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Guideline/Fact Sheet
2023 Clinical Practice Guidelines for Diabetes Management in Korea: Full Version Recommendation of the Korean Diabetes Association
Jun Sung Moon, Shinae Kang, Jong Han Choi, Kyung Ae Lee, Joon Ho Moon, Suk Chon, Dae Jung Kim, Hyun Jin Kim, Ji A Seo, Mee Kyoung Kim, Jeong Hyun Lim, Yoon Ju Song, Ye Seul Yang, Jae Hyeon Kim, You-Bin Lee, Junghyun Noh, Kyu Yeon Hur, Jong Suk Park, Sang Youl Rhee, Hae Jin Kim, Hyun Min Kim, Jung Hae Ko, Nam Hoon Kim, Chong Hwa Kim, Jeeyun Ahn, Tae Jung Oh, Soo-Kyung Kim, Jaehyun Kim, Eugene Han, Sang-Man Jin, Jaehyun Bae, Eonju Jeon, Ji Min Kim, Seon Mee Kang, Jung Hwan Park, Jae-Seung Yun, Bong-Soo Cha, Min Kyong Moon, Byung-Wan Lee
Diabetes Metab J. 2024;48(4):546-708.   Published online July 26, 2024
DOI: https://doi.org/10.4093/dmj.2024.0249
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  • 4 Crossref
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Citations

Citations to this article as recorded by  
  • Adherence to the nutritional recommendations according to diabetes status in Korean adults: a cross-sectional study
    Jong Han Choi, Chen Lulu, Seon-Joo Park, Hae-Jeung Lee
    BMC Public Health.2024;[Epub]     CrossRef
  • 당뇨병 치료의 진화: 관해를 향해가는 혁신적 약물치료와 첨단 관리기기의 결합
    종한 최, 민경 문
    Public Health Weekly Report.2024; 17(44): 1905.     CrossRef
  • The Impact of the Dietary Inflammatory Index, Fasting Blood Glucose, and Smoking Status on the Incidence and Survival of Pancreatic Cancer: A Retrospective Case–Control Study and a Prospective Study
    Ga Hyun Lee, Yeon Hee Kim, Sang Myung Woo, Woo Jin Lee, Sung-Sik Han, Sang-Jae Park, Sherry Price, Penias Tembo, James R. Hébert, Mi Kyung Kim
    Nutrients.2024; 16(22): 3941.     CrossRef
  • Enhancing Large Language Model Reliability: Minimizing Hallucinations with Dual Retrieval-Augmented Generation Based on the Latest Diabetes Guidelines
    Jaedong Lee, Hyosoung Cha, Yul Hwangbo, Wonjoong Cheon
    Journal of Personalized Medicine.2024; 14(12): 1131.     CrossRef
Reviews
Guideline/Fact Sheet
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2023 Clinical Practice Guidelines for Diabetes Mellitus of the Korean Diabetes Association
Jong Han Choi, Kyung Ae Lee, Joon Ho Moon, Suk Chon, Dae Jung Kim, Hyun Jin Kim, Nan Hee Kim, Ji A Seo, Mee Kyoung Kim, Jeong Hyun Lim, YoonJu Song, Ye Seul Yang, Jae Hyeon Kim, You-Bin Lee, Junghyun Noh, Kyu Yeon Hur, Jong Suk Park, Sang Youl Rhee, Hae Jin Kim, Hyun Min Kim, Jung Hae Ko, Nam Hoon Kim, Chong Hwa Kim, Jeeyun Ahn, Tae Jung Oh, Soo-Kyung Kim, Jaehyun Kim, Eugene Han, Sang-Man Jin, Won Suk Choi, Min Kyong Moon, Committee of Clinical Practice Guidelines, Korean Diabetes Association
Diabetes Metab J. 2023;47(5):575-594.   Published online September 26, 2023
DOI: https://doi.org/10.4093/dmj.2023.0282
  • 10,966 View
  • 1,183 Download
  • 32 Web of Science
  • 39 Crossref
AbstractAbstract PDFPubReader   ePub   
In May 2023, the Committee of Clinical Practice Guidelines of the Korean Diabetes Association published the revised clinical practice guidelines for Korean adults with diabetes and prediabetes. We incorporated the latest clinical research findings through a comprehensive systematic literature review and applied them in a manner suitable for the Korean population. These guidelines are designed for all healthcare providers nationwide, including physicians, diabetes experts, and certified diabetes educators who manage patients with diabetes or individuals at risk of developing diabetes. Based on recent changes in international guidelines and the results of a Korean epidemiological study, the recommended age for diabetes screening has been lowered. In collaboration with the relevant Korean medical societies, recently revised guidelines for managing hypertension and dyslipidemia in patients with diabetes have been incorporated into this guideline. An abridgment containing practical information on patient education and systematic management in the clinic was published separately.

