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Original Article
Safety and Efficacy of Modern Insulin Analogues
Hye Jin Yoo, Keun Yong Park, Kang Seo Park, Kyu Jeung Ahn, Kyung Wan Min, Jeong Hyun Park, Sang Ah Chang, Bong Soo Cha, Dong-Jun Kim, Yong Seong Kim, Tae Keun Oh, Suk Chon, Il Seong Nam-Goong, Mi Jin Kim, Hye-Soon Kim, Young Sik Choi, You Hern Ahn, Sora Lee, Sei Hyun Baik
Diabetes Metab J. 2013;37(3):181-189.   Published online June 14, 2013
DOI: https://doi.org/10.4093/dmj.2013.37.3.181
  • 4,272 View
  • 32 Download
  • 9 Crossref
AbstractAbstract PDFPubReader   
Background

A1chieve® was a noninterventional study evaluating the clinical safety and efficacy of biphasic insulin aspart 30, insulin detemir, and insulin aspart.

Methods

Korean type 2 diabetes patients who have not been treated with the study insulin or have started it within 4 weeks before enrollment were eligible for the study. The patient selection and the choice of regimen were at the discretion of the physician. The safety and efficacy information was collected from the subjects at baseline, week 12, and week 24. The number of serious adverse drug reactions (SADRs) was the primary endpoint. The changes of clinical diabetic markers at week 12 and/or at week 24 compared to baseline were the secondary endpoints.

Results

Out of 4,058 exposed patients, 3,003 completed the study. During the study period, three SADRs were reported in three patients (0.1%). No major hypoglycemic episodes were observed and the rate of minor hypoglycemic episodes marginally decreased during 24 weeks (from 2.77 to 2.42 events per patient-year). The overall quality of life score improved (from 66.7±15.9 to 72.5±13.5) while the mean body weight was slightly increased (0.6±3.0 kg). The 24-week reductions in glycated hemoglobin, fasting plasma glucose and postprandial plasma glucose were 1.6%±2.2%, 2.5±4.7 mmol/L, and 4.0±6.4 mmol/L, respectively.

Conclusion

The studied regimens showed improvements in glycemic control with low incidence of SADRs, including no incidence of major hypoglycemic episodes in Korean patients with type 2 diabetes.

Citations

Citations to this article as recorded by  
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    Byung-Wan Lee, Jin Hwa Kim, Seung-Hyun Ko, Kyu Yeon Hur, Nan-Hee Kim, Sang Youl Rhee, Hyun Jin Kim, Min Kyong Moon, Seok-O Park, Kyung Mook Choi
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  • Insulin Therapy for Adult Patients with Type 2 Diabetes Mellitus: A Position Statement of the Korean Diabetes Association, 2017
    Byung-Wan Lee, Jin Hwa Kim, Seung-Hyun Ko, Kyu-Yeon Hur, Nan-Hee Kim, Sang Youl Rhee, Hyun Jin Kim, Min Kyong Moon, Seok-O Park, Kyung Mook Choi
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    Gyuri Kim, Ji Cheol Bae, Byoung Kee Yi, Kyu Yeon Hur, Dong Kyung Chang, Moon-Kyu Lee, Jae Hyeon Kim, Sang-Man Jin
    BMC Medical Informatics and Decision Making.2017;[Epub]     CrossRef
  • Characteristics Predictive for a Successful Switch from Insulin Analogue Therapy to Oral Hypoglycemic Agents in Patients with Type 2 Diabetes
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    The Korean Journal of Internal Medicine.2015; 30(1): 6.     CrossRef
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  • The optimal morning:evening ratio in total dose of twice‐daily biphasic insulin analogue in poorly controlled Type 2 diabetes: a 24‐week multi‐centre prospective, randomized controlled, open‐labelled clinical study
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    Diabetic Medicine.2014; 31(1): 68.     CrossRef
  • The glycemic efficacies of insulin analogue regimens according to baseline glycemic status in Korean patients with type 2 diabetes: sub‐analysis from the A 1 chieve ® study
    Y.‐C. Hwang, J. G. Kang, K. J. Ahn, B. S. Cha, S.‐H. Ihm, S. Lee, M. Kim, B.‐W. Lee
    International Journal of Clinical Practice.2014; 68(11): 1338.     CrossRef
  • Letter: Efficacy and Safety of Biphasic Insulin Aspart 30/70 in Type 2 Diabetes Suboptimally Controlled on Oral Antidiabetic Therapy in Korea: A Multicenter, Open-Label, Single-Arm Study (Diabetes Metab J2013;37:117-24)
    Byung-Wan Lee
    Diabetes & Metabolism Journal.2013; 37(3): 212.     CrossRef
Review
Smoking and Type 2 Diabetes Mellitus
Sang Ah Chang
Diabetes Metab J. 2012;36(6):399-403.   Published online December 12, 2012
DOI: https://doi.org/10.4093/dmj.2012.36.6.399
  • 7,936 View
  • 174 Download
  • 128 Crossref
AbstractAbstract PDFPubReader   

Cigarette smoking is a well-known risk factor in many diseases, including various kinds of cancer and cardiovascular disease. Many studies have also reported the unfavorable effects of smoking for diabetes mellitus. Smoking increases the risk of developing diabetes, and aggravates the micro- and macro-vascular complications of diabetes mellitus. Smoking is associated with insulin resistance, inflammation and dyslipidemia, but the exact mechanisms through which smoking influences diabetes mellitus are not clear. However, smoking cessation is one of the important targets for diabetes control and the prevention diabetic complications.

