Diabetes & Metabolism Journal

Original Articles

Clinical Diabetes and Therapeutics
Cardio-Ankle Vascular Index as a Surrogate Marker of Early Atherosclerotic Cardiovascular Disease in Koreans with Type 2 Diabetes Mellitus: So Young Park, Sang Ook Chin, Sang Youl Rhee, Seungjoon Oh, Jeong-Taek Woo, Sung Woon Kim, Suk Chon; Diabetes Metab J. 2018;42(4):285-295. Published online July 27, 2018; DOI: https://doi.org/10.4093/dmj.2017.0080

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Background

Carotid artery intima medial thickness (IMT), brachial-ankle pulse wave velocity (baPWV), and ankle-brachial index (ABI) are commonly used surrogate markers of subclinical atherosclerosis in patients with type 2 diabetes mellitus (T2DM). The cardio-ankle vascular index (CAVI) is a complement to the baPWV, which is affected by blood pressure. However, it is unclear which marker is the most sensitive predictor of atherosclerotic cardiovascular disease (ASCVD).

Methods

This was a retrospective non-interventional study that enrolled 219 patients with T2DM. The correlations among IMT, ABI, and CAVI as well as the relationship of these tests to the 10-year ASCVD risk were also analyzed.

Results

Among the 219 patients, 39 (17.8%) had ASCVD. In the non-ASCVD group, CAVI correlated significantly with IMT after adjusting for confounding variables, but ABI was not associated with CAVI or IMT. The analyses after dividing the non-ASCVD group into three subgroups according to the CAVI score (<8, ≥8 and <9, and ≥9) demonstrated the significant increase in the mean IMT, 10-year ASCVD risk and number of metabolic syndrome risk factors, and decrease in the mean ABI in the high-CAVI group. A high CAVI was an independent risk factor in the non-ASCVD group for both a high 10-year ASCVD risk (≥7.5%; odds ratio [OR], 2.42; P<0.001) and atherosclerosis (mean IMT ≥1 mm; OR, 1.53; P=0.007).

Conclusion

In Korean patients with T2DM without ASCVD, CAVI was the most sensitive of several surrogate markers for the detection of subclinical atherosclerosis.

Citations

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The effects of severe periodontitis on arterial stiffness using cardio‐ankle vascular index in patients with type 2 diabetes
Gizem Torumtay Cin, Semin Melahat Fenkci, Ismail Doğu Kiliç, Halil Serdar Aslan, Cihan İlyas Sevgican, Hande Şenol
Journal of Periodontal Research.2024; 59(1): 74. CrossRef
Predictive value of Systematic Coronary Risk Evaluation 2‐Diabetes risk model and arterial stiffness for cardiovascular events in the Asian population with type 2 diabetes mellitus
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Journal of Diabetes Investigation.2024; 15(9): 1266. CrossRef
Prediction of cardiovascular disease using deep learning algorithms to prevent COVID 19
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Journal of Experimental & Theoretical Artificial Intelligence.2023; 35(6): 791. CrossRef
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A framework of biomarkers for vascular aging: a consensus statement by the Aging Biomarker Consortium
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Life Medicine.2023;[Epub] CrossRef
Diastolic Pressure and ACR Are Modifiable Risk Factors of Arterial Stiffness in T2DM Without Cardiovascular Disease
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The Journal of Clinical Endocrinology & Metabolism.2022; 107(9): e3857. CrossRef
Risk assessment indicators and brachial-ankle pulse wave velocity to predict atherosclerotic cardiovascular disease
Hung-Ju Ko, Chuan-Chuan Liu, Po-Jui Hsu, Kuang-Chun Hu, Chung-Lieh Hung, Lo-Yip Yu, Yun-Chieh Huang, Shou-Chuan Shih
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Cardio-ankle vascular index represents the best surrogate for 10-year ASCVD risk estimation in patients with primary hypertension
Mustafa Tarik Agac, Süret Ağaç, Muhammed Necati Murat Aksoy, Mehmet Bülent Vatan
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The Relationship Between Glycemic Control and Concomitant Hypertension on Arterial Stiffness in Type II Diabetes

