Diabetes & Metabolism Journal

Original Articles

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 Metab J. 2011;35(6):580-586. Published online December 26, 2011; DOI: https://doi.org/10.4093/dmj.2011.35.6.580

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Background

Diabetes self-management education and reinforcement are important for effective management of the disease. We investigated the effectiveness of interactive small-group education on glycemic, blood pressure, and lipid levels.

Methods

For this study, 207 type 2 diabetes patients with suboptimal glycemic control (HbA1c levels >6.5%) were enrolled. The conventional education group received an existing education program from April to November in 2006, and the interactive education group received a new small-group education program from December 2006 to July 2007. The two groups were comparatively analyzed for changes in blood sugar, glycated hemoglobin, lipid, and blood pressure at baseline, 3, 6, and 12 months and the proportion of patients achieving target goals at 12 months.

Results

After 12 months of follow-up, HbA1c levels in the interactive education group were significantly lower than in the conventional education group (6.7% vs. 6.4%, P<0.001). Fasting and 2 hour postprandial glucose concentrations, total cholesterol, and low density lipoprotein cholesterol were significantly lower in the interactive education group than in the conventional education group. The proportion of patients that achieved target goals was significantly higher in the interactive education group.

Conclusion

The small-group educational method improved and re-established the existing group educational method. This finding suggests that the importance of education appears to be related to the method by which it is received rather than the education itself. Thus, the use of small-group educational methods to supplement existing educational methods established for diverse age levels should be considered in the future.

Citations

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The Effectiveness of Multidisciplinary Team-Based Education in the Management of Type 2 Diabetes
Jong Ho Kim, Yun Jeong Nam, Won Jin Kim, Kyung Ah Lee, A Ran Baek, Jung Nam Park, Jin Mi Kim, Seo Young Oh, Eun Heui Kim, Min Jin Lee, Yun Kyung Jeon, Bo Hyun Kim, In Joo Kim, Yong Ki Kim, Sang Soo Kim
The Journal of Korean Diabetes.2018; 19(2): 119. CrossRef
Diabetes Camp as Continuing Education for Diabetes Self-Management in Middle-Aged and Elderly People with Type 2 Diabetes Mellitus
So Young Park, Sun Young Kim, Hye Mi Lee, Kyu Yeon Hur, Jae Hyeon Kim, Moon-Kyu Lee, Kang-Hee Sim, Sang-Man Jin
Diabetes & Metabolism Journal.2017; 41(2): 99. CrossRef
Impact of ENPP1 K121Q on Change of Insulin Resistance after Web-Based Intervention in Korean Men with Diabetes and Impaired Fasting Glucose
Ji Yeon Kang, Sook Hee Sung, Yeon Ju Lee, Tae In Choi, Seung Jin Choi
Journal of Korean Medical Science.2014; 29(10): 1353. CrossRef
It's Still Not Too Late to Make a Change: Current Status of Glycemic Control in Korea
Sang Yong Kim
Diabetes & Metabolism Journal.2014; 38(3): 194. CrossRef
Education as Prescription for Patients with Type 2 Diabetes Mellitus: Compliance and Efficacy in Clinical Practice
Mi Yeon Kim, Sunghwan Suh, Sang-Man Jin, Se Won Kim, Ji Cheol Bae, Kyu Yeon Hur, Sung Hye Kim, Mi Yong Rha, Young Yun Cho, Myung-Shik Lee, Moon Kyu Lee, Kwang-Won Kim, Jae Hyeon Kim
Diabetes & Metabolism Journal.2012; 36(6): 452. CrossRef

Retrospective Analysis on the Efficacy, Safety and Treatment Failure Group of Sitagliptin for Mean 10-Month Duration: Won Jun Kim, Cheol-Young Park, Eun Haeng Jeong, Jeong Youn Seo, Ji Soo Seol, Se Eun Park, Eun Jung Rhee, Won Young Lee, Ki Won Oh, Sung Woo Park, Sun Woo Kim; Diabetes Metab J. 2011;35(3):290-297. Published online June 30, 2011; DOI: https://doi.org/10.4093/dmj.2011.35.3.290

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Abstract PDF PubReader

Background

To investigate the clinical results of sitagliptin (SITA) and the characteristics of the treatment failure group or of low responders to SITA.

Methods

A retrospective study of type 2 diabetic patients reviewed 99 cases, including 12 treatment failure cases, who stopped SITA because of worsening patients' condition, and 87 cases, who continued treatment over five visits (total 9.9±10.1 months) after receiving the prescription of SITA from December 2008 to June 2009. Subjects were classified as five groups administered SITA as an initial combination with metformin (MET), add-on to metformin or sulfonylurea, and switching from sulfonylurea or thiazolidinedione. The changes in HbA1c level from the first to last visit (ΔHbA1c) in treatment maintenance group were subanalyzed.

