Ye Seul Yang, Hack-Lyoung Kim, Sang-Hyun Kim, Min Kyong Moon, on Behalf of Committee of Clinical Practice Guideline, Korean Diabetes Association and Clinical Practice Guideline Committee, Korean Society of Lipid and Atherosclerosis
Diabetes Metab J. 2023;47(1):1-9. Published online January 20, 2023
Dyslipidemia in patients with diabetes is an important treatment target as a modifiable risk factor for cardiovascular disease (CVD). Although the primary treatment goal for dyslipidemia is to control low-density lipoprotein cholesterol (LDL-C), achieving this goal remains suboptimal according to recent studies. It is important to set the target goal for LDL-C control based on an accurate risk assessment for CVD. Here, we summarize the latest evidence on lipid management in patients with diabetes and present a consensus of the Korean Diabetes Association and Korean Society of Lipid and Atherosclerosis on the treatment goals of LDL-C according to the duration of diabetes, presence of CVD, target organ damage, or major cardiovascular risk factors. In patients with type 2 diabetes mellitus (T2DM) and CVD, an LDL-C goal of <55 mg/dL and a reduction in LDL-C level by 50% or more from the baseline is recommended. For the primary prevention of CVD in patients with T2DM with a duration of diabetes ≥10 years, major cardiovascular risk factors, or target organ damage, an LDL-C goal of <70 mg/dL is recommended. In patients with T2DM with a duration of diabetes <10 years and no major cardiovascular risk factors, an LDL-C goal of <100 mg/dL is recommended.
Citations
Citations to this article as recorded by
Associations of omega-3 fatty acids vs. fenofibrate with adverse cardiovascular outcomes in people with metabolic syndrome: propensity matched cohort study Nam Hoon Kim, Ji Yoon Kim, Jimi Choi, Sin Gon Kim European Heart Journal - Cardiovascular Pharmacotherapy.2024; 10(2): 118. CrossRef
Clinical Characteristics of Patients With Statin Discontinuation in Korea: A Nationwide Population-Based Study Kyung-Soo Kim, Sangmo Hong, Kyungdo Han, Cheol-Young Park Journal of Lipid and Atherosclerosis.2024; 13(1): 41. CrossRef
Role of Fenofibrate Use in Dyslipidemia and Related Comorbidities in the Asian Population: A Narrative Review Chaicharn Deerochanawong, Sin Gon Kim, Yu-Cheng Chang Diabetes & Metabolism Journal.2024; 48(2): 184. CrossRef
Fenofibrate’s impact on cardiovascular risk in patients with diabetes: a nationwide propensity-score matched cohort study Sangmo Hong, Kyung-Soo Kim, Kyungdo Han, Cheol-Young Park Cardiovascular Diabetology.2024;[Epub] CrossRef
The mediating effect of TyG and its derived indices in the association between OSAHS and atherosclerosis in patients with T2DM Ling Ding, Xiaohong Jiang Sleep and Breathing.2024; 28(6): 2469. CrossRef
Fenofibrate to prevent amputation and reduce vascular complications in patients with diabetes: FENO-PREVENT Eu Jeong Ku, Bongseong Kim, Kyungdo Han, Seung-Hwan Lee, Hyuk-Sang Kwon Cardiovascular Diabetology.2024;[Epub] CrossRef
Dyslipidemia Fact Sheet in South Korea, 2022 Eun-Sun Jin, Jee-Seon Shim, Sung Eun Kim, Jae Hyun Bae, Shinae Kang, Jong Chul Won, Min-Jeong Shin, Heung Yong Jin, Jenny Moon, Hokyou Lee, Hyeon Chang Kim, In-Kyung Jeong Diabetes & Metabolism Journal.2023; 47(5): 632. CrossRef
2023 Clinical Practice Guidelines for Diabetes Min Kyong Moon The Journal of Korean Diabetes.2023; 24(3): 120. CrossRef
2023 Clinical Practice Guidelines for Diabetes Mellitus of the Korean Diabetes Association Jong Han Choi, Kyung Ae Lee, Joon Ho Moon, Suk Chon, Dae Jung Kim, Hyun Jin Kim, Nan Hee Kim, Ji A Seo, Mee Kyoung Kim, Jeong Hyun Lim, YoonJu Song, Ye Seul Yang, Jae Hyeon Kim, You-Bin Lee, Junghyun Noh, Kyu Yeon Hur, Jong Suk Park, Sang Youl Rhee, Hae J Diabetes & Metabolism Journal.2023; 47(5): 575. CrossRef
Management of Dyslipidemia in Patients with Diabetes Mellitus Kyung Ae Lee The Journal of Korean Diabetes.2023; 24(3): 111. CrossRef
2023 Clinical Practice Guidelines for Diabetes: Management of Cardiovascular Risk Factors Ye Seul Yang The Journal of Korean Diabetes.2023; 24(3): 135. CrossRef
Dyslipidemia Fact Sheet in South Korea, 2022 Eun-Sun Jin, Jee-Seon Shim, Sung Eun Kim, Jae Hyun Bae, Shinae Kang, Jong Chul Won, Min-Jeong Shin, Heung Yong Jin, Jenny Moon, Hokyou Lee, Hyeon Chang Kim, In-Kyung Jeong Journal of Lipid and Atherosclerosis.2023; 12(3): 237. CrossRef
Kyu-Sun Lee, Junghyun Noh, Seong-Mi Park, Kyung Mook Choi, Seok-Min Kang, Kyu-Chang Won, Hyun-Jai Cho, Min Kyong Moon, The Committee of Clinical Practice Guidelines, Korean Diabetes Association and Committee of Clinical Practice Guidelines, Korean Society of Heart Failure
Diabetes Metab J. 2023;47(1):10-26. Published online January 26, 2023
Diabetes mellitus is a major risk factor for the development of heart failure. Furthermore, the prognosis of heart failure is worse in patients with diabetes mellitus than in those without it. Therefore, early diagnosis and proper management of heart failure in patients with diabetes mellitus are important. This review discusses the current criteria for diagnosis and screening tools for heart failure and the currently recommended pharmacological therapies for heart failure. We also highlight the effects of anti-diabetic medications on heart failure.