Teonchit Nuamchit, Duangduan Siriwittayawan, Piyanuch Thitiwuthikiat
Vascular Health and Risk Management.2020; Volume 16: 343. CrossRef
Relationship between cardio-ankle vascular index and obstructive coronary artery disease
Divya Birudaraju, Lavanya Cherukuri, April Kinninger, Bhanu T. Chaganti, Pishoy Haroun, Sivakrishna Pidikiti, Suvasini Lakshmanan, Sajad Hamal, Ferdinand Flores, Christopher Dailing, Kashif Shaikh, Sion K. Roy, Matthew J. Budoff
Coronary Artery Disease.2020; 31(6): 550. CrossRef
Association of Kidney Function Tests with a Cardio-Ankle Vascular Index in Community-Dwelling Individuals with a Normal or Mildly Decreased Estimated Glomerular Filtration Rate
Javad Alizargar, Chyi-Huey Bai, Nan-Chen Hsieh, Shu-Fang Vivienne Wu, Shih-Yen Weng, Jia-Ping Wu
Medicina.2019; 55(10): 657. CrossRef
Cardiovascular remodeling in patients with diabetic сardiomyopathy
A. S. Veklich, N. A. Koziolova, P. G. Karavaev
Russian Journal of Cardiology.2019; (11): 42. CrossRef
Short‑term impact of aged garlic extract on endothelial function in diabetes: A randomized, double‑blind, placebo‑controlled trial
Sajad Hamal, Lavanya Cherukuri, Divya Birudaraju, Suguru Matsumoto, April Kinninger, Bhanu Chaganti, Ferdinand Flores, Kashif Shaikh, Sion Roy, Matthew Budoff
Experimental and Therapeutic Medicine.2019;[Epub] CrossRef
Association between Breakfast Frequency and Atherosclerotic Cardiovascular Disease Risk: A Cross-Sectional Study of KNHANES Data, 2014–2016
Hyeon Ji Lee, Jieun Jang, Sang Ah Lee, Dong-Woo Choi, Eun-Cheol Park
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Response: Cardio-Ankle Vascular Index as a Surrogate Marker of Early Atherosclerotic Cardiovascular Disease in Koreans with Type 2 Diabetes Mellitus (Diabetes Metab J 2018;42:285-95)
So Young Park, Suk Chon
Diabetes & Metabolism Journal.2018; 42(5): 449. CrossRef
Letter: Cardio-Ankle Vascular Index as a Surrogate Marker of Early Atherosclerotic Cardiovascular Disease in Koreans with Type 2 Diabetes Mellitus (Diabetes Metab J 2018;42:285-95)
Dongwon Yi
Diabetes & Metabolism Journal.2018; 42(5): 447. CrossRef

Others
Effects of Rebamipide on Gastrointestinal Symptoms in Patients with Type 2 Diabetes Mellitus: Sejeong Park, So Young Park, Yu Jin Kim, Soo Min Hong, Suk Chon, Seungjoon Oh, Jeong-taek Woo, Sung-Woon Kim, Young Seol Kim, Sang Youl Rhee; Diabetes Metab J. 2016;40(3):240-247. Published online April 5, 2016; DOI: https://doi.org/10.4093/dmj.2016.40.3.240

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Abstract PDF Supplementary Material PubReader

Background

Gastrointestinal (GI) symptoms are common in patients with type 2 diabetes mellitus (T2DM). Rebamipide is an effective gastric cytoprotective agent, but there are few data on its usefulness in T2DM. The aim of this study is to evaluate the improvement of GI symptoms after rebamipide treatment in patients with T2DM.

Methods

Patients with T2DM and atypical GI symptoms were enrolled. They took rebamipide (100 mg thrice daily) for 12 weeks and filled out the diabetes bowel symptom questionnaire (DBSQ) before and after rebamipide treatment. The DBSQ consisted of 10 questions assessing the severity of GI symptoms by a 1 to 6 scoring system. Changes in the DBSQ scores before and after rebamipide treatment were analyzed to evaluate any improvements of GI symptoms.

Results

A total of 107 patients were enrolled, and 84 patients completed the study. The mean age was 65.0±7.8, 26 patients were male (24.8%), the mean duration of T2DM was 14.71±9.12 years, and the mean glycosylated hemoglobin level was 6.97%±0.82%. The total DBSQ score was reduced significantly from 24.9±8.0 to 20.4±7.3 before and after rebamipide treatment (P<0.001). The DBSQ scores associated with reflux symptoms, indigestion, nausea or vomiting, abdominal bloating or distension, peptic ulcer, abdominal pain, and constipation were improved after rebamipide treatment (P<0.05). However, there were no significant changes in symptoms associated with irritable bowel syndrome, diarrhea, and anal incontinence. No severe adverse events were reported throughout the study.

Conclusion

Rebamipide treatment for 12 weeks improved atypical GI symptoms in patients with T2DM.

Citations

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INFLUENCE OF TYPE 2 DIABETES ON THE EFFICIENCY OF ENDOSCOPIC HEMOSTASIS FOR BLEEDING FROM PEPTIC GASTRODUODENAL ULCER
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Letter: Effects of Rebamipide on Gastrointestinal Symptoms in Patients with Type 2 Diabetes Mellitus (Diabetes Metab J2016;40:240-7)
Jin Hwa Kim
Diabetes & Metabolism Journal.2016; 40(4): 334. CrossRef
Response: Effects of Rebamipide on Gastrointestinal Symptoms in Patients with Type 2 Diabetes Mellitus (Diabetes Metab J 2016;40:240-7)
Sejeong Park, So Young Park, Sang Youl Rhee
Diabetes & Metabolism Journal.2016; 40(4): 336. CrossRef

