Diabetes & Metabolism Journal

Original Article

Clinical Diabetes & Therapeutics
Efficacy and Safety of Voglibose Plus Metformin in Patients with Type 2 Diabetes Mellitus: A Randomized Controlled Trial: Tae Jung Oh, Jae Myung Yu, Kyung Wan Min, Hyun Shik Son, Moon Kyu Lee, Kun Ho Yoon, Young Duk Song, Joong Yeol Park, In Kyung Jeong, Bong Soo Cha, Yong Seong Kim, Sei Hyun Baik, In Joo Kim, Doo Man Kim, Sung Rae Kim, Kwan Woo Lee, Jeong Hyung Park, In Kyu Lee, Tae Sun Park, Sung Hee Choi, Sung Woo Park; Diabetes Metab J. 2019;43(3):276-286. Published online December 7, 2018; DOI: https://doi.org/10.4093/dmj.2018.0051

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Background

Combination of metformin to reduce the fasting plasma glucose level and an α-glucosidase inhibitor to decrease the postprandial glucose level is expected to generate a complementary effect. We compared the efficacy and safety of a fixed-dose combination of voglibose plus metformin (vogmet) with metformin monotherapy in drug-naïve newly-diagnosed type 2 diabetes mellitus.

Methods

A total of 187 eligible patients aged 20 to 70 years, with a glycosylated hemoglobin (HbA1c) level of 7.0% to 11.0%, were randomized into either vogmet or metformin treatments for 24 weeks. A change in the HbA1c level from baseline was measured at week 24.

Results

The reduction in the levels of HbA1c was −1.62%±0.07% in the vogmet group and −1.31%±0.07% in the metformin group (P=0.003), and significantly more vogmet-treated patients achieved the target HbA1c levels of <6.5% (P=0.002) or <7% (P=0.039). Glycemic variability was also significantly improved with vogmet treatment, estimated by M-values (P=0.004). Gastrointestinal adverse events and hypoglycemia (%) were numerically lower in the vogmet-treated group. Moreover, a significant weight loss was observed with vogmet treatment compared with metformin (−1.63 kg vs. −0.86 kg, P=0.039).

Conclusion

Vogmet is a safe antihyperglycemic agent that controls blood glucose level effectively, yields weight loss, and is superior to metformin in terms of various key glycemic parameters without increasing the risk of hypoglycemia.

Citations

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Bioequivalence Study of Two Empagliflozin Tablets in Healthy Chinese Subjects Under Fasting and Fed Conditions
Yuyan Lei, Yuan Liu, Lichen Gao, Xueqiong Peng, Lulu Chen, Chao Li, Weiming Chen, Junmei Xu, Dongsheng Ouyang, Xiaohui Li
Clinical Pharmacology in Drug Development.2025; 14(7): 542. CrossRef
Rationality over convenience: The CDSCO’s regulatory ban on irrational antidiabetic fixed-dose combinations in India and its clinical-pharmacological imperatives
Shambo Samrat Samajdar, Shashank R. Joshi, Noor Husain, Khushboo Bisht, Shravan Venkatraman, Shatavisa Mukherjee, Rajeev Chawla
International Journal of Diabetes in Developing Countries.2025; 45(2): 261. CrossRef
Phytochemical analysis and antihyperglycemic activity of Castilleja arvensis
Mónica Aideé Díaz-Román, Juan José Acevedo-Fernández, Gabriela Ávila-Villarreal, Elizabeth Negrete-León, A. Berenice Aguilar-Guadarrama
Fitoterapia.2024; 174: 105839. CrossRef
Efficacy and Safety of DPP-4 Inhibitors and Metformin Combinations in Type 2 Diabetes: A Systematic Literature Review and Network Meta-Analysis
Rongping Chen, Jing Li, Danqi Chen, Weiheng Wen, Susu Zhang, Jitong Li, Yuting Ruan, Zhen Zhang, Jia Sun, Hong Chen
Diabetes, Metabolic Syndrome and Obesity.2024; Volume 17: 2471. CrossRef
Metformin-Associated Gastrointestinal Adverse Events Are Reduced by Probiotics: A Meta-Analysis
Izabela Szymczak-Pajor, Józef Drzewoski, Sylwia Wenclewska, Agnieszka Śliwińska
Pharmaceuticals.2024; 17(7): 898. CrossRef
YAP/TAZ axis was involved in the effects of metformin on breast cancer
Yu Xu, Hongke Cai, Yuanfeng Xiong, Li Tang, Longjiang Li, Li Zhang, Yi Shen, Yongqiang Yang, Ling Lin, Jiayi Huang
Journal of Chemotherapy.2023; 35(7): 627. CrossRef
Diabetes Remission
Ashok Kumar, Shubha Laxmi Margekar, Ravi Kumar
Indian Journal of Medical Specialities.2023; 14(1): 3. CrossRef
Analysis of Reports Sent to the Portuguese Pharmacovigilance System and Published Literature Regarding the Safety of Metformin in the Elderly
Beatriz Esteves, Cristina Monteiro, Ana Paula Coelho Duarte
Healthcare.2023; 11(15): 2197. CrossRef
Rapid prediction method of α-Glycosidase inhibitory activity of Coreopsis tinctoria extract from different habitats by near infrared spectroscopy
Xiaogang He, Xiang Han, Jiaping Yu, Yulong Feng, Ganghui Chu
Spectrochimica Acta Part A: Molecular and Biomolecular Spectroscopy.2022; 268: 120601. CrossRef
Insulin autoimmune syndrome in patients with type 2 diabetes: A report of two cases
Y. Shin, T.J. Oh, S.H. Choi, H.C. Jang
Diabetes & Metabolism.2021; 47(1): 101115. CrossRef
Efficacy and Safety of Treatment with Quadruple Oral Hypoglycemic Agents in Uncontrolled Type 2 Diabetes Mellitus: A Multi-Center, Retrospective, Observational Study
Jun Sung Moon, Sunghwan Suh, Sang Soo Kim, Heung Yong Jin, Jeong Mi Kim, Min Hee Jang, Kyung Ae Lee, Ju Hyung Lee, Seung Min Chung, Young Sang Lyu, Jin Hwa Kim, Sang Yong Kim, Jung Eun Jang, Tae Nyun Kim, Sung Woo Kim, Eonju Jeon, Nan Hee Cho, Mi-Kyung Ki
Diabetes & Metabolism Journal.2021; 45(5): 675. CrossRef
Quantifying Remission Probability in Type 2 Diabetes Mellitus
Sanjay Kalra, Ganapathi Bantwal, Nitin Kapoor, Rakesh Sahay, Saptarshi Bhattacharya, Beatrice Anne, Raju A Gopal, Sunil Kota, Ashok Kumar, Ameya Joshi, Debmalya Sanyal, Mangesh Tiwaskar, Ashok Kumar Das
Clinics and Practice.2021; 11(4): 850. CrossRef
The effect of voglibose on metabolic profiles in patients with type 2 diabetes mellitus: A systematic review and meta-analysis of clinical trials
Peyman Nowrouzi-Sohrabi, Reza Tabrizi, Shahla Rezaei, Fatemeh Jafari, Kamran Hessami, Mehdi Abedi, Mohammad Jalali, Pedram Keshavarzi, Saeed Shahabi, Ali Asghar Kolahi, Kristin Carson-Chahhoud, Amirhossein Sahebkar, Saeid Safiri
Pharmacological Research.2020; 159: 104988. CrossRef
Role of Intestinal Microbiota in Metabolism of Voglibose In Vitro and In Vivo
Mahesh Raj Nepal, Mi Jeong Kang, Geon Ho Kim, Dong Ho Cha, Ju-Hyun Kim, Tae Cheon Jeong
Diabetes & Metabolism Journal.2020; 44(6): 908. CrossRef
Response: Efficacy and Safety of Voglibose Plus Metformin in Patients with Type 2 Diabetes Mellitus: A Randomized Controlled Trial (Diabetes metab J 2019;43;276-86)
Tae Jung Oh, Sung Hee Choi
Diabetes & Metabolism Journal.2019; 43(4): 547. CrossRef
Letter: Efficacy and Safety of Voglibose Plus Metformin in Patients with Type 2 Diabetes Mellitus: A Randomized Controlled Trial (Diabetes Metab J 2019;43;276-86)
Hannah Seok, Tae Seo Sohn
Diabetes & Metabolism Journal.2019; 43(4): 545. CrossRef

Brief Report

Others
A Potential Issue with Screening Prediabetes or Diabetes Using Serum Glucose: A Delay in Diagnosis: Jun Goo Kang, Cheol-Young Park, Sung-Hee Ihm, Sung Woo Park; Diabetes Metab J. 2016;40(5):414-417. Published online September 1, 2016; DOI: https://doi.org/10.4093/dmj.2016.40.5.414

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The aim of this study was to compare the fasting serum glucose level with the fasting plasma glucose level for diagnosing hyperglycemic states in real-life clinical situations. Additionally, we investigated a usual delay in sample processing and how such delays can impact the diagnosis of hyperglycemic states. Among 1,254 participants who had normoglycemia or impaired fasting glucose (IFG) assessed by the fasting serum glucose level, 20.9% were newly diagnosed with diabetes based on the plasma fasting glucose level. Of the participants with normoglycemia, 62.1% and 14.2% were newly diagnosed with IFG and diabetes, respectively, according to the plasma fasting glucose level. In our clinical laboratory for performing health examinations, the time delay from blood sampling to glycemic testing averaged 78±52 minutes. These findings show that the ordinary time delay for sample processing of the serum glucose for screening hyperglycemic states may be an important reason for these diagnoses to be underestimated in Korea.

