Diabetes & Metabolism Journal

Original Articles

Complications
Non-Alcoholic Fatty Liver Disease with Sarcopenia and Carotid Plaque Progression Risk in Patients with Type 2 Diabetes Mellitus: Yongin Cho, Hye-Sun Park, Byung Wook Huh, Yong-ho Lee, Seong Ha Seo, Da Hea Seo, Seong Hee Ahn, Seongbin Hong, So Hun Kim; Diabetes Metab J. 2023;47(2):232-241. Published online January 19, 2023; DOI: https://doi.org/10.4093/dmj.2021.0355

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Background
We aimed to evaluate whether non-alcoholic fatty liver disease (NAFLD) with or without sarcopenia is associated with progression of carotid atherosclerosis in patients with type 2 diabetes mellitus (T2DM).
Methods
We investigated 852 T2DM patients who underwent abdominal ultrasonography, bioelectrical impedance analysis, and carotid artery ultrasonography at baseline and repeated carotid ultrasonography after 6 to 8 years. NAFLD was confirmed by abdominal ultrasonography, and sarcopenia was defined as a sex-specific skeletal muscle mass index (SMI) value <2 standard deviations below the mean for healthy young adults. SMI was calculated by dividing the sum of appendicular skeletal mass by body weight. We investigated the association between NAFLD with or without sarcopenia and the progression of carotid atherosclerosis.
Results
Of the 852 patients, 333 (39.1%) were classified as NAFLD without sarcopenia, 66 (7.7%) were classified as sarcopenia without NAFLD, and 123 (14.4%) had NAFLD with sarcopenia at baseline. After 6 to 8 years, patients with both NAFLD and sarcopenia had a higher risk of atherosclerosis progression (adjusted odds ratio, 2.20; P<0.009) than controls without NAFLD and sarcopenia. When a subgroup analysis was performed on only patients with NAFLD, female sex, absence of central obesity, and non-obesity were significant factors related to increased risk of plaque progression risk in sarcopenic patients.
Conclusion
NAFLD with sarcopenia was significantly associated with the progression of carotid atherosclerosis in T2DM patients.

Citations

Citations to this article as recorded by

Metabolic-associated fatty liver disease and sarcopenia: A double whammy
Aditya Viswanath, Sherouk Fouda, Cornelius James Fernandez, Joseph M Pappachan
World Journal of Hepatology.2024; 16(2): 152. CrossRef
Prevalence and outcome of sarcopenia in non-alcoholic fatty liver disease
Suprabhat Giri, Prajna Anirvan, Sumaswi Angadi, Ankita Singh, Anurag Lavekar
World Journal of Gastrointestinal Pathophysiology.2024;[Epub] CrossRef
Association between non-alcoholic fatty liver disease and risk of sarcopenia: a systematic review and meta-analysis
Chao Deng, Qifeng Ou, Xuee Ou, Ding Pan
BMJ Open.2024; 14(5): e078933. CrossRef
Rituximab, cyclophosphamide, doxorubicin, vincristine, and prednisolone (R-CHOP) therapy decreases lean body mass and appendicular skeletal muscle mass index even until one year after the final treatment in patients with B-cell non-Hodgkin lymphoma
Sanshiro Nakao, Daiji Ngayama, Chiaki Nakaseko, Naomi Shimizu
Journal of Chemotherapy.2024; : 1. CrossRef
Association of nonalcoholic fatty liver disease and carotid media‐intima thickness: A systematic review and a meta‐analysis
Manouchehr Khoshbaten, Sepideh H. Maleki, Sara Hadad, Amrit Baral, Ana V. Rocha, Laxmi Poudel, Alireza Abdshah
Health Science Reports.2023;[Epub] CrossRef
Cardiometabolic risk factors in patients with type 2 diabetes and sarcopenia
Yu. G. Samoilova, M. V. Matveeva, E. A. Khoroshunova, D. V. Podchinenova, L. L. Maksimova, G. G. Gorbach, A. B. Trivozhenko, V. A. Avkhimenko
Cardiovascular Therapy and Prevention.2023; 23(1): 3655. CrossRef

Complications
Advanced Liver Fibrosis Is Associated with Chronic Kidney Disease in Patients with Type 2 Diabetes Mellitus and Nonalcoholic Fatty Liver Disease: Da Hea Seo, Young Ju Suh, Yongin Cho, Seong Hee Ahn, Seongha Seo, Seongbin Hong, Yong-ho Lee, Young Ju Choi, Eunjig Lee, So Hun Kim; Diabetes Metab J. 2022;46(4):630-639. Published online January 26, 2022; DOI: https://doi.org/10.4093/dmj.2021.0130

