Diabetes & Metabolism Journal

Original Articles

Technology/Device
Association between Continuous Glucose Monitoring and Risk of Acute Diabetes-Related Complications in Pediatric Type 1 Diabetes Mellitus: A Nationwide Cohort Study: Ji Yoon Kim, Seohyun Kim, Jae Hyeon Kim; Received August 21, 2025 Accepted February 3, 2026 Published online April 22, 2026; DOI: https://doi.org/10.4093/dmj.2025.0794 [Epub ahead of print]

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Abstract PDF: Background
Evidence supporting the benefits of continuous glucose monitoring (CGM) in reducing diabetes-related complications remains scarce. This study aimed to investigate the association between CGM and diabetes-related complications, specifically diabetic ketoacidosis (DKA) and severe hypoglycemia in children and adolescents with type 1 diabetes mellitus (T1DM).
Methods
From the Korean Nationwide Cohort (2016–2022), we included children and adolescents (aged <19 years) with T1DM who received rapid-acting insulin between 2019 and 2022. The primary outcomes were DKA and severe hypoglycemia. Adjusted hazard ratios (HRs) for the primary outcomes were compared between CGM users and non-users using Cox proportional hazards regression models. Additionally, among the CGM users, the frequencies of DKA and severe hypoglycemia were compared before and after CGM initiation using a paired t-test.
Results
This study included 3,765 children and adolescents (2,313 CGM users and 1,452 non-users). During a median follow-up of 2.7 years, CGM users showed a lower risk of DKA (adjusted HR, 0.44; 95% confidence interval [CI], 0.35 to 0.56) and severe hypoglycemia (adjusted HR, 0.48; 95% CI, 0.29 to 0.79) than non-users. Among CGM users, the mean frequency of DKA decreased by 64%, and that of severe hypoglycemia decreased by 57% after CGM initiation (P<0.001 for both).
Conclusion
In this nationwide cohort study, CGM was associated with a reduced risk of DKA and severe hypoglycemia in children and adolescents with T1DM.

Complications
Objectively-Defined Sleep Regularity Is Associated with Macrovascular and Microvascular Complications among Individuals with Type 2 Diabetes Mellitus: A Cohort Study: Ying Zheng, Manrui Zhang, Hanzhang Wu, Jiahe Wei, Hui-Xin Wang, Torbjörn Åkerstedt, Xiaoyu Li, Xiao Tan; Received June 17, 2025 Accepted December 1, 2025 Published online April 17, 2026; DOI: https://doi.org/10.4093/dmj.2025.0530 [Epub ahead of print]

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Abstract PDF Supplementary Material PubReader ePub: Background
To assess the association of accelerometer-measured sleep regularity with macrovascular and microvascular complications among individuals with type 2 diabetes mellitus (T2DM).
Methods
A total of 3,862 participants with T2DM at baseline participated. The sleep regularity metrics measured by wrist-worn accelerometers include sleep regularity index (SRI) and standard deviation (SD) of sleep duration. Incident macrovascular complications including coronary heart disease (CHD) and stroke, microvascular complications including diabetic neuropathy, diabetic kidney disease, and diabetic retinopathy were recorded. Cox proportional hazard models were used to estimate hazard ratios (HRs) and 95% confidence intervals (CIs) for macrovascular and microvascular complications.
Results
During a median follow-up of 7.2 years, 410 composite macrovascular and 615 composite microvascular events occurred. Compared to regular sleepers (the highest tertile of SRI), irregular sleepers were at higher risk of composite macrovascular complications (HR, 1.29; 95% CI, 1.01 to 1.66) and stroke (HR, 1.97; 95% CI, 1.08 to 3.58). Compared to regular sleepers (the lowest tertile of sleep duration SD), irregular sleepers were at higher risk of composite macrovascular complications (HR, 1.44; 95% CI, 1.12 to 1.84), CHD (HR, 1.40; 95% CI, 1.07 to 1.82), and stroke (HR, 2.07; 95% CI, 1.13 to 3.81). For microvascular complications, no significant association of sleep regularity metrics was found (all P>0.05). However, the dose-response analysis suggested a potential nonlinear association between SRI and diabetic neuropathy, with lower SRI consistently associated with higher risk of diabetic neuropathy (HR, 1.92; 95% CI, 1.28 to 2.88; 5th percentile vs. 50th percentile).
Conclusion
An irregular sleep pattern across days is clinically relevant for increasing the risk of macrovascular complications and diabetic neuropathy among individuals with T2DM.