Review

The Role of Glucagon-Like Peptide-1 Receptor Agonists in Type 2 Diabetes: Understanding How Data Can Inform Clinical Practice in Korea: Seungjoon Oh, Suk Chon, Kyu Jeong Ahn, In-Kyung Jeong, Byung-Joon Kim, Jun Goo Kang; Diabetes Metab J. 2015;39(3):177-187. Published online June 15, 2015; DOI: https://doi.org/10.4093/dmj.2015.39.3.177

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Abstract PDF PubReader

Glucagon-like peptide-1 receptor agonists (GLP-1RAs) reduce glycosylated hemoglobin (HbA1c, 0.5% to 1.0%), and are associated with moderate weight loss and a relatively low risk of hypoglycemia. There are differences between Asian and non-Asian populations. We reviewed available data on GLP-1RAs, focusing on Korean patients, to better understand their risk/benefit profile and help inform local clinical practice. Control of postprandial hyperglycemia is important in Asians in whom the prevalence of post-challenge hyperglycemia is higher (vs. non-Asians). The weight lowering effects of GLP-1RAs are becoming more salient as the prevalence of overweight and obesity among Korean patients increases. The higher rate of gastrointestinal adverse events amongst Asian patients in clinical trials may be caused by higher drug exposure due to the lower body mass index of the participants (vs. non-Asian studies). Data on the durability of weight loss, clinically important health outcomes, safety and optimal dosing in Korean patients are lacking. Use of GLP-1RAs is appropriate in several patient groups, including patients whose HbA1c is uncontrolled, especially if this is due to postprandial glucose excursions and patients who are overweight or obese due to dietary problems (e.g., appetite control). The potential for gastrointestinal adverse events should be explained to patients at treatment initiation to facilitate the promotion of better compliance.

Citations

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Original Articles

A Smartphone Application Significantly Improved Diabetes Self-Care Activities with High User Satisfaction: Yu Jin Kim, Sang Youl Rhee, Jong Kyu Byun, So Young Park, Soo Min Hong, Sang Ouk Chin, Suk Chon, Seungjoon Oh, Jeong-taek Woo, Sung Woon Kim, Young Seol Kim; Diabetes Metab J. 2015;39(3):207-217. Published online April 22, 2015; DOI: https://doi.org/10.4093/dmj.2015.39.3.207

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Background

We developed for the first time a smartphone application designed for diabetes self-management in Korea and registered a patent for the relevant algorithm. We also investigated the user satisfaction with the application and the change in diabetes related self-care activities after using the application.

Methods

We conducted a questionnaire survey on volunteers with diabetes who were using the application. Ninety subjects responded to the questionnaire between June 2012 and March 2013. A modified version of the Summary of Diabetes Self-Care Activities (SDSCA) was used in this study.

Results

The survey results exhibited a mean subject age of 44.0 years old, and males accounted for 78.9% of the subjects. Fifty percent of the subjects had diabetes for less than 3 years. The majority of respondents experienced positive changes in their clinical course after using the application (83.1%) and were satisfied with the structure and completeness of the application (86.7%). Additionally, the respondents' answers indicated that the application was easy to use (96.7%) and recommendable to others (97.7%) and that they would continue using the application to manage their diabetes (96.7%). After using the Diabetes Notepad application, diabetes related self-care activities assessed by SDSCA displayed statistically significant improvements (P<0.05), except for the number of days of drinking.

Conclusion

This smartphone-based application can be a useful tool leading to positive changes in diabetes related self-care activities and increase user satisfaction.

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Michael Waisbourd, Hermandeep Dhami, Chen Zhou, Michael Hsieh, Pramod Abichandani, Michael J. Pro, Marlene R. Moster, L. Jay Katz, Lisa A. Hark, Jonathan S. Myers
Journal of Glaucoma.2016; 25(9): e787. CrossRef
Testing the Feasibility of Remote Patient Monitoring in Prenatal Care Using a Mobile App and Connected Devices: A Prospective Observational Trial
Kathryn I Marko, Jill M Krapf, Andrew C Meltzer, Julia Oh, Nihar Ganju, Anjali G Martinez, Sheetal G Sheth, Nancy D Gaba
JMIR Research Protocols.2016; 5(4): e200. CrossRef
Social Networking Services-Based Communicative Care for Patients with Diabetes Mellitus in Korea
Hun-Sung Kim, Yoo Jeong, Sun Baik, So Yang, Tong Kim, Hyunah Kim, Hyunyong Lee, Seung-Hwan Lee, Jae Cho, In-Young Choi, Kun-Ho Yoon
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Mi Kyeong Hong, Young Yun Cho, Mi Yong Rha, Jae Hyeon Kim, Moon-Kyu Lee
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Vikash Dadlani, James A. Levine, Shelly K. McCrady-Spitzer, Eyal Dassau, Yogish C. Kudva
Journal of Diabetes Science and Technology.2015; 9(6): 1208. CrossRef

