Diabetes & Metabolism Journal

Short Communication

Pathophysiology
Glutamic Acid Decarboxylase and Tyrosine Phosphatase-Related Islet Antigen-2 Positivity among Children and Adolescents with Diabetes in Korea: Ka Young Kim, Min Seung Kim, Yun Jeong Lee, Young Ah Lee, Seong Yong Lee, Choong Ho Shin, Jae Hyun Kim; Diabetes Metab J. 2022;46(6):948-952. Published online March 8, 2022; DOI: https://doi.org/10.4093/dmj.2021.0332

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Autoantibodies against glutamic acid decarboxylase (GADA), tyrosine phosphatase-related islet antigen 2 (IA2A), insulin (INSA), and islet cells (ICA) are critical for determining the type of diabetes and management strategy in new-onset diabetes mellitus (NODM), but there have been few reports of all diabetes-associated autoantibody (DAA) in Korea. We retrospectively analyzed 193 patients with NODM aged 0 to 18 years who were followed at two tertiary centers in Korea (2017 to 2021). Patients with type 1 diabetes mellitus (T1DM) and type 2 diabetes mellitus (T2DM) were 93 (48.2%) and 100 (51.8%), respectively. In T1DM patients, the DAA positivity rate was 94.6%; prevalence of GADA, IA2A, INSA, and ICA was 71.0%, 71.0%, 31.2%, and 10.8%, respectively; and IA2A added 10.7% point autoantibody positivity (83.9% for GADA+INSA+ICA and 94.6% for GADA+INSA+ICA+IA2A). Among the patients with T2DM, 12 (12.0%) were positive for DAA, and all were positive for INSA. These findings suggest that DAA at diagnosis, especially GADA and IA2A, is useful for classifying diabetes in Korean children and adolescents.

Citations

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Immune-Checkpoint Inhibitors-Induced Type 1 Diabetes Mellitus: From Its Molecular Mechanisms to Clinical Practice
Yun Kyung Cho, Chang Hee Jung
Diabetes & Metabolism Journal.2023; 47(6): 757. CrossRef
Diagnostic and Therapeutic Strategies of Type 2 Diabetes Mellitus in Youth
Hwa Young Kim, Jae Hyun Kim
The Ewha Medical Journal.2022;[Epub] CrossRef

Original Articles

Metabolic Risk/Epidemiology
Maternal Hyperglycemia during Pregnancy Increases Adiposity of Offspring: Hye Rim Chung, Joon Ho Moon, Jung Sub Lim, Young Ah Lee, Choong Ho Shin, Joon-Seok Hong, Soo Heon Kwak, Sung Hee Choi, Hak Chul Jang; Diabetes Metab J. 2021;45(5):730-738. Published online February 22, 2021; DOI: https://doi.org/10.4093/dmj.2020.0154

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Background
The effect of intrauterine hyperglycemia on fat mass and regional fat proportion of the offspring of mothers with gestational diabetes mellitus (OGDM) remains to be determined.
Methods
The body composition of OGDM (n=25) and offspring of normoglycemic mothers (n=49) was compared using dualenergy X-ray absorptiometry at age 5 years. The relationship between maternal glucose concentration during a 100 g oral glucose tolerance test (OGTT) and regional fat mass or proportion was analyzed after adjusting for maternal prepregnancy body mass index (BMI).
Results
BMI was comparable between OGDM and control (median, 16.0 kg/m² vs. 16.1 kg/m² ). Total, truncal, and leg fat mass were higher in OGDM compared with control (3,769 g vs. 2,245 g, P=0.004; 1,289 g vs. 870 g, P=0.017; 1,638 g vs. 961 g, P=0.002, respectively), whereas total lean mass was lower in OGDM (15,688 g vs. 16,941 g, P=0.001). Among OGDM, total and truncal fat mass were correlated with fasting and 3-hour glucose concentrations of maternal 100 g OGTT during pregnancy (total fat mass, r=0.49, P=0.018 [fasting], r=0.473, P=0.023 [3-hour]; truncal fat mass, r=0.571, P=0.004 [fasting], r=0.558, P=0.006 [3-hour]), but there was no correlation between OGDM leg fat mass and maternal OGTT during pregnancy. Regional fat indices were not correlated with concurrent maternal 75 g OGTT values.
Conclusion
Intrauterine hyperglycemia is associated with increased fat mass, especially truncal fat, in OGDM aged 5 years.

