Diabetes is an increasing global health problem worldwide. Diabetes and its complications have become a major cause of morbidity and mortality in Korea. The prevalence of diabetes in Korea has increased six- to seven-fold from 1.5% to 9.9% in the past 40 years. The prevalence of impaired fasting glucose also increased to about 20% in 2009. The International Diabetes Federation has estimated that the prevalence of diabetes will rise to 11.4% in 2030. Possible risk factors for diabetes in Korea are age, male gender, obesity, prediabetes, gestational diabetes, smoking, decreased physical activity, and short sleep duration. With increasing obesity, especially in childhood, and improved longevity, the prevalence of diabetes is expected to dramatically increase more than previously estimated. Therefore, public efforts to introduce healthy lifestyle changes and diabetic prevention programs are necessary to reduce the global epidemic of diabetes.

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Glycosphingolipids (GSLs) are present in all mammalian cell plasma membranes and intracellular membrane structures. They are especially concentrated in plasma membrane lipid domains that are specialized for cell signaling. Plasma membranes have typical structures called rafts and caveola domain structures, with large amounts of sphingolipids, cholesterol, and sphingomyelin. GSLs are usually observed in many organs ubiquitously. However, GSLs, including over 400 derivatives, participate in diverse cellular functions. Several studies indicate that GSLs might have an effect on signal transduction related to insulin receptors and epidermal growth factor receptors. GSLs may modulate immune responses by transmitting signals from the exterior to the interior of the cell. Guillain-Barré syndrome is one of the autoimmune disorders characterized by symmetrical weakness in the muscles of the legs. The targets of the immune response are thought to be gangliosides, which are one group of GSLs. Other GSLs may serve as second messengers in several signaling pathways that are important to cell survival or programmed cell death. In the search for clear evidence that GSLs may play critical roles in various biological functions, many researchers have made genetically engineered mice. Before the era of gene manipulation, spontaneous animal models or chemical-induced disease models were used.

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Several polymers were used to delivery genes to diabetic animals. Polyaminobutyl glycolic acid was utilized to deliver IL-10 plasmid DNA to prevent autoimmune insulitis of non-obese diabetic (NOD) mouse. Polyethylene glycol grafted polylysine was combined with antisense glutamic acid decarboxylase (GAD) MRNA to represent GAD autoantigene expression. GLP1 and TSTA (SP-EX4) were delivered by bioreducible polymer to stop diabetic progression. Fas siRNA delivery was carried out to treat diabetic NOD mice animal.

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With a developing worldwide epidemic of diabetes mellitus, the renal complications associated with diabetes have become a serious health concern. Primary therapy for treating diabetic nephropathy is a multifactorial process. Peroxisome proliferator-activated receptor alpha (PPARα) agonists have been used primarily in clinical practice for the treatment of dyslipidemia and insulin resistance. Given that PPARα expression and regulation of metabolic pathways are involved in oxidative stress, inflammation, blood pressure regulation, and the renin-angiotensin aldosterone system, PPARα likely influences the development and pathogenesis of diabetic nephropathy via indirect effects on glucose and lipid homeostasis and also by direct action on the kidneys. These findings suggest that PPARα may become an important therapeutic target for treating diabetic renal complications.

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  International Journal of Clinical Medicine.2015; 06(09): 672.     CrossRef
• Short‐ and long‐term effect of sitagliptin after near normalization of glycemic control with insulin in poorly controlled Japanese type 2 diabetic patients
  Keiko Fujisawa, Tetsuyuki Yasuda, Hideaki Kaneto, Naoto Katakami, Mayumi Tsuji, Fumiyo Kubo, Shugo Sasaki, Kazuyuki Miyashita, Toyoko Naka, Ryuuichi Kasami, Akio Kuroda, Munehide Matsuhisa, Iichiro Shimomura
  Journal of Diabetes Investigation.2014; 5(5): 548.     CrossRef
• Efficacy and safety of vildagliptin, Saxagliptin or Sitagliptin as add-on therapy in Chinese patients with type 2 diabetes inadequately controlled with dual combination of traditional oral hypoglycemic agents
  Chun-Jun Li, Xiao-Juan Liu, Lian Bai, Qian Yu, Qiu-Mei Zhang, Pei Yu, De-Min Yu
  Diabetology & Metabolic Syndrome.2014;[Epub]     CrossRef
• Tolerability, effectiveness and predictive parameters for the therapeutic usefulness of exenatide in obese, Korean patients with type 2 diabetes
  Sun Ok Song, Kwang Joon Kim, Byung‐Wan Lee, Eun Seok Kang, Bong Soo Cha, Hyun Chul Lee
  Journal of Diabetes Investigation.2014; 5(5): 554.     CrossRef
• Efficacy of vildagliptin on glucose fluctuation in Japanese type 2 diabetic patients with ongoing sulfonylurea based oral glycemic agent therapy
  Keiji Yoshioka, Haruhiko Isotani, Shin-ichiro Ohashi, Minoru Imamura
  Diabetes & Metabolic Syndrome: Clinical Research & Reviews.2013; 7(1): 32.     CrossRef
• Glimepiride Strongly Enhances the Glucose-Lowering Effect in Triple Oral Antidiabetes Therapy with Sitagliptin and Metformin for Japanese Patients with Type 2 Diabetes Mellitus
  Keiko Arai, Hajime Maeda, Sin-ichiro Sirabe, Ritsuko Yamamoto, Mikio Yamauchi, Tetsuyuki Hirao, Setsuko Hirao, Koichi Hirao
  Diabetes Technology & Therapeutics.2013; 15(4): 335.     CrossRef
• Efficacy of sitagliptin on blood glucose fluctuation in Japanese type 2 diabetic patients with basal-supported oral therapy
  Mitsuyoshi Takahara, Toshihiko Shiraiwa, Hideaki Kaneto, Naoto Katakami, Taka-aki Matsuoka, Iichiro Shimomura
  Endocrine Journal.2012; 59(12): 1131.     CrossRef