Citations

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Original Article
Severe Hypoglycemia Is a Serious Complication and Becoming an Economic Burden in Diabetes
Won Chul Ha, Su Jin Oh, Ji Hyun Kim, Jung Min Lee, Sang Ah Chang, Tae Seo Sohn, Hyun Shik Son
Diabetes Metab J. 2012;36(4):280-284.   Published online August 20, 2012
DOI: https://doi.org/10.4093/dmj.2012.36.4.280
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AbstractAbstract PDFPubReader   
Background

The prevalence of hypoglycemia is increasing due to the growing incidence of diabetes and the latest strict guidelines for glycated hemoglobin (HbA1c) levels under 7%. This study examined the clinical characteristics, causal factors, and medical costs of severely hypoglycemic patients in an emergency room (ER) of Uijeongbu St. Mary's Hospital.

Methods

The study consisted of a retrospective analysis of the characteristics, risk factors, and medical costs of 320 severely hypoglycemic patients with diabetes who presented to an ER of Uijeongbu St. Mary's Hospital from January 1, 2006 to December 31, 2009.

Results

Most hypoglycemic patients (87.5%, 280/320) were over 60 years old with a mean age of 69.5±10.9 years and a mean HbA1c level of 6.95±1.46%. Mean serum glucose as noted in the ER was 37.9±34.5 mg/dL. Renal function was decreased, serum creatinine was 2.0±2.1 mg/dL and estimated glomerular filtration rate (eGFR) was 48.0±33.6 mL/min/1.73 m2. In addition, hypoglycemic patients typically were taking sulfonylureas or insulin and a variety of other medications, and had a long history of diabetes.

Conclusion

Severe hypoglycemia is frequent in older diabetic patients, subjects with low HbA1c levels, and nephropathic patients. Therefore, personalized attention is warranted, especially in long-term diabetics with multiple comorbidities who may not have been properly educated or may need re-education for hypoglycemia.

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Response
Response: The Effect of an Angiotensin Receptor Blocker on Arterial Stiffness in Type 2 Diabetes Mellitus Patients with Hypertension (Diabetes Metab J 2011;35:236-42)
Ji Hyun Kim, Su Jin Oh, Jung Min Lee, Eun Gyoung Hong, Jae Myung Yu, Kyung Ah Han, Kyung Wan Min, Hyun Shik Son, Sang Ah Chang
Diabetes Metab J. 2011;35(4):429-430.   Published online August 31, 2011
DOI: https://doi.org/10.4093/dmj.2011.35.4.429
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Original Articles
The Effect of an Angiotensin Receptor Blocker on Arterial Stiffness in Type 2 Diabetes Mellitus Patients with Hypertension
Ji Hyun Kim, Su Jin Oh, Jung Min Lee, Eun Gyoung Hong, Jae Myung Yu, Kyung Ah Han, Kyung Wan Min, Hyun Shik Son, Sang Ah Chang
Diabetes Metab J. 2011;35(3):236-242.   Published online June 30, 2011
DOI: https://doi.org/10.4093/dmj.2011.35.3.236
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  • 7 Crossref
AbstractAbstract PDFPubReader   
Background

Hypertension and type 2 diabetes mellitus are major risk factors for cardiovascular disease. This study analyzed the changes in central aortic waveforms and pulse wave velocity as well as related parameters after treatment with valsartan, an angiotensin II type 1 receptor blocker, in patients with type 2 diabetes and hypertension.

Methods

We used pulse wave analysis to measure central aortic waveform in a total of 98 subjects. In 47 of these patients, pulse wave velocity measurements were obtained before and after 12 weeks of treatment with valsartan.

Results

In the central aortic waveform analysis, the aortic pulse pressure and augmentation index were significantly decreased after valsartan treatment, as was the aortic pulse wave velocity. Factors contributing to the improvement in pulse wave velocity were the fasting blood glucose and haemoglobin A1c levels.

Conclusion

Short-term treatment with valsartan improves arterial stiffness in patients with type 2 diabetes and hypertension, and the glucose status at baseline was associated with this effect.

