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Complications
Presence of Carotid Plaque Is Associated with Rapid Renal Function Decline in Patients with Type 2 Diabetes Mellitus and Normal Renal Function
Da Hea Seo, So Hun Kim, Joon Ho Song, Seongbin Hong, Young Ju Suh, Seong Hee Ahn, Jeong-Taek Woo, Sei Hyun Baik, Yongsoo Park, Kwan Woo Lee, Young Seol Kim, Moonsuk Nam
Diabetes Metab J. 2019;43(6):840-853.   Published online March 12, 2019
DOI: https://doi.org/10.4093/dmj.2018.0186
  • 5,951 View
  • 58 Download
  • 18 Web of Science
  • 16 Crossref
AbstractAbstract PDFSupplementary MaterialPubReader   
Background

Recent evidences indicate that early rapid renal function decline is closely associated with the development and progression of diabetic kidney disease. We have investigated the association between carotid atherosclerosis and rapid renal function decline in patients with type 2 diabetes mellitus and preserved renal function.

Methods

In a prospective, multicenter cohort, a total of 967 patients with type 2 diabetes mellitus and preserved renal function were followed for 6 years with serial estimated glomerular filtration rate (eGFR) measurements. Common carotid intima-media thickness (CIMT) and presence of carotid plaque were assessed at baseline. Rapid renal function decline was defined as an eGFR decline >3.3% per year.

Results

Over a median follow-up of 6 years, 158 participants (16.3%) developed rapid renal function decline. While there was no difference in CIMT, the presence of carotid plaque in rapid decliners was significantly higher than in non-decliners (23.2% vs. 12.2%, P<0.001). In multivariable logistic regression analysis, presence of carotid plaque was an independent predictor of rapid renal function decline (odds ratio, 2.33; 95% confidence interval, 1.48 to 3.68; P<0.0001) after adjustment for established risk factors. The model including the carotid plaque had better performance for discrimination of rapid renal function decline than the model without carotid plaque (area under the receiver operating characteristic curve 0.772 vs. 0.744, P=0.016).

Conclusion

Close monitoring of renal function and early intensive management may be beneficial in patients with type 2 diabetes mellitus and carotid plaques.

Citations

Citations to this article as recorded by  
  • Impact of diabetes distress on glycemic control and diabetic complications in type 2 diabetes mellitus
    Hye-Sun Park, Yongin Cho, Da Hea Seo, Seong Hee Ahn, Seongbin Hong, Young Ju Suh, Suk Chon, Jeong-Taek Woo, Sei Hyun Baik, Kwan Woo Lee, So Hun Kim
    Scientific Reports.2024;[Epub]     CrossRef
  • Correlation analysis of carotid plaque in young patients with newly diagnosed type 2 diabetes and platelet-to-lymphocyte ratio and neutrophil–lymphocyte ratio
    Huijun Wen, Hai Yu
    Vascular.2023; 31(1): 90.     CrossRef
  • Diabetic vascular diseases: molecular mechanisms and therapeutic strategies
    Yiwen Li, Yanfei Liu, Shiwei Liu, Mengqi Gao, Wenting Wang, Keji Chen, Luqi Huang, Yue Liu
    Signal Transduction and Targeted Therapy.2023;[Epub]     CrossRef
  • Carotid intima-media thickness and atherosclerotic plaques are associated with renal function decline: a 14-year longitudinal population-based study
    Miriam Goepfert, Till Ittermann, Marcus Dörr, Nele Friedrich, Henry Völzke, Thomas Dabers, Stephan B Felix, Ulf Schminke, Sylvia Stracke, Sabrina von Rheinbaben
    Nephrology Dialysis Transplantation.2023; 38(11): 2598.     CrossRef
  • Blood pressure and vascular determinants of glomerular filtration rate decline in diabetic kidney disease
    Luca Truscello, Dina Nobre, Vehashini Sabaratnam, Olivier Bonny, Grégoire Wuerzner, Michel Burnier, Fadi Fakhouri, Menno Pruijm, Anne Zanchi
    Frontiers in Cardiovascular Medicine.2023;[Epub]     CrossRef
  • Explainable Artificial Intelligence Paves the Way in Precision Diagnostics and Biomarker Discovery for the Subclass of Diabetic Retinopathy in Type 2 Diabetics
    Fatma Hilal Yagin, Seyma Yasar, Yasin Gormez, Burak Yagin, Abdulvahap Pinar, Abedalrhman Alkhateeb, Luca Paolo Ardigò
    Metabolites.2023; 13(12): 1204.     CrossRef
  • Evaluation of Subclinical Vascular Disease in Diabetic Kidney Disease: A Tool for Personalization of Management of a High-Risk Population
    Christodoula Kourtidou, Vasileios Rafailidis, Garyfallia Varouktsi, Efthimios Kanakis, Vassilios Liakopoulos, Timoleon-Achilleas Vyzantiadis, Maria Stangou, Smaragdi Marinaki, Konstantinos Tziomalos
    Journal of Personalized Medicine.2022; 12(7): 1139.     CrossRef
  • Prevalence and Predictors of Renal Disease in a National Representative Sample of the Romanian Adult Population: Data from the SEPHAR IV Survey
    Călin Pop, Oana Florentina Gheorghe Fronea, Ioana Antonia Branea, Lucian Mihai Itu, Roxana Darabont, Irinel Parepa, Theodora Benedek, Maria Dorobantu
    Diagnostics.2022; 12(12): 3199.     CrossRef
  • Clinical features of and risk factors for normoalbuminuric diabetic kidney disease in hospitalized patients with type 2 diabetes mellitus: a retrospective cross-sectional study
    Qi Dai, Nan Chen, Ling Zeng, Xin-Jie Lin, Feng-Xiu Jiang, Xiong-Jie Zhuang, Ze-Yuan Lu
    BMC Endocrine Disorders.2021;[Epub]     CrossRef
  • The Predictive Value of Carotid Ultrasonography With Cardiovascular Risk Factors—A “SPIDER” Promoting Atherosclerosis
    Hongwei Li, Xiaolin Xu, Baoming Luo, Yuling Zhang
    Frontiers in Cardiovascular Medicine.2021;[Epub]     CrossRef
  • Update on pathogenesis and diagnosis flow of normoalbuminuric diabetes with renal insufficiency
    Le Deng, Wenjie Li, Gaosi Xu
    European Journal of Medical Research.2021;[Epub]     CrossRef
  • Association of serum fibroblast growth factor 21 with kidney function in a population-based Chinese cohort
    Rui Zhang, Yufeng Li, Xianghai Zhou, Fang Zhang, Meng Li, Simin Zhang, Xiuying Zhang, Xin Wen, Linong Ji
    Medicine.2021; 100(50): e28238.     CrossRef
  • Letter: Presence of Carotid Plaque Is Associated with Rapid Renal Function Decline in Patients with Type 2 Diabetes Mellitus and Normal Renal Function (Diabetes Metab J 2019;43:840–53)
    Min-Ji Kim, Jae-Han Jeon
    Diabetes & Metabolism Journal.2020; 44(1): 201.     CrossRef
  • Response: Presence of Carotid Plaque Is Associated with Rapid Renal Function Decline in Patients with Type 2 Diabetes Mellitus and Normal Renal Function (Diabetes Metab J 2019;43:840–53)
    Da Hea Seo, So Hun Kim, Moonsuk Nam
    Diabetes & Metabolism Journal.2020; 44(1): 205.     CrossRef
  • Serum Levels of Adipocyte Fatty Acid-Binding Protein Are Associated with Rapid Renal Function Decline in Patients with Type 2 Diabetes Mellitus and Preserved Renal Function
    Da Hea Seo, Moonsuk Nam, Mihye Jung, Young Ju Suh, Seong Hee Ahn, Seongbin Hong, So Hun Kim
    Diabetes & Metabolism Journal.2020; 44(6): 875.     CrossRef
  • Proteinuria Is Associated with Carotid Artery Atherosclerosis in Non-Albuminuric Type 2 Diabetes: A Cross-Sectional Study
    Jaehyun Bae, Yong-ho Lee, Eun Seok Kang, Bong-Soo Cha, Byung-Wan Lee
    Journal of Clinical Medicine.2020; 9(1): 136.     CrossRef
Clinical Diabetes & Therapeutics
Efficacy and Safety of Voglibose Plus Metformin in Patients with Type 2 Diabetes Mellitus: A Randomized Controlled Trial
Tae Jung Oh, Jae Myung Yu, Kyung Wan Min, Hyun Shik Son, Moon Kyu Lee, Kun Ho Yoon, Young Duk Song, Joong Yeol Park, In Kyung Jeong, Bong Soo Cha, Yong Seong Kim, Sei Hyun Baik, In Joo Kim, Doo Man Kim, Sung Rae Kim, Kwan Woo Lee, Jeong Hyung Park, In Kyu Lee, Tae Sun Park, Sung Hee Choi, Sung Woo Park
Diabetes Metab J. 2019;43(3):276-286.   Published online December 7, 2018
DOI: https://doi.org/10.4093/dmj.2018.0051
  • 7,477 View
  • 103 Download
  • 13 Web of Science
  • 13 Crossref
AbstractAbstract PDFPubReader   
Background

