Diabetes & Metabolism Journal

Original Articles

Clinical Diabetes & Therapeutics
Efficacy and Safety of Sodium-Glucose Cotransporter-2 Inhibitors in Korean Patients with Type 2 Diabetes Mellitus in Real-World Clinical Practice: A Ram Hong, Bo Kyung Koo, Sang Wan Kim, Ka Hee Yi, Min Kyong Moon; Diabetes Metab J. 2019;43(5):590-606. Published online February 28, 2019; DOI: https://doi.org/10.4093/dmj.2018.0134

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Background

This study aimed to evaluate the efficacy and safety of sodium-glucose cotransporter-2 (SGLT2) inhibitors in Korean patients who had inadequately controlled type 2 diabetes mellitus (T2DM) in real-world clinical practice.

Methods

We included 410 patients who started SGLT2 inhibitors (empagliflozin or dapagliflozin) as add-on therapy or switch therapy between February 2015 and June 2017. The primary efficacy endpoint was a change in glycosylated hemoglobin (HbA1c) from baseline to week 12. The secondary endpoints were patients achieving HbA1c <7.0% and changes in the fasting plasma glucose (FPG), lipid profiles, body weight, and blood pressure (BP).

Results

The mean HbA1c at baseline was 8.5% (8.6% in the add-on group and 8.4% in the switch group). At week 12, the mean adjusted HbA1c decreased by −0.68% in the overall patients (P<0.001), by −0.94% in the add-on group, and by −0.42% in the switch group. Significant reductions in FPG were also observed both in the add-on group and switch group (−30.3 and −19.8 mg/dL, respectively). Serum triglyceride (−16.5 mg/dL), body weight (−2.1 kg), systolic BP (−4.7 mm Hg), and diastolic BP (−1.3 mm Hg) were significantly improved in the overall patients. Approximately 18.3% of the patients achieved HbA1c <7.0% at week 12. A low incidence of hypoglycemia and genital tract infection was observed (6.3% and 2.2%, respectively).

Conclusion

SGLT2 inhibitors can be a suitable option as either add-on or switch therapy for Korean patients with inadequately controlled T2DM.