Results

The HbA1c level was significantly reduced in four groups, including initial coadministration of SITA with metformin (ΔHbA1c=-1.1%, P<0.001), add-on to MET (ΔHbA1c=-0.6%, P=0.017), add-on to sulfonylurea (ΔHbA1c=-0.5%, P<0.001), and switching from thiazolidinedione (ΔHbA1c=-0.3%, P=0.013). SITA was noninferior to sulfonlyurea (ΔHbA1c=-0.2%, P=0.63). There was no significant adverse effect. The treatment failure group had a longer diabeties duration (P=0.008), higher HbA1c (P=0.001) and fasting plasma glucose (P=0.003) compared to the maintenance group. Subanalysis on the tertiles of ΔHbA1c showed that low-response to SITA (tertile 1) was associated with a longer diabetes duration (P=0.009) and lower HbA1c (P<0.001).

Conclusion

SITA was effective and safe for use in Korean type 2 diabetic patients. However, its clinical responses and long-term benefit-harm profile is yet to be established.

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Roger Yazbeck, Simone Jaenisch, Michelle Squire, Catherine A. Abbott, Emma Parkinson-Lawrence, Douglas A. Brooks, Ross N. Butler
Scientific Reports.2019;[Epub] CrossRef
Characterization of changes in HbA1c in patients with and without secondary failure after metformin treatments by a population pharmacodynamic analysis using mixture models
Yoko Tamaki, Kunio Maema, Makoto Kakara, Masato Fukae, Ryoko Kinoshita, Yushi Kashihara, Shota Muraki, Takeshi Hirota, Ichiro Ieiri
Drug Metabolism and Pharmacokinetics.2018; 33(6): 264. CrossRef
Effects of 6-Month Sitagliptin Treatment on Insulin and Glucagon Responses in Korean Patients with Type 2 Diabetes Mellitus
Hae Kyung Yang, Borami Kang, Seung-Hwan Lee, Hun-Sung Kim, Kun-Ho Yoon, Bong-Yun Cha, Jae-Hyoung Cho
Diabetes & Metabolism Journal.2015; 39(4): 335. CrossRef
Clinical Characteristics and Metabolic Predictors of Rapid Responders to Dipeptidyl Peptidase-4 Inhibitor as an Add-on Therapy to Sulfonylurea and Metformin
Ye An Kim, Won Sang Yoo, Eun Shil Hong, Eu Jeong Ku, Kyeong Seon Park, Soo Lim, Young Min Cho, Kyong Soo Park, Hak Chul Jang, Sung Hee Choi
Diabetes & Metabolism Journal.2015; 39(6): 489. CrossRef
Letter: Predictive Factors for Efficacy of Dipeptidyl Peptidase-4 Inhibitors in Patients with Type 2 Diabetes Mellitus (Diabetes Metab J2015;39:342-7)
Ye An Kim
Diabetes & Metabolism Journal.2015; 39(5): 444. CrossRef
Optimal Candidates for the Switch from Glimepiride to Sitagliptin to Reduce Hypoglycemia in Patients with Type 2 Diabetes Mellitus
Hyun Min Kim, Jung Soo Lim, Byung-Wan Lee, Eun-Seok Kang, Hyun Chul Lee, Bong-Soo Cha
Endocrinology and Metabolism.2015; 30(1): 84. CrossRef
One-year real-life efficacy of sitagliptin revealed importance of concomitant pioglitazone use in Japanese patients with type 2 diabetes mellitus
Ayako Suzuki, Nakayuki Yoshimura, Yamato Mashimo, Maiko Numakura, Yuko Fujimaki, Tomomi Maeda, Toshio Ishikawa, Shin Fujimori, Kazuhiro Eto
Diabetes & Metabolic Syndrome: Clinical Research & Reviews.2013; 7(3): 143. CrossRef
Clinical Characteristics of the Responders to Dipeptidyl Peptidase-4 Inhibitors in Korean Subjects with Type 2 Diabetes
Tae Jung Oh, Hye Seung Jung, Jae Hyun Bae, Yeong Gi Kim, Kyeong Seon Park, Young Min Cho, Kyong Soo Park, Seong Yeon Kim
Journal of Korean Medical Science.2013; 28(6): 881. CrossRef
Factors predicting therapeutic efficacy of combination treatment with sitagliptin and metformin in type 2 diabetic patients: the COSMETIC study
Soo Lim, Jee Hyun An, Hayley Shin, Ah Reum Khang, Yenna Lee, Hwa Young Ahn, Ji Won Yoon, Seon Mee Kang, Sung Hee Choi, Young Min Cho, Kyong Soo Park, Hak Chul Jang
Clinical Endocrinology.2012; 77(2): 215. CrossRef