Citations

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  • Mechanisms underlying the blood pressure‐lowering effects of empagliflozin, losartan and their combination in people with type 2 diabetes: A secondary analysis of a randomized crossover trial
    Rosalie A. Scholtes, Charlotte M. Mosterd, Anne C. Hesp, Mark M. Smits, Hiddo J. L. Heerspink, Daniël H. van Raalte
    Diabetes, Obesity and Metabolism.2023; 25(1): 198.     CrossRef
  • Distinct effects of losartan and atenolol on vascular stiffness in Marfan syndrome
    Ami B Bhatt, J Stewart Buck, Jonah P Zuflacht, Jessica Milian, Samoneh Kadivar, Kimberlee Gauvreau, Michael N Singh, Mark A Creager
    Vascular Medicine.2015; 20(4): 317.     CrossRef
  • The impact of angiotensin receptor blockers on arterial stiffness: a meta-analysis
    Feng Peng, Hongming Pan, Bin Wang, Jinxiu Lin, Wenquan Niu
    Hypertension Research.2015; 38(9): 613.     CrossRef
  • Arterial stiffness in atherosclerotic renovascular hypertension
    Ljiljana Fodor, Vedran Premužić, Vanja Ivković, Dražen Perkov, Mario Laganović, Tajana Željković Vrkić, Živka Dika, Marijana Živko, Bojan Jelaković
    Journal of Hypertension.2014; 32(11): 2238.     CrossRef
  • Improvement of arterial wall characteristics by the low-dose fluvastatin and valsartan combination in type 1 diabetes mellitus patients
    Vedran Savić, Barbara Eržen, Miodrag Janić, Mojca Lunder, Maja Boncelj, Karin Kanc, Andrej Janež, Mišo Šabovič
    Diabetes and Vascular Disease Research.2013; 10(5): 420.     CrossRef
  • The association between regional arterial stiffness and diabetic retinopathy in type 2 diabetes
    Won Jun Kim, Cheol-Young Park, Se Eun Park, Eun Jung Rhee, Won Young Lee, Ki Won Oh, Sung Woo Park, Sun Woo Kim, SuJeong Song
    Atherosclerosis.2012; 225(1): 237.     CrossRef
  • Letter: The Effect of an Angiotensin Receptor Blocker on Arterial Stiffness in Type 2 Diabetes Mellitus Patients with Hypertension (Diabetes Metab J 2011;35:236-42)
    Chul-Hee Kim
    Diabetes & Metabolism Journal.2011; 35(4): 427.     CrossRef
Effect of Diabetes Education Program on Glycemic Control and Self Management for Patients with Type 2 Diabetes Mellitus.
Ji Hyun Kim, Sang Ah Chang
Korean Diabetes J. 2009;33(6):518-525.   Published online December 1, 2009
DOI: https://doi.org/10.4093/kdj.2009.33.6.518
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  • 23 Crossref
AbstractAbstract PDF
BACKGROUND
Diabetes mellitus is a chronic disease requiring continuous treatment and vigorous self-management. Reinforcement of effective self management and diabetes education are important factors in successful treatment. The aim of this study was to evaluate the effectiveness of the current diabetes education program on blood glucose control, self-management, and self-efficacy of patients with type 2 diabetes mellitus. METHODS: A total of 592 patients with newly diagnosed or uncontrolled type 2 diabetes mellitus were recruited to the diabetes education program from January to December 2007. We surveyed 338 patients from April to July 2008. A total of 117 patients had biochemical examinations and completed a questionnaire about knowledge, self-management and self-efficacy of diabetes treatment (no education group (n = 23), education group (n = 94)). RESULTS: The total scores from the questionnaires and the results of laboratory data showed no differences between the two groups. However, there were significant reductions in hemoglobin A1c level in the education group, as compared with the no education group (P = 0.039). Although the score for knowledge about diabetes mellitus was significantly higher in the education group (P = 0.005), greater knowledge was not reflected in the self-management or self-efficacy of the patients. CONCLUSION: The current diabetes education program had no effect on the self-management or self-efficacy of patients with diabetes, although did show some degree of association with blood glucose control and diabetes knowledge level. We conclude that a more effective diabetes education program needs to be developed and applied to daily practice for the improvement ofself-efficacy in patients with diabetes mellitus.