Citations

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Glucometer versus analyzer: comparable results with negligible clinical risk
Alper Gümüş, Cihan Coşkun, Kamil Taha Uçar, İbrahim Erdin, Semih Tek, Betül Evran, Abdulkadir Çat, Oğuzhan Zengi
Scandinavian Journal of Clinical and Laboratory Investigation.2025; 85(1): 11. CrossRef
Comparing glycemic traits in defining diabetes among rural Chinese older adults
Pin Wang, Yuanjing Li, Mingqi Wang, Lin Song, Yi Dong, Xiaolei Han, Jaakko Tuomilehto, Yongxiang Wang, Yifeng Du, Chengxuan Qiu, Fredirick Lazaro mashili
PLOS ONE.2024; 19(1): e0296694. CrossRef
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Amy Thachil, Li Wang, Rupasri Mandal, David Wishart, Tom Blydt-Hansen
Metabolites.2024; 14(9): 474. CrossRef
Serum glucose, a cost-effective alternate of plasma glucose in diagnosing and monitoring diabetes mellitus
Vivek Pant, Anders Kallner
International Journal of Diabetes in Developing Countries.2023; 43(3): 377. CrossRef
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Dimitrios Angelis, Mambarambath A. Jaleel, Luc P. Brion
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Global, regional, and national burden of diabetes from 1990 to 2021, with projections of prevalence to 2050: a systematic analysis for the Global Burden of Disease Study 2021
Kanyin Liane Ong, Lauryn K Stafford, Susan A McLaughlin, Edward J Boyko, Stein Emil Vollset, Amanda E Smith, Bronte E Dalton, Joe Duprey, Jessica A Cruz, Hailey Hagins, Paulina A Lindstedt, Amirali Aali, Yohannes Habtegiorgis Abate, Melsew Dagne Abate, Mo
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PM2.5 exposure increases the risk of preterm birth in pre-pregnancy impaired fasting glucose women: A cohort study in a Southern province of China
Zhijiang Liang, Lina Zhao, Jialing Qiu, Xinhong Zhu, Min Jiang, Guocheng Liu, Qingguo Zhao
Environmental Research.2022; 204: 112403. CrossRef
The impact of maternal prepregnancy impaired fasting glucose on preterm birth and large for gestational age: a large population-based cohort study
Jie Tang, Xinhong Zhu, Mingzhen Li, Dongming Huang, Qingguo Zhao
American Journal of Obstetrics and Gynecology.2020; 222(3): 265.e1. CrossRef
Utility of point‐of‐care vs reference laboratory testing for the evaluation of glucose levels
O. M. Andriankaja, F. J. Muñoz‐Torres, J. L. Vergara, C. M. Pérez, K. Joshipura
Diabetic Medicine.2019; 36(5): 626. CrossRef
Pre-analytical factors in blood glucose measurement
Alpesh Goyal, Yashdeep Gupta
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Long-term stability of glucose: glycolysis inhibitor vs. gel barrier tubes
Theresa Winter, Anke Hannemann, Juliane Suchsland, Matthias Nauck, Astrid Petersmann
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Original Articles

Clinical Care/Education
Insulin Initiation in Insulin-Naïve Korean Type 2 Diabetic Patients Inadequately Controlled on Oral Antidiabetic Drugs in Real-World Practice: The Modality of Insulin Treatment Evaluation Study: Sang Soo Kim, In Joo Kim, Yong Ki Kim, Kun Ho Yoon, Ho Young Son, Sung Woo Park, Yeon Ah Sung, Hong Sun Baek; Diabetes Metab J. 2015;39(6):481-488. Published online November 25, 2015; DOI: https://doi.org/10.4093/dmj.2015.39.6.481

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Background

The Modality of Insulin Treatment Evaluation (MOTIV) study was performed to provide real-world data concerning insulin initiation in Korean type 2 diabetes mellitus (T2DM) patients with inadequate glycemic control with oral hypoglycemic agents (OHAs).

Methods

This multicenter, non-interventional, prospective, observational study enrolled T2DM patients with inadequate glycemic control (glycosylated hemoglobin [HbA1c] ≥7.0%) who had been on OHAs for ≥3 months and were already decided to introduce basal insulin by their physician prior to the start of the study. All treatment decisions were at the physician's discretion to reflect real-world practice.

Results

A total of 9,196 patients were enrolled, and 8,636 patients were included in the analysis (mean duration of diabetes, 8.9 years; mean HbA1c, 9.2%). Basal insulin plus one OHA was the most frequently (51.0%) used regimen. After 6 months of basal insulin treatment, HbA1c decreased to 7.4% and 44.5% of patients reached HbA1c <7%. Body weight increased from 65.2 kg to 65.5 kg, which was not significant. Meanwhile, there was significant increase in the mean daily insulin dose from 16.9 IU at baseline to 24.5 IU at month 6 (P<0.001). Overall, 17.6% of patients experienced at least one hypoglycemic event.

Conclusion

In a real-world setting, the initiation of basal insulin is an effective and well-tolerated treatment option in Korean patients with T2DM who are failing to meet targets with OHA therapy.

Citations

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Real-World Outcomes of Individualized Targeted Therapy with Insulin Glargine 300 Units/mL in Insulin-Naïve Korean People with Type 2 Diabetes: TOBE Study
Eun-Gyoung Hong, Kyung-Wan Min, Jung Soo Lim, Kyu-Jeung Ahn, Chul Woo Ahn, Jae-Myung Yu, Hye Soon Kim, Hyun Jin Kim, Won Kim, Dong Han Kim, Hak Chul Jang
Advances in Therapy.2024; 41(5): 1967. CrossRef
Clinical Evidence and Practice-Based Guidelines on the Utility of Basal Insulin Combined Oral Therapy (Metformin and Glimepiride) in the Current Era
Abhishek Shrivastava, Jothydev Kesavadev, Viswanathan Mohan, Banshi Saboo, Dina Shrestha, Anuj Maheshwari, Brij Mohan Makkar, Kirtikumar D. Modi, Ashok Kumar Das
Current Diabetes Reviews.2023;[Epub] CrossRef
Where to Initiate Basal Insulin Therapy: Inpatient or Outpatient Department? Real-World Observation in China
Minyuan Chen, Puhong Zhang, Yang Zhao, Nadila Duolikun, Linong Ji
Diabetes, Metabolic Syndrome and Obesity: Targets and Therapy.2022; Volume 15: 3375. CrossRef
Therapeutic Effect of Quadruple Oral Hypoglycemic Agents in Patients with Type 2 Diabetes Mellitus Who Have Insulin Limitations
Won Sang Yoo, Do Hee Kim, Hee Jin Kim, Hyun Kyung Chung
The Journal of Korean Diabetes.2019; 20(2): 117. CrossRef
Use of Insulin Glargine 100 U/mL for the Treatment of Type 2 Diabetes Mellitus in East Asians: A Review
Takahisa Hirose, Ching-Chu Chen, Kyu Jeung Ahn, Jacek Kiljański
Diabetes Therapy.2019; 10(3): 805. CrossRef
Nationwide Trends in Pancreatitis and Pancreatic Cancer Risk Among Patients With Newly Diagnosed Type 2 Diabetes Receiving Dipeptidyl Peptidase 4 Inhibitors
Minyoung Lee, Jiyu Sun, Minkyung Han, Yongin Cho, Ji-Yeon Lee, Chung Mo Nam, Eun Seok Kang
Diabetes Care.2019; 42(11): 2057. CrossRef
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
The Korean Journal of Internal Medicine.2017; 32(6): 967. CrossRef
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
Diabetes & Metabolism Journal.2017; 41(5): 367. CrossRef
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Sunghwan Suh, Sun Ok Song, Jae Hyeon Kim, Hyungjin Cho, Woo Je Lee, Byung-Wan Lee
Journal of Diabetes Research.2017; 2017: 1. CrossRef
Comparison of Antidiabetic Regimens in Patients with Type 2 Diabetes Uncontrolled by Combination Therapy of Sulfonylurea and Metformin: Results of the MOHAS Disease Registry in Korea
Sung Hee Choi, Tae Jung Oh, Hak Chul Jang
Diabetes & Metabolism Journal.2017; 41(3): 170. CrossRef
Instauration d’une insulinothérapie chez le patient diabétique de type 2 en médecine générale : Comparaison de l’étude belge InsuStar avec quelques études françaises et internationales
A.-J. Scheen
Médecine des Maladies Métaboliques.2016; 10(4): 334. CrossRef

Maximal Fat Oxidation Rate during Exercise in Korean Women with Type 2 Diabetes Mellitus: Min Hwa Suk, Yeo-Jin Moon, Sung Woo Park, Cheol-Young Park, Yun A Shin; Diabetes Metab J. 2015;39(4):328-334. Published online July 8, 2015; DOI: https://doi.org/10.4093/dmj.2015.39.4.328

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Background

The purpose of this study was to determine the appropriate exercise intensity associated with maximum fat oxidation, improvement of body composition, and metabolic status in Korean women with type 2 diabetes mellitus (T2DM).

Methods

The study included a T2DM group (12 women) and a control group (12 women). The groups were matched in age and body mass index. The subjects performed a graded exercise test on a cycle ergometer to measure their maximal fat oxidation (Fat_max). We also measured their body composition, metabolic profiles, and mitochondrial DNA (mtDNA).

Results

The exercise intensity for Fat_max was significantly lower in the T2DM group (34.19% maximal oxygen uptake [VO₂ max]) than the control group (51.80% VO₂ max). Additionally, the rate of fat oxidation during exercise (P<0.05) and mtDNA (P<0.05) were significantly lower in the T2DM group than the control group. The VO₂ max level (P<0.001) and the insulin level (P<0.05) were positively correlated with the rate of fat oxidation.

Conclusion

The results of this study suggest lower exercise intensity that achieves Fat_max is recommended for improving fat oxidation and enhancing fitness levels in Korean women with T2DM. Our data could be useful when considering an exercise regimen to improve health and fitness.