Citations
Citations to this article as recorded by
A Multicenter, Randomized, Open-Label Study to Compare the Effects of Gemigliptin Add-on or Escalation of Metformin Dose on Glycemic Control and Safety in Patients with Inadequately Controlled Type 2 Diabetes Mellitus Treated with Metformin and SGLT-2 Inh Hae Jin Kim, Jung Hyun Noh, Min Kyong Moon, Sung Hee Choi, Seung-Hyun Ko, Eun-Jung Rhee, Kyu Yeon Hur, In-Kyung Jeong, Mark Yorek Journal of Diabetes Research.2024; 2024: 1. CrossRef
Epicardial Adipose Tissue and Heart Failure, Friend or Foe? Dong-Hyuk Cho, Seong-Mi Park Diabetes & Metabolism Journal.2024; 48(3): 373. CrossRef
Adiposity modifies the association between heart failure risk and glucose metabolic disorder in older individuals: a community-based prospective cohort study Liming Hou, Xin Wang, Peilin Li, Hua Zhang, Yanli Yao, Zhendong Liu, Juan Wang, Weike Liu Cardiovascular Diabetology.2024;[Epub] CrossRef
Paper-based colorimetric microfluidic device for visual detection of glucose coupling different-shaped gold nanostructures with cerium oxide nanozyme Fareeha Arshad, Koo Pey Ting, Siti Nurul Azian Zakaria, Noor Faizah Mohd-Naim, Ying Woan Soon, Minhaz Uddin Ahmed Applied Materials Today.2024; 41: 102451. CrossRef
Comparison of the effects of gemigliptin versus glimepiride on cardiac function in patients with type 2 diabetes uncontrolled with metformin: The gemi‐heart study Seung Min Chung, Jun Sung Moon, Jun Hwa Hong, In‐Chang Hwang, Soo Lim Diabetes, Obesity and Metabolism.2023; 25(8): 2181. CrossRef
Optimization of guideline-directed medical treatment for heart failure patients with reduced ejection fraction Minjung Bak, Jin-Oh Choi The Korean Journal of Internal Medicine.2023; 38(5): 595. CrossRef
Continuous glucose monitoring (CGM) technology has evolved over the past decade with the integration of various devices including insulin pumps, connected insulin pens (CIPs), automated insulin delivery (AID) systems, and virtual platforms. CGM has shown consistent benefits in glycemic outcomes in type 1 diabetes mellitus (T1DM) and type 2 diabetes mellitus (T2DM) treated with insulin. Moreover, the combined effect of CGM and education have been shown to improve glycemic outcomes more than CGM alone. Now a CIP is the expected future technology that does not need to be worn all day like insulin pumps and helps to calculate insulin doses with a built-in bolus calculator. Although only a few clinical trials have assessed the effectiveness of CIPs, they consistently show benefits in glycemic outcomes by reducing missed doses of insulin and improving problematic adherence. AID systems and virtual platforms made it possible to achieve target glycosylated hemoglobin in diabetes while minimizing hypoglycemia, which has always been challenging in T1DM. Now fully automatic AID systems and tools for diabetes decisions based on artificial intelligence are in development. These advances in technology could reduce the burden associated with insulin treatment for diabetes.
Citations
Citations to this article as recorded by
Inter-temporal dynamic joint learning model considering intra- and inter-day mutable correlations for blood glucose level prediction Shuang Wen, Hongru Li, Yinghua Yang Biomedical Signal Processing and Control.2025; 101: 107204. CrossRef
Recent advances in artificial intelligence-assisted endocrinology and diabetes Ioannis T. Oikonomakos, Ranjit M. Anjana, Viswanathan Mohan, Charlotte Steenblock, Stefan R. Bornstein Exploration of Endocrine and Metabolic Disease.2024; 1(1): 16. CrossRef
Accuracy and Safety of the 15-Day CareSens Air Continuous Glucose Monitoring System Kyung-Soo Kim, Seung-Hwan Lee, Won Sang Yoo, Cheol-Young Park Diabetes Technology & Therapeutics.2024; 26(4): 222. CrossRef
Real-World Continuous Glucose Monitoring Data from a Population with Type 1 Diabetes in South Korea: Nationwide Single-System Analysis Ji Yoon Kim, Sang-Man Jin, Sarah B. Andrade, Boyang Chen, Jae Hyeon Kim Diabetes Technology & Therapeutics.2024; 26(6): 394. CrossRef
Recent advances in the precision control strategy of artificial pancreas Wuyi Ming, Xudong Guo, Guojun Zhang, Yinxia Liu, Yongxin Wang, Hongmei Zhang, Haofang Liang, Yuan Yang Medical & Biological Engineering & Computing.2024; 62(6): 1615. CrossRef
Digital Health in Diabetes and Cardiovascular Disease Dorothy Avoke, Abdallah Elshafeey, Robert Weinstein, Chang H. Kim, Seth S. Martin Endocrine Research.2024; 49(3): 124. CrossRef
Continuous glucose monitoring with structured education in adults with type 2 diabetes managed by multiple daily insulin injections: a multicentre randomised controlled trial Ji Yoon Kim, Sang-Man Jin, Kang Hee Sim, Bo-Yeon Kim, Jae Hyoung Cho, Jun Sung Moon, Soo Lim, Eun Seok Kang, Cheol-Young Park, Sin Gon Kim, Jae Hyeon Kim Diabetologia.2024; 67(7): 1223. CrossRef
Smart solutions in hypertension diagnosis and management: a deep dive into artificial intelligence and modern wearables for blood pressure monitoring Anubhuti Juyal, Shradha Bisht, Mamta F. Singh Blood Pressure Monitoring.2024; 29(5): 260. CrossRef
Emerging trends in functional molecularly imprinted polymers for electrochemical detection of biomarkers Sanjida Yeasmin, Li-Jing Cheng Biomicrofluidics.2024;[Epub] CrossRef
Continuous glucose monitoring in pregnant women with pregestational type 2 diabetes: a narrative review Sylvia Ye, Ibrahim Shahid, Christopher J Yates, Dev Kevat, I-Lynn Lee Obstetric Medicine.2024; 17(4): 194. CrossRef
Advancements in nanohybrid material-based acetone gas sensors relevant to diabetes diagnosis: A comprehensive review Arpit Verma, Deepankar Yadav, Subramanian Natesan, Monu Gupta, Bal Chandra Yadav, Yogendra Kumar Mishra Microchemical Journal.2024; 201: 110713. CrossRef
Current treatment options of diabetes mellitus type 1 in pediatric population Petr Polák, Renata Pomahačová, Karel Fiklík, Petra Paterová, Josef Sýkora Pediatrie pro praxi.2024; 25(3): 161. CrossRef