Combination of metformin to reduce the fasting plasma glucose level and an α-glucosidase inhibitor to decrease the postprandial glucose level is expected to generate a complementary effect. We compared the efficacy and safety of a fixed-dose combination of voglibose plus metformin (vogmet) with metformin monotherapy in drug-naïve newly-diagnosed type 2 diabetes mellitus.

Methods

A total of 187 eligible patients aged 20 to 70 years, with a glycosylated hemoglobin (HbA1c) level of 7.0% to 11.0%, were randomized into either vogmet or metformin treatments for 24 weeks. A change in the HbA1c level from baseline was measured at week 24.

Results

The reduction in the levels of HbA1c was −1.62%±0.07% in the vogmet group and −1.31%±0.07% in the metformin group (P=0.003), and significantly more vogmet-treated patients achieved the target HbA1c levels of <6.5% (P=0.002) or <7% (P=0.039). Glycemic variability was also significantly improved with vogmet treatment, estimated by M-values (P=0.004). Gastrointestinal adverse events and hypoglycemia (%) were numerically lower in the vogmet-treated group. Moreover, a significant weight loss was observed with vogmet treatment compared with metformin (−1.63 kg vs. −0.86 kg, P=0.039).

Conclusion

Vogmet is a safe antihyperglycemic agent that controls blood glucose level effectively, yields weight loss, and is superior to metformin in terms of various key glycemic parameters without increasing the risk of hypoglycemia.

Citations

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  • Phytochemical analysis and antihyperglycemic activity of Castilleja arvensis
    Mónica Aideé Díaz-Román, Juan José Acevedo-Fernández, Gabriela Ávila-Villarreal, Elizabeth Negrete-León, A. Berenice Aguilar-Guadarrama
    Fitoterapia.2024; 174: 105839.     CrossRef
  • Efficacy and Safety of DPP-4 Inhibitors and Metformin Combinations in Type 2 Diabetes: A Systematic Literature Review and Network Meta-Analysis
    Rongping Chen, Jing Li, Danqi Chen, Weiheng Wen, Susu Zhang, Jitong Li, Yuting Ruan, Zhen Zhang, Jia Sun, Hong Chen
    Diabetes, Metabolic Syndrome and Obesity.2024; Volume 17: 2471.     CrossRef
  • YAP/TAZ axis was involved in the effects of metformin on breast cancer
    Yu Xu, Hongke Cai, Yuanfeng Xiong, Li Tang, Longjiang Li, Li Zhang, Yi Shen, Yongqiang Yang, Ling Lin, Jiayi Huang
    Journal of Chemotherapy.2023; 35(7): 627.     CrossRef
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    Ashok Kumar, ShubhaLaxmi Margekar, Ravi Kumar
    Indian Journal of Medical Specialities.2023; 14(1): 3.     CrossRef
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    Beatriz Esteves, Cristina Monteiro, Ana Paula Coelho Duarte
    Healthcare.2023; 11(15): 2197.     CrossRef
  • Rapid prediction method of α-Glycosidase inhibitory activity of Coreopsis tinctoria extract from different habitats by near infrared spectroscopy
    Xiaogang He, Xiang Han, Jiaping Yu, Yulong Feng, Ganghui Chu
    Spectrochimica Acta Part A: Molecular and Biomolecular Spectroscopy.2022; 268: 120601.     CrossRef
  • Insulin autoimmune syndrome in patients with type 2 diabetes: A report of two cases
    Y. Shin, T.J. Oh, S.H. Choi, H.C. Jang
    Diabetes & Metabolism.2021; 47(1): 101115.     CrossRef
  • Efficacy and Safety of Treatment with Quadruple Oral Hypoglycemic Agents in Uncontrolled Type 2 Diabetes Mellitus: A Multi-Center, Retrospective, Observational Study
    Jun Sung Moon, Sunghwan Suh, Sang Soo Kim, Heung Yong Jin, Jeong Mi Kim, Min Hee Jang, Kyung Ae Lee, Ju Hyung Lee, Seung Min Chung, Young Sang Lyu, Jin Hwa Kim, Sang Yong Kim, Jung Eun Jang, Tae Nyun Kim, Sung Woo Kim, Eonju Jeon, Nan Hee Cho, Mi-Kyung Ki
    Diabetes & Metabolism Journal.2021; 45(5): 675.     CrossRef
  • Quantifying Remission Probability in Type 2 Diabetes Mellitus
    Sanjay Kalra, Ganapathi Bantwal, Nitin Kapoor, Rakesh Sahay, Saptarshi Bhattacharya, Beatrice Anne, Raju A Gopal, Sunil Kota, Ashok Kumar, Ameya Joshi, Debmalya Sanyal, Mangesh Tiwaskar, Ashok Kumar Das
    Clinics and Practice.2021; 11(4): 850.     CrossRef
  • The effect of voglibose on metabolic profiles in patients with type 2 diabetes mellitus: A systematic review and meta-analysis of clinical trials
    Peyman Nowrouzi-Sohrabi, Reza Tabrizi, Shahla Rezaei, Fatemeh Jafari, Kamran Hessami, Mehdi Abedi, Mohammad Jalali, Pedram Keshavarzi, Saeed Shahabi, Ali Asghar Kolahi, Kristin Carson-Chahhoud, Amirhossein Sahebkar, Saeid Safiri
    Pharmacological Research.2020; 159: 104988.     CrossRef
  • Role of Intestinal Microbiota in Metabolism of Voglibose In Vitro and In Vivo
    Mahesh Raj Nepal, Mi Jeong Kang, Geon Ho Kim, Dong Ho Cha, Ju-Hyun Kim, Tae Cheon Jeong
    Diabetes & Metabolism Journal.2020; 44(6): 908.     CrossRef
  • Response: Efficacy and Safety of Voglibose Plus Metformin in Patients with Type 2 Diabetes Mellitus: A Randomized Controlled Trial (Diabetes metab J 2019;43;276-86)
    Tae Jung Oh, Sung Hee Choi
    Diabetes & Metabolism Journal.2019; 43(4): 547.     CrossRef
  • Letter: Efficacy and Safety of Voglibose Plus Metformin in Patients with Type 2 Diabetes Mellitus: A Randomized Controlled Trial (Diabetes Metab J 2019;43;276-86)
    Hannah Seok, Tae Seo Sohn
    Diabetes & Metabolism Journal.2019; 43(4): 545.     CrossRef
Clinical Care/Education
Impact of Socioeconomic Status on Health Behaviors, Metabolic Control, and Chronic Complications in Type 2 Diabetes Mellitus
So Hun Kim, Seung Youn Lee, Chei Won Kim, Young Ju Suh, Seongbin Hong, Seong Hee Ahn, Da Hae Seo, Moon-Suk Nam, Suk Chon, Jeong-Taek Woo, Sei Hyun Baik, Yongsoo Park, Kwan Woo Lee, Young Seol Kim
Diabetes Metab J. 2018;42(5):380-393.   Published online June 29, 2018
DOI: https://doi.org/10.4093/dmj.2017.0102
  • 5,243 View
  • 73 Download
  • 14 Web of Science
  • 16 Crossref
AbstractAbstract PDFSupplementary MaterialPubReader   
Background

