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Pathophysiology
Attention to Innate Circadian Rhythm and the Impact of Its Disruption on Diabetes
Da Young Lee, Inha Jung, So Young Park, Ji Hee Yu, Ji A Seo, Kyeong Jin Kim, Nam Hoon Kim, Hye Jin Yoo, Sin Gon Kim, Kyung Mook Choi, Sei Hyun Baik, Nan Hee Kim
Diabetes Metab J. 2024;48(1):37-52.   Published online January 3, 2024
DOI: https://doi.org/10.4093/dmj.2023.0193
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AbstractAbstract PDFPubReader   ePub   
Novel strategies are required to reduce the risk of developing diabetes and/or clinical outcomes and complications of diabetes. In this regard, the role of the circadian system may be a potential candidate for the prevention of diabetes. We reviewed evidence from animal, clinical, and epidemiological studies linking the circadian system to various aspects of the pathophysiology and clinical outcomes of diabetes. The circadian clock governs genetic, metabolic, hormonal, and behavioral signals in anticipation of cyclic 24-hour events through interactions between a “central clock” in the suprachiasmatic nucleus and “peripheral clocks” in the whole body. Currently, circadian rhythmicity in humans can be subjectively or objectively assessed by measuring melatonin and glucocorticoid levels, core body temperature, peripheral blood, oral mucosa, hair follicles, rest-activity cycles, sleep diaries, and circadian chronotypes. In this review, we summarized various circadian misalignments, such as altered light-dark, sleep-wake, rest-activity, fasting-feeding, shift work, evening chronotype, and social jetlag, as well as mutations in clock genes that could contribute to the development of diabetes and poor glycemic status in patients with diabetes. Targeting critical components of the circadian system could deliver potential candidates for the treatment and prevention of type 2 diabetes mellitus in the future.
Original Article
Technology/Device
Clinical and Lifestyle Determinants of Continuous Glucose Monitoring Metrics in Insulin-Treated Patients with Type 2 Diabetes Mellitus
Da Young Lee, Namho Kim, Inha Jung, So Young Park, Ji Hee Yu, Ji A Seo, Jihee Kim, Kyeong Jin Kim, Nam Hoon Kim, Hye Jin Yoo, Sin Gon Kim, Kyung Mook Choi, Sei Hyun Baik, Sung-Min Park, Nan Hee Kim
Diabetes Metab J. 2023;47(6):826-836.   Published online August 24, 2023
DOI: https://doi.org/10.4093/dmj.2022.0273
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  • 190 Download
  • 1 Crossref
AbstractAbstract PDFSupplementary MaterialPubReader   ePub   
Background
There was limited evidence to evaluate the association between lifestyle habits and continuous glucose monitoring (CGM) metrics. Thus, we aimed to depict the behavioral and metabolic determinants of CGM metrics in insulin-treated patients with type 2 diabetes mellitus (T2DM).
Methods
This is a prospective observational study. We analyzed data from 122 insulin-treated patients with T2DM. Participants wore Dexcom G6 and Fitbit, and diet information was identified for 10 days. Multivariate-adjusted logistic regression analysis was performed for the simultaneous achievement of CGM-based targets, defined by the percentage of time in terms of hyper, hypoglycemia and glycemic variability (GV). Intake of macronutrients and fiber, step counts, sleep, postprandial C-peptide-to-glucose ratio (PCGR), information about glucose lowering medications and metabolic factors were added to the analyses. Additionally, we evaluated the impact of the distribution of energy and macronutrient during a day, and snack consumption on CGM metrics.
Results
Logistic regression analysis revealed that female, participants with high PCGR, low glycosylated hemoglobin (HbA1c) and daytime step count had a higher probability of achieving all targets based on CGM (odds ratios [95% confidence intervals] which were 0.24 [0.09 to 0.65], 1.34 [1.03 to 1.25], 0.95 [0.9 to 0.99], and 1.15 [1.03 to 1.29], respectively). And participants who ate snacks showed a shorter period of hyperglycemia and less GV compared to those without.
Conclusion
We confirmed that residual insulin secretion, daytime step count, HbA1c, and women were the most relevant determinants of adequate glycemic control in insulin-treated patients with T2DM. In addition, individuals with snack consumption were exposed to lower times of hyperglycemia and GV.

