Diabetes & Metabolism Journal

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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Citations

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Adherence to the nutritional recommendations according to diabetes status in Korean adults: a cross-sectional study
Jong Han Choi, Chen Lulu, Seon-Joo Park, Hae-Jeung Lee
BMC Public Health.2024;[Epub] CrossRef

Cardiovascular Risk/Epidemiology
Real-World Treatment Patterns according to Clinical Practice Guidelines in Patients with Type 2 Diabetes Mellitus and Established Cardiovascular Disease in Korea: Multicenter, Retrospective, Observational Study: Ye Seul Yang, Nam Hoon Kim, Jong Ha Baek, Seung-Hyun Ko, Jang Won Son, Seung-Hwan Lee, Sang Youl Rhee, Soo-Kyung Kim, Tae Seo Sohn, Ji Eun Jun, In-Kyung Jeong, Chong Hwa Kim, Keeho Song, Eun-Jung Rhee, Junghyun Noh, Kyu Yeon Hur, Committee of Clinical Practice Guidelines, Korean Diabetes Association; Diabetes Metab J. 2024;48(2):279-289. Published online January 26, 2024; DOI: https://doi.org/10.4093/dmj.2023.0225

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Background
Recent diabetes management guidelines recommend that sodium-glucose cotransporter 2 inhibitors (SGLT2is) or glucagon-like peptide 1 receptor agonists (GLP-1RAs) with proven cardiovascular benefits should be prioritized for combination therapy in patients with type 2 diabetes mellitus (T2DM) and established cardiovascular disease (CVD). This study was aimed at evaluating SGLT2i or GLP-1RA usage rates and various related factors in patients with T2DM and established CVD.
Methods
We enrolled adults with T2DM aged ≥30 years who were hospitalized due to established CVD from January 2019 to May 2020 at 13 secondary and tertiary hospitals in Korea in this retrospective observational study.
Results
Overall, 2,050 patients were eligible for analysis among 2,107 enrolled patients. The mean patient age, diabetes duration, and glycosylated hemoglobin level were 70.0 years, 12.0 years, and 7.5%, respectively. During the mean follow-up duration of 9.7 months, 25.7% of the patients were prescribed SGLT2is after CVD events. However, only 1.8% were prescribed GLP-1RAs. Compared with SGLT2i non-users, SGLT2i users were more frequently male and obese. Furthermore, they had a shorter diabetes duration but showed worse glycemic control and better renal function at the time of the event. GLP-1RA users had a longer duration of diabetes and worse glycemic control at the time of the event than GLP-1RA non-users.
Conclusion
The SGLT2i or GLP-1RA prescription rates were suboptimal in patients with T2DM and established CVD. Sex, body mass index, diabetes duration, glycemic control, and renal function were associated with the use of these agents.

Citations

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Enhancing Patient Outcomes: Prioritizing SGLT2is and GLP-1RAs in Diabetes with CVD
Gwanpyo Koh
Diabetes & Metabolism Journal.2024; 48(2): 208. CrossRef

Reviews

Guideline/Fact Sheet
2023 Clinical Practice Guidelines for Diabetes Mellitus of the Korean Diabetes Association: Jong Han Choi, Kyung Ae Lee, Joon Ho Moon, Suk Chon, Dae Jung Kim, Hyun Jin Kim, Nan Hee Kim, Ji A Seo, Mee Kyoung Kim, Jeong Hyun Lim, YoonJu Song, Ye Seul Yang, Jae Hyeon Kim, You-Bin Lee, Junghyun Noh, Kyu Yeon Hur, Jong Suk Park, Sang Youl Rhee, Hae 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, Won Suk Choi, Min Kyong Moon, Committee of Clinical Practice Guidelines, Korean Diabetes Association; Diabetes Metab J. 2023;47(5):575-594. Published online September 26, 2023; DOI: https://doi.org/10.4093/dmj.2023.0282

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In May 2023, the Committee of Clinical Practice Guidelines of the Korean Diabetes Association published the revised clinical practice guidelines for Korean adults with diabetes and prediabetes. We incorporated the latest clinical research findings through a comprehensive systematic literature review and applied them in a manner suitable for the Korean population. These guidelines are designed for all healthcare providers nationwide, including physicians, diabetes experts, and certified diabetes educators who manage patients with diabetes or individuals at risk of developing diabetes. Based on recent changes in international guidelines and the results of a Korean epidemiological study, the recommended age for diabetes screening has been lowered. In collaboration with the relevant Korean medical societies, recently revised guidelines for managing hypertension and dyslipidemia in patients with diabetes have been incorporated into this guideline. An abridgment containing practical information on patient education and systematic management in the clinic was published separately.