Efectividad de un sistema híbrido de circuito cerrado en pacientes con diabetes tipo 1 durante el ejercicio físico: un estudio descriptivo en la vida real Ruben Martin-Payo, Maria del Mar Fernandez-Alvarez, Rebeca García-García, Ángela Pérez-Varela, Shelini Surendran, Isolina Riaño-Galán Anales de Pediatría.2024; 101(3): 183. CrossRef
Effectiveness of a hybrid closed-loop system for children and adolescents with type 1 diabetes during physical exercise: A cross-sectional study in real life Ruben Martin-Payo, Maria del Mar Fernandez-Alvarez, Rebeca García-García, Ángela Pérez-Varela, Shelini Surendran, Isolina Riaño-Galán Anales de Pediatría (English Edition).2024; 101(3): 183. CrossRef
Real-time continuous glucose monitoring vs. self-monitoring of blood glucose: cost-utility in South Korean type 2 diabetes patients on intensive insulin Ji Yoon Kim, Sabrina Ilham, Hamza Alshannaq, Richard F. Pollock, Waqas Ahmed, Gregory J. Norman, Sang-Man Jin, Jae Hyeon Kim Journal of Medical Economics.2024; 27(1): 1245. CrossRef
Impact of missed insulin doses on glycaemic parameters in people with diabetes using smart insulin pens Malavika Varma, David J T Campbell Evidence Based Nursing.2024; : ebnurs-2024-104109. CrossRef
Clinical Trial Protocol for Porcine Islet Xenotransplantation in South Korea Byung-Joon Kim, Jun-Seop Shin, Byoung-Hoon Min, Jong-Min Kim, Chung-Gyu Park, Hee-Jung Kang, Eung Soo Hwang, Won-Woo Lee, Jung-Sik Kim, Hyun Je Kim, Iov Kwon, Jae Sung Kim, Geun Soo Kim, Joonho Moon, Du Yeon Shin, Bumrae Cho, Heung-Mo Yang, Sung Joo Kim, Diabetes & Metabolism Journal.2024; 48(6): 1160. CrossRef
Long-Term Benefits of Continuous Glucose Monitoring Combined with Insulin Pump Therapy Rukhsana Zulfiqar, Komal Abbas, Saeeda Khan, Kanwal Fatima, Adnan Manzoor, Muhammad Awais Indus Journal of Bioscience Research.2024; 2(2): 785. CrossRef
Glycemic Outcomes During Early Use of the MiniMed™ 780G Advanced Hybrid Closed-Loop System with Guardian™ 4 Sensor Toni L. Cordero, Zheng Dai, Arcelia Arrieta, Fang Niu, Melissa Vella, John Shin, Andrew S. Rhinehart, Jennifer McVean, Scott W. Lee, Robert H. Slover, Gregory P. Forlenza, Dorothy I. Shulman, Rodica Pop-Busui, James R. Thrasher, Mark S. Kipnes, Mark P. Ch Diabetes Technology & Therapeutics.2023; 25(9): 652. CrossRef
Navigating the Seas of Glycemic Control: The Role of Continuous Glucose Monitoring in Type 1 Diabetes Mellitus Jun Sung Moon Diabetes & Metabolism Journal.2023; 47(3): 345. CrossRef
APSec1.0: Innovative Security Protocol Design with Formal Security Analysis for the Artificial Pancreas System Jiyoon Kim, Jongmin Oh, Daehyeon Son, Hoseok Kwon, Philip Virgil Astillo, Ilsun You Sensors.2023; 23(12): 5501. CrossRef
Advances and Development of Electronic Neural Interfaces Xue Jiaxiang, Liu Zhixin Journal of Computing and Natural Science.2023; : 147. CrossRef
Continuous Glucose Monitoring (CGM) and Metabolic Control in a Cohort of Patients with Type 1 Diabetes and Coeliac Disease Flavia Amaro, Maria Alessandra Saltarelli, Marina Primavera, Marina Cerruto, Stefano Tumini Endocrines.2023; 4(3): 595. CrossRef
Comparison of Glycemia Risk Index with Time in Range for Assessing Glycemic Quality Ji Yoon Kim, Jee Hee Yoo, Jae Hyeon Kim Diabetes Technology & Therapeutics.2023; 25(12): 883. CrossRef
The Benefits Of Continuous Glucose Monitoring In Pregnancy Jee Hee Yoo, Jae Hyeon Kim Endocrinology and Metabolism.2023; 38(5): 472. CrossRef
The Growing Challenge of Diabetes Management in an Aging Society Seung-Hwan Lee Diabetes & Metabolism Journal.2023; 47(5): 630. CrossRef
An Observational Pilot Study of a Tailored Environmental Monitoring and Alert System for Improved Management of Chronic Respiratory Diseases Mohammed Alotaibi, Fady Alnajjar, Badr A Alsayed, Tareq Alhmiedat, Ashraf M Marei, Anas Bushnag, Luqman Ali Journal of Multidisciplinary Healthcare.2023; Volume 16: 3799. CrossRef
Smart Insulin Pen: Managing Insulin Therapy for People with Diabetes in the Digital Era Jee Hee Yoo, Jae Hyeon Kim The Journal of Korean Diabetes.2023; 24(4): 190. CrossRef
Min Kyong Moon, Junghyun Noh, Eun-Jung Rhee, Sang Hyun Park, Hyeon Chang Kim, Byung Jin Kim, Hae Jin Kim, Seonghoon Choi, Jin Oh Na, Young Youl Hyun, Bum Joon Kim, Kyung-Do Han, In-Kyung Jeong, on Behalf of the Committee of Practice Guideline of Korean Lipid and Atheroscelerosis
Diabetes Metab J. 2023;47(1):45-58. Published online January 26, 2023
Background There are no clear data to support the cardiovascular (CV) risk categories and low-density lipoprotein cholesterol (LDL-C) treatment goals in Korean people with type 2 diabetes mellitus (T2DM). We evaluated the incidence of cardiovascular disease (CVD) according to comorbidities and suggested LDL-C treatment goals in Korean people with T2DM in nationwide cohort data.
Methods Using the Korean National Health Insurance Service database, 248,002 people aged 30 to 90 years with T2DM who underwent routine health check-ups during 2009 were included. Subjects with previous CVD were excluded from the study. The primary outcome was incident CVD, defined as a composite of myocardial infarction and ischemic stroke during the follow-up period from 2009 to 2018.
Results The mean age of the study participants was 59.6±10.9 years, and median follow-up period was 9.3 years. CVD incidence increased in the order of DM duration of 5 years or more (12.04/1,000 person-years), hypertension (HT) (12.27/1,000 personyears), three or more CV risk factors (14.10/1,000 person-years), and chronic kidney disease (18.28/1,000 person-years). The risk of incident CVD increased linearly from an LDL-C level of ≥70 mg/dL in most patients with T2DM. In T2DM patients without HT or with a DM duration of less than 5 years, the CVD incidence increased from LDL-C level of ≥100 mg/dL.