The aim of the study was to assess the impact of socioeconomic status (SES) on health behaviors, metabolic control, and chronic complications in people with type 2 diabetes mellitus (T2DM) from South Korea, a country with universal health insurance coverage and that has experienced rapid economic and social transition.

Methods

A total of 3,294 Korean men and women with T2DM aged 30 to 65 years, participating in the Korean National Diabetes Program (KNDP) cohort who reported their SES and had baseline clinical evaluation were included in the current cross-sectional analysis. SES included the level of education and monthly household income.

Results

Lower education level and lower income level were closely related, and both were associated with older age in men and women. Women and men with lower income and education level had higher carbohydrate and lower fat intake. After adjustment for possible confounding factors, higher education in men significantly lowered the odds of having uncontrolled hyperglycemia (glycosylated hemoglobin ≥7.5%) (odds ratio [OR], 0.63; 95% confidence interval [CI], 0.43 to 0.91 for highest education; Ptrend=0.048), while higher household income in men significantly lowered the odds of having diabetic retinopathy (OR, 0.59; 95% CI, 0.37 to 0.95 for highest income level; Ptrend=0.048). In women, lower income was associated with a higher stress level.

Conclusion

Men with lower SES had higher odds of having diabetic retinopathy and uncontrolled hyperglycemia, showing the need to improve care targeted to this population.

Citations

Citations to this article as recorded by  
  • A Scoping Review of Possible Solutions for Decreasing Socioeconomic Inequalities in Type 2 Diabetes Mellitus
    Laleh Gharacheh, Mostafa Amini-Rarani, Amin Torabipour, Saeed Karimi
    International Journal of Preventive Medicine.2024;[Epub]     CrossRef
  • Socioeconomic status and the effect of prolonged pandemic confinement on anthropometric and glycaemic outcomes in adults with type 2 diabetes mellitus
    Chandana Wijeweera, Ummul Muhfaza, Reginald V. Lord, Peter Petocz, Juliana Chen, Veronica Preda
    Primary Care Diabetes.2024; 18(3): 308.     CrossRef
  • Income variability and incident cardiovascular disease in diabetes: a population-based cohort study
    Yong-Moon Mark Park, Jong-Ha Baek, Hong Seok Lee, Tali Elfassy, Clare C Brown, Mario Schootman, Marie-Rachelle Narcisse, Seung-Hyun Ko, Pearl A McElfish, Michael R Thomsen, Benjamin C Amick, Seong-Su Lee, Kyungdo Han
    European Heart Journal.2024; 45(21): 1920.     CrossRef
  • Temporal trends in the visual impairment burden attributable to high fasting plasma glucose levels: a population-based study
    Jianqi Chen, Xiaohong Chen, Zhidong Li, Xuhao Chen, Shaofen Huang, Guitong Ye, Rui Xie, Ruiyu Luo, Yuan Zhang, Xinyue Shen, Yehong Zhuo, Shengsong Huang, Yiqing Li, Yingting Zhu
    Acta Diabetologica.2024;[Epub]     CrossRef
  • Association of diet quality with glycemia, insulinemia, and insulin resistance in families at high risk for type 2 diabetes mellitus in Europe: Feel4 Diabetes Study
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    Ratu Ayu Dewi Sartika, Fathimah Sulistyowati Sigit, Edy Purwanto, Norliyana Aris, Avliya Quratul Marjan, Wahyu Kurnia Yusrin Putra, Sutanto Priyo Hastono
    Annals of Pediatric Endocrinology & Metabolism.2023; 28(4): 267.     CrossRef
  • Effects of Diabetes Quality Assessment on Diabetes Management Behaviors Based on a Nationwide Survey
    Chang Kyun Choi, Jungho Yang, Ji-An Jeong, Min-Ho Shin
    International Journal of Environmental Research and Public Health.2022; 19(23): 15781.     CrossRef
  • FOLLOW-UP ADHERENCE IN PATIENTS WITH NONPROLIFERATIVE DIABETIC RETINOPATHY PRESENTING TO AN OPHTHALMIC EMERGENCY DEPARTMENT
    Arjun Watane, Meghana Kalavar, Elizabeth A. Vanner, Kara Cavuoto, Jayanth Sridhar
    Retina.2021; 41(6): 1293.     CrossRef
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    Endocrine.2021; 73(2): 316.     CrossRef
  • Tip 2 Diyabetli Bireylerin Hastalık Yönetiminde Karşılaştıkları Engellerin Değerlendirilmesi
    Şuheda ÜSTÜNDAĞ, Nuray DAYAPOĞLU
    Adnan Menderes Üniversitesi Sağlık Bilimleri Fakültesi Dergisi.2021; 5(3): 514.     CrossRef
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    Batoul Safieddine, Stefanie Sperlich, Johannes Beller, Karin Lange, Jelena Epping, Juliane Tetzlaff, Fabian Tetzlaff, Siegfried Geyer
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    Carlos de Mestral, Silvia Stringhini, Idris Guessous, François R Jornayvaz
    BMJ Open Diabetes Research & Care.2020; 8(1): e001273.     CrossRef
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    Małgorzata Elżbieta Zujko, Anna Waśkiewicz, Wojciech Drygas, Alicja Cicha-Mikołajczyk, Kinga Zujko, Danuta Szcześniewska, Krystyna Kozakiewicz, Anna Maria Witkowska
    Nutrients.2020; 12(2): 518.     CrossRef
  • Diabetes Fact Sheets in Korea, 2018: An Appraisal of Current Status
    Bo-Yeon Kim, Jong Chul Won, Jae Hyuk Lee, Hun-Sung Kim, Jung Hwan Park, Kyoung Hwa Ha, Kyu Chang Won, Dae Jung Kim, Kyong Soo Park
    Diabetes & Metabolism Journal.2019; 43(4): 487.     CrossRef
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    R. Lauretta, M. Sansone, A. Sansone, F. Romanelli, M. Appetecchia
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The Relationship between Diabetes Mellitus and Health-Related Quality of Life in Korean Adults: The Fourth Korea National Health and Nutrition Examination Survey (2007-2009)
Yong Jun Choi, Min Suk Lee, So Yeon An, Tae Ho Kim, Seung Jin Han, Hae Jin Kim, Yoon-Sok Chung, Kwan Woo Lee, Dae Jung Kim
Diabetes Metab J. 2011;35(6):587-594.   Published online December 26, 2011
DOI: https://doi.org/10.4093/dmj.2011.35.6.587
  • 5,125 View
  • 52 Download
  • 45 Crossref
AbstractAbstract PDFPubReader   
Background