Citations

Citations to this article as recorded by

Effectiveness and Safety of Sodium-Glucose Cotransporter 2 Inhibitors Added to Dual or Triple Treatment in Patients with Type 2 Diabetes Mellitus
Yesol Hong, Yoomin Jeon, Yoona Choi, Tae Kyu Chung, Howard Lee
Diabetes Therapy.2024; 15(2): 487. CrossRef
Real-world assessment of effectiveness and safety profile of remogliflozin etabonate in management of type 2 diabetes mellitus
Bipin Sethi, Subhankar Chowdhury, Supratik Bhattacharya, Sagar Katare, Sachin Suryawanshi, Hanmant Barkate
International Journal of Diabetes in Developing Countries.2023; 43(2): 214. CrossRef
Effects of dapagliflozin compared with glimepiride on body composition in Asian patients with type 2 diabetes inadequately controlled with metformin: The BEYOND study
Hyeong Kyu Park, Kyoung‐Ah Kim, Kyung‐Wan Min, Tae‐Seo Sohn, In Kyung Jeong, Chul Woo Ahn, Nan‐Hee Kim, Ie Byung Park, Ho Chan Cho, Choon Hee Chung, Sung Hee Choi, Kang Seo Park, Seoung‐Oh Yang, Kwan Woo Lee
Diabetes, Obesity and Metabolism.2023; 25(9): 2743. CrossRef
Efficacy and Safety of Evogliptin Add-on Therapy to Dapagliflozin/Metformin Combinations in Patients with Poorly Controlled Type 2 Diabetes Mellitus: A 24-Week Multicenter Randomized Placebo-Controlled Parallel-Design Phase-3 Trial with a 28-Week Extensio
Jun Sung Moon, Il Rae Park, Hae Jin Kim, Choon Hee Chung, Kyu Chang Won, Kyung Ah Han, Cheol-Young Park, Jong Chul Won, Dong Jun Kim, Gwan Pyo Koh, Eun Sook Kim, Jae Myung Yu, Eun-Gyoung Hong, Chang Beom Lee, Kun-Ho Yoon
Diabetes & Metabolism Journal.2023; 47(6): 808. CrossRef
Real-world Data of Glycemic Control in a Suburban Population in Northern India during the COVID-19 Pandemic
Jaydip V. Revale, Preeti J. Revale
International Journal of Diabetes and Technology.2023; 2(2): 60. CrossRef
Sodium glucose co-transporter-2 inhibitor, Empagliflozin, is associated with significant reduction in weight, body mass index, fasting glucose, and A1c levels in Type 2 diabetic patients with established coronary heart disease: the SUPER GATE study
Satilmis Bilgin, Ozge Kurtkulagi, Tuba Taslamacioglu Duman, Burcin Meryem Atak Tel, Gizem Kahveci, Murat Kiran, Eray Erge, Gulali Aktas
Irish Journal of Medical Science (1971 -).2022; 191(4): 1647. CrossRef
Efficacy and Safety of Empagliflozin as Add-On Therapy in Patients of Type-2 Diabetes Mellitus
Nauman Wazir, Shafqat Ur Rehman
Journal of Gandhara Medical and Dental Science.2022; 9(1): 24. CrossRef
Five comparative cohorts to assess the risk of genital tract infections associated with sodium‐glucose cotransporter‐2 inhibitors initiation in type 2 diabetes mellitus
Wajd Alkabbani, Arsène Zongo, Jasjeet K. Minhas‐Sandhu, Dean T. Eurich, Baiju R. Shah, Mhd. Wasem Alsabbagh, John‐Michael Gamble
Diabetic Medicine.2022;[Epub] CrossRef
Effect of Dapagliflozin in Combination with Lobeglitazone and Metformin in Korean Patients with Type 2 Diabetes in Real-World Clinical Practice
Da Hea Seo, Young Ju Suh, Yongin Cho, Seong Hee Ahn, Seongha Seo, Seongbin Hong, Yong-ho Lee, Young Ju Choi, Eunjig Lee, So Hun Kim
Yonsei Medical Journal.2022; 63(9): 825. CrossRef
Using real-world data for supporting regulatory decision making: Comparison of cardiovascular and safety outcomes of an empagliflozin randomized clinical trial versus real-world data
Ha Young Jang, In-Wha Kim, Jung Mi Oh
Frontiers in Pharmacology.2022;[Epub] CrossRef
Study comparing the efficacy and renal safety for patients with diabetes switching from dapagliflozin to empagliflozin
Ai-Yu Yang, Hung-Chun Chen
International Journal of Clinical Pharmacy.2021; 43(4): 1015. CrossRef
Empagliflozin Regulates the AdipoR1/p-AMPK/p-ACC Pathway to Alleviate Lipid Deposition in Diabetic Nephropathy
Zhiqin Zhang, Lihua Ni, Lian Zhang, Dongqing Zha, Chun Hu, Lingli Zhang, Huiling Feng, Xiaobao Wei, Xiaoyan Wu
Diabetes, Metabolic Syndrome and Obesity: Targets and Therapy.2021; Volume 14: 227. CrossRef
Efficacy and Safety of Luseogliflozin in Patients with Type 2 Diabetes Complicated by Hepatic Dysfunction: A Single-Site, Single-Arm, Open-Label, Exploratory Trial
Hiroaki Seino
Diabetes Therapy.2021; 12(3): 863. CrossRef
Sodium–Glucose Cotransporter 2 Inhibitors and Risk of Retinal Vein Occlusion Among Patients With Type 2 Diabetes: A Propensity Score–Matched Cohort Study
Min-Kyung Lee, Bongsung Kim, Kyungdo Han, Jae-Hyuk Lee, Minhee Kim, Mee Kyoung Kim, Ki-Hyun Baek, Ki-Ho Song, Hyuk-Sang Kwon, Young-Jung Roh
Diabetes Care.2021; 44(10): 2419. CrossRef
Sodium-Glucose Cotransporter-2 Inhibitors Improve Cardiovascular Dysfunction in Type 2 Diabetic East Asians
Muhammad Afzal, Fahad Al-Abbasi, Muhammad Nadeem, Sultan Alshehri, Mohammed Ghoneim, Syed Imam, Waleed Almalki, Imran Kazmi
Metabolites.2021; 11(11): 794. CrossRef
Sodium-Glucose Cotransporter-2 Inhibitor for Renal Function Preservation in Patients with Type 2 Diabetes Mellitus: A Korean Diabetes Association and Korean Society of Nephrology Consensus Statement
Tae Jung Oh, Ju-Young Moon, Kyu Yeon Hur, Seung Hyun Ko, Hyun Jung Kim, Taehee Kim, Dong Won Lee, Min Kyong Moon
Diabetes & Metabolism Journal.2020; 44(4): 489. CrossRef
Sodium-glucose cotransporter-2 inhibitor for renal function preservation in patients with type 2 diabetes mellitus: A Korean Diabetes Association and Korean Society of Nephrology consensus statement
Tae Jung Oh, Ju-Young Moon, Kyu Yeon Hur, Seung Hyun Ko, Hyun Jung Kim, Taehee Kim, Dong Won Lee, Min Kyong Moon
Kidney Research and Clinical Practice.2020; 39(3): 269. CrossRef
Use and effectiveness of dapagliflozin in patients with type 2 diabetes mellitus: a multicenter retrospective study in Taiwan
Jung-Fu Chen, Yun-Shing Peng, Chung-Sen Chen, Chin-Hsiao Tseng, Pei-Chi Chen, Ting-I Lee, Yung-Chuan Lu, Yi-Sun Yang, Ching-Ling Lin, Yi-Jen Hung, Szu-Ta Chen, Chieh-Hsiang Lu, Chwen-Yi Yang, Ching-Chu Chen, Chun-Chuan Lee, Pi-Jung Hsiao, Ju-Ying Jiang, S
PeerJ.2020; 8: e9998. CrossRef
Long-Term Effectiveness and Safety of SGLT-2 Inhibitors in an Italian Cohort of Patients with Type 2 Diabetes Mellitus
Maria Mirabelli, Eusebio Chiefari, Patrizia Caroleo, Raffaella Vero, Francesco Saverio Brunetti, Domenica Maria Corigliano, Biagio Arcidiacono, Daniela Patrizia Foti, Luigi Puccio, Antonio Brunetti
Journal of Diabetes Research.2019; 2019: 1. CrossRef
An Age of Sodium-Glucose Cotransporter-2 Inhibitor Priority: Are We Ready?
Ji A Seo
Diabetes & Metabolism Journal.2019; 43(5): 578. CrossRef