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Background
Nonalcoholic fatty liver disease (NAFLD) is associated with chronic kidney disease (CKD). However, the causal relationship between NAFLD and CKD is uncertain, particularly in patients with type 2 diabetes mellitus (T2DM). We aimed to investigate the association between the presence and severity of NAFLD and incident CKD in patients with T2DM.
Methods
In this longitudinal cohort study of patients with T2DM, 3,188 patients with preserved renal function were followed up for the occurrence of incident CKD. NAFLD was defined as the presence of hepatic steatosis on ultrasonography, without any other causes of chronic liver disease. Advanced liver fibrosis of NAFLD was defined as a fibrosis-4 index ≥2.67. CKD was defined as an estimated glomerular filtration rate <60 mL/min/1.73 m².
Results
At baseline, 1,729 (54.2%) patients had NAFLD, of whom 94 (5.4%) had advanced liver fibrosis. During the follow-up of 8.3±3.6 years, 472 (14.8%) patients developed incident CKD: 220 (15.1%) in the non-NAFLD group, 231 (14.1%) in the NAFLD without advanced fibrosis group and 28 (31.1%) in the NAFLD with advanced fibrosis group. There was no increased risk of incident CKD in the NAFLD group compared to the non-NAFLD group (P=0.435). However, among patients with NAFLD, advanced liver fibrosis was associated with an increased risk of CKD (adjusted hazard ratio, 1.75; 95% confidence interval, 1.15 to 2.66; P=0.009).
Conclusion
Advanced liver fibrosis in patients with NAFLD is independently associated with an increased risk of incident CKD in patients with T2DM.

