Diabetes & Metabolism Journal

Original Articles

Cardiovascular Risk/Epidemiology
Glycemic Control and Adverse Clinical Outcomes in Patients with Chronic Kidney Disease and Type 2 Diabetes Mellitus: Results from KNOW-CKD: Ga Young Heo, Hee Byung Koh, Hyung Woo Kim, Jung Tak Park, Tae-Hyun Yoo, Shin-Wook Kang, Jayoun Kim, Soo Wan Kim, Yeong Hoon Kim, Su Ah Sung, Kook-Hwan Oh, Seung Hyeok Han; Diabetes Metab J. 2023;47(4):535-546. Published online April 25, 2023; DOI: https://doi.org/10.4093/dmj.2022.0112

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Background
The optimal level of glycosylated hemoglobin (HbA1c) to prevent adverse clinical outcomes is unknown in patients with chronic kidney disease (CKD) and type 2 diabetes mellitus (T2DM).
Methods
We analyzed 707 patients with CKD G1-G5 without kidney replacement therapy and T2DM from the KoreaN Cohort Study for Outcome in Patients With Chronic Kidney Disease (KNOW-CKD), a nationwide prospective cohort study. The main predictor was time-varying HbA1c level at each visit. The primary outcome was a composite of development of major adverse cardiovascular events (MACEs) or all-cause mortality. Secondary outcomes included the individual endpoint of MACEs, all-cause mortality, and CKD progression. CKD progression was defined as a ≥50% decline in the estimated glomerular filtration rate from baseline or the onset of end-stage kidney disease.
Results
During a median follow-up of 4.8 years, the primary outcome occurred in 129 (18.2%) patients. In time-varying Cox model, the adjusted hazard ratios (aHRs) for the primary outcome were 1.59 (95% confidence interval [CI], 1.01 to 2.49) and 1.99 (95% CI, 1.24 to 3.19) for HbA1c levels of 7.0%–7.9% and ≥8.0%, respectively, compared with <7.0%. Additional analysis of baseline HbA1c levels yielded a similar graded association. In secondary outcome analyses, the aHRs for the corresponding HbA1c categories were 2.17 (95% CI, 1.20 to 3.95) and 2.26 (95% CI, 1.17 to 4.37) for MACE, and 1.36 (95% CI, 0.68 to 2.72) and 2.08 (95% CI, 1.06 to 4.05) for all-cause mortality. However, the risk of CKD progression did not differ between the three groups.
Conclusion
This study showed that higher HbA1c levels were associated with an increased risk of MACE and mortality in patients with CKD and T2DM.

Citations

Citations to this article as recorded by

Unveiling the utility of artificial intelligence for prediction, diagnosis, and progression of diabetic kidney disease: an evidence-based systematic review and meta-analysis
Sagar Dholariya, Siddhartha Dutta, Amit Sonagra, Mehul Kaliya, Ragini Singh, Deepak Parchwani, Anita Motiani
Current Medical Research and Opinion.2024; 40(12): 2025. CrossRef
Non-Alcoholic Fatty Liver Disease and Its Association with Kidney and Cardiovascular Outcomes in Moderate to Advanced Chronic Kidney Disease
Cheol Ho Park, Hyunsun Lim, Youn Nam Kim, Jae Young Kim, Hyung Woo Kim, Tae Ik Chang, Seung Hyeok Han
American Journal of Nephrology.2024; : 1. CrossRef
The Beneficial Effect of Glycemic Control against Adverse Outcomes in Patients with Type 2 Diabetes Mellitus and Chronic Kidney Disease
Dong-Hwa Lee
Diabetes & Metabolism Journal.2023; 47(4): 484. CrossRef
Prevalence and predictors of chronic kidney disease among type 2 diabetic patients worldwide, systematic review and meta-analysis
Eneyew Talie Fenta, Habitu Birhan Eshetu, Natnael Kebede, Eyob Ketema Bogale, Amare Zewdie, Tadele Derbew Kassie, Tadele Fentabil Anagaw, Elyas Melaku Mazengia, Sintayehu Shiferaw Gelaw
Diabetology & Metabolic Syndrome.2023;[Epub] CrossRef
Efficacy and safety of teneligliptin in patients with type 2 diabetes mellitus: a Bayesian network meta-analysis
Miao Zhu, Ruifang Guan, Guo Ma
Frontiers in Endocrinology.2023;[Epub] CrossRef

Effect of Sea Tangle Powder on the Regulation of Blood Glucose Level and Body Weight in Streptozotocin (STZ)-induced Diabetic Rats.: Hyung Woo Kim, Jae Seung Kang, Su In Kim, Wang Jae Lee; Korean Diabetes J. 2006;30(6):459-465. Published online November 1, 2006; DOI: https://doi.org/10.4093/jkda.2006.30.6.459

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Abstract PDF

BACKGROUND
Sea tangle is one of the low calorie diet and the fibers in sea tangle suppress the increase of blood glucose level. Therefore, it has a better impact than any other diets for diabetic patients. In the present study, we have investigated the effect of sea tangle powder, hereafter referred as Substance , as an antihyperglycemic agent and antioxidant in streptozotocin (STZ)-induced diabetic rats. METHODS: Male Wistar rats were divided into three groups: group 1) vehicle-treated normal rats; group 2) vehicle-treated STZ-diabetic rats; group 3) sea tangle powder-treated STZ-diabetic rats. Fasting blood glucose levels and body weights were measured. Intracellular ROS levels were measured using Cytofluor 2350 plate reader. RESULTS: Oral administration of sea tangle powder for 10 days resulted in lowered levels of blood glucose in early stage (within a week) and preventing effect of weight loss in late stage. Treatment with sea tangle powder resulted in the decrease of intracellular ROS levels in Dendritic Cell line. CONCLUSION: Sea tangle powder exhibits antihyperglycemic activity and restorative activity on weight loss in STZ-induced diabetic rats. It's abilities depend not on protecting disruption of beta-cell, but on antioxidant effect in other organs.

Citations

Citations to this article as recorded by

The Effect of Saccharina japonica on the Physicochemical Characteristics and Antioxidant Properties with Consumer Acceptance Test of Grain Nurungji
YeRim Jeong, IlSook Choi
Journal of the East Asian Society of Dietary Life.2023; 33(1): 40. CrossRef
Effects of Coated Liposome from Discorea rhizoma Extract (DRE) -on Hypoglycemic, Serum Insulin, and Lipid Levels in Streptozotocin-Induced
Kyung-Soon Choi
The Korean Journal of Food And Nutrition.2013; 26(2): 310. CrossRef
Effects of Hambag Mushroom (Grifola frondosa)-Powder on Hyperglycemia and Hyperlipemia in STZ and High Fat Diet-induced Diabetic Rats
Soon-Lee Lee, Yeong-Chul Park, Jong-Bong Kim
Journal of Life Science.2007; 17(10): 1387. CrossRef

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