Citations

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Advances in free fatty acid profiles in gestational diabetes mellitus
Haoyi Du, Danyang Li, Laura Monjowa Molive, Na Wu
Journal of Translational Medicine.2024;[Epub] CrossRef
2023 Clinical Practice Guidelines for Diabetes Management in Korea: Full Version Recommendation of the Korean Diabetes Association
Jun Sung Moon, Shinae Kang, Jong Han Choi, Kyung Ae Lee, Joon Ho Moon, Suk Chon, Dae Jung Kim, Hyun Jin Kim, Ji A Seo, Mee Kyoung Kim, Jeong Hyun Lim, Yoon Ju Song, Ye Seul Yang, Jae Hyeon Kim, You-Bin Lee, Junghyun Noh, Kyu Yeon Hur, Jong Suk Park, Sang
Diabetes & Metabolism Journal.2024; 48(4): 546. CrossRef
Type 1 Diabetes and Pregnancy: Challenges in Glycemic Control and Maternal–Fetal Outcomes
Tejumola Apata, Dennis Samuel, Laticia Valle, Sarah D. Crimmins
Seminars in Reproductive Medicine.2024;[Epub] CrossRef
Association between serum free fatty acids and gestational diabetes mellitus
Danyang Li, Haoyi Du, Na Wu
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Mihoko Yamaguchi, Jun Mori, Nozomi Nishida, Satoshi Miyagaki, Yasuhiro Kawabe, Takeshi Ota, Hidechika Morimoto, Yusuke Tsuma, Shota Fukuhara, Takehiro Ogata, Takuro Okamaura, Naoko Nakanishi, Masahide Hamaguchi, Hisakazu Nakajima, Michiaki Fukui, Tomoko I
Journal of Developmental Origins of Health and Disease.2023; 14(2): 261. CrossRef
Prediction of gestational diabetes mellitus in Asian women using machine learning algorithms
Byung Soo Kang, Seon Ui Lee, Subeen Hong, Sae Kyung Choi, Jae Eun Shin, Jeong Ha Wie, Yun Sung Jo, Yeon Hee Kim, Kicheol Kil, Yoo Hyun Chung, Kyunghoon Jung, Hanul Hong, In Yang Park, Hyun Sun Ko
Scientific Reports.2023;[Epub] CrossRef
Effects of early standardized management on the growth trajectory of offspring with gestational diabetes mellitus at 0–5 years old: a preliminary longitudinal study
Bingbing Guo, Jingjing Pei, Yin Xu, Yajie Wang, Xinye Jiang
Scientific Reports.2023;[Epub] CrossRef
Gestational Diabetes Mellitus: Diagnostic Approaches and Maternal-Offspring Complications
Joon Ho Moon, Hak Chul Jang
Diabetes & Metabolism Journal.2022; 46(1): 3. CrossRef
Increased Pro-Inflammatory T Cells, Senescent T Cells, and Immune-Check Point Molecules in the Placentas of Patients With Gestational Diabetes Mellitus
Yea Eun Kang, Hyon-Seung Yi, Min-Kyung Yeo, Jung Tae Kim, Danbit Park, Yewon Jung, Ok Soon Kim, Seong Eun Lee, Ji Min Kim, Kyong Hye Joung, Ju Hee Lee, Bon Jeong Ku, Mina Lee, Hyun Jin Kim
Journal of Korean Medical Science.2022;[Epub] CrossRef

Epidemiology
Discrepancies between Glycosylated Hemoglobin and Fasting Plasma Glucose for Diagnosing Impaired Fasting Glucose and Diabetes Mellitus in Korean Youth and Young Adults: Jieun Lee, Young Ah Lee, Jae Hyun Kim, Seong Yong Lee, Choong Ho Shin, Sei Won Yang; Diabetes Metab J. 2019;43(2):174-182. Published online November 2, 2018; DOI: https://doi.org/10.4093/dmj.2018.0046

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Background

Glycosylated hemoglobin (HbA1c) has been recommended as a diagnostic test for prediabetes and diabetes. Here, we evaluated the level of agreement between diagnoses based on fasting plasma glucose (FPG) versus HbA1c levels and determined optimal HbA1c cutoff values for these diseases in youth and young adults.

Methods

The study included 7,332 subjects (n=4,129, aged 10 to 19 years in youth group; and n=3,203 aged 20 to 29 years in young adult group) from the 2011 to 2016 Korea National Health and Nutrition Examination Survey. Prediabetes and diabetes were defined as 100 to 125 mg/dL (impaired fasting glucose [IFG]) and ≥126 mg/dL for FPG (diabetes mellitus [DM] by FPG [DM_FPG]), and 5.7% to 6.4% and ≥6.5% for HbA1c, respectively.

Results

In the youth group, 32.5% with IFG had an HbA1c level of 5.7% to 6.4%, and 72.2% with DM_FPG had an HbA1c ≥6.5%. In the young adult group, 27.5% with IFG had an HbA1c level of 5.7% to 6.4%, and 66.6% with DM_FPG had an HbA1c ≥6.5%. Kappa coefficients for agreement between the FPG and HbA1c results were 0.12 for the youth group and 0.19 for the young adult group. In receiver operating characteristic curve analysis, the optimal HbA1c cutoff for IFG and DM_FPG were 5.6% and 5.9% in youths and 5.5% and 5.8% in young adults, respectively.