Citations

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Type 2 diabetes mellitus’ impact on heart failure patients’ exercise tolerance: a focus on maximal fat oxidation during exercise
Huiying Zhu, Jianchao Pan, Jianxuan Wen, Xiaojing Dang, Xiankun Chen, Yunxiang Fan, Weihui Lu, Wei Jiang
Frontiers in Cardiovascular Medicine.2025;[Epub] CrossRef
Methodological issues related to maximal fat oxidation and FATmax reproducibility: a narrative review
Isaac A. Chávez Guevara, Francisco J. Amaro-Gahete
International Journal of Obesity.2025; 49(10): 1984. CrossRef
Toward Exercise Guidelines for Optimizing Fat Oxidation During Exercise in Obesity: A Systematic Review and Meta-Regression
Isaac A. Chávez-Guevara, Francisco J. Amaro-Gahete, Arnulfo Ramos-Jiménez, Jean Frederic Brun
Sports Medicine.2023; 53(12): 2399. CrossRef
Cardiorespiratory fitness in individuals with type 2 diabetes mellitus: a systematic review and meta-analysis
Aline Chagastelles Pinto de Macedo, Camila Wohlgemuth Schaan, Patricia Martins Bock, Mariana Brutto de Pinto, Cintia Ehlers Botton, Daniel Umpierre, Beatriz D. Schaan
Archives of Endocrinology and Metabolism.2023;[Epub] CrossRef
Inclusion of sprints during moderate-intensity continuous exercise enhances post-exercise fat oxidation in young males
Bruno Nicanor Mello-Silva, Gabriel Völz Protzen, Fabrício Boscolo Del Vecchio
Applied Physiology, Nutrition, and Metabolism.2022; 47(2): 165. CrossRef
Resting and exercise metabolic characteristics in obese children with insulin resistance
Cao Youxiang, Zhu Lin, Chen Zekai, Xie Weijun
Frontiers in Physiology.2022;[Epub] CrossRef
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Shaea Alkahtani, Osama Aljuhani, Nasser Alkhalidi, Naif Almasuod, Omar Hezam, Ibrahim Aljaloud, Haitham Abdel Hamid Dawoud, Ahmed Abdusalam, Danilo Sales Bocalini
BioMed Research International.2020;[Epub] CrossRef
Diurnal influences of fasted and non-fasted brisk walking on gastric emptying rate, metabolic responses, and appetite in healthy males
Victoria J. McIver, Lewis R. Mattin, Gethin H. Evans, Adora M.W. Yau
Appetite.2019; 143: 104411. CrossRef
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Zihong He, Ye Tian, Pedro L. Valenzuela, Chuanye Huang, Jiexiu Zhao, Ping Hong, Zilin He, Shuhui Yin, Alejandro Lucia
Frontiers in Physiology.2019;[Epub] CrossRef
Exercise as ‘precision medicine’ for insulin resistance and its progression to type 2 diabetes: a research review
Fred J. DiMenna, Avigdor D. Arad
BMC Sports Science, Medicine and Rehabilitation.2018;[Epub] CrossRef
High-intensity aerobic interval training improves aerobic fitness and HbA1c among persons diagnosed with type 2 diabetes
Eva Maria Støa, Sondre Meling, Lill-Katrin Nyhus, Glenn Strømstad, Karl Magnus Mangerud, Jan Helgerud, Solfrid Bratland-Sanda, Øyvind Støren
European Journal of Applied Physiology.2017; 117(3): 455. CrossRef

Perception of Clinicians and Diabetic Patients on the Importance of Postprandial Glucose Control and Diabetes Education Status: A Cross Sectional Survey: Ji Hun Choi, Cheol Young Park, Bong Soo Cha, In Joo Kim, Tae Sun Park, Joong Yeol Park, Kyung Soo Park, Kun Ho Yoon, In Kyu Lee, Sung Woo Park; Diabetes Metab J. 2012;36(2):120-127. Published online April 17, 2012; DOI: https://doi.org/10.4093/dmj.2012.36.2.120

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Background

Recent studies have shown the importance of postprandial glucose (PPG) in the development of diabetes complications. This study was conducted in order to survey the perceptions of clinicians and diabetic patients with respect to PPG management and the current status of diabetes education.

Methods

This was a cross-sectional study involving face-to-face interviews and an open questionnaire survey conducted in Korea. A total of 300 patients and 130 clinicians completed questionnaires, which included current education status, self monitoring of blood glucose (SMBG), criteria of diagnosis and management, and perceptions relating to PPG management.

Results

While there was a significantly higher perceived need for diabetes education, the sufficiency of the current education was considered to be severely lacking. Fasting plasma glucose (FPG), PPG, and glycosylated hemoglobin (HbA1c) were all important considerations for clinicians when making a diagnosis of diabetes, although PPG was considered less important than FPG or HbA1c in the treatment of diabetes. Most clinicians and patients were aware of the importance of PPG, but actual education on the importance of PPG was not actively being delivered.

Conclusion

Our study showed that the current status of diabetes education is insufficient to meet the needs of the Korean population. A considerable gap was found to exist between awareness and what was actually taught in the current education program in regard to the importance of PPG. These results suggest that clinicians need to be more active in patient education, especially in regard to the importance of PPG.

Citations

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Kevin Cowart, Rachel Franks, Olivia Pane, Ellen Murphy, Kelly Oldziej
ADCES in Practice.2022; 10(2): 30. CrossRef
Post hoc efficacy and safety analysis of insulin glargine/lixisenatide fixed- ratio combination in North American patients compared with the rest of world
George Dailey, Harpreet S Bajaj, Terry Dex, Melanie Groleau, William Stager, Aaron Vinik
BMJ Open Diabetes Research & Care.2019; 7(1): e000581. CrossRef
Experiences of Diabetes Education among Educators of Diabetes : a content analysis approach
Soo Jin Kang, Soo Jung Chang
Journal of Korean Public Health Nursing.2016; 30(2): 221. CrossRef
BeAM value: an indicator of the need to initiate and intensify prandial therapy in patients with type 2 diabetes mellitus receiving basal insulin
Ariel Zisman, Francienid Morales, John Stewart, Andreas Stuhr, Aleksandra Vlajnic, Rong Zhou
BMJ Open Diabetes Research & Care.2016; 4(1): e000171. CrossRef
Does Availability of Reliable Home Blood Glucose Data at Diabetes Appointments Improve Glycemia?
Gillian S. Boyd-Woschinko, David L. Kaiser, Michael Diefenbach, Ronald Tamler
Endocrine Practice.2014; 20(4): 299. CrossRef
Safety and effectiveness of insulin aspart in type 2 diabetic patients: Results from the ASEAN cohort of the A1chieve study
Wan Mohamad Wan Bebakar, Mary Anne Lim-Abrahan, Ananá B. Jain, Darren Seah, Pradana Soewondo
Diabetes Research and Clinical Practice.2013; 100: S17. CrossRef

Low Density Lipoprotein Cholesterol Target Goal Attainment Rate and Physician Perceptions about Target Goal Achievement in Korean Patients with Diabetes: Jenie Yoonoo Hwang, Chang Hee Jung, Woo Je Lee, Cheol Young Park, Sung Rae Kim, Kun-Ho Yoon, Moon Kyu Lee, Sung Woo Park, Joong-Yeol Park; Diabetes Metab J. 2011;35(6):628-636. Published online December 26, 2011; DOI: https://doi.org/10.4093/dmj.2011.35.6.628

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Background

This study aims to investigate the discrepancy between clinicians' perceptions and actual achievement rates of low density lipoprotein cholesterol (LDL-C) in Korean patients with diabetes according to updated American Diabetes Association (ADA)/American College of Cardiology Foundation (ACC) recommendations.

Methods

This is a multi-center, retrospective, non-interventional, observational study. Diabetic patients aged 18 years or older were eligible if they had been diagnosed with hypercholesterolemia or were receiving a lipid-lowering therapy between May 2010 and August 2010. The information was obtained by reviewing medical records and using a self-completed questionnaire to examine physician perceptions.

Results

A total of 2,591 subjects who satisfied the inclusion criteria were enrolled. Highest-risk and high-risk patients accounted for 61.9% and 38.1% of the patients, respectively. Although most (96.3%) underwent a statin monotherapy or a statin-based combination therapy, just 47.4% of patients attained the LDL-C target. However, the physicians' perceptions on target achievement rate (70.6%) were different from the actual results (47.4%). Many patients (65.3%) remained on the starting doses of statins, despite evidence of poor achievement of lipid goals.

Conclusion

Only less than half of patients with diabetes attained the LDL-C goal. The surveys showed that poor physician performance might be due to the lack of recognition on ADA/ACC consensus causing a low LDL-C target attainment rate. Therefore, changes in doctor perception are needed to attain target LDL-C level and reduce cardiovascular risk in Korean patients with diabetes.

Citations

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Juan Cosín-Sales, Raquel Campuzano Ruiz, José Luis Díaz Díaz, Carlos Escobar Cervantes, María Rosa Fernández Olmo, Juan José Gómez-Doblas, José María Mostaza, Juan Pedro-Botet, Núria Plana Gil, Pedro Valdivielso
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Diabetes & Metabolism Journal.2022; 46(3): 464. CrossRef
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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

Management of Blood Pressure in Patients with Type 2 Diabetes Mellitus: A Nationwide Survey in Korean: Mi Hae Seo, Woo Je Lee, Cheol Young Park, Sung Rae Kim, Joong Yeol Park, Kun-Ho Yoon, Moon Kyu Lee, Sung Woo Park; Diabetes Metab J. 2011;35(4):348-353. Published online August 31, 2011; DOI: https://doi.org/10.4093/dmj.2011.35.4.348

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Background

Hypertension is common in patients with type 2 diabetes, affecting up to 60% of patients. The Korean Diabetes Association performed a nationwide survey about prevalence, awareness and control of hypertension among diabetic Koreans.

Methods

The current survey included 3,859 diabetic patients recruited from 43 hospitals in Korea. Age, gender, height, weight and blood pressure (BP) were measured by standard methods. Data on fasting plasma glucose, glycosylated hemoglobin (HbA1c), awareness of hypertension, and compliance of antihypertensive medication were collected via interview and reviewed using patient medical records.

Results

A total of 57.5% of all patients were >60 years old. Their mean HbA1c was 7.6±1.5%. Among antihypertensive medication users, 39.9% had <130 mm Hg and <80 mm Hg, whereas 60.1% had ≥130 mm Hg or ≥80 mm Hg. The answer "BP is under good control" was given by 75.1% of the antihypertensive medication users. Out of these patients, 26.4% had <130 mm Hg and <80 mm Hg, whereas 73.6% had ≥130 mm Hg or ≥80 mm Hg. A total of 75.5% of antihypertensive medication users answered that they had taken their antihypertensive medication every day for the past 2 weeks. "Forgetfulness" was most frequently the reason of non-compliance for patients that did not take their antihypertensive medication regularly.