Risk Factors for the Progression of Intima-Media Thickness of Carotid Arteries: A 2-Year Follow-Up Study in Patients with Newly Diagnosed Type 2 Diabetes: Sang Ouk Chin, Jin Kyung Hwang, Sang Youl Rhee, Suk Chon, You-Cheol Hwang, Seungjoon Oh, Kyu Jeung Ahn, Ho Yeon Chung, Jeong-taek Woo, Sung-Woon Kim, Young Seol Kim, Ja-Heon Kang, In-Kyung Jeong; Diabetes Metab J. 2013;37(5):365-374. Published online October 17, 2013; DOI: https://doi.org/10.4093/dmj.2013.37.5.365

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Background

Intima-media thickness (IMT) of the carotid arteries is known to have a positive correlation with the risk of cardiovascular disease. This study was designed to identify risk factors affecting the progression of carotid IMT in patients with type 2 diabetes mellitus (T2DM).

Methods

Patients with newly diagnosed T2DM with carotid IMT measurements were enrolled, and their clinical data and carotid IMT results at baseline and 2 years later were compared.

Results

Of the 171 patients, 67.2% of males and 50.8% of females had abnormal baseline IMT of the left common carotid artery. At baseline, systolic blood pressure, body mass index and smoking in male participants, and fasting plasma glucose and glycated hemoglobin levels in females were significantly higher in patients with abnormal IMT than in those with normal IMT. Low density lipoprotein cholesterol (LDL-C) levels in males and high density lipoprotein cholesterol (HDL-C) levels in females at the 2-year follow-up were significantly different between the nonprogression and the progression groups. Reduction of the United Kingdom Prospective Diabetes Study (UKPDS) 10-year coronary heart disease (CHD) risk score after 2 years was generally higher in the nonprogression group than the progression group.

Conclusion

LDL-C levels in males and HDL-C levels in females at the 2-year follow-up were significantly different between participants with and without progression of carotid IMT. Furthermore, a reduction in the UKPDS 10-year CHD risk score appeared to delay the advancement of atherosclerosis. Therefore, the importance of establishing the therapeutic goal of lipid profiles should be emphasized to prevent the progression of carotid IMT in newly diagnosed T2DM patients.

Citations

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Comparison of the Effectiveness of Low Carbohydrate Versus Low Fat Diets, in Type 2 Diabetes: Systematic Review and Meta-Analysis of Randomized Controlled Trials
Tanefa A. Apekey, Maria J. Maynard, Monia Kittana, Setor K. Kunutsor
Nutrients.2022; 14(20): 4391. CrossRef
Nomogram Based on Risk Factors for Type 2 Diabetes Mellitus Patients with Coronary Heart Disease

Rong Shi, Birong Wu, Zheyun Niu, Hui Sun, Fan Hu
Diabetes, Metabolic Syndrome and Obesity: Targets and Therapy.2020; Volume 13: 5025. CrossRef
HMGA1 Mediated High-Glucose-Induced Vascular Smooth Muscle Cell Proliferation in Diabetes Mellitus: Association Between PI3K/Akt Signaling and HMGA1 Expression
Qinghai Zhang, Ling Chen, Zhibo Zhao, Ying Wu, Jing Zhong, Gebo Wen, Renxian Cao, Xuyu Zu, Jianghua Liu
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Relationship between frequency of hypoglycemic episodes and changes in carotid atherosclerosis in insulin-treated patients with type 2 diabetes mellitus
Tomoya Mita, Naoto Katakami, Toshihiko Shiraiwa, Hidenori Yoshii, Nobuichi Kuribayashi, Takeshi Osonoi, Hideaki Kaneto, Keisuke Kosugi, Yutaka Umayahara, Masahiko Gosho, Iichiro Shimomura, Hirotaka Watada
Scientific Reports.2017;[Epub] CrossRef
Impact of carotid atherosclerosis detection on physician and patient behavior in the management of type 2 diabetes mellitus: a prospective, observational, multicenter study
In-Kyung Jeong, Sin-Gon Kim, Dong Hyeok Cho, Chong Hwa Kim, Chul Sik Kim, Won-Young Lee, Kyu-Chang Won, Doo-Man Kim
BMC Cardiovascular Disorders.2016;[Epub] CrossRef
The effect of fibroblast growth factors and advanced glycation end-products on the intima-media complex thickness in patients with coronary heart disease and type 2 diabetes
Ekaterina Vladimirovna Ivannikova, Victor Yurievich Kalashnikov, Olga Mikhailovna Smirnova, Alexander Borisovich Kuznetsov, Сергей Anatolievich Terekhin, Alexander Viktorovich Il'in
Diabetes mellitus.2014; 17(2): 47. CrossRef