Diabetes is a major health problem in Korea. However, interest in the quality of life in patients with diabetes is low. We examined the effects of diabetes on health-related quality of life (HRQoL) and compared it with HRQoL in the general Korean population using the Fourth Korea National Health and Nutrition Examination Survey (KNHANES IV) (2007-2009).

Methods

Using KNHANES IV data, we compared EuroQol (EQ)-5D and EQ-visual analogue scale (VAS) scores after adjusting for sociodemographic and psychosocial factors as well as for comorbidities (hypertension, heart disease, stroke, arthritis, and chronic renal disease). Logistic regressions were used to explore determinants for the lowest quintile HRQoL scales in the diabetes group.

Results

The mean age of the 14,441 enrolled subjects (6,129 men and 8,312 women) was 52.5±14.5 years. The mean EQ-5D and EQ-VAS scores were significantly lower in the diabetes group (EQ-5D. 0.87; EQ-VAS, 71.94) than in the non-diabetes group (EQ-5D, 0.94; EQ-VAS, 77.40) (P<0.001). Self-reported depressive symptom had a significant effect on lowering the EQ-VAS (odds ratio [OR], 1.7; 95% confidence interval [CI], 1.1 to 2.6) in the diabetes group. Stress level had a significant effect in lowering both the EQ-5D (OR, 2.0; 95% CI, 1.3 to 2.9) and the EQ-VAS (OR, 1.9; 95% CI, 1.3 to 2.9). HbA1c, diabetes duration, and treatment modalities had no significant effect on lowering HRQoL.

Conclusion

Diabetes was clearly associated with impaired HRQoL compared with the non-diabetic population regardless of comorbidities. Therapeutic approaches should focus much more on the subjective perception of health in patients with diabetes.

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    Ninik Ambar Sari, Ceria Nurhayati
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    Inhwan Lee, Shinuk Kim, Hyunsik Kang
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    Abdulkarim M. Meraya, Monira Alwhaibi
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Review
Costs of Diabetes Mellitus in Korea
Kwan Woo Lee
Diabetes Metab J. 2011;35(6):567-570.   Published online December 26, 2011
DOI: https://doi.org/10.4093/dmj.2011.35.6.567
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AbstractAbstract PDFPubReader   

Outcome research focusing on the economics of the medical field began in the mid-1990s and has included studies about costs, cost effectiveness, and policies. According to the American Diabetes Association, the total estimated cost of diabetes in 2007 was $174 billion. The economic burden of patients with diabetes in Canada is expected to be about $12.2 billion in 2010. Recent Korean studies have analyzed the expenses associated with type 2 diabetes for patients in selected general hospitals. Type 2 diabetic patients without complications cost approximately 1,184,563 won (the equivalent of US $1,184) per patient for healthcare annually. In contrast, patients with microvascular disease due to diabetic complications cost up to 4.7 times that amount, and patients with macrovascular disease incur up to 10.7 times the annual costs for patients without diabetic complications. Diabetic complications ultimately impact the quality of life for patients and patient mortality, and are associated with higher direct medical expenses for patients. To avoid increased medical costs, appropriate management techniques must be implemented to ensure timely care for patients with diabetes.

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Original Articles
Prevalence of Chronic Complications in Korean Patients with Type 2 Diabetes Mellitus Based on the Korean National Diabetes Program
Sang Youl Rhee, Suk Chon, Mi Kwang Kwon, Ie Byung Park, Kyu Jeung Ahn, In Ju Kim, Sung-Hoon Kim, Hyoung Woo Lee, Kyung Soo Koh, Doo Man Kim, Sei Hyun Baik, Kwan Woo Lee, Moon Suk Nam, Yong Soo Park, Jeong-taek Woo, Young Seol Kim
Diabetes Metab J. 2011;35(5):504-512.   Published online October 31, 2011
DOI: https://doi.org/10.4093/dmj.2011.35.5.504
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AbstractAbstract PDFPubReader   
Background

The Korean National Diabetes Program (KNDP) cohort study is performing an ongoing large-scale prospective multicenter investigation to discover the pathogenesis of type 2 diabetes in Korean patients. This study was performed to examine the prevalence of chronic complications in patients with type 2 diabetes among those registered in the KNDP cohort within the past 4 years.

Methods

This study was performed between June 2006 and September 2009 at 13 university hospitals and included 4,265 KNDP cohort participants. Among the participants, the crude prevalence of microvascular and macrovascular diseases of those checked for diabetes-related complications was determined, and the adjusted standard prevalence and standardization of the general population prevalence ratio (SPR) was estimated based on the 2005 Korean National Health and Nutrition Examination Survey (KNHANES) population demographics.

Results

Among the KNDP registrants, 43.2% had hypertension, 34.8% had dyslipidemia, 10.8% had macrovascular disease, and 16.7% had microvascular disease. The SPR of the KNDP registrants was significantly higher than that of the KNHANES subjects after adjusting for demographics in the KNHANES 2005 population. However, with the exception of cardiovascular disease in females, the standardized prevalence for the most complicated items in the survey was significantly higher than that in the KNHANES subjects.