Review

Triple Combination Therapy Using Metformin, Thiazolidinedione, and a GLP-1 Analog or DPP-IV Inhibitor in Patients with Type 2 Diabetes Mellitus: Sun Woo Kim; Korean Diabetes J. 2010;34(6):331-337. Published online December 31, 2010; DOI: https://doi.org/10.4093/kdj.2010.34.6.331

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Abstract PDF PubReader

Although there is no HbA1c threshold for cardiovascular risk, the American Diabetic Association-recommended goal of HbA1c < 7.0% appears to be unacceptably high. To achieve an optimal HbA1c level goal of 6.0% or less, a high dosage of sulfonylureas and insulin would be required; the trade-off would be the common adverse effects of hypoglycemia and weight gain. In contrast, hypoglycemia is uncommon with insulin sensitizers and GLP-1 analogs, allowing the physician to titrate these drugs to maximum dosage to reduce HbA1c levels below 6.0% and they have been shown to preserve β-cell function. Lastly, weight gain is common with sulfonylurea and insulin therapy, whereas GLP-1 analogs induce weight loss and offset the weight gain associated with TZDs. A treatment paradigm shift is recommended in which combination therapy is initiated with diet/exercise, metformin (which has antiatherogenic effects and improves hepatic insulin sensitivity), a TZD (which improves insulin sensitivity and preserves β-cell function with proven durability), and a GLP-1 analog (which improves β, α-cell function and promotes weight loss) or a dipeptidyl peptidase IV inhibitor in patients with type 2 diabetes mellitus.

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A Case Report of Diabetes Mellitus with Herniated Intervertebral Lumbar Discs Improved by Korean Medicine Treatment
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Original Articles

The Cutoff Value of HbA1c in Predicting Diabetes in Korean Adults in a University Hospital in Seoul.: Ji Cheol Bae, Eun Jung Rhee, Eun Suk Choi, Ji Hoon Kim, Won Jun Kim, Seung Hyun Yoo, Se Eun Park, Cheol Young Park, Won Young Lee, Ki Won Oh, Sung Woo Park, Sun Woo Kim; Korean Diabetes J. 2009;33(6):503-510. Published online December 1, 2009; DOI: https://doi.org/10.4093/kdj.2009.33.6.503

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Abstract PDF

BACKGROUND
Glycated hemoglobin (HbA1c) levels represent a 2~3 month average of blood glucose concentration. The use of HbA1c as a diagnostic tool for diabetes is gaining interest. Therefore, we determined the cutoff point of HbA1c for predicting abnormal glucose tolerance status in non-diabetic Korean subjects. METHODS: We analyzed the data from 1,482 subjects without diabetes mellitus in whom a 75-g oral glucose tolerance test (OGTT) was performed due to suspected abnormal glucose tolerance. We obtained an HbA1c cutoff point for predicting diabetes using Receiver Operating Characteristic (ROC) curve analysis. RESULTS: A cut-off point of 5.95% HbA1c yielded sensitivity of 60.8% and specificity of 85.6%, respectively, for predicting diabetes. There was a difference in HbA1c cut-off value between men and women, 5.85% and 6.05%, respectively. CONCLUSION: To use the cut-off point of 5.95% HbA1c for predicting undiagnosed diabetes in Koreans may be reliable. However, studies of different ethnic groups have reported disparate HbA1c cut-off points. Thus, ethnicity, age, gender, and population prevalence of diabetes are important factors to consider in using elevated HbA1c value as a tool to diagnose diabetes.