Citations

Citations to this article as recorded by  
  • Efficacy and safety of a fixed‐dose combination of dapagliflozin and linagliptin (AJU‐A51) in patients with type 2 diabetes mellitus: A multicentre, randomized, double‐blind, parallel‐group, placebo‐controlled phase III study
    Jun Hwa Hong, Myung Jin Kim, Kyung Wan Min, Jong Chul Won, Tae Nyun Kim, Byung‐Wan Lee, Jun Goo Kang, Jae Hyeon Kim, Jung Hwan Park, Bon Jeong Ku, Chang Beom Lee, Sang Yong Kim, Ho Sang Shon, Woo Je Lee, Joong‐Yeol Park
    Diabetes, Obesity and Metabolism.2025; 27(1): 81.     CrossRef
  • Management of Elderly Patients with Chronic Kidney Disease
    Yohan Park, Won Min Hwang
    Yonsei Medical Journal.2025;[Epub]     CrossRef
  • Mortality in metabolic dysfunction-associated steatotic liver disease: A nationwide population-based cohort study
    Eugene Han, Byung-Wan Lee, Eun Seok Kang, Bong-Soo Cha, Sang Hoon Ahn, Yong-ho Lee, Seung Up Kim
    Metabolism.2024; 152: 155789.     CrossRef
  • Letter by In-Kyung Jeong Regarding Article, Trends in Prevalence of Hypertriglyceridemia and Related Factors in Korean Adults: A Serial Cross-Sectional Study
    In-Kyung Jeong
    Journal of Lipid and Atherosclerosis.2024; 13(1): 80.     CrossRef
  • Association between cardiovascular disease risk and incident type 2 diabetes mellitus in individuals with prediabetes: A retrospective cohort study
    Myung Jin Kim, Yun Kyung Cho, Chang Hee Jung, Woo Je Lee
    Diabetes Research and Clinical Practice.2024; 208: 111125.     CrossRef
  • Korea Hypertension Fact Sheet 2023: analysis of nationwide population-based data with a particular focus on hypertension in special populations
    Hyeon Chang Kim, Hokyou Lee, Hyeok-Hee Lee, Dasom Son, Minsung Cho, Sojung Shin, Yeeun Seo, Eun-Jin kim, Song Vogue Ahn, Sun Ha Jee, Sungha Park, Hae-Young Lee, Min Ho Shin, Sang-Hyun Ihm, Seung Won Lee, Jong Ku Park, Il Suh, Tae-Yong Lee
    Clinical Hypertension.2024;[Epub]     CrossRef
  • Diabetes Duration, Cholesterol Levels, and Risk of Cardiovascular Diseases in Individuals With Type 2 Diabetes
    Mee Kyoung Kim, Kyu Na Lee, Kyungdo Han, Seung-Hwan Lee
    The Journal of Clinical Endocrinology & Metabolism.2024; 109(12): e2317.     CrossRef
  • Effect of Adding Apolipoprotein B Testing on the Prevalence of Dyslipidemia and Risk of Cardiovascular Disease in the Korean Adult Population
    Rihwa Choi, Sang Gon Lee, Eun Hee Lee
    Metabolites.2024; 14(3): 169.     CrossRef
  • Fenofibrate to prevent amputation and reduce vascular complications in patients with diabetes: FENO-PREVENT
    Eu Jeong Ku, Bongseong Kim, Kyungdo Han, Seung-Hwan Lee, Hyuk-Sang Kwon
    Cardiovascular Diabetology.2024;[Epub]     CrossRef
  • A self-powered and supercapacitive microneedle continuous glucose monitoring system with a wide range of glucose detection capabilities
    Hye-Jun Kil, Jang Hyeon Kim, Kanghae Lee, Tae-Uk Kang, Ju-Hyun Yoo, Yong-ho Lee, Jin-Woo Park
    Biosensors and Bioelectronics.2024; 257: 116297.     CrossRef
  • Cardiorenal outcomes and mortality after sodium‐glucose cotransporter‐2 inhibitor initiation in type 2 diabetes patients with percutaneous coronary intervention history
    Jin Hwa Kim, Young Sang Lyu, BongSeong Kim, Mee Kyung Kim, Sang Yong Kim, Ki‐Hyun Baek, Ki‐Ho Song, Kyungdo Han, Hyuk‐Sang Kwon
    Diabetes, Obesity and Metabolism.2024; 26(7): 2567.     CrossRef
  • SGLT2i impact on HCC incidence in patients with fatty liver disease and diabetes: a nation-wide cohort study in South Korea
    Hyo Jung Cho, Eunyoung Lee, Soon Sun Kim, Jae Youn Cheong
    Scientific Reports.2024;[Epub]     CrossRef
  • The importance of diabetes mellitus in dental practice
    Nina Dimitrijević-Jovanović, Hristina Ugrinović, Radomir Mitić, Nevena Kalezić
    Galenika Medical Journal.2024; 3(9): 80.     CrossRef
  • Evaluation of glycemic response of ten local meals commonly consumed from Chad
    Zoufane Guedeungbe, Jean Paul Bayang, Benoît Bargui Koubala
    Journal of Agriculture and Food Research.2024; 17: 101251.     CrossRef
  • Glycemic Control and Oral Health Outcomes in Patients With Diabetes: Insights From a Nationwide Korean Survey
    Song-Yi Yu, Sun-Kyung Lee, Bumhee Yang, Hyun Lee, Hyun Jeong Jeon, Dong-Hwa Lee
    Journal of Korean Medical Science.2024;[Epub]     CrossRef
  • Efficacy and safety of albiglutide, a once-weekly glucagon-like peptide-1 receptor agonist, in patients with type 2 diabetes: A systematic review and meta-analysis
    A.B.M. Kamrul-Hasan, Deep Dutta, Lakshmi Nagendra, Saptarshi Bhattacharya, Rajiv Singla, Sanjay Kalra
    Medicine.2024; 103(25): e38568.     CrossRef
  • Longitudinal Analysis of Diabetes Mellitus Risk: Smoking Status and Smoking Cessation
    Da-Eun Sung, Seung-Jae Lee, Mi-Yeon Lee, Eun-Jung Rhee, Ki-Chul Sung
    Journal of Clinical Medicine.2024; 13(13): 3927.     CrossRef
  • Current type 2 diabetes guidelines: Individualized treatment and how to make the most of metformin
    Juliana C. N. Chan, Aimin Yang, Natural Chu, Elaine Chow
    Diabetes, Obesity and Metabolism.2024; 26(S3): 55.     CrossRef
  • Comprehensive management of polypharmacy in older patients with diabetes
    Kang Seo Park, Hea Min Yu
    Journal of the Korean Medical Association.2024; 67(7): 449.     CrossRef
  • The Key Role of Nutritional Intervention in Delaying Disease Progression and the Therapeutic Management of Diabetic Kidney Disease—A Challenge for Physicians and Patients
    Ileana Peride, Miruna Anastasiu, Silvia Alexandra Serban, Mirela Tiglis, Razvan Ene, Ana-Maria Nechita, Tiberiu Paul Neagu, Ionel Alexandru Checherita, Andrei Niculae
    Journal of Personalized Medicine.2024; 14(8): 778.     CrossRef
  • Efficacy and Safety of Pioglitazone Add-on in Patients with Type 2 Diabetes Mellitus Inadequately Controlled with Metformin and Dapagliflozin: A Multicenter, Randomized, Double-blind, and Placebo-controlled Study