Citations

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Eugene Han, Byung-Wan Lee, Eun Seok Kang, Bong-Soo Cha, Sang Hoon Ahn, Yong-ho Lee, Seung Up Kim
Metabolism.2024; 152: 155789. CrossRef
Letter by In-Kyung Jeong Regarding Article, Trends in Prevalence of Hypertriglyceridemia and Related Factors in Korean Adults: A Serial Cross-Sectional Study
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Association between cardiovascular disease risk and incident type 2 diabetes mellitus in individuals with prediabetes: A retrospective cohort study
Myung Jin Kim, Yun Kyung Cho, Chang Hee Jung, Woo Je Lee
Diabetes Research and Clinical Practice.2024; 208: 111125. CrossRef
Korea Hypertension Fact Sheet 2023: analysis of nationwide population-based data with a particular focus on hypertension in special populations
Hyeon Chang Kim, Hokyou Lee, Hyeok-Hee Lee, Dasom Son, Minsung Cho, Sojung Shin, Yeeun Seo, Eun-Jin kim, Song Vogue Ahn, Sun Ha Jee, Sungha Park, Hae-Young Lee, Min Ho Shin, Sang-Hyun Ihm, Seung Won Lee, Jong Ku Park, Il Suh, Tae-Yong Lee
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The Journal of Clinical Endocrinology & Metabolism.2024;[Epub] CrossRef
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Diabetes, Obesity and Metabolism.2024; 26(7): 2567. CrossRef
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Glycemic Control and Oral Health Outcomes in Patients With Diabetes: Insights From a Nationwide Korean Survey
Song-Yi Yu, Sun-Kyung Lee, Bumhee Yang, Hyun Lee, Hyun Jeong Jeon, Dong-Hwa Lee
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Juliana C. N. Chan, Aimin Yang, Natural Chu, Elaine Chow
Diabetes, Obesity and Metabolism.2024; 26(S3): 55. CrossRef
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Kang Seo Park, Hea Min Yu
Journal of the Korean Medical Association.2024; 67(7): 449. CrossRef
The Key Role of Nutritional Intervention in Delaying Disease Progression and the Therapeutic Management of Diabetic Kidney Disease—A Challenge for Physicians and Patients
Ileana Peride, Miruna Anastasiu, Silvia Alexandra Serban, Mirela Tiglis, Razvan Ene, Ana-Maria Nechita, Tiberiu Paul Neagu, Ionel Alexandru Checherita, Andrei Niculae
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Efficacy and Safety of Pioglitazone Add-on in Patients with Type 2 Diabetes Mellitus Inadequately Controlled with Metformin and Dapagliflozin: A Multicenter, Randomized, Double-blind, and Placebo-controlled Study
Yun Kyung Cho, Kyung-Soo Kim, Byung-Wan Lee, Jun Hwa Hong, Jae Myung Yu, Soo Lim, Ye An Kim, Chang Beom Lee, Sang Soo Kim, Soo Heon Kwak, Woo Je Lee
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Joonyub Lee, Kun‐Ho Yoon
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Effect of gout and diabetic kidney disease on renal cancer development in Korea
Seung Min Chung, Inha Jung, Da Young Lee, So Young Park, Ji Hee Yu, Jun Sung Moon, Ji A Seo, Kyungdo Han, Nan Hee Kim
Clinical Kidney Journal.2024;[Epub] CrossRef
Cardiovascular autonomic neuropathy and the risk of diabetic kidney disease
Injeong Cho, Seohyun Lim, Minjae Kwon, Seung Min Chung, Jun Sung Moon, Ji Sung Yoon, Kyu Chang Won
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Educational Needs and Priorities of People with Diabetes and Healthcare Providers in South Korea: A Mixed-Methods Study
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Diabetes, Obesity and Metabolism.2024;[Epub] CrossRef
Management of Dyslipidemia in Patients with Diabetes Mellitus
Kyung Ae Lee
The Journal of Korean Diabetes.2023; 24(3): 111. CrossRef
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Junghyun Noh
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2023 Clinical Practice Guidelines for Diabetes
Min Kyong Moon
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Ye Seul Yang
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Jong Han Choi
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Sung-Soo Kim, Hun-Sung Kim
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Guideline/Fact Sheet
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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1,716 Download
142 Web of Science
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Graphical Abstract Abstract PDF PubReader 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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Lipid Management in Korean People with Type 2 Diabetes Mellitus: Korean Diabetes Association and Korean Society of Lipid and Atherosclerosis Consensus Statement
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Analysis of the Incidence of Type 2 Diabetes, Requirement of Insulin Treatment, and Diabetes-Related Complications among Patients with Cancer
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젊은 2형 당뇨병 환자의 관리
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Response