Citations

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The Cutoff Value of HbA1c in Predicting Diabetes and Impaired Fasting Glucose
Seyoung Kwon, Youngak Na
The Korean Journal of Clinical Laboratory Science.2017; 49(2): 114. CrossRef
Role of HbA1c in the Screening of Diabetes Mellitus in a Korean Rural Community
Jae Hyun Kim, Gun Woo Kim, Mi Young Lee, Jang Yel Shin, Young Goo Shin, Sang Baek Koh, Choon Hee Chung
Diabetes & Metabolism Journal.2012; 36(1): 37. CrossRef
Impact of HbA1c Criterion on the Detection of Subjects with Increased Risk for Diabetes among Health Check-Up Recipients in Korea
Hong-Kyu Kim, Sung-Jin Bae, Jaeone Choe
Diabetes & Metabolism Journal.2012; 36(2): 151. CrossRef
The Utility of HbA1c as a Diagnostic Criterion of Diabetes
Hee-Jung Kim, Eun Young Choi, Eal Whan Park, Yoo Seock Cheong, Hong-Yoen Lee, Ji Hyun Kim
Korean Journal of Family Medicine.2011; 32(7): 383. CrossRef
2011 Clinical Practice Guidelines for Type 2 Diabetes in Korea
Seung-Hyun Ko, Sung-Rea Kim, Dong-Joon Kim, Seung-Joon Oh, Hye-Jin Lee, Kang-Hee Shim, Mi-Hye Woo, Jun-Young Kim, Nan-Hee Kim, Jae-Taik Kim, Chong Hwa Kim, Hae Jin Kim, In-Kyung Jeong, Eun-Kyung Hong, Jae-Hyoung Cho, Ji-Oh Mok, Kun-Ho Yoon
Diabetes & Metabolism Journal.2011; 35(5): 431. CrossRef
2011 Clinical Practice Guidelines for Type 2 Diabetes in Korea
Seung-Hyun Ko, Dong-Joon Kim, Seung-Joon Oh, Hye-Jin Lee, Kang-Hee Shim, Mi-Hye Woo, Jun-Young Kim, Nan-Hee Kim, Jae-Taik Kim, Chong Hwa Kim, Hye Jin Kim, In-Kyung Jeong, Eun-Gyoung Hong, Jae-Hyoung Cho, Ji-Oh Mok, Kun-Ho Yoon, Sung-Rea Kim
Journal of Korean Diabetes.2011; 12(4): 183. CrossRef

The Relationship between Serum Retinol-Binding Protein 4 Levels and Coronary Artery Disease in Korean Adults.: Ji Hoon Kim, Eun Jung Rhee, Eun Suk Choi, Jong Chul Won, Cheol Young Park, Won Young Lee, Ki Won Oh, Byung Jin Kim, Ki Chul Sung, Bum Soo Kim, Jin Ho Kang, Sung Woo Park, Sun Woo Kim, Man Ho Lee, Jung Roe Park; Korean Diabetes J. 2009;33(2):105-112. Published online April 1, 2009; DOI: https://doi.org/10.4093/kdj.2009.33.2.105

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Abstract PDF

BACKGROUND
A recently discovered adipokine, retinol-binding protein-4 (RBP-4), is reportedly associated with insulin resistance and metabolic syndrome. This study was performed to analyze the relationship between serum RBP-4 levels and coronary artery disease (CAD) in Korean adults. METHODS: In 235 subjects (mean age 58 years) in whom coronary artery angiograms were performed due to complaints of chest pain, serum RBP-4 levels were measured by enzyme-linked immunosorbent assay. Coronary artery angiograms were performed in all subjects and the severity of CAD was assessed by the number of stenotic vessels. The presence of metabolic syndrome was defined by AHA/NHLBI criteria with body mass index substituted for waist circumference. RESULTS: Coronary angiogram showed that 101 subjects (43%) had normal coronary vessel, 82 subjects (34.9%) had 1-vessel disease, 31 subjects (13.2%) had 2-vessel disease and 21 subjects (8.9%) had 3-vessel disease. Subjects with coronary artery stenosis showed a higher mean age (60.5 +/- 10.0 years), fasting glucose (123.3 mg +/- 45.0 mg/dL) and lower mean value for high-density lipoprotein cholesterol (HDL-C) level (49.0 +/- 13.2 mg/dL), although serum RBP-4 levels were not significantly different between those with and without CAD. Mean age and fasting glucose level increased significantly as the number of stenotic vessels increased, although serum RBP4 level showed no significant differences among the different groups. Among the metabolic parameters, only serum triglyceride levels showed a significant correlation with serum RBP-4 levels. CONCLUSION: There was no difference in mean serum RBP-4 levels between subjects with or without coronary artery disease in Korean adults. Further studies are warranted to draw a clear conclusion on the effect of RBP-4 on atherosclerosis.

Citations

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Retinol binding protein 4 levels relate to the presence and severity of coronary artery disease
Gokay Nar, Sara Sanlialp, Rukiye Nar
Journal of Medical Biochemistry.2021; 40(4): 384. CrossRef

Insulin Sensitivity and Insulin Secretion Determined by Homeostasis Model Assessment and Future Risk of Diabetes Mellitus in Korean Men.: Eun Suk Choi, Eun Jung Rhee, Ji Hoon Kim, Jong Chul Won, Cheol Young Park, Won Young Lee, Ki Won Oh, Sung Woo Park, Sun Woo Kim; Korean Diabetes J. 2008;32(6):498-505. Published online December 1, 2008; DOI: https://doi.org/10.4093/kdj.2008.32.6.498