Citations

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Esteatosis hepática metabólica y nefropatía diabética: una llamada a la acción
Salvador Benlloch, Francesc Moncho, Jose Luis Górriz
Nefrología.2024; 44(2): 129. CrossRef
Longitudinal Outcomes Associated With Metabolic Dysfunction-Associated Steatotic Liver Disease: A Meta-analysis of 129 Studies
Kai En Chan, Elden Yen Hng Ong, Charlotte Hui Chung, Christen En Ya Ong, Benjamin Koh, Darren Jun Hao Tan, Wen Hui Lim, Jie Ning Yong, Jieling Xiao, Zhen Yu Wong, Nicholas Syn, Apichat Kaewdech, Margaret Teng, Jiong-Wei Wang, Nicholas Chew, Dan Yock Young
Clinical Gastroenterology and Hepatology.2024; 22(3): 488. CrossRef
Association of NAFLD/NASH, and MAFLD/MASLD with chronic kidney disease: an updated narrative review
Amedeo Lonardo
Metabolism and Target Organ Damage.2024;[Epub] CrossRef
Targeting metabolic-associated fatty liver disease in diabetic kidney disease: A call to action
Salvador Benlloch, Francesc Moncho, Jose Luis Górriz
Nefrología (English Edition).2024; 44(2): 129. CrossRef
Epidemiology, screening, and co-management of type 2 diabetes mellitus and metabolic dysfunction–associated steatotic liver disease
Xiaolong Qi, Jie Li, Cyrielle Caussy, Gao-Jun Teng, Rohit Loomba
Hepatology.2024;[Epub] CrossRef
Impact of dietary fiber intake on non-alcoholic fatty liver disease risk in Korean patients with obesity and type 2 diabetes mellitus
Ji-Sook Park, Hina Akbar, Young-Seol Kim, Jung-Eun Yim
Journal of Nutrition and Health.2024; 57(3): 282. CrossRef
Digestive system diseases and a chronic kidney disease — the two sides of the healthcare global problems
A.M. Osadchuk, I.D. Loranskaya, M.A. Osadchuk
Russian Journal of Preventive Medicine.2024; 27(7): 108. CrossRef
MAFLD and NAFLD in the prediction of incident chronic kidney disease
So Yoon Kwon, Jiyun Park, So Hee Park, You-Bin Lee, Gyuri Kim, Kyu Yeon Hur, Janghyun Koh, Jae Hwan Jee, Jae Hyeon Kim, Mira Kang, Sang-Man Jin
Scientific Reports.2023;[Epub] CrossRef
Associations of non-invasive indices of liver steatosis and fibrosis with progressive kidney impairment in adults with type 2 diabetes
Mei Chung Moh, Sharon Li Ting Pek, Kenny Ching Pan Sze, Serena Low, Tavintharan Subramaniam, Keven Ang, Wern Ee Tang, Simon Biing Ming Lee, Chee Fang Sum, Su Chi Lim
Acta Diabetologica.2023; 60(6): 827. CrossRef
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Utility of non-invasive liver fibrosis markers to predict the incidence of chronic kidney disease (CKD): A systematic review, meta-analysis, and meta-regression
Rudi Supriyadi, Theo Audi Yanto, Timotius Ivan Hariyanto, Ketut Suastika
Diabetes & Metabolic Syndrome: Clinical Research & Reviews.2023; 17(8): 102814. CrossRef
Significance of Diabetic Kidney Disease Biomarkers in Predicting Metabolic-Associated Fatty Liver Disease
Jaehyun Bae, Byung-Wan Lee
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Hepatic Fibrosis Evaluated in Patients with Type 2 Diabetes with and without Chronic Kidney Disease
Therese Adrian, Mads Hornum, Filip Krag Knop, Karl Bang Christensen, Thomas Almdal, Peter Rossing, Lisa Í Lídaa, Niels Søndergaard Heinrich, Vincent Oltman Boer, Anouk Marsman, Esben Thade Petersen, Hartwig Roman Siebner, Bo Feldt-Rasmussen
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Olivier Deckmyn, Thierry Poynard, Pierre Bedossa, Valérie Paradis, Valentina Peta, Raluca Pais, Vlad Ratziu, Dominique Thabut, Angelique Brzustowski, Jean-François Gautier, Patrice Cacoub, Dominique Valla
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Fibrosis Risk in Nonalcoholic Fatty Liver Disease Is Related to Chronic Kidney Disease in Older Type 2 Diabetes Patients
Yifan Sun, Liang Hong, Zhe Huang, Lihong Wang, Yanqin Xiong, Shuhang Zong, Rui Zhang, Jun Liu, Shufei Zang
The Journal of Clinical Endocrinology & Metabolism.2022; 107(9): e3661. CrossRef
Beyond Liver Disease: Non-Alcoholic Fatty Liver Disease and Advanced Liver Fibrosis in Kidney Disease
Eugene Han
Diabetes & Metabolism Journal.2022; 46(4): 564. CrossRef
A higher FIB‐4 index is associated with an increased incidence of renal failure in the general population
Eva Maria Schleicher, Simon Johannes Gairing, Peter Robert Galle, Julia Weinmann‐Menke, Jörn M. Schattenberg, Karel Kostev, Christian Labenz
Hepatology Communications.2022; 6(12): 3505. CrossRef
Advanced Liver Fibrosis Is Associated with Chronic Kidney Disease in Patients with Type 2 Diabetes Mellitus and Nonalcoholic Fatty Liver Disease (Diabetes Metab J 2022;46:630-9)
Ji Hye Huh
Diabetes & Metabolism Journal.2022; 46(6): 953. CrossRef
Advanced Liver Fibrosis Is Associated with Chronic Kidney Disease in Patients with Type 2 Diabetes Mellitus and Nonalcoholic Fatty Liver Disease (Diabetes Metab J 2022;46:630-9)
Da Hea Seo, So Hun Kim
Diabetes & Metabolism Journal.2022; 46(6): 956. CrossRef

Guideline/Fact Sheet
Diabetes Fact Sheets in Korea, 2020: An Appraisal of Current Status: Chan-Hee Jung, Jang Won Son, Shinae Kang, Won Jun Kim, Hun-Sung Kim, Hae Soon Kim, Mihae Seo, Hye-Jung Shin, Seong-Su Lee, Su Jin Jeong, Yongin Cho, Seung Jin Han, Hyang Mi Jang, Mira Rho, Shinbi Lee, Mihyun Koo, Been Yoo, Jung-Wha Moon, Hye Young Lee, Jae-Seung Yun, Sun Young Kim, Sung Rae Kim, In-Kyung Jeong, Ji-Oh Mok, Kun Ho Yoon; Diabetes Metab J. 2021;45(1):1-10. Published online January 13, 2021; DOI: https://doi.org/10.4093/dmj.2020.0254