Reviews

Guideline/Statement/Fact Sheet
Defining Severe Diabetes Mellitus: A Consensus Framework for Grading and Staging Diabetes Based on Pathophysiology and Complications: Jae Hyun Bae, Hun Jee Choe, Ye Seul Yang, Mi Hae Seo, Jong Han Choi, Gyuri Kim, Young Sang Lyu, Jeung Hun Han, Shinae Kang, Won Jun Kim, Kyung-Soo Kim, Young Min Cho, Bong Soo Cha, for the Severe Diabetes Mellitus Task Force of the Korean Diabetes Association; Diabetes Metab J. 2025;49(6):1141-1154. Published online October 28, 2025; DOI: https://doi.org/10.4093/dmj.2025.0739

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Diabetes mellitus comprises a heterogeneous group of metabolic disorders differing in etiology, clinical course, and outcomes. Traditional classifications, such as type 1 and type 2 diabetes mellitus, fail to capture the full heterogeneity, including variation in insulin deficiency, insulin resistance, and complication burden. To address these limitations, we propose the Diabetes Grade–Stage Classification, an integrated system that combines pathophysiology-based grading with complication-based staging. Grading quantifies metabolic dysfunction through the assessment of insulin deficiency and insulin resistance. In parallel, staging assesses the extent of target organ damage, particularly in the cardiovascular, renal, ocular, and nervous systems. Together, this framework enables a comprehensive assessment of disease status, identification of vulnerable or high-risk phenotypes, and implementation of risk-adapted management strategies. Clinically, it facilitates personalized care, promotes collaborative coordination, and strengthens physician–patient communication. Furthermore, this framework provides a scalable structure for integrating disease severity into both individual- and population-level interventions. Although the current criteria for grading and staging are based on expert consensus and selected clinical indicators, such as low C-peptide levels and advanced complications, further validation and refinement are needed. In conclusion, the grading and staging system provides an operational tool for classifying the severity of diabetes mellitus and has the potential to extend life expectancy and improve quality of life for people living with diabetes mellitus.

Citations

Citations to this article as recorded by

Bridging Evidence and Practice: A Consensus Statement from the Korean Diabetes Association on Diabetes Screening, Pharmacological Treatment and Severe Diabetes
Jong Han Choi, Shinae Kang, Soo-Kyung Kim, Won Jun Kim, Ji Min Kim, Jaehyun Bae, Jae-Seung Yun, Eonju Jeon, Young-Eun Kim, Jae Hyun Bae, Hun Jee Choe, Young Min Cho, Seung-Hyun Ko, Sang Yong Kim, Hae Jin Kim, You-Cheol Hwang, Min Kyong Moon, Suk Chon, Seo
Diabetes & Metabolism Journal.2025; 49(6): 1155. CrossRef

Complications
Clinical Phenotypes of Diabetic Peripheral Neuropathy: Implications for Phenotypic-Based Therapeutics Strategies: Jie-Eun Lee, Jong Chul Won; Diabetes Metab J. 2025;49(4):542-564. Published online July 1, 2025; DOI: https://doi.org/10.4093/dmj.2025.0299

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Diabetic peripheral neuropathy (DPN) is a common complication of diabetes mellitus that encompasses a heterogeneous group of conditions with diverse clinical manifestations. Despite its prevalence, no universally established classification or treatment approach is currently available. Recent findings have underscored the role of systemic inflammation, oxidative stress, and neurochemical imbalances in shaping DPN phenotypes, emphasizing the need for phenotype-specific diagnostic and therapeutic approaches. Advanced diagnostic techniques, including magnetic resonance imaging-based neuroimaging and quantitative sensory testing, are emerging as tools for phenotypic characterization. Therapeutic interventions are moving toward precision medicine, with targeted pharmacological and non-pharmacological strategies tailored to specific clinical presentations. Innovations such as digital health platforms, regenerative therapies, and combinatorial pharmacotherapy are promising for addressing primary neuropathic pain and its associated complications. This review synthesizes the current evidence on DPN phenotypes (painful, painless, and mixed forms), their underlying pathophysiological mechanisms, and the efficacy of treatment approaches. A framework for optimizing management strategies is also proposed. By leveraging novel insights into sensory phenotypes and treatment responsiveness, clinicians can adopt DPN phenotype-based treatment models to optimize patient care, improve treatment outcomes, reduce the substantial disease burden, and enhance patient quality of life.

