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Original Article
Pharmacotherapy
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Efficacy and Safety of HD-6277, a Novel G Protein-Coupled Receptor 40 Agonist, in Individuals with Type 2 Diabetes Mellitus: A Double-Blind, Randomized, Placebo-Controlled, Parallel-Group, Multicenter Phase 2 Clinical Trial
Yong-ho Lee, Kyung Wan Min, Jun Hwa Hong, Soo Lim, Jae Myung Yu, Choon Hee Chung, Jun Sung Moon, Jong Chul Won, Chul Woo Ahn, Jie-Eun Lee, Tae Nyun Kim, Byung-Wan Lee
Diabetes Metab J. 2026;50(3):576-586.   Published online December 19, 2025
DOI: https://doi.org/10.4093/dmj.2025.0528
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  • 131 Download
  • 1 Crossref
AbstractAbstract PDFSupplementary MaterialPubReader   ePub   
Background
This study assessed the efficacy and safety of HD-6277, a novel oral G protein-coupled receptor 40 (GPR40) agonist in adults with inadequate control of type 2 diabetes mellitus (T2DM).
Methods
This double-blind, randomized, placebo-controlled phase 2 trial recruited 112 individuals aged 18–75 years with T2DM and glycosylated hemoglobin (HbA1c) levels between 7.0% and 10.0% while on diet and exercise alone for at least 8 weeks before screening. Parallel-group randomized trials of HD-6277 (50 and 100 mg groups vs. placebo) were conducted for 12 weeks. The primary outcome was the change in HbA1c levels from baseline to week 12. Secondary outcomes included changes in HbA1c, fasting plasma glucose (FPG), postprandial glucose, insulin, glycoalbumin, and C-peptide at weeks 4, 8, and 12.
Results
At week 12, HD-6277 at 50 and 100 mg demonstrated statistically significant reductions in HbA1c compared to placebo, with least square (LS) mean differences of –0.73% (95% confidence interval [CI], –1.11 to –0.35; P=0.0002) and –0.85% (95% CI, –1.21 to –0.50; P<0.0001), respectively. Both doses also produced clinically meaningful reductions in FPG. Additionally, HD- 6277 at 100 mg significantly increased the insulinogenic index compared to placebo, with an LS mean difference of 1.91 (95% CI, 0.34 to 3.48; P=0.0175). No clinically relevant treatment-related adverse events were observed.
Conclusion
HD-6277 at 50 and 100 mg improved glycemic control and was well-tolerated in adults with T2DM inadequately managed with diet and exercise. GPR40 agonists may offer a promising new therapeutic option for T2DM.

Citations

Citations to this article as recorded by  
  • Revisiting GPR40 Agonist in Type 2 Diabetes Mellitus: A Cautious but Meaningful Return
    Eun-Hee Cho
    Diabetes & Metabolism Journal.2026; 50(3): 472.     CrossRef
Review
Guideline/Statement/Fact Sheet
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Bridging Evidence and Practice: A Consensus Statement from the Korean Diabetes Association on Diabetes Screening, Pharmacological Treatment and Severe Diabetes
Jong Han Choi, Shinae Kang, Soo-Kyung Kim, Won Jun Kim, Ji Min Kim, Jaehyun Bae, Jae-Seung Yun, Eonju Jeon, Young-Eun Kim, Jae Hyun Bae, Hun Jee Choe, Young Min Cho, Seung-Hyun Ko, Sang Yong Kim, Hae Jin Kim, You-Cheol Hwang, Min Kyong Moon, Suk Chon, Seon Mee Kang, Hyuk-Sang Kwon, Mi Kyung Kim, You-Bin Lee, Se Hee Min, Jung Hwan Park, Woo Je Lee, Bong-Soo Cha, Byung-Wan Lee
Diabetes Metab J. 2025;49(6):1155-1177.   Published online November 1, 2025
DOI: https://doi.org/10.4093/dmj.2025.0978
  • 11,790 View
  • 348 Download
  • 5 Web of Science
  • 5 Crossref
AbstractAbstract PDFSupplementary MaterialPubReader   ePub   
This Korean Diabetes Association (KDA) consensus statement bridges global evidence with the Korean clinical context, where large randomized and real-world data remain limited. Recommendations required ≥80% agreement by the committee of clinical practice guideline and approval by the board of directors. The statement comprises three domains: diabetes screening aligned with Korean epidemiology; pharmacologic management guided by pathophysiology and comorbidities; and a severity construct of “severe diabetes mellitus” that links complication-based staging with metabolic grading to match therapeutic intensity to disease complexity. Compared with prior KDA guidelines, this statement introduces substantive advances in three areas. First, screening recommendations are streamlined to emphasize risk-aligned, practical implementation rather than prescriptive test sequences. Second, pharmacologic management applies an individualized framework for drug selection that jointly considers pathophysiology and comorbidities. It operationalizes individualized selection by dominant pathophysiology (insulin resistance vs. insulin insufficiency) and coexisting conditions, and formalizes treatment dynamics—early combination, timely initiation of injectables, avoidance of overbasalization, and structured deintensification. It also prioritizes agents with proven cardiovascular and renal protection and elevates management of obesity and metabolic dysfunction-associated steatotic liver disease as central goals; clinically, insulin should be initiated promptly in hypercatabolic states or suspected islet failure, and technology-enabled care—including continuous glucose monitoring and automated insulin delivery—are integral across all stages. Third, the newly introduced severity construct underpins treatment-intensity decisions across domains without reiterating prescriptive algorithms. Collectively, these recommendations provide a coherent, context-appropriate framework for diabetes screening and management in Korea and identify priorities for future evidence generation.

Citations

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    Diabetes Research and Clinical Practice.2026; 236: 113272.     CrossRef
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    Diabetes Research and Clinical Practice.2026; 238: 113388.     CrossRef
Original Article
Guideline/Statement/Fact Sheet
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2025 Clinical Practice Guidelines for Diabetes Management in Korea: Recommendation of the Korean Diabetes Association
Shinae Kang, Seon Mee Kang, Jong Han Choi, Seung-Hyun Ko, Bo Kyung Koo, Hyuk-Sang Kwon, Mi Kyung Kim, Sang Yong Kim, Soo-Kyung Kim, Young-eun Kim, Eun Sook Kim, Jae Hyeon Kim, Chong Hwa Kim, Ji Min Kim, Hae Jin Kim, Min Kyong Moon, Sun Joon Moon, Jun Sung Moon, Joon Ho Moon, Se Hee Min, Jung Hwan Park, Jaehyun Bae, Keeho Song, Ji Yoon Ahn, Jae-Seung Yun, Woo Je Lee, You-Bin Lee, Suk Chon, Eonju Jeon, Sang-Man Jin, Eugene Han, You-Cheol Hwang, Jae Hyun Bae, YoonJu Song, Jeong Hyun Lim, Jae Won Cho, Ji Yeon Choi, Yong Hee Hong, Jieun Lee, Sung Eun Kim, Ji Yun Noh, Bong-Soo Cha, Byung-Wan Lee
Diabetes Metab J. 2025;49(4):582-783.   Published online July 1, 2025
DOI: https://doi.org/10.4093/dmj.2025.0469
  • 116,225 View
  • 3,221 Download
  • 36 Web of Science
  • 31 Crossref
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    Journal of Hepato-Biliary-Pancreatic Sciences.2026; 33(3): 208.     CrossRef
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    Clinical Endocrinology.2026; 104(5): 453.     CrossRef
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  • Efficacy and safety of adding a fourth oral antidiabetic drug versus metformin dose escalation in patients with type 2 diabetes inadequately controlled on triple oral combination therapy (EFFORT): A 24‐week, randomized, open‐label, multicenter trial
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    Diabetes, Obesity and Metabolism.2026; 28(4): 3305.     CrossRef
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    Journal of Korean Biological Nursing Science.2026; 28(1): 96.     CrossRef
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    Journal of Korean Biological Nursing Science.2026; 28(1): 78.     CrossRef
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Review
Guideline/Fact Sheet
Article image
Metabolic Dysfunction-Associated Steatotic Liver Disease in Type 2 Diabetes Mellitus: A Review and Position Statement of the Fatty Liver Research Group of the Korean Diabetes Association
Jaehyun Bae, Eugene Han, Hye Won Lee, Cheol-Young Park, Choon Hee Chung, Dae Ho Lee, Eun-Hee Cho, Eun-Jung Rhee, Ji Hee Yu, Ji Hyun Park, Ji-Cheol Bae, Jung Hwan Park, Kyung Mook Choi, Kyung-Soo Kim, Mi Hae Seo, Minyoung Lee, Nan-Hee Kim, So Hun Kim, Won-Young Lee, Woo Je Lee, Yeon-Kyung Choi, Yong-ho Lee, You-Cheol Hwang, Young Sang Lyu, Byung-Wan Lee, Bong-Soo Cha, on Behalf of the Fatty Liver Research Group of the Korean Diabetes Association
Diabetes Metab J. 2024;48(6):1015-1028.   Published online November 1, 2024
DOI: https://doi.org/10.4093/dmj.2024.0541
  • 17,567 View
  • 564 Download
  • 18 Web of Science
  • 19 Crossref
AbstractAbstract PDFPubReader   ePub   
Since the role of the liver in metabolic dysfunction, including type 2 diabetes mellitus, was demonstrated, studies on non-alcoholic fatty liver disease (NAFLD) and metabolic dysfunction-associated fatty liver disease (MAFLD) have shown associations between fatty liver disease and other metabolic diseases. Unlike the exclusionary diagnostic criteria of NAFLD, MAFLD diagnosis is based on the presence of metabolic dysregulation in fatty liver disease. Renaming NAFLD as MAFLD also introduced simpler diagnostic criteria. In 2023, a new nomenclature, steatotic liver disease (SLD), was proposed. Similar to MAFLD, SLD diagnosis is based on the presence of hepatic steatosis with at least one cardiometabolic dysfunction. SLD is categorized into metabolic dysfunction-associated steatotic liver disease (MASLD), metabolic dysfunction and alcohol-related/-associated liver disease, alcoholrelated liver disease, specific etiology SLD, and cryptogenic SLD. The term MASLD has been adopted by a number of leading national and international societies due to its concise diagnostic criteria, exclusion of other concomitant liver diseases, and lack of stigmatizing terms. This article reviews the diagnostic criteria, clinical relevance, and differences among NAFLD, MAFLD, and MASLD from a diabetologist’s perspective and provides a rationale for adopting SLD/MASLD in the Fatty Liver Research Group of the Korean Diabetes Association.

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    Jaehyun Bae
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Original Articles
Guideline/Fact Sheet
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 Youl Rhee, Hae Jin Kim, Hyun Min Kim, Jung Hae Ko, Nam Hoon Kim, Chong Hwa Kim, Jeeyun Ahn, Tae Jung Oh, Soo-Kyung Kim, Jaehyun Kim, Eugene Han, Sang-Man Jin, Jaehyun Bae, Eonju Jeon, Ji Min Kim, Seon Mee Kang, Jung Hwan Park, Jae-Seung Yun, Bong-Soo Cha, Min Kyong Moon, Byung-Wan Lee
Diabetes Metab J. 2024;48(4):546-708.   Published online July 26, 2024
DOI: https://doi.org/10.4093/dmj.2024.0249
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  • 53 Web of Science
  • 68 Crossref
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Drug/Regimen
Article image
Real-World Prescription Patterns and Barriers Related to the Use of Sodium-Glucose Cotransporter 2 Inhibitors among Korean Patients with Type 2 Diabetes Mellitus and Cardiovascular Disease
Jong Ha Baek, Ye Seul Yang, Seung-Hyun Ko, Kyung Do Han, Jae Hyeon Kim, Min Kyong Moon, Jong Suk Park, Byung-Wan Lee, Tae Jung Oh, Suk Chon, Jong Han Choi, Kyu Yeon Hur, Committee of Clinical Practice Guidelines, Korean Diabetes Association
Diabetes Metab J. 2022;46(5):701-712.   Published online June 3, 2022
DOI: https://doi.org/10.4093/dmj.2022.0002
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Graphical AbstractGraphical Abstract AbstractAbstract PDFSupplementary MaterialPubReader   ePub   
Background
To evaluate prescription trends and clinical factors of the sodium-glucose cotransporter 2 inhibitors (SGLT2i) use according to the presence of atherosclerotic cardiovascular disease (ASCVD) or heart failure (HF) in Korean patients with type 2 diabetes mellitus (T2DM).
Methods
Prescription patterns of SGLT2i use between 2015 and 2019 were determined using the Korean National Health Insurance Service database of claims.
Results
Of all patients with T2DM (n=4,736,493), the annual prescription rate of SGLT2i increased every year in patients with ASCVD (from 2.2% to 10.7%) or HF (from 2.0% to 11.1%). After the first hospitalization for ASCVD (n=518,572), 13.7% (n=71,259) of patients initiated SGLT2i with a median of 10.6 months. After hospitalization for HF (n=372,853), 11.2% (n=41,717) of patients initiated SGLT2i after a median of 8.8 months. In multivariate regression for hospitalization, older age (per 10 years, odds ratio [OR], 0.57; 95% confidence interval [CI], 0.56 to 0.57), lower household income (OR, 0.93; 95% CI, 0.92 to 0.95), rural residents (OR, 0.95; 95% CI, 0.93 to 0.97), and dipeptidyl peptidase-4 inhibitor (DPP-4i) users (OR, 0.82; 95% CI, 0.81 to 0.84) were associated with lesser initiation of SGLT2i in ASCVD. Additionally, female gender (OR, 0.97; 95% CI, 0.95 to 0.99) was associated with lesser initiation of SGLT2i in HF.
Conclusion
The prescription rate of SGLT2i increased gradually up to 2019 but was suboptimal in patients with ASCVD or HF. After the first hospitalization for ASCVD or HF, older age, female gender, low household income, rural residents, and DPP-4i users were less likely to initiate SGLT2i.

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Review
Guideline/Fact Sheet
Article image
2021 Clinical Practice Guidelines for Diabetes Mellitus in Korea
Kyu Yeon Hur, Min Kyong Moon, Jong Suk Park, Soo-Kyung Kim, Seung-Hwan Lee, Jae-Seung Yun, Jong Ha Baek, Junghyun Noh, Byung-Wan Lee, Tae Jung Oh, Suk Chon, Ye Seul Yang, Jang Won Son, Jong Han Choi, Kee Ho Song, Nam Hoon Kim, Sang Yong Kim, Jin Wha Kim, Sang Youl Rhee, You-Bin Lee, Sang-Man Jin, Jae Hyeon Kim, Chong Hwa Kim, Dae Jung Kim, SungWan Chun, Eun-Jung Rhee, Hyun Min Kim, Hyun Jung Kim, Donghyun Jee, Jae Hyun Kim, Won Seok Choi, Eun-Young Lee, Kun-Ho Yoon, Seung-Hyun Ko, Committee of Clinical Practice Guidelines, Korean Diabetes Association
Diabetes Metab J. 2021;45(4):461-481.   Published online July 30, 2021
DOI: https://doi.org/10.4093/dmj.2021.0156
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Graphical AbstractGraphical Abstract AbstractAbstract PDFPubReader   ePub   
The Committee of Clinical Practice Guidelines of the Korean Diabetes Association (KDA) updated the previous clinical practice guidelines for Korean adults with diabetes and prediabetes and published the seventh edition in May 2021. We performed a comprehensive systematic review of recent clinical trials and evidence that could be applicable in real-world practice and suitable for the Korean population. The guideline is provided for all healthcare providers including physicians, diabetes experts, and certified diabetes educators across the country who manage patients with diabetes or the individuals at the risk of developing diabetes mellitus. The recommendations for screening diabetes and glucose-lowering agents have been revised and updated. New sections for continuous glucose monitoring, insulin pump use, and non-alcoholic fatty liver disease in patients with diabetes mellitus have been added. The KDA recommends active vaccination for coronavirus disease 2019 in patients with diabetes during the pandemic. An abridgement that contains practical information for patient education and systematic management in the clinic was published separately.