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    Sohyun Jin, Youngshin Song
    Journal of Korean Academy of Fundamentals of Nursing.2024; 31(1): 80.     CrossRef
  • The Association between Diabetes Education and Glucose Control in Diabetic Patients: Using the 2008 and 2013 Korea National Health and Nutrition Examination Survey
    Ga Hyun Kim, Yoonhyung Park, Hee-Sook Lim
    Clinical Nutrition Research.2020; 9(2): 81.     CrossRef
  • Educational Needs Associated with the Level of Complication and Comparative Risk Perceptions in People with Type 2 Diabetes
    Youngji Hwang, Dongsuk Lee, Yeon Sook Kim
    Osong Public Health and Research Perspectives.2020; 11(4): 170.     CrossRef
  • Factors Affecting the Self-Management of Adolescents with Type 1 Diabetes Mellitus based on the Information-Motivation-Behavioral Skills Model
    Hooyun Lee, Eun Kyoung Choi, Heejung Kim, Ho-Seon Kim, Hee-Soon Kim
    Child Health Nursing Research.2019; 25(2): 234.     CrossRef
  • Experiences of Patients With a Diabetes Self-Care App Developed Based on the Information-Motivation-Behavioral Skills Model: Before-and-After Study
    Eunjoo Jeon, Hyeoun-Ae Park
    JMIR Diabetes.2019; 4(2): e11590.     CrossRef
  • The Role of Medical Social Worker Engaging in Diabetes Management
    Ga-Young Choi
    The Journal of Korean Diabetes.2019; 20(4): 251.     CrossRef
  • Effects of an Intensive Management Program for Diabetic Patients on a Blood Biochemical Profile and Diabetes Knowledge
    Su-Jeong Yeo, Bok-Hee Kim
    Korean Journal of Community Nutrition.2018; 23(2): 148.     CrossRef
  • Needs for Development of IT-based Nutritional Management Program for Women with Gestational Diabetes Mellitus
    Chan-Jung Han, Sun-Young Lim, Eunsuk Oh, Yoon-Hee Choi, Kun-Ho Yoon, Jin-Hee Lee
    Korean Journal of Community Nutrition.2017; 22(3): 207.     CrossRef
  • Understanding and Approaching Low Motivation in Young Adults with Diabetes Mellitus
    Yu Jeong Park
    The Journal of Korean Diabetes.2017; 18(2): 121.     CrossRef
  • Physician-Directed Diabetes Education without a Medication Change and Associated Patient Outcomes
    Hun-Sung Kim, Hyunah Kim, Hae-Kyung Yang, Eun Young Lee, Yoo Jin Jeong, Tong Min Kim, So Jung Yang, Seo Yeon Baik, Seung-Hwan Lee, Jae Hyoung Cho, In Young Choi, Hyeon Woo Yim, Bong-Yun Cha
    Diabetes & Metabolism Journal.2017; 41(3): 187.     CrossRef
  • Effects of Health Literacy and Knowledge on Diabetic Self-care in the Elderly with DM Living Alone
    Nan Hui Kim, Youngran Yang, Myung Ha Lee
    Journal of Korean Academy of Community Health Nursing.2016; 27(4): 370.     CrossRef
  • The Current Strategic Direction of Diabetes Education: American Association of Diabetes Educators Yearly Strategic Plan 2016~2018
    Yu Jeong Park
    The Journal of Korean Diabetes.2016; 17(3): 196.     CrossRef
  • Research Review: Effective of Self-Management Education in Diabetes Patients
    Eun Chong Shin
    The Journal of Korean Diabetes.2016; 17(3): 185.     CrossRef
  • Self-Care and Related Factors in Young and Middle Adulthood Patients with Type 2 Diabetes
    Kyung Mee Jung, Sook Ja Lee, Eun Sook Park, Young Joo Park, Sin Gon Kim, Dong Seop Choi
    The Journal of Korean Diabetes.2015; 16(1): 65.     CrossRef
  • Psychometric Properties of the Diabetes Management Self-Efficacy Scale in Korean Patients with Type 2 Diabetes
    Eun-Hyun Lee, Jaap van der Bijl, Lillie M. Shortridge-Baggett, Seung Jin Han, Seung Hei Moon
    International Journal of Endocrinology.2015; 2015: 1.     CrossRef
  • Diabetes Education Compliance and Knowledge among Diabetes Patients: Analysis of Patients Who Refuse Diabetes Education at an Academic Medical Center
    Kang Hee Sim, Bo Ram Wang, Jin-Won Noh, Moon Kyu Lee, Young Dae Kwon
    The Journal of Korean Diabetes.2014; 15(1): 51.     CrossRef
  • Effects of Individual and Group Education Programs on Coping and Self-care Behaviors in Cancer Patients
    Young Mi Kim, Won Ock Kim, Sang Sook Han
    Journal of East-West Nursing Research.2014; 20(1): 1.     CrossRef
  • Role of Diabetes Educators and Effectiveness of Diabetes Education
    HeeSook Kim
    The Journal of Korean Diabetes.2013; 14(4): 194.     CrossRef
  • Development of a Comprehensive Self-Management Program Promoting Self Efficacy for Type 2 Diabetic Patients
    Ju-Young Park, Il-Sun Ko
    Journal of Korean Academy of Fundamentals of Nursing.2012; 19(1): 74.     CrossRef
  • Effect on Glycemic, Blood Pressure, and Lipid Control according to Education Types
    Mi-Ju Choi, Seung-Hyun Yoo, Kum-Rae Kim, Yoo-Mi Bae, Sun-Hee Ahn, Seong-Shin Kim, Seong-Ah Min, Jin-Sun Choi, Seung-Eun Lee, Yeo-Jin Moon, Eun Jung Rhee, Cheol-Young Park, Won Young Lee, Ki Won Oh, Sung Woo Park, Sun Woo Kim
    Diabetes & Metabolism Journal.2011; 35(6): 580.     CrossRef
  • Effects of Nutrition Education in Type 2 Diabetes Mellitus on Diabetes Control and Blood Antioxidant Status
    Kyung-Nam Shin, Hye-Sang Lee, Chong-Suk Kwon
    Journal of the Korean Society of Food Science and Nutrition.2011; 40(5): 689.     CrossRef
  • Study on Survey of Knowledge and Awareness Level of Diabetic Retinopathy in Type 2 Diabetes Patients: Results from Seoul Metro-City Diabetes Prevention Program Survey
    Dae Woong Lee, Chul Young Park, Su Jeong Song
    Journal of the Korean Ophthalmological Society.2011; 52(11): 1296.     CrossRef
  • A Study on the Performance and Utilization of Results of Self-monitoring of Blood Glucose in Type Ⅱ Diabetes
    Jung-Mi Ha, Dong-Hee Kim
    The Journal of Korean Academic Society of Nursing Education.2010; 16(2): 330.     CrossRef
Association of Spot Urine Albumin-to-Creatinine Ratio and 24 Hour-Collected Urine Albumin Excretion Rate in Patients with Type 2 Diabetes Mellitus.
Jee In Lee, Hyuk Sang Kwon, Su Jin Oh, Jung Min Lee, Sang Ah Chang, Bong Yun Cha, Hyun Shik Son, Tae Seo Sohn
Korean Diabetes J. 2009;33(4):299-305.   Published online August 1, 2009
DOI: https://doi.org/10.4093/kdj.2009.33.4.299
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AbstractAbstract PDF
BACKGROUND
Measuring urine albumin in diabetic patients is an important screening test to identify those individuals at high risk for cardiovascular disease and the progression of kidney disease. Recently, spot urine albumin-to-creatinine ratio (ACR) has replaced 24 hour-collected urine albumin excretion rate (AER) as a screening test for microalbuminuria given its comparative simplicity. The purpose of the current study was to evaluate the degree of correlation between AER and ACR in the normal, microalbuminuric and macroalbuminuric ranges, and to identify the lower limits of ACR for both genders. METHODS: A total of 310 type 2 diabetics admitted to one center were enrolled in the present study. Following the collection of a spot urine sample, urine was collected for 24 hours and albumin content was measured in both specimens. RESULTS: Mean patient age was 60.2 years. A total of 25.4% had microalbuminuria and 15.8% had macroalbuminuria. The data revealed a strongly positive correlation between AER and ACR across all ranges of albuminuria (R = 0.8). The cut-off value of ACR for 30 mg/day of AER by the regression equation was 24 microgram/mg for men, 42 microgram/mg for women and 31.2 microgram/mg for all patients. The diagnostic performance expressed as the area under the curve (AUC) was 0.938 (95% CI, 0.911-0.965) for ACR. ACR revealed a sensitivity of 84% and specificity of 84%, when a cut-off value of 31.2 microgram/mg was employed. CONCLUSION: ACR was highly correlated with AER, particularly in the range of microalbuminuria. The gender combined cut-off value of ACR in type 2 diabetic patients was determined to be 31.2 microg/mg However, additional studies of large outpatient populations, as opposed to the inpatient population used in the present study, are required to confirm the utility of this value.
The Changes of Central Aortic Pulse Wave Analysis in Metabolic Syndrome.
Jee In Lee, Tae Seo Sohn, Hyuk Sang Kwon, Jung Min Lee, Sang Ah Chang, Bong Yun Cha, Hyun Shik Son
Korean Diabetes J. 2008;32(6):522-528.   Published online December 1, 2008
DOI: https://doi.org/10.4093/kdj.2008.32.6.522
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AbstractAbstract PDF
The metabolic syndrome (MS) has been characterized as a cluster of risk factors that includes dyslipidemia, hypertension, glucose intolerance and central obesity. This syndrome increases the risk of cardiovascular disease. Augmentation index (AIx), a composite of wave reflection form medium-sized muscular arteries is related to the development of coronary artery disease. The aim of this study is to examine the change on central aortic waveforms in subjects between patients with metabolic syndrome and normal subjects. Using the non-invasive technique of pulse wave analysis by applantation tonometry, we investigated central aortic waveforms in 45 patients with MS and 45 matched controls. The MS was defined by NCEP-ATP III criteria. Age did not differ between the two groups. AIx was significantly elevated in patinets with MS compared with controls (21.91 +/- 11.41% vs 18.14 +/- 11.07%; P < 0.01). Subendocardial viability ratio (SEVR) (158.09 +/- 28.69 vs 167.09 +/- 30.06; P < 0.01) was significantly decreased in patients with MS compared with controls. Only the fasting glucose (r = 0.317, P = 0.03) among the components of MS and age (r = 0.424, P = 0.004) had a positive correlation with AIx. AIx increased as the number of MS components increased. These results show that the MS increased systemic arterial stiffness. Age and fasting blood glucose are independent risk factors of arterial stiffness in MS. The individual MS components, except for fasting blood glucose, do not affect arterial stiffness independently. But the clustering of MS components might interact to synergistically affect arterial stiffness.