Conclusion

Approximately one third of the patients with diabetes were found to reach target blood pressure control in the 43 hospitals across Korea. Stricter control is needed to reduce severe complications of diabetes in Korea.

Citations

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Value of ambulatory blood pressure measurement in diagnosing hypotension in hypertensive diabetic patients with medication-controlled BP
Kamal Alghalayini
JRSM Cardiovascular Disease.2020;[Epub] CrossRef
Association between blood pressure and target organ damage in patients with chronic kidney disease and hypertension: results of the APrODiTe study
Ran-hui Cha, Sejoong Kim, Sun Ae Yoon, Dong-Ryeol Ryu, Ji Eun Oh, Sang-Youb Han, Eun Young Lee, Dong Ki Kim, Yon Su Kim
Hypertension Research.2014; 37(2): 172. CrossRef
Blood Pressure Control According to the Prevalence of Diabetes in Renal Transplant Recipients
E. Zbroch, J. Malyszko, I. Glowinska, D. Maciorkowska, G. Kobus, M. Mysliwiec
Transplantation Proceedings.2013; 45(1): 200. CrossRef
Prevalence, awareness, treatment and control of hypertension in adults with diagnosed diabetes: The Fourth Korea National Health and Nutrition Examination Survey (KNHANES IV)
H-S Lee, S-S Lee, I-Y Hwang, Y-J Park, S-H Yoon, K Han, J-W Son, S-H Ko, Y G Park, H W Yim, W-C Lee, Y-M Park
Journal of Human Hypertension.2013; 27(6): 381. CrossRef
Multi-Institutional Analysis of Localized Renal Cell Carcinoma that Demonstrates the Impact of Diabetic Status on Prognosis After Nephrectomy
Yun-Sok Ha, Won Tae Kim, Seok-Joong Yun, Sang-Cheol Lee, Wun-Jae Kim, Yong Hyun Park, Seok Ho Kang, Sung-Hoo Hong, Seok-Soo Byun, Yong-June Kim
Annals of Surgical Oncology.2013; 20(11): 3662. 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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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
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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
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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
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Clinical Endocrinology.2012; 77(2): 215. CrossRef

Comparison of the Efficacy of Glimepiride, Metformin, and Rosiglitazone Monotherapy in Korean Drug-Naïve Type 2 Diabetic Patients: The Practical Evidence of Antidiabetic Monotherapy Study: Kun Ho Yoon, Jeong Ah Shin, Hyuk Sang Kwon, Seung Hwan Lee, Kyung Wan Min, Yu Bae Ahn, Soon Jib Yoo, Kyu Jeung Ahn, Sung Woo Park, Kwan Woo Lee, Yeon Ah Sung, Tae Sun Park, Min Seon Kim, Yong Ki Kim, Moon Suk Nam, Hye Soon Kim, Ie Byung Park, Jong Suk Park, Jeong Taek Woo, Ho Young Son; Diabetes Metab J. 2011;35(1):26-33. Published online February 28, 2011; DOI: https://doi.org/10.4093/dmj.2011.35.1.26

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Background

Although many anti-diabetic drugs have been used to control hyperglycemia for decades, the efficacy of commonly-used oral glucose-lowering agents in Korean type 2 diabetic patients has yet to be clearly demonstrated.

Methods

We evaluated the efficacy of glimepiride, metformin, and rosiglitazone as initial treatment for drug-naïve type 2 diabetes mellitus patients in a 48-week, double-blind, randomized controlled study that included 349 Korean patients. Our primary goal was to determine the change in HbA1c levels from baseline to end point. Our secondary goal was to evaluate changes in fasting plasma glucose (FPG) levels, body weight, frequency of adverse events, and the proportion of participants achieving target HbA1c levels.

Results

HbA1c levels decreased from 7.8% to 6.9% in the glimepiride group (P<0.001), from 7.9% to 7.0% in the metformin group (P<0.001), and from 7.8% to 7.0% (P<0.001) in the rosiglitazone group. Glimepiride and rosiglitazone significantly increased body weight and metformin reduced body weight during the study period. Symptomatic hypoglycemia was more frequent in the glimepiride group and diarrhea was more frequent in the metformin group.

Conclusion

The efficacy of glimepiride, metformin, and rosiglitazone as antidiabetic monotherapies in drug-naïve Korean type 2 diabetic patients was similar in the three groups, with no statistical difference. This study is the first randomized controlled trial to evaluate the efficacy of commonly-used oral hypoglycemic agents in Korean type 2 diabetic patients. An additional subgroup analysis is recommended to obtain more detailed information.

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Diabetes Technology & Therapeutics.2013; 15(10): 810. CrossRef
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Metformin Based Dual-Combination Therapies in Drug Naïve Type 2 Diabetic Patients
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Diabetes & Metabolism Journal.2013; 37(6): 429. CrossRef
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Anna Edberg, Daniel Soeria-Atmadja, Jonas Bergman Laurila, Fredrik Johansson, Mats G. Gustafsson, Ulf Hammerling
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Efficacy and safety of ginsam, a vinegar extract from Panax ginseng, in type 2 diabetic patients: Results of a double‐blind, placebo‐controlled study
Ji Won Yoon, Seon Mee Kang, Jason L Vassy, Hayley Shin, Yun Hee Lee, Hwa Young Ahn, Sung Hee Choi, Kyong Soo Park, Hak Chul Jang, Soo Lim
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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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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.

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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
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Diabetes & Metabolism Journal.2011; 35(5): 431. CrossRef
2011 Clinical Practice Guidelines for Type 2 Diabetes in Korea
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Journal of Korean Diabetes.2011; 12(4): 183. CrossRef

Randomized Controlled Trial

Effects of Adding omega-3 Fatty Acids to Simvastatin on Lipids, Lipoprotein Size and Subspecies in Type 2 Diabetes Mellitus with Hypertriglyceridemia.: Won Jun Kim, Chang Beom Lee, Cheol Young Park, Se Eun Park, Eun Jung Rhee, Won Young Lee, Ki Won Oh, Sung Woo Park, Dae Jung Kim, Hae Jin Kim, Seung Jin Han, Hong Keum Cho; Korean Diabetes J. 2009;33(6):494-502. Published online December 1, 2009; DOI: https://doi.org/10.4093/kdj.2009.33.6.494

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Abstract PDF: BACKGROUND
omega-3 fatty acids are known to improve lipid profiles, the distribution of lipoprotein subclasses, and secondary prevention against post-myocardial infarction. Rare reports have emerged of synergistic results of omega-3 fatty acids with simvastatin in cases of type 2 diabetes mellitus with hypertriglyceridemia. The purpose of this study was to determine the combined relationship of omega-3 fatty acids plus simvastatin on lipid, lipoprotein size and the types of subspecies. METHODS: This randomized, multi-center, comparison study evaluated eight weeks of combination therapy (omega-3 fatty acids (Omacor) 4 g/day plus simvastatin 20 mg/day) or monotherapy (simvastatin 20 mg/day) for at least six weeks in 62 diabetic patients. Subjects with a triglyceride concentration of more than 200 mg/dL were eligible for inclusion. RESULTS: No significant differences for omega-3 fatty acids + simvastatin versus simvastatin alone were observed for triglycerides (-22.7% vs. -14.3%, P = 0.292), HDL peak particle size (+2.8% vs. -0.4%, P = 0.076), LDL mean particle size (+0.4% vs -0.1%, P = 0.376) or LDL subspecies types, although the combination therapy showed a tendency toward lower triglycerides, larger HDL, and LDL particle sizes than did the monotherapy. There were no significant differences between the two groups in regard to HDL-C, LDL-C, or HbA1c levels. There were no serious adverse events and no abnormalities in the laboratory values associated with this study. CONCLUSION: omega-3 fatty acids were a safeform of treatment in hypertriglyceridemic patients with type 2 diabetes mellitus. But, regarding efficacy, a much larger sample size and longer-term follow-up may be needed to distinguish between the effects of combination therapy and monotherapy.

Original Articles

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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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.

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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

Effect of Valsartan on Blood Pressure and Urinary Albumin Excretion in Hypertensive Type 2 Diabetic Patients: An Open-Label, Multicenter Study.: Se Jun Park, Dae Jung Kim, Hae Jin Kim, Soo Yeon Park, Ji A Seo, Nan Hee Kim, Sung Hee Choi, Soo Lim, Hak Chul Jang, Seung Hyun Ko, Ki Ho Song, Yu Bae Ahn, Soo Kyoung Kim, Yong Wook Cho, Jun Goo Kang, Sung Hee Ihm, Cheol Young Park, Sung Woo Park, Dong Hyun Shin, Yong Hyun Kim, Kwan Woo Lee; Korean Diabetes J. 2008;32(6):513-521. Published online December 1, 2008; DOI: https://doi.org/10.4093/kdj.2008.32.6.513

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Abstract PDF: BACKGROUND
Activation of renin-angiotensin system (RAS) has been an important mechanism of microvascular and macrovascular complications in diabetic patients. It has been reported that RAS blockades reduce the development and progression of diabetic nephropathy. The aim of this study was to evaluate whether valsartan, an angiotensin II receptor blocker (ARB), reduced blood pressure and urinary albumin excretion rate (UAER) in hypertensive type 2 diabetic patients. METHOD: Three hundred forty-seven hypertensive type 2 diabetic patients who had not taken angiotensin converting enzyme inhibitors or ARB for 6 months prior to this study were enrolled. We measured blood pressure and UAER before and after 24 weeks of valsartan treatment. RESULT: Baseline mean systolic and diastolic blood pressure was 143 +/- 15 and 87 +/- 11 mmHg, respectively and the median albumin excretion rate was 27 ug/mg. Reduction in systolic and diastolic blood pressure was 16 mmHg/10 mmHg and the median UAER was 19.3 ug/mg after 24 weeks (P < 0.01, respectively). When we divided the subjects into three groups according to the UAER (normoalbuminuria, microalbuminuria and macroalbuminuria), significant changes were reported in the microalbuminuria and the macroalbuminuria groups. Thirty-eight (42%) patients with microalbuminuria improved to normoalbuminuria and twelve (41%) patients with macroalbuminuria improved to microalbuminuria. We found an association between the improvement of blood pressure and UAER (R = 0.165, P = 0.015). CONCLUSION: We concluded that valsartan reduces urinary albumin excretion and blood pressure in hypertensive type 2 diabetic patients.