Status of Diabetic Neuropathy in Korea: A National Health Insurance Service-National Sample Cohort Analysis (2006 to 2015) (Diabetes Metab J 2021;45:115-9): Seong-Su Moon, Chong Hwa Kim, Seon Mee Kang, Eun Sook Kim, Tae Jung Oh, Jae-Seung Yun, Ho Chan Cho, Dae Jung Kim, Tae Sun Park; Diabetes Metab J. 2021;45(3):459-460. Published online May 25, 2021; DOI: https://doi.org/10.4093/dmj.2021.0084

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Citations

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Comorbidity Patterns and Management in Inpatients with Endocrine Diseases by Age Groups in South Korea: Nationwide Data
Sung-Soo Kim, Hun-Sung Kim
Journal of Personalized Medicine.2023; 14(1): 42. CrossRef

Brief Report

Complications
Status of Diabetic Neuropathy in Korea: A National Health Insurance Service-National Sample Cohort Analysis (2006 to 2015): Seong-Su Moon, Chong Hwa Kim, Seon Mee Kang, Eun Sook Kim, Tae Jung Oh, Jae-Seung Yun, Ho Chan Cho, Dae Jung Kim, Tae Sun Park; Diabetes Metab J. 2021;45(1):115-119. Published online December 18, 2020; DOI: https://doi.org/10.4093/dmj.2020.0120

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This report presents the status of diabetic neuropathy (DN) in Korea as determined using a National Health Insurance ServiceNational Sample Cohort (NHIS-NSC). Annual prevalences of DN were estimated by age and gender using descriptive statistics. Pharmacological treatments for DN were also analyzed. The annual prevalence of DN increased from 24.9% in 2006 to 26.6% in 2007, and thereafter, gradually subsided to 20.8% in 2015. In most cases, pharmacological treatments involved a single drug, which accounted for 91.6% of total prescriptions in 2015. The most commonly used drugs (in decreasing order) were thioctic acid, an anti-convulsive agent, or a tricyclic antidepressant. In conclusion, the prevalence of DN decreased over the 10-year study period. Thioctic acid monotherapy was usually prescribed for DN. To reduce the socio-economic burden of DN, more attention should be paid to the diagnosis of this condition and to the appropriate management of patients.

Citations

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Diabetic Neuropathy: A Guide to Pain Management
Emily X. Zhang, Cyrus Yazdi, Rahib K. Islam, Ahmed I. Anwar, Alana Alvares-Amado, Horace Townsend, Kaitlyn E. Allen, Elena Plakotaris, Jon D. Hirsch, Ross G. Rieger, Varsha Allampalli, Jamal Hasoon, Kazi N. Islam, Sahar Shekoohi, Alan D. Kaye, Christopher
Current Pain and Headache Reports.2024; 28(10): 1067. CrossRef
Recent Trends in Diabetic and Nondiabetic Neuropathies: A Retrospective Hospital-based Nationwide Cohort Study
Horatiu F. Coman, Adriana Rusu, Norina A. Gavan, Cosmina I. Bondor, Alexandru D. Gavan, Cornelia G. Bala
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Hyunji Koo, Seung Hun You, Sewon Park, Kyeong Hye Jeong, Nakyung Jeon, Sun-Young Jung
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Qi Pan, Sijia Fei, Lina Zhang, Huan Chen, Jingyi Luo, Weihao Wang, Fei Xiao, Lixin Guo
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Han Na Jang, Tae Jung Oh
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Original Article

Drug/Regimen
γ-Linolenic Acid versus α-Lipoic Acid for Treating Painful Diabetic Neuropathy in Adults: A 12-Week, Double-Placebo, Randomized, Noninferiority Trial: Jong Chul Won, Hyuk-Sang Kwon, Seong-Su Moon, Sung Wan Chun, Chong Hwa Kim, Ie Byung Park, In Joo Kim, Jihyun Lee, Bong Yun Cha, Tae Sun Park; Diabetes Metab J. 2020;44(4):542-554. Published online November 4, 2019; DOI: https://doi.org/10.4093/dmj.2019.0099

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Background

This study was a multicenter, parallel-group, double-blind, double-dummy, randomized, noninferiority trial to evaluate the efficacy and safety of γ-linolenic acid (GLA) relative to α-lipoic acid (ALA) over a 12-week treatment period in type 2 diabetes mellitus (T2DM) patients with painful diabetic peripheral neuropathy (DPN).