Hemoglobin A1c May Be an Inadequate Diagnostic Tool for Diabetes Mellitus in Anemic Subjects: Jung Il Son, Sang Youl Rhee, Jeong-taek Woo, Jin Kyung Hwang, Sang Ouk Chin, Suk Chon, Seungjoon Oh, Sung Woon Kim, Young Seol Kim; Diabetes Metab J. 2013;37(5):343-348. Published online October 17, 2013; DOI: https://doi.org/10.4093/dmj.2013.37.5.343

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Abstract PDF PubReader

Background

Recently, a hemoglobin A1c (HbA1c) level of 6.5% has been determined to be a criterion for diabetes mellitus (DM), and it is a widely used marker for the diagnosis of DM. However, HbA1c may be influenced by a number of factors. Anemia is one of the most prevalent diseases with an influence on HbA1c; however, its effect on HbA1c varies based on the variable pathophysiology of anemia. The aim of this study was to determine the effect of anemia on HbA1c levels.

Methods

Anemic subjects (n=112) and age- and sex-matched controls (n=217) who were drug naive and suspected of having DM were enrolled. The subjects underwent an oral glucose tolerance test and HbA1c simultaneously. We compared mean HbA1c and its sensitivity and specificity for diagnosing DM between each subgroup.

Results

Clinical characteristics were found to be similar between each subgroup. Also, when glucose levels were within the normal range, the difference in mean HbA1c was not significant (P=0.580). However, when plasma glucose levels were above the diagnostic cutoff for prediabetes and DM, the mean HbA1c of the anemic subgroup was modestly higher than in the nonanemic group. The specificity of HbA1c for diagnosis of DM was significantly lower in the anemic subgroup (P<0.05).

Conclusion

These results suggest that the diagnostic significance of HbA1c might be limited in anemic patients.

Citations

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Eman Elsheikh, Sereen S Aljohani , Munirah M Alshaikhmubarak, Meshari A Alhawl, Alhanouf W Alsubaie, Norah Alsultan, Asmaa F Sharif, Sayed Ibrahim Ali
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Jari Intra, Giuseppe Limonta, Fabrizio Cappellini, Maria Bertona, Paolo Brambilla
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Serum Adiponectin and Type 2 Diabetes: A 6-Year Follow-Up Cohort Study: Sun Ha Jee, Chul Woo Ahn, Jong Suk Park, Chang Gyu Park, Hyon-Suk Kim, Sang-Hak Lee, Sungha Park, Myoungsook Lee, Chang Beom Lee, Hye Soon Park, Heejin Kimm, Sung Hee Choi, Jidong Sung, Seungjoon Oh, Hyojee Joung, Sung Rae Kim, Ho-Joong Youn, Sun Mi Kim, Hong Soo Lee, Yejin Mok, Eunmi Choi, Young Duk Yun, Soo-Jin Baek, Jaeseong Jo, Kap Bum Huh; Diabetes Metab J. 2013;37(4):252-261. Published online August 14, 2013; DOI: https://doi.org/10.4093/dmj.2013.37.4.252

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Abstract PDF PubReader

Background

Studies on factors which may predict the risk of diabetes are scarce. This prospective cohort study was conducted to determine the association between adiponectin and type 2 diabetes among Korean men and women.

Methods

A total of 42,845 participants who visited one of seven health examination centers located in Seoul and Gyeonggi province, Republic of Korea between 2004 and 2008 were included in this study. The incidence rates of diabetes were determined through December 2011. To evaluate the effects of adiponectin on type 2 diabetes, the Cox proportional hazard model was used.

Results

Of the 40,005 participants, 959 developed type 2 diabetes during a 6-year follow-up. After the adjustment for age, body mass index (BMI), and waist circumference, the risks for type 2 diabetes in participants with normoglycemia had a 1.70-fold (95% confidence interval [CI], 1.21 to 2.38) increase in men and a 1.83-fold (95% CI, 1.17 to 2.86) increase in women with the lowest tertile of adiponectin when compared to the highest tertile of adiponectin. For participants with impaired fasting glucose (IFG), the risk for type 2 diabetes had a 1.46-fold (95% CI, 1.17 to 1.83) increase in men and a 2.52-fold (95% CI, 1.57 to 4.06) increase in women with the lowest tertile of adiponectin. Except for female participants with normoglycemia, all the risks remained significant after the adjustment for fasting glucose and other confounding variables. Surprisingly, BMI and waist circumference were not predictors of type 2 diabetes in men or women with IFG after adjustment for fasting glucose and other confounders.

Conclusion

A strong association between adiponectin and diabetes was observed. The use of adiponectin as a predictor of type 2 diabetes is considered to be useful.