Citations

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  • Arterial Stiffness by Aerobic Exercise Is Related with Aerobic Capacity, Physical Activity Energy Expenditure and Total Fat but not with Insulin Sensitivity in Obese Female Patients with Type 2 Diabetes
    Ji Yeon Jung, Kyung Wan Min, Hee Jung Ahn, Hwi Ryun Kwon, Jae Hyuk Lee, Kang Seo Park, Kyung Ah Han
    Diabetes & Metabolism Journal.2014; 38(6): 439.     CrossRef
  • The Changes of the body composition and vascular flexibility According to Pilates mat Exercise during 12 weeks in elderly women
    Ji-Eun Jang, Yong-Kwon Yoo, Byung-Hoon Lee
    The Journal of the Korea institute of electronic communication sciences.2013; 8(11): 1777.     CrossRef
  • Traditional East Asian Medical Pulse Diagnosis: A Preliminary Physiologic Investigation
    Kylie A. O'Brien, Stephen Birch, Estelle Abbas, Paul Movsessian, Michael Hook, Paul A. Komesaroff
    The Journal of Alternative and Complementary Medicine.2013; 19(10): 793.     CrossRef
Clinical Characteristics and Outcomes of Diabetic Ketoacidosis at a Single Institution.
Jee In Lee, Tae Seo Sohn, Sang Ah Chang, Jung Min Lee, Bong Yun Cha, Ho Young Son, Hyun Shik Son
Korean Diabetes J. 2008;32(2):165-170.   Published online April 1, 2008
DOI: https://doi.org/10.4093/kdj.2008.32.2.165
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AbstractAbstract PDF
AIMS: The aim of this study was to describe the clinical characteristics and outcomes of diabetic ketoacidosis (DKA) in Hospital for past 6 years. METHODS: We reviewed the retrospective medical records of all patients admitted with a diagnosis of DKA from 2000 to 2005 in Uijeongbu St. Mary's Hospital. Clinical characteristics including precipitating factors and hospital mortality were analyzed. RESULTS: Seventy-eight patients (78 episodes) fulfilled criteria for inclusion in this study. Their mean age was 41.89 years. 66 episodes had a prior history of diabetes but DKA was the initial presentation in 12 episodes. 24.4% were on no treatment, 14.1% were using oral hypoglycemic agents and 53.8% were on insulin. Poor glycemic control were the most common precipitating factor (56.4%). There were 3 deaths. CONCLUSION: Our report is similar with past reports of DKA in Korea. but it is different that poor glycemic control is most common precipitating factor and mortality rate are lower than past reports. This observation suggests that many cases of DKA can be prevented by better access to medical care, proper education, and effective communication with a health care provider.