Conclusion

The prevalence of macrovascular disease and peripheral vascular disease were significantly higher in Korean patients with type 2 diabetes than in the normal population. However, no significant difference was noted in the prevalence of cardiovascular disease in females.

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Comparison of the Efficacy of Glimepiride, Metformin, and Rosiglitazone Monotherapy in Korean Drug-Naïve Type 2 Diabetic Patients: The Practical Evidence of Antidiabetic Monotherapy Study
Kun Ho Yoon, Jeong Ah Shin, Hyuk Sang Kwon, Seung Hwan Lee, Kyung Wan Min, Yu Bae Ahn, Soon Jib Yoo, Kyu Jeung Ahn, Sung Woo Park, Kwan Woo Lee, Yeon Ah Sung, Tae Sun Park, Min Seon Kim, Yong Ki Kim, Moon Suk Nam, Hye Soon Kim, Ie Byung Park, Jong Suk Park, Jeong Taek Woo, Ho Young Son
Diabetes Metab J. 2011;35(1):26-33.   Published online February 28, 2011
DOI: https://doi.org/10.4093/dmj.2011.35.1.26
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AbstractAbstract PDFPubReader   
Background

Although many anti-diabetic drugs have been used to control hyperglycemia for decades, the efficacy of commonly-used oral glucose-lowering agents in Korean type 2 diabetic patients has yet to be clearly demonstrated.

Methods

We evaluated the efficacy of glimepiride, metformin, and rosiglitazone as initial treatment for drug-naïve type 2 diabetes mellitus patients in a 48-week, double-blind, randomized controlled study that included 349 Korean patients. Our primary goal was to determine the change in HbA1c levels from baseline to end point. Our secondary goal was to evaluate changes in fasting plasma glucose (FPG) levels, body weight, frequency of adverse events, and the proportion of participants achieving target HbA1c levels.

Results

HbA1c levels decreased from 7.8% to 6.9% in the glimepiride group (P<0.001), from 7.9% to 7.0% in the metformin group (P<0.001), and from 7.8% to 7.0% (P<0.001) in the rosiglitazone group. Glimepiride and rosiglitazone significantly increased body weight and metformin reduced body weight during the study period. Symptomatic hypoglycemia was more frequent in the glimepiride group and diarrhea was more frequent in the metformin group.

Conclusion

The efficacy of glimepiride, metformin, and rosiglitazone as antidiabetic monotherapies in drug-naïve Korean type 2 diabetic patients was similar in the three groups, with no statistical difference. This study is the first randomized controlled trial to evaluate the efficacy of commonly-used oral hypoglycemic agents in Korean type 2 diabetic patients. An additional subgroup analysis is recommended to obtain more detailed information.

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Effect of Valsartan on Blood Pressure and Urinary Albumin Excretion in Hypertensive Type 2 Diabetic Patients: An Open-Label, Multicenter Study.
Se Jun Park, Dae Jung Kim, Hae Jin Kim, Soo Yeon Park, Ji A Seo, Nan Hee Kim, Sung Hee Choi, Soo Lim, Hak Chul Jang, Seung Hyun Ko, Ki Ho Song, Yu Bae Ahn, Soo Kyoung Kim, Yong Wook Cho, Jun Goo Kang, Sung Hee Ihm, Cheol Young Park, Sung Woo Park, Dong Hyun Shin, Yong Hyun Kim, Kwan Woo Lee
Korean Diabetes J. 2008;32(6):513-521.   Published online December 1, 2008
DOI: https://doi.org/10.4093/kdj.2008.32.6.513
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AbstractAbstract PDF
BACKGROUND
Activation of renin-angiotensin system (RAS) has been an important mechanism of microvascular and macrovascular complications in diabetic patients. It has been reported that RAS blockades reduce the development and progression of diabetic nephropathy. The aim of this study was to evaluate whether valsartan, an angiotensin II receptor blocker (ARB), reduced blood pressure and urinary albumin excretion rate (UAER) in hypertensive type 2 diabetic patients. METHOD: Three hundred forty-seven hypertensive type 2 diabetic patients who had not taken angiotensin converting enzyme inhibitors or ARB for 6 months prior to this study were enrolled. We measured blood pressure and UAER before and after 24 weeks of valsartan treatment. RESULT: Baseline mean systolic and diastolic blood pressure was 143 +/- 15 and 87 +/- 11 mmHg, respectively and the median albumin excretion rate was 27 ug/mg. Reduction in systolic and diastolic blood pressure was 16 mmHg/10 mmHg and the median UAER was 19.3 ug/mg after 24 weeks (P < 0.01, respectively). When we divided the subjects into three groups according to the UAER (normoalbuminuria, microalbuminuria and macroalbuminuria), significant changes were reported in the microalbuminuria and the macroalbuminuria groups. Thirty-eight (42%) patients with microalbuminuria improved to normoalbuminuria and twelve (41%) patients with macroalbuminuria improved to microalbuminuria. We found an association between the improvement of blood pressure and UAER (R = 0.165, P = 0.015). CONCLUSION: We concluded that valsartan reduces urinary albumin excretion and blood pressure in hypertensive type 2 diabetic patients.
An Analysis of Medical Costs of Diabetic Patients in a University Hospital (1996~2005).
Ki Hong Chun, Kwan Woo Lee, Dae Jung Kim, Hae Jin Kim, Kyung Won Paek, Soo Jin Lee
Korean Diabetes J. 2008;32(4):366-376.   Published online August 1, 2008
DOI: https://doi.org/10.4093/kdj.2008.32.4.366
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AbstractAbstract PDF
BACKGROUND
The aim of this research was to find out the costs of diabetes, as research in a prospective cohort study looking into the development of diabetic complications followed by treatment intervention by a medical institution. The research compared the changes in medical costs by following-up on the treatment details of diagnosed diabetes for the last 10 years in a university hospital. METHODS: The research used data of outpatient, inpatient, pharmaceutical and total medical costs, from 1996 to 2005, of individual patients who were diagnosed with diabetic patients, to analyze the outpatient and inpatient total medical cost changes over the years. RESULTS: After antidiabetic drug, in the case of outpatient treatment, pharmaceutical costs increased on average by about 25,000 won a month for diabetic patients without complications and by 35,000 won for diabetic patients with microvascular complications. Outpatient medical costs were affected after drug treatment by as much of an increase as created by the pharmaceutical costs. The total medical costs, that is the sum of inpatient and outpatient costs, decreased by 30~40% compared to that before drug treatment. In the case of total medical cost, MI or ESRD cost 2~3 times more in pharmaceutical costs than before the development of complications. The total medical costs of diabetic patients with CVA, MI and ESRD complications increased in the first year after development of the complication, and this was followed by a decrease in the next year, showing a tendency to remain constant with no increase or decrease over subsequent years. This means that the total medical costs of patients with complications remain continuously large throughout the life of the diagnosed patient. CONCLUSION: For diabetic patients, pharmaceutical costs are the most important factor in determining outpatient medical costs.