Citations

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Adiponectin and metabolic cardiovascular diseases: Therapeutic opportunities and challenges
Xiaotian Lei, Sheng Qiu, Gangyi Yang, Qinan Wu
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Low levels of total and high-molecular-weight adiponectin may predict non-alcoholic fatty liver in Korean adults
Young-Sang Kim, Soo-Hyun Lee, Seung Geon Park, Bo Youn Won, Hyejin Chun, Doo-Yeoun Cho, Moon-Jong Kim, Ji Eun Lee, Ji-Hee Haam, Kunhee Han
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Sahar M. El-Haggar, Wael F. Farrag, Fedaa A. Kotkata
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Autoimmune Hypoglycemia in a Patient with Characterization of Insulin Receptor Autoantibodies: Suk Chon, Moon Chan Choi, Yun Jung Lee, You Cheol Hwang, In-Kyung Jeong, Seungjoon Oh, Kyu Jeung Ahn, Ho Yeon Chung, Jeong-Taek Woo, Sung-Woon Kim, Jin-Woo Kim, Young Seol Kim; Diabetes Metab J. 2011;35(1):80-85. Published online February 28, 2011; DOI: https://doi.org/10.4093/dmj.2011.35.1.80

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Abstract PDF PubReader

Background

Type B insulin resistance syndrome is a manifestation of autoantibodies to the insulin receptor that results in severe hyperglycemia and acanthosis nigricans. However, the mechanisms by which these autoantibodies induce hypoglycemia are largely unknown. In this paper, we report the case of patient with type B insulin resistance syndrome who presented with frequent severe fasting hypoglycemia and acanthosis nigricans.

Methods

To evaluate the mechanism of hypoglycemia, we measured the inhibition of insulin binding to erythrocytes and IM9 lymphocytes in a sample of the patient's dialyzed serum before and after immunosuppressive therapy.

Results

In the patient's pre-treatment serum IgG, the binding of ¹²⁵I-insulin to erythrocytes was markedly inhibited in a dose-dependent manner until the cold insulin level reached 10^-9 mol/L. We also observed dose-dependent inhibition of insulin binding to IM9 lymphocytes, which reached approximately 82% inhibition and persisted even when diluted 1:20. After treatment with glucocorticoids, insulin-erythrocyte binding activity returned to between 70% and 80% of normal, while the inhibition of insulin-lymphocyte binding was reduced by 17%.

Conclusion

We treated a patient with type B insulin resistance syndrome showing recurrent fasting hypoglycemia with steroids and azathioprine. We characterized the patient's insulin receptor antibodies by measuring the inhibition of insulin binding.

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Natasha Brown, Marianne S Elston
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Luizianne Mariano Martins, Virgínia Oliveira Fernandes, Manuela Montenegro Dias de Carvalho, Daniel Duarte Gadelha, Paulo Cruz de Queiroz, Renan Magalhães Montenegro
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杉本龍 (Ryu Sugimoto), 髙木誠 (Makoto Takaki), 前原潤一 (Junichi Maehara), 具嶋泰弘 (Yasuhiro Gushima)
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Devina L. Willard, Mary Stevenson, Devin Steenkamp
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Christelle Liminet, Julien Vouillarmet, Karim Chikh, Emmanuel Disse
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Adel A.A. Ismail
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Seon Mee Kang, Heung Yong Jin, Kyung Ae Lee, Ji Hyun Park, Hong Sun Baek, Tae Sun Park
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The Changes in Early Phase Insulin Secretion in Newly Diagnosed, Drug Naive Korean Prediabetes Subjects: Sang Youl Rhee, Joo Young Kim, Suk Chon, You Cheol Hwang, In Kyung Jeong, Seungjoon Oh, Kyu Jeung Ahn, Ho Yeon Chung, Jeong-taek Woo, Sung Woon Kim, Jin-Woo Kim, Young Seol Kim; Korean Diabetes J. 2010;34(3):157-165. Published online June 30, 2010; DOI: https://doi.org/10.4093/kdj.2010.34.3.157

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Abstract PDF PubReader

Background

There have been no systematic observations regarding changes in early phase insulin secretion among Korean prediabetes and early stage type 2 diabetes mellitus (T2DM) patients.

Methods

We conducted 75-g oral glucose tolerance tests (OGTT) in 873 subjects with suspected abnormal glucose tolerance. All subjects were diagnosed as having normal glucose tolerance (NGT), prediabetes (preDM), or T2DM according to the OGTT results and the insulin secretory and insulin resistance indices of each subject were calculated. Additionally, we analyzed the changes in early phase insulin secretion according to changes in fasting (Glc₀), post-prandial (Glc₁₂₀) glucose and HbA1c (A1c) levels.

Results

As compared to subjects with NGT, the insulin secretory indices of the preDM and T2DM subjects progressively declined, and the insulin resistance indices were progressively aggravated. Early phase insulin secretion decreased rapidly according to the increments of Glc₀, Glc₁₂₀ and A1c, and these changes were most prominent in the NGT stage. Compared to the control group, the early phase insulin secretion levels of the preDM or T2DM subjects were less than 50% when Glc₀ was over 100 mg/dL, Glc₁₂₀ was over 145 mg/dL, and A1c was over 5.8%.

Conclusion

This study suggests that progressive beta cell dysfunction in Koreans may be initiated and rapidly aggravated during the period generally designated as 'normal.'