Methods

This study included 100 T2DM patients between 20 and 75 years of age who had painful DPN and received either GLA (320 mg/day) and placebo or ALA (600 mg/day) and placebo for 12 weeks. The primary outcome measures were mean changes in pain intensities as measured by the visual analogue scale (VAS) and the total symptom scores (TSS).

Results

Of the 100 subjects who initially participated in the study, 73 completed the 12-week treatment period. Per-protocol analyses revealed significant decreases in the mean VAS and TSS scores compared to baseline in both groups, but there were no significant differences between the groups. The treatment difference for the VAS (95% confidence interval [CI]) between the two groups was −0.65 (−1.526 to 0.213) and the upper bound of the 95% CI did not exceed the predefined noninferiority margin (δ₁=0.51). For the TSS, the treatment difference was −0.05 (−1.211 to 1.101) but the upper bound of the 95% CI crossed the noninferiority margin (δ₂=0.054). There were no serious adverse events associated with the treatments.

Conclusion

GLA treatment in patients with painful DPN was noninferior to ALA in terms of reducing pain intensity measured by the VAS over 12 weeks.

Citations

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Response

Response: Effects of High-Dose α-Lipoic Acid on Heart Rate Variability of Type 2 Diabetes Mellitus Patients with Cardiac Autonomic Neuropathy in Korea (Diabetes Metab J 2017;41:275-83): Chong Hwa Kim, Sol Jae Lee, Bong Yun Cha; Diabetes Metab J. 2017;41(5):420-421. Published online October 24, 2017; DOI: https://doi.org/10.4093/dmj.2017.41.5.420

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Original Articles

Clinical Diabetes & Therapeutics
Effects of High-Dose α-Lipoic Acid on Heart Rate Variability of Type 2 Diabetes Mellitus Patients with Cardiac Autonomic Neuropathy in Korea: Sol Jae Lee, Su Jin Jeong, Yu Chang Lee, Yong Hoon Lee, Jung Eun Lee, Chong Hwa Kim, Kyung Wan Min, Bong Yun Cha; Diabetes Metab J. 2017;41(4):275-283. Published online July 6, 2017; DOI: https://doi.org/10.4093/dmj.2017.41.4.275

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Background

Diabetic cardiac autonomic neuropathy (CAN) is one of the important complications of diabetes. It is characterized by reduced heart rate variability (HRV).

Methods

In this randomized, double-blind, placebo-controlled, multicenter trial, 75 patients were randomly assigned to one of two groups. One group (n=41) received α-lipoic acid (ALA) at an oral dose of 600 mg/day for the first 12 weeks and then 1,200 mg/day for the next 12 weeks. The other group (n=34) received placebo treatment for 24 weeks. CAN was assessed by measuring HRVs in people with diabetes.

Results

Most of the baseline measures for HRVs were similar between the ALA and placebo groups. Although there were no statistically significant HRV changes in the ALA group compared to the placebo group after 24 weeks of trial, we found a positive tendency in some of the HRV parameters of the ALA group. The standard deviations of normal-to-normal RR intervals in the standing position increased by 1.87 ms in the ALA group but decreased by −3.97 ms in the placebo group (P=0.06). The power spectrum of the low frequency (LF) band in the standing position increased by 15.77 ms² in the ALA group, whereas it declined by −15.04 ms² in the placebo group (P=0.08). The high frequency/LF ratio in the upright position increased by 0.35 in the ALA group, whereas it declined by −0.42 in the placebo group (P=0.06). There were no differences between the two groups regarding rates of adverse events.

Conclusion

Although a slight improvement tendency was seen in HRV in the ALA group, there were no statistically significant HRV changes in the ALA group compared to the placebo group after 24 weeks of trial. However, the high oral dose of ALA was well-tolerated.