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Abstract PDF

BACKGROUND
Insulin resistance and progressive pancreatic beta cell dysfunction have been identified as the two fundamental features in the type 2 diabetes. Homeostasis model assessment (HOMA), based on plasma levels of fasting glucose and insulin, has been widely validated and applied for quantifying insulin resistance and secretion. This study was performed to assess the predictive value of HOMA indices for future diabetes risk. METHODS: In 14,976 Korean men, in which medical check-up was performed both in 2002 and 2006 in a university hospital health promotion center in Seoul, Korea, prospective assessment for diabetes risk was assessed. At baseline, anthropometric measurements were done and fasting glucose, insulin, lipid profiles were measured. HOMA-insulin resistance (HOMA-IR) and beta cell function (HOMA beta-cell) were calculated from fasting glucose and insulin levels. RESULTS: After 4 years, 286 subjects (1.9%) were newly diagnosed as diabetes mellitus. These patients (mean age 40.3 years) were age-matched with 632 control subjects (mean age 39.8 years) and diabetes risk was assessed with HOMA indices. Among the parameters, body mass index, fasting glucose and HOMA beta-cell were the significant determinants for future diabetes risk. When the subjects were divided into two groups according to the baseline median values of HOMA-IR and HOMA beta-cell, and assessed jointly, those with the low HOMA beta-cell and high HOMA-IR showed the highest risk for future diabetes (RR 39.065, 95% CI 11.736~130.035, P < 0.01). The subjects with low baseline HOMA beta-cell showed higher RR for diabetes than those with high baseline HOMA-IR (4.413 vs. 3.379, P = 0.018, P = 0.051). CONCLUSION: High HOMA-IR and low HOMA beta-cell were associated with the highest risk for future diabetes in this prospective study of Korean male subjects. These data suggest the value of HOMA indices for diabetes risk in epidemiologic studies in Asian subjects.

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Effects of a 2-Week Kinect-Based Mixed-Reality Exercise Program on Prediabetes: A Pilot Trial during COVID-19
So Young Ahn, Si Woo Lee, Hye Jung Shin, Won Jae Lee, Jun Hyeok Kim, Hyun-Jun Kim, Wook Song
Journal of Obesity & Metabolic Syndrome.2024; 33(1): 54. CrossRef
Case Report of Impaired Fasting Glucose Improved with Korean Medicine Treatment and Dietetic Therapy
Eun-mi Kim, Ki-tae Kim
The Journal of Internal Korean Medicine.2021; 42(2): 175. CrossRef
Insulin Resistance Is Associated with Early Gastric Cancer: A Prospective Multicenter Case Control Study
Hye Jung Kwon, Moo In Park, Seun Ja Park, Won Moon, Sung Eun Kim, Jae Hyun Kim, Youn Jung Choi, Sang Kil Lee
Gut and Liver.2019; 13(2): 154. CrossRef
Effect of Coenzyme Q10 on Insulin Resistance in Korean Patients with Prediabetes: A Pilot Single-Center, Randomized, Double-Blind, Placebo-Controlled Study
Ja-Young Yoo, Keun-Sang Yum
BioMed Research International.2018; 2018: 1. CrossRef
Insulin resistance increases the risk of incident type 2 diabetes mellitus in patients with non‐alcoholic fatty liver disease
Yuya Seko, Yoshio Sumida, Saiyu Tanaka, Kojiroh Mori, Hiroyoshi Taketani, Hiroshi Ishiba, Tasuku Hara, Akira Okajima, Atsushi Umemura, Taichiro Nishikawa, Kanji Yamaguchi, Michihisa Moriguchi, Kazuyuki Kanemasa, Kohichiroh Yasui, Shunsuke Imai, Keiji Shim
Hepatology Research.2018;[Epub] CrossRef
The Distribution and Characteristics of Abnormal Findings Regarding Fasting Plasma Glucose and HbA1c - Based on Adults Except for Known Diabetes
Seyoung Kwon, Youngak Na
The Korean Journal of Clinical Laboratory Science.2017; 49(3): 239. CrossRef
Association of arsenobetaine with beta-cell function assessed by homeostasis model assessment (HOMA) in nondiabetic Koreans: data from the fourth Korea National Health and Nutrition Examination Survey (KNHANES) 2008-2009
Kiook Baek, Namhoon Lee, Insung Chung
Annals of Occupational and Environmental Medicine.2017;[Epub] CrossRef
The Association between Food Group Consumption Patterns and Early Metabolic Syndrome Risk in Non-Diabetic Healthy People
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Glycemic Effects of Rebaudioside A and Erythritol in People with Glucose Intolerance
Dong Hee Shin, Ji Hye Lee, Myung Shin Kang, Tae Hoon Kim, Su Jin Jeong, Chong Hwa Kim, Sang Soo Kim, In Joo Kim
Diabetes & Metabolism Journal.2016; 40(4): 283. CrossRef
Comparison of the Usefulness of the Updated Homeostasis Model Assessment (HOMA2) with the Original HOMA1 in the Prediction of Type 2 Diabetes Mellitus in Koreans
Young Seok Song, You-Cheol Hwang, Hong-Yup Ahn, Cheol-Young Park
Diabetes & Metabolism Journal.2016; 40(4): 318. CrossRef
The effects of Atractylodes japonica Koidz. on type 2 diabetic rats
Dae Hoon Lee, Jae Min Han, Woong Mo Yang
Journal of Korean Medicine.2015; 36(1): 75. CrossRef
Normal Glucose Tolerance with a High 1-Hour Postload Plasma Glucose Level Exhibits Decreased β-Cell Function Similar to Impaired Glucose Tolerance
Tae Jung Oh, Se Hee Min, Chang Ho Ahn, Eun Ky Kim, Soo Heon Kwak, Hye Seung Jung, Kyong Soo Park, Young Min Cho
Diabetes & Metabolism Journal.2015; 39(2): 147. CrossRef
Relative contributions of insulin resistance and β‐cell dysfunction to the development of Type 2 diabetes in Koreans
C.‐H. Kim, H.‐K. Kim, E. H. Kim, S. J. Bae, J.‐Y. Park
Diabetic Medicine.2013; 30(9): 1075. CrossRef
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
A Case of Complete Agenesis of the Dorsal Pancreas in a Patient with Newly Diagnosed Diabetes Mellitus
Dong Pil Kim, Kang Seo Park, Dong Sun Kim, Bong Suk Ko, Ji Hae Lee, Jae Hyuk Lee, Jong Ho Shin, Byung Jun Kim, Hyun Jin Kim
Journal of Korean Endocrine Society.2010; 25(1): 78. CrossRef
Insulin Sensitivity and Insulin Secretion Determined by Homeostasis Model Assessment and Future Risk of Diabetes Mellitus in Korean Men (Korean Diabetes J 32(6):498-505, 2008)
Sang Yong Kim
Korean Diabetes Journal.2009; 33(1): 73. CrossRef
Insulin Sensitivity and Insulin Secretion Determined by Homeostasis Model Assessment and Future Risk of Diabetes Mellitus in Korean Men (Korean Diabetes J 32(6):498-505, 2008)
Eun-Suk Choi, Eun-Jung Rhee
Korean Diabetes Journal.2009; 33(1): 75. CrossRef

