations between glycemic control and family support. CONCLUSION: In this study, there were no significant associations between glycemic control and family support. More large prospective studies will be followed to exactly evaluate the role of family support in diabetic patients.

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The role of psychological insulin resistance in diabetes self‐care management
Ancho Lim, Youngshin Song
Nursing Open.2020; 7(3): 887. CrossRef
A Predictive Model of Health Outcomes for Young People with Type 2 Diabetes
Sun Young Jung, Sook Ja Lee, Sun Hee Kim, Kyung Mi Jung
Asian Nursing Research.2015; 9(1): 73. CrossRef
Factors Influencing Self-Care Behaviors Related to Insulin Therapy in Elders with Diabetes Mellitus
Na-Yeong Sohn, Jin-Hyang Yang
Journal of Korean Academy of Fundamentals of Nursing.2013; 20(1): 27. CrossRef
Perception of social support by individuals with diabetes mellitus and foot ulcers
Ana Laura Galhardo Figueira, Lílian Cristiane Gomes Villas Boas, Maria Cristina Foss de Freitas, Milton César Foss, Ana Emilia Pace
Acta Paulista de Enfermagem.2012; 25(spe1): 20. CrossRef
The impact of family support on metabolic control in patients with type 2 diabetes
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Zdrowie Publiczne.2012; 122(3): 265. CrossRef
Effects of Low Glycemic Index Nutrition Education on the Blood Glucose Control in Patients with Type 2 Diabetes Mellitus
Mi-Ja Kim, Sunja Kwon, Sun Yung Ly
The Korean Journal of Nutrition.2010; 43(1): 46. CrossRef
Relationships of family support, diet therapy practice and blood glucose control in typeII diabetic patients
Jeong-Ok Yun, Ki-Nam Kim
Nutrition Research and Practice.2009; 3(2): 141. CrossRef

Case Report

A Case of Fulminant Type 1 Diabetes with Pulmonary Hypertension.: Do Hyeong Kim, Mi Kyoung Kim, Jun Hoon Jung, Na Rae Kim, Dong Hyeon Rho, Jong Sun Park, Chang Hun Lee, Yoon Sung Cho, Tae Woo Kim, Kyung Il Lee; Korean Diabetes J. 2007;31(5):444-450. Published online September 1, 2007; DOI: https://doi.org/10.4093/jkda.2007.31.5.444

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Abstract PDF

Some patients with idiopathic type 1 diabetes have a fulminant disorder characterized by the absence of insulitis and of diabetes-related antibodies, a remarkably abrupt onset and high serum pancreatic enzyme concentrations. This is referred to as fulminant type 1 diabetes. Cardiopulmonary disorders are rarely observed around the onset of fulminant type 1 diabetes. A 51-year-old woman suffering from nausea and vomiting was transferred to our hospital. Laboratory findings revealed high blood glucose level and the evidence of diabetic ketoacidosis, but the serum HbA1c was normal nevertheless. The low level of plasma C-peptide indicated the loss of endogenous insulin secretion. The patient satisfied the criteria for the diagnosis of fulminant type 1 diabetes. Electrocardiogram (ECG) revealed nonspecific ST-T-wave abnormalities. Transthoracic echocardiogram demonstrated that she had severe pulmonary hypertension and minimal pericardial effusion. In a week, pulmonary hypertension improved to mild degree without specific treatment. Acute myocarditis was suspected based upon flulike symptoms, nonspecific ST-T-wave abnormalities, minimal pericardial effusion and asymptomatic pulmonary hypertension. We considered it worthwhile reporting this case because fulminant type 1 diabetes with acute myocarditis has never been published yet.

Citations

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A Case of Fulminant Type 1 Diabetes Mellitus Complicated with Ischemic Ileitis
Se-Won Oh, Ju-Ri Park, Yun-Jeong Lee, Hee-Yeong Kim, Ji-A Seo, Nan-Hee Kim, Kyung-Mook Choi, Sei-Hyun Baik, Dong-Seop Choi, Sin-Gon Kim
Journal of Korean Endocrine Society.2009; 24(2): 116. CrossRef

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