    Yun Kyung Cho, Kyung-Soo Kim, Byung-Wan Lee, Jun Hwa Hong, Jae Myung Yu, Soo Lim, Ye An Kim, Chang Beom Lee, Sang Soo Kim, Soo Heon Kwak, Woo Je Lee
    Clinical Therapeutics.2024; 46(9): 662.     CrossRef
  • Islet transplantation in Korea
    Joonyub Lee, Kun‐Ho Yoon
    Journal of Diabetes Investigation.2024; 15(9): 1165.     CrossRef
  • Effect of gout and diabetic kidney disease on renal cancer development in Korea
    Seung Min Chung, Inha Jung, Da Young Lee, So Young Park, Ji Hee Yu, Jun Sung Moon, Ji A Seo, Kyungdo Han, Nan Hee Kim
    Clinical Kidney Journal.2024;[Epub]     CrossRef
  • Cardiovascular autonomic neuropathy and the risk of diabetic kidney disease
    Injeong Cho, Seohyun Lim, Minjae Kwon, Seung Min Chung, Jun Sung Moon, Ji Sung Yoon, Kyu Chang Won
    Frontiers in Endocrinology.2024;[Epub]     CrossRef
  • Educational Needs and Priorities of People with Diabetes and Healthcare Providers in South Korea: A Mixed-Methods Study
    Shinae Seo, Chun-Ja Kim, Hee Sun Kang, Elizabeth A. Schlenk
    Journal of Transcultural Nursing.2024;[Epub]     CrossRef
  • Changes in serum uteroglobin level in type 2 diabetes mellitus patients
    Joung Youl Lim, Sang-Hyeon Ju, Ji Min Kim, Hyon-Seung Yi, Ju Hee Lee, Hyun Jin Kim, Bon Jeong Ku, Kyong Hye Joung
    Frontiers in Endocrinology.2024;[Epub]     CrossRef
  • 1-Hour Postload Glucose: Early Screening for High Risk of Type 2 Diabetes in Koreans With Normal Fasting Glucose
    Min Jin Lee, Ji Hyun Bae, Ah Reum Khang, Dongwon Yi, Joo Yeon Kim, Su Hyun Kim, Dong Hee Kim, Dasol Kang, Sujin Park, Yun Kyung Jeon, Sang Soo Kim, Bo Hyun Kim, Mi Sook Yun, Yang Ho Kang
    The Journal of Clinical Endocrinology & Metabolism.2024;[Epub]     CrossRef
  • Sodium-glucose cotransporter 2 inhibitors in cardiocerebrovascular disease
    Jin Joo Park
    Cardiovascular Prevention and Pharmacotherapy.2024; 6(4): 103.     CrossRef
  • Systematic review of guideline recommendations for older and frail adults with type 2 diabetes mellitus
    Jennifer Bolt, Valeria Carvalho, Kristine Lin, Sung Ju Lee, Colleen Inglis
    Age and Ageing.2024;[Epub]     CrossRef
  • Trends in prescribing sodium‐glucose cotransporter 2 inhibitors for individuals with type 2 diabetes with and without cardiovascular‐renal disease in South Korea, 2015–2021
    Kyoung Hwa Ha, Soyoung Shin, EunJi Na, Dae Jung Kim
    Journal of Diabetes Investigation.2024;[Epub]     CrossRef
  • Socioeconomic inequalities in the prevalence, non-awareness, non-treatment, and non-control of diabetes among South Korean adults in 2021
    Seongju Kim, Dong Jun Kim, Hooyeon Lee, Dong Keon Yon
    PLOS ONE.2024; 19(11): e0313988.     CrossRef
  • Association of Uterine Leiomyoma with Type 2 Diabetes Mellitus in Young Women: A Population-Based Cohort Study
    Ji-Hee Sung, Kyung-Soo Kim, Kyungdo Han, Cheol-Young Park
    Diabetes & Metabolism Journal.2024; 48(6): 1105.     CrossRef
  • Combined impact of prediabetes and hepatic steatosis on cardiometabolic outcomes in young adults
    Wonsuk Choi, Minae Park, Sojeong Park, Ji Yong Park, A Ram Hong, Jee Hee Yoon, Kyoung Hwa Ha, Dae Jung Kim, Hee Kyung Kim, Ho-Cheol Kang
    Cardiovascular Diabetology.2024;[Epub]     CrossRef
  • Management of Dyslipidemia in Patients with Diabetes Mellitus
    Kyung Ae Lee
    The Journal of Korean Diabetes.2023; 24(3): 111.     CrossRef
  • 2023 Clinical Practice Guidelines for Diabetes: Recommendations for Pharmacological Treatment of Type 2 Diabetes
    Junghyun Noh
    The Journal of Korean Diabetes.2023; 24(3): 127.     CrossRef
  • 2023 Clinical Practice Guidelines for Diabetes
    Min Kyong Moon
    The Journal of Korean Diabetes.2023; 24(3): 120.     CrossRef
  • 2023 Clinical Practice Guidelines for Diabetes: Management of Cardiovascular Risk Factors
    Ye Seul Yang
    The Journal of Korean Diabetes.2023; 24(3): 135.     CrossRef
  • A 33-Year-Old Man Presented with Abdominal Pain and Vomiting Starting a Day Ago
    Jong Han Choi
    The Korean Journal of Medicine.2023; 98(6): 289.     CrossRef
  • Comorbidity Patterns and Management in Inpatients with Endocrine Diseases by Age Groups in South Korea: Nationwide Data
    Sung-Soo Kim, Hun-Sung Kim
    Journal of Personalized Medicine.2023; 14(1): 42.     CrossRef
Guideline/Fact Sheet
Article image
Screening for Prediabetes and Diabetes in Korean Nonpregnant Adults: A Position Statement of the Korean Diabetes Association, 2022
Kyung Ae Lee, Dae Jung Kim, Kyungdo Han, Suk Chon, Min Kyong Moon, on Behalf of the Committee of Clinical Practice Guideline of Korean Diabetes Association
Diabetes Metab J. 2022;46(6):819-826.   Published online November 24, 2022
DOI: https://doi.org/10.4093/dmj.2022.0364
  • 5,945 View
  • 294 Download
  • 7 Web of Science
  • 12 Crossref
AbstractAbstract PDFPubReader   ePub   
Diabetes screening serves to identify individuals at high-risk for diabetes who have not yet developed symptoms and to diagnose diabetes at an early stage. Globally, the prevalence of diabetes is rapidly increasing. Furthermore, obesity and/or abdominal obesity, which are major risk factors for type 2 diabetes mellitus (T2DM), are progressively increasing, particularly among young adults. Many patients with T2DM are asymptomatic and can accompany various complications at the time of diagnosis, as well as chronic complications develop as the duration of diabetes increases. Thus, proper screening and early diagnosis are essential for diabetes care. Based on reports on the changing epidemiology of diabetes and obesity in Korea, as well as growing evidence from new national cohort studies on diabetes screening, the Korean Diabetes Association has updated its clinical practice recommendations regarding T2DM screening. Diabetes screening is now recommended in adults aged ≥35 years regardless of the presence of risk factors, and in all adults (aged ≥19) with any of the risk factors. Abdominal obesity based on waist circumference (men ≥90 cm, women ≥85 cm) was added to the list of risk factors.