Citations

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Cardiovascular autonomic neuropathy in diabetes: an update with a focus on management
Aikaterini Eleftheriadou, Vincenza Spallone, Abd A. Tahrani, Uazman Alam
Diabetologia.2024;[Epub] CrossRef
Effect of Ramipril on Cardiac Autonomic Neuropathy in Patients With Type II Diabetes Mellitus
Chaitali A Chindhalore, Ganesh N Dakhale, Prathamesh H Kamble, Bharatsing D Rathod, Sunita Kumbhalkar, Mrunal S Phatak
Cureus.2023;[Epub] CrossRef
Evaluating treatment options for cardiovascular autonomic neuropathy in patients with diabetes mellitus: a systematic review
Jasmine KaiLi Goh, Leroy Koh
Diabetology International.2023; 14(3): 224. CrossRef
The effects of alpha lipoic acid (ALA) supplementation on blood pressure in adults: a GRADE-assessed systematic review and dose-response meta-analysis of randomized controlled trials
Mahdi Vajdi, Nooshin Noshadi, Shirin Hassanizadeh, Atefeh Bonyadian, Hooria Seyedhosseini-Ghaheh, Gholamreza Askari
Frontiers in Cardiovascular Medicine.2023;[Epub] CrossRef
Combination Therapy of Alpha-Lipoic Acid, Gliclazide and Ramipril Protects Against Development of Diabetic Cardiomyopathy via Inhibition of TGF-β/Smad Pathway
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Scott Williams, Siddig Abdel Raheim, Muhammad Ilyas Khan, Umme Rubab, Prathap Kanagala, Sizheng Steven Zhao, Anne Marshall, Emily Brown, Uazman Alam
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Mahsa Mahmoudi-Nezhad, Mahdi Vajdi, Mahdieh Abbasalizad Farhangi
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Management of diabetic neuropathy
Simona Cernea, Itamar Raz
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Victoria A. Serhiyenko, Ludmila M. Serhiyenko, Volodymyr B. Sehin, Alexandr A. Serhiyenko
Endocrine Regulations.2021; 55(4): 224. CrossRef
The Role of Alpha-lipoic Acid Supplementation in the Prevention of Diabetes Complications: A Comprehensive Review of Clinical Trials
Sarah Jeffrey, Punitha Isaac Samraj, Behin Sundara Raj
Current Diabetes Reviews.2021;[Epub] CrossRef
Safety Evaluation of α-Lipoic Acid Supplementation: A Systematic Review and Meta-Analysis of Randomized Placebo-Controlled Clinical Studies
Federica Fogacci, Manfredi Rizzo, Christoffer Krogager, Cormac Kennedy, Coralie M.G. Georges, Tamara Knežević, Evangelos Liberopoulos, Alexandre Vallée, Pablo Pérez-Martínez, Eliane F.E. Wenstedt, Agnė Šatrauskienė, Michal Vrablík, Arrigo F.G. Cicero
Antioxidants.2020; 9(10): 1011. CrossRef
Update on the Impact, Diagnosis and Management of Cardiovascular Autonomic Neuropathy in Diabetes: What Is Defined, What Is New, and What Is Unmet
Vincenza Spallone
Diabetes & Metabolism Journal.2019; 43(1): 3. CrossRef
Alpha-lipoic acid (ALA) supplementation effect on glycemic and inflammatory biomarkers: A Systematic Review and meta- analysis
Mehran Rahimlou, Maryam Asadi, Nasrin Banaei Jahromi, Anahita Mansoori
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Alpha-lipoic acid and diabetic cardiac autonomic neuropathy
Victoria Serhiyenko, Ludmila Serhiyenko, Alexandr Serhiyenko
MOJ Public Health.2019; 8(1): 8. CrossRef
Response: Effects of High-Dose α-Lipoic Acid on Heart Rate Variability of Type 2 Diabetes Mellitus Patients with Cardiac Autonomic Neuropathy in Korea (Diabetes Metab J 2017;41:275-83)
Chong Hwa Kim, Sol Jae Lee, Bong Yun Cha
Diabetes & Metabolism Journal.2017; 41(5): 420. CrossRef
Letter: Effects of High-Dose α-Lipoic Acid on Heart Rate Variability of Type 2 Diabetes Mellitus Patients with Cardiac Autonomic Neuropathy in Korea (Diabetes Metab J2017;41:275-83)
Jeongmin Lee, Jae Hyoung Cho
Diabetes & Metabolism Journal.2017; 41(5): 417. CrossRef