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Original Articles
Complications
Article image
Renal Tubular Damage Marker, Urinary N-acetyl-β-D-Glucosaminidase, as a Predictive Marker of Hepatic Fibrosis in Type 2 Diabetes Mellitus
Hae Kyung Kim, Minyoung Lee, Yong-ho Lee, Eun Seok Kang, Bong-Soo Cha, Byung-Wan Lee
Diabetes Metab J. 2022;46(1):104-116.   Published online July 13, 2021
DOI: https://doi.org/10.4093/dmj.2020.0273
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Graphical AbstractGraphical Abstract AbstractAbstract PDFSupplementary MaterialPubReader   ePub   
Background
Non-alcoholic steatohepatitis is closely associated with the progression of diabetic kidney disease (DKD) in type 2 diabetes mellitus (T2DM). We investigated whether urinary N-acetyl-β-D-glucosaminidase (u-NAG), an early renal tubular damage biomarker in DKD, could be related to the degree of hepatic fibrosis in patients with T2DM.
Methods
A total of 300 patients with T2DM were enrolled in this study. Hepatic steatosis and fibrosis were determined using transient elastography. The levels of urinary biomarkers, including u-NAG, albumin, protein, and creatinine, and glucometabolic parameters were measured.
Results
Based on the median value of the u-NAG to creatinine ratio (u-NCR), subjects were divided into low and high u-NCR groups. The high u-NCR group showed a significantly longer duration of diabetes, worsened hyperglycemia, and a more enhanced hepatic fibrosis index. A higher u-NCR was associated with a greater odds ratio for the risk of higher hepatic fibrosis stage (F2: odds ratio, 1.99; 95% confidence interval [CI], 1.04 to 3.82). Also, u-NCR was an independent predictive marker for more advanced hepatic fibrosis, even after adjusting for several confounding factors (β=1.58, P<0.01).
Conclusion
The elevation of u-NAG was independently associated with a higher degree of hepatic fibrosis in patients with T2DM. Considering the common metabolic milieu of renal and hepatic fibrosis in T2DM, the potential use of u-NAG as an effective urinary biomarker reflecting hepatic fibrosis in T2DM needs to be validated in the future.

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Basic Research
Article image
Ipragliflozin, an SGLT2 Inhibitor, Ameliorates High-Fat Diet-Induced Metabolic Changes by Upregulating Energy Expenditure through Activation of the AMPK/ SIRT1 Pathway
Ji-Yeon Lee, Minyoung Lee, Ji Young Lee, Jaehyun Bae, Eugene Shin, Yong-ho Lee, Byung-Wan Lee, Eun Seok Kang, Bong-Soo Cha
Diabetes Metab J. 2021;45(6):921-932.   Published online February 22, 2021
DOI: https://doi.org/10.4093/dmj.2020.0187
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Graphical AbstractGraphical Abstract AbstractAbstract PDFSupplementary MaterialPubReader   ePub   
Background
Sodium-glucose co-transporter 2 (SGLT2) inhibitors are a new class of antidiabetic drugs that exhibit multiple extraglycemic effects. However, there are conflicting results regarding the effects of SGLT2 inhibition on energy expenditure and thermogenesis. Therefore, we investigated the effect of ipragliflozin (a selective SGLT2 inhibitor) on energy metabolism.
Methods
Six-week-old male 129S6/Sv mice with a high propensity for adipose tissue browning were randomly assigned to three groups: normal chow control, 60% high-fat diet (HFD)-fed control, and 60% HFD-fed ipragliflozin-treated groups. The administration of diet and medication was continued for 16 weeks.
Results
The HFD-fed mice became obese and developed hepatic steatosis and adipose tissue hypertrophy, but their random glucose levels were within the normal ranges; these features are similar to the metabolic features of a prediabetic condition. Ipragliflozin treatment markedly attenuated HFD-induced hepatic steatosis and reduced the size of hypertrophied adipocytes to that of smaller adipocytes. In the ipragliflozin treatment group, uncoupling protein 1 (Ucp1) and other thermogenesis-related genes were significantly upregulated in the visceral and subcutaneous adipose tissue, and fatty acid oxidation was increased in the brown adipose tissue. These effects were associated with a significant reduction in the insulin-to-glucagon ratio and the activation of the AMP-activated protein kinase (AMPK)/sirtuin 1 (SIRT1) pathway in the liver and adipose tissue.
Conclusion
SGLT2 inhibition by ipragliflozin showed beneficial metabolic effects in 129S6/Sv mice with HFD-induced obesity that mimics prediabetic conditions. Our data suggest that SGLT2 inhibitors, through their upregulation of energy expenditure, may have therapeutic potential in prediabetic obesity.

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Technology/Device
Article image
Data Configuration and Publication Trends for the Korean National Health Insurance and Health Insurance Review & Assessment Database
Hae Kyung Kim, Sun Ok Song, Junghyun Noh, In-Kyung Jeong, Byung-Wan Lee
Diabetes Metab J. 2020;44(5):671-678.   Published online October 21, 2020
DOI: https://doi.org/10.4093/dmj.2020.0207
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  • 142 Crossref
AbstractAbstract PDFPubReader   ePub   
Background
Big data reports related to diseases and health care for the Korean population have been published since the National Health Insurance Service (NHIS) and the Health Insurance Review & Assessment (HIRA) Service provided limited open access to their databases. Here, we reviewed the structure, content, and means of using data from the National Health Insurance (NHI) system for the benefit of Korean researchers and presented the latest publication trends in Korean healthcare data procured from the NHI and HIRA databases.
Methods
Since 2013, researchers have been able to obtain nationwide population-based studies using the NHI and HIRA databases of the insured. We searched publications using the NHI and the HIRA databases between 2013 and 2019 retrieved from PubMed.
Results
The NHI and HIRA databases provide nationwide population-based data. The total number of publications from 2014 to 2019 using NHI and HIRA databases is 2,541 and 655, respectively. A total of 5,465 endocrinology-related studies were performed during 2014 to 2019.
Conclusion
The NHIS and HIRA databases have provided tools for guidelines to approach world-leading population-based epidemiology and disease research.

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Type 1 Diabetes
Article image
Age at Diagnosis and the Risk of Diabetic Nephropathy in Young Patients with Type 1 Diabetes Mellitus
Jong Ha Baek, Woo Je Lee, Byung-Wan Lee, Soo Kyoung Kim, Gyuri Kim, Sang-Man Jin, Jae Hyeon Kim
Diabetes Metab J. 2021;45(1):46-54.   Published online July 10, 2020
DOI: https://doi.org/10.4093/dmj.2019.0134
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AbstractAbstract PDFPubReader   ePub   
Background

The aim of this study was to evaluate characteristics and risk of diabetic complications according to age at diagnosis among young adults with type 1 diabetes mellitus (T1DM).

Methods

A total of 255 T1DM patients aged less than 40 years were included. Patients were categorized into three groups (<20, 20 to 29, and 30 to 40 years) according to age at diagnosis. Diabetic nephropathy (DN) was defined when spot urine-albumin creatinine ratio was 300 mg/g or more and/or estimated glomerular filtration ratio (eGFR) level was 60 mL/min/1.73 m2 or less.

Results

Median age at diagnosis was 25 years and disease duration was 14 years. Individuals diagnosed with T1DM at childhood/adolescent (age <20 years) had lower stimulated C-peptide levels. They received more intensive insulin treatment with higher total daily insulin doses compared to older onset groups. The prevalence of DN was higher in the childhood/adolescent-onset group than in older onset groups (25.3% vs. 15.3% vs. 9.6%, P=0.022). The eGFR was inversely associated with disease duration whilst the degree of decrease was more prominent in the childhood/adolescent-onset group than in the later onset group (aged 30 to 40 years; P<0.001). Childhood/adolescent-onset group was independently associated with the risk of DN compared to the older onset group (aged 30 to 40 years; odds ratio, 3.47; 95% confidence interval, 1.45 to 8.33; P=0.005).

Conclusion

In individuals with childhood/adolescent-onset T1DM, the reduction in renal function is more prominent with disease duration. Early age-onset T1DM is an independent risk of DN.

Citations

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Drug/Regimen
Article image
Effect of Dapagliflozin as an Add-on Therapy to Insulin on the Glycemic Variability in Subjects with Type 2 Diabetes Mellitus (DIVE): A Multicenter, Placebo-Controlled, Double-Blind, Randomized Study
Seung-Hwan Lee, Kyung-Wan Min, Byung-Wan Lee, In-Kyung Jeong, Soon-Jib Yoo, Hyuk-Sang Kwon, Yoon-Hee Choi, Kun-Ho Yoon
Diabetes Metab J. 2021;45(3):339-348.   Published online May 28, 2020
DOI: https://doi.org/10.4093/dmj.2019.0203
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Graphical AbstractGraphical Abstract AbstractAbstract PDFSupplementary MaterialPubReader   ePub   
Background

Glycemic variability is associated with the development of diabetic complications and hypoglycemia. However, the effect of sodium-glucose transporter 2 (SGLT2) inhibitors on glycemic variability is controversial. We aimed to examine the effect of dapagliflozin as an add-on therapy to insulin on the glycemic variability assessed using continuous glucose monitoring (CGM) in subjects with type 2 diabetes mellitus.

Methods

In this multicenter, placebo-controlled, double-blind, randomized study, 84 subjects received 10 mg of dapagliflozin (n=41) or the placebo (n=43) for 12 weeks. CGM was performed before and after treatment to compare the changes in glycemic variability measures (standard deviation [SD], mean amplitude of glycemic excursions [MAGEs]).

Results

At week 12, significant reductions in glycosylated hemoglobin (−0.74%±0.66% vs. 0.01%±0.65%, P<0.001), glycated albumin (−3.94%±2.55% vs. −0.67%±2.48%, P<0.001), and CGM-derived mean glucose (−41.6±39.2 mg/dL vs. 1.1±46.2 mg/dL, P<0.001) levels were observed in the dapagliflozin group compared with the placebo group. SD and MAGE were significantly decreased in the dapagliflozin group, but not in the placebo group. However, the difference in ΔSD and ΔMAGE failed to reach statistical significance between two groups. No significant differences in the incidence of safety endpoints were observed between the two groups.

Conclusion

Dapagliflozin effectively decreased glucose levels, but not glucose variability, after 12 weeks of treatment in participants with type 2 diabetes mellitus receiving insulin treatment. The role of SGLT2 inhibitors in glycemic variability warrants further investigations.

Citations

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Review
Guideline/Fact Sheet
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, Korean Diabetes Association (KDA) Fatty Liver Research Group
Diabetes Metab J. 2020;44(3):382-401.   Published online May 11, 2020
DOI: https://doi.org/10.4093/dmj.2020.0010
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AbstractAbstract PDFPubReader   ePub   

This clinical practice position statement, a product of the Fatty Liver Research Group of the Korean Diabetes Association, proposes recommendations for the diagnosis, progression and/or severity assessment, management, and follow-up of non-alcoholic fatty liver disease (NAFLD) in patients with type 2 diabetes mellitus (T2DM). Patients with both T2DM and NAFLD have an increased risk of non-alcoholic steatohepatitis (NASH) and fibrosis and a higher risk of cardiovascular diseases and diabetic complications compared to those without NAFLD. With regards to the evaluation of patients with T2DM and NAFLD, ultrasonography-based stepwise approaches using noninvasive biomarker models such as fibrosis-4 or the NAFLD fibrosis score as well as imaging studies such as vibration-controlled transient elastography with controlled attenuation parameter or magnetic resonance imaging-proton density fat fraction are recommended. After the diagnosis of NAFLD, the stage of fibrosis needs to be assessed appropriately. For management, weight reduction achieved by lifestyle modification has proven beneficial and is recommended in combination with antidiabetic agent(s). Evidence that some antidiabetic agents improve NAFLD/NASH with fibrosis in patients with T2DM is emerging. However, there are currently no definite pharmacologic treatments for NAFLD in patients with T2DM. For specific cases, bariatric surgery may be an option if indicated.

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Corrigendum
Corrigenda: Table Correction. Nonalcoholic Fatty Liver Disease in Diabetes. Part I: Epidemiology and Diagnosis
Yong-ho Lee, Yongin Cho, Byung-Wan Lee, Cheol-Young Park, Dae Ho Lee, Bong-Soo Cha, Eun-Jung Rhee
Diabetes Metab J. 2019;43(5):731-731.   Published online October 24, 2019
DOI: https://doi.org/10.4093/dmj.2019.0188
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
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    Varun Saxena, Weilu Wu, Sreepriya Balasubramanian, Nizar Mukhtar, Suk I. Seo, Joanna B. Ready, Brock A. MacDonald, Julie A. Schmittdiel
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Original Article
Clinical Diabetes & Therapeutics
Effectiveness and Safety of Adding Basal Insulin Glargine in Patients with Type 2 Diabetes Mellitus Exhibiting Inadequate Response to Metformin and DPP-4 Inhibitors with or without Sulfonylurea
Yu Mi Kang, Chang Hee Jung, Seung-Hwan Lee, Sang-Wook Kim, Kee-Ho Song, Sin Gon Kim, Jae Hyeon Kim, Young Min Cho, Tae Sun Park, Bon Jeong Ku, Gwanpyo Koh, Dol Mi Kim, Byung-Wan Lee, Joong-Yeol Park
Diabetes Metab J. 2019;43(4):432-446.   Published online June 19, 2019
DOI: https://doi.org/10.4093/dmj.2018.0092
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AbstractAbstract PDFSupplementary MaterialPubReader   ePub   
Background

We aimed to investigate the effectiveness and safety of adding basal insulin to initiating dipeptidyl peptidase-4 (DPP-4) inhibitor and metformin and/or sulfonylurea (SU) in achieving the target glycosylated hemoglobin (HbA1c) in patients with type 2 diabetes mellitus (T2DM).

Methods

This was a single-arm, multicenter, 24-week, open-label, phase 4 study in patients with inadequately controlled (HbA1c ≥7.5%) T2DM despite the use of DPP-4 inhibitor and metformin. A total of 108 patients received insulin glargine while continuing oral antidiabetic drugs (OADs). The primary efficacy endpoint was the percentage of subjects achieving HbA1c ≤7.0%. Other glycemic profiles were also evaluated, and the safety endpoints were adverse events (AEs) and hypoglycemia.

Results

The median HbA1c at baseline (8.9%; range, 7.5% to 11.1%) decreased to 7.6% (5.5% to 11.7%) at 24 weeks. Overall, 31.7% subjects (n=33) achieved the target HbA1c level of ≤7.0%. The mean differences in body weight and fasting plasma glucose were 1.2±3.4 kg and 56.0±49.8 mg/dL, respectively. Hypoglycemia was reported in 36 subjects (33.3%, 112 episodes), all of which were fully recovered. There was no serious AE attributed to insulin glargine. Body weight change was significantly different between SU users and nonusers (1.5±2.5 kg vs. −0.9±6.0 kg, P=0.011).

Conclusion

The combination add-on therapy of insulin glargine, on metformin and DPP-4 inhibitors with or without SU was safe and efficient in reducing HbA1c levels and thus, is a preferable option in managing T2DM patients exhibiting dysglycemia despite the use of OADs.