Comparison of the Predictability of Cardiovascular Disease Risk According to Different Metabolic Syndrome Criteria of American Heart Association/National Heart, Lung, and Blood Institute and International Diabetes Federation in Korean Men.: Do Young Lee, Eun Jung Rhee, Eun Suk Choi, Ji Hoon Kim, Jong Chul Won, Cheol Young Park, Won Young Lee, Ki Won Oh, Sung Woo Park, Sun Woo Kim; Korean Diabetes J. 2008;32(4):317-327. Published online August 1, 2008; DOI: https://doi.org/10.4093/kdj.2008.32.4.317

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Abstract PDF

BACKGROUND
We compared the prevalences of two criteria of metabolic syndrome, that is, American Heart Association/National Heart, Lung, and Blood Institute (AHA/NHLBI) and International Diabetes Federation (IDF), in Korean male adults and compared the predictability of insulin resistance and future cardiovascular diseases using Framingham Risk Score. METHODS: In total 23,467 male adults (mean age 43.3 years) who participated in medical check-up in 2005, the prevalences of metabolic syndrome according to AHA/NHLBI and IDF criteria and the presence of insulin resistance, defined by the highest quartile of Homeostasis Model Assessment of insulin resistance index (HOMA-IR), were compared. The relative risk (calculated risk/average risk) for 10-year risk for coronary artery disease (CHD) assessed by Framingham Risk Score were compared. RESULTS: 5.8% of the subjects had diabetes mellitus. 20.7% and 13.2%of the subjects had metabolic syndrome defined by AHA/NHLBI and IDF criteria, and the two criteria showed high agreement with kappa value of 0.737 (P < 0.01). More subjects in IDF-defined group had insulin resistance compared with AHA/NHLBI definition (59.8 vs. 54%, P < 0.01). The odds ratio for increased relative risk (> 1.0) for 10-year CHD were higher in AHA/NHLBI-defined subjects compared with IDF-defined subject (3.295 vs. 3.082). The Kappa values for the analysis of agreement between each criteria and prediction of insulin resistance or cardiovascular disease risk, were too low for comparison. CONCLUSION: In Korean males, the prevalence for metabolic syndrome defined by AHA/NHLBI criteria was higher than those defined by IDF criteria. IDF criteria detected more subjects with insulin resistance, but didn't have better predictability for CHD compared with AHA/NHLBI criteria.