Citations

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  • Outcome Research in Diabetes
    Kwan Woo Lee
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Clinical Characteristics and Direct Medical Costs of Type 2 Diabetic Patients.
Eun Joon Moon, Young Eun Jo, Tae Chin Park, Yun Kyung Kim, Sun Hye Jung, Hae Jin Kim, Dae Jung Kim, Yoon Sok Chung, Kwan Woo Lee
Korean Diabetes J. 2008;32(4):358-365.   Published online August 1, 2008
DOI: https://doi.org/10.4093/kdj.2008.32.4.358
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  • 15 Crossref
AbstractAbstract PDF
BACKGROUND
Type 2 diabetes mellitus is an expensive chronic metabolic disorder and its prevalence has been increasing rapidly in South Korea, owing to a westernized lifestyle. We analyzed the annual direct medical costs attributable to type 2 diabetes and its chronic complications in Korea retrospectively. METHODS: We randomly selected 1,051 patients with type 2 diabetes who visited Ajou University Hospital as an outpatient in 2005. Clinical characteristics, duration of diabetes, and microvascular and macrovascular complications were assessed from a medical chart review. The annual direct medical costs included insurance covered and uncovered medical costs. RESULTS: Of the 1,051 patients with type 2 diabetes, 48.2% had at least one microvascular complication, 5.6% had at least one macrovascular complication, and 12.4% of the patients had both microvascular and macrovascular complications. The average annual direct medical cost was found to be 3,348,488won per patient. In patients with microvascular complications, the total cost of management was increased 1.4 times compared to those without complications. Direct medical costs for patients with macrovascular complications were 2.1-fold as high as patients with no complications. Those patients with both microvascular and macrovascular complications, increased costs by 3.1-fold over those without complications. CONCLUSION: Chronic complications have a substantial impact on the direct medical costs of type 2 diabetes. The prevention of chronic diabetic complications will not only influence the mortality and morbidity of patients with type 2 diabetes, but also potentially reduce medical costs.

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    Morena Ustulin, Sang Youl Rhee, Suk Chon, Kyu Keung Ahn, Ji Eun Lim, Bermseok Oh, Sung-Hoon Kim, Sei Hyun Baik, Yongsoo Park, Moon Suk Nam, Kwan Woo Lee, Young Seol Kim, Jeong-Taek Woo
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  • Features of Long-Standing Korean Type 2 Diabetes Mellitus Patients with Diabetic Retinopathy: A Study Based on Standardized Clinical Data
    Sejeong Park, Sang Youl Rhee, Su Jin Jeong, Kiyoung Kim, Suk Chon, Seung-Young Yu, Jeong-Taek Woo
    Diabetes & Metabolism Journal.2017; 41(5): 393.     CrossRef
  • Association between Sleep Duration and Impaired Fasting Glucose in Korean Adults: Results from the Korean National Health and Nutrition Examination Survey 2011–2012
    Cho-Rong Kim, Yun-Mi Song, Jin-Young Shin, Wook Gim
    Korean Journal of Family Medicine.2016; 37(1): 51.     CrossRef
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    Kyoung Hwa Ha, Dae Jung Kim
    Endocrinology and Metabolism.2015; 30(2): 142.     CrossRef
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    Jin-Won Noh, Young Dae Kwon, Jin-Hee Jung, Kang Hee Sim, Hee-Sook Kim, Minjae Choi, Jumin Park
    The Journal of Korean Diabetes.2015; 16(4): 293.     CrossRef
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    Eun-Kyong Kim, Sang Gyu Lee, Youn-Hee Choi, Kyu-Chang Won, Jun Sung Moon, Anwar T Merchant, Hee-Kyung Lee
    BMC Oral Health.2013;[Epub]     CrossRef
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    In-Hye Kim, Jong-Bae Kim, Kang-Jin Cho, Jae-Hyun Kim, Ae-Son Om
    Korean Journal of Plant Resources.2012; 25(2): 184.     CrossRef
  • The Protective Effects of Chrysanthemum cornarium L. var. spatiosum Extract on HIT-T15 Pancreatic β-Cells against Alloxan-induced Oxidative Stress
    In-Hye Kim, Kang-Jin Cho, Jeong-Sook Ko, Jae-Hyun Kim, Ae-Son Om
    The Korean Journal of Food And Nutrition.2012; 25(1): 123.     CrossRef
  • Outcome Research in Diabetes
    Kwan Woo Lee
    Journal of Korean Diabetes.2011; 12(1): 2.     CrossRef
  • Costs of Diabetes Mellitus in Korea
    Kwan Woo Lee
    Diabetes & Metabolism Journal.2011; 35(6): 567.     CrossRef
  • The Epidemiology of Diabetes in Korea
    Dae Jung Kim
    Diabetes & Metabolism Journal.2011; 35(4): 303.     CrossRef
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    Journal of Life Science.2010; 20(7): 1113.     CrossRef
  • Epidemiologic Characteristics of Diabetes Mellitus in Korea: Current Status of Diabetic Patients Using Korean Health Insurance Database
    Ie Byung Park, Sei Hyun Baik
    Korean Diabetes Journal.2009; 33(5): 357.     CrossRef
  • Management of Diabetic Mellitus in Low-income Rural Patients
    Hye-Yeon Kim, Woo-Jun Yun, Min-Ho Shin, Sun-Seong Kweon, Hye-Ran Ahn, Seong-Woo Choi, Young-Hoon Lee, Dong-Hyeok Cho, Jung-Ae Rhee
    Journal of Preventive Medicine and Public Health.2009; 42(5): 315.     CrossRef
  • Prevalence of Pancreatic Cancer in Diabetics and Clinical Characteristics of Diabetes-associated with Pancreatic Cancer - Comparison between Diabetes with and without Pancreatic Cancer -
    Seung Goun Hong, Jae Seon Kim, Sung Joo Jung, Moon Kyung Joo, Beom Jae Lee, Jong Eun Yeon, Jong-Jae Park, Kwan Soo Byun, Young-Tae Bak
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A Study on Resistance in Type 2 Diabetic Patient Against Commencement of Insulin Treatment.
Sun Hwa Hong, Mi Jin Kim, Sung Gab Noh, Dae Won Suh, Suk Jung Youn, Kwan Woo Lee, Ho Chae Lee, Yang Soo Chung, Hong Ryang Chung, Hyuk Sang Kwon, Bong Yun Cha, Ho Young Son, Kun Ho Yoon
Korean Diabetes J. 2008;32(3):269-279.   Published online June 1, 2008
DOI: https://doi.org/10.4093/kdj.2008.32.3.269
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AbstractAbstract PDF
BACKGROUND
To achieve tight glycemic control in the poorly controlled type 2 diabetic patients with oral hypoglycemic agent, it maybe beneficial to initiate insulin treatment at the early stage. Many patients with type 2 diabetes are often reluctant to begin insulin therapy despite poor glycemic control with oral hypoglycemic agents, this little known phenomenon, often termed 'psychological insulin resistance (PIR)'. This study investigates psychological insulin resistance in Korean patients with type 2 diabetes. METHOD: This study examined a total of 76 type 2 diabetic patients with poor glycemic control during period of April to July 2006. Through questionnaire and telephone survey, total 24 questions were asked about various attitudes on insulin therapy including psychological barriers and patients' acceptance of this treatment. Subjects were asked to allocate points in 5-point scale (from 5 points for 'very true' to 1 point for 'very untrue'). RESULTS: The means of psychological rejection, injection-related anxiety and fear of insulin side effects such as hypoglycemia and weight gain were 3.65 +/- 0.92, 3.17 +/- 0.98 and 2.8 +/- 1.02, respectively. Unwillingness was common in insulin therapy, 67% of patient rejected or was unwilling to take insulin. Main reasons of patients most frequently endorsed beginning insulin indicate that disease is worsening, permanence (once you start insulin you can never quit) and sense of personal failure. Furthermore, study indicates that patients' reasons for avoiding insulin therapy were mainly psychological rejection, which extended far beyond a simple injection related anxiety. CONCLUSION: PIR was psychological reluctance rather than injection related anxiety. To overcome these psychological barriers to insulin treatment, it is necessary to address appropriate diabetes education including training and counseling with excellent interactive communications between patients and clinicians.