Citations

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  • The Effect of Insulin Glargine in Control of Diabetes Among Sudanese Patients in 2024: A Cross-Sectional Study
    Hiba Abdelgadir, Husam Abdlraheem, Housameldin Ali, Hussam Jadallah, Hind Abdelgadir, Eltoum Elnour, Mosab Ahmed, Ahmed Awad
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  • Glycaemic control with add‐on thiazolidinedione or a sodium‐glucose co‐transporter‐2 inhibitor in patients with type 2 diabetes after the failure of an oral triple antidiabetic regimen: A 24‐week, randomized controlled trial
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Short Communication
Clinical Diabetes & Therapeutics
A Lower Baseline Urinary Glucose Excretion Predicts a Better Response to the Sodium Glucose Cotransporter 2 Inhibitor
You-Cheol Hwang, Jae Hyeon Kim, Byung-Wan Lee, Woo Je Lee
Diabetes Metab J. 2019;43(6):898-905.   Published online June 14, 2019
DOI: https://doi.org/10.4093/dmj.2018.0257
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AbstractAbstract PDFSupplementary MaterialPubReader   ePub   

We aimed to identify the clinical variables associated with a better glucose-lowering response to the sodium glucose cotransporter 2 inhibitor ipragliflozin in people with type 2 diabetes mellitus (T2DM). We especially focused on urinary glucose excretion (UGE). This was a single-arm multicenter prospective study. A total of 92 people with T2DM aged 20 to 70 years with glycosylated hemoglobin (HbA1c) levels ≥7.0% and ≤9.5% were enrolled. Ipragliflozin (50 mg) was added to the background therapy for these people for 12 weeks. After 3 months treatment with ipragliflozin, the mean HbA1c levels were decreased from 7.6% to 6.9% and 62.0% of the people reached the HbA1c target of less than 7.0% (P<0.001). In addition, body weight, blood pressure, and lipid parameters were improved after ipragliflozin treatment (all P<0.001). The baseline HbA1c (r=0.66, P<0.001) and morning spot urine glucose to creatinine ratio (r=−0.30, P=0.001) were independently associated with the HbA1c reduction. Ipragliflozin treatment for 12 weeks improves glycemic control and other metabolic parameters. A higher HbA1c and lower UGE at baseline predicts a better glucose-lowering efficacy of ipragliflozin.

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Review
Clinical Diabetes & Therapeutics
Nonalcoholic Fatty Liver Disease and Diabetes: Part II: Treatment
Kyung-Soo Kim, Byung-Wan Lee, Yong Jin Kim, Dae Ho Lee, Bong-Soo Cha, Cheol-Young Park
Diabetes Metab J. 2019;43(2):127-143.   Published online April 15, 2019
DOI: https://doi.org/10.4093/dmj.2019.0034
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AbstractAbstract PDFPubReader   ePub   

Nonalcoholic fatty liver disease (NAFLD) and diabetes are common metabolic disorders that are often comorbid conditions. Among many proposed treatments, weight reduction is the only approved option for NAFLD to date. However, it is not easy to maintain weight loss by lifestyle modification alone; pharmacological treatments are helpful in this regard. Although many drugs have been investigated, pioglitazone could be a first-line therapy in patients with NAFLD and diabetes. Many more drugs are currently being developed and investigated, and it is likely that combination strategies will be used for future treatment of NAFLD and diabetes. Attention should be paid to the management of NAFLD and diabetes and efforts should be made to intervene early and individualize treatment of NAFLD in patients with diabetes.

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Original Articles
Metabolic Risk/Epidemiology
Association between Non-Alcoholic Steatohepatitis and Left Ventricular Diastolic Dysfunction in Type 2 Diabetes Mellitus
Hokyou Lee, Gyuri Kim, Young Ju Choi, Byung Wook Huh, Byung-Wan Lee, Eun Seok Kang, Bong-Soo Cha, Eun Jig Lee, Yong-ho Lee, Kap Bum Huh
Diabetes Metab J. 2020;44(2):267-276.   Published online February 28, 2019
DOI: https://doi.org/10.4093/dmj.2019.0001
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AbstractAbstract PDFPubReader   ePub   
Background

Impaired diastolic heart function has been observed in persons with non-alcoholic fatty liver disease (NAFLD) and/or with type 2 diabetes mellitus (T2DM). However, it is unclear whether NAFLD fibrotic progression, i.e., non-alcoholic steatohepatitis, poses an independent risk for diastolic dysfunction in T2DM. We investigated the association between liver fibrosis and left ventricular (LV) diastolic dysfunction in T2DM.

Methods

We analyzed 606 patients with T2DM, aged ≥50 years, who had undergone liver ultrasonography and pulsed-wave Doppler echocardiography. Insulin sensitivity was measured by short insulin tolerance test. Presence of NAFLD and/or advanced liver fibrosis was determined by abdominal ultrasonography and NAFLD fibrosis score (NFS). LV diastolic dysfunction was defined according to transmitral peak early to late ventricular filling (E/A) ratio and deceleration time, using echocardiography.

Results

LV diastolic dysfunction was significantly more prevalent in the NAFLD versus non-NAFLD group (59.7% vs. 49.0%, P=0.011). When NAFLD was stratified by NFS, subjects with advanced liver fibrosis exhibited a higher prevalence of diastolic dysfunction (49.0%, 50.7%, 61.8%; none, simple steatosis, advanced fibrosis, respectively; P for trend=0.003). In multivariable logistic regression, liver fibrosis was independently associated with diastolic dysfunction (odds ratio [OR], 1.58; 95% confidence interval [CI], 1.07 to 2.34; P=0.022) after adjusting for insulin resistance and cardiometabolic risk factors. This association remained significant in patients without insulin resistance (OR, 4.32; 95% CI, 1.73 to 11.51; P=0.002).

Conclusions

Liver fibrosis was associated with LV diastolic dysfunction in patients with T2DM and may be an independent risk factor for diastolic dysfunction, especially in patients without systemic insulin resistance.

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Clinical Diabetes & Therapeutics
Predictors of the Therapeutic Efficacy and Consideration of the Best Combination Therapy of Sodium-Glucose Co-transporter 2 Inhibitors
Ji-Yeon Lee, Yongin Cho, Minyoung Lee, You Jin Kim, Yong-ho Lee, Byung-Wan Lee, Bong-Soo Cha, Eun Seok Kang
Diabetes Metab J. 2019;43(2):158-173.   Published online January 25, 2019
DOI: https://doi.org/10.4093/dmj.2018.0057
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AbstractAbstract PDFSupplementary MaterialPubReader   ePub   
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).

Methods

A 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.

Results

After 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.

Conclusion

A 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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Clinical Diabetes & Therapeutics
Acarbose Add-on Therapy in Patients with Type 2 Diabetes Mellitus with Metformin and Sitagliptin Failure: A Multicenter, Randomized, Double-Blind, Placebo-Controlled Study
Hae Kyung Yang, Seung-Hwan Lee, Juyoung Shin, Yoon-Hee Choi, Yu-Bae Ahn, Byung-Wan Lee, Eun Jung Rhee, Kyung Wan Min, Kun-Ho Yoon
Diabetes Metab J. 2019;43(3):287-301.   Published online December 20, 2018
DOI: https://doi.org/10.4093/dmj.2018.0054
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Background

We evaluated the efficacy and safety of acarbose add-on therapy in Korean patients with type 2 diabetes mellitus (T2DM) who are inadequately controlled with metformin and sitagliptin.

Methods

A total of 165 subjects were randomized to metformin and sitagliptin (Met+Sita, n=65), metformin, sitagliptin, and acarbose (Met+Sita+Acarb, n=66) and sitagliptin and acarbose (Sita+Acarb, exploratory assessment, n=34) therapy in five institutions in Korea. After 16 weeks of acarbose add-on or metformin-switch therapy, a triple combination therapy was maintained from week 16 to 24.

Results

The add-on of acarbose (Met+Sita+Acarb group) demonstrated a 0.44%±0.08% (P<0.001 vs. baseline) decrease in glycosylated hemoglobin (HbA1c) at week 16, while changes in HbA1c were insignificant in the Met+Sita group (−0.09%±0.10%, P=0.113). After 8 weeks of triple combination therapy, HbA1c levels were comparable between Met+Sita and Met+Sita+Acarb group (7.66%±0.13% vs. 7.47%±0.12%, P=0.321). Acarbose add-on therapy demonstrated suppressed glucagon secretion (area under the curve of glucagon, 4,726.17±415.80 ng·min/L vs. 3,314.38±191.63 ng·min/L, P=0.004) in the absence of excess insulin secretion during the meal tolerance tests at week 16 versus baseline. The incidence of adverse or serious adverse events was similar between two groups.

Conclusion

In conclusion, a 16-week acarbose add-on therapy to metformin and sitagliptin, effectively lowered HbA1c without significant adverse events. Acarbose might be a good choice as a third-line therapy in addition to metformin and sitagliptin in Korean subjects with T2DM who have predominant postprandial hyperglycemia and a high carbohydrate intake.

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Review
Complications
Nonalcoholic Fatty Liver Disease in Diabetes. Part I: Epidemiology and Diagnosis
Yong-ho Lee, Yongin Cho, Byung-Wan Lee, Cheol-Young Park, Dae Ho Lee, Bong-Soo Cha, Eun-Jung Rhee
Diabetes Metab J. 2019;43(1):31-45.   Published online December 17, 2018
DOI: https://doi.org/10.4093/dmj.2019.0011
Correction in: Diabetes Metab J 2019;43(5):731
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AbstractAbstract PDFPubReader   ePub   

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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Original Article
Complications
Glycated Albumin Is a More Useful Glycation Index than HbA1c for Reflecting Renal Tubulopathy in Subjects with Early Diabetic Kidney Disease
Ji Hye Huh, Minyoung Lee, So Young Park, Jae Hyeon Kim, Byung-Wan Lee
Diabetes Metab J. 2018;42(3):215-223.   Published online May 2, 2018
DOI: https://doi.org/10.4093/dmj.2017.0091
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AbstractAbstract PDFPubReader   ePub   
Background

The aim of this study was to investigate which glycemic parameters better reflect urinary N-acetyl-β-D-glucosaminidase (uNAG) abnormality, a marker for renal tubulopathy, in subjects with type 2 diabetes mellitus (T2DM) subjects with normoalbuminuria and a normal estimated glomerular filtration rate (eGFR).

Methods

We classified 1,061 participants with T2DM into two groups according to uNAG level—normal vs. high (>5.8 U/g creatinine)—and measured their biochemical parameters.

Results

Subjects with high uNAG level had significantly higher levels of fasting and stimulated glucose, glycated albumin (GA), and glycosylated hemoglobin (HbA1c) and lower levels of homeostasis model assessment of β-cell compared with subjects with normal uNAG level. Multiple linear regression analyses showed that uNAG was significantly associated with GA (standardized β coefficient [β]=0.213, P=0.016), but not with HbA1c (β=−0.137, P=0.096) or stimulated glucose (β=0.095, P=0.140) after adjusting confounding factors. In receiver operating characteristic analysis, the value of the area under the curve (AUC) for renal tubular injury of GA was significantly higher (AUC=0.634; 95% confidence interval [CI], 0.646 to 0.899) than those for HbA1c (AUC=0.598; 95% CI, 0.553 to 0.640), stimulated glucose (AUC=0.594; 95% CI, 0.552 to 0.636), or fasting glucose (AUC=0.558; 95% CI, 0.515 to 0.600). The optimal GA cutoff point for renal tubular damage was 17.55% (sensitivity 59%, specificity 62%).

Conclusion

GA is a more useful glycation index than HbA1c for reflecting renal tubulopathy in subjects with T2DM with normoalbuminuria and normal eGFR.

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Reviews
Clinical Diabetes & Therapeutics
Article image
Glucagon-Like Peptide-1 Receptor Agonists for the Treatment of Type 2 Diabetes Mellitus: A Position Statement of the Korean Diabetes Association
Hyun Jin Kim, Seok O Park, Seung-Hyun Ko, Sang Youl Rhee, Kyu-Yeon Hur, Nan-Hee Kim, Min Kyong Moon, Byung-Wan Lee, Jin Hwa Kim, Kyung Mook Choi
Diabetes Metab J. 2017;41(6):423-429.   Published online December 19, 2017
DOI: https://doi.org/10.4093/dmj.2017.41.6.423
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AbstractAbstract PDFPubReader   ePub   

The glucagon-like peptide-1 receptor agonists (GLP-1RAs) were recommended as a monotherapy or combination therapy with oral hypoglycemic agents or basal insulin in the position statement of the Korean Diabetes Association 2017 for pharmacological therapy. Many randomized clinical trials and systematic reviews report that GLP-1RAs have considerable glucose-lowering effect and lead to weight reduction and low risk of hypoglycemia when used as a monotherapy or combination therapy. The cardiovascular safety of GLP-1RAs has been assessed in several randomized clinical trials and systematic reviews. The results of cardiovascular outcome trials of long-acting GLP-1RAs (liraglutide, semaglutide) demonstrated cardiovascular benefits in subjects with type 2 diabetes mellitus and a high risk of cardiovascular disease. The GLP-1RA may be a choice of therapy when weight control and avoidance of hypoglycemia are important, and patients with high risk of cardiovascular disease might also favor choosing GLP-1RA.

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Clinical Diabetes & Therapeutics
Article image
Insulin Therapy for Adult Patients with Type 2 Diabetes Mellitus: A Position Statement of the Korean Diabetes Association, 2017
Byung-Wan Lee, Jin Hwa Kim, Seung-Hyun Ko, Kyu-Yeon Hur, Nan-Hee Kim, Sang Youl Rhee, Hyun Jin Kim, Min Kyong Moon, Seok-O Park, Kyung Mook Choi
Diabetes Metab J. 2017;41(5):367-373.   Published online October 24, 2017
DOI: https://doi.org/10.4093/dmj.2017.41.5.367
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AbstractAbstract PDFPubReader   ePub   

The Korean Diabetes Association (KDA) has regularly updated its Clinical Practice Guidelines. In 2017, the KDA published a position statement on the use of antihyperglycemic agents for patients with type 2 diabetes mellitus (T2DM). Growing evidence from new multinational clinical trials using novel and traditional insulin analogues has also been accumulated. Following global trends, many results of clinical trials, especially concerning the clinical efficacy and safety of insulin therapy, have been published about Korean patients with T2DM. After a systematic search of recent evidence, the KDA updated and modified its clinical practice recommendations regarding the initiation, choice, and intensification of insulin and created an insulin treatment algorithm for the first time to guide physicians caring for adult Korean patients with T2DM.

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Clinical Diabetes & Therapeutics
Article image
Combination Therapy of Oral Hypoglycemic Agents in Patients with Type 2 Diabetes Mellitus
Min Kyong Moon, Kyu-Yeon Hur, Seung-Hyun Ko, Seok-O Park, Byung-Wan Lee, Jin Hwa Kim, Sang Youl Rhee, Hyun Jin Kim, Kyung Mook Choi, Nan-Hee Kim
Diabetes Metab J. 2017;41(5):357-366.   Published online October 24, 2017
DOI: https://doi.org/10.4093/dmj.2017.41.5.357
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AbstractAbstract PDFPubReader   ePub   

The Korean Diabetes Association (KDA) recently updated the Clinical Practice Guidelines on antihyperglycemic agent therapy for adult patients with type 2 diabetes mellitus (T2DM). In combination therapy of oral hypoglycemic agents (OHAs), general recommendations were not changed from those of the 2015 KDA guidelines. The Committee on Clinical Practice Guidelines of the KDA has extensively reviewed and discussed the results of meta-analyses and systematic reviews of effectiveness and safety of OHAs and many clinical trials on Korean patients with T2DM for the update of guidelines. All OHAs were effective when added to metformin or metformin and sulfonylurea, although the effects of each agent on body weight and hypoglycemia were different. Therefore, selection of a second agent as a metformin add-on therapy or third agent as a metformin and sulfonylurea add-on therapy should be based on the patient's clinical characteristics and the efficacy, side effects, mechanism of action, risk of hypoglycemia, effect on body weight, patient preference, and combined comorbidity. In this review, we address the results of meta-analyses and systematic reviews, comparing the effectiveness and safety among OHAs. It will help to choose the appropriate drug for an individual patient with T2DM.