Clinical Care/Education
Improvement of Glycosylated Hemoglobin in Patients with Type 2 Diabetes Mellitus under Insulin Treatment by Reimbursement for Self-Monitoring of Blood Glucose: Young Shin Song, Bo Kyung Koo, Sang Wan Kim, Ka Hee Yi, Kichul Shin, Min Kyong Moon; Diabetes Metab J. 2018;42(1):28-42. Published online September 28, 2017; DOI: https://doi.org/10.4093/dmj.2018.42.1.28

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Background

In Korea, the costs associated with self-monitoring of blood glucose (SMBG) for patients with type 2 diabetes mellitus (T2DM) under insulin treatment have been reimbursed since November 2015. We investigated whether this new reimbursement program for SMBG has improved the glycemic control in the beneficiaries of this policy.

Methods

Among all adult T2DM patients with ≥3 months of reimbursement (n=854), subjects without any changes in anti-hyperglycemic agents during the study period were selected. The improvement of glycosylated hemoglobin (HbA1c) was defined as an absolute reduction in HbA1c ≥0.6% or an HbA1c level at follow-up <7%.

Results

HbA1c levels significantly decreased from 8.5%±1.3% to 8.2%±1.2% during the follow-up (P<0.001) in all the study subjects (n=409). Among them, 35.5% (n=145) showed a significant improvement in HbA1c. Subjects covered under the Medical Aid system showed a higher prevalence of improvement in HbA1c than those with medical insurance (52.2% vs. 33.3%, respectively, P=0.012). In the improvement group, the baseline HbA1c (P<0.001), fasting C-peptide (P=0.016), and daily dose of insulin/body weight (P=0.024) showed significant negative correlations with the degree of HbA1c change. Multivariate analysis showed that subjects in the Medical Aid system were about 2.5-fold more likely to improve in HbA1c compared to those with medical insurance (odds ratio, 2.459; 95% confidence interval, 1.138 to 5.314; P=0.022).

Conclusion

The reimbursement for SMBG resulted in a significant improvement in HbA1c in T2DM subjects using insulin, which was more prominent in subjects with poor glucose control at baseline or covered under the Medical Aid system.

Citations

Citations to this article as recorded by

Immunogenicity and Efficacy of Insulin Glargine Biosimilar Ezelin versus Originator Insulin Glargine in Patients with Type 2 Diabetes
Tri Juli Edi Tarigan, Adisti Dwijayanti, Susie Setyowati, Melva Louisa
Diabetes, Metabolic Syndrome and Obesity: Targets and Therapy.2021; Volume 14: 107. CrossRef
Insulin Glargine U100 Utilization in Patients with Type 2 Diabetes in an Italian Real-World Setting: A Retrospective Study
Luca Degli Esposti, Valentina Perrone, Stefania Saragoni, Valerio Blini, Stefano Buda, Rosella D’avella, Gina Gasperini, Fabio Lena, Francesca Fanelli, Luca Gazzi, Francesco Giorgino
Journal of Diabetes Research.2019; 2019: 1. CrossRef
Self-Monitoring of Blood Glucose in Patients with Insulin-Treated Type 2 Diabetes Mellitus
Kyung-Soo Kim
Diabetes & Metabolism Journal.2018; 42(1): 26. CrossRef