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  • Using Motivational Interviewing to Overcome Psychological Insulin Resistance
    Sung-Chul Lim
    The Journal of Korean Diabetes.2023; 24(4): 227.     CrossRef
  • Psychological Insulin Resistance: Key Factors and Intervention
    Yeon Jeong Jang
    The Journal of Korean Diabetes.2021; 22(3): 192.     CrossRef
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    Ji Hyeon Yu, Hye Young Kim, Sung Reul Kim, Eun Ko, Heung Yong Jin
    International Journal of Nursing Practice.2019;[Epub]     CrossRef
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    Youngshin Song, Younghee Jeon, Jeonghwa Cho, Bohyun Kim
    Journal of Korean Academy of Nursing.2016; 46(6): 813.     CrossRef
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    Youngshin Song, Eunkyong Ah
    Journal of Digital Convergence.2016; 14(12): 283.     CrossRef
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    Youngshin Song
    Journal of Korean Academy of Nursing.2016; 46(3): 443.     CrossRef
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    Min Jeong Gu
    The Journal of Korean Diabetes.2016; 17(4): 261.     CrossRef
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    Sun-Joo Boo
    Korean Journal of Adult Nursing.2012; 24(4): 406.     CrossRef
Direct Medical Costs of Type 2 Diabetic Patients in the Tertiary Hospital.
Joo An Hwang, Tae Chin Park, Sun Hye Jung, Hae Jin Kim, Dae Jung Kim, So Hun Kim, Moon Suk Nam, Tae Hyun Kim, Moon Kyu Lee, Kwan Woo Lee
Korean Diabetes J. 2008;32(3):259-268.   Published online June 1, 2008
DOI: https://doi.org/10.4093/kdj.2008.32.3.259
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AbstractAbstract PDF
BACKGROUND
Type 2 diabetes mellitus is a common, chronic and costly disease. Its prevalence is rapidly increasing worldwide. Diabetes has big economic burden mainly because of its chronic complications. We analyzed the annual direct medical costs of type 2 diabetic patients, including the costs associated with its complications in Korea retrospectively. METHODS: We enrolled 531 type 2 diabetic patients who had been treated in the 3 Tertiary Hospital in 2005. Clinical characteristics, duration of diabetes, modality of glycemic control, and presence of microvascular and macrovascular complications were assessed by the review of medical records. The annual direct medical costs were assessed using the hospital electronic database and included insurance covered and uncovered medical costs. RESULTS: The annual direct medical costs of type 2 diabetic patients without any complications was 1,184,563 won (95% CI for mean: 973,006~1,396,121 won). Compared to diabetic patients without complications, annual total medical costs increased 4.7-fold, 10.7-fold, and 8.8-fold in patients with microvascular complications, macrovascular complications and both complications, respectively. Hospitalization costs largely increased by 78.7-fold and 61.0-fold in patients with macrovascular complications and both complications, respectively. Major complications to increase medical costs were kidney transplantation (23.1-fold), dialysis (21.0-fold), PTCA or CABG (12.4-fold), and leg amputation (11.8-fold). The total medical costs dramatically increased according to the stage of diabetic retinopathy and nephropathy. CONCLUSION: Diabetic complications have a substantial impact on the direct medical costs of type 2 diabetic patients. The prevention of diabetic complications will benefit the patients as well as the overall healthcare expenditures.

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    Kyung-Chul Moon, Donghyeok Shin, Kyu-Won Baek, Changsik John Pak, Young-Joon Jun
    Journal of Wound Management and Research.2022; 18(3): 249.     CrossRef
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    Sera Lee, Miyoung Ock, Hun‐Sung Kim, Hyunah Kim
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    Yong-ho Lee, Gyuri Kim, Eun Seok Kang
    The Journal of Korean Diabetes.2016; 17(1): 11.     CrossRef
  • Outcome Research in Diabetes
    Kwan Woo Lee
    Journal of Korean Diabetes.2011; 12(1): 2.     CrossRef
  • Costs of Diabetes Mellitus in Korea
    Kwan Woo Lee
    Diabetes & Metabolism Journal.2011; 35(6): 567.     CrossRef
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    Kyung Sik Park
    The Korean Journal of Gastroenterology.2011; 58(6): 297.     CrossRef
Clinical Characteristics of Korean Type 2 Diabetic Patients According to Insulin Secretion and Insulin Resistance.
Kyoung Eun Song, Dae Jung Kim, Ji Won Park, Hong Keun Cho, Kwan Woo Lee, Kap Bum Huh
Korean Diabetes J. 2007;31(2):123-129.   Published online March 1, 2007
DOI: https://doi.org/10.4093/jkda.2007.31.2.123
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AbstractAbstract PDF
BACKGROUND
Korean type 2 diabetic patients are known to differ from western diabetes because of their unique characteristics, such as non-obese but centrally obese anthropometry and relatively more insulin secretory defects than insulin resistance compared to western diabetic patients. METHODS: We recruited 1,646 diabetic patients in the present study and excluded the 45 patients with fasting C-peptide < 0.20 nmol/L. We had assessed insulin secretion by fasting serum C-peptide level and insulin resistance by short insulin tolerance test (Kitt ; rate constant for plasma glucose disappearance, %/min) in the private diabetes clinic. The insulin secretory defect was divided by severe (C-peptide < 0.37 nmol/L), moderate (C-peptide 0.37~0.56 nmol/L), and normal (C-peptide > or = 0.57 nmol/L) group. The insulin resistance was divided by insulin resistant (IR) (Kitt < 2.5 %/min) and insulin sensitive (IS) (Kitt > or = 2.5 %/min) group. RESULTS: We analysed the data of 1,601 type 2 diabetic patients (831 men and 770 women, age 56.5 +/- 10.8 years, duration of diabetes 9.6 +/- 7.3 years). The prevalence of BMI > or = 25.0 kg/m2 is 42.5% and BMI > or = 23.0 kg/m2 is 70.2%. The prevalence of abdominal obesity (waist > or = 90 cm in men and 80 cm in women) is 45.2% (36.0% and 55.2%, respectively in men and women). Fasting C-peptide level is 0.64 +/- 0.29 nmol/L and Kitt value is 2.03 +/- 0.96%/min. According to fasting C-peptide level, the degree of insulin secretory defect were severe (13.1%), moderate (33.0%) and normal (53.9%). According to Kitt value, the IR group is 70.6% and the IS group is 29.4%. CONCLUSION: Obese type 2 diabetes is markedly increasing in Korea. Therefore, the major problem in Korean type 2 diabetic patients is being changed into insulin resistance instead of insulin secretory defect.