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Background
This study aimed to investigate the recent prevalence, management, and comorbidities of diabetes among Korean adults aged ≥30 years by analyzing nationally representative data.
Methods
This study used data from the Korea National Health and Nutrition Examination Survey from 2016 to 2018, and the percentage and total number of people ≥30 years of age with diabetes and impaired fasting glucose (IFG) were estimated.
Results
In 2018, 13.8% of Korean adults aged ≥30 years had diabetes, and adults aged ≥65 years showed a prevalence rate of 28%. The prevalence of IFG was 26.9% in adults aged ≥30 years. From 2016 to 2018, 35% of the subjects with diabetes were not aware of their condition. Regarding comorbidities, 53.2% and 61.3% were obese and hypertensive, respectively, and 72% had hypercholesterolemia as defined by low-density lipoprotein cholesterol (LDL-C) ≥100 mg/dL in people with diabetes. Of the subjects with diabetes, 43.7% had both hypertension and hypercholesterolemia. With regard to glycemic control, only 28.3% reached the target level of <6.5%. Moreover, only 11.5% of subjects with diabetes met all three targets of glycosylated hemoglobin, blood pressure, and LDL-C. The percentage of energy intake from carbohydrates was higher in diabetes patients than in those without diabetes, while that from protein and fat was lower in subjects with diabetes.
Conclusion
The high prevalence and low control rate of diabetes and its comorbidities in Korean adults were confirmed. More stringent efforts are needed to improve the comprehensive management of diabetes to reduce diabetes-related morbidity and mortality.

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A Novel Salivary Sensor with Integrated Au Electrodes and Conductivity Meters for Screening of Diabetes
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Predicting micropollutant fate during wastewater treatment using refined classical kinetic model based on quantitative monitoring in multi-metropolitan regions of South Korea
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Intake of Fruit and Glycemic Control in Korean Patients with Diabetes Mellitus Using the Korea National Health and Nutrition Examination Survey
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Diabetes Mellitus in the Elderly Adults in Korea: Based on Data from the Korea National Health and Nutrition Examination Survey 2019 to 2020
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Association between diabetes mellitus and cause of death in patients with tuberculosis: A Korean nationwide cohort study
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Position Statement on the Appropriateness and Significance of Adding the Glycated Hemoglobin Test to the National Health Examination
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Increased risk of cancer and cancer-related mortality in middle-aged Korean women with prediabetes and diabetes: a population-based study
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Efficacy and Safety of Treatment with Quadruple Oral Hypoglycemic Agents in Uncontrolled Type 2 Diabetes Mellitus: A Multi-Center, Retrospective, Observational Study (Diabetes Metab J 2021;45:675-83)
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Comparison of Health Outcomes by Care Provider Type for Newly Diagnosed Mild Type 2 Diabetes Patients in South Korea: A Retrospective Cohort Study
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A deep learning model for screening type 2 diabetes from retinal photographs
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Rheological, textural, and functional characteristics of 3D-printed cheesecake containing guava leaf, green tea, and barley sprout powders
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Exercise, Mitohormesis, and Mitochondrial ORF of the 12S rRNA Type-C (MOTS-c)
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Correlation of advanced glycation end products and heme oxygenase-1 in Korean diabetic patients
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The Impact of the Association between Cancer and Diabetes Mellitus on Mortality
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Development and implementation of patient-level prediction models of end-stage renal disease for type 2 diabetes patients using fast healthcare interoperability resources
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Prevalence of Diabetic Retinopathy in Undiagnosed Diabetic Patients: A Nationwide Population-Based Study
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Advanced Glycation End Products and Their Effect on Vascular Complications in Type 2 Diabetes Mellitus
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The Association of Pachydrusen Characteristics with Choroidal Thickness and Patient’s Age in Polypoidal Choroidal Vasculopathy versus Central Serous Chorioretinopathy
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Experiences of Using Wearable Continuous Glucose Monitors in Adults With Diabetes: A Qualitative Descriptive Study
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Prediction Model for Hypertension and Diabetes Mellitus Using Korean Public Health Examination Data (2002–2017)
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Recent Increases in Influenza-Related Hospitalizations, Critical Care Resource Use, and In-Hospital Mortality: A 10-Year Population-Based Study in South Korea
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Experience of Elderly Korean Women with Diabetes and Multimorbidity in Elderly Couple Households: A Qualitative Study
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Long-Term Changes in HbA1c According to Blood Glucose Control Status During the First 3 Months After Visiting a Tertiary University Hospital
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Sex and Diet-Related Disparities in Low Handgrip Strength among Young and Middle-Aged Koreans: Findings Based on the Korea National Health and Nutrition Examination Survey (KNHANES) from 2014 to 2017
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Rising Incidence of Diabetes in Young Adults in South Korea: A National Cohort Study
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Analysis of the Association between Metabolic Syndrome and Renal Function in Middle-Aged Patients with Diabetes
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International Journal of Environmental Research and Public Health.2022; 19(18): 11832. CrossRef
Exploring the risk factors of impaired fasting glucose in middle-aged population living in South Korean communities by using categorical boosting machine
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Low relative hand grip strength is associated with a higher risk for diabetes and impaired fasting glucose among the Korean population
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Association of Glycosylated Hemoglobin Level and Cancer-Related Mortality in Patients without Diabetes
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Risk of Carotid Atherosclerosis in Subjects with Prediabetes Overlapping Metabolic Syndrome
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Lifestyle changes and risk of tuberculosis in patients with type 2 diabetes mellitus: A nationwide cohort study
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Differences in health behavior and nutrient intake status between diabetes-aware and unaware Korean adults based on the Korea national health and nutrition examination survey 2016–18 data: A cross-sectional study
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Screening for Prediabetes and Diabetes in Korean Nonpregnant Adults: A Position Statement of the Korean Diabetes Association, 2022
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Association between Amount of Alcohol Consumption and Serum Fasting Glucose Level in Korean Male in their 40s and 50s: The Seventh Korea National Health and Nutrition Examination Survey 2016-2018
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Chronic Disease Prediction Using the Common Data Model: Development Study
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Editorial