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Clinical Diabetes & Therapeutics
Article image
Monotherapy in Patients with Type 2 Diabetes Mellitus
Sang Youl Rhee, Hyun Jin Kim, Seung-Hyun Ko, Kyu-Yeon Hur, Nan-Hee Kim, Min Kyong Moon, Seok-O Park, Byung-Wan Lee, Kyung Mook Choi, Jin Hwa Kim
Diabetes Metab J. 2017;41(5):349-356.   Published online October 19, 2017
DOI: https://doi.org/10.4093/dmj.2017.41.5.349
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AbstractAbstract PDFPubReader   ePub   

In order to improve the quality of life and to prevent chronic complications related to diabetes mellitus, intensive lifestyle modification and proper medication are needed from the early stage of diagnosis of type 2 diabetes mellitus (T2DM). When using the first medication for diabetic patients, the appropriate treatment should be selected considering the clinical characteristics of the patient, efficacy of the drug, side effects, and cost. In general, the use of metformin as the first treatment for oral hypoglycemic monotherapy is recommended because of its excellent blood glucose-lowering effect, relatively low side effects, long-term proven safety, low risk of hypoglycemia, and low weight gain. If metformin is difficult to use as a first-line treatment, other appropriate medications should be selected in view of the clinical situation. If the goal of achieving glycemic control is not achieved by monotherapy, a combination therapy with different mechanisms of action should be initiated promptly.

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Clinical Diabetes & Therapeutics
Article image
Antihyperglycemic Agent Therapy for Adult Patients with Type 2 Diabetes Mellitus 2017: A Position Statement of the Korean Diabetes Association
Seung-Hyun Ko, Kyu-Yeon Hur, Sang Youl Rhee, Nan-Hee Kim, Min Kyong Moon, Seok-O Park, Byung-Wan Lee, Hyun Jin Kim, Kyung Mook Choi, Jin Hwa Kim
Diabetes Metab J. 2017;41(5):337-348.   Published online October 17, 2017
DOI: https://doi.org/10.4093/dmj.2017.41.5.337
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AbstractAbstract PDFPubReader   ePub   

In 2017, the Korean Diabetes Association (KDA) published a position statement on the use of antihyperglycemic agents for patients with type 2 diabetes mellitus (T2DM). The KDA regularly updates its Clinical Practice Guidelines, but since the last update in 2015, many results from clinical trials have been introduced, and domestic data from studies performed in Korean patients with T2DM have been published. Recently, evidence from large clinical studies assessing cardiovascular outcomes following the use of sodium-glucose cotransporter 2 inhibitors and glucagon-like peptide 1 receptor agonists in patients with T2DM were incorporated into the recommendations. Additionally, new data from clinical trials using dipeptidyl peptidase 4 inhibitors and thiazolidinediones in Korean patients with T2DM were added. Following a systematic review and assessment of recent evidence, the KDA updated and modified its clinical practice recommendations regarding the use of antihyperglycemic agents and revised the treatment algorithm for Korean adult patients with T2DM.

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Response
Response: Increased Risk of Hospitalization for Heart Failure with Newly Prescribed Dipeptidyl Peptidase-4 Inhibitors and Pioglitazone Using the Korean Health Insurance Claims Database (Diabetes Metab J 2015;39:247-52)
Sunghwan Suh, Gi Hyeon Seo, Chang Hee Jung, Mee-Kyoung Kim, Sang-Man Jin, You-Cheol Hwang, Byung-Wan Lee, Jae Hyeon Kim
Diabetes Metab J. 2015;39(4):350-351.   Published online August 17, 2015
DOI: https://doi.org/10.4093/dmj.2015.39.4.350
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PDFPubReader   ePub   
Original Articles
Increased Risk of Hospitalization for Heart Failure with Newly Prescribed Dipeptidyl Peptidase-4 Inhibitors and Pioglitazone Using the Korean Health Insurance Claims Database
Sunghwan Suh, Gi Hyeon Seo, Chang Hee Jung, Mee-Kyoung Kim, Sang-Man Jin, You-Cheol Hwang, Byung-Wan Lee, Jae Hyeon Kim
Diabetes Metab J. 2015;39(3):247-252.   Published online April 22, 2015
DOI: https://doi.org/10.4093/dmj.2015.39.3.247
  • 8,104 View
  • 41 Download
  • 21 Web of Science
  • 19 Crossref
AbstractAbstract PDFPubReader   ePub   
Background

We assessed the association of dipeptidyl peptidase 4 inhibitors (DPP4i) with hospitalization for heart failure (HF) using the Korean Health Insurance claims database.

Methods

We collected data on newly prescribed sitagliptin, vildagliptin, and pioglitazone between January 1, 2009 and December 31, 2012 (mean follow-up of 336.8 days) to 935,519 patients with diabetes (518,614 males and 416,905 females) aged 40 to 79 years (mean age of 59.4 years).

Results

During the study, 998 patients were hospitalized for primary HF (115.7 per 100,000 patient-years). The incidence rate of hospitalization for HF was 117.7 per 100,000 per patient-years among patients on pioglitazone, 105.7 for sitagliptin, and 135.8 for vildagliptin. The hospitalization rate for HF was greatest in the first 30 days after starting the medication, which corresponded to a significantly higher incidence at days 0 to 30 compared with days 31 to 360 for all three drugs. The hazard ratios were 1.85 (pioglitazone), 2.00 (sitagliptin), and 1.79 (vildagliptin). The incidence of hospitalization for HF did not differ between the drugs for any time period.

Conclusion

This study showed an increase in hospitalization for HF in the initial 30 days of the DPP4i and pioglitazone compared with the subsequent follow-up period. However, the differences between the drugs were not significant.

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1,5-Anhydroglucitol as a Useful Marker for Assessing Short-Term Glycemic Excursions in Type 1 Diabetes
Hannah Seok, Ji Hye Huh, Hyun Min Kim, Byung-Wan Lee, Eun Seok Kang, Hyun Chul Lee, Bong Soo Cha
Diabetes Metab J. 2015;39(2):164-170.   Published online March 9, 2015
DOI: https://doi.org/10.4093/dmj.2015.39.2.164
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AbstractAbstract PDFPubReader   ePub   
Background

Type 1 diabetes is associated with more severe glycemic variability and more frequent hypoglycemia than type 2 diabetes. Glycemic variability is associated with poor glycemic control and diabetic complications. In this study, we demonstrate the clinical usefulness of serum 1,5-anhydroglucitol (1,5-AG) for assessing changes in glycemic excursion in type 1 diabetes.

Methods

Seventeen patients with type 1 diabetes were enrolled in this study. A continuous glucose monitoring system (CGMS) was applied twice at a 2-week interval to evaluate changes in glycemic variability. The changes in serum glycemic assays, including 1,5-AG, glycated albumin and hemoglobin A1c (HbA1c), were also evaluated.

Results

Most subjects showed severe glycemic excursions, including hypoglycemia and hyperglycemia. The change in 1,5-AG level was significantly correlated with changes in the glycemic excursion indices of the standard deviation (SD), mean amplitude of glucose excursion (MAGE), lability index, mean postmeal maximum glucose, and area under the curve for glucose above 180 mg/dL (r=-0.576, -0.613, -0.600, -0.630, and -0.500, respectively; all P<0.05). Changes in glycated albumin were correlated with changes in SD and MAGE (r=0.495 and 0.517, respectively; all P<0.05). However, changes in HbA1c were not correlated with any changes in the CGMS variables.

Conclusion

1,5-AG may be a useful marker for the assessment of short-term changes in glycemic variability. Furthermore, 1,5-AG may have clinical implications for the evaluation and treatment of glycemic excursions in type 1 diabetes.

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The Glycated Albumin to Glycated Hemoglobin Ratio Might Not Be Associated with Carotid Atherosclerosis in Patients with Type 1 Diabetes
Wonjin Kim, Kwang Joon Kim, Byung-Wan Lee, Eun Seok Kang, Bong Soo Cha, Hyun Chul Lee
Diabetes Metab J. 2014;38(6):456-463.   Published online December 15, 2014
DOI: https://doi.org/10.4093/dmj.2014.38.6.456
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AbstractAbstract PDFPubReader   ePub   
Background

The ratio of glycated albumin to glycated hemoglobin (GA/A1c) is known to be elevated in subjects with type 2 diabetes mellitus (T2DM) who had decreased insulin secretion. Additionally, the carotid intima media thickness (IMT) is greater in T2DM patients with higher GA/A1c ratios. We investigated whether increased GA/A1c ratio and IMT are also associated in type 1 diabetes mellitus (T1DM), which is characterized by lack of insulin secretory capacity.

Methods

In this cross-sectional study, we recruited 81 T1DM patients (33 men, 48 women; mean age 44.1±13.0 years) who underwent carotid IMT, GA, and HbA1c measurements.

Results

The mean GA/A1c ratio was 2.90. Based on these results, we classified the subjects into two groups: group I (GA/A1c ratio <2.90, n=36) and group II (GA/A1c ratio ≥2.90, n=45). Compared with group I, the body mass indexes (BMIs), waist circumferences, and IMTs were lower in group II. GA/A1c ratio was negatively correlated with BMI, urine albumin to creatinine ratio (P<0.001 for both), and both the mean and maximal IMT (P=0.001, both). However, after adjusting the confounding factors, we observed that IMT was no longer associated with GA/A1c ratio.

Conclusion

In contrast to T2DM, IMT was not significantly related to GA/A1c ratio in the subjects with T1DM. This suggests that the correlations between GA/A1c ratio and the parameters known to be associated with atherosclerosis in T2DM could be manifested differently in T1DM. Further studies are needed to investigate these relationships in T1DM.

Citations

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Background and Data Configuration Process of a Nationwide Population-Based Study Using the Korean National Health Insurance System
Sun Ok Song, Chang Hee Jung, Young Duk Song, Cheol-Young Park, Hyuk-Sang Kwon, Bong Soo Cha, Joong-Yeol Park, Ki-Up Lee, Kyung Soo Ko, Byung-Wan Lee
Diabetes Metab J. 2014;38(5):395-403.   Published online October 17, 2014
DOI: https://doi.org/10.4093/dmj.2014.38.5.395
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AbstractAbstract PDFPubReader   ePub   
Background

The National Health Insurance Service (NHIS) recently signed an agreement to provide limited open access to the databases within the Korean Diabetes Association for the benefit of Korean subjects with diabetes. Here, we present the history, structure, contents, and way to use data procurement in the Korean National Health Insurance (NHI) system for the benefit of Korean researchers.

Methods

The NHIS in Korea is a single-payer program and is mandatory for all residents in Korea. The three main healthcare programs of the NHI, Medical Aid, and long-term care insurance (LTCI) provide 100% coverage for the Korean population. The NHIS in Korea has adopted a fee-for-service system to pay health providers. Researchers can obtain health information from the four databases of the insured that contain data on health insurance claims, health check-ups and LTCI.

Results

Metabolic disease as chronic disease is increasing with aging society. NHIS data is based on mandatory, serial population data, so, this might show the time course of disease and predict some disease progress, and also be used in primary and secondary prevention of disease after data mining.

Conclusion

The NHIS database represents the entire Korean population and can be used as a population-based database. The integrated information technology of the NHIS database makes it a world-leading population-based epidemiology and disease research platform.