Citations

Citations to this article as recorded by

Why are we still missing the pain? Rethinking diabetic neuropathy in primary care – lessons from the REGENERAR study
Antonio Alcántara Montero
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Plasma Mucin-1 as a Potential Biomarker for Diabetic Peripheral Neuropathy in Type 2 Diabetes
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Biomolecules.2026; 16(1): 128. CrossRef
The association between Apolipoprotein A1, Apolipoprotein B and their ratio with diabetes‐related neuropathy in elderly patients
Iskandar R. Budianto, Ervina Gosal, Tena Djuartina, Alfred Sutrisno
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Microglial activation in diabetic neuropathic pain: Molecular trigger mechanisms, neuroimmune crosstalk, and emerging therapeutic targets
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Arterial stenosis and electrophysiological nerve dysfunction in type 2 diabetes: clinical evidence from GEE models and transcriptomic pathway analysis
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The role of brain mechanisms in diabetic peripheral neuropathy: recent advances and comprehensive analysis
Min Wei, Ye Jiang, Jiayin Shou, Guogang Xing, Min Li
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On a Phenotypic Approach to Diabetic Peripheral Neuropathy (Diabetes Metab J 2025;49:542-64)
Antonio Alcántara Montero
Diabetes & Metabolism Journal.2025; 49(6): 1349. CrossRef
Effects of CXCR1/2 Blockade with Ladarixin on Streptozotocin-Induced Type 1 Diabetes Mellitus and Peripheral Neuropathy and Retinopathy in Rat (Diabetes Metab J 2025;49:990-1005)
Heung Yong Jin
Diabetes & Metabolism Journal.2025; 49(6): 1351. CrossRef
Clinical Phenotypes of Diabetic Peripheral Neuropathy: Implications for Phenotypic-Based Therapeutics Strategies (Diabetes Metab J 2025;49:542-64)
Jie-Eun Lee, Jong Chul Won
Diabetes & Metabolism Journal.2025; 49(6): 1354. CrossRef
Precision approach to diabetic peripheral neuropathy: modified nerve decompression surgery and MNGF treatment
Yanji Zhang, Hehua Song, Yang Jian, Silang Cai, Chengliang Deng, Zairong Wei
Frontiers in Medicine.2025;[Epub] CrossRef
Apolipoprotein E genotypes are associated with diabetic peripheral neuropathy in Lebanese adults with type 2 diabetes: a case-control study
Rita Nemr, Sabrina Zidi, Akram Echtay, Eddie Racoubian, Nisrine Beydoun, Wassim Y. Almawi
Frontiers in Endocrinology.2025;[Epub] CrossRef
Neuroinflammation-Based Novel Biomarkers for Early Detection of Diabetic Neuropathy
Jee Hee Yoon, Ho-Cheol Kang
The Journal of Korean Diabetes.2025; 26(4): 222. CrossRef

Original Article

Metabolic Risk/Epidemiology
Birth Weight, Cardiovascular Health, and Microvascular Complications in Individuals with Diabetes Mellitus: Chaolun Yu, Anping Feng, Xia Zou, Siqi Chen, Lingyan Dai, Qingmei Cui, Xiaojing Kuang, Gaoli She, Ying Ma, Haixia Guan, Jie Li; Diabetes Metab J. 2025;49(5):1075-1086. Published online May 23, 2025; DOI: https://doi.org/10.4093/dmj.2024.0518