Early Development of Bidirectional Associations between Sleep Disturbance and Diabetes: Yongin Cho; Diabetes Metab J. 2020;44(5):668-670. Published online October 21, 2020; DOI: https://doi.org/10.4093/dmj.2020.0198

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Corrigendum

Corrigenda: Table Correction. Nonalcoholic Fatty Liver Disease in Diabetes. Part I: Epidemiology and Diagnosis: Yong-ho Lee, Yongin Cho, Byung-Wan Lee, Cheol-Young Park, Dae Ho Lee, Bong-Soo Cha, Eun-Jung Rhee; Diabetes Metab J. 2019;43(5):731-731. Published online October 24, 2019; DOI: https://doi.org/10.4093/dmj.2019.0188; Corrects: Diabetes Metab J 2019;43(1):31

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Original Article

Clinical Diabetes & Therapeutics
Predictors of the Therapeutic Efficacy and Consideration of the Best Combination Therapy of Sodium-Glucose Co-transporter 2 Inhibitors: Ji-Yeon Lee, Yongin Cho, Minyoung Lee, You Jin Kim, Yong-ho Lee, Byung-Wan Lee, Bong-Soo Cha, Eun Seok Kang; Diabetes Metab J. 2019;43(2):158-173. Published online January 25, 2019; DOI: https://doi.org/10.4093/dmj.2018.0057

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Background

We investigated the predictive markers for the therapeutic efficacy and the best combination of sodium-glucose co-transporter 2 (SGLT2) inhibitors (empagliflozin, dapagliflozin, and ipragliflozin) therapy in patients with type 2 diabetes mellitus (T2DM).

Methods

A total of 804 patients with T2DM who had taken SGLT2 inhibitor as monotherapy or an add-on therapy were analyzed. Multivariate regression analyses were performed to identify the predictors of SGLT2 inhibitor response including the classes of baseline anti-diabetic medications.

Results

After adjusting for age, sex, baseline body mass index (BMI), diabetes duration, duration of SGLT2 inhibitor use, initial glycosylated hemoglobin (HbA1c) level, estimated glomerular filtration rate (eGFR), and other anti-diabetic agent usage, multivariate analysis revealed that shorter diabetes duration, higher initial HbA1c and eGFR were associated with better glycemic response. However, baseline BMI was inversely correlated with glycemic status; lean subjects with well-controlled diabetes and obese subjects with inadequately controlled diabetes received more benefit from SGLT2 inhibitor treatment. In addition, dipeptidyl peptidase 4 (DPP4) inhibitor use was related to a greater reduction in HbA1c in patients with higher baseline HbA1c ≥7%. Sulfonylurea users experienced a larger change from baseline HbA1c but the significance was lost after adjustment for covariates and metformin and thiazolidinedione use did not affect the glycemic outcome.

Conclusion

A better response to SGLT2 inhibitors is expected in Korean T2DM patients who have higher baseline HbA1c and eGFR with a shorter diabetes duration. Moreover, the add-on of an SGLT2 inhibitor to a DPP4 inhibitor is likely to show the greatest glycemic response.