Citations

Citations to this article as recorded by  
  • Oxidative Balance Score and New-Onset Type 2 Diabetes Mellitus in Korean Adults without Non-Alcoholic Fatty Liver Disease: Korean Genome and Epidemiology Study-Health Examinees (KoGES-HEXA) Cohort
    Mid-Eum Moon, Dong Hyuk Jung, Seok-Jae Heo, Byoungjin Park, Yong Jae Lee
    Antioxidants.2024; 13(1): 107.     CrossRef
  • Efficacy and Safety of Once-Weekly Semaglutide Versus Once-Daily Sitagliptin as Metformin Add-on in a Korean Population with Type 2 Diabetes
    Byung-Wan Lee, Young Min Cho, Sin Gon Kim, Seung-Hyun Ko, Soo Lim, Amine Dahaoui, Jin Sook Jeong, Hyo Jin Lim, Jae Myung Yu
    Diabetes Therapy.2024; 15(2): 547.     CrossRef
  • Triglyceride-glucose index predicts type 2 diabetes mellitus more effectively than oral glucose tolerance test-derived insulin sensitivity and secretion markers
    Min Jin Lee, Ji Hyun Bae, Ah Reum Khang, Dongwon Yi, Mi Sook Yun, Yang Ho Kang
    Diabetes Research and Clinical Practice.2024; 210: 111640.     CrossRef
  • Association of sleep fragmentation with general and abdominal obesity: a population-based longitudinal study
    Yu-xiang Xu, Shan-shan Wang, Yu-hui Wan, Pu-yu Su, Fang-biao Tao, Ying Sun
    International Journal of Obesity.2024; 48(9): 1258.     CrossRef
  • Oxidative balance score as a useful predictive marker for new-onset type 2 diabetes mellitus in Korean adults aged 60 years or older: The Korean Genome and Epidemiologic Study–Health Examination (KoGES-HEXA) cohort
    Mid-Eum Moon, Dong Hyuk Jung, Seok-Jae Heo, Byoungjin Park, Yong Jae Lee
    Experimental Gerontology.2024; 193: 112475.     CrossRef
  • The optimal dose of metformin to control conversion to diabetes in patients with prediabetes: A meta-analysis
    Xiaoyan Yi, Yongliang Pan, Huan Peng, Mengru Ren, Qin Jia, Bing Wang
    Journal of Diabetes and its Complications.2024; 38(10): 108846.     CrossRef
  • Changes in the Epidemiological Landscape of Diabetes in South Korea: Trends in Prevalence, Incidence, and Healthcare Expenditures
    Kyoung Hwa Ha, Dae Jung Kim
    Endocrinology and Metabolism.2024; 39(5): 669.     CrossRef
  • Development and validation of machine learning models to predict prediabetes using dietary intake data in young adults in Korea: a cross-sectional study
    Myoung-Lyun Heo
    Journal of Korean Biological Nursing Science.2024; 26(4): 300.     CrossRef
  • Cumulative muscle strength and risk of diabetes: A prospective cohort study with mediation analysis
    Shanhu Qiu, Xue Cai, Yan Liang, Wenji Chen, Duolao Wang, Zilin Sun, Bo Xie, Tongzhi Wu
    Diabetes Research and Clinical Practice.2023; 197: 110562.     CrossRef
  • Revisiting the Diabetes Crisis in Korea: Call for Urgent Action
    Jun Sung Moon
    The Journal of Korean Diabetes.2023; 24(1): 1.     CrossRef
  • 2023 Clinical Practice Guidelines for Diabetes Mellitus of the Korean Diabetes Association
    Jong Han Choi, Kyung Ae Lee, Joon Ho Moon, Suk Chon, Dae Jung Kim, Hyun Jin Kim, Nan Hee Kim, Ji A Seo, Mee Kyoung Kim, Jeong Hyun Lim, YoonJu Song, Ye Seul Yang, Jae Hyeon Kim, You-Bin Lee, Junghyun Noh, Kyu Yeon Hur, Jong Suk Park, Sang Youl Rhee, Hae J
    Diabetes & Metabolism Journal.2023; 47(5): 575.     CrossRef
  • 2023 Clinical Practice Guidelines for Diabetes
    Min Kyong Moon
    The Journal of Korean Diabetes.2023; 24(3): 120.     CrossRef
Original Articles
Complications
Article image
Influence of Glucose Fluctuation on Peripheral Nerve Damage in Streptozotocin-Induced Diabetic Rats
Yu Ji Kim, Na Young Lee, Kyung Ae Lee, Tae Sun Park, Heung Yong Jin
Diabetes Metab J. 2022;46(1):117-128.   Published online September 9, 2021
DOI: https://doi.org/10.4093/dmj.2020.0275
  • 6,452 View
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  • 4 Web of Science
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Graphical AbstractGraphical Abstract AbstractAbstract PDFPubReader   ePub   
Background
It is unclear whether glycemic variability (GV) is a risk factor for diabetic peripheral neuropathy (DPN), and whether control of GV is beneficial for DPN. The purpose of this study was to investigate the effect of GV on peripheral nerve damage by inducing glucose fluctuation in streptozotocin-induced diabetic rats.
Methods
Rats were divided into four groups: normal (normal glucose group [NOR]), diabetes without treatment (sustained severe hyperglycemia group; diabetes mellitus [DM]), diabetes+once daily insulin glargine (stable hyperglycemia group; DM+LAN), and diabetes+once daily insulin glargine with twice daily insulin glulisine (unstable glucose fluctuation group; DM+Lantus [LAN]+Apidra [API]). We measured anti-oxidant enzyme levels and behavioral responses against tactile, thermal, and pressure stimuli in the plasma of rats. We also performed a quantitative comparison of cutaneous and sciatic nerves according to glucose fluctuation.
Results
At week 24, intraepidermal nerve fiber density was less reduced in the insulin-administered groups compared to the DM group (P<0.05); however, a significant difference was not observed between the DM+LAN and DM+LAN+API groups irrespective of glucose fluctuation (P>0.05; 16.2±1.6, 12.4±2.0, 14.3±0.9, and 13.9±0.6 for NOR, DM, DM+LAN, and DM+LAN+API, respectively). The DM group exhibited significantly decreased glutathione levels compared to the insulin-administered groups (2.64±0.10 μmol/mL, DM+LAN; 1.93±0.0 μmol/mL, DM+LAN+API vs. 1.25±0.04 μmol/mL, DM; P<0.05).
Conclusion
Our study suggests that glucose control itself is more important than glucose fluctuation in the prevention of peripheral nerve damage, and intra-day glucose fluctuation has a limited effect on the progression of peripheral neuropathy in rats with diabetes.