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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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
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Rimkyo Yeo, So Ra Yoon, Oh Yoen Kim
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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
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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
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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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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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Abstract 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.

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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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Abstract 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.

Effects of Type 2 Diabetes Mellitus on Risk Factors of Acute Coronary Syndrome.: Hong Ju Moon, Jun Goo Kang, Min Ho Jo, Byung Wan Lee, Cheol Young Park, Seong Jin Lee, Eun Kyung Hong, Jae Myoung Yu, Doo Man Kim, Sung Hee Ihm, Hyun Kyu Kim, Chong Yun Rhim, Moon Gi Choi, Hyung Joon Yoo, Sung Woo Park; Korean Diabetes J. 2006;30(6):435-441. Published online November 1, 2006; DOI: https://doi.org/10.4093/jkda.2006.30.6.435

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Abstract PDF

BACKGROUND
Diabetes mellitus (DM) is equivalent as well a risk factor of cardiovascular disease. We analyzed the effects of DM on clinical risk factors of acute coronary syndrome by comparing DM group with Non-DM group. METHODS: A total of 847 (514 males and 333 females) patients with acute coronary syndrome was selected from 1664 patients who had undergone coronary angiography (CAG). These patients comprised 105 subjects with non-ST elevation myocardial infarction (MI), 313 with ST elevation MI and 429 with unstable angina. According to the presence of DM, we retrospectively reviewed the measured basic demographics, biochemical markers and coronary angiographic findings. RESULTS: In the multivariated analysis, history of hypertension (P = 0.001), C-reactive protein (CRP) level (P = 0.001) and triglyceride level (P = 0.018) were independent risk factors in type 2 diabetic group. Also the frequency of multiple coronary vessel disease was higher in DM group than non-DM group on the coronary angiographic finding CONCLUSIONS: Classic risk factors for acute coronary syndrome are strong predictors in patients with type 2 DM. Among these factors, the most important powerful risk factor is history of hypertension.

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Gender-Based Differences in the Management and Prognosis of Acute Coronary Syndrome in Korea
Hee Tae Yu, Kwang Joon Kim, Woo-Dae Bang, Chang-Myung Oh, Ji-Yong Jang, Sung-Soo Cho, Jung-Sun Kim, Young-Guk Ko, Donghoon Choi, Myeong-Ki Hong, Yangsoo Jang
Yonsei Medical Journal.2011; 52(4): 562. CrossRef

Review

Physical Activity and Type 2 Diabetes Mellitus.: Kyung Wan Min, Sung Woo Park; Korean Diabetes J. 2006;30(1):1-9. Published online January 1, 2006; DOI: https://doi.org/10.4093/jkda.2006.30.1.1

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Full mouth rehabilitation for a disabled patient: a case report
Ae-Ra Kim, Mong-Sook Vang, Sang-Won Park, Hyun-Pil Lim, Kwi-Dug Yun, Hong-So Yang
The Journal of Korean Academy of Prosthodontics.2013; 51(3): 208. CrossRef

Original Articles

The Study of Physical Activity in the Korean with Type 2 Diabetes.: Kyung Wan Min, Keun Hee An, Tae Seo Sohn, Yong Moon Park, Yeong Sun Hong, Yeon Su Kim, Yi Byeong Park, Kang Seo Park, Gwan Woo Lee, In Ju Kim, Kyung Ah Han, Jae Myoung Yu, Hyun Shik Son, Sei Hyun Baik, Won Cheol Lee, Chung Gu Cho, Hyoung Woo Lee, Sung Woo Park; Korean Diabetes J. 2005;29(6):517-525. Published online November 1, 2005

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Abstract PDF: BACKGROUND
Despite the importance of exercise, little is known about the epidemiology of exercise among persons with diabetes in the Korea. We do not have any standard method to evaluate physical activity of diabetics. So exercise committee of Korean diabetic association decided to survey the physical activities of Korean type 2 diabetic patients. METHODS: Cross-sectional study including 1073 type 2 diabetics (509 males, 564 females) over 18 age. 34 general hospitals collected data about physical activity from Dec. 2004 to Feb.2005. Data were randomly collected by interviewers using numeration table. Respondents were asked about the physical activities or exercise during recent 7 days and frequency, duration of each activity. To compare with normal population, we use 2001 KNHANES (Korean National Health and Nutrition Examination Survey) results. RESULTS: People with type 2 diabetes were more likely to report exercising regularly than people without this disease (52.5% vs. 27.5%) (p<0.0001), but 47.5% of type 2 diabetics didn't take exercise. Walking time of type 2 diabetics wasmore than that of people without this disease (p<0.0001). Type 2 diabetics exerting <700kcal/week of energy expenditure with physical activity were 45.5% in the exercising type 2 diabetics (males:44.2%, females:55.8%). Energy expenditure was positively correlated with frequency of physical exercise and exercise period (p<0.001). CONCLUSION: 47.5% of Korean type 2 diabetics and 72.5% of normal population did not take exercise. 45.5% of exercising type 2 diabetics exerted energy expenditure under 700kcal/week with physical activity. Therefore, various programs for initiating physical activity and increasing energy expenditure are required.

Clinical Characteristics and Analysis of Risk Factor for Gastroesophageal Reflux Disease in Diabetic Patient.: Kwang Hyuk Park, Seong Bo Yoon, Min Ho Jo, Eon Kyung Hong, Seong Jin Lee, In Kyung Jeong, Chul Young Park, Ki Won Oh, Hyun Kyu Kim, Jac Myoung Yu, Doo Man Kim, Sung Hee Lim, Moon Ki Choi, Hyung Jun Yoo, Sung Woo Park, Heung Young Oh, Jin Bae Kim, Il Hyun Baek, Myung Seok Lee; Korean Diabetes J. 2005;29(4):358-366. Published online July 1, 2005

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Abstract PDF: BACKGROUND
A high prevalence of gastroesophageal reflux disease(GERD) has been reported in diabetic patient. However, the exact mechanisms of GERD in diabetic patient have not been described. In several studies, diabetic neuropathy and dysfunction of the autonomic nervous system have been suggested as risk factors of GERD. However, there have been no studies on the exact prevalence or risk factors of GERD in Korean diabetic patients. Therefore, the prevalence of GERD in Korean diabetics patients was examined, and the risk factors for GERD, the differences in symptoms between GERD and non-GERD patients, and the degree of symptom relief after treatment were also analyzed. METHODS: A total of 310 diabetic patients, who underwent an upper gastroendoscopy due to diverse gastrointestinal symptoms, between April 2001 and November 2003, were enrolled. The diagnostic criteria or GERD included the upper gastroendoscopic view, which was analyzed using the scale of 'The Los Angeles Classification of Esophagus' from grades A to D. The prevalence and symptoms of GERD patients and the variable risk factors, such as blood glucose level, smoking and diabetic neuropathy, were examined. RESULTS: 1) There was an 18.4% prevalence of GERD in diabetic patients. 2) The clinical characteristics, including sex, age and serum lipid level, of the GERD group were not significantly different to those of the control group. However, the duration of smoking, the fasting and postprandial 2-hour serum glucose levels, and the diabetic neuropathy significantly affected GERD, 3) The main symptoms of the GERD group were dyspepsia(47.4%) and heart burn(26.3%). 4) The degree of subjective symptom relief in the GERD group after treatment with the proton pump inhibitor, pantoprazole(40mg), was remarkably lower than in the control group for approximately 1 month. CONCLUSION: In this study, the prevalence of GERD in diabetic patient was higher than that found in the general population which suggests that GERD in diabetic patient was due to a poorly controlled serum glucose level and diabetic neuropathy. The chief complaints pertaining to gastrointestinal symptoms in both study groups were non-specific. However, the recovery from symptoms in the GERD group was lower than the control group following drug therapy. The causes of the lower response rate in the GERD group will need to be examined in further studies.

The Relationship Between the C1818T Polymorphism in Exon 4 of the klotho Gene with Fasting Glucose and Insulin Levels in Korean Women.: Ki Won Oh, Eun Joo Yun, Eun Jung Rhee, Won Young Lee, Ki Hyun Baek, Kun Ho Yoon, Moo Il Kang, Seong Gyun Kim, Cheol Young Park, Sung Hee Ihm, Moon Gi Choi, Hyung Joon Yoo, Sung Woo Park; Korean Diabetes J. 2005;29(3):189-197. Published online May 1, 2005