Epidemiology
Dietary Sodium Intake in People with Diabetes in Korea: The Korean National Health and Nutrition Examination Survey for 2008 to 2010: Myung Shin Kang, Chong Hwa Kim, Su Jin Jeong, Tae Sun Park; Diabetes Metab J. 2016;40(4):290-296. Published online June 23, 2016; DOI: https://doi.org/10.4093/dmj.2016.40.4.290

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Background

Diabetics are likely to receive advice from their physicians concerning lifestyle changes. To understand how much sodium is consumed by diabetics in Korea, we compared the average daily sodium intake between diabetics and non-diabetics after controlling for confounding factors.

Methods

We obtained the sodium intake data for 13,957 individuals who participated in the Korean National Health and Nutrition Examination Survey (KNHANES), 2008 to 2010, which consisted of a health interview and behavioral and nutritional surveys. The KNHANES uses a stratified, multistage, probability-sampling design, and weighting adjustments were conducted to represent the entire population.

Results

Our analysis revealed that, overall, diabetics tended to have lower sodium intake (4,910.2 mg) than healthy individuals (5,188.2 mg). However, both diabetic and healthy individuals reported higher sodium intake than is recommended by the World Health Organization (WHO). Stratified subgroup analyses revealed that the sodium intake (4,314.2 mg) among newly diagnosed diabetics was higher among women when compared to patients with known diabetes (3,812.5 mg, P=0.035). Female diabetics with cardiovascular disease had lower average sodium intake compared to those without cardiovascular disease after adjusting for sex, age, body mass index, and total energy intake (P=0.058). Sodium intake among male diabetics with hypercholesterolemia (P=0.011) and female diabetics with hypertriglyceridemia (P=0.067) tended to be higher than that among those who without dyslipidemia.

Conclusion

The average sodium intake of diabetics in Korea was higher than the WHO recommends. Sodium intake in newly diagnosed diabetics was significantly higher than that in non-diabetics and previously diagnosed diabetics among females. Prospective studies are needed to identify the exact sodium intake.

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Clinical Care/Education
Glycemic Effects of Rebaudioside A and Erythritol in People with Glucose Intolerance: Dong Hee Shin, Ji Hye Lee, Myung Shin Kang, Tae Hoon Kim, Su Jin Jeong, Chong Hwa Kim, Sang Soo Kim, In Joo Kim; Diabetes Metab J. 2016;40(4):283-289. Published online June 15, 2016; DOI: https://doi.org/10.4093/dmj.2016.40.4.283

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Background

Rebaudioside A and erythritol are nonnutritive sweeteners. There have been several studies of their glycemic effects, but the outcomes remain controversial. The purpose of this study was to evaluate the glycemic effects of rebaudioside A and erythritol as a sweetener in people with glucose intolerance.

Methods

This trial evaluated the glycemic effect after 2 weeks of consumption of rebaudioside A and erythritol as sweeteners in a pre-diabetic population. The patients were evaluated for fructosamine, fasting plasma glucose, C-peptide, insulin, and 2-hour plasma glucose before and after consumption of sweetener. The primary outcome was a change in fructosamine levels from the baseline to the end of treatment. Secondary outcomes were the changes in levels of fasting plasma glucose and 2-hour plasma glucose.

Results

From the baseline to the end of experiment, the changes in fructosamine levels after consumption of rebaudioside A and erythritol, did not differ significantly (244.00±19.57 vs. 241.68±23.39 µmol/L, P=0.366). The change in levels from the baseline to end of the study for rebaudioside A and erythritol were fasting plasma glucose (102.56±10.72 vs. 101.32±9.20 mg/dL), 2-hour plasma glucose (154.92±54.53 vs. 141.92±42.22 mg/dL), insulin (7.56±4.29 vs. 7.20±5.12 IU/mL), and C-peptide (2.92±1.61 vs. 2.73±1.31 ng/mL), respectively, and also did not differ significantly (P>0.05 for all).

Conclusion

Our study suggests that consumption of rebaudioside A and erythritol does not alter the glucose homeostasis in people with glucose intolerance.