Citations

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  • Clinical and Laboratory Characteristics of Pediatric Diabetic Ketoacidosis: A Single-Center Study
    Iee Ho Choi, Min Sun Kim, Pyoung Han Hwang, Dae-Yeol Lee
    The Journal of Korean Diabetes.2017; 18(3): 193.     CrossRef
  • Clinical and Biochemical Characteristics of Elderly Patients With Hyperglycemic Emergency State at a Single Institution
    Yun Jae Shin, Dae In Kim, Dong Won Lee, Beung Kwan Jeon, Jung Geun Ji, Jung Ah Lim, Young Jung Cho, Hong Woo Nam
    Annals of Geriatric Medicine and Research.2016; 20(4): 185.     CrossRef
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    Hae-Won Jung, Ile-Kyu Park
    Laboratory Medicine Online.2012; 2(1): 15.     CrossRef
  • A Case of Severe Diabetic Ketoacidosis in a Child with Type 2 Diabetes
    Jaesung Yu, Hyunju Jin, Joontae Ko, Hoseok Kang
    Journal of Korean Society of Pediatric Endocrinology.2011; 16(1): 46.     CrossRef
  • Clinical Characteristics of Patients with Hyperglycemic Emergency State Accompanying Rhabdomyolysis
    Soo Kyoung Kim, Jong Ha Baek, Kyeong Ju Lee, Jong Ryeal Hahm, Jung Hwa Jung, Hee Jin Kim, Ho-Su Kim, Sungsu Kim, Soon Il Chung, Tae Sik Jung
    Endocrinology and Metabolism.2011; 26(4): 317.     CrossRef
The Differences of Circulating Adiponectin Levels and Multimerization According to Obesity in Type 2 Diabetes Mellitus of Men.
Sang Ah Chang, Ho Young Son, Jung Min Lee, Tae Seo Sohn, Hyuk Sang Kwon, Hyun Shik Son, Kun Ho Yoon, Hee Seung Kim, Bong Yun Cha, Kwang Woo Lee
Korean Diabetes J. 2007;31(3):243-252.   Published online May 1, 2007
DOI: https://doi.org/10.4093/jkda.2007.31.3.243
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AbstractAbstract PDF
BACKGROUND
Adiponectin is adipose tissue derived hormone, which has been shown to play an important role in the regulation of glucose and lipid metabolism. Low adiponectin levels are associated with obesity and diabetes and coronary artery disease. In addition to adiponectin level, the adiponectin multimerization and its ratio to total adiponectin have also affect on metabolic risk factors and insulin resistance. However, the adiponectin multimerization pattern in type 2 diabetes of Korean has not been established. We investigated adiponectin levels and adiponectin multimerization pattern according to obesity in type 2 diabetes males of Korean. METHOD: The subjects of this study were 86 of diabetes patients and 89 of control subjects whose fasting blood glucose was below 110 mg/dL. They were divided into two subgroup, non-obese and obese, according to BMI (non-obese 25 < BMI). Anthropometric parameter and other metabolic risk factors were measured. Insulin resistance was presented by HOMA-IR. Plasma adiponectin level was measured by radioimmunoassay method. Adiponectin multimerization was fractionated by SDS-PAGE under non-reducing and non-heat denaturing state and performed immunoblotting. RESULT: Serum adiponectin levels were significantly reduced in obese than non obese group in diabetes patients (7.73 +/- 5.2 versus 12.56 +/- 8 microgram/mL, P = 0.003). Correlational analyses demonstrated that BMI, body weight, waist circumference, diastolic pressure, glucose and height correlated significantly with adiponectin levels in the diabetes patients. The HOMA-IR did not affect the plasma adiponectin levels in diabetic patients. There were no differences in adiponectin multimerization distribution and ratio between obese and non-obese group in the diabetes, however middle molecular weight multimers (MMW, ~110~160 Kda, hexamer) ratio in the control subjects were significantly reduced in obese group than non-obese group (49 +/- 9 versus 56 +/- 11%, P < 0.05). CONCLUSION: The adipoenctin levels were lower in obese than non-obese group of diabetes males in Korea. Aiponectin levels correlated with BMI and weight but not insulin resistance. The differences of adiponectin multimerization distribution and ratio between obese and non-obese group in diabetes were not detected.
The Appropriate Distance and Duration of Walking for Exercise in Patients with Type 2 Diabetes Mellitus.
Tae Seo Sohn, Jung Min Lee, Sang Ah Chang, Kyung Ah Han, Hyun Shik Son, Hyo Jeong Kim, Chul Woo Ahn, Yeon Ah Sung, Kyung Wan Min, Sei Hyun Baik, Jae Myeong Yu, Sung Woo Park
Korean Diabetes J. 2007;31(2):157-162.   Published online March 1, 2007
DOI: https://doi.org/10.4093/jkda.2007.31.2.157
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  • 4 Crossref
AbstractAbstract PDF
BACKGROUND
For decades, exercise has been considered a cornerstone of diabetes managements, along with diet and medication. Many studies have shown that regular physical activity improves quality of life, reduces the risk of mortality from all causes, and is particularly advantageous in subjects with impaired glucose tolerance or type 2 diabetes mellitus. However, high-quality evidence and basic data on the importance of exercise and physical fitness in Korean diabetic patients were lacking until recent years. METHOD: This study included 240 diabetic patients (122 men, 118 women) recruited from 6 diabetic centers in Korea. To measure step length and walking velocity at normal walking speed, we made the patient walk 12 meter at normal speed. The patients wore the pedometer for 7 days and we got the equation between the walking steps per day and calorie expenditure for 7 days. From the equation, we calculated appropriate steps, distance and duration of walking in type 2 diabetic patients as exercise program RESULTS: In men, the walking velocity was 4.4 +/- 0.6 km/h and step length was 67.6 +/- 7.3 cm at normal walking speed. In women, the walking velocity was 4.0 +/- 0.6 km/h and step length was 58.4 +/- 5.5 cm at normal walking speed. The equation between kcal per week and steps per day was that kcal/week = (steps/day) x 0.268 + 64.074 (R2 = 0.854, P < 0.01) in men and kcal/week in women = (steps/day) x 0.256 - 39.005 (R2 = 0.890, P < 0.01). The steps/day, walking distance and walking duration which correspond to 700 kcal/week was 2,373 steps/day, 21.9 minutes and 1,604 meter in men, and 2,887 steps/day, 25.3 minutes and 1,690 meter in women at normal walking speed. CONCLUSION: To exert at least 700 kcal/week with exercise, it is recommended that type 2 diabetic patients walk at least 25 minutes/day or 1,700 meter/day or 2,500 steps/day in men and 30 minutes/day or 1,800 meter/day or 3,000 steps/day in women at normal walking speed.