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Retractions of Publication

Clinical Experience of the Reverse Iontophoresis Based Glucose Measuring System: Glucall(TM).: Sang Youl Rhee, Suk Chon, Gwanpyo Koh, Seungjoon Oh, Jeong taek Woo, Sung Woon Kim, Jin Woo Kim, Young Seol Kim; Korean Diabetes J. 2009;33(2):167-167. Published online April 1, 2009; DOI: https://doi.org/10.4093/kdj.2009.33.2.167

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Abstract PDF: To the editor, My original paper that published in Journal of Korean Diabetes Association 2005;29:167-172, entitled, Clinical Experience of the Reverse Iontophoresis Based Glucose Measuring System: Glucall(TM) was submitted to other international journals by me and the coauthor at the same time independently. I hereby retract the paper.

Retraction: Insulin Secretion and Insulin Resistance in Newly Diagnosed, Drug Naive Prediabetes and Type 2 Diabetes Patients With/Without Metabolic Syndrome.: Sang Youl Rhee, Suk Chon, Seungjoon Oh, Sung Woon Kim, Jin Woo Kim, Young Seol Kim, Jeong Taek Woo; Korean Diabetes J. 2007;31(2):184-184. Published online March 1, 2007; DOI: https://doi.org/10.4093/jkda.2007.31.2.184

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Abstract PDF: No abstract available.

Original Articles

Mechanism of 2-Deoxy-D-ribose-induced Damage in Pancreatic beta-cells.: Gwanpyo Koh, Jeong taek Woo, Dae Ho Lee, Seungjoon Oh, Sung Woon Kim, Jin Woo Kim, Young Seol Kim, Deok Bae Park; Korean Diabetes J. 2007;31(2):105-112. Published online March 1, 2007; DOI: https://doi.org/10.4093/jkda.2007.31.2.105

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Abstract PDF

BACKGROUND
Mechanism for glucose toxicity is known to be an increased oxidative stress produced by multiple pathways. In our previous report, 2-deoxy-d-ribose (dRib) promoted apoptosis by increasing oxidative stress in a pancreatic beta-cell line. We performed this study to investigate the mechanism of dRib-induced damage of beta-cells. METHODS: HIT-T15 cells were cultured in RPMI-1640 medium with 40 mM dRib for 24 hours after pretreatment with various concentrations of a metal chelator (DTPA) and inhibitors of protein glycation (aminoguanidine and pyridoxamine). Cell viability was determined by MTT assay. Apoptosis was analyzed by flow cytometry with annexin V/PI double staining. RESULTS: DTPA, which inhibits the monosaccharide autoxidation, partially reversed dRib-induced cytotoxicity in a dose-dependent manner (P < 0.01). The cytotoxicity was also suppressed dose-dependently by aminoguanidine (AG) and pyridoxamine (PM) (P < 0.05 and P < 0.01, repectively). Flow cytometric analysis showed that pretreatment of DTPA and AG also reversed the dRib-triggered apoptosis in a dose-dependent manner. We assessed the additional protective effects of inhibitors of protein glycation from dRib-induced cytotoxiciy in the presence of a metal chelator. The additions of AG (P < 0.05) and PM (P < 0.01) significantly reduced the cytotoxicity compared with DTPA alone group. CONCLUSION: This results suggest that dRib produce cytotoxicity and apoptosis through the mechanisms of advanced glycation endproducts (AGEs) formation including the monsaccharide autoxidation and protein glycation in pancreatic beta-cell. Thus, dRib could be a surrogate for glucose in the study of glucose toxicity and chronic diabetic complications.

Citations

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Isolation of Citrus Peel Flavonoid Bioconversion Microorganism and Inhibitory Effect on the Oxidative Damage in Pancreatic Beta Cells
Chi-Deok Park, Hee-Kyung Jung, Chang-Ho Park, Yoo-Seok Jung, Joo-Heon Hong, Hee-Sun Ko, Dong-Hee Kang, Hyun-Soo Kim
KSBB Journal.2012; 27(1): 67. CrossRef
Kaempferol protects HIT‐T15 pancreatic beta cells from 2‐deoxy‐D‐ribose‐induced oxidative damage
Yun Jung Lee, Kwang Sik Suh, Moon Chan Choi, Suk Chon, Seungjoon Oh, Jeong‐Taek Woo, Sung‐Woon Kim, Jin‐Woo Kim, Young Seol Kim
Phytotherapy Research.2010; 24(3): 419. CrossRef

Insulin Secretion and Insulin Resistance in Newly Diagnosed, Drug Naive Prediabetes and Type 2 Diabetes Patients With/Without Metabolic Syndrome.: Sang Youl Rhee, Suk Chon, Seungjoon Oh, Sung Woon Kim, Jin Woo Kim, Young Seol Kim, Jeong Taek Woo; Korean Diabetes J. 2006;30(3):198-206. Published online May 1, 2006; DOI: https://doi.org/10.4093/jkda.2006.30.3.198