Citations

Citations to this article as recorded by  
  • Explanatory variables of objectively measured 24-h movement behaviors in people with prediabetes and type 2 diabetes: A systematic review
    Lotte Bogaert, Iris Willems, Patrick Calders, Eveline Dirinck, Manon Kinaupenne, Marga Decraene, Bruno Lapauw, Boyd Strumane, Margot Van Daele, Vera Verbestel, Marieke De Craemer
    Diabetes & Metabolic Syndrome: Clinical Research & Reviews.2024; 18(4): 102995.     CrossRef
Response
Time to Reach Target Glycosylated Hemoglobin Is Associated with Long-Term Durable Glycemic Control and Risk of Diabetic Complications in Patients with Newly Diagnosed Type 2 Diabetes Mellitus: A 6-Year Observational Study (Diabetes Metab J 2021;45:368-78)
Kyoung Jin Kim, Jimi Choi, Jae Hyun Bae, Kyeong Jin Kim, Hye Jin Yoo, Ji A Seo, Nan Hee Kim, Kyung Mook Choi, Sei Hyun Baik, Sin Gon Kim, Nam Hoon Kim
Diabetes Metab J. 2021;45(4):617-618.   Published online July 30, 2021
DOI: https://doi.org/10.4093/dmj.2021.0152
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  • 2 Crossref
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Citations

Citations to this article as recorded by  
  • The effect of close and intensive therapeutic monitoring of patients with poorly controlled type 2 diabetes with different glycemic background
    Ayşe Naciye Erbakan, Müzeyyen Arslan Bahadir, Fatoş Nimet Kaya, Büşra Güleç, Miraç Vural Keskinler, Özge Faydaliel, Banu Mesçi, Aytekin Oğuz
    Medicine.2023; 102(50): e36680.     CrossRef
  • Reduced macula microvascular densities may be an early indicator for diabetic peripheral neuropathy
    Xiaoyu Deng, Shiqi Wang, Yan Yang, Aizhen Chen, Jinger Lu, Jinkui Hao, Yufei Wu, Qinkang Lu
    Frontiers in Cell and Developmental Biology.2022;[Epub]     CrossRef
Original Articles
Complications
Time to Reach Target Glycosylated Hemoglobin Is Associated with Long-Term Durable Glycemic Control and Risk of Diabetic Complications in Patients with Newly Diagnosed Type 2 Diabetes Mellitus: A 6-Year Observational Study
Kyoung Jin Kim, Jimi Choi, Jae Hyun Bae, Kyeong Jin Kim, Hye Jin Yoo, Ji A Seo, Nan Hee Kim, Kyung Mook Choi, Sei Hyun Baik, Sin Gon Kim, Nam Hoon Kim
Diabetes Metab J. 2021;45(3):368-378.   Published online October 20, 2020
DOI: https://doi.org/10.4093/dmj.2020.0046
  • 9,332 View
  • 342 Download
  • 17 Web of Science
  • 19 Crossref
Graphical AbstractGraphical Abstract AbstractAbstract PDFSupplementary MaterialPubReader   ePub   
Background
To evaluate the association of time to reach the target glycosylated hemoglobin (HbA1c) level with long-term durable glycemic control and risk of diabetic complications in patients with newly diagnosed type 2 diabetes mellitus (T2DM).
Methods
In a longitudinal observational cohort, 194 patients with T2DM newly diagnosed between January 2011 and March 2013 were followed up over 6 years. Patients were classified according to the time needed to reach the target HbA1c (<7.0%): <3, 3 to 6 (early achievement group), and ≥6 months (late achievement group). Risks of microvascular complications including diabetic retinopathy, nephropathy, and neuropathy as well as macrovascular events including ischemic heart disease, ischemic stroke, and peripheral arterial disease were assessed by multivariable Cox proportional hazards analysis.
Results
During a median follow-up of 6.53 years, 66 microvascular and 14 macrovascular events occurred. Maintenance of durable glycemic control over 6 years was more likely in the early achievement groups than in the late achievement group (34.5%, 30.0%, and 16.1% in <3, 3 to 6, and ≥6 months, respectively, P=0.039). Early target HbA1c achievement was associated with lower risk of composite diabetic complications (adjusted hazard ratio [HR, 0.47; 95% confidence interval [CI], 0.26 to 0.86 in <3 months group) (adjusted HR, 0.50; 95% CI, 0.23 to 1.10 in 3 to 6 months group, in reference to ≥6 months group). Similar trends were maintained for risks of microvascular and macrovascular complications, although statistical significance was not reached for macrovascular complications.
Conclusion
Early target HbA1c achievement was associated with long-term durable glycemic control and reduced risk of diabetic complications in newly diagnosed T2DM.