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    Cancer Epidemiology, Biomarkers & Prevention.2026; 35(5): 743.     CrossRef
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    European Journal of Public Health.2026;[Epub]     CrossRef
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    Hee Joo Park, Youngsun Park, Juyeon Oh, Jian Lee, Juho Sim, Byungyoon Yun, Jin-Ha Yoon
    Journal of Korean Medical Science.2026;[Epub]     CrossRef
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    Journal of Neuroimmunology.2026; 418: 578961.     CrossRef
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    Jihui Jeon, Yoonjeong Choi, Tae-Woo Kim, Ja-Ho Leigh
    BMC Geriatrics.2026;[Epub]     CrossRef
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    Hyun-Kyung Kim, Suyoung Jo, Kyung-Duk Min, Sung-il Cho
    Journal of Infection.2026; 92(6): 106753.     CrossRef
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    Yoon Park, Byung‐Woo Kim, Jin‐Kyoung Oh, Bo Hyun Kim, Sang‐Jae Park, Kyung‐Ah Kim, Moran Ki
    Liver International.2026;[Epub]     CrossRef
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    Ha-Na Kim, Ji Hyun Lee, Yoonjong Bae, Hoseob Kim, Sang-Wook Song
    British Journal of Dermatology.2026;[Epub]     CrossRef
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    Epidemiology.2026; 37(4): 494.     CrossRef
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    Anesthesiology.2026; 145(1): 135.     CrossRef
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    Jung Soo Yoon, Jiyeong Kim, Eun Hee Hong, Sunjin Hwang
    Diabetes Research and Clinical Practice.2026; 238: 113351.     CrossRef
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    Parkinson's Disease.2026;[Epub]     CrossRef
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    Journal of the European Academy of Dermatology and Venereology.2026;[Epub]     CrossRef
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    Neuroepidemiology.2026; : 1.     CrossRef
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    BMC Medicine.2026;[Epub]     CrossRef
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    Investigative Radiology.2026;[Epub]     CrossRef
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    Value in Health.2026;[Epub]     CrossRef
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    Samel Park, Hyun Jung Kim, Hyung Woo Kim, Sun‐Hee Park, Sang Youb Han
    Diabetes, Obesity and Metabolism.2026;[Epub]     CrossRef
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    JAMA Network Open.2026; 9(6): e2620030.     CrossRef
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    Sang-Yong Eom, Hyun-a Jang, Yo Han Im, Kyung-Hwa Choi, Ji Hyoun Kim
    Rheumatology.2025; 64(1): 173.     CrossRef
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    Digestive and Liver Disease.2025; 57(1): 176.     CrossRef
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    American Journal of Gastroenterology.2025; 120(2): 410.     CrossRef
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    Hyo Kee Kim, Pyoung Jae Park, Jee Hyun Park, Young Ju Oh, Cheol Woong Jung, Heungman Jun
    Vascular.2025; 33(4): 790.     CrossRef
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    Internal and Emergency Medicine.2025; 20(1): 105.     CrossRef
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    Ophthalmology Retina.2025; 9(4): 386.     CrossRef
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    Rheumatology.2025; 64(5): 2601.     CrossRef
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    Eye.2025; 39(4): 755.     CrossRef
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    JHEP Reports.2025; 7(4): 101313.     CrossRef
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    Journal of the American Heart Association.2025;[Epub]     CrossRef
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    BMC Women's Health.2025;[Epub]     CrossRef
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    Journal of Clinical Periodontology.2025; 52(3): 375.     CrossRef
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    American Journal of Gastroenterology.2025; 120(10): 2361.     CrossRef
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    Diabetes Care.2025; 48(3): 422.     CrossRef
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    Obesity Surgery.2025; 35(2): 463.     CrossRef
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    European Journal of Cardio-Thoracic Surgery.2025;[Epub]     CrossRef
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    Chronic Diseases and Translational Medicine.2025; 11(2): 130.     CrossRef
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    Journal of Preventive Medicine and Public Health.2025; 58(1): 60.     CrossRef
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    European Respiratory Journal.2025; 65(2): 2401484.     CrossRef
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    Soo-Hee Hwang, Youngs Chang, Haibin Bai, Jieun Yun, Hyejin Lee, Jin Yong Lee, Dong Keon Yon
    PLOS ONE.2025; 20(2): e0316943.     CrossRef
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    World Journal of Gastrointestinal Oncology.2025;[Epub]     CrossRef
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    BMJ Mental Health.2025; 28(1): e301306.     CrossRef
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    Frontiers in Oncology.2025;[Epub]     CrossRef
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    Journal of Korean Medical Science.2025;[Epub]     CrossRef
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    Yonsei Medical Journal.2025; 66(7): 429.     CrossRef
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    BMJ Open.2025; 15(3): e087884.     CrossRef
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    Scientific Reports.2025;[Epub]     CrossRef
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    BMC Public Health.2025;[Epub]     CrossRef
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    BMJ Public Health.2025; 3(1): e002020.     CrossRef
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    Ho Jin Kim, Ye-Jee Kim, Minju Kim, Jae Suk Yoo, Dae-Hee Kim, Duk-Woo Park, Sung-Ho Jung, Suk Jung Choo, Joon Bum Kim
    The Journal of Thoracic and Cardiovascular Surgery.2024; 167(3): 981.     CrossRef
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    Suk Ho Sohn, Yoonjin Kang, Ji Seong Kim, Ho Young Hwang, Kyung Hwan Kim, Jae Woong Choi
    The Journal of Thoracic and Cardiovascular Surgery.2024; 167(6): 2117.     CrossRef
  • A Nationwide Population‐Based Study for the Recurrence and Comorbidities in Sudden Sensorineural Hearing Loss
    Hye Yeon Ko, Hae Jeong Nam, Min Hee Kim
    The Laryngoscope.2024; 134(3): 1417.     CrossRef
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    Jae-Woo Ju, Ho-Jin Lee, Karam Nam, Seungwook Kim, Hyunsook Hong, Seung Ho Yoo, Seohee Lee, Youn Joung Cho, Yunseok Jeon
    Anesthesia & Analgesia.2024; 139(1): 114.     CrossRef
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    International Journal of Stroke.2024; 19(3): 359.     CrossRef
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    Hong Rae Kim, Ho Jin Kim, Seonok Kim, Yejee Kim, Jung-Min Ahn, Joon Bum Kim, Dae-Hee Kim
    The Journal of Thoracic and Cardiovascular Surgery.2024; 168(5): 1438.     CrossRef
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    Yohwan Yeo, Jung Eun Yoo, Kyungdo Han, Jin-Hyung Jung, Hayoung Choi, Jongkyu Park, Dong Wook Shin, Hyun Lee
    Journal of Infection and Public Health.2024; 17(2): 286.     CrossRef
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    Journal of Bone and Joint Surgery.2024; 106(5): 381.     CrossRef
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    Jeong-Ik Park, Youngjin Jang, Hojong Park, Sungchoul Pyun, Hong Rae Cho, Sang Jun Park
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    Da Hea Seo, Mina Kim, Young Ju Suh, Yongin Cho, Seong Hee Ahn, Seongbin Hong, So Hun Kim
    Diabetes Research and Clinical Practice.2024; 208: 111098.     CrossRef
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    Minyoul Baik, Jimin Jeon, Jinkwon Kim, Joonsang Yoo
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    Yonsei Medical Journal.2024; 65(4): 234.     CrossRef
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    Clinical Lymphoma Myeloma and Leukemia.2024; 24(10): e366.     CrossRef
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    British Journal of Dermatology.2024; 190(6): 858.     CrossRef
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    Ji Seong Kim, Jinhee Kim, Yoonjin Kang, Suk Ho Sohn, Yewon Lee, Sue Hyun Kim, Ho Young Hwang, Kyung Hwan Kim, Mi-Sook Kim, Jae Woong Choi
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    International Journal of Telemedicine and Applications.2024; 2024: 1.     CrossRef
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    Journal of Epidemiology and Global Health.2024; 14(3): 1142.     CrossRef
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    JMIR Public Health and Surveillance.2024; 10: e48047.     CrossRef
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    Annals of Neurology.2023; 93(2): 384.     CrossRef
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    PLOS ONE.2023; 18(1): e0280642.     CrossRef
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    Journal of Integrative Medicine.2023; 21(2): 176.     CrossRef
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    Obstetrics & Gynecology Science.2023; 66(3): 190.     CrossRef
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    Bokyung Kim, Kyungdo Han, Hyunsoo Chung, Sang Gyun Kim, Soo‐Jeong Cho
    Cancer.2023; 129(18): 2893.     CrossRef
  • Acute Pancreatitis and the Risk of Dementia in Diabetes: A Nationwide Cohort Study Using Korean Healthcare Claims Database
    Woo Hyun Paik, Dong Kee Jang, Soyoung Cho, Jin Ho Choi, Min Kyu Kim, In Rae Cho, Ji Kon Ryu, Yong-Tae Kim, Kyung-Do Han, Sang Hyub Lee
    Journal of Alzheimer’s Disease.2023; 94(1): 205.     CrossRef
  • Application of big data in ophthalmology
    Zhi Da Soh, Ching-Yu Cheng
    Taiwan Journal of Ophthalmology.2023; 13(2): 123.     CrossRef
  • Impact of mental disorders on the risk of heart failure among Korean patients with diabetes: a cohort study
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  • Evaluating Reference Ages for Selecting Prosthesis Types for Heart Valve Replacement in Korea
    Sung Jun Park, You Jung Ok, Ho Jin Kim, Ye-Jee Kim, Seonok Kim, Jung-Min Ahn, Dae-Hee Kim, Jae-Sung Choi, Joon Bum Kim
    JAMA Network Open.2023; 6(5): e2314671.     CrossRef
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    Sangmo Hong, Kyungdo Han, Jung Hwan Park, Sung Hoon Yu, Chang Beom Lee, Dong Sun Kim
    Journal of Lipid and Atherosclerosis.2023; 12(2): 164.     CrossRef
  • Impact of Allergic Disease on the Risk of Mycobacterial Disease
    Taehee Kim, Hayoung Choi, Hyun Lee, Kyungdo Han, Dong Won Park, Tai Sun Park, Ji-Yong Moon, Tae-Hyung Kim, Jang Won Sohn, Ho Joo Yoon, Sang-Heon Kim
    The Journal of Allergy and Clinical Immunology: In Practice.2023; 11(9): 2830.     CrossRef
  • Trends in the Prevalence of Blindness and Correlation With Health Status in Korean Adults: A 10-Year Nationwide Population-Based Study
    Kyeong Ik Na, Won June Lee, Young Kook Kim
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  • Association between regular physical activity and lower incidence of colorectal cancer in patients with diabetes mellitus: a nationwide cohort study
    Han Hee Lee, Kyu‐na Lee, Jin Su Kim, Dae Young Cheung, Hyuk‐Sang Kwon, Bo‐In Lee, Young‐Seok Cho, Soo‐Heon Park, Kyungdo Han, Jin Il Kim
    Colorectal Disease.2023; 25(8): 1588.     CrossRef
  • Bovine pericardial versus porcine bioprosthetic mitral valves: results from a Korean Nationwide Cohort Study
    Hong Rae Kim, Jino Park, Sung Jun Park, Ho Jin Kim, Seonok Kim, Ye-Jee Kim, Jung-Min Ahn, Dae-Hee Kim, Joon Bum Kim
    European Journal of Cardio-Thoracic Surgery.2023;[Epub]     CrossRef
  • Examining the factors associated with inpatients’ perception of overtreatment in Korea: a cross-sectional study
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    BMC Health Services Research.2023;[Epub]     CrossRef
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    Suk Ho Sohn, Yoonjin Kang, Ji Seong Kim, Ho Young Hwang, Kyung Hwan Kim, Jae Woong Choi
    European Journal of Cardio-Thoracic Surgery.2023;[Epub]     CrossRef
  • Association of physical activity with total and cause-specific mortality in patients with diabetes: A nationwide population-based cohort study
    Inha Jung, Kyung-Do Han, Sun Joon Moon, Hyemi Kwon, Se Eun Park, Eun-Jung Rhee, Won-Young Lee
    Diabetes Research and Clinical Practice.2023; 202: 110819.     CrossRef
  • The Association Between Institutional Case Volume of Hematopoietic Stem Cell Transplantation and Mortality
    Leerang Lim, Eun Jin Jang, Jun Woo Jo, Junghoon Shin, Hyobin Lee, Hannah Lee, Seung-Young Oh, Hyunjae Im, Ho Geol Ryu
    Transplantation Proceedings.2023; 55(7): 1715.     CrossRef
  • Association between periodontal disease status and risk of atrial fibrillation: a nationwide population-based cohort study
    Jung-Hyun Park, Hyungwoo Lee, Jin-Woo Kim, Tae-Jin Song
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  • Trends in the incidence and prevalence of dysphagia requiring medical attention among adults in South Korea, 2006–2016: A nationwide population study
    SuYeon Kwon, Seungwoo Cha, Junsik Kim, Kyungdo Han, Nam-Jong Paik, Won-Seok Kim, Sina Azadnajafabad
    PLOS ONE.2023; 18(6): e0287512.     CrossRef
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    Byungyoon Yun, Juyeon Oh, Jaesung Choi, Laura S. Rozek, Heejoo Park, Juho Sim, Yangwook Kim, Jongmin Lee, Jin-Ha Yoon
    Journal of Korean Medical Science.2023;[Epub]     CrossRef
  • Association between smoking status and death from COVID-19 in South Korea: A nationwide cohort study
    Jae Woo Choi
    Tobacco Induced Diseases.2023; 21(July): 1.     CrossRef
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    Sangmo Hong, Kyung-Soo Kim, Kyungdo Han, Cheol-Young Park
    Kidney International.2023; 104(4): 820.     CrossRef
  • Comparative cardiovascular outcomes in type 2 diabetes patients taking dapagliflozin versus empagliflozin: a nationwide population-based cohort study
    Jaehyun Lim, You-Jung Choi, Bong Sung Kim, Tae-Min Rhee, Hyun-Jung Lee, Kyung-Do Han, Jun-Bean Park, Jin Oh Na, Yong-Jin Kim, Heesun Lee, Hyung-Kwan Kim
    Cardiovascular Diabetology.2023;[Epub]     CrossRef
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    Donghee Kwak, Seok-joo Moon, Jong Woong Park, Duk Hee Lee, Jung Il Lee
    Orthopaedic Journal of Sports Medicine.2023;[Epub]     CrossRef
  • Incident dementia in kidney transplantation recipients: a matched comparative nationwide cohort study in South Korea
    Seon Ha Baek, Jina Park, Sehoon Park, Mi-yeon Yu, Ji Eun Kim, Sang Hyun Park, Kyungdo Han, Yong Chul Kim, Dong Ki Kim, Kwon Wook Joo, Yon Su Kim, Hajeong Lee
    Kidney Research and Clinical Practice.2023; 42(4): 519.     CrossRef
  • Developing Operational Definitions Related toHelicobacter pyloriEradication Therapy
    Chan Hyuk Park, Sun-Young Jung, Ju Won Lee, Hyo-Joon Yang, Joon Sung Kim, Beom Jin Kim, Soo In Choi, Seung In Seo, Joongyub Lee, Jae Gyu Kim
    Journal of Korean Medical Science.2023;[Epub]     CrossRef
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    Ji Min Lee, Kyungdo Han, Kang-Moon Lee, Jae-Seung Yun
    Journal of Korean Medical Science.2023;[Epub]     CrossRef
  • Sex differences in mortality in patients with acromegaly: a nationwide cohort study in Korea
    Jiwon Kim, Namki Hong, Jimi Choi, Ju Hyung Moon, Eui Hyun Kim, Jae Won Hong, Eun Jig Lee, Sin Gon Kim, Cheol Ryong Ku
    European Journal of Endocrinology.2023; 189(2): 225.     CrossRef
  • Proton pump inhibitor use and the risk of metachronous gastric cancer after H. pylori eradication in patients who underwent endoscopic resection for gastric neoplasms: A population‐based cohort study
    Eun Jeong Gong, Hye‐Kyung Jung, Bora Lee, Jitaek Hong, Jong Wook Kim, Cheol Min Shin, Young Hoon Youn, Kwang Jae Lee
    Alimentary Pharmacology & Therapeutics.2023; 58(7): 668.     CrossRef
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    Hyun Jee Lee, Yujin Choi, Jaeyu Park, Yong-Sung Choi, Dong Keon Yon, Do Hyun Kim
    Children.2023; 10(9): 1436.     CrossRef
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    Yong Kang Lee, Hyun Sun Lim, Youn I Choi, Eun Ju Choe, Seonji Kim, Seng Chan You, Kyung Joo Lee, Yerim Kim, Da Hee Park, Woon Geon Shin, Seung In Seo
    Pharmaceuticals.2023; 16(9): 1213.     CrossRef
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    Jae Young Kim, Changhwan Seo, Haeyong Pak, Hyunsun Lim, Tae Ik Chang
    Journal of Korean Medical Science.2023;[Epub]     CrossRef
  • Occupational characteristics and risk factors associated with endometriosis among Korean female workers
    Seunghyun Lee, Seung-Yeon Lee, Wanhyung Lee, Federico Romano