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Abstract PDF: BACKGROUND
A novel gene, termed klotho has been identified as a suppressor of several aging phenotypes, and a genetic defect of klotho in mice resulted in a syndrome resembling human aging, i.e., a short lifespan, infertility, arteriosclerosis, skin atrophy, osteoporosis, and pulmonary emphysema. Since klotho mice also showed an abnormal glucose metabolism, we investigated the relationship between the C1818T polymorphism in exon 4 of the klotho gene and fasting glucose and insulin resistance in Korean women to observe its contribution to glucose metabolism. METHODS: The weight, height, blood pressure, fasting blood glucose, insulin, and lipid profiles were measured in 241 women(mean age, 51.2+/-7.0yr) by using the standard methods. Homeostasis model assessment(HOMA)-insulin resistance(IR), the quantitative insulin sensitivity check index(QUICKI) and HOMAbeta-cell were calculated. The genotyping of the C1818T polymorphism in exon 4 of the klotho gene was performed by allelic discrimination with using a 5' nuclease polymerase chain reaction assay. RESULTS: The allele frequencies were 0.805 for the C allele and 0.195 for the T allele, and they were in Hardy-Weinberg equilibrium(P=0.290). The mean fasting blood glucose(P= 0.005) and HOMA IR(P=0.035) were significantly higher in the T allele carriers compared with the non-carriers. After adjustment was made for age, fasting blood glucose was persistently significant(P=0.015), but the HOMA-IR became marginally significant(P=0.063). In the premenopausal women, the T allele carriers showed a higher mean fasting blood glucose(P=0.038), insulin(P=0.024), HOMA-IR(P=0.010), total cholesterol(P=0.039), and triglyceride levels(P=0.031) than in the non-carriers. After adjustment was made for age, the fasting blood glucose, insulin, HOMA-IR and triglyceride were persistently significant(P= 0.043, P=0.026, P=0.011, P=0.040). Also, the QUICKI, total cholesterol and low-density ilpo-protein cholesterol became marginally significant(P=0.073, P=0.061, P=0.098). For the postmenopausal women, the T allele carriers showed a tendency for higher mean fasting blood glucose levels(P=0.065) and lower HOMA beta-cell levels(P=0.085) than in the noncarriers. These differences became non-significant after adjustment was made for age. CONCLUSION: We observed that the C1818T polymorphism in exon 4 of the klotho gene was partly associated with glucose metabolism in Korean women. Also, these data suggest that the C1818T polymorphism is related with some cardiovascular risk factors in Korean women. The mechanism linking this gene with glucose metabolism warrants further study

The Influence of Metabolic Syndrome on the Intima-Medial Thickness and Cardiovascular Risk Factors in Type 2 Diabetes.: Kwang Pyo Son, Young Je Chae, Tae Yu Lee, In Kyung Jeong, Mina Hur, Gu Young Jo, Young Lee, Seong Jin Lee, Chul Young Park, Ki Won Oh, Eon Kyung Hong, Hyun Kyu Kim, Jae Myoung Yu, Doo Man Kim, Sung Hee Lim, Moon Ki Choi, Hyung Jun Yoo, Sung Woo Park; Korean Diabetes J. 2004;28(5):392-406. Published online October 1, 2004

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Abstract PDF: BACKGROUND
Metabolic syndrome (MS) is usually present in type 2 DM (T2DM), and it is associated with atherosclerosis. The aim of this study is to exam the influence of MS on the intima-medial thickness(IMT) and the cardiovascular risk factors for type 2 diabetic patients. SUBJECTS AND METHODS: A cross sectional study was performed on 82 patients with Type 2 diabetes mellitus (DM) and 84 healthy controls. MS was defined according to the NCEP-ATP III criteria. Those subjects with any history of cerebro vascular accident, ischemic heart disease or acute inflammation were excluded. The cardiovascular risk factors (hsCRP, lipid profile, homocysteine, and uric acid), the status of glucose metabolism (HbA1c, fasting glucose, insulin, and HOMA-IR), the diabetic microvascular complications and the IMT at both common carotid arteries were measured. RESULTS: 1) For patients with T2DM, the levels of waist circumference, blood pressure, TG (1.7+/-1.4 vs 2.2+/-1.4 mmol/L), HDL-C (1.5+/-0.4 vs. 1.3+/-0.3 mmol/L), LDL-C (2.7+/-0.7 vs 3.1+/-0.9 mmol/L), TC/HDL-C (3.5 vs. 41), log of (hsCRP) (-0.11+/-0.4 vs 0.17+/-0.4), mean carotid IMT (0.63+/-0.12 vs. 0.74+/-0.12 mm) and max IMT (0.68+/-0.14 vs. 0.86+/-0.15 mm) were significantly different from the healthy control group. 2) The prevalence of MS in the T2DM groups was 64%. However, a decrease of the waist circumference, as measured by the modified Asian criteria, increased the crude prevalence of MS by up to 75%. 3) Diabetic patients with MS had a higher incidence of hypertension, a lower level of HDL-C, and higher levels of waist circumference, HOMA-IR, TG, and TC/HDL-C, a greater extent of microvasculopathy, an increased log (hsCRP), homocysteine, and carotid IMT than did diabetic patients without MS. 4) Among the component of MS, the presence of hypertriglyceridemia had an influence on the IMT mean and max. 5) The carotid IMT of patients with DM correlated with age, homocysteine, log (hsCRP), and uric acid on univariate analysis, and age and homocysteine we found to be independent risk factors of carotid IMT on multivariated analysis. CONCLUSION: Metabolic syndrome in subjects with glucose intolerance increases the risk of atherosclerosis.

Effect of Glucose Concentrations on the Cell Proliferation and Expression of L-type Calcium Channel mRNA in Cultured Rat Aortic Vascular Smooth Muscle Cells.: Young Jung Cho, Hyung Joon Yoo, Hong Woo Nam, Ji Young Suh, In Kyung Jeong, Sung Hee Ihm, Hyeon Kyu Kim, Cheol Young Park, Jae Myung Yoo, Doo Man Kim, Moon Gi Choi, Sung Woo Park; Korean Diabetes J. 2003;27(3):253-259. Published online June 1, 2003

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Abstract PDF: BACKGROUND
Vascular smooth muscle cell (VSMC) proliferation is one of the major pathogenic mechanisms for atherosclerosis. It is known that L-type calcium channels play a role in VSMC proliferation in diabetic rats. However, there have been no studies that show an association between the L-type calcium channels and the VSMC proliferation due to various glucose concentrations in the culture media. Therefore, the association between the voltage-dependent L-type calcium channels of the VSMCs, and the growth of vascular smooth muscle cells, was examined. METHODS: Rat aortic VSMCs were isolated from the aorta of Sprague-Dawley and OLETF rats, using an enzymic method. The VSMCs were cultured in various concentrations of glucose (5.5, 11.0, 16.6, 25, 30 and 40 mM). The VSMCs (1x10(4) cells in 24-well plates) were incubated in the presence of Bay K 8644 (10(-6)M), both with and without verapamil (10(-6)M), for 48 hours. The proliferation was then assessed by the MTT (methylthiazole tetrazolium) assay, and the expression of L-type calcium channel mRNA by RT-PCR. RESULTS: The vascular smooth muscle cell proliferation was significantly increased, in a dose-dependent manner, with glucose concentrations below 25 mM in both in a dose-dependent manner, with glucose concentrations below 25 mM in both kinds of rat. However, the increase in the VSMC proliferation of the OLETF rat was significantly higher than in the Sprague-Dawley rat. After the Bay K 8644 treatment, with the same glucose concentration, the VSMC proliferation and the expression of L-type calcium channel mRNA were significantly increased in both kinds of rat. After treatment with verapamil, the increased VSMC proliferation and expression of L-type calcium channel mRNA, due to the Bay K 8644, were suppressed to control levels in both kinds of rat. CONCLUSION: The results suggest that below certain concentrations of glucose, 25 mM, the L-type calcium channels may play a role in the VSMC proliferation of OLETF and Sprague-Dawley rats. The growth of the VSMCs in OLETF rats, due to various glucose concentrations (< 25 mM), was significantly higher than in the Sprague-Dawley rats.

Effect of Advanced Glycation End Products on Rat Aortic Vascular Smooth Muscle Cells.: Jin Young Song, Sung Hee Ihm, Ji Young Suh, Young Joong Cho, Hyung Joon Yoo, Sung Woo Park, Ja Hei Ihm; Korean Diabetes J. 2002;26(2):91-99. Published online April 1, 2002

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Abstract PDF: BACKGROUND
Diabetes mellitus is an epidemiologically proven risk factor for atherosclerosis. Advanced glycation end products (AGE) have been implicated in the pathogenesis of many diabetic vascular complications. AGE not only change the physicochemical properties of proteins, but also induce a wide range of cell-mediated responses. However, biological effects of AGE on the vascular smooth muscle cells (VSMCs) have not been fully explained despite of presence of an AGE-receptor on the VSMCs. METHODS: In order to test whether AGE promotes atherosclerosis by stimulation of the growth promoting signal transduction pathways in the VSMCs, the proliferation of rat aortic VSMCs cultured in the presence of AGE-BSA with/without anti-AGE antibodies, the MAP kinase inhibitor and antioxidants was measured. The VSMCs (1 x 104 cells in 24-well plates) isolated from the aorta of Sprague-Dawley rats were incubated for 48 hours and the proliferation was assessed by a MTT assay. RESULTS: AGE-BSA increased the proliferation of rat aortic VSMCs by 1.5~1.6 fold at the g/mL level. The stimulatory effect of AGE-BSA (5 microgram/mL) was blocked by the anti-AGE antibodies (100 microgram/mL). PD98059 at 50 M inhibited the AGE - BSA - induced VSMC proliferation, suggesting that MAP kinase activation might be responsible for the proliferative response of the VSMCs to AGE. AGE - BSA - induced VSMC proliferation was also attenuated by N-acetylcysteine (1 micro M) and butylated hydroxyanisole (10 micro M), implying that increased intracellular oxidative stress might be also involved in the proliferative response to AGE. CONCLUSION: These results suggest AGE play a role in diabetic atherosclerosis by stimulating of the growth promoting signal transduction pathways in the VSMCs.