Citations

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  • HbA1c As Diabetes Mellitus Biomarker and Its Methods Evolution
    Liong Boy Kurniawan
    INDONESIAN JOURNAL OF CLINICAL PATHOLOGY AND MEDICAL LABORATORY.2024; 30(2): 191.     CrossRef
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    Young Sang Lyu, Sangmo Hong, Si Eun Lee, Bo Young Cho, Cheol-Young Park
    Cardiovascular Diabetology.2024;[Epub]     CrossRef
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    Mengjie Chen, Man Liu, Ying Pu, Juan Wu, Mingjiao Zhang, Hongxia Tang, Laixi Kong, Maoting Guo, Kexue Zhu, Yuxiu Xie, Zhe Li, Bei Deng, Zhenzhen Xiong
    Frontiers in Public Health.2024;[Epub]     CrossRef
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    I. V. Druk, S. S. Safronova
    Meditsinskiy sovet = Medical Council.2023; (13): 130.     CrossRef
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    Kun Lu, Tingqing Yu, Xinyi Cao, Hui Xia, Shaokang Wang, Guiju Sun, Liang Chen, Wang Liao
    Frontiers in Nutrition.2023;[Epub]     CrossRef
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    Frontiers in Cardiovascular Medicine.2023;[Epub]     CrossRef
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    Xue-Cong Zheng, Jin-Bo Su, Jin-Jie Zheng
    BMC Gastroenterology.2023;[Epub]     CrossRef
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    青 周
    Advances in Clinical Medicine.2023; 13(12): 18908.     CrossRef
  • Validity of the diagnosis of diabetic microvascular complications in Korean national health insurance claim data
    Hyung Jun Kim, Moo-Seok Park, Jee-Eun Kim, Tae-Jin Song
    Annals of Clinical Neurophysiology.2022; 24(1): 7.     CrossRef
  • Metformin plus a low hypoglycemic risk antidiabetic drug vs. metformin monotherapy for untreated type 2 diabetes mellitus: A meta-analysis of randomized controlled trials
    Wei-Tse Hung, Yuan-Jung Chen, Chun-Yu Cheng, Bruce Ovbiagele, Meng Lee, Chia-Yu Hsu
    Diabetes Research and Clinical Practice.2022; 189: 109937.     CrossRef
  • Peripheral arterial disease progression and ankle brachial index: a cohort study with newly diagnosed patients with type 2 diabetes
    João Soares Felício, Franciane Trindade Cunha de Melo, Giovana Miranda Vieira, Vitória Teixeira de Aquino, Fernanda de Souza Parente, Wanderson Maia da Silva, Nivin Mazen Said, Emanuele Rocha da Silva, Ana Carolina Contente Braga de Souza, Maria Clara Ner
    BMC Cardiovascular Disorders.2022;[Epub]     CrossRef
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    Chen Long, Yaling Tang, Jiangsheng Huang, Suo Liu, Zhenhua Xing
    Frontiers in Endocrinology.2022;[Epub]     CrossRef
  • The Degree of Glycemic Control for the First Three Months Determines the Next Seven Years