    PLOS ONE.2023; 18(10): e0292362.     CrossRef
  • Suicidal Thinking Among Patients With Spinal Conditions in South Korea: A Population-Based Cross-Sectional Study
    Tak Kyu Oh, Hye Yoon Park, In-Ae Song
    Psychiatry Investigation.2023; 20(9): 834.     CrossRef
  • Increased risk of venous and arterial thromboembolism in patients with colorectal cancer receiving cetuximab-based combination chemotherapy: A population-based study in Korea
    Ho-Young Yhim, Juhyun Lee, Kyoung Ha Kim, Sang-A Kim, Ji Yun Lee, Hun-Gyu Hwang, Junshik Hong, Jeong-Ok Lee, Soo-Mee Bang
    Thrombosis Research.2023; 231: 50.     CrossRef
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    Ga Hee Kim, Hyungchul Park, Kee Wook Jung, Min-Ju Kim, Ye-Jee Kim, Ji Min Lee, Bong Eun Lee, Yang Won Min, Jeong Hwan Kim, Hee Kyong Na, Ji Yong Ahn, Jeong Hoon Lee, Do Hoon Kim, Kee Don Choi, Ho June Song, Gin Hyug Lee, Hwoon-Yong Jung, Hyun Jin Kim
    Gut and Liver.2023; 17(6): 894.     CrossRef
  • Differential Impact of Obesity on the Risk of Diabetes Development in Two Age Groups: Analysis from the National Health Screening Program
    Tae Kyung Yoo, Kyung-Do Han, Yang-Hyun Kim, Ga Eun Nam, Sang Hyun Park, Eun-Jung Rhee, Won-Young Lee
    Diabetes & Metabolism Journal.2023; 47(6): 846.     CrossRef
  • Association between preoperative modifiable lifestyle factors and mortality after cancer surgery: a population-based cohort study in South Korea
    Tak Kyu Oh, In-Ae Song
    Annals of Surgical Treatment and Research.2023; 105(4): 179.     CrossRef
  • Classification of long-term clinical course of Parkinson’s disease using clustering algorithms on social support registry database
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    Journal of Big Data.2023;[Epub]     CrossRef
  • Association between Proteinuria Status and Risk of Hypertension: A Nationwide Population-Based Cohort Study
    Hyungwoo Lee, Moo-Suk Park, Min Kyoung Kang, Tae-Jin Song
    Journal of Personalized Medicine.2023; 13(9): 1414.     CrossRef
  • Association of physical activity with the risk of Parkinson's disease in depressive disorder: A nationwide longitudinal cohort study
    Ji hyun An, Kyung-do Han, Jin-Hyung Jung, Hong Jin Jeon
    Journal of Psychiatric Research.2023; 167: 93.     CrossRef
  • Effect of changes in the hearing aid subsidy on the prevalence of hearing loss in South Korea
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  • Preoperative Body Mass Index, Waist Circumference, and Mortality After Major Cancer Surgery: A Nationwide Cohort Study in Korea
    Tak Kyu Oh, In-Ae Song
    Journal of Korean Medical Science.2023;[Epub]     CrossRef
  • Characteristics and risk factors of suicide among people who attempted self-harm in South Korea: A longitudinal National Cohort Study in South Korea
    Hye Hyeon Kim, Jin Hyuk Lee, In Han Song, Yu Rang Park
    Psychiatry Research.2023; 330: 115613.     CrossRef
  • Association Between Premature Menopause and Cardiovascular Diseases and All‐Cause Mortality in Korean Women
    Gyu Bae Lee, Ga Eun Nam, Wonsock Kim, Byoungduck Han, Kyung Hwan Cho, Seon Mee Kim, Youn Seon Choi, Do Hoon Kim, Yong‐Gyu Park, Jin‐Hyung Jung, Kyungdo Han, Yang‐Hyun Kim
    Journal of the American Heart Association.2023;[Epub]     CrossRef
  • Risk of gastric cancer among long-term proton pump inhibitor users: a population-based cohort study
    Jong Wook Kim, Hye-Kyung Jung, Bora Lee, Cheol Min Shin, Eun Jeong Gong, Jitaek Hong, Young Hoon Youn, Kwang Jae Lee
    European Journal of Clinical Pharmacology.2023; 79(12): 1699.     CrossRef
  • Cancer Risk in Elderly Korean Patients with Neurodegenerative Disease and its relation to Type 2 Diabetes
    Hee-Cheol Kim, Ji-Hun Kim, Ho-Jun Lee, Yang-Tae Kim, Byeong-Churl Jang
    The Open Neurology Journal.2023;[Epub]     CrossRef
  • Performance of Cardiovascular Risk Prediction Models in Korean Patients With New‐Onset Rheumatoid Arthritis: National Cohort Study
    Jae Hyun Kim, Gaeun Lee, Jinseub Hwang, Ji‐Won Kim, Jin‐Won Kwon, Yun‐Kyoung Song
    Journal of the American Heart Association.2023;[Epub]     CrossRef
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    Susie Yoon, Sun-Young Jung, Myo-Song Kim, Danbi Yoon, Younghae Cho, Yunseok Jeon
    Annals of Surgery.2023; 278(6): 1024.     CrossRef
  • Decreased Risk of Knee Osteoarthritis with Taller Height in an East Asian Population: A Nationwide Cohort Study
    Dong Hwan Lee, Hwa Sung Lee, Soo Hyun Jang, Jun-Young Heu, Kyungdo Han, Se-Won Lee
    Journal of Clinical Medicine.2023; 13(1): 92.     CrossRef
  • Cost-effectiveness of the anti-vascular endothelial growth factor intravitreal injection and panretinal photocoagulation for patients with proliferative diabetic retinopathy in South Korea
    Hyeon-Jeong Lee, Songhee Cho, Jungeun Park, Yan Jin, Hyung Min Kim, Donghyun Jee
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  • Prior Evaluation of Nutritional Status and Mortality in Patients with Sepsis in South Korea
    Tak Kyu Oh, In-Ae Song
    Nutrients.2023; 15(24): 5040.     CrossRef
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    Jiwon Kim, Namki Hong, Jimi Choi, Ju Hyung Moon, Eui Hyun Kim, Eun Jig Lee, Sin Gon Kim, Cheol Ryong Ku
    Endocrinology and Metabolism.2023; 38(6): 690.     CrossRef
  • Proton Pump Inhibitor Co-Therapy in Patients with Atrial Fibrillation Treated with Oral Anticoagulants and a Prior History of Upper Gastrointestinal Tract Bleeding
    So-Ryoung Lee, Soonil Kwon, Eue-Keun Choi, Jin-Hyung Jung, Kyung-Do Han, Seil Oh, Gregory Y. H. Lip
    Cardiovascular Drugs and Therapy.2022; 36(4): 679.     CrossRef
  • Institutional case volume-incorporated mortality risk prediction model for cardiac surgery
    Seohee Lee, Eun Jin Jang, Junwoo Jo, Dongnyeok Park, Ho Geol Ryu
    Asian Journal of Surgery.2022; 45(1): 189.     CrossRef
  • Does Surgical Ablation of Atrial Fibrillation Benefit Patients Undergoing Bioprosthetic Valve Replacement?
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    Seminars in Thoracic and Cardiovascular Surgery.2022; 34(3): 906.     CrossRef
  • Burden of comorbidities and medication use in childbearing women with rheumatic diseases: a nationwide population-based study
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    The Korean Journal of Internal Medicine.2022; 37(6): 1250.     CrossRef
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    Hypertension.2022; 79(1): 218.     CrossRef
  • Continuing regular physical activity and maintaining body weight have a synergistic interaction in improving survival: a population-based cohort study including 6.5 million people
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    European Journal of Preventive Cardiology.2022; 29(3): 547.     CrossRef
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    Neurological Sciences.2022; 43(5): 3395.     CrossRef
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    Journal of Chemotherapy.2022; 34(8): 534.     CrossRef
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    Bum Sik Tae, Young Eun Yoon, Woong Na, Kyung Jin Oh, Sung Yul Park, Jae Young Park, Hong Sang Moon
    Investigative and Clinical Urology.2022; 63(1): 92.     CrossRef
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    European Heart Journal.2022; 43(15): 1491.     CrossRef
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    Korean Circulation Journal.2022; 52(2): 136.     CrossRef
  • Effect of obesity and metabolic health on urolithiasis: A nationwide population-based study
    Changil Choi, Jong Keun Kim, Kyungdo Han, Young Goo Lee, Jun Hyun Han
    Investigative and Clinical Urology.2022; 63(1): 63.     CrossRef
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    BMC Pulmonary Medicine.2022;[Epub]     CrossRef
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    Health Informatics Journal.2022;[Epub]     CrossRef
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    Journal of Neurotrauma.2022; 39(5-6): 390.     CrossRef
  • Female Reproductive Factors and the Risk of Bronchiectasis: A Nationwide Population-Based Longitudinal Study
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    Biomedicines.2022; 10(2): 303.     CrossRef
  • Clinical outcomes of early closure versus conservative strategy after diagnosis with atrial septal defect: a nationwide population-based cohort study
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    European Journal of Cardio-Thoracic Surgery.2022;[Epub]     CrossRef
  • Risk of Osteoporotic Fractures Among Obese Women Based on Body Mass Index and Waist Circumference: A Nationwide Cohort in South Korea
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    Clinical Nutrition Research.2022; 11(1): 32.     CrossRef
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    Resuscitation.2022; 173: 31.     CrossRef
  • Blood pressure and mortality after percutaneous coronary intervention: a population-based cohort study
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    Scientific Reports.2022;[Epub]     CrossRef
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    JAMA Network Open.2022; 5(2): e220262.     CrossRef
  • Hip Fracture Risk According to Diabetic Kidney Disease Phenotype in a Korean Population
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    Endocrinology and Metabolism.2022; 37(1): 148.     CrossRef
  • Non-Alcoholic Fatty Liver Disease Defined by Fatty Liver Index and Incidence of Heart Failure in the Korean Population: A Nationwide Cohort Study
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    Diagnostics.2022; 12(3): 663.     CrossRef
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    Journal of Psychiatric Research.2022; 149: 226.     CrossRef
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    Sung Kyun Kim, Seok Jin Hong, Dae Myoung Yoo, Chanyang Min, Hyo Geun Choi
    Scientific Reports.2022;[Epub]     CrossRef
  • Prognosis of pregnancy after breast cancer diagnosis according to the type of treatment: A population-based study in Korea by the SMARTSHIP group
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    The Breast.2022; 63: 46.     CrossRef
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    Journal of Bone and Mineral Metabolism.2022; 40(4): 602.     CrossRef
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    Archives of Orthopaedic and Trauma Surgery.2022; 143(5): 2307.     CrossRef
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    PLOS ONE.2022; 17(4): e0266262.     CrossRef
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    Cancer Research and Treatment.2022; 54(2): 572.     CrossRef
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    International Journal of Environmental Research and Public Health.2022; 19(9): 4949.     CrossRef
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    Juhee Lee, So-Young Kwak, Dahyun Park, Ga-Eun Kim, Clara Yongjoo Park, Min-Jeong Shin
    Nutrients.2022; 14(8): 1644.     CrossRef
  • Lifestyle, body mass index, diabetes, and the risk of pancreatic cancer in a nationwide population-based cohort study with 7.4 million Korean subjects
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    British Journal of Cancer.2022; 127(3): 549.     CrossRef
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    Journal of the American Heart Association.2022;[Epub]     CrossRef
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    Journal of Personalized Medicine.2022; 12(5): 691.     CrossRef
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    American Journal of Gastroenterology.2022; 117(5): 758.     CrossRef
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    Clinical Psychopharmacology and Neuroscience.2022; 20(2): 320.     CrossRef
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    Journal of Clinical Oncology.2022; 40(29): 3394.     CrossRef
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    International Archives of Occupational and Environmental Health.2022; 95(9): 1829.     CrossRef
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    Journal of Lipid and Atherosclerosis.2022; 11(2): 178.     CrossRef
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    Scientific Reports.2022;[Epub]     CrossRef
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    BMC Medicine.2022;[Epub]     CrossRef
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    Gut and Liver.2022; 16(4): 555.     CrossRef
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    Yonsei Medical Journal.2022; 63(8): 774.     CrossRef
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    Scientific Reports.2022;[Epub]     CrossRef
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    Journal of Personalized Medicine.2022; 12(8): 1260.     CrossRef
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    Hepatology Research.2022; 52(12): 975.     CrossRef
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    Frontiers in Medicine.2022;[Epub]     CrossRef
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    Academic Emergency Medicine.2022; 29(12): 1438.     CrossRef
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    Clinical and Molecular Hepatology.2022; 28(4): 851.     CrossRef
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  • Metformin and Gastrointestinal Cancer Development in Newly Diagnosed Type 2 Diabetes: A Population-Based Study in Korea
    Ji Hong You, Sun Ok Song, Min Jin Kang, Yoon Young Cho, Sun Wook Kim, Sung Hwan Suh, Sujin Lee, Yong-ho Lee, Byung-Wan Lee
    Clinical and Translational Gastroenterology.2020; 11(11): e00254.     CrossRef
  • Machine learning prediction for mortality of patients diagnosed with COVID-19: a nationwide Korean cohort study
    Chansik An, Hyunsun Lim, Dong-Wook Kim, Jung Hyun Chang, Yoon Jung Choi, Seong Woo Kim
    Scientific Reports.2020;[Epub]     CrossRef
  • The association between hospital case volume and in-hospital and one-year mortality after hip fracture surgery
    Seokha Yoo, Eun Jin Jang, Junwoo Jo, Jun Gi Jo, Seungpyo Nam, Hansol Kim, Hannah Lee, Ho Geol Ryu
    The Bone & Joint Journal.2020; 102-B(10): 1384.     CrossRef
  • Association between physical activity and conversion from mild cognitive impairment to dementia
    Yeo Jin Kim, Kyung-Do Han, Min Seok Baek, Hanna Cho, Eun Joo Lee, Chul Hyoung Lyoo
    Alzheimer's Research & Therapy.2020;[Epub]     CrossRef
  • Clinical Outcomes of COVID-19 Patients with Type 2 Diabetes: A Population-Based Study in Korea
    Ji Hong You, Sang Ah Lee, Sung-Youn Chun, Sun Ok Song, Byung-Wan Lee, Dae Jung Kim, Edward J. Boyko
    Endocrinology and Metabolism.2020; 35(4): 901.     CrossRef
  • Does Diabetes Increase the Risk of Contracting COVID-19? A Population-Based Study in Korea
    Sung-Youn Chun, Dong Wook Kim, Sang Ah Lee, Su Jung Lee, Jung Hyun Chang, Yoon Jung Choi, Seong Woo Kim, Sun Ok Song
    Diabetes & Metabolism Journal.2020; 44(6): 897.     CrossRef
  • The triglyceride glucose index is a simple and low-cost marker associated with atherosclerotic cardiovascular disease: a population-based study
    Sangmo Hong, Kyungdo Han, Cheol-Young Park
    BMC Medicine.2020;[Epub]     CrossRef
  • The durability and effectiveness of sensor-augmented insulin pump therapy in pediatric and young adult patients with type 1 diabetes
    Yun Jeong Lee, Young Ah Lee, Jae Hyun Kim, Hye Rim Chung, Min Jeong Gu, Ji Young Kim, Choong Ho Shin
    Annals of Pediatric Endocrinology & Metabolism.2020; 25(4): 248.     CrossRef
  • Impact of comorbid asthma on severity of coronavirus disease (COVID-19)
    Sang Chul Lee, Kang Ju Son, Chang Hoon Han, Ji Ye Jung, Seon Cheol Park
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  • Big Data in Ophthalmology
    Ching-Yu Cheng, Zhi Da Soh, Shivani Majithia, Sahil Thakur, Tyler Hyungtaek Rim, Yih Chung Tham, Tien Yin Wong
    Asia-Pacific Journal of Ophthalmology.2020; 9(4): 291.     CrossRef
  • Maintenance of body weight is an important determinant for the risk of ischemic stroke: A nationwide population-based cohort study
    Jung-Hwan Cho, Eun-Jung Rhee, Se Eun Park, Hyemi Kwon, Jin-Hyung Jung, Kyung-Do Han, Yong-Gyu Park, Soon-Jib Yoo, Yang-Hyun Kim, Won-Young Lee, Sabine Rohrmann
    PLOS ONE.2019; 14(1): e0210153.     CrossRef
  • Effect of Institutional Case Volume on In-Hospital and Long-Term Mortality in Critically Ill Patients Requiring Mechanical Ventilation for 48 Hours or More
    Hannah Lee, Seongmi Choi, Eun Jin Jang, Juhee Lee, Dalho Kim, Seokha Yoo, Seung Young Oh, Ho Geol Ryu
    Journal of Korean Medical Science.2019;[Epub]     CrossRef
  • Impact of the 2015 Middle East Respiratory Syndrome Outbreak on Emergency Care Utilization and Mortality in South Korea
    Sun Young Lee, Young-Ho Khang, Hwa-Kyung Lim
    Yonsei Medical Journal.2019; 60(8): 796.     CrossRef
  • Effect of Institutional Case Volume on In-hospital Mortality After Living Donor Liver Transplantation: Analysis of 7073 Cases Between 2007 and 2016 in Korea
    Seokha Yoo, Eun Jin Jang, Nam-Joon Yi, Ga Hee Kim, Dal Ho Kim, Hannah Lee, Chul-Woo Jung, Ho Geol Ryu
    Transplantation.2019; 103(5): 952.     CrossRef