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    Ye Rin Kim, Eun-young Kim, Seong Uk Lee, Young Wan Kim, Yoon Hee Kim
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    Eun-Gyoung Hong
    Korean Diabetes Journal.2009; 33(1): 13.     CrossRef
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Randomized Controlled Trial
Comparison of the Efficacy and Safety of Glimepiride/Metformin Fixed Combination Versus Free Combination in Patients with Type 2 Diabetes: Multicenter, Randomized, Controlled Trial.
Seung Hwan Lee, In Kyu Lee, Sei Hyun Baik, Dong Seop Choi, Kyong Soo Park, Ki Ho Song, Kwan Woo Lee, Bong Soo Cha, Chul Woo Ahn, Hyoung Woo Lee, Choon Hee Chung, Moon Suk Nam, Hong Sun Baek, Yong Ki Kim, Hyo Young Rhim, Ho Young Son
Korean Diabetes J. 2006;30(6):466-475.   Published online November 1, 2006
DOI: https://doi.org/10.4093/jkda.2006.30.6.466
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AbstractAbstract PDF
BACKGROUND
Failure to manage diabetes mellitus receiving monotherapy increases as the duration of the disease is protracted, and in many cases it becomes inevitable to introduce combined therapies. However, compliance of the patients tends to decrease. We conducted a clinical study to compare the efficacy and safety of preconstituted and fixed combination therapy of glimepiride plus metformin to those of free combination therapy. METHODS: Two hundred and thirteen patients with type 2 diabetes who had been diagnosed at least six months ago were randomly assigned either to a fixed group or a free group. The initial dosage was chosen according to the previous treatment history and then adjusted every two weeks following a predefined titration algorithm to meet the target mean fasting glucose levels (140 mg/dL). The medications were given for 16 weeks. The primary endpoint was the change in HbA1c level from baseline to week 16. Various parameters were checked as secondary outcome measures and safety criteria. RESULTS: HbA1c level of the fixed group and the free group decreased by 1.09% and 1.08%, respectively. The 95% CI of the changes' difference between the two groups (-0.21%, +0.19%) was within the predefined equivalence interval (-0.5%, +0.5%). Secondary outcome measures (the changes of fasting and postprandial plasma glucose level, response rate and compliance) and safety criteria (frequency of hypoglycemia and adverse reactions) were similar between the two groups. CONCLUSION: Fixed combination of glimepiride/metformin is as effective and safe therapy as free combination in type 2 diabetes patients.

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  • Efficacy and safety of glimepiride/metformin sustained release once daily vs. glimepiride/metformin twice daily in patients with type 2 diabetes
    Y.-C. Hwang, M. Kang, C. W. Ahn, J. S. Park, S. H. Baik, D. J. Chung, H. C. Jang, K.-A. Kim, I.-K. Lee, K. W. Min, M. Nam, T. S. Park, S. M. Son, Y.-A. Sung, J.-T. Woo, K. S. Park, M.-K. Lee
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Original Article
Efficacy Evaluation of Atorvastatin in Korean Hyperlipidemic Patients with Type 2 Diabetes Mellitus.
Dong Seop Choi, Duk Kyu Kim, Doo Man Kim, Seong Yeon Kim, Moon Suk Nam, Yong Soo Park, Ho Sang Shon, Chul Woo Ahn, Kwan Woo Lee, Ki Up Lee, Moon Kyu Lee, Choon Hee Chung, Bong Yeon Cha
Korean Diabetes J. 2006;30(4):292-302.   Published online July 1, 2006
DOI: https://doi.org/10.4093/jkda.2006.30.4.292
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AbstractAbstract PDF
BACKGROUND
NCEP ATP III Guideline recommends aggressive treatments of diabetic dyslipidemia, recognizing diabetes mellitus as CHD risk equivalents. This study was conducted to evaluate the effectiveness and safety of atorvastatin in hyperlipidemic patients with Type 2 diabetes mellitus through post-marketing drug use investigation of atorvastatin. METHODS: An open, multi-center, non-comparison, titrated dosage study was conducted in hyperlipidemic patients, who were treated with atorvastatin at first visiting hospitals from Mar. 2004 to Sep. 2004. 96 endocrinologists participated from 66 centers in this study. Total 2,182 hyperlipidemic patients were enrolled and 1,514 patients among them were accompanied by diabetes mellitus. Efficacy was evaluated at later than 4-week treatment by % change of total cholesterol, triglycerides, HDL-cholesterol and LDL-cholesterol from baseline. Percent of patients reaching LDL-cholesterol level less than 100 mg/dL was also analyzed. The adverse events incidence and abnormalities of clinical laboratory values were evaluated for safety monitoring. RESULTS: Total cholesterol, triglycerides, and LDL-cholesterol level were reduced by 26.6%, 12.0%, and 34.8%, respectively, in diabetic hyperlipidemic patients after atorvastatin treatment. The patients with LDL-cholesterol level of less than 100 mg/dL were increased from 2.8% to 52.6%. Atorvastatin was considered to be safe because adverse drug reactions were reported in 32 patients (1.5%) of total 2,182 patients. CONCLUSION: Atorvastatin was effective and safe in hyperlipidemic patients with type 2 diabetes mellitus.

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  • Response: A Retrospective Study on the Efficacy of a Ten-Milligram Dosage of Atorvastatin for Treatment of Hypercholesterolemia in Type 2 Diabetes Mellitus Patients (Korean Diabetes J 2010;34:359-67)
    Dong Kyun Kim, Sa Rah Lee, Min Sik Kim, Suk Hyang Bae, Jin Yeon Hwang, Jung-Min Kim, Sung Hwan Suh, Hye-Jeong Lee, Mi Kyoung Park, Duk Kyu Kim
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  • A Retrospective Study on the Efficacy of a Ten-Milligram Dosage of Atorvastatin for Treatment of Hypercholesterolemia in Type 2 Diabetes Mellitus Patients
    Dong Kyun Kim, Sa Rah Lee, Min Sik Kim, Suk Hyang Bae, Jin Yeon Hwang, Jung-Min Kim, Sung Hwan Suh, Hye-Jeong Lee, Mi Kyoung Park, Duk Kyu Kim
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    Hye Sook Hong, Jong Suk Park, Han Kyoung Ryu, Wha Young Kim
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