    Nami Lee, Dae Jung Kim
    Journal of Korean Medical Science.2022;[Epub]     CrossRef
  • Inhibition of advanced glycation end products and protein oxidation by leaf extracts and phenolics from Chilean bean landraces
    Felipe Ávila, Nadia Cruz, Jazmin Alarcon-Espósito, Nélida Nina, Hernán Paillan, Katherine Márquez, Denis Fuentealba, Alberto Burgos-Edwards, Cristina Theoduloz, Carmina Vejar-Vivar, Guillermo Schmeda-Hirschmann
    Journal of Functional Foods.2022; 98: 105270.     CrossRef
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    Anqi Zhang, Jinsong Wang, Xiaojuan Wan, Jing Zhang, Zihe Guo, Yamin Miao, Shuhan Zhao, Shuo Bai, Ziyi Zhang, Weiwei Yang
    Patient Preference and Adherence.2022; Volume 16: 3015.     CrossRef
  • Early Glycosylated Hemoglobin Target Achievement Predicts Clinical Outcomes in Patients with Newly Diagnosed Type 2 Diabetes Mellitus
    Joonyub Lee, Jae Hyoung Cho
    Diabetes & Metabolism Journal.2021; 45(3): 337.     CrossRef
  • Time to Reach Target Glycosylated Hemoglobin Is Associated with Long-Term Durable Glycemic Control and Risk of Diabetic Complications in Patients with Newly Diagnosed Type 2 Diabetes Mellitus: A 6-Year Observational Study (Diabetes Metab J 2021;45:368-78)
    Ja Young Jeon
    Diabetes & Metabolism Journal.2021; 45(4): 613.     CrossRef
  • Time to Reach Target Glycosylated Hemoglobin Is Associated with Long-Term Durable Glycemic Control and Risk of Diabetic Complications in Patients with Newly Diagnosed Type 2 Diabetes Mellitus: A 6-Year Observational Study (Diabetes Metab J 2021;45:368-78)
    Kyoung Jin Kim, Jimi Choi, Jae Hyun Bae, Kyeong Jin Kim, Hye Jin Yoo, Ji A Seo, Nan Hee Kim, Kyung Mook Choi, Sei Hyun Baik, Sin Gon Kim, Nam Hoon Kim
    Diabetes & Metabolism Journal.2021; 45(4): 617.     CrossRef
  • Plasma Nesfatin-1: Potential Predictor and Diagnostic Biomarker for Cognitive Dysfunction in T2DM Patient
    Dandan Xu, Yue Yu, Yayun Xu, Jinfang Ge
    Diabetes, Metabolic Syndrome and Obesity: Targets and Therapy.2021; Volume 14: 3555.     CrossRef
Epidemiology
Ten-Year Mortality Trends for Adults with and without Diabetes Mellitus in South Korea, 2003 to 2013
Kyeong Jin Kim, Tae Yeon Kwon, Sungwook Yu, Ji A Seo, Nan Hee Kim, Kyung Mook Choi, Sei Hyun Baik, Dong Seop Choi, Sin Gon Kim, Yousung Park, Nam Hoon Kim
Diabetes Metab J. 2018;42(5):394-401.   Published online April 26, 2018
DOI: https://doi.org/10.4093/dmj.2017.0088
  • 4,797 View
  • 58 Download
  • 25 Web of Science
  • 30 Crossref
AbstractAbstract PDFPubReader   
Background

To estimate and compare the trends of all-cause and cause-specific mortality rates for subjects with and without diabetes in South Korea, from 2003 to 2013.