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M. L. Morieri, I. Raz, A. Consoli, M. Rigato, A. Lapolla, F. Broglio, E. Bonora, A. Avogaro, G. P. Fadini, Federica Ginestra, Gloria Formoso, Agostino Consoli, Francesco Andreozzi, Giorgio Sesti, Salvatore Turco, Luigi Lucibelli, Adriano Gatti, Raffaella
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Angiotensin II up-regulates sodium-glucose co-transporter 2 expression and SGLT2 inhibitor attenuates Ang II-induced hypertensive renal injury in mice
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Letter: Predictors of the Therapeutic Efficacy and Consideration of the Best Combination Therapy of Sodium-Glucose Co-transporter 2 Inhibitors (Diabetes Metab J 2019;43:158–73)
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Response: Predictors of the Therapeutic Efficacy and Consideration of the Best Combination Therapy of Sodium-Glucose Co-transporter 2 Inhibitors (Diabetes Metab J 2019;43:158–73)
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Review

Complications
Nonalcoholic Fatty Liver Disease in Diabetes. Part I: Epidemiology and Diagnosis: Yong-ho Lee, Yongin Cho, Byung-Wan Lee, Cheol-Young Park, Dae Ho Lee, Bong-Soo Cha, Eun-Jung Rhee; Diabetes Metab J. 2019;43(1):31-45. Published online December 17, 2018; DOI: https://doi.org/10.4093/dmj.2019.0011; Correction in: Diabetes Metab J 2019;43(5):731

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Nonalcoholic fatty liver disease (NAFLD) and diabetes are common metabolic disorders whose prevalence rates are expected to rise worldwide, corresponding to aging and increasingly obese populations. Compared to the general population (around 25%), 50% to 70% of people with diabetes have NAFLD, and NAFLD severity (including fibrosis) tends to be worsened by the presence of diabetes. NAFLD is considered an emerging risk factor for type 2 diabetes mellitus and a contributor to the development of chronic diabetes-related complications. This reciprocal relationship demonstrates the importance of confirming suspected NAFLD in patients with diabetes. Due to the invasive nature of liver biopsy to assess NAFLD status, various alternative non-invasive modalities have been developed and validated. Here, we summarized the epidemiology of NAFLD in patients with diabetes and reviewed currently available imaging modalities and biomarker-based prediction models for their ability to detect liver steatosis and/or fibrosis.

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Original Articles

Clinical Diabetes & Therapeutics
Effectiveness of Exercise Intervention in Reducing Body Weight and Glycosylated Hemoglobin Levels in Patients with Type 2 Diabetes Mellitus in Korea: A Systematic Review and Meta-Analysis: Ji-Eun Jang, Yongin Cho, Byung Wan Lee, Ein-Soon Shin, Sun Hee Lee; Diabetes Metab J. 2019;43(3):302-318. Published online November 19, 2018; DOI: https://doi.org/10.4093/dmj.2018.0062

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Abstract PDF Supplementary Material PubReader

Background

This study aimed to assess the effectiveness of exercise intervention in reducing body weight and glycosylated hemoglobin (HbA1c) level in patients with type 2 diabetes mellitus (T2DM) in Korea.

Methods

Cochrane, PubMed, Embase, KoreaMed, KMbase, NDSL, KCI, RISS, and DBpia databases were used to search randomized controlled trials and controlled clinical trials that compared exercise with non-exercise intervention among patients with non-insulin-treated T2DM in Korea. The effectiveness of exercise intervention was estimated by the mean difference in body weight changes and HbA1c level. Weighted mean difference (WMD) with its corresponding 95% confidence interval (CI) was used as the effect size. The pooled mean differences of outcomes were calculated using a random-effects model.

Results

We identified 7,692 studies through literature search and selected 23 articles (723 participants). Compared with the control group, exercise intervention (17 studies) was associated with a significant decline in HbA1c level (WMD, −0.58%; 95% CI, −0.89 to −0.27; I²=73%). Although no significant effectiveness on body weight was observed, eight aerobic training studies showed a significant reduction in body weight (WMD, −2.25 kg; 95% CI, −4.36 to −0.13; I²=17%) in the subgroup analysis.

Conclusion

Exercise significantly improves glycemic control; however, it does not significantly reduce body weight. Aerobic training can be beneficial for patients with non-insulin-treated T2DM in Korea.