Obesity and Metabolic Syndrome
Association between Blood Mercury Level and Visceral Adiposity in Adults: Jong Suk Park, Kyoung Hwa Ha, Ka He, Dae Jung Kim; Diabetes Metab J. 2017;41(2):113-120. Published online December 21, 2016; DOI: https://doi.org/10.4093/dmj.2017.41.2.113

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Background

Few studies have examined the association between mercury exposure and obesity. The aim of this study is to investigate the association between blood mercury concentrations and indices of obesity in adults.

Methods

A total of 200 healthy subjects, aged 30 to 64 years, who had no history of cardiovascular or malignant disease, were examined. Anthropometric and various biochemical profiles were measured. Visceral adipose tissue (VAT) was measured using dual-energy X-ray absorptiometry (DXA).

Results

All subjects were divided into three groups according to blood mercury concentrations. Compared with the subjects in the lowest tertile of mercury, those in the highest tertile were more likely to be male; were current alcohol drinkers and smokers; had a higher body mass index (BMI), waist circumference (WC), and VAT; had higher levels of blood pressure, fasting glucose, and insulin resistance; and consumed more fish. The blood mercury concentration was significantly associated with anthropometric parameters, showing relationships with BMI, WC, and VAT. After adjusting for multiple risk factors, the odds ratios (ORs) for high mercury concentration was significantly higher in the highest VAT tertile than in the lowest VAT tertile (OR, 2.66; 95% confidence interval, 1.05 to 6.62; P<0.05).

Conclusion

The blood mercury concentration was significantly associated with VAT in healthy adults. Further studies are warranted to confirm our findings.

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Low Economic Status Is Identified as an Emerging Risk Factor for Diabetes Mellitus in Korean Men Aged 30 to 59 Years in Korean National Health and Nutrition Examination Survey 2008 to 2010: Bo Kyung Koo, Sang Wan Kim, Ka Hee Yi, Min Kyong Moon; Diabetes Metab J. 2015;39(2):137-146. Published online March 11, 2015; DOI: https://doi.org/10.4093/dmj.2015.39.2.137

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Background

We compared the association between economic status and the prevalence of diabetes mellitus (DM) using large nationwide datasets covering the previous 10 years in Korea.

Methods

We analyzed the association between economic status and DM using Korean National Health and Nutrition Examination Survey (KNHANES) data from 2001 to 2010 weighted to represent the Korean population between 30 and 59 years of age. The economic status of participants was classified into quartiles according to monthly family income with an equivalence scale.

Results

In men, the prevalence of diabetes in the lowest income quartile (Q1) was significantly higher than that in the other quartiles in 2008 (age and body mass index-adjusted odds ratio [OR], 1.846; 95% confidence interval [CI], 1.126 to 3.027; P=0.015), 2009 (OR, 1.706; 95% CI, 1.094 to 2.661; P=0.019), and 2010 (OR, 1.560; 95% CI, 1.024 to 2.377; P=0.039) but not in 2001 or 2005. The data indicated that classification in the lowest economic status was an independent risk factor for diabetes even after adjusting for abdominal obesity, dyslipidemia, hypertension and education level in men of KNHANES 2008 to 2010. Although economic status was significantly associated with abdominal obesity, hypertriglyceridemia, and hypertension in women (P<0.001), there was no significant association between economic status and DM in women.

Conclusion

Korean men between 30 and 59 years of age with the lowest economic status had a significantly higher prevalence of DM in 2008 to 2010 even after adjusting for other risk factors.

Citations

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Subjective Assessment of Diabetes Self-Care Correlates with Perceived Glycemic Control but not with Actual Glycemic Control: Jung Hun Ohn, Ju Hee Lee, Eun Shil Hong, Bo Kyung Koo, Sang Wan Kim, Ka Hee Yi, Min Kyong Moon; Diabetes Metab J. 2015;39(1):31-36. Published online February 16, 2015; DOI: https://doi.org/10.4093/dmj.2015.39.1.31

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Background

We investigated whether patients' perceived glycemic control and self-reported diabetes self-care correlated with their actual glycemic control.

Methods

A survey was administered among patients with diabetes mellitus at an outpatient clinic with structured self-report questionnaires regarding perceived glycemic control and diabetes self-management. Actual glycemic control was defined as a change in glycated hemoglobin (A1C) or fasting plasma glucose (FPG) since the last clinic visit.