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Abstract PDF Supplementary Material PubReader ePub: Background
Diabetes often leads to microvascular complications, including nephropathy, neuropathy, and retinopathy. Understanding the impact of early-life factors like birth weight and modifiable behaviors such as cardiovascular health (CVH) is essential for preventing these complications.
Methods
We included 11,515 participants with diabetes but without microvascular complications at baseline from the UK Biobank Study. CVH was evaluated using the Life’s Essential 8 score. Independent and joint associations of birth weight and CVH with microvascular complications were analyzed using Cox proportional hazard models. Two-sample Mendelian randomization (MR) analyses estimated unconfounded associations between birth weight and microvascular complications.
Results
Over a median follow-up of 13.1 years, 3,010 microvascular complications occurred. Compared with normal birth weight (2.5–4.0 kg), low birth weight (LBW; <2.5 kg) was associated with 15% higher risk of diabetic nephropathy (hazard ratio [HR], 1.15; 95% confidence interval [CI], 1.01 to 1.31), but not with neuropathy and retinopathy. High birth weight (>4.0 kg) was not associated with the risk of diabetic microvascular complications. MR analysis confirmed the association between LBW and nephropathy. Adherence to high CVH was associated with a reduced risk of microvascular complications compared to low CVH, regardless of birth weight. The HRs were 0.70 (95% CI, 0.59 to 0.84) for the LBW group and 0.74 (95% CI, 0.68 to 0.80) for the group with birth weight ≥2.5 kg (P for interaction=0.69).
Conclusion
LBW was an independent risk factor for nephropathy among diabetic patients. However, the detrimental effects of LBW might be mitigated by improvement in CVH.

Review

Cardiovascular Risk/Epidemiology
Intensified Multifactorial Intervention in Patients with Type 2 Diabetes Mellitus: Takayoshi Sasako, Toshimasa Yamauchi, Kohjiro Ueki; Diabetes Metab J. 2023;47(2):185-197. Published online January 12, 2023; DOI: https://doi.org/10.4093/dmj.2022.0325

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In the management of diabetes mellitus, one of the most important goals is to prevent its micro- and macrovascular complications, and to that end, multifactorial intervention is widely recommended. Intensified multifactorial intervention with pharmacotherapy for associated risk factors, alongside lifestyle modification, was first shown to be efficacious in patients with microalbuminuria (Steno-2 study), then in those with less advanced microvascular complications (the Anglo-Danish-Dutch Study of Intensive Treatment In People with Screen Detected Diabetes in Primary Care [ADDITION]-Europe and the Japan Diabetes Optimal Treatment study for 3 major risk factors of cardiovascular diseases [J-DOIT3]), and in those with advanced microvascular complications (the Nephropathy In Diabetes-Type 2 [NID-2] study and Diabetic Nephropathy Remission and Regression Team Trial in Japan [DNETT-Japan]). Thus far, multifactorial intervention led to a reduction in cardiovascular and renal events, albeit not necessarily significant. It should be noted that not only baseline characteristics but also the control status of the risk factors and event rates during intervention among the patients widely varied from one trial to the next. Further evidence is needed for the efficacy of multifactorial intervention in a longer duration and in younger or elderly patients. Moreover, now that new classes of antidiabetic drugs are available, it should be addressed whether strict and safe glycemic control, alongside control of other risk factors, could lead to further risk reductions in micro- and macrovascular complications, thereby decreasing all-cause mortality in patients with type 2 diabetes mellitus.

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Original Article

Complication
Waist Circumference and Body Mass Index Variability and Incident Diabetic Microvascular Complications: A Post Hoc Analysis of ACCORD Trial: Daniel Nyarko Hukportie, Fu-Rong Li, Rui Zhou, Jia-Zhen Zheng, Xiao-Xiang Wu, Xian-Bo Wu; Diabetes Metab J. 2022;46(5):767-780. Published online May 10, 2022; DOI: https://doi.org/10.4093/dmj.2021.0258