Conclusion For primary prevention of CVD in Korean adults with T2DM, it can be helpful to lower LDL-C targets when there are chronic kidney disease, HT, a long duration of diabetes mellitus, or three or more CV risk factors.
Citations
Citations to this article as recorded by
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
Lipid Management in Korean People with Type 2 Diabetes Mellitus: Korean Diabetes Association and Korean Society of Lipid and Atherosclerosis Consensus Statement Ye Seul Yang, Hack-Lyoung Kim, Sang-Hyun Kim, Min Kyong Moon Diabetes & Metabolism Journal.2023; 47(1): 1. CrossRef
Optimal Low-Density Lipoprotein Cholesterol Level for Primary Prevention in Koreans with Type 2 Diabetes Mellitus Ji Yoon Kim, Nam Hoon Kim Diabetes & Metabolism Journal.2023; 47(1): 42. CrossRef
Lipid Management in Korean People With Type 2 Diabetes Mellitus: Korean Diabetes Association and Korean Society of Lipid and Atherosclerosis Consensus Statement Ye Seul Yang, Hack-Lyoung Kim, Sang-Hyun Kim, Min Kyong Moon Journal of Lipid and Atherosclerosis.2023; 12(1): 12. CrossRef
2023 Clinical Practice Guidelines for Diabetes: Management of Cardiovascular Risk Factors Ye Seul Yang The Journal of Korean Diabetes.2023; 24(3): 135. CrossRef
2023 Clinical Practice Guidelines for Diabetes Mellitus of the Korean Diabetes Association Jong Han Choi, Kyung Ae Lee, Joon Ho Moon, Suk Chon, Dae Jung Kim, Hyun Jin Kim, Nan Hee Kim, Ji A Seo, Mee Kyoung Kim, Jeong Hyun Lim, YoonJu Song, Ye Seul Yang, Jae Hyeon Kim, You-Bin Lee, Junghyun Noh, Kyu Yeon Hur, Jong Suk Park, Sang Youl Rhee, Hae J Diabetes & Metabolism Journal.2023; 47(5): 575. CrossRef
Management of Dyslipidemia in Patients with Diabetes Mellitus Kyung Ae Lee The Journal of Korean Diabetes.2023; 24(3): 111. CrossRef
Significant Gap Between Guidelines and Practice in the Management of LDL Cholesterol: Insight From the Survey of the Korean Society of Myocardial Infarction Sang Yeub Lee, Kyung Hoon Cho, Jang Hoon Lee, Young Joon Hong, Jin yong Hwang, Myung Ho Jeong, Weon Kim Journal of Korean Medical Science.2023;[Epub] CrossRef
Junghyun Noh, Min Kyong Moon, Eun-Jung Rhee, Sang Hyun Park, Hyeon Chang Kim, Byung Jin Kim, Hae Jin Kim, Seonghoon Choi, Jin Oh Na, Young Youl Hyun, Bum Joon Kim, Kyung-Do Han, In-Kyung Jeong, on Behalf of the Committee of Practice Guideline of Korean Lipid and Atheroscelerosis
Diabetes Metab J. 2023;47(1):59-71. Published online January 26, 2023
Background To validate the treatment target of low-density lipoprotein cholesterol (LDL-C) level according to the cardiovascular disease (CVD) risk which was recommended by Korean dyslipidemia guideline.
Methods We used the Korean National Health Insurance Service database which included 3,958,048 people aged 20 to 89 years who underwent regular health screening. The primary outcome was incident CVD, defined as a composite of myocardial infarction and stroke during the follow-up period from 2009 to 2018.
Results The risk of CVD increased from LDL-C level of 70 mg/dL in very high-risk and high-risk groups and from 130 mg/dL in moderate-risk and low-risk groups. Adjusted hazard ratios (HRs) of LDL-C ranges 70–99, 100–129, 130–159, 160–189, and ≥190 mg/dL were 1.20 (95% confidence interval [CI], 1.08–1.33), 1.27 (1.15–1.42), 1.39 (1.23–1.56), 1.69 (1.45–1.96), and 1.84 (1.49– 2.27) in very high-risk group, and 1.07 (1.02–1.13), 1.16 (1.10–1.21), 1.29 (1.22–1.36), 1.45 (1.36–1.55), and 1.73 (1.58–1.90) in high-risk group. Adjusted HRs (95% CI) of LDL-C ranges 130–159, 160–189, and ≥190 mg/dL were 1.15 (1.11–1.20), 1.28 (1.22– 1.34), and 1.45 (1.36–1.54) in moderate-risk group and 1.07 (1.02–1.13), 1.20 (1.13–1.26), and 1.47 (1.37–1.57) in low-risk group.
Conclusion We confirmed the incidence of CVD was increased in higher LDL-C range. The risk of CVD increased from ≥70 mg/dL of LDL-C in very high-risk and high-risk groups, and from ≥130 mg/dL of LDL-C in moderate-risk and low-risk groups in Korean adults.
Citations
Citations to this article as recorded by
Colorimetric aptasensors for sensitive low-density lipoprotein detection based on reduced oxide graphene@molybdenum disulfide-ferrocene nanosheets with peroxidase-like activity Guiyin Li, Tingting Yu, Haimei Li, Bingbing Wan, Xiaohong Tan, Xueqing Zhou, Jintao Liang, Zhide Zhou Analytical Methods.2024;[Epub] CrossRef
Efficacy and Safety of a Single-Pill Triple Combination of Olmesartan, Amlodipine, and Rosuvastatin in Hypertensive Patients with Low-to-Moderate Cardiovascular Risk: A Multicenter, Randomized, Open-Label, Active-Control, Phase IV Clinical Trial Byung Jin Kim, Kwang Soo Cha, Wook Hyun Cho, Eung Ju Kim, Seung-Hyuk Choi, Moo Hyun Kim, Sang-Hyun Kim, Jun-Bean Park, Seong-Mi Park, Il Suk Sohn, Kyu Hyung Ryu, In-Ho Chae Journal of Cardiovascular Pharmacology and Therapeutics.2023;[Epub] CrossRef
Background No meta-analysis has analysed efficacy and safety of fast-acting aspart insulin (FIAsp) with insulin pump in type 1 diabetes mellitus (T1DM).
Methods Electronic databases were searched for randomised controlled trials (RCTs) involving T1DM patients on insulin pump receiving FIAsp in intervention arm, and placebo/active comparator insulin in control arm. Primary outcome was to evaluate changes in 1- and 2-hour post-prandial glucose (1hPPG and 2hPPG). Secondary outcomes were to evaluate alterations in percentage time with blood glucose <3.9 mmol/L (hypoglycaemia), time in range (TIR) blood glucose 3.9 to 10 mmol/L, insulin requirements and adverse events.