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Abstract PDF

BACKGROUND
To evaluate the relationships between deterioration in insulin secretion and aggravated insulin resistance in patients with newly diagnosed prediabetes (preDM) and type 2 diabetes mellitus (T2DM) according to the presence of metabolic syndrome (MS). METHODS: We performed oral glucose tolerance test (OGTT) on 322 drug naive subjects with a history of hyperglycemia of < or = 3 months, and divided these patients into 3 groups, normal glucose tolerance (NGT), preDM (IFG and/or IGT) and T2DM. We also diagnosed these subjects with respect to MS according to ATP III criteria modified by Asia-Pacific guidelines and compared IGI and HOMA-IR in the 3 groups. RESULTS: According to OGTT, 63 subjects were diagnosed with NGT, 81 with preDM, and 178 with T2DM. Using modified ATP III criteria, 218 (67.7%) subjects were diagnosed as MS. When compare groups stratified by the presence of MS, preDM and T2DM groups with MS showed significantly higher mean HOMA-IR and IGI than those without MS. When compare groups with respect to glucose tolerance, NGT, preDM, and T2DM subgroups in MS group showed significant higher HOMA-IR and lower IGI according to glucose tolerance. However, NGT, preDM, and T2DM subgroups in non-MS group showed a significant decrease in IGI but no significant difference in HOMA-IR as glucose tolerance worsened. CONCLUSION: Deterioration in IGI and aggravation of HOMA-IR are both important in the primary pathogenesis of diabetes in those with MS. However, IGI deterioration may be the only important factor in the primary pathogenesis of T2DM in the absence of MS.

Citations

Citations to this article as recorded by

The Relationship between β-cell Function and Nutrient Intakes in Korean Adult - Using 4thKorea National Health and Nutrition Examination Survey 2009 -
You Mi Lee, Hye Kyung Chung, Heejin Kimm, Sun Ha Jee
Korean Journal of Community Nutrition.2012; 17(2): 243. CrossRef

Clinical Experience of the Reverse Iontopheresis Based Glucose Measuring System: GlucallTM.: Sang Youl Rhee, Suk Chon, Gwanpyo Koh, Seungjoon Oh, Jeong Taek Woo, Sung Woon Kim, Jin Woo Kim, Young Seol Kim; Korean Diabetes J. 2005;29(2):167-172. Published online March 1, 2005

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Abstract PDF: BACKGROUND
Finger pricking is currently the common method of blood glucose measurement in patients with diabetes mellitus. However, diabetes patients have proven reluctant to regularly check their glucose profiles because of the small amount of blood that is required. Recently, a non-invasive and continuous glucose monitoring device that is based on reverse iontophoresis(GlucallTM) has been developed. In this study we wanted to evaluate the accuracy and the clinical acceptability of this new device. METHODS: The study was conducted during the period from November 2003 to January 2004 on 19 in-patients who had been admitted to Kyung Hee University Hospital. Glucose measurements using GlucallTM were performed between 10am and 4pm. The concurrent plasma glucose levels were checked hourly and they were subsequently compared with the GlucallTM data. RESULTS: The mean error(ME) of the GlucallTM measurements was -3.45+/-52.99mg/dL with a mean absolute relative error(MARE) of 20+/-15.16%. Measurements obtained by GlucallTM had a correlation coefficient of 0.784(P<0.05) with the plasma glucose levels, as was determined by linear regression analysis. This correlation was consistent regardless of the time of data collection. However, after excluding such confounding variables as age and gender, the correlation coefficient exhibited a tendency to increase. 98.9% of the results were clinically acceptable according to Clarke error grid analysis. CONCLUSION: GlucallTM does not yet have the reliability and accuracy to wholly replace the conventional methods. However, further technical advancements to reduce its shortcomings will make this device useful for the management of diabetes patients

Case Report

A Case of Failure in Insulin Pump Treatment due to Abdominal Subcutaneous Fat Atrophy and Lipohypertrophied Nodules.: Sang Youl Rhee, Suk Chon, Gwanpyo Koh, Seungjoon Oh, Jeong taek Woo, Sung Woon Kim, Jin Woo Kim, Young Seol Kim; Korean Diabetes J. 2004;28(6):547-553. Published online December 1, 2004

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Abstract PDF: The insulin pump is an effective glycemic control device those function is analogous to the physiologic regulation of insulin in vivo. When sufficient patient education and proper selection of patients is done, the insulin pump is one of the most effective treatment modalities for diabetic patients. However, various side effects and complications might occur during its application. We report here on an unusual case of diabetic ketoacidosis that was caused by acute inflammatory colitis and insulin pump malfunction. Peculiarly, the cause of pump malfunction was far removed from its mechanical problem. We concluded that the cause of the insulin pump malfunction was due to abdominal subcutaneous fat atrophy and the lipohypertrophied nodules of the patient that developed due to the prolonged usage of the insulin pump.

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