Citations

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  • Effects of Tai Chi Exercise on Glucose Control, Neuropathy Scores, Balance, and Quality of Life in Patients with Type 2 Diabetes and Neuropathy
    Sukhee Ahn, Rhayun Song
    The Journal of Alternative and Complementary Medicine.2012; 18(12): 1172.     CrossRef
  • Small Rice Bowl-Based Meal Plan for Energy and Marcronutrient Intake in Korean Men with Type 2 Diabetes: A Pilot Study
    Hee Jung Ahn, Kyung Ah Han, Jin Young Jang, Jae Hyuk Lee, Kang Seo Park, Kyung Wan Min
    Diabetes & Metabolism Journal.2011; 35(3): 273.     CrossRef
  • Group Classification on Management Behavior of Diabetic Mellitus
    Sung-Hong Kang, Soon-Ho Choi
    Journal of the Korea Academia-Industrial cooperation Society.2011; 12(2): 765.     CrossRef
  • Bowl-Based Meal Plan versus Food Exchange-Based Meal Plan for Dietary Intake Control in Korean Type 2 Diabetic Patients
    Hee-Jung Ahn, Boo-Kyung Koo, Ji-Yeon Jung, Hwi-Ryun Kwon, Hyun-Jin Kim, Kang-Seo Park, Kyung-Ah Han, Kyung-Wan Min
    Korean Diabetes Journal.2009; 33(2): 155.     CrossRef
Pedometer-Determined Physical Activity in Type 2 Diabetes in Korea.
Sang Ah Chang, Jung Min Lee, Tae Seo Sohn, Hyun Shik Son, Sung Woo Park, Sei Hyun Baik, Jae Myung Yu, Yeon Ah Sung, Chul Woo Ahn, Kyung Wan Min, Kyung Ah Han
Korean Diabetes J. 2007;31(1):83-88.   Published online January 1, 2007
DOI: https://doi.org/10.4093/jkda.2007.31.1.83
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AbstractAbstract PDF
BACKGROUND
Walking is a popular, convenient and relatively safe form of exercise. However, there is few objective data for walking exercise. The aim of this study was to evaluate pedometer-determined physical activity defined as steps/day in type 2 diabetes mellitus. Therefore, it could be the basic data for programming walking exercise in diabetes mellitus. METHODS: Participants with type 2 diabetes who visited in 6 university hospitals on February, 2006 in Seoul and Kyung-gi area were recruited. The participants were asked their ambulatory activity with the given pedometer and calorimeter for 1 week. Total 240 (Male 122, Female 118) subjects who walked above 1000 steps/day were analyzed. We also collected their biochemical data from the medical records. RESULTS: Participants took 8532 +/- 4130 steps for day (step/day) and energy expenditure were 320 +/- 161 Cal/day. Steps/day was not significantly different between male and female, but energy expenditure was higher in male than female ( P < 0.05). Steps/day was significantly lower in obese patients than non-obese patients (P < 0.001). BMI (r = -0.325, P < 0.001), waist circumference (r = -0.287, P < 0.001), triglyceride (r = 0.164, P < 0.018) showed significant inverse correlation with steps/day, but BUN (r = 0.165, P = 0.019) and HDL-cholesterol (r = 0.164, P = 0.018) were positive correlated with steps/day significantly. BMI (r = -0.14, P < 0.032) and cholesterol (r = -0.139, P < 0.041) showed significantly inverse correlation with energy expenditure and BUN (r = 0.187, P = 0.008) and HDL cholesterol (r = 0.145, P < 0.037) positively correlated with energy expenditure. Pedometer-determined steps/day was positively associated with energy expenditure (r2 = 0.824, P < 0.001). CONCLUSION: This study showed the objective quantification of physical activity measured by simple and inexpensive pedometers. It could be used to recommend walking exercise since the practitioners can estimate steps/day for required energy expenditure.
The long-term effect of ramipril on Gialpha2-protein and Protein Tyrosine Phosphatase 1B in an animal model of type 2 diabetes(OLETF rat).
Jung Min Lee, Ok Ki Hong, Hyuk Sang Kwon, Sung Dae Moon, Sang Ah Chang, Hyun Shik Son, Kun Ho Yoon, Bong Yun Cha, Sung Koo Kang
Korean Diabetes J. 2006;30(1):25-38.   Published online January 1, 2006
DOI: https://doi.org/10.4093/jkda.2006.30.1.25
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BACKGROUND
The regulation of tyrosine phosphorylation/dephosphorylation is an important mechanism in various intracellular metabolism. Also impaired insulin signal transduction is important in pathogenesis of type 2 diabetes. It has been reported that PTP1B is a negative regulator of insulin action, and Gialpha2-protein is related to the regulation of PTP1B. Herein we investigated the long-term effects of ramipril on PTP1B/insulin signal protein interaction and the relation between Gialpha2 and PTP1B in animal model of type 2 diabetes (OLETF rat). METHODS: OLETF rats and age-matched LETO rats were divided into two groups. One group of rats received ramipril (10 mg/kg body weight) for 12 weeks, and another group did not. Finally, each group was divided into 2 subgroups, with or without insulin injection intravenously, before sacrifice. After sacrifice, tissues extracts of liver, hind limb muscle, and epididymal fat were obtained for quantification of PTP1B, Gialpha2, and several insulin signal proteins by western blotting. RESULTS: In liver and muscle, the levels of basal PTP1B and activated PTP1B of OLETF rats treated with ramipril and insulin were significantly decreased. The levels of Gialpha2, activated IRS-2, and activated p-85alpha were significantly increased in OLETF rats treated with ramipril and insulin. In adipose tissue, the levels of Gialpha2 and activated p-85alpha of OLETF rats treated with ramipril and insulin were slightly increased as in liver and muscle. But, the levels of basal PTP1B and activated PTP1B were significantly increased. And, the levels of activated IRS-1 and activated IRS-2 were decreased. CONCLUSION: These results suggest that the improvement of insulin sensitivity by treatment with ramipril was related to the decreased level of activated PTP1B. Also, we could suggest that the changes of activated PTP1B level was related with the changes of Gialpha2-protein. However, the results of adipose tissue were different from those of liver and muscle. So it seemed likely that there would be various major modulators for regulation of insulin signal pathway according to tissue.