Results Data from four RCTs involving 640 patients was analysed. FIAsp use in insulin pump was associated with significantly greater lowering of 1hPPG (mean difference [MD], –1.35 mmol/L; 95% confidence interval [CI], –1.72 to –0.98; P<0.01; I2=63%) and 2hPPG (MD, –1.19 mmol/L; 95% CI, –1.38 to –1.00; P<0.01; I2=0%) as compared to controls. TIR was comparable among groups (MD, 1.06%; 95% CI, –3.84 to 5.96; P=0.67; I2=70%). Duration of blood glucose <3.9 mmol/L was lower in FIAsp group, approaching significance (MD, –0.91%; 95% CI, –1.84 to 0.03; P=0.06; I2=0%). Total hypoglycaemic episodes (risk ratio [RR], 1.35; 95% CI, 0.55 to 3.31; P=0.51; I2=0%), severe hypoglycaemia (RR, 2.26; 95% CI, 0.77 to 6.66; P=0.14), infusion site reactions (RR, 1.35; 95% CI, 0.63 to 2.93; P=0.77; I2=0%), and treatment-emergent adverse events (RR, 1.13; 95% CI, 0.80 to 1.60; P=0.50; I2=0%) were comparable.
Conclusion FIAsp use in insulin pump is associated with better post-prandial glycaemic control with no increased hypoglycaemia or glycaemic variability.
Citations
Citations to this article as recorded by
Burden and Coping Strategies of Hypoglycemia in People with Diabetes Aris Liakos, Thomas Karagiannis, Ioannis Avgerinos, Apostolos Tsapas, Eleni Bekiari Current Diabetes Reviews.2024;[Epub] CrossRef
Ultrafast-acting insulin: pharmacological properties and their impact on clinical aspects L. A. Suplotova, A. Sh. Tilkiyan Meditsinskiy sovet = Medical Council.2024; (13): 146. CrossRef
Unveiling the Spectrum of Glucose Variability: A Novel Perspective on FreeStyle Libre Monitoring Data Adrian H. Heald, Mike Stedman, John Warner-Levy, Lleyton Belston, Angela Paisley, Aleksandra Jotic, Nebojsa Lalic, Martin Gibson, Hellena H. Habte-Asres, Martin Whyte, Angus Forbes Diabetes Therapy.2024; 15(12): 2475. CrossRef
Efficacy and Safety of Ultra-rapid Lispro Insulin in Managing Type-1 and Type-2 Diabetes: A Systematic Review and Meta-Analysis Deep Dutta, Lakshmi Nagendra, Saptarshi Bhattacharya, Meha Sharma Indian Journal of Endocrinology and Metabolism.2023; 27(6): 467. CrossRef
Jun Sung Moon, Nam Hoon Kim, Jin Oh Na, Jae Hyoung Cho, In-Kyung Jeong, Soon Hee Lee, Ji-Oh Mok, Nan Hee Kim, Dong Jin Chung, Jinhong Cho, Dong Woo Lee, Sun Woo Lee, Kyu Chang Won
Diabetes Metab J. 2023;47(1):82-91. Published online June 20, 2022
Background To evaluate the safety and effectiveness of empagliflozin in routine clinical settings, we collected and assessed the clinical profiles of Korean patients with type 2 diabetes mellitus.
Methods This was a post-marketing surveillance study of empagliflozin 10 and 25 mg. Information on adverse events and adverse drug reactions (ADRs) was collected as safety data sets. Available effectiveness outcomes, including glycosylated hemoglobin (HbA1c) level, fasting plasma glucose, body weight, and blood pressure, were assessed.
Results The incidence rate of ADRs was 5.14% in the safety dataset (n=3,231). Pollakiuria, pruritis genital, and weight loss were the most common ADRs. ADRs of special interest accounted for only 1.18%, and there were no serious events that led to mortality or hospitalization. In the effectiveness data set (n=2,567), empagliflozin significantly reduced the mean HbA1c level and body weight during the study period by –0.68%±1.39% and –1.91±3.37 kg (both P<0.0001), respectively. In addition, shorter disease duration, absence of dyslipidemia, and higher baseline HbA1c levels were identified as the clinical features characteristic of a “responder” to empagliflozin therapy.
Conclusion Empagliflozin is a safe and potent glucose-lowering drug in routine use among Korean patients with type 2 diabetes mellitus. It is expected to have better glycemic efficacy in Korean patients with poorly controlled type 2 diabetes mellitus.
Citations
Citations to this article as recorded by
Evaluation of Efficacy and Safety of Empagliflozin in Bangladeshi Patients with Type 2 Diabetes Mellitus (EFFISAEM Study) Mohammad Saifuddin, Ajit K. Paul, Sultana M. Shefin, Md. Jahangir Alam, Shahjada Selim, Sunjida Islam, Tanjina Hossain, Sadiqa Tuqan, Nusrat Sultana, Marufa Mustari, Ramen C. Basak, Kazi A. Aftab, Indrajit Prasad, Mohammad R. Uddin, Shoma Sharker, Md. Abu Indian Journal of Endocrinology and Metabolism.2024; 28(5): 500. CrossRef
Blood pressure reduction with empagliflozin in Japanese patients with type 2 diabetes and cardiovascular diseases: a post-hoc sub-analysis of the placebo-controlled randomized EMBLEM trial Atsushi Tanaka, Michio Shimabukuro, Hiroki Teragawa, Hisako Yoshida, Yosuke Okada, Toshinari Takamura, Isao Taguchi, Shigeru Toyoda, Hirofumi Tomiyama, Shinichiro Ueda, Yukihito Higashi, Koichi Node, Junya Ako, Hirohisa Amano, Itaru Hisauchi, Yumi Ikehara Hypertension Research.2024; 47(9): 2295. CrossRef
Comparison of the Pharmacokinetics, Safety, and Tolerability of Two Empagliflozin Formulations in Healthy Korean Subjects Xu Jiang, Sungyeun Bae, Deok Yong Yoon, Shin Jung Park, Jaeseong Oh, Joo-Youn Cho, Kyung-Sang Yu Drug Design, Development and Therapy.2023; Volume 17: 2137. CrossRef
Comparative safety of different sodium-glucose transporter 2 inhibitors in patients with type 2 diabetes: a systematic review and network meta-analysis of randomized controlled trials Chun Xing Li, Li Yan Liu, Chen Xiao Zhang, Xu Hua Geng, Si Meng Gu, Yu Qiao Wang, Hua Liu, Qing Xie, Shuo Liang Frontiers in Endocrinology.2023;[Epub] CrossRef
Background We investigated whether Lactobacillus plantarum strain LMT1-48, isolated from Korean fermented foods and newborn feces, is a suitable probiotic supplement to treat overweight subjects.