Citations

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Review

2011 Clinical Practice Guidelines for Type 2 Diabetes in Korea: Seung-Hyun Ko, Sung-Rea Kim, Dong-Joon Kim, Seung-Joon Oh, Hye-Jin Lee, Kang-Hee Shim, Mi-Hye Woo, Jun-Young Kim, Nan-Hee Kim, Jae-Taik Kim, Chong Hwa Kim, Hae Jin Kim, In-Kyung Jeong, Eun-Kyung Hong, Jae-Hyoung Cho, Ji-Oh Mok, Kun-Ho Yoon; Diabetes Metab J. 2011;35(5):431-436. Published online October 31, 2011; DOI: https://doi.org/10.4093/dmj.2011.35.5.431

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As in other countries, type 2 diabetes is major health concern in Korea. A dramatic increase in the prevalence of type 2 diabetes and its chronic complications has led to an increase in health costs and economic burdens. Early detection of high risk individuals, hidden diabetic patients, and improvement in the quality of care for the disease are the first steps to mitigate the increase in prevalence. The Committee of Clinical Practice Guidelines of the Korean Diabetes Association revised and updated the '3rd Clinical Practice Guidelines' at the end of 2010. In the guidelines, the committee recommended active screening of high risk individuals for early detection and added the hemoglobin A1c level to the diagnostic criteria for type 2 diabetes based on clinical studies performed in Korea. Furthermore, the committee members emphasized that integrating patient education and self-management is an essential part of care. The drug treatment algorithm based on the degree of hyperglycemia and patient characteristics were also updated.

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Original Articles

A Survey of Diabetic Educators and Patients for the Revision of Korean Food Exchange Lists: Jae Won Cho, Mee Ra Kweon, Young Mi Park, Mi Hye Woo, Hye Sook Yoo, Jeong Hyun Lim, Bo Kyung Koo, Chong Hwa Kim, Hae Jin Kim, Tae Sun Park, Choong Ho Shin, Kyu Chang Won, Soo Lim, Hak Chul Jang; Diabetes Metab J. 2011;35(2):173-181. Published online April 30, 2011; DOI: https://doi.org/10.4093/dmj.2011.35.2.173

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Background

Food exchange lists are one of the main methods of nutritional education. However, Korean food exchange lists have not been revised since 1994. Therefore, we surveyed the opinions of diabetes educators and patients with diabetes regarding the need for revision of the current food exchange lists.

Methods

For two weeks beginning on 10 March 2008, a 12-item questionnaire regarding the opinion and need for revision of the current food exchange lists was e-mailed to diabetes educators nationwide. Another 15-question survey was administered to patients with diabetes in 13 hospitals located in the Seoul and Gyeonggi regions of Korea.

Results

We obtained survey responses from 101 diabetes educators and 209 patients; 65 (64.3%) of the educators answered that the current food exchange lists should be revised. The items that needed revision were the glycemic index, addition of new foods and reaffirmation of exchange standard amounts. The patients demanded specific education about choosing appropriate foods, a balanced meal plan, proper snacks, and dining intake.

Conclusion

Our survey results demonstrate the need to revise the Korean food exchange lists. This process should focus on glycemic index, the addition of new foods and reconfirmation of one exchange reference unit.

Citations

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Mediterranean Diet and Naltrexone/Bupropion Treatment for Weight Loss in Overweight and Obese Breast Cancer Survivors and Non-Cancer Participants: A Pilot Randomized Controlled Trial

A-Ra Cho, Won-Jun Choi, Yu-Jin Kwon, Hye Sun Lee, Sung Gwe Ahn, Ji-Won Lee
Diabetes, Metabolic Syndrome and Obesity: Targets and Therapy.2020; Volume 13: 3325. CrossRef
Development of a Spanish Food Exchange List: Application of Statistical Criteria to a Rationale Procedure
Iva Marques-Lopes, Susana Menal-Puey, J. Alfredo Martínez, Giuseppe Russolillo
Journal of the Academy of Nutrition and Dietetics.2018; 118(7): 1161. CrossRef
A Practical Approach to the Management of Micronutrients and Other Nutrients of Concern in Food Exchange Lists for Meal Planning
Giuseppe Russolillo-Femenías, Susana Menal-Puey, J. Alfredo Martínez, Iva Marques-Lopes
Journal of the Academy of Nutrition and Dietetics.2018; 118(11): 2029. CrossRef
How much fruit should diabetic patients eat?
Jeong Hyun Lim
The Journal of Korean Diabetes.2014; 15(4): 185. CrossRef
Korean Food Exchange Lists for Diabetes: Revised 2010
Dal Lae Ju, Hak Chul Jang, Young Yun Cho, Jae Won Cho, Hye Sook Yoo, Kyung Suk Choi, Mi Hye Woo, Cheong Min Sohn, Yoo Kyoung Park, Ryo Won Choue
Journal of Korean Diabetes.2011; 12(4): 228. CrossRef
Korean Food Exchange Lists for Diabetes: Revised 2010
Dal Lae Ju, Hak Chul Jang, Young Yun Cho, Jae Won Cho, Hye Sook Yoo, Kyung Suk Choi, Mi Hye Woo, Cheong Min Sohn, Yoo Kyoung Park, Ryowon Choue
The Korean Journal of Nutrition.2011; 44(6): 577. CrossRef