Results

Patients who perceived their glycemic control as "improved" actually showed a mild but significant decrease in the mean A1C (-0.1%, P=0.02), and those who perceived glycemic control as "aggravated" had a significant increase in the mean FPG (10.5 mg/dL or 0.59 mmol/L, P=0.04) compared to the "stationary" group. However, one-half of patients falsely predicted their actual glycemic control status. Subjective assessment of diabetes self-care efforts, such as adherence to a diet regimen or physical activity, correlated positively with perceived glycemic control but showed no association with actual glycemic control.

Conclusion

Patients should be encouraged to assess and monitor diabetes self-care more objectively to motivate behavioral modifications and improve their actual glycemic control.

Citations

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Social Networking Services-Based Communicative Care for Patients with Diabetes Mellitus in Korea
Hun-Sung Kim, Yoo Jeong, Sun Baik, So Yang, Tong Kim, Hyunah Kim, Hyunyong Lee, Seung-Hwan Lee, Jae Cho, In-Young Choi, Kun-Ho Yoon
Applied Clinical Informatics.2016; 07(03): 899. CrossRef

Insulin Secretion and Incretin Hormone Concentration in Women with Previous Gestational Diabetes Mellitus: Sung Hoon Yu, Bongjun Cho, Yejin Lee, Eunhye Kim, Sung Hee Choi, Soo Lim, Ka Hee Yi, Young Joo Park, Kyong Soo Park, Hak Chul Jang; Diabetes Metab J. 2011;35(1):58-64. Published online February 28, 2011; DOI: https://doi.org/10.4093/dmj.2011.35.1.58

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Background

We examined the change in the levels of incretin hormone and effects of glucose-dependent insulinotropic polypeptide (GIP) and glucagon-like peptide 1 (GLP-1) on insulin secretion in women with previous gestational diabetes (pGDM).

Methods

A 75-g oral glucose tolerance test (OGTT) was conducted on 34 women with pGDM. In addition, 11 women with normal glucose tolerance, matched for age, height and weight, were also tested. The insulin, GIP, GLP-1, and glucagon concentrations were measured, and their anthropometric and biochemical markers were also measured.

Results

Among 34 women with pGDM, 18 had normal glucose tolerance, 13 had impaired glucose tolerance (IGT) and 1 had diabetes. No significant differences were found in GLP-1 concentration between the pGDM and control group. However, a significantly high level of glucagon was present in the pGDM group at 30 minutes into the OGTT. The GIP concentration was elevated at 30 minutes and 60 minutes in the pGDM group. With the exception of the 30-minute timepoint, women with IGT had significantly high blood glucose from 0 to 120 minutes. However, there was no significant difference in insulin or GLP-1 concentration. The GIP level was significantly high from 0 to 90 minutes in patients diagnosed with IGT.

Conclusion

GLP-1 secretion does not differ between pGDM patients and normal women. GIP was elevated, but that does not seem to induce in increase in insulin secretion. Therefore, we conclude that other factors such as heredity and environment play important roles in the development of type 2 diabetes.

Citations

Citations to this article as recorded by

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Journal of Korean Medical Science.2022;[Epub] CrossRef
Simulation of Oral Glucose Tolerance Tests and the Corresponding Isoglycemic Intravenous Glucose Infusion Studies for Calculation of the Incretin Effect
Myeungseon Kim, Tae Jung Oh, Jung Chan Lee, Karam Choi, Min Young Kim, Hee Chan Kim, Young Min Cho, Sungwan Kim
Journal of Korean Medical Science.2014; 29(3): 378. CrossRef
Metabolic, hormonal characteristics and genetic variants of TCF7L2 associated with development of gestational diabetes mellitus in Mexican women
Ruth Reyes‐López, Elva Pérez‐Luque, Juan Manuel Malacara
Diabetes/Metabolism Research and Reviews.2014; 30(8): 701. CrossRef
Reduced postprandial GLP‐1 responses in women with gestational diabetes mellitus
L. Bonde, T. Vilsbøll, T. Nielsen, J. I. Bagger, J. A. Svare, J. J. Holst, S. Larsen, F. K. Knop
Diabetes, Obesity and Metabolism.2013; 15(8): 713. CrossRef
Women with normal glucose tolerance and a history of gestational diabetes show significant impairment of β-cell function at normal insulin sensitivity
P. Molęda, K. Homa, K. Safranow, Z. Celewicz, A. Fronczyk, L. Majkowska
Diabetes & Metabolism.2013; 39(2): 155. CrossRef

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