Citations

Citations to this article as recorded by

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The Effect of DPP-4 Inhibitors on Metabolic Parameters in Patients with Type 2 Diabetes: Eun Yeong Choe, Yongin Cho, Younjeong Choi, Yujung Yun, Hye Jin Wang, Obin Kwon, Byung-Wan Lee, Chul Woo Ahn, Bong Soo Cha, Hyun Chul Lee, Eun Seok Kang; Diabetes Metab J. 2014;38(3):211-219. Published online June 17, 2014; DOI: https://doi.org/10.4093/dmj.2014.38.3.211

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Abstract PDF Supplementary Material PubReader

Background

We evaluated the effects of two dipeptidyl peptidase-4 (DPP-4) inhibitors, sitagliptin and vildagliptin, on metabolic parameters in patients with type 2 diabetes mellitus.

Methods

A total of 170 type 2 diabetes patients treated with sitagliptin or vildagliptin for more than 24 weeks were selected. The patients were separated into two groups, sitagliptin (100 mg once daily, n=93) and vildagliptin (50 mg twice daily, n=77). We compared the effect of each DPP-4 inhibitor on metabolic parameters, including the fasting plasma glucose (FPG), postprandial glucose (PPG), glycated hemoglobin (HbA1c), and glycated albumin (GA) levels, and lipid parameters at baseline and after 24 weeks of treatment.

Results

The HbA1c, FPG, and GA levels were similar between the two groups at baseline, but the sitagliptin group displayed a higher PPG level (P=0.03). After 24 weeks of treatment, all of the glucose-related parameters were significantly decreased in both groups (P=0.001). The levels of total cholesterol and triglycerides were only reduced in the vildagliptin group (P=0.001), although the sitagliptin group received a larger quantity of statins than the vildagliptin group (P=0.002).The mean change in the glucose- and lipid-related parameters after 24 weeks of treatment were not significantly different between the two groups (P=not significant). Neither sitagliptin nor vildagliptin treatment was associated with a reduction in the high sensitive C-reactive protein level (P=0.714).

Conclusion

Vildagliptin and sitagliptin exert a similar effect on metabolic parameters, but vildagliptin exerts a more potent beneficial effect on lipid parameters.

Citations

Citations to this article as recorded by

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Diabetes & Metabolism Journal.2021; 45(5): 675. CrossRef
Vasculoprotective Effects of Vildagliptin. Focus on Atherogenesis
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International Journal of Molecular Sciences.2020; 21(7): 2275. CrossRef
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Effect of Switching from Linagliptin to Teneligliptin Dipeptidyl Peptidase-4 Inhibitors in Older Patients with Type 2 Diabetes Mellitus