Erythropoietin Levels According to the Presence of Peripheral Neuropathy in Diabetic Patients with Anemia.: Heung Yong Jin, Su Jin Jeung, Chong Hwa Kim, Ji Hyun Park, Hong Sun Baek, Tae Sun Park; Korean Diabetes J. 2007;31(2):151-156. Published online March 1, 2007; DOI: https://doi.org/10.4093/jkda.2007.31.2.151

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Abstract PDF

BACKGROUND
Peripheral neuropathy is a common complication of diabetes mellitus, contributing the greatest morbidity and mortality and impairing the quality of life. Recently the receptor of erythropoietin (Epo) was proven to be expressed in neuronal cell and recombinant human Epo (rhEpo) has been shown to have neuroprotective and neurotrophic potential in peripheral neuropathy. But there is no report about baseline Epo level in blood before rhEpo treatment with diabetic peripheral neuropathy. METHODS: From Jan. 2000 to Sep. 2006, diabetic patients were reviewed about Epo level in blood, anemia, and peripheral neuropathy in Chonbuk National University Hospital. And we compared the mean value of baseline Epo level in diabetic patients with anemia according to the peripheral neuropathy. RESULTS: The mean value of Epo of patients with peripheral neuropathy was lower than that of patients without peripheral neuropathy (16.3 +/- 7.1 vs 26.1 +/- 29.7 mU/mL, P < 0.05). There was no significance in the correlation between hemoglobin and Epo level in diabetic patients with anemia irrespective of presence of peripheral neuropathy (r = -0.02, P = 0.81). CONCLUSION: We suggest that decreased Epo level in blood is possible to be an additional cause in the development of peripheral neuropathy. However, simultaneously another possibility that neuropathy causes reduced Epo level should be considered, so further studies are warranted in this field.

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The Association between Serum GGT Concentration and Diabetic Peripheral Polyneuropathy in Type 2 Diabetic Patients
Ho Chan Cho
Korean Diabetes Journal.2010; 34(2): 111. CrossRef

Plasma Fibrinogen Level is Associated with Carotid Plaque Progression in Type 2 Diabetic Patients.: Seong Hun Kim, Ji Hye Kim, Chong Hwa Kim, Ji Hyun Park, Tae Sun Park, Hong Sun Back; Korean Diabetes J. 2004;28(4):293-303. Published online August 1, 2004

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Abstract PDF: BACKGROUND
The level of plasma fibrinogen has emerged as an important risk factor for cardiovascular diseases. Raised fibrinogen levels result in enhanced fibrin deposition in areas of vessel wall injury, which in turn may accelerate the development of atherosclerotic disease. The aim of present study was to investigate whether the plasma fibrinogen levels was related to carotid atherosclerosis in type 2 diabetic patients. METHODS: The sbjects of this study were 210 type 2 diabetic patients. The intima-media thickness (IMT) and plaques in the each segment of the both carotid arteries were evaluated by a duplex scan. The mean of the total IMT values (7 points on each side), the each mean value of the CCA, bulb and ICA, and the maximal IMT, plaque count and score were measured. The plaque score was defined by the sum of longitudinal diameters of each plaque. RESULTS: The correlation between the plasma fibrinogen level and measured IMT values was statistically insignificant (r<0.15, P>0.05). However, there were significant positive correlations between the level of fibrinogen and the plaque count (r=0.20, P=0.019) or plaque score (r=0.24, P=0.006). Stepwise multiple regression analysis revealed the level of plasma fibrinogen as a predictor of the plaque score. CONCLUSION: These results suggest that an elevated plasma fibrinogen level may be related with carotid atherosclerosis in type 2 diabetic patients. Also, there a need to address the discriminating risk factors for the formation or progression of plaques, or IMT thickening.

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