Citations

Citations to this article as recorded by  
  • Glucose Fluctuation Inhibits Nrf2 Signaling Pathway in Hippocampal Tissues and Exacerbates Cognitive Impairment in Streptozotocin-Induced Diabetic Rats
    Haiyan Chi, Yujing Sun, Peng Lin, Junyu Zhou, Jinbiao Zhang, Yachao Yang, Yun Qiao, Deshan Liu, Eusebio Chiefari
    Journal of Diabetes Research.2024; 2024: 1.     CrossRef
  • Artesunate Inhibits Apoptosis and Promotes Survival in Schwann Cells via the PI3K/AKT/mTOR Axis in Diabetic Peripheral Neuropathy
    Xin Zhang, Zhifang Liang, Ying Zhou, Fang Wang, Shan Wei, Bing Tan, Yujie Guo
    Biological and Pharmaceutical Bulletin.2023; 46(6): 764.     CrossRef
  • The Potential of Glucose Treatment to Reduce Reactive Oxygen Species Production and Apoptosis of Inflamed Neural Cells In Vitro
    Juin-Hong Cherng, Shu-Jen Chang, Hsin-Da Tsai, Chung-Fang Chun, Gang-Yi Fan, Kenneth Dean Reeves, King Hei Stanley Lam, Yung-Tsan Wu
    Biomedicines.2023; 11(7): 1837.     CrossRef
  • Relationship between acute glucose variability and cognitive decline in type 2 diabetes: A systematic review and meta-analysis
    Haiyan Chi, Min Song, Jinbiao Zhang, Junyu Zhou, Deshan Liu, Victor Manuel Mendoza-Nuñez
    PLOS ONE.2023; 18(9): e0289782.     CrossRef
Drug/Regimen
Article image
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 Kim, Hye Soon Kim, Il Seong Nam-Goong, Eun Sook Kim, Jin Ook Chung, Dong-Hyeok Cho, Chang Won Lee, Young Il Kim, Dong Jin Chung, Kyu Chang Won, In Joo Kim, Tae Sun Park, Duk Kyu Kim, Hosang Shon
Diabetes Metab J. 2021;45(5):675-683.   Published online August 12, 2020
DOI: https://doi.org/10.4093/dmj.2020.0107
  • 36,957 View
  • 391 Download
  • 10 Web of Science
  • 7 Crossref
Graphical AbstractGraphical Abstract AbstractAbstract PDFSupplementary MaterialPubReader   ePub   
Background

Only few studies have shown the efficacy and safety of glucose-control strategies using the quadruple drug combination. Therefore, the aim of the present study was to investigate the usefulness of the quadruple combination therapy with oral hypoglycemic agents (OHAs) in patients with uncontrolled type 2 diabetes mellitus (T2DM).

Methods

From March 2014 to December 2018, data of patients with T2DM, who were treated with quadruple hypoglycemic medications for over 12 months in 11 hospitals in South Korea, were reviewed retrospectively. We compared glycosylated hemoglobin (HbA1c) levels before and 12 months after quadruple treatment with OHAs. The safety, maintenance rate, and therapeutic patterns after failure of the quadruple therapy were also evaluated.

Results

In total, 357 patients were enrolled for quadruple OHA therapy, and the baseline HbA1c level was 9.0%±1.3% (74.9±14.1 mmol/mol). After 12 months, 270 patients (75.6%) adhered to the quadruple therapy and HbA1c was significantly reduced from 8.9%±1.2% to 7.8%±1.3% (mean change, −1.1%±1.2%; P<0.001). The number of patients with HbA1c <7% increased significantly from 5 to 68 (P<0.005). In addition, lipid profiles and liver enzyme levels were also improved whereas no changes in body weight. There was no significant safety issue in patients treated with quadruple OHA therapy.

Conclusion

This study shows the therapeutic efficacy of the quadruple OHA regimen T2DM and demonstrates that it can be an option for the management of T2DM patients who cannot use insulin or reject injectable therapy.