Conclusion

Usefulness of HbA1c for diagnosis of IFG and DM_FPG in Koreans aged <30 years remains to be determined due to discrepancies between the results of glucose- and HbA1c-based tests. Additional testing might be warranted at lower HbA1c levels to detect IFG and DM_FPG in this age group.

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Juan Chen, Song Lin, Xingzhou Wang, Xiwei Wang, Pengxia Gao
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Glycemic traits and colorectal cancer survival in a cohort of South Korean patients: A Mendelian randomization analysis
So Yon Jun, Sooyoung Cho, Min Jung Kim, Ji Won Park, Seung‐Bum Ryoo, Seung Yong Jeong, Kyu Joo Park, Aesun Shin
Cancer Medicine.2024;[Epub] CrossRef
Prevalence and clinical correlates of impaired fasting blood glucose in children and adolescents with depressive disorder and relationship with triglyceride and high-density lipoprotein ratio
Zhiwei Liu, Liang Sun, Feng Sun, Shu Cui, Yulong Zhang, Juan Wang, Zhaokun Zhang, Longlong Sun, Rongchun Yang, Gaofeng Yao, Yun Liu
Scientific Reports.2024;[Epub] CrossRef
Associations between HbA1c-derived estimated average glucose and fasting plasma glucose in patients with normal and abnormal hemoglobin patterns
Wilaiwan Sriwimol, Phattanapong Choosongsang, Pensiri Choosongsang, Warakorn Petkliang, Pittaya Treerut
Scandinavian Journal of Clinical and Laboratory Investigation.2022; 82(3): 192. CrossRef
Increasing prevalence of fasting hyperglycemia in adolescents aged 10–18 years and its relationship with metabolic indicators: the Korea National Health and Nutrition Examination Study (KNHANES), 2007–2018
Seung Eun Yoo, Ji Hyen Lee, Jung Won Lee, Hye Sook Park, Hye Ah Lee, Hae Soon Kim
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Hypertriglyceridemia is associated with long-term risk of cardiovascular events and specific comorbidity in very high-risk hypertensive patients
O. Ya. Korolyuk, O. M. Radchenko
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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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Abstract PDF PubReader

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.

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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

Changes of Insulin-like Growth Factor- I, Insulin-like Growth Factor Binding Protein-3 and 24-hour Urinary Growth Hormone in PrepubertalChildren with Insulin Dependent Diabetes Mellitus.: Choong Ho Shin, Sei Won Yang; Korean Diabetes J. 1999;23(1):25-35. Published online January 1, 2001

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Abstract PDF: BACKGROUND
The growth hormone - insulin-like growth factor-I(GH/IGF-I) axis and the insulin nutrition axis constitute two major anabolic hormone systems that interact at varous levels. It is well established that patients with type 1 diabetes mellitus have elevated GH levels and inappropriate low IGF-I for high GH levels. Such a deranged GH/IGF-I axis may complicate the somatic growth of children with diabetes. The purpose of this study assess the nature of deranged GH/IGF-I axis and the effect on somatic growth. METHODS: In the present study, serum levels of IGF-I and IGFBP-3 were measured in 31 prepubertal children with type 1 DM (age, 8.93.1yr) and were compared with those levels in children with normal short stature (control) (age, 8.4+/-2.5 yr). RESULTS: In diabetic patients, age-adjusted serum levels of IGF-I and IGFBP-3 were significantly lower than those in controls (p<0.05). The difference of serum levels of IGF-I and IGFBP-3 between diabetic patients and control increased with chronologic age. There was no difference in 24-h urinary GH (24-h uGH) excretion between diabetic patients and normal controls. Simple regression analysis reveled no correlation between height SDS (standard deviation score)and HbA, (average 7.4%), IGF-I, IGFBP-3, urinary growth hormone, and chronological age. But height SDS had a tendency to decrease with the duration of diabetes, but without statistical significance. In diabetic patients, the 24-h uGH expressed as ng/24 h was correlated with chronologic age, IGF-I, and IGFBP-3, but such correlation was not obsc:rved when the 24-h uGH was expressed as ng/g creatinine In the control group, the 24-h u(GH was expressed as ng/24 h, correlated with only IGFRP-3. CONCLUSION: The growth impairment during puberty (which may be dependent on the degree of blood glucose control), rather than during prepuberty is probably responsible for the reduced final adult height in diabetic patients. This might be partly due to a relatively good blood glucose ontrol during prepubertal period. More importantly, it is suggested that this reduced final adult height comes from a gradual decrease in IGF-I and IGFBP-3 levels for long period during diabetes, regardless of the 24-h urinary growth hormone excretion.

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