  • Increased risk of benign paroxysmal positional vertigo in osteoporosis: a nationwide population-based cohort study
    Hayoung Byun, Jae Ho Chung, Seung Hwan Lee, Chul Won Park, Eun Mi Kim, Inah Kim
    Scientific Reports.2019;[Epub]     CrossRef
  • Incremental economic burden associated with exudative age-related macular degeneration: a population-based study
    Siin Kim, Sang Jun Park, Seong Jun Byun, Kyu Hyung Park, Hae Sun Suh
    BMC Health Services Research.2019;[Epub]     CrossRef
  • Patients with Inflammatory Bowel Disease Are at an Increased Risk of Parkinson’s Disease: A South Korean Nationwide Population-Based Study
    Seona Park, Jihye Kim, Jaeyoung Chun, Kyungdo Han, Hosim Soh, Eun Ae Kang, Hyun Jung Lee, Jong Pil Im, Joo Sung Kim
    Journal of Clinical Medicine.2019; 8(8): 1191.     CrossRef
  • Effect of hypertension duration and blood pressure level on ischaemic stroke risk in atrial fibrillation: nationwide data covering the entire Korean population
    Tae-Hoon Kim, Pil-Sung Yang, Hee Tae Yu, Eunsun Jang, Hyejung Shin, Ha Yan Kim, Jae-Sun Uhm, Jong-Youn Kim, Jung-Hoon Sung, Hui-Nam Pak, Moon-Hyoung Lee, Boyoung Joung, Gregory Y H Lip
    European Heart Journal.2019; 40(10): 809.     CrossRef
  • Perioperative red blood cell transfusion and mortality following heart transplantation: A retrospective nationwide population‐based study between 2007 and 2016 in Korea
    Karam Nam, Eun Jin Jang, Ga Hee Kim, Hyung Been Yhim, Hannah Lee, Dal Ho Kim, Ho Geol Ryu
    Journal of Cardiac Surgery.2019; 34(10): 927.     CrossRef
  • The Effect of Health-Related Behaviors on Disease Progression and Mortality in Early Stages of Chronic Kidney Disease: A Korean Nationwide Population-Based Study
    Yookyung Lee, SuYeon Kwon, Jong Joo Moon, Kyungdo Han, Nam-Jong Paik, Won-Seok Kim
    Journal of Clinical Medicine.2019; 8(8): 1100.     CrossRef
  • Association of body mass index with bladder cancer risk in men depends on abdominal obesity
    Jin Bong Choi, Jung Ho Kim, Sung-Hoo Hong, Kyung-Do Han, U-Syn Ha
    World Journal of Urology.2019; 37(11): 2393.     CrossRef
  • Time‐ and Dose‐Dependent Association of Statin Use With Risk of Clinically Relevant New‐Onset Diabetes Mellitus in Primary Prevention: A Nationwide Observational Cohort Study
    Min Jung Ko, Ae Jeong Jo, Yun Jung Kim, Shin Hee Kang, Songhee Cho, Sang‐Ho Jo, Cheol‐Young Park, Sung‐Cheol Yun, Woo Je Lee, Duk‐Woo Park
    Journal of the American Heart Association.2019;[Epub]     CrossRef
  • Association of Long-term Use of Low-Dose Aspirin as Chemoprevention With Risk of Lung Cancer
    Shinhee Ye, Myeongjee Lee, Dongheon Lee, Eun-Hee Ha, Eun Mi Chun
    JAMA Network Open.2019; 2(3): e190185.     CrossRef
  • Association between BMI and risk of severe hypoglycaemia in type 2 diabetes
    J.-S. Yun, Y.-M. Park, K. Han, S.-A. Cha, Y.-B. Ahn, S.-H. Ko
    Diabetes & Metabolism.2019; 45(1): 19.     CrossRef
  • Risk of Incident Dementia According to Metabolic Health and Obesity Status in Late Life: A Population-Based Cohort Study
    Ji-Yeon Lee, Kyungdo Han, Eugene Han, Gyuri Kim, Hanna Cho, Kwang Joon Kim, Byung Wan Lee, Eun Seok Kang, Bong-Soo Cha, Carol Brayne, Yong-ho Lee
    The Journal of Clinical Endocrinology & Metabolism.2019; 104(7): 2942.     CrossRef
  • Increased Risk of Osteoporotic Fracture in Postgastrectomy Gastric Cancer Survivors Compared With Matched Controls: A Nationwide Cohort Study in Korea
    Dong Wook Shin, Beomseok Suh, Hyunsun Lim, Yun-Suhk Suh, Yoon Jin Choi, Su-Min Jeong, Jae Moon Yun, Sun Ok Song, Youngmin Park
    American Journal of Gastroenterology.2019; 114(11): 1735.     CrossRef
  • Metabolic syndrome is associated with an increased risk of psoriasis: A nationwide population-based study
    Ha-Na Kim, Kyungdo Han, Yong-Gyu Park, Ji Hyun Lee
    Metabolism.2019; 99: 19.     CrossRef
  • Association of Exposure to Diagnostic Low-Dose Ionizing Radiation With Risk of Cancer Among Youths in South Korea
    Jae-Young Hong, Kyungdo Han, Jin-Hyung Jung, Jung Sun Kim
    JAMA Network Open.2019; 2(9): e1910584.     CrossRef
  • Long‐term clinical outcomes in patients with autoimmune hepatitis according to treatment response in Asian country
    Jonggi Choi, Gwang Hyeon Choi, Danbi Lee, Ju Hyun Shim, Young‐Suk Lim, Han Chu Lee, Young‐Hwa Chung, Yung‐Sang Lee, Kang Mo Kim
    Liver International.2019; 39(5): 985.     CrossRef
  • Effectiveness and Safety of Direct Oral Anticoagulant for Secondary Prevention in Asians with Atrial Fibrillation
    Jiesuck Park, So-Ryoung Lee, Eue-Keun Choi, Soonil Kwon, Jin-Hyung Jung, Kyung-Do Han, Myung-Jin Cha, Sang-Bae Ko, Seil Oh, Gregory Y. H. Lip
    Journal of Clinical Medicine.2019; 8(12): 2228.     CrossRef
  • Optimal Rivaroxaban Dose in Asian Patients With Atrial Fibrillation and Normal or Mildly Impaired Renal Function
    So-Ryoung Lee, Eue-Keun Choi, Kyung-Do Han, Jin-Hyung Jung, Seil Oh, Gregory Y.H. Lip
    Stroke.2019; 50(5): 1140.     CrossRef
  • Tobacco Smoking and Alcohol Consumption Are Related to Benign Parotid Tumor: A Nested Case-Control Study Using a National Health Screening Cohort
    So Young Kim, Chanyang Min, Dong Jun Oh, Hyo Geun Choi
    Clinical and Experimental Otorhinolaryngology.2019; 12(4): 412.     CrossRef
  • Increased Risk of Diabetes in Inflammatory Bowel Disease Patients: A Nationwide Population-Based Study in Korea
    Eun Ae Kang, Kyungdo Han, Jaeyoung Chun, Hosim Soh, Seona Park, Jong Pil Im, Joo Sung Kim
    Journal of Clinical Medicine.2019; 8(3): 343.     CrossRef
  • Changes in the Diagnostic Efficiency of Thyroid Fine-Needle Aspiration Biopsy during the Era of Increased Thyroid Cancer Screening in Korea
    Young Ki Lee, Kyeong Hye Park, Young Duk Song, Taemi Youk, Joo Young Nam, Sun Ok Song, Dong Yeob Shin, Eun Jig Lee
    Cancer Research and Treatment.2019; 51(4): 1430.     CrossRef
  • Safety and Effectiveness of Contemporary P2Y 12 Inhibitors in an East Asian Population With Acute Coronary Syndrome: A Nationwide Population‐Based Cohort Study
    Ji Eun Yun, Yun Jung Kim, Ji Jeong Park, Sehee Kim, Keunhui Park, Min Soo Cho, Gi‐Byoung Nam, Duk‐Woo Park
    Journal of the American Heart Association.2019;[Epub]     CrossRef
  • Direct Oral Anticoagulants in Patients With Nonvalvular Atrial Fibrillation and Low Body Weight
    So-Ryoung Lee, Eue-Keun Choi, Chan Soon Park, Kyung-Do Han, Jin-Hyung Jung, Seil Oh, Gregory Y.H. Lip
    Journal of the American College of Cardiology.2019; 73(8): 919.     CrossRef
  • Trends in varicella and herpes zoster epidemiology before and after the implementation of universal one-dose varicella vaccination over one decade in South Korea, 2003–2015
    Jae-Ki Choi, Sun Hee Park, Sanghyun Park, Su-Mi Choi, Si-Hyun Kim, Dong-Gun Lee, Jin-Hong Yoo, Jung-Hyun Choi, Jin Han Kang
    Human Vaccines & Immunotherapeutics.2019; 15(11): 2554.     CrossRef
  • Obesity Fact Sheet in Korea, 2018: Data Focusing on Waist Circumference and Obesity-Related Comorbidities
    Ga Eun Nam, Yang-Hyun Kim, Kyungdo Han, Jin-Hyung Jung, Yong Gyu Park, Kwan-Woo Lee, Eun-Jung Rhee, Jang Won Son, Seong-Su Lee, Hyuk-Sang Kwon, Won-Young Lee, Soon Jib Yoo
    Journal of Obesity & Metabolic Syndrome.2019; 28(4): 236.     CrossRef
  • Long-Term Impact of Newly Diagnosed Atrial Fibrillation During Critical Care
    Kyu Kim, Pil-Sung Yang, Eunsun Jang, Hee Tae Yu, Tae-Hoon Kim, Jae-Sun Uhm, Jong-Youn Kim, Jung-Hoon Sung, Hui-Nam Pak, Moon-Hyoung Lee, Gregory Y.H. Lip, Boyoung Joung
    Chest.2019; 156(3): 518.     CrossRef
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    Bum Sik Tae, Byung Jo Jeon, Seung Hun Shin, Hoon Choi, Jae Hyun Bae, Jae Young Park
    Cancer Research and Treatment.2019; 51(2): 593.     CrossRef
  • Non-Vitamin K Antagonist Oral Anticoagulants in Patients with Atrial Fibrillation and Valvular Heart Disease
    Inki Moon, So-Ryoung Lee, Eue-Keun Choi, Euijae Lee, Jin-Hyung Jung, Kyung-Do Han, Myung-Jin Cha, Seil Oh, Gregory Y.H. Lip
    Journal of Clinical Medicine.2019; 8(10): 1624.     CrossRef
  • Relation between Baseline Height and New Diabetes Development: A Nationwide Population-Based Study
    Eun-Jung Rhee, Jung-Hwan Cho, Hyemi Kwon, Se-Eun Park, Jin-Hyung Jung, Kyung-Do Han, Yong-Gyu Park, Yang-Hyun Kim, Won-Young Lee
    Diabetes & Metabolism Journal.2019; 43(6): 794.     CrossRef
  • The Risk of Myocardial Infarction and Ischemic Stroke According to Waist Circumference in 21,749,261 Korean Adults: A Nationwide Population-Based Study
    Jung-Hwan Cho, Eun-Jung Rhee, Se-Eun Park, Hyemi Kwon, Jin-Hyung Jung, Kyung-Do Han, Yong-Gyu Park, Hye Soon Park, Yang-Hyun Kim, Soon-Jib Yoo, Won-Young Lee
    Diabetes & Metabolism Journal.2019; 43(2): 206.     CrossRef
  • The risk of end-stage renal disease in systemic lupus erythematosus
    Hong Sang Choi, Kyung-Do Han, Jin-Hyung Jung, Chang Seong Kim, Eun Hui Bae, Seong Kwon Ma, Soo Wan Kim
    Medicine.2019; 98(28): e16420.     CrossRef
  • Antithrombotic Therapy in Patients With Atrial Fibrillation After Percutaneous Coronary Intervention During 2-Year Follow-Up, from a Nationwide Population Study
    Jiesuck Park, Eue-Keun Choi, Kyung-Do Han, You-Jung Choi, So-Ryoung Lee, Myung-Jin Cha, Jeehoon Kang, Kyung Woo Park, Seil Oh, Gregory Y.H. Lip
    The American Journal of Cardiology.2019; 123(12): 1921.     CrossRef
  • Outcomes After Use of Standard- and Low-Dose Non–Vitamin K Oral Anticoagulants in Asian Patients With Atrial Fibrillation
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    Stroke.2019; 50(1): 110.     CrossRef
  • Association between Atrial Fibrillation, Myocardial Infarction, Heart Failure and Mortality in Patients with Nontuberculous Mycobacterial Infection: a nationwide population-based study
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    Scientific Reports.2019;[Epub]     CrossRef
  • National practice patterns and direct medical costs for prostate cancer in Korea across a 10 year period: a nationwide population-based study using a national health insurance database
    Ho Won Kang, Seok-Joong Yun, Jae Il Chung, Hoon Choi, Jae Heon Kim, Ho Song Yu, Yun-Sok Ha, In-Chang Cho, Hyung Joon Kim, Hyun Chul Chung, Jun Sung Koh, Wun-Jae Kim, Jong-Hyock Park, Ji Youl Lee, So-Young Kim
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    International Heart Journal.2019; 60(3): 695.     CrossRef
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    Scientific Reports.2019;[Epub]     CrossRef
  • Venous thromboembolism in relapsed or refractory multiple myeloma patients treated with lenalidomide plus dexamethasone
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    International Journal of Hematology.2019; 109(1): 79.     CrossRef
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    Diabetes & Metabolism.2019; 45(1): 32.     CrossRef
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    International Journal of Cardiology.2019; 275: 77.     CrossRef
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    Journal of Psychiatric Research.2019; 118: 31.     CrossRef
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    Clinical and Translational Gastroenterology.2019; 10(10): e00090.     CrossRef
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    Mayo Clinic Proceedings.2019; 94(2): 225.     CrossRef
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    Hak Min Lee, Bo Wook Kim, Seho Park, Sungmin Park, Jeon Eon Lee, Young Jin Choi, Sung Yong Kim, Sang Uk Woo, Hyun Jo Youn, Ilkyun Lee
    Breast Cancer Research and Treatment.2019; 176(2): 419.     CrossRef
  • Obstructive sleep apnea as a risk factor for incident end stage renal disease: a nationwide population-based cohort study from Korea
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    Clinical and Experimental Nephrology.2019; 23(12): 1391.     CrossRef
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    Cardiovascular Diabetology.2019;[Epub]     CrossRef
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    Scientific Reports.2019;[Epub]     CrossRef
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    Journal of Clinical Medicine.2019; 8(5): 654.     CrossRef
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    Diabetes Care.2019; 42(11): 2057.     CrossRef
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    Journal of Gastroenterology.2019; 54(10): 881.     CrossRef
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    Cancer Medicine.2019; 8(9): 4475.     CrossRef
  • Adult lung transplantation case-volume and in-hospital and long-term mortality in Korea
    Susie Yoon, Eun Jin Jang, Ga Hee Kim, Dal Ho Kim, Tae-Yoon Lim, Hannah Lee, Ho Geol Ryu
    Journal of Cardiothoracic Surgery.2019;[Epub]     CrossRef
  • Systemic lupus erythematosus is a risk factor for cancer: a nationwide population-based study in Korea
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    Lupus.2019; 28(3): 317.     CrossRef
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    Annals of Pharmacotherapy.2019; 53(11): 1102.     CrossRef
  • Validation of diagnostic codes of major clinical outcomes in a National Health Insurance database
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    International Journal of Arrhythmia.2019;[Epub]     CrossRef
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    The Journal of Clinical Endocrinology & Metabolism.2019; 104(11): 5633.     CrossRef
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    Annals of Surgical Treatment and Research.2019; 96(2): 58.     CrossRef
  • Effect of Case Volume on Mortality After Pediatric Liver Transplantation in Korea
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    Transplantation.2019; 103(8): 1649.     CrossRef
  • Prescription Patterns and Burden of Pediatric Asthma in Korea
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    Allergy, Asthma & Immunology Research.2019; 11(2): 280.     CrossRef
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    Dong Woog Yoon, Dong Wook Shin, Jong Ho Cho, Jeong Hoon Yang, Su-Min Jeong, Kyungdo Han, Sang Hyun Park
    Lung Cancer.2019; 136: 115.     CrossRef
  • Waist Circumference and All-Cause Mortality Independent of Body Mass Index in Korean Population from the National Health Insurance Health Checkup 2009–2015
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    Journal of Clinical Medicine.2019; 8(1): 72.     CrossRef
  • Temporal trends in prevalence and antithrombotic treatment among Asians with atrial fibrillation undergoing percutaneous coronary intervention: A nationwide Korean population-based study
    Jiesuck Park, Eue-Keun Choi, Kyung-Do Han, You-jung Choi, Euijae Lee, Wonseok Choe, So-Ryoung Lee, Myung-Jin Cha, Woo-Hyun Lim, Jeehoon Kang, Kyung Woo Park, Seil Oh, Gregory Y. H. Lip, Chiara Lazzeri
    PLOS ONE.2019; 14(1): e0209593.     CrossRef
  • Factors influencing the incidence and treatment of intracranial aneurysm and subarachnoid hemorrhage: time trends and socioeconomic disparities under an universal healthcare system
    Won Kyung Lee, Chang Wan Oh, Heeyoung Lee, Kun Sei Lee, Hyeonseon Park
    Journal of NeuroInterventional Surgery.2019; 11(2): 159.     CrossRef
  • Increasing trends in hospital care burden of atrial fibrillation in Korea, 2006 through 2015
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    Heart.2018; 104(24): 2010.     CrossRef
  • Appropriate Amount of Regular Exercise Is Associated with a Reduced Mortality Risk
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  • The effect of continuity of care on the incidence of end-stage renal disease in patients with newly detected type 2 diabetic nephropathy: a retrospective cohort study
    Yun Jung Jang, Yoon Soo Choy, Chung Mo Nam, Ki Tae Moon, Eun-Cheol Park
    BMC Nephrology.2018;[Epub]     CrossRef
  • Increased end-stage renal disease risk in patients with inflammatory bowel disease: A nationwide population-based study
    Seona Park, Jaeyoung Chun, Kyung-Do Han, Hosim Soh, Kookhwan Choi, Ji Hye Kim, Jooyoung Lee, Changhyun Lee, Jong Pil Im, Joo Sung Kim
    World Journal of Gastroenterology.2018; 24(42): 4798.     CrossRef
  • Cardiovascular disease risk differences between bus company employees and general workers according to the Korean National Health Insurance Data
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    Annals of Occupational and Environmental Medicine.2018;[Epub]     CrossRef
  • Impact of Renal Function on Outcomes With Edoxaban in Real-World Patients With Atrial Fibrillation
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    Stroke.2018; 49(10): 2421.     CrossRef
  • Association between adult height, myocardial infarction, heart failure, stroke and death: a Korean nationwide population-based study
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The Effect of DPP-4 Inhibitors on Metabolic Parameters in Patients with Type 2 Diabetes
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
Diabetes Metab J. 2014;38(3):211-219.   Published online June 17, 2014
DOI: https://doi.org/10.4093/dmj.2014.38.3.211
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AbstractAbstract PDFSupplementary MaterialPubReader   ePub   
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.