Eugene Han, Minyoung Lee, Yong-ho Lee, Hye Soon Kim, Byung-wan Lee, Bong-Soo Cha, Eun Seok Kang
Diabetes, Metabolic Syndrome and Obesity: Targets and Therapy.2020; Volume 13: 4113. CrossRef
Combined vildagliptin and memantine treatment downregulates expression of amyloid precursor protein, and total and phosphorylated tau in a rat model of combined Alzheimer’s disease and type 2 diabetes
Samar S. Khalaf, Mohamed M. Hafez, Eman T. Mehanna, Noha M. Mesbah, Dina M. Abo-Elmatty
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Therapeutic experience of saxagliptin as first add-on after metformin in Indian type 2 diabetes patients: A non-interventional, prospective, observational study (ONTARGET-INDIA)
Sanjay Kalra, Sarita Bajaj, AG Unnikrishnan, ManashP Baruah, Rakesh Sahay, V Hardik, Amit Kumar
Indian Journal of Endocrinology and Metabolism.2019; 23(3): 312. CrossRef
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Treatment of Dyslipidemias to Prevent Cardiovascular Disease in Patients with Type 2 Diabetes
Maryam Khavandi, Francisco Duarte, Henry N. Ginsberg, Gissette Reyes-Soffer
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Sodium butyrate has context-dependent actions on dipeptidyl peptidase-4 and other metabolic parameters
Eun-Sol Lee, Dong-Sung Lee, Prakash Raj Pandeya, Youn-Chul Kim, Dae-Gil Kang, Ho-Sub Lee, Byung-Chul Oh, Dae Ho Lee
The Korean Journal of Physiology & Pharmacology.2017; 21(5): 519. CrossRef
Risk of Myopathy Associated With DPP-4 Inhibitors in Combination With Statins: A Disproportionality Analysis Using Data From the WHO and French Spontaneous Reporting Databases
Vanessa Labat, Mickael Arnaud, Ghada Miremont-Salamé, Francesco Salvo, Bernard Bégaud, Antoine Pariente
Diabetes Care.2017; 40(3): e27. CrossRef
Soluble DPP-4 up-regulates toll-like receptors and augments inflammatory reactions, which are ameliorated by vildagliptin or mannose-6-phosphate
Dong-Sung Lee, Eun-Sol Lee, Md. Morshedul Alam, Jun-Hyeog Jang, Ho-Sub Lee, Hyuncheol Oh, Youn-Chul Kim, Zahid Manzoor, Young-Sang Koh, Dae-Gil Kang, Dae Ho Lee
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Association between DPP4 gene polymorphism and serum lipid levels in Chinese type 2 diabetes individuals
Xiaomin Xing, Yi Han, Xiaojun Zhou, Bo Zhang, Yan Li, Zhongsu Wang, Lin Liao, Lequn Su
Neuropeptides.2016; 60: 1. CrossRef
Common medications used by patients with type 2 diabetes mellitus: what are their effects on the lipid profile?
Paul D. Rosenblit
Cardiovascular Diabetology.2016;[Epub] CrossRef
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Trials.2016;[Epub] CrossRef
Efficacy of different dipeptidyl peptidase-4 (DPP-4) inhibitors on metabolic parameters in patients with type 2 diabetes undergoing dialysis
Se Hee Park, Joo Young Nam, Eugene Han, Yong-ho Lee, Byung-Wan Lee, Beom Seok Kim, Bong-Soo Cha, Chul Sik Kim, Eun Seok Kang
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Mennatallah A. Ali, Hanan S. El-Abhar, Maher A. Kamel, Ahmed S. Attia, John Calvert
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Response: The Effect of DPP-4 Inhibitors on Metabolic Parameters in Patients with Type 2 Diabetes (Diabetes Metab J2014;38:211-9)
EunYeong Choe, Eun Seok Kang
Diabetes & Metabolism Journal.2014; 38(4): 319. CrossRef
Letter: The Effect of DPP-4 Inhibitors on Metabolic Parameters in Patients with Type 2 Diabetes (Diabetes Metab J2014;38:211-9)
Seung-Hwan Lee
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Glycemic Effectiveness of Metformin-Based Dual-Combination Therapies with Sulphonylurea, Pioglitazone, or DPP4-Inhibitor in Drug-Naïve Korean Type 2 Diabetic Patients: Young Ki Lee, Sun Ok Song, Kwang Joon Kim, Yongin Cho, Younjeong Choi, Yujung Yun, Byung-Wan Lee, Eun-Seok Kang, Bong Soo Cha, Hyun Chul Lee; Diabetes Metab J. 2013;37(6):465-474. Published online December 12, 2013; DOI: https://doi.org/10.4093/dmj.2013.37.6.465

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78 Download
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Abstract PDF PubReader

Background

This study compared the glycemic effectiveness of three metformin-based dual therapies according to baseline hemoglobin A1c (HbA1c) to evaluate the appropriateness of the guideline enforced by the National Health Insurance Corporation of Korea for initial medication of type 2 diabetes (T2D).

Methods

This prospective observational study was conducted across 24 weeks for drug-naïve Korean T2D patients with HbA1c greater than 7.5%. Subjects were first divided into three groups based on the agent combined with metformin (group 1, gliclazide-modified release or glimepiride; group 2, pioglitazone; group 3, sitagliptin). Subjects were also classified into three categories according to baseline HbA1c (category I, 7.5%≤HbA1c<9.0%; category II, 9.0%≤HbA1c<11.0%; category III, 11.0%≤HbA1c).

Results

Among 116 subjects, 99 subjects completed the study, with 88 subjects maintaining the initial medication. While each of the metformin-based dual therapies showed a significant decrease in HbA1c (group 1, 8.9% to 6.4%; group 2, 9.0% to 6.6%; group 3, 9.3% to 6.3%; P<0.001 for each), there was no significant difference in the magnitude of HbA1c change among the groups. While the three HbA1c categories showed significantly different baseline HbA1c levels (8.2% vs. 9.9% vs. 11.9%; P<0.001), endpoint HbA1c was not different (6.4% vs. 6.6% vs. 6.0%; P=0.051).

Conclusion

The three dual therapies using a combination of metformin and either sulfonylurea, pioglitazone, or sitagliptin showed similar glycemic effectiveness among drug-naïve Korean T2D patients. In addition, these regimens were similarly effective across a wide range of baseline HbA1c levels.

Citations

Citations to this article as recorded by

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