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Young-Joo Park, Nah-Mee Shin, Ji-Won Yoon, Jiwon Choi, Sook-Ja Lee
Journal of Korean Academy of Nursing.2010; 40(6): 831. CrossRef

The Association of Pro12Ala Polymorphism in PPAR-gamma Gene with Coronary Artery Disease in Korean Subjects.: Chang Hee Kwon, Eun Jung Rhee, Se Yeon Kim, Eun Ran Kim, Chang Uk Chon, Chan Hee Jung, Ji Ho Yun, Byung Jin Kim, Ki Chul Sung, Bum Su Kim, Won Young Lee, Ki Won Oh, Jin Ho Kang, Sun Woo Kim, Man Ho Lee, Jung Roe Park; Korean Diabetes J. 2006;30(2):122-129. Published online March 1, 2006; DOI: https://doi.org/10.4093/jkda.2006.30.2.122

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Abstract PDF: BACKGROUND
PPAR-gamma, a member of nuclear family, which is involved in the differentiation of adipose tissue, is reported to be associated in the pathogenesis of type 2 diabetes mellitus, insulin resistance and atherosclerosis. We conducted a research to see whether the prevalence of coronary artery disease is associated with Pro12Ala polymorphism in exon B of PPAR-gamma in Korean adults. METHODS: The study was conducted in 161 subjects (97 males, 64 females, mean age 57 year old) who underwent coronary angiogram due to chest pain. We assessed cardiovascular risk factors in all subjects, such as blood pressure, body mass index (BMI), fasting blood sugar and serum lipid profiles. Subjects were divided into four groups as normal, 1-vessel, 2-vessel and 3-vessel disease according to the number of stenosed coronary arteries. Genotypings of Pro12Ala polymorphism were done with Real-time polymerase chain reaction. RESULTS: Allelic frequency for proline was 0.957 and 0.043 for alanine, and they were in compliance with Hardy-Weinberg equilibrium (P = 0.85). 79 subjects (43.5%) had normal coronary artery, 52 subjects (31%), 1-vessel disease, 24 subjects (14.9%), 2-vessel disease and 15 subjects (9.3%), 3-vessel disease. When the cardiovascular risk factors were compared among these four groups, there were no meaningful differences except the age and high-density lipoprotein cholesterol levels, which were lost after adjustment for age and BMI. There were no significant differences in the prevalence or severity of coronary artery diseases according to the different genotypes of Pro12Ala polymorphism. CONCLUSIONS: There was no significantassociation between Pro12Ala polymorphism in exon B of PPAR-gamma and prevalence or severity of coronary artery disease in Korean adults. It is considered that further studies on the correlation between Pro12Ala polymorphism and coronary artery disease should be carried out in larger Korean population in the future

The Association of Interleukin-6 Gene Promoter Region Polymorphism G174C with Insulin Resistance and Metabolic Syndrome in Korean Women.: Eun Jung Rhee, Won Young Lee, Se Yeon Kim, Eun Sook Oh, Ki Hyun Baek, Ki Won Oh, Moo Il Kang, Sun Woo Kim; Korean Diabetes J. 2005;29(3):181-188. Published online May 1, 2005

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Abstract PDF: BACKGROUND
Interleukin(IL)-6 is a cytokine that is produced from immune cells and adipose tissue. It is thought to be a factor to explain the link between insulin resistance and inflammation, and it is also thought to be involved in glucose metabolism and lipid metabolism. We observed the frequency of the G174C polymorphism in the IL-6 gene promoter region in Korean women and we investigated the association of fasting glucose, insulin resistance indices and metabolic syndrome. METHODS: Measurements of the blood pressure, body fat, fasting glucose, insulin, lipid profiles and anthropometric measurements were done for 268 Korean women(mean age 51.4yrs, range 37~73yrs). Homeostasis model assessement(HOMA) and the quantitative insulin sensitivity check index(QUICKI) were calculated and the presence of metabolic syndrome was assessed according to ATP III criteria. Genotyping was done with the PCRRFLP method on the blood samples of the participants. RESULTS: The allele frequencies were 0.965 for the G allele and 0.035 for the C allele, and they were in Hardy-Weinberg equilibrium(P=0.50). The fasting insulin level and HOMA were significantly higher and the QUICKI was significantly lower in the C allele carriers compared with non-carriers. Although the prevalence of metabolic syndrome was not significantly different according to the different genotypes, among the individual components, the prevalence of hypertriglyceridemia was significantly higher in the C allele carriers compared with the non-carriers. There were no differences in the prevalence of normoglycemia, fasting hyperglycemia and provisional diabetes according to the different genotypes. CONCLUSION: The G174C polymorphism in The IL-6 promoter region was not frequently observed in Korean women. The insulin resistance indices were higher in the C allele carriers compared with the non-carriers. Although the prevalence of metabolic syndrome was not associated with the polymorphism, the prevalence of hypertriglyceridemia was higher in The C allele carriers, suggesting that it is possibile for candidate gene of insulin resistance