Methods In this randomized, double-blind, placebo-controlled clinical trial, 100 volunteers with a body mass index of 25 to 30 kg/m2 were assigned randomly (1:1) to receive 2×1010 colony forming units of LMT1-48 or to a placebo treatment group. Body composition was measured by dual-energy X-ray absorptiometry, and abdominal visceral fat area (VFA) and subcutaneous fat area were measured by computed tomography scanning. Changes in body fat, VFA, anthropometric parameters, and biomarkers were compared between the two treatment groups (ClinicalTrials.gov number: NCT03759743).
Results After 12 weeks of treatment, the body weight decreased significantly from 76.6±9.4 to 75.7±9.2 kg in the LMT1-48 group but did not change in the placebo group (P=0.022 between groups). A similar pattern was found in abdominal VFA between the two groups (P=0.041). Serum insulin levels, the corresponding homeostasis model assessment of insulin resistance, and leptin levels decreased in the LMT1-48 group but increased in the placebo group (all P<0.05). Decrease in body weight and body mass index by treatment with LMT1-48 was correlated with increase in Lactobacillus levels significantly. LMT1-48 also increased Oscillibacter levels significantly, which were negatively correlated with triglyceride and alanine transaminase levels.
Conclusion Administration of LMT1-48 decreased body weight, abdominal VFA, insulin resistance, and leptin levels in these subjects with overweight, suggesting its anti-obesogenic therapeutic potential.
Citations
Citations to this article as recorded by
Beneficial effects of the probiotics and synbiotics supplementation on anthropometric indices and body composition in adults: A systematic review and meta‐analysis Saeede Saadati, Kaveh Naseri, Omid Asbaghi, Mohsen Yousefi, Elnaz Golalipour, Barbora de Courten Obesity Reviews.2024;[Epub] CrossRef
The Effect of Lactobacillus plantarum on the Fecal Microbiota, Short Chain Fatty Acids, Odorous Substances, and Blood Biochemical Indices of Cats Bing Han, Shukun Liang, Jintao Sun, Hui Tao, Zhenlong Wang, Baosheng Liu, Xiumin Wang, Jie Liu, Jinquan Wang Microorganisms.2024; 12(1): 91. CrossRef
Natto alleviates hyperlipidemia in high-fat diet-fed mice by modulating the composition and metabolic function of gut microbiota Le-Yuan Shang, Shuo Zhang, Min Zhang, Xiao-Dong Sun, Qi Wang, Yu-Jie Liu, Yan-Ni Zhao, Mei Zhao, Peng-Jiao Wang, Xiu-Li Gao Journal of Functional Foods.2024; 112: 105968. CrossRef
Microbial-Based Bioactive Compounds to Alleviate Inflammation in Obesity Oladayo Emmanuel Apalowo, Grace Adeola Adegoye, Tolulope Mobolaji Obuotor Current Issues in Molecular Biology.2024; 46(3): 1810. CrossRef
Anti-obesogenic effects of plant natural products: A focus on Korean traditional foods Gitishree Das, Luis Alfonso Jiménez Ortega, Sandra Gonçalves, J. Basilio Heredia, Maria de Lourdes Gomes Pereira, Anabela Romano, Han-Seung Shin, Jayanta Kumar Patra Trends in Food Science & Technology.2024; : 104470. CrossRef
A 12-Week, Single-Centre, Randomised, Double-Blind, Placebo-Controlled, Parallel-Design Clinical Trial for the Evaluation of the Efficacy and Safety of Lactiplantibacillus plantarum SKO-001 in Reducing Body Fat Seon Mi Shin, Jeong-Su Park, Sang Back Kim, Young Hee Cho, Hee Seo, Hak Sung Lee Nutrients.2024; 16(8): 1137. CrossRef
Efficacy and Safety of WCFA19 (Weissella confusa WIKIM51) in Reducing Body Fat in Overweight and Obese Adults Hwayeon Sun, Jinyoung Shin, Min-ji Kim, Sunghwan Bae, Nicole Dain Lee, Byungwook Yoo Journal of Clinical Medicine.2024; 13(9): 2559. CrossRef
The Role of Lactobacillus plantarum in Reducing Obesity and Inflammation: A Meta-Analysis Chen-Pi Li, Chin-Chang Chen, Yao Hsiao, Chieh-Hsin Kao, Chin-Chu Chen, Hao-Jan Yang, Ru-Yin Tsai International Journal of Molecular Sciences.2024; 25(14): 7608. CrossRef
Complete genome sequence and anti-obesity potential of Lactiplantibacillus plantarum HOM2217 in 3T3-L1 cells and high-fat diet-fed rats Tingting Wang, Xiao Zhang, Linlin Fan, Ying Zhao, Zhengwen Zhang, Zhonghua Cao, Ying Xu, Suwon Lee, Chongyoon Lim, Shiqi Zhang Frontiers in Microbiology.2024;[Epub] CrossRef
3D printing of microencapsulated Lactobacillus rhamnosus for oral delivery Pablo Rosas-Val, Masoud Adhami, Ana Brotons-Canto, Carlos Gamazo, Juan M. Irache, Eneko Larrañeta International Journal of Pharmaceutics.2023; 641: 123058. CrossRef
Gut commensal Kineothrix alysoides mitigates liver dysfunction by restoring lipid metabolism and gut microbial balance Kyoung Jin Choi, Mi Young Yoon, Ji-Eun Kim, Sang Sun Yoon Scientific Reports.2023;[Epub] CrossRef
Ameliorating Effects of Bifidobacterium longum subsp. infantis FB3-14 against High-Fat-Diet-Induced Obesity and Gut Microbiota Disorder Ruixin Kou, Jin Wang, Ang Li, Yuanyifei Wang, Bowei Zhang, Jingmin Liu, Yi Sun, Shuo Wang Nutrients.2023; 15(19): 4104. CrossRef
Effect of Continuous Ingestion of Bifidobacteria and Inulin on Reducing Body Fat: A Randomized, Double-Blind, Placebo-Controlled, Parallel-Group Comparison Study Yuhei Baba, Yasuo Saito, Mei Kadowaki, Naoki Azuma, Daisuke Tsuge Nutrients.2023; 15(24): 5025. CrossRef
A Review of the Potential of Probiotic Bacteria in Managing the Body Weight of Obese Individuals A Didban, L Manafi, R Mahmoudi Journal of Health and Hygiene.2023; 14(4): 388. CrossRef
Plant-Derived Lactobacillus paracasei IJH-SONE68 Improves the Gut Microbiota Associated with Hepatic Disorders: A Randomized, Double-Blind, and Placebo-Controlled Clinical Trial Narandalai Danshiitsoodol, Masafumi Noda, Keishi Kanno, Tomoyuki Uchida, Masanori Sugiyama Nutrients.2022; 14(21): 4492. CrossRef
Background The association of myosteatosis measured using visual muscular quality map in computed tomography (CT) with nonalcoholic fatty liver disease (NAFLD), its severity, and fibrosis was analyzed in a large population.