Methods

Using a population-based cohort (2003 to 2013), we evaluated annual mortality rates in adults (≥30 years) with and without diabetes. The number of subjects in this analysis ranged from 585,795 in 2003 to 670,020 in 2013.

Results

Age- and sex-adjusted all-cause mortality rates decreased consistently in both groups from 2003 to 2013 (from 14.4 to 9.3/1,000 persons in subjects with diabetes and from 7.9 to 4.4/1,000 persons in those without diabetes). The difference in mortality rates between groups also decreased (6.61 per 1,000 persons in 2003 to 4.98 per 1,000 persons in 2013). The slope associated with the mortality rate exhibited a steeper decrease in subjects with diabetes than those without diabetes (regression coefficients of time: −0.50 and −0.33, respectively; P=0.004). In subjects with diabetes, the mortality rate from cardiovascular disease decreased by 53.5% (from 2.73 to 1.27 per 1,000 persons, P for trend <0.001). Notably, the decrease in mortality from ischemic stroke (79.2%, from 1.20 to 0.25 per 1,000 persowns) was more profound than that from ischemic heart disease (28.3%, from 0.60 to 0.43 per 1,000 persons).

Conclusion

All-cause and cardiovascular mortality rates decreased substantially from 2003 to 2013, and the decline in ischemic stroke mortality mainly contributed to the decreased cardiovascular mortality in Korean people with diabetes.

Citations

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Clinical Diabetes & Therapeutics
Determinants of Long-Term Durable Glycemic Control in New-Onset Type 2 Diabetes Mellitus
Kyoung Jin Kim, Ju Hee Choi, Kyeong Jin Kim, Jee Hyun An, Hee Young Kim, Sin Gon Kim, Nam Hoon Kim
Diabetes Metab J. 2017;41(4):284-295.   Published online August 3, 2017
DOI: https://doi.org/10.4093/dmj.2017.41.4.284
  • 4,354 View
  • 80 Download
  • 10 Web of Science
  • 11 Crossref
AbstractAbstract PDFSupplementary MaterialPubReader   
Background

Long-term durable glycemic control is a difficult goal in the management of type 2 diabetes mellitus (T2DM). We evaluated the factors associated with durable glycemic control in a real clinical setting.

Methods

We retrospectively reviewed the medical records of 194 new-onset, drug-naïve patients with T2DM who were diagnosed between January 2011 and March 2013, and were followed up for >2 years. Glycemic durability was defined as the maintenance of optimal glycemic control (glycosylated hemoglobin [HbA1c] <7.0%) for 2 years without substitution or adding other glucose-lowering agents. Clinical factors and glycemic markers associated with glycemic durability were compared between two groups: a durability group and a non-durability group.

Results

Patients in the durability group had a higher baseline body mass index (26.1 kg/m2 vs. 24.9 kg/m2) and lower HbA1c (8.6% vs. 9.7%) than the non-durability group. The initial choice of glucose-lowering agents was similar in both groups, except for insulin and sulfonylureas, which were more frequently prescribed in the non-durability group. In multiple logistic regression analyses, higher levels of education, physical activity, and homeostasis model assessment of β-cell function (HOMA-β) were associated with glycemic durability. Notably, lower HbA1c (<7.0%) at baseline and first follow-up were significantly associated with glycemic durability (adjusted odds ratio [OR], 7.48; 95% confidence interval [CI], 2.51 to 22.3) (adjusted OR, 9.27; 95% CI, 1.62 to 53.1, respectively), after adjusting for confounding variables including the types of glucose-lowering agents.

Conclusion

Early achievement of HbA1c level within the glycemic target was a determinant of long-term glycemic durability in new-onset T2DM, as were higher levels of education, physical activity, and HOMA-β.

Citations

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Diabetes Metab J : Diabetes & Metabolism Journal