Citations

Citations to this article as recorded by  
  • Estimating Type 2 Diabetes Prevalence: A Model of Drug Consumption Data
    Rita Oliveira, Matilde Monteiro-Soares, José Pedro Guerreiro, Rúben Pereira, António Teixeira-Rodrigues
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    Sevgi Demir Çam, Sevda Uzun
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    Nadia Gul, Inayat Ur Rehman, Yasar shah, Arbab Muhammad Ali, Zahid Ali, Omer Shehzad, Khang Wen Goh, Long Chiau Ming, Amal K. Suleiman, Nimesh Lageju
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    Kyung-Soo Kim, Kyung Ah Han, Tae Nyun Kim, Cheol-Young Park, Jung Hwan Park, Sang Yong Kim, Yong Hyun Kim, Kee Ho Song, Eun Seok Kang, Chul Sik Kim, Gwanpyo Koh, Jun Goo Kang, Mi Kyung Kim, Ji Min Han, Nan Hee Kim, Ji Oh Mok, Jae Hyuk Lee, Soo Lim, Sang S
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  • Effectiveness and safety of teneligliptin added to patients with type 2 diabetes inadequately controlled by oral triple combination therapy: A multicentre, randomized, double‐blind, and placebo‐controlled study
    Minyoung Lee, Woo‐je Lee, Jae Hyeon Kim, Byung‐Wan Lee
    Diabetes, Obesity and Metabolism.2022; 24(6): 1105.     CrossRef
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Brief Reports
Complications
Effect of Empagliflozin, a Selective Sodium-Glucose Cotransporter 2 Inhibitor, on Kidney and Peripheral Nerves in Streptozotocin-Induced Diabetic Rats
Kyung Ae Lee, Heung Yong Jin, Na Young Lee, Yu Ji Kim, Tae Sun Park
Diabetes Metab J. 2018;42(4):338-342.   Published online April 25, 2018
DOI: https://doi.org/10.4093/dmj.2017.0095
  • 4,811 View
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  • 18 Web of Science
  • 21 Crossref
AbstractAbstract PDFPubReader   

The effect of sodium-glucose cotransporter 2 inhibitors on peripheral nerves and kidneys in diabetes mellitus (DM) remains unexplored. Therefore, this study aimed to explore the effect of empagliflozin in diabetic rats. DM in rats was induced by streptozotocin injection, and diabetic rats were treated with empagliflozin 3 or 10 mg/kg. Following 24-week treatment, response thresholds to four different stimuli were tested and found to be lower in diabetic rats than in normal rats. Empagliflozin significantly prevented hypersensitivity (P<0.05) and the loss of skin intraepidermal nerve fibers, and mesangial matrix expansion in diabetic rats. Results of this study demonstrate the potential therapeutic effects of empagliflozin for the treatment of diabetic peripheral neuropathy and nephropathy.

Citations

Citations to this article as recorded by  
  • Effect of empagliflozin in peripheral diabetic neuropathy of patients with type 2 diabetes mellitus
    Sahar Mohamed El-Haggar, Yasser Mostafa Hafez, Amira Mohamed El Sharkawy, Maha Khalifa
    Medicina Clínica.2024; 163(2): 53.     CrossRef
  • Effect of empagliflozin in peripheral diabetic neuropathy of patients with type 2 diabetes mellitus
    Sahar Mohamed El-Haggar, Yasser Mostafa Hafez, Amira Mohamed El Sharkawy, Maha Khalifa
    Medicina Clínica (English Edition).2024; 163(2): 53.     CrossRef
  • Neuroprotective Effects of Sodium-Glucose Cotransporter-2 (SGLT2) Inhibitors (Gliflozins) on Diabetes-Induced Neurodegeneration and Neurotoxicity: A Graphical Review
    Mina Gholami, Natalie Coleman-Fuller, Mahsa Salehirad, Sepideh Darbeheshti, Majid Motaghinejad
    International Journal of Preventive Medicine.2024;[Epub]     CrossRef
  • A Review of Recent Pharmacological Advances in the Management of Diabetes-Associated Peripheral Neuropathy
    Osman Syed, Predrag Jancic, Nebojsa Nick Knezevic
    Pharmaceuticals.2023; 16(6): 801.     CrossRef
  • Renal intrinsic cells remodeling in diabetic kidney disease and the regulatory effects of SGLT2 Inhibitors
    Wenwen Guo, Han Li, Yixuan Li, Wen Kong
    Biomedicine & Pharmacotherapy.2023; 165: 115025.     CrossRef
  • A systematic review on renal effects of SGLT2 inhibitors in rodent models of diabetic nephropathy
    Aqsa Ashfaq, Myriam Meineck, Andrea Pautz, Ebru Arioglu-Inan, Julia Weinmann-Menke, Martin C. Michel
    Pharmacology & Therapeutics.2023; 249: 108503.     CrossRef
  • The impact of canagliflozin on the risk of neuropathy events: A post-hoc exploratory analysis of the CREDENCE trial
    Jinlan Liao, Amy Kang, Chao Xia, Tamara Young, Gian Luca Di Tanna, Clare Arnott, Carol Pollock, Arun V. Krishnan, Rajiv Agarwal, George Bakris, David M. Charytan, Dick de Zeeuw, Hiddo J.L. Heerspink, Adeera Levin, Bruce Neal, David C. Wheeler, Hong Zhang,
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  • Sodium Glucose Cotransporter-2 Inhibitor Protects Against Diabetic Neuropathy and Nephropathy in Modestly Controlled Type 2 Diabetes: Follow-Up Study
    Fukashi Ishibashi, Aiko Kosaka, Mitra Tavakoli
    Frontiers in Endocrinology.2022;[Epub]     CrossRef
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    Sandy R. Botros, Asmaa I. Matouk, Aliaa Anter, Mohamed M.A. Khalifa, Gehan H. Heeba
    Environmental Toxicology and Pharmacology.2022; 94: 103907.     CrossRef
  • Empagliflozin mitigates type 2 diabetes-associated peripheral neuropathy: a glucose-independent effect through AMPK signaling
    Noha F. Abdelkader, Marawan A. Elbaset, Passant E. Moustafa, Sherehan M. Ibrahim
    Archives of Pharmacal Research.2022; 45(7): 475.     CrossRef
  • Pathogenesis and Treatment of Diabetic Peripheral Neuropathy
    Seon Mee Kang
    The Journal of Korean Diabetes.2022; 23(4): 222.     CrossRef
  • Empagliflozin and neohesperidin protect against methotrexate-induced renal toxicity via suppression of oxidative stress and inflammation in male rats
    Adel T. Osman, Souty M.Z. Sharkawi, Mohamed I.A. Hassan, Amira M. Abo-youssef, Ramadan A.M. Hemeida
    Food and Chemical Toxicology.2021; 155: 112406.     CrossRef
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    Tushar Issar, Natalie C.G. Kwai, Ann M. Poynten, Ria Arnold, Kerry-Lee Milner, Arun V. Krishnan
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  • Effectiveness of Empagliflozin With Vitamin D Supplementation in Peripheral Neuropathy in Type 2 Diabetic Patients
    Sanjana Mehta, Parminder Nain, Bimal K Agrawal, Rajinder P Singh, Jaspreet Kaur, Sabyasachi Maity, Aniruddha Bhattarcharjee, Jagannadha Peela, Shreya Nauhria, Samal Nauhria
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    Ahmed M. Kabel, Remon S. Estfanous, Majed M. Alrobaian
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  • Empagliflozin reduces high glucose-induced oxidative stress and miR-21-dependent TRAF3IP2 induction and RECK suppression, and inhibits human renal proximal tubular epithelial cell migration and epithelial-to-mesenchymal transition
    Nitin A. Das, Andrea J. Carpenter, Anthony Belenchia, Annayya R. Aroor, Makoto Noda, Ulrich Siebenlist, Bysani Chandrasekar, Vincent G. DeMarco
    Cellular Signalling.2020; 68: 109506.     CrossRef
  • Differential Effects of Empagliflozin on Microvascular Complications in Murine Models of Type 1 and Type 2 Diabetes
    Stephanie A. Eid, Phillipe D. O’Brien, Lucy M. Hinder, John M. Hayes, Faye E. Mendelson, Hongyu Zhang, Lixia Zeng, Katharina Kretzler, Samanthi Narayanan, Steven F. Abcouwer, Frank C. Brosius, Subramaniam Pennathur, Masha G. Savelieff, Eva L. Feldman
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  • Pre-treatment with Empagliflozin ameliorates Cisplatin induced acute kidney injury by suppressing apoptosis
    Maaly A. Abd Elmaaboud, Ahmed M. Kabel, Mohamed Elrashidy
    Journal of Applied Biomedicine.2019; 17(1): 90.     CrossRef
  • Effects of ticagrelor, empagliflozin and tamoxifen against experimentally-induced vascular reactivity defects in rats in vivo and in vitro
    Yasmin Moustafa Ahmed, Basim Anwar Shehata Messiha, Mahmoud El-Sayed El-Daly, Ali Ahmed Abo-Saif
    Pharmacological Reports.2019; 71(6): 1034.     CrossRef
  • SGLT2 inhibition with empagliflozin attenuates myocardial oxidative stress and fibrosis in diabetic mice heart
    Chenguang Li, Jie Zhang, Mei Xue, Xiaoyu Li, Fei Han, Xiangyang Liu, Linxin Xu, Yunhong Lu, Ying Cheng, Ting Li, Xiaochen Yu, Bei Sun, Liming Chen
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  • Empagliflozin Contributes to Polyuria via Regulation of Sodium Transporters and Water Channels in Diabetic Rat Kidneys
    Sungjin Chung, Soojeong Kim, Mina Son, Minyoung Kim, Eun Sil Koh, Seok Joon Shin, Seung-Hyun Ko, Ho-Shik Kim
    Frontiers in Physiology.2019;[Epub]     CrossRef
Complication
Morphologic Comparison of Peripheral Nerves in Adipocyte Tissue from db/db Diabetic versus Normal Mice
Kyung Ae Lee, Na Young Lee, Tae Sun Park, Heung Yong Jin
Diabetes Metab J. 2018;42(2):169-172.   Published online March 21, 2018
DOI: https://doi.org/10.4093/dmj.2018.42.2.169
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AbstractAbstract PDFPubReader   