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Background
Obesity is associated with adverse health events among diabetic patients, however, the relationship between obesity fluctuation and risk of microvascular complications among this specific population is unclear. We aimed to examine the effect of waist circumference (WC) and body mass index (BMI) variability on the risk of diabetic microvascular outcome
Methods
Annually recorded anthropometric data in the Action to Control Cardiovascular Risk in Diabetes (ACCORD) study was used to examine the association of WC and BMI variability defined as variability independent of mean, with the risk of microvascular outcomes, including neuropathy, nephropathy, and retinopathy. Cox proportional hazards models were used to estimate the hazard ratios (HRs) and 95% confidence intervals (CIs) (Trial registration: ClinicalTrials.gov., no. NCT00000620).
Results
There were 4,031, 5,369, and 2,601 cases of neuropathy, nephropathy, and retinopathy during a follow-up period of 22,524, 23,941, and 23,850 person-years, respectively. Higher levels of WC and BMI variability were associated with an increased risk of neuropathy. Compared with the lowest quartile, the fully-adjusted HR (95% CI) for the highest quartile of WC and BMI variability for neuropathy risk were 1.21 (1.05 to 1.40) and 1.16 (1.00 to 1.33), respectively. Also, higher quartiles of BMI variability but not WC variability were associated with increased risk of nephropathic events. The fully-adjusted HR (95% CI) for the highest quartile compared with the lowest quartile of BMI variability was 1.31 (1.18 to 1.46). However, the results for retinopathic events were all insignificant.
Conclusion
Among participants with type 2 diabetes mellitus, WC and BMI variability were associated with a higher risk of neuropathic events, whereas BMI variability was associated with an increased risk of nephropathic events.

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Review

Type 1 Diabetes
Time in Range from Continuous Glucose Monitoring: A Novel Metric for Glycemic Control: Jee Hee Yoo, Jae Hyeon Kim; Diabetes Metab J. 2020;44(6):828-839. Published online December 23, 2020; DOI: https://doi.org/10.4093/dmj.2020.0257; Correction in: Diabetes Metab J 2021;45(5):795

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Glycosylated hemoglobin (HbA1c) has been the sole surrogate marker for assessing diabetic complications. However, consistently reported limitations of HbA1c are that it lacks detailed information on short-term glycemic control and can be easily interfered with by various clinical conditions such as anemia, pregnancy, or liver disease. Thus, HbA1c alone may not represent the real glycemic status of a patient. The advancement of continuous glucose monitoring (CGM) has enabled both patients and healthcare providers to monitor glucose trends for a whole single day, which is not possible with HbA1c. This has allowed for the development of core metrics such as time spent in time in range (TIR), hyperglycemia, or hypoglycemia, and glycemic variability. Among the 10 core metrics, TIR is reported to represent overall glycemic control better than HbA1c alone. Moreover, various evidence supports TIR as a predictive marker of diabetes complications as well as HbA1c, as the inverse relationship between HbA1c and TIR reveals. However, there are more complex relationships between HbA1c, TIR, and other CGM metrics. This article provides information about 10 core metrics with particular focus on TIR and the relationships between the CGM metrics for comprehensive understanding of glycemic status using CGM.

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Original Articles

Complications
Time to Reach Target Glycosylated Hemoglobin Is Associated with Long-Term Durable Glycemic Control and Risk of Diabetic Complications in Patients with Newly Diagnosed Type 2 Diabetes Mellitus: A 6-Year Observational Study: Kyoung Jin Kim, Jimi Choi, Jae Hyun Bae, Kyeong Jin Kim, Hye Jin Yoo, Ji A Seo, Nan Hee Kim, Kyung Mook Choi, Sei Hyun Baik, Sin Gon Kim, Nam Hoon Kim; Diabetes Metab J. 2021;45(3):368-378. Published online October 20, 2020; DOI: https://doi.org/10.4093/dmj.2020.0046

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Background
To evaluate the association of time to reach the target glycosylated hemoglobin (HbA1c) level with long-term durable glycemic control and risk of diabetic complications in patients with newly diagnosed type 2 diabetes mellitus (T2DM).
Methods
In a longitudinal observational cohort, 194 patients with T2DM newly diagnosed between January 2011 and March 2013 were followed up over 6 years. Patients were classified according to the time needed to reach the target HbA1c (<7.0%): <3, 3 to 6 (early achievement group), and ≥6 months (late achievement group). Risks of microvascular complications including diabetic retinopathy, nephropathy, and neuropathy as well as macrovascular events including ischemic heart disease, ischemic stroke, and peripheral arterial disease were assessed by multivariable Cox proportional hazards analysis.
Results
During a median follow-up of 6.53 years, 66 microvascular and 14 macrovascular events occurred. Maintenance of durable glycemic control over 6 years was more likely in the early