Methods Subjects (n=13,452) with abdominal CT between 2012 and 2013 were measured total abdominal muscle area (TAMA) at L3 level. TAMA was segmented into intramuscular adipose tissue and skeletal muscle area (SMA), which was further classified into normal attenuation muscle area (NAMA) and low attenuation muscle area (LAMA). The following variables were adopted as indicators of myosteatosis: SMA/body mass index (BMI), NAMA/BMI, NAMA/TAMA, and LAMA/BMI. NAFLD and its severity were assessed by ultrasonography, and liver fibrosis was measured by calculating the NAFLD fibrosis score (NFS) and fibrosis-4 index (FIB-4) scores.
Results According to multiple logistic regression analyses, as quartiles of SMA/BMI, NAMA/BMI, and NAMA/TAMA increased, the odds ratios (ORs) for NAFLD decreased in each sex (P for trend <0.001 for all). The ORs of moderate/severe NAFLD were significantly higher in the Q1 group than in the Q4 group for SMA/BMI, NAMA/BMI, and NAMA/TAMA in men. The ORs of intermediate/high liver fibrosis scores assessed by NFS and FIB-4 scores increased linearly with decreasing quartiles for SMA/BMI, NAMA/BMI, and NAMA/TAMA in each sex (P for trend <0.001 for all). Conversely, the risk for NAFLD and fibrosis were positively associated with LAMA/BMI quartiles in each sex (P for trend <0.001 for all).
Conclusion A higher proportion of good quality muscle was associated with lower risks of NAFLD and fibrosis.
Citations
Citations to this article as recorded by
Association between atherogenic dyslipidemia and muscle quality defined by myosteatosis Hwi Seung Kim, Yun Kyung Cho, Myung Jin Kim, Eun Hee Kim, Min Jung Lee, Woo Je Lee, Hong-Kyu Kim, Chang Hee Jung Frontiers in Endocrinology.2024;[Epub] CrossRef
Myosteatosis Predicts Bariatric Surgery Response: A Longitudinal Study in Patients With Morbid Obesity Eugene Han, Mi Kyung Kim, Hye Won Lee, Seungwan Ryu, Hye Soon Kim, Byoung Kuk Jang, Youngsung Suh The Journal of Clinical Endocrinology & Metabolism.2024;[Epub] CrossRef
Artificial intelligence-based evaluation of prognosis in cirrhosis Yinping Zhai, Darong Hai, Li Zeng, Chenyan Lin, Xinru Tan, Zefei Mo, Qijia Tao, Wenhui Li, Xiaowei Xu, Qi Zhao, Jianwei Shuai, Jingye Pan Journal of Translational Medicine.2024;[Epub] CrossRef
Association of Myosteatosis with Nonalcoholic Fatty Liver Disease, Severity, and Liver Fibrosis Using Visual Muscular Quality Map in Computed Tomography (Diabetes Metab J 2023;47:104-17) Hwi Seung Kim, Hong-Kyu Kim, Chang Hee Jung Diabetes & Metabolism Journal.2023; 47(2): 304. CrossRef
Association of Myosteatosis with Nonalcoholic Fatty Liver Disease, Severity, and Liver Fibrosis Using Visual Muscular Quality Map in Computed Tomography (Diabetes Metab J 2023;47:104-17) Eun Roh Diabetes & Metabolism Journal.2023; 47(2): 301. CrossRef
Sarcopenia, a condition shared by various diseases: can we alleviate or delay the progression? Giovanni Tarantino, Gaia Sinatti, Vincenzo Citro, Silvano Santini, Clara Balsano Internal and Emergency Medicine.2023; 18(7): 1887. CrossRef
Association of Visceral Fat Obesity, Sarcopenia, and Myosteatosis with Non-Alcoholic Fatty Liver Disease without Obesity Hong-Kyu Kim, Sung-Jin Bae, Min Jung Lee, Eun Hee Kim, Hana Park, Hwi Seung Kim, Yun Kyung Cho, Chang Hee Jung, Woo Je Lee, Jaewon Choe Clinical and Molecular Hepatology.2023; 29(4): 987. CrossRef
Current view of the surgical anatomy of the anterolateral abdominal wall muscles and their aponeuroses A.V. Pavlov, A.S. Baranova, A.V. Fedoseyev, A.I. Vvedensky, G.S. Lazutina, N.V. Ovchinnikova, I.V. Bakharev Operativnaya khirurgiya i klinicheskaya anatomiya (Pirogovskii nauchnyi zhurnal).2023; 7(3): 44. CrossRef
Muscle Fat Content Is Associated with Nonalcoholic Fatty Liver Disease and Liver Fibrosis in Chinese Adults W. Guo, X. Zhao, D. Cheng, X. Liang, M. Miao, X. Li, J. Lu, N. Xu, Shuang Hu, Qun Zhang The Journal of nutrition, health and aging.2023; 27(11): 960. CrossRef
Background Type 2 diabetes mellitus (T2DM) is related to increased inflammatory processes. The effects of resistance exercise on inflammatory biomarkers in T2DM are controversial. Our purpose was to determine the effectiveness of resistance exercise on inflammatory biomarkers in patients diagnosed with T2DM.
Methods We searched four databases until September 2021. We included randomized clinical trials (RCTs) of the effects of resistance exercise on inflammatory biomarkers (C-reactive protein [CRP], tumor necrosis factor alpha, interleukin-6, and interleukin-10) in patients with T2DM. A random effects meta-analysis was conducted to determine the standardized mean difference (SMD) and the raw mean difference (MD) for CRP.
Results Thirteen RCTs were included in the review, and 11 in the meta-analysis for CRP. Lower CRP levels were observed when resistance exercise was compared with the control groups (SMD=–0.20; 95% confidence interval [CI], –0.37 to –0.02). When conducting the MD meta-analysis, resistance exercise showed a significant decrease in CRP of –0.59 mg/dL (95% CI, –0.88 to –0.30); otherwise, in the control groups, the CRP values increased 0.19 mg/dL (95% CI, 0.17 to 0.21).