Present study investigated the morphologic changes of autonomic nerves in the adipose tissue in diabetic animal model. Male obese type 2 diabetic db/db mice and age matched non-diabetic db/m control mice were used. Epididymal adipose tissue from diabetic db/db mice with that from control heterozygous db/m mice was compared using confocal microscopy-based method to visualize intact whole adipose tissue. Immunohistochemistry with tyrosine hydroxylase for sympathetic (SP), choline acetyltransferase for parasympathetic (PSP), and protein gene product 9.5 (PGP 9.5) for whole autonomic nerves was performed. The quantity of immunostained portion of SP, PSP, and PGP 9.5 stained nerve fibers showed decreased trend in diabetic group; however, the ratio of SP/PSP of adipose tissue was higher in diabetic group compared with control group as follows (0.70±0.30 vs. 0.95±0.25, P<0.05; normal vs. diabetic, respectively). Both SP and PSP nerve fibers were observed in white adipose tissue and PSP nerve fibers were suggested as more decreased in diabetes based on our observation.

Original Articles
The Relationship between Anemia and the Initiation of Dialysis in Patients with Type 2 Diabetic Nephropathy
Sun Hee Kim, Kyung Ae Lee, Heung Yong Jin, Hong Sun Baek, Tae Sun Park
Diabetes Metab J. 2015;39(3):240-246.   Published online April 22, 2015
DOI: https://doi.org/10.4093/dmj.2015.39.3.240
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AbstractAbstract PDFPubReader   
Background

Anemia is associated with various poor clinical outcomes in chronic kidney disease patients. The aim of this study was to investigate the relationship between anemia and the initiation degree and time of dialysis in type 2 diabetic nephropathy patients.

Methods

This observational retrospective study included 130 type 2 diabetic nephropathy patients in Korea. The existence of anemia, the degree and time of dialysis initiation were reviewed. Clinical characteristics and variables were also compared.

Results

The levels of hemoglobin and serum creatinine were significantly correlated with the dialysis initiation (P<0.05) during the 10-year follow-up period. Patients with anemia showed rapid decline of renal function, causing significantly more dialysis initiation (54.1% vs. 5.4%, P<0.05) compare to the patients without anemia. Average time to initiate dialysis in patients with anemia was 45.1 months (range, 8.0 to 115.8 months), which was significantly faster than that (68.3 months [range, 23.3 to 108.8 months]) in patients without anemia (P<0.01). The risk to dialysis initiation was significantly increased in patients with anemia compared to the patients without anemia (adjusted hazard ratio, 8.1; 95% confidence interval, 2.4 to 27.0; P<0.05).

Conclusion

Anemia is associated with rapid decline of renal dysfunction and faster initiation of dialysis in diabetic nephropathy patients. Therefore, clinicians should pay an earlier attention to anemia during the management of diabetes.