The Relation of Diabetes Control to Stress Amounts Associated with Life Events in Diabetics.: Jung Won Lim, Hyung Joon Yoo, Kyung Ae Choi, Sung Hee Lim, Yoo Sun Chung, Sung O Seo, Chul Su Choi, Hyun Kyu Kim, Jae Myung Yoo, Doo Man Kim, Moon Gi Choi, Sung Woo Park, Young Joong Cho; Korean Diabetes J. 2001;25(3):240-249. Published online June 1, 2001

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Abstract PDF: BACKGROUND
The life events which diabetic patients experience has an influence on conduct and communication pattern that is essential to control diabetes. The psychosocial life events which patients experienced in recently, as well as in the past has an important meanings in the process of the plan, implementation and evaluation of diabetic control. However, the most researches on this issues are scanty. Thus, we evaluated the relation of diabetic control to stress amounts associated with the life event which diabetic patients experience for the past one year. METHODS: In this study, 81 diabetic patients admitted to H hospital from March, 1999 to February 2000 were examined in stress amounts associated with life events, blood sugar, HbA1C, duration, complication, family history, treatment to inspect the hypothesis that stress experiences for recent 1 year are related to diabetic control. The 'Life Psychosocial Event Scale' invented by Lee was used. To examine the hypothesis that diabetic control may be influenced by the amount of stress, we investigated the difference of the means between the two groups (upper 30% of patients vs. lower 30% of patients) by T-test. RESULTS: The mean age was 56.9+/-15.1 years and the mean duration of diabetes was 8.9+/-7 years. Fasting plasma glucose (FPG) was 200.3+/-71.0 mg/dL, PP2 was 292.9+/-87.2 mg/dL, HbA1C was 10.5+/-2.6%, complication was 0.8+/-0.9. The age showed negative correlation with stress amounts. The other variables did not show significant correlation with stress amounts. Thus, our study indicated that the hypothesis that stress experiences for recent 1 year are related to diabetic control was rejected. However, considering the perception-phenomenological approach on stress, if we study the relationship between stress with diabetic control inclusively, it seems that we can recognize such relationship. CONCLUSION: To address relation between stress with diabetic control inclusively, we need to consider stress factors in diversified aspects more than only one. Therefore, we must investigate how do patients perceive and cope with stress inclusively, because the crisis of life is influenced on the stress coping skill of patients. The study on this issue must be continued to identified the key factors associated with stress in diabetes.

Some immunogenetic characteristics and clinical heterogeneity of young adult-onset insulin-dependent diabetes mellitus in Korea.: Ryoung Doo Rhee, Ki Up Lee, Hyung Joo Ryu, Sung Woo Park, Dong Seop Choi, Hoon Han, Geum Ryong Kim, Chan Soo Shin, Kyong Soo Park, Bong Kyu Lee, Chang Soon Koh, Hun Ki Min; Korean Diabetes J. 1992;16(1):25-34. Published online January 1, 2001

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Abstract PDF: No abstract available.

Risk Factors of Peripheral Vascular Disease (PVD) and Nutritional Factors in Diabetic Patients over 60 Years Old Complicated with PVD Diagnosed by Ankle-Brachial Index ( ABI ).: Yoo Sun Chung, Hyung Joon Yoo, Sung O Seo, Hyun Kyu Kim, Doo Man Kim, Jae Myung Yoo, Sung Hee Ihm, Moon Gi Choi, Sung Woo Park; Korean Diabetes J. 1999;23(6):814-821. Published online January 1, 2001

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Abstract PDF: BACKGROUND
The subjects with diabetes mellitus are at high risk for peripheral vascular disease (PVD). The ABI (Ankle-Brachial Index) was done for diagnosis of PVD in diabetes. Numerous studies have been conducted to determine the risk factors for diabetes PVD. Most of the risk factors have been found are largely affected by the age and patients nutritional status to some extent. Especially in older diabetes, risk factors cannot be evaluated by numerical values only, for most patients are in background of poor nutritional support. Therefore, in this study, our aim was to evaluate on the influences of the nutritional status as the risk factors for PVD in older patients, ie., 60 years and older. METHODS: We selected 59 patients who are above 60 years old and took neither anti-hypertensive drug nor lipid lowering agents. All subjects ABI was measured by IMEXLAB 9000 and the study group was stratified according to the ABI values: the normal (ABI >10), PVD group (ABI <0.9). The ABI (Ankle-Brachial Index) was measured by The data were analyzed using one-way analysis of variance. If statistically significant effect was found, post hoc analysis (e.g., Newman-Keuls' test) was performed to evaluate the difference between the groups. The values are expressed as the mean+/-standard error (SE). RESULT: There was significant difference in smoking (ABI < 0.9; 0.54+/-0.16 packs/day, ABI > 1.0; 0.35+/-0.08 packs/day), the serum level triglyceride(ABI < 0.9; 1.960.19 mmol/L, ABI > 1.0; 1.56 + 0.21 mmol/L), HDL-cholesterol(ABI < 0.9; 0.88+/-0.11 mmol/L, ABI > 1.0; 1.10+/-0.08 mmol/1) when compared between the normal and ABI decreased subjects(P < 0.05). However, we found no significant differences in systolic blood pressure, total cholesterol and LDL-C between the two groups. Serum level of the nutritional factors such as albumin, transferrin, total lympocyte count, folate, zinc were lower than the normal values in both groups. However, these levels were not statistically significant when two groups compared. CONCLUSION: The relationship between the known PVD risk factors and PVD in older diabetes was weak. Therefore, based on the findings from this study, we suggest that when investigators interpretate the risk factors of PVD in elderly patients one must consider nutritional effects along the other factors.

Proliferative Ability of Aortic Smooth Muscle Cells and Lipid Peroxidation of Red Blood Cell Membrane in Diabetic Rats.: Sae Young Park, Hyung Joon Yoo, Kyun Soo Kim, Hyun Kyu Kim, Doo Man Kim, Jae Myung Yoo, Sung Hee Ihm, Moon Gi Choi, Sung Woo Park; Korean Diabetes J. 1999;23(6):785-792. Published online January 1, 2001

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Abstract PDF: BACKGROUND
Diabetes mellitus is a known risk factor for atherosclerosis, and lipid peroxidation, expression of oxidative stress, is also known to related to diabetes mellitus. The purpose of this study was to investigate the proliferative behaviour of cultured vascular smooth muscle cells (VSMCs) and the alteration of lipid peroxidation in relation to the pathogenesis of diabetic atherosclerosis. METHODS: Seven streptozotocin-induced insulin dependent diabetic Sprague Dawley rats and 7 normal rats were studied. Using enzyme method, aortic VSMCs was cultured in diabetic rats. and proliferation was compared between normal and diabetic rat. The membrane lipid peroxidaton of erythrocytes was determined by measurement of malonyl- dialdehyde(MDA), an end-product of fatty acid peroxidation with thiobarbituric acid (TBA) reaction. MDA-TBA colored complex concentration was calculated with the extinction coefficient of MDA-TBA complex at 532nm = 1.56X105cm-lM-1. RESULT: 1. The proliferative ability of cultured VSMCs was much higher in diabetic rats than in nondiabetic ones (p<0.05). 2. Compared with normal control rats, MDA concentration of diabetic rats was significantly increased (p<0.05). CONCLUSION: We concluded that proliferation of cultured VSMCs is due to oxidative stress in diabetes mellitus as a result of the increased proliferative ability of cultured VSMCs combined with increased lipid pemxidation in diabetic rats.

The role of impaired response of skeletal muscle glycogen synthase activity to insulin in the pathogenesis of insulin resistance instreptozotocin induced diabetic rats.: Sung Woo Park, Kyo Il Suh, Kyung Soo Park, Yeon Jin Jang, Ki Up Lee; Korean Diabetes J. 1991;15(2):183-188. Published online January 1, 2001

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Abstract PDF: No abstract available.

The effect of insulin on glycogen synthase activity in individualskeletal muscle in rat.: Sung Woo Park, Kye Il Suh, Jin Hee Kim, Hae Sun Park, Yeon Jin Jang, Ki Up Lee; Korean Diabetes J. 1991;15(1):35-40. Published online January 1, 2001

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Abstract PDF: No abstract available.

HbA1c Concentration of Elderly Diabetic Patients with the Hypoglycemic Shock who were Admitted via Emergency Room.: Jin Cheol Park, Hyung Joon Yoo, Hae Seang Yim, Yong Tae Kim, Do Kyun Jin, Hyun Kyu Kim, Doo Man Kim, Jae Myung Yoo, Sung Hee Ihm, Moon Gi Choi, Sung Woo Park; Korean Diabetes J. 1998;22(4):546-551. Published online January 1, 2001

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Abstract PDF: BACKGROUND
Mild degree of hypoglycemia is not unusual during drug therapy in elderly diabetic patients. However it is very difficult that the precise incidence of hypoglycemia is measured in elderly patients because the decreased cognitive function and autonomic dysfunction contribute to atypical hypoglycemic symptoms and signs. Therefore, most cases of elderly diabetic patients with hypoglycemia are discovered in comatose mental state. We did this study to evaluate the clinical charaeteristics of elderly diabetic patients with the hypoglycemic shock who were admitted via emergency room. METHODS: We analyzed the precipitating factors, mental status, and blood chemistries of the adult group(n=22, age 51+3.6 year, BMI-19 kg/m2) and elderly group(n=37, age=72+4.3 year, BMI=23 kg/m) that were classified by the point of 65 years old who were admitted via emergency room in state of the hypoglycemic shock. RESULTS: 1) In the precipitating factor of hypoglycemia, irregular oral intake was found in 64%(14/22) of the adult group and 64%(23/37) of the elderly group, and drug overdose was found in 27 %(1.6/22) of the adult group and 24%(9/37) of the elderly group. But there, was no significant difference between the adult and elderly group. 2) Those who arrived at the emerency room in comatose mental status were found in 45.5 % of adult group and 54.1 % of elderly group, that was no difference stastically. 3) HbA 1c was 5.8 +- 0.27% in elderly group and 8.0 +- 0.63% in the adult group who arrived at the emergency room, which was stastically significant difference between two groups. CONCLUSION: We concluded that lower HbA 1c in the elderly group than adult group who arrived at the emergency room suggest there was probability of unrecognized mild hypoglycemia before the onset of hypoglycemic shock.