Conclusion Evidence supports resistance exercise as an effective strategy to manage systemic inflammation by decreasing CRP levels in patients with T2DM. The evidence is still inconclusive for other inflammatory biomarkers.
Citations
Citations to this article as recorded by
Predictors of Resistance Training Behavior among Glucagon-like Peptide 1 Medication Users Justin M. Kompf, Ryan E. Rhodes Translational Journal of the American College of Sports Medicine.2025;[Epub] CrossRef
Körperliche Aktivität und Trainingstherapie bei Typ-2-Diabetes – ein Update Andreas M. Nieß, Ansgar Thiel Diabetologie und Stoffwechsel.2024; 19(01): 38. CrossRef
Genetic predisposition, lifestyle inflammation score, food-based dietary inflammatory index, and the risk for incident diabetes: Findings from the KoGES data Hye Ah Lee, Hyesook Park, Bomi Park Nutrition, Metabolism and Cardiovascular Diseases.2024; 34(3): 642. CrossRef
Associations of meeting 24-h movement guidelines and metabolic syndrome in Korean adults during the COVID-19 pandemic S.W. Shin, Y. Choi, Y.H. Kang, J. Kim Public Health.2024; 227: 187. CrossRef
Association of hypoglycemic events with cognitive impairment in patients with type 2 diabetes mellitus: Protocol for a dose-response meta-analysis Min Ye, Ai Hong Yuan, Qi Qi Yang, Qun Wei Li, Fei Yue Li, Yan Wei, Muhammad Shahzad Aslam PLOS ONE.2024; 19(2): e0296662. CrossRef
Exercise Interventions for the Prevention and Treatment of Anthracycline-Induced Cardiotoxicity in Women with Breast Cancer: A Systematic Review Hongmei Li, Haiyun Liu, Boliang Wang, Xiao Jia, Jingjing Yu, Yurong Zhang, Die Sang, Yimin Zhang Journal of Science in Sport and Exercise.2024;[Epub] CrossRef
Effectiveness of resistance training in modulating inflammatory biomarkers among Asian patients with sarcopenia: a systematic review and meta-analysis of randomized controlled trials Jingxian Xue, Xi Han, Yan Zheng, Qiuxia Zhang, Lingyu Kong Frontiers in Immunology.2024;[Epub] CrossRef
Additive impact of diabetes and sarcopenia on all-cause and cardiovascular mortality: A longitudinal nationwide population-based study Eyun Song, Soon Young Hwang, Min Jeong Park, Ahreum Jang, Kyeong Jin Kim, Ji Hee Yu, Nam Hoon Kim, Hye Jin Yoo, Ji A. Seo, Sin Gon Kim, Nan Hee Kim, Sei Hyun Baik, Kyung Mook Choi Metabolism.2023; 148: 155678. CrossRef
Endothelial progenitor cell response to a multicomponent exercise training program in adults with cardiovascular risk factors Suiane Cavalcante, Manuel Teixeira, Marisol Gouveia, Ana Duarte, Miriam Ferreira, Maria I. Simões, Maria Conceição, Mariana Costa, Ilda P. Ribeiro, Ana Cristina Gonçalves, José Oliveira, Fernando Ribeiro German Journal of Exercise and Sport Research.2023; 53(2): 225. CrossRef
“Does Physical Exercise Promote Health Benefits for Diabetic Patients during the COVID-19 Pandemic?”: A Systematic Review Erivaldo de Souza, Daniela Meneses-Santos, Josué Cruz Santos, Felipe J. Aidar, Carla Roberta de Oliveira Carvalho, Jymmys Lopes dos Santos, Anderson Carlos Marçal Sports.2023; 11(10): 192. CrossRef
Effect of exercise on inflammatory markers in postmenopausal women with overweight and obesity: A systematic review and meta-analysis Liang Tan, Weihua Yan, Weilin Yang, Agata Kamionka, Mariusz Lipowski, Zijian Zhao, Gang Zhao Experimental Gerontology.2023; 183: 112310. CrossRef
Resistance Training Improves Beta Cell Glucose Sensing and Survival in Diabetic Models Gabriela Alves Bronczek, Gabriela Moreira Soares, Carine Marmentini, Antonio Carlos Boschero, José Maria Costa-Júnior International Journal of Molecular Sciences.2022; 23(16): 9427. CrossRef
We compared the glycemic efficacy of treatment intensification between quadruple oral antidiabetic drug therapy and once-weekly glucagon-like peptide-1 receptor agonist (GLP-1RA)-based triple therapy in patients with poorly controlled type 2 diabetes mellitus refractory to triple oral therapy. For 24 weeks, changes in glycosylated hemoglobin (HbA1c) from baseline were compared between the two treatment groups. Of all 96 patients, 50 patients were treated with quadruple therapy, and 46 were treated with GLP-1RA therapy. Reductions in HbA1c for 24 weeks were comparable (in both, 1.1% reduction from baseline; P=0.59). Meanwhile, lower C-peptide level was associated with a lower glucose-lowering response of GLP-1RA therapy (R=0.3, P=0.04) but not with quadruple therapy (R=–0.13, P=0.40). HbA1c reduction by GLP-1RA therapy was inferior to that by quadruple therapy in the low C-peptide subgroup (mean, –0.1% vs. –1.3%; P=0.04). Treatment intensification by switching to quadruple oral therapy showed similar glucose-lowering efficacy to weekly GLP-1RA-based triple therapy. Meanwhile, the therapeutic response was affected by C-peptide levels in the GLP-1RA therapy group but not in the quadruple therapy group.
In clinical practice, the distinction between type 1 diabetes mellitus (T1DM) and type 2 diabetes mellitus (T2DM) can be challenging, leaving patients with “ambiguous” diabetes type. Insulin-treated patients (n=115) previously diagnosed with T2DM had to be re-classified based on clinical phenotype and laboratory results, and were operationally defined as having an ambiguous diabetes type. They were compared against patients with definite T1DM and T2DM regarding 12 clinical and laboratory features typically different between diabetes types. Characteristics of patients with ambiguous diabetes type, representing approximately 6% of all patients with T1DM or T2DM seen at our specialized clinic, fell in between those of patients with definite T1DM and T2DM, both regarding individual features and with respect to a novel classification based on multi-variable regression analysis (P<0.0001). In conclusion, a substantial proportion of diabetes patients in a tertiary care centre presented with an “ambiguous” diabetes type. Their clinical characteristics fall in between those of definite T1DM or T2DM patients.