Effect of 12-week Oral Treatment with alpha-lipoic acid on the Nerve Conduction in Symptomatic Diabetic Neuropathy.
Tae Seo Sohn, Jung Min Lee, Sang Ah Chang, Hyun Shik Son, Bong Youn Cha, Ho Young Son, Kwang Woo Lee, Sung Ku Kang
Korean Diabetes J. 2005;29(6):533-539.   Published online November 1, 2005
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BACKGROUND
Diabetic peripheral neuropathy is multifactorial disorder arising from hyperglycemia and insulin deficiency. It has been suggested that oxidative stress resulting from enhanced free-radical formation and defects in antioxidant defence plays a major role among the putative pathogenic mechanisms of diabetic neuropathy. As alpha-lipoic acid, a natural antioxidant, has been suggested to improve symptoms of diabetic neuropathy, we assessed the efficacy of alpha-lipoic acid on neuropathic symptoms and peripheral nerve conduction in patients with type 2 diabetes mellitus with symptomatic polyneuropathy. METHODS: A cohort of 30 type 2 diabetic patients with symptomatic polyneuropathy received a daily dose of 600 mg alpha-lipoic acid, and was followed for 3 months. Neuropathic symptoms (pain, burning, paraesthesiae, and numbness) of the feet were scored at monthly interval and summarized as a Total Symptom Score (TSS). Nerve conduction study was done before and after 3 month treatment of alpha-lipoic acid. RESULTS: Treatment of alpha-lipoic acid given 600 mg per oral for 12 weeks improved the symptoms of diabetic polyneuropathy. Effects of alpha-lipoic acid on nerve conduction study were that in the motor nerve, the amplitudes of median nerve and tibial nerve and the conduction velocity of tibial nerve improved after 12 weeks treatment. In the sensory nerve, the conduction velocities of median nerve, ulnar nerve, and sural nerve improved after 12 weeks. CONCLUSION: alpha-Lipoic acid was effective in the treatment of diabetic peripheral polyneuropathy improving both clinical manifestations and nerve conduction. The improvement of clinical manifestations may be due to improved conduction velocity of sensory fibers.
The Relation of Serum Adipokines with Metabolic Risk Factors in Type 2 Diabetic Subjects.
Tae Seo Sohn, Jung Min Lee, Sang Ah Chang, Hyun Shik Son, Young Mi Ku, Bong Yun Cha, Kwang Woo Lee, Ho Young Son, Sung Ku Kang
Korean Diabetes J. 2004;28(6):521-529.   Published online December 1, 2004
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BACKGROUND
Accumulation of fat, especially in the visceral space, has been claimed to have a causative role in the development of macroangiopathies, because of the secretion of adipokine from the fat tissue. Indeed, the adipocyte secretes chemical messengers (e.g., adipokines) that include leptin, TNF-alpha , IL-6, adiponectin, and resistin. Since adipokines have biologic activities within the vascular system, they might be involved in the development of diabetic angiopathies. The aim of this study is to investigate the relation of adipokine with adiposity, metabolic risk factors, diabetic micro-, and macroangiopathies in type 2 diabetic patients. METHODS: The subjects of this study were 57 type 2 diabetic patients. Anthropometric parameters (height, body weight, waist circumference and body fat composition), cardiovascular risk factors (BP, Lp (a), lipid profile, hs-CRP, fibrinogen), status of glucose metabolism (HbA1c, fasting glucose), diabetic microvascular complication, intima-media thickness (IMT) at both common carotid artery and adipokine (leptin, adiponectin, resistin) were measured. RESULTS: The correlation between the serum adipokine level and duration of diabetes was statistically significant (P <0.01). The leptin was correlated with body mass index (r=0.446, P <0.01), waist circumference (r=0.553, P <0.01) and body fat content (r=0.573, P <0.01). The adiponectin was negatively correlated with plasmatotal cholesterol (r=-0.366, P <0.01) and triglyceride (r=-0.276, P <0.05). The resistin was correlated with Lp (a) (r=0.386, P <0.01), hs-CRP (r=0.413, P <0.01), fibrinogen (r=0.562, P <0.01) and 24hr microalbuminuria (r=0.353, P <0.05). The adiponectin was increased in patients with microalbuminuria than with normo- and macroalbuminuria (P <0.05). The resistin was increased in patients with micro- or macroalbuminuria than normoalbuminuria (P <0.05). The adiponectin was increased in patients with retinopathy (P <0.05). The serum adipokine level was not correlated with IMT of common carotid artery. CONCLUSION: This study reveals that serum adipokine was related with metabolic risk factor in type 2 diabetic patients. Among adipokines, adiponectin and resistin might be involved in diabetic angiopathy. The underlying mechanisms remained to be elucidated in the role of adipokine to the development of diabetic angiopathy.

Diabetes Metab J : Diabetes & Metabolism Journal
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