Methods

A 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.

Results

The 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).

Conclusion

Vildagliptin and sitagliptin exert a similar effect on metabolic parameters, but vildagliptin exerts a more potent beneficial effect on lipid parameters.

Citations

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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
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
Diabetes Metab J. 2013;37(6):465-474.   Published online December 12, 2013
DOI: https://doi.org/10.4093/dmj.2013.37.6.465
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AbstractAbstract PDFPubReader   ePub   
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).

Methods

This 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).

Results

Among 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).

Conclusion

The 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.

Citations

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Letter
Responses
Response: The Risk of Bladder Cancer in Korean Diabetic Subjects Treated with Pioglitazone (Diabetes Metab J 2012;36:371-8)
Kwang Joon Kim, Sun Ok Song, Byung-Wan Lee
Diabetes Metab J. 2013;37(1):83-84.   Published online February 15, 2013
DOI: https://doi.org/10.4093/dmj.2013.37.1.83
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PDFPubReader   ePub   
Response: The Risk of Bladder Cancer in Korean Diabetic Subjects Treated with Pioglitazone (Diabetes Metab J 2012;36:371-8)
Sun Ok Song, Kwang Joon Kim, Byung-Wan Lee
Diabetes Metab J. 2012;36(6):462-463.   Published online December 12, 2012
DOI: https://doi.org/10.4093/dmj.2012.36.6.462
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  • 26 Download
  • 1 Crossref
PDFPubReader   ePub   

Citations

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  • Comparison of the effect between pioglitazone and metformin in treating patients with PCOS:a meta-analysis
    Yifeng Xu, Yanxiang Wu, Qin Huang
    Archives of Gynecology and Obstetrics.2017; 296(4): 661.     CrossRef
Original Articles
The Risk of Bladder Cancer in Korean Diabetic Subjects Treated with Pioglitazone
Sun Ok Song, Kwang Joon Kim, Byung-Wan Lee, Eun Seok Kang, Bong Soo Cha, Hyun Chul Lee
Diabetes Metab J. 2012;36(5):371-378.   Published online October 18, 2012
DOI: https://doi.org/10.4093/dmj.2012.36.5.371
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  • 40 Download
  • 31 Crossref
AbstractAbstract PDFPubReader   ePub   
Background

There is growing concern regarding the increased incidence of bladder cancer in diabetic patients using pioglitazone. This study aimed to investigate the association between bladder cancer and the use of pioglitazone in Korean diabetics.

Methods

This retrospective, matched case-control study included a case group (n=329) of diabetic patients with bladder cancer who presented at the Severance Hospital from November 2005 to June 2011. The control group consisted of patients without bladder cancer (1:2 ratio matching for sex and age, n=658) who were listed on the Severance Hospital diabetes registry.

Results

The percentage of subjects who had ever used pioglitazone was significantly lower in the case group than in the control group (6.4% vs. 15.0%, P<0.001). Multivariate conditional logistic analysis revealed that independent factors affecting bladder cancer were smoking (odds ratio [OR], 11.64; 95% confidence interval [CI], 6.56 to 20.66; P<0.001), coexisting cancer (OR, 6.11; 95% CI, 2.25 to 16.63; P<0.001), and hemoglobin levels (OR, 0.78; 95% CI, 0.69 to 0.88; P<0.001). The OR of the history of pioglitazone use was 2.09 and was not significantly different between the two groups (95% CI, 0.26 to 16.81; P=0.488).

Conclusion

A relationship between pioglitazone use and incidence of bladder cancer was not observed in Korean diabetic patients. This suggests that the risk for bladder cancer in Korean diabetic subjects treated with pioglitazone might be different from that of Caucasian populations. Large-scale, well-designed and multi-center studies are needed to further evaluate this relationship.

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Balsamic Vinegar Improves High Fat-Induced Beta Cell Dysfunction via Beta Cell ABCA1
Hannah Seok, Ji Young Lee, Eun Mi Park, Se Eun Park, Jae Hyuk Lee, Seungtaek Lim, Byung-Wan Lee, Eun Seok Kang, Hyun Chul Lee, Bong Soo Cha
Diabetes Metab J. 2012;36(4):275-279.   Published online August 20, 2012
DOI: https://doi.org/10.4093/dmj.2012.36.4.275
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AbstractAbstract PDFPubReader   ePub   
Background

The aim of this study was to investigate the effects of balsamic vinegar on β-cell dysfunction.

Methods

In this study, 28-week-old Otsuka Long-Evans Tokushima Fatty (OLETF) rats were fed a normal chow diet or a high-fat diet (HFD) and were provided with tap water or dilute balsamic vinegar for 4 weeks. Oral glucose tolerance tests and histopathological analyses were performed thereafter.

Results

In rats fed both the both chow diet and the HFD, the rats given balsamic vinegar showed increased insulin staining in islets compared with tap water administered rats. Balsamic vinegar administration also increased β-cell ATP-binding cassette transporter subfamily A member 1 (ABCA1) expression in islets and decreased cholesterol levels.

Conclusion

These findings provide the first evidence for an anti-diabetic effect of balsamic vinegar through improvement of β-cell function via increasing β-cell ABCA1 expression.

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    Dong-Su Kim, Kwang-Soon Shin
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Glycemic Effects of Once-a-Day Rapid-Acting Insulin Analogue Addition on a Basal Insulin Analogue in Korean Subjects with Poorly Controlled Type 2 Diabetes Mellitus
Eun Yeong Choe, Yong-ho Lee, Byung-Wan Lee, Eun-Seok Kang, Bong Soo Cha, Hyun Chul Lee
Diabetes Metab J. 2012;36(3):230-236.   Published online June 14, 2012
DOI: https://doi.org/10.4093/dmj.2012.36.3.230
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AbstractAbstract PDFPubReader   ePub   
Background

The present study investigates the efficacy in glycemic control by adding once-a-day glulisine to glargine as a basal plus regimen and factors influencing glycemic control with the basal plus regimen in Korean subjects with type 2 diabetes.

Methods

In the present retrospective study, subjects previously treated with the basal plus regimens for at least 6 months were reviewed. Changes in glycemic profiles and clinical parameters were evaluated.

Results

A total of 87 subjects were ultimately enrolled in this study. At baseline, mean glycated hemoglobin (A1c) and glycated albumin were 8.5% (8.0% to 9.6%) and 25.2±7.6%, respectively. After treatment with the basal plus regimen, patients had significant reductions of A1c at 6 months (0.8±0.1%, P<0.001) and their postprandial glucose levels were decreased by 48.7±10.3 mg/dL (P<0.001). Multiple logistic regression showed old age (odds ratio [OR], 1.25; 95% confidence interval [CI], 1.02 to 1.55), high initial A1c (OR, 22.21; 95% CI, 2.44 to 201.78), and lower amounts of glargine (OR, 0.85; 95% CI, 0.76 to 0.99), and glimepiride (OR, 0.23; 95% CI, 0.06 to 0.93) at baseline were independently associated with good responders whose A1c reduction was more than 0.5%.

Conclusion

The authors suggest a basal plus regimen may be effective in reducing glucose levels of subjects with old age, high initial A1c, and patients on low doses of glimepiride and glargine. Despite the use of high doses of hypoglycemic agents, elderly patients with poorly-controlled diabetes are preferred for early initiation of the basal plus regimen.

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Review
The Roles of Glycated Albumin as Intermediate Glycation Index and Pathogenic Protein
Kwang Joon Kim, Byung-Wan Lee
Diabetes Metab J. 2012;36(2):98-107.   Published online April 17, 2012
DOI: https://doi.org/10.4093/dmj.2012.36.2.98
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AbstractAbstract PDFPubReader   ePub   

The conventional glycemic indices used in management of diabetic patients includes A1c, fructosamine, 1,5-anhydroglucitol, and glycated albumin (GA). Among these indices, A1c is currently used as the gold standard. However, A1c cannot reflect the glycemic change over a relatively short period of time, and its accuracy is known to decrease when abnormalities in hemoglobin metabolism, such as anemia, coexist. When considering these weaknesses, there have been needs for finding a novel glycemic index for diagnosing and managing diabetes, as well as for predicting diabetic complications properly. Recently, several studies have suggested the potential of GA as an intermediate-term glycation index in covering the short-term effect of treatment. Furthermore, its role as a pathogenic protein affecting the worsening of diabetes and occurrence of diabetic complications is receiving attention as well. Therefore, in this article, we wanted to review the recent status of GA as a glycemic index and as a pathogenic protein.

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Original Articles
Dietary Oleate Has Beneficial Effects on Every Step of Non-Alcoholic Fatty Liver Disease Progression in a Methionine- and Choline-Deficient Diet-Fed Animal Model
Ji Young Lee, Jae Hoon Moon, Jong Suk Park, Byung-Wan Lee, Eun Seok Kang, Chul Woo Ahn, Hyun Chul Lee, Bong Soo Cha
Diabetes Metab J. 2011;35(5):489-496.   Published online October 31, 2011
DOI: https://doi.org/10.4093/dmj.2011.35.5.489
  • 37,163 View
  • 53 Download
  • 17 Crossref
AbstractAbstract PDFPubReader   ePub   
Background

Non-alcoholic fatty liver disease (NAFLD) is increasingly recognized as a major cause of liver-related morbidity and mortality. The underlying mechanisms of disease progression remain poorly understood, and primary therapy of NAFLD is not yet established. We investigated the effects of dietary oleate on the development and progression of NAFLD in a methionine- and choline-deficient (MCD) diet-fed animal model.

Methods

A total of 30 C57BL/6J mice were randomly divided into three groups (n=10 in each group) and fed various experimental diets for four weeks: chow, MCD diet, or OMCD (MCD diet with oleate, 0.5 mg/g/day). Liver samples were examined for steatohepatitis and fibrosis parameters and associated genes.

Results

Additional dietary oleate dramatically reduced MCD diet-induced hepatic steatosis. Hepatic carbohydrate responsive element-binding protein was overexpressed in MCD diet-fed mice, and dietary oleate prevented this overexpression (P<0.001). Dietary oleate partially prevented MCD diet-induced serum level increases in aspartate aminotransferase and alanine aminotransferase (P<0.001, respectively). The mRNA expressions of hepatic monocyte chemoattractant protein 1, tumor necrosis factor-α and matrix metalloproteinase-9 were increased in MCD diet-fed mice, and this overexpression of inflammatory molecules was prevented by dietary oleate (P<0.001). Hepatic pericellular fibrosis was observed in MCD diet-fed mice, and dietary oleate prevented this fibrosis. Altogether, dietary oleate prevented MCD diet-induced hepatic steatosis, inflammation and fibrosis.

Conclusion

Dietary oleate has beneficial effects in every step of NAFLD development and progression and could be a nutritional option for NAFLD prevention and treatment.

Citations

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Postprandial Triglyceride Is Associated with Fasting Triglyceride and HOMA-IR in Korean Subjects with Type 2 Diabetes
Seo Hee Lee, Byung-Wan Lee, Hee Kwan Won, Jae Hoon Moon, Kwang Joon Kim, Eun Seok Kang, Bong Soo Cha, Hyun Chul Lee
Diabetes Metab J. 2011;35(4):404-410.   Published online August 31, 2011
DOI: https://doi.org/10.4093/dmj.2011.35.4.404
  • 11,091 View
  • 57 Download
  • 16 Crossref
AbstractAbstract PDFSupplementary MaterialPubReader   ePub   
Background

Recent studies indicate postprandial triglyceride (TG) had a better association with cardiovascular events and metabolic syndrome than fasting TG. The authors of the present study investigated the metabolic and clinical relevance of postprandial TG.

Methods

In a cross-sectional retrospective study, the authors of the present study compared fasting and postprandial TG and analyzed the relationship between postprandial TG and various demographic and metabolic parameters in 639 Korean subjects with type 2 diabetes (T2D, group I, n=539) and impaired fasting glucose (IFG, group II, n=100) after ingestion of a standardized liquid meal (total 500 kcal, 17.5 g fat, 68.5 g carbohydrate, and 17.5 g protein).

Results

Fasting and postprandial TG were significantly correlated (r=0.973, r=0.937, P<0.001) in group I and II, respectively. Of the variables, total cholesterol, waist circumference and body mass index were significantly correlated with fasting and postprandial TG in both groups. Only postprandial TG showed a significant correlation with glucose metabolic parameters (e.g., postprandial glucose, homeostatic model assessment of insulin resistance [HOMA-IR], and fasting C-peptide) in subjects with T2D. Multiple regression analysis showed fasting TG and HOMA-IR could be predictable variables for postprandial TG in subjects with T2D.

Conclusion

Postprandial TG was very strongly correlated with fasting TG. The authors of the present study suggest insulin resistance may be more associated with postprandial TG than fasting TG in Korean T2D patients on a low-fat diet.

Citations

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