Citations

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    Lei Haung, YanLin Ding, XiaoYong Yu
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    Tae Ryom Oh, Su Hyun Song, Hong Sang Choi, Chang Seong Kim, Seung Hyeok Han, Kyung Pyo Kang, Young Joo Kwon, Soo Wan Kim, Seong Kwon Ma, Eun Hui Bae
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Relationship between the Korean Version Survey of the Autonomic Symptoms Score and Cardiac Autonomic Neuropathy Parameters in Patients with Diabetic Peripheral Neuropathy
Sun Hee Kim, Kyung Ae Lee, Heung Yong Jin, Hong Sun Baek, Tae Sun Park
Diabetes Metab J. 2014;38(5):349-355.   Published online October 17, 2014
DOI: https://doi.org/10.4093/dmj.2014.38.5.349
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AbstractAbstract PDFPubReader   
Background

The Survey of Autonomic Symptom (SAS) scale was reported as an easy instrument to assess the autonomic symptoms in patients with early diabetic neuropathy. In this study, we investigated the relationship between the SAS scale and the parameters of cardiac autonomic neuropathy (CAN) in Korean patients with diabetic peripheral neuropathy (DPN).

Methods

The SAS scale was tested in 30 healthy controls and 73 patients with DPN at Chonbuk National University Hospital, in Korea. The SAS score was compared to the parameters of the CAN test and the total symptom score (TSS) for DPN in patients with DPN.

Results

The SAS symptom score and total impact score were increased in patients with DPN compared to the control group (P=0.01), particularly in sudomotor dysfunction (P=0.01), and vasomotor dysfunction (P=0.01). The SAS score was increased in patients with CAN compared to patients without CAN (P<0.05). Among the diverse CAN parameters, the valsalva ratio and postural hypotension were associated with the SAS score (P<0.05). However, there was no association between the SAS scale and TSS for DPN, and TSS for DPN did not differ between patients with and without CAN.

Conclusion

SAS is a simple instrument that can be used to assess autonomic symptoms in patients with diabetes and can be used as a screening tool for autonomic neuropathy, particularly for CAN.

Citations

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  • Autonomic neuropathic symptoms in patients with diabetes: practical tools for screening in daily routine
    Ana Raquel Souza de Azevedo Vieira, Lara Benigno Porto-Dantas, Flaviene Alves do Prado Romani, Patrícia Souza Carvalho, Rodica Pop-Busui, Hermelinda Cordeiro Pedrosa
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    Vincenza Spallone
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    Bo Kyung Koo
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Brief Report
Effect of Granulocyte Colony-Stimulating Factor on the Peripheral Nerves in Streptozotocin-Induced Diabetic Rat
Kyung Ae Lee, Kyung Taek Park, Hea Min Yu, Heung Yong Jin, Hong Sun Baek, Tae Sun Park
Diabetes Metab J. 2013;37(4):286-290.   Published online August 14, 2013
DOI: https://doi.org/10.4093/dmj.2013.37.4.286
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  • 6 Crossref
AbstractAbstract PDFPubReader   

There are controversial reports about the effect of granulocyte colony-stimulating factor (G-CSF) in peripheral nerve protection. Therefore, the present study aimed to investigate the effect of G-CSF on peripheral nerves in streptozotocin (STZ) induced diabetic rats. After STZ or vehicle injection, rats were divided into five groups (n=6) as follows: normal+vehicle, normal+G-CSF (50 µg/kg for 5 days), diabetes mellitus (DM)+vehicle, DM+G-CSF (50 µg/kg for 5 days), and DM+G-CSF extension (50 µg/kg for 5 days and followed by two injections per week up to 24 weeks). Our results showed that the current perception threshold was not significantly different among experimental groups. G-CSF treatment inhibited the loss of cutaneous nerves and gastric mucosal small nerve fibers in morphometric comparison, but statistical significance was not observed. The present results demonstrated that G-CSF has no harmful but minimal beneficial effects with respect to peripheral nerve preservation in diabetic rats.

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    Fredrik H.G. Ahlström, Hanna Viisanen, Leena Karhinen, Vidya Velagapudi, Kim J. Blomqvist, Tuomas O. Lilius, Pekka V. Rauhala, Eija A. Kalso
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Original Article
The Correlation and Accuracy of Glucose Levels between Interstitial Fluid and Venous Plasma by Continuous Glucose Monitoring System
Young Ha Baek, Heung Yong Jin, Kyung Ae Lee, Seon Mee Kang, Woong Ji Kim, Min Gul Kim, Ji Hyun Park, Soo Wan Chae, Hong Sun Baek, Tae Sun Park
Korean Diabetes J. 2010;34(6):350-358.   Published online December 31, 2010
DOI: https://doi.org/10.4093/kdj.2010.34.6.350
  • 5,879 View
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  • 14 Crossref
AbstractAbstract PDFPubReader   
Background

Clinical experience with the continuous glucose monitoring systems (CGMS) is limited in Korea. The objective of this study is to evaluate the accuracy of the CGMS and the correlation between interstitial fluid and venous plasma glucose level in Korean healthy male subjects.

Methods

Thirty-two subjects were served with glucose solution contained same amount of test food's carbohydrate and test foods after separate overnight fasts. CGMS was performed over 3 days during hopitalization for each subjects. Venous plasma glucose measurements were carried out during 4 hours (0, 0.25, 0.5, 0.75, 1, 2, 4 hours) just before and after glucose solution and test food load. The performance of the CGMS was evaluated by comparing its readings to those obtained at the same time by the hexokinase method using the auto biochemistry machine (Hitachi 7600-110). Also, correlations between glucose recorded with CGMS and venous plasma glucose value were examined.

Results

CGMS slightly underestimated the glucose value as compared with the venous plasma glucose level (16.3 ± 22.2 mg/dL). Correlation between CGMS and venous plasma glucose values throughout sensor lifetime is 0.73 (regression analysis: slope = 1.08, intercept = 8.38 mg/dL). Sensor sensitivity can deteriorate over time, with correlations between venous blood glucose and CGMS values dropping from 0.77 during 1st day to 0.65 during 2nd and 3rd day.

Conclusion

The accuracy of data provided by CGMS may be less than expected. CGMS sensor sensitivity is decreased with the passage of time. But, from this study, CGMS can be used for glucose variability tendency monitoring conveniently to the Korean.

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