The Frequency of ICA and anti-GAD Antibody in Korean IDDM and NIDDM Patients.: Kyung Soo Ko, Sung Kwan Hong, Ki Up Lee, Nan Hee Kim, Dong Seop Choi, Sung Hee Ihm, Sung Woo Park, Chul Hee Kim, Dong Won Byun, Kyo Il Suh, Hak Chul Chang, Byoung Doo Rhee; Korean Diabetes J. 1998;22(3):312-319. Published online January 1, 2001

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Abstract PDF: BACKGROUND
It has been suggested that the clinical and immunological characteristics of diabetes mellitus in Koreans are different from those of Caucasians. This study was undertaken to investigate the prevalence of autoimmune markers in Korean adults with IDDM and recent-onset NIDDM. METHODS: Seventy-seven Korean adults with IDDM and 245 recently(within 2 years) diagnosed NIDDM were included in the study. Islet cell cytoplasmic antibody was measured by immunohistochemical method, and anti-glutamic acid decarboxylase (anti-GAD) antibody was measured by radioimmunoassay. RESULTS: 1) The prevalence of ICA, anti-GAD antibody positivity was 27% and 40% in IDDM patients, and 5% and 4% in recent-onset NIDDM patients, respectively. 2) The prevalence of ICA positivity in IDDM patients decreased from 42% within one year to 21% over one year after clinical onset of disease. On the other hand, the positivity of anti-GAD antibody did not change according to the duration of diabetes. 3) The prevalence of ICA tends to be lower in IDDW patients with low serum C-peptide concentrations. In contrast, the prevalence of anti-GAD antibody was not different according to sernm C-peptide levels. CONCLUSION: These results suggested that the prevalence of ICA and antii-GAD antibody was lower in Korean adult IDDM and recent-onset NIDDM patients than that in Caucasians.

Skeletal Muscle Glycogen Synthase in the Pathogenesis of Insulin Resistance.: Sung Woo Park; Korean Diabetes J. 1998;22(2):117-126. Published online January 1, 2001

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Abstract PDF: No abstract available.

Effect of Aminoguanidine on Lipid Peroxidation in Streptozotocin-induced Diabetic Rats.: Kwon Yeop Lee, Sung Hee Ihm, Hyung Joon Yoo, Sung Woo Park, Ja Hei Ihm; Korean Diabetes J. 1997;21(4):372-380. Published online January 1, 2001

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Abstract PDF: BACKGROUND
Diabetes mellitus is postulated to be associated with increased lipid peroxidation which may contribute to vascular complications. One potential mechanism of the increased lipid peroxidation in diabetes is lipid-linked advanced glycosylation and oxidation. Aminoguanidine(AMGN), the prototype inhibitor of advanced glycosylation end-product formation, has been recently shown to prevent oxidative moditication of LDL in vitro at moderate concentration. It is unknown whether AMGN might act as an anti-oxidant against lipid peroxidation under hyperglycemia in vivo. METHODS: To investigate the in vivo effect of AMGN on lipid peroxidation in diabetes, we administered AMGN(1 g/L in drinking water) or vitamin E (400mg/day, 5 days/week) to streptozotocin(STZ)-induced diabetic rats for 9 weeks and measured plasma lipid hydroperoxides by ferrous oxidation with xylenol orange II method and RBC membrane malon-dialdehyde(MDA) by thiobarbituric acid method. RESULTS: Plasma lipid hydroperoxide level was higher in STZ-induced diabetic rats than in control rats(7.53+/-2.03 vs.5.62+/-0.44*pmol/L). RBC membrane MDA was also higher in STZ-induced diabetic rats than in control rats(2.67+/-0.46 vs. 1.81+/-0.19* nmol/mL). Plasma lipid hydroperoxide level was lower in AMGN-treated(6.23+/-0.59*umol/L) and vitamin E-treated(5.29+/-0.27*umol/L) diabetic rats than in untreated diabetic rats. RBC membrane MDA was also lower in AMGN-treated(1.93+/-0.12""'nmol/ mL) diabetic rats than in untreated diabetic rats. There was no significant difference in plasma glucose, triglyceride levels among diabetic groups(Mean +/-S.D; *, P<0.05 vs. untreated STZ-induced diabetic rats; n=8-14/group). CONCLUSION: Although the mechanisms of action of AMGN on lipid peroxidation in vivo should be studied further, these results suggest that AMGN might have an additional beneficial effect as an antioxidant against lipid peroxidation in prevention trial for diabetic vascular complications.

Prognostic Factors in the Elderly Diabetic Hyperosmolar Non-ketotic Coma.: Min Sook Park, Hyung Joon Yoo, Sun Hwa Jung, Kwon Yeop Lee, Cheol Soo Park, Cheol Hong Kim, Hyun Gyu Kim, Jae Myeog Yoo, Du Man Kim, Sung Hee Ihm, Moon Gi Choi, Sung Woo Park; Korean Diabetes J. 1997;21(2):194-199. Published online January 1, 2001

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Abstract PDF: OBJECTIVES
: The diabetic hyperosmolar non-ketotic coma represents an acute complication of diabetes affecting mostly elderly persons with non-insulin dependent diabetes rnellitus. It is characterized by marked hyperglycemia, hyperosmolarity, severe dehydration, occasional neurologic signs, obtunded sensorium, and absence of ketonemia or acidosis. Most investigators have evaluated the relationship of predisposing conditions with HNKC, to evaluate outcome of the elderly HNKC we studied the prognostic factors in the elderly HNKC. Patients and METHODS: We retrospectively studied 43 patients with HNKC admitted to Hospital of Hallym University during an 6-year period, 1990 through 1995. All medical records of elderly patients (65 years old or more) discharged with the diagnosis of HNKC, were reviewed. To be included as a case, patients had to have a serum glucose level greater than 500mg/dL, measured plasma osmolarity greater than 320mOsm/L, pH greater than 7.30 and disoriented sensorium. 1nformation that was gathered age, glucose, blood urea nitrigen, creatinine, Na+, K+, HCO3-, anion gap, plasma osmolarity, urine osmolarity and whether the patients was discharged alive or died in the hospital. Data were analyzed by one-factor ANOVA and significance of difference between proportions was calculated by Newman-Keuls test. RESULTS: Survivors of 43 elderly HNKC were 22 patients and non-survivors were 21 patients. Mortality was 49%. Analysis revealed that the plasma osmolarity was significantly higher among those who non-survivors (376 +/- 10.8versus 331 +/- 5.0mOsm/L, p 0.01). Non-survivors also had significantly higher serum creatinine level than survivors (2.1+/-0.41versus 1.6 +/- 0.18mg/dL, p = 0.024) Conelusion: These results suggest that the prognostic factors of elderly HNKC were plasma osrnolarity and serum creatinine level.

Mechanism of Insulin Resistance : Time Dependence of the Development of Insulin Resistance in High Fat Fed Rats.: Kyong Soo Park, Ki Up Lee, Sung Woo Park, Hong Kyu Lee, Hun Ki Min; Korean Diabetes J. 1997;21(2):168-175. Published online January 1, 2001

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Abstract PDF: BACKGROUND
Increased FFA availability is known to induce insulin resistance by decrease in peripheral glucose utilization and increase in hepatic glucose procluction. However, there are conflicting results about the time dependence of the developrnent of insulin resistance with increased availability of FFA. METHODS: To elucidate the time dependence of the development of insulin resistance associated with increased availability of FFA, peripheral glucose utilization rate and hepatic glucose production rate were measured by euglycemic hyperinsulinemic clamp with 3-3H glucose infusion in rats fed high fat diet (1 week or 3 weeks) or control diet(ordinary chow diet). RESULTS: Basal plasrna FFA levels and steady state plasma insulin levels increased after high fat diet. After 1 week of high fat diet, suppressibility of hepatic glucose production rate by insulin was impaired(p<0.05 vs control). Insulin sensitivity index(glucose utilization rates/steady state plasma insulin concentrmtions X100) was decreased only after 3 weeks of high fat diet(p<0.05 vs control) which was accompanied by decreased glycogen synthase activity. CONCLUSION: High fat diet induces hepatic insulin resistance before peripheral insulin resistance and decreased glycogen synthase activity may contribute to the development of peripheral insulin resistance in rats fed high fat diet.

Case Report

Two Cases of Hyperamylasemia not Aassociated with Acute Pancreatits in Non-ketotic Hyperosmolar Syndrome.: Jong Hyung Choi, Doo Man Kim, Han Su Cho, Ki Sung Lee, Ji Young Seo, Hyun Kyoo Kim, Cheol Soo Choi, Sung Hee Ihm, Jae Myung Yu, Moon Ki Choi, Hyung Joon Yoo, Sung Woo Park; Korean Diabetes J. 2000;24(5):614-618. Published online January 1, 2001

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Abstract: The serum amylase level is widely used as a screening test for acute pancreatitis and rises also in a wide variety of diseases involving the pancreas, salivary glands, intestines, liver, genitourinary tract, and lung, in metabolic aberrations such as diabetic ketoacidosis, and even during normal pregnancy. Although it is commonly assumed that the diseased organ is releasing amylase into the serum, in many conditions the precise relationship between the hyperamylasemia and the condition is not clear. Serum amylase is abnormally elevated in more than 60% of patients with diabetic ketoacidosis, but increased pancreatic enzyme activity, even in combination with abdominal pain, should not be diagnosed as acute pancreatitis. In nonketotic hyperosmolar syndrome, elevated serum amylase level without pancreatitis has not been reported. Nonketotic hyperosmolar syndrome is usually a complcation of type 2 DM and characterized by severe hyperosmolarity (serum osmolality> or =320 mOsm/L), hyperglycemia (serum glucose> or = 600 mg/dL) and dehydration. We experienced two cases of nonketotic hyperosmolar syndrome with elevated serum amylase. Serum amylase level was 1556 U/L in first case, 229 U/L in second case. Two patients did not complain of abdominal pain, nausea, vomiting and abdomen CT with enhancement showed the normal pancreases.

Original Articles

Lowering of plasma free fatty acids by acipimox increases insulin sensitivity in rats.: Ki Up Lee, Kyo Il Suh, Sung Woo Park, Kyung Soo Park, Hong Kyu Lee, Hun Ki Min; Korean Diabetes J. 1993;17(1):73-78. Published online January 1, 2001

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Abstract PDF: No abstract available.

Fasting plasma glucose levels determine insulin response to glucosein NIDDM.: Sung Woo Park, Young Bae Kwon, Chul Woo Lee, Sung Hee Ihm, Moon Gi Choi, Byung Tae Kim, Yeon Bok Chang, Hyung Joon Yoo, Ki Up Lee; Korean Diabetes J. 1992;16(4):289-297. Published online January 1, 2001

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Abstract PDF: No abstract available.

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