Left Ventricular Mass Index Increases in Proportion to the Urinary Microalbumin Excretion Rate in Type 2 Diabetes.: Seung Ha Park, Won Young Lee, Sun Woo Kim; Korean Diabetes J. 2002;26(6):500-508. Published online December 1, 2002

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Abstract PDF: BACKGROUND
In type 2 diabetes, microalbuminuria is an early marker of the atherosclerotic process and of endothelial dysfunction. It has also been shown to be related with the prevalence and morbidity of renal and cardiovascular diseases, and is associated with other risk factors of vascular damage. Left ventricular hypertrophy (LVH) has long been established as a major independent marker of future cardiovascular morbidity and mortality, depending on the body mass and blood pressure load. In order to clarify any association between the urinary microalbumin excretion rate (UAER) and the left ventricular mass index (LVMI), which may explain the observed poor prognosis in these patients, we analysed the clinical characteristics and laboratory findings data of type 2 diabetes. METHODS: We conducted a cross-sectional study of 48 patients with type 2 diabetes, who had been echocardiographically assessed and their 24-h urine collection analyzed for UAER, and the patients with clinical evidence of heart and renal diseases were excluded. The patients were divided into two groups according to their mean LVMI value (Low LVMI group: LVMI <97 g/m2, n=26; High LVMI group: LVMI >or=97 g/m2, n=22). RESULTS: The UAER, and systolic and diastolic blood pressures, were higher in the High LVMI group, but age, sex, body mass index (BMI) and duration of diabetes were similar in both group. The correlation of UAER and systolic blood pressure with LVMI remained significant, even after a multiple regression analysis (p=0.042, p=0.01 respectively). CONCLUSION: The significant relationship between the UAER and LVMI was independent of blood pressure, age, sex, BMI, duration of diabetes and other cardiovascular risk factors in type 2 diabetes. Therefore, an increased UAER may play an important role in the development of LVH.

Relationship between C-peptide, Metabolic Control and Chronic Complications in Type 2 Diabetes.: Jeung Mook Kang, Won Young Lee, Ji Youn Kim, Jung Won Yun, Sun Woo Kim; Korean Diabetes J. 2002;26(6):490-499. Published online December 1, 2002

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Abstract PDF: BACKGROUND
Type 2 diabetes mellitus is a heterogeneous disease characterized by variable degrees of insulin resistance, impaired insulin secretion and increased glucose production. As the decline of beta-cell function in type 2 diabetes is very slow, the relationship between the insulin secretory capacity, the degree of metabolic control and chronic complications is still unclear. The determination of plasma C-peptide allows for the assessment of the endogenous insulin production, even in the presence of exogenous insulin administration. The aim of this study was to evaluate the relationship between the serum C-peptide level and metabolic parameters, and the complications in type 2 diabetes. METHOD: The clinical characteristics and laboratory findings, such as lipid profile, fasting plasma glucose, HbA1C and uric acid, were evaluated, and their relationships with chronic complications analyzed. We measured the serum C-peptide level by radioimmunoassay (RIA) in 384 type 2 diabetes mellitus patients. The patients were divided into quartile groups according to their fasting C-peptide levels (quartile 1: <1.73 ng/mL, n=95; quartile 2:>or=1.73 ng/mL and <2.38 ng/mL, n=95; quartile 3:>or=2.38 ng/mL and <3.18 ng/mL, n=98; quartile 4:>or=3.18 ng/mL, n=96). RESULTS: Patients in the lowest C-peptide quartile showed significantly higher durations of diabetes, HbA1C and postprandial plasma glucose values, and HDL-cholesterol. Conversely, the BMI, systolic blood pressure, total cholesterol and triglyceride were significantly higher in the highest C-peptide quartile. The prevalence of diabetic retinopathy and urinary protein excretion were higher in lowest quartile, and the diastolic blood pressure was highest in the upper quartile, but these were not statistically significant. The associations between C-peptide, and the duration of diabetes, BMI, total cholesterol, triglyceride, HDL cholesterol, postprandial 2 plasma glucose and systolic blood pressure remained significant, even after multiple adjustments. CONCLUSION: In type 2 diabetes, higher C-peptide levels are associated with a component of metabolic syndrome and lower C-peptide levels due to decreased cell reserves, associated with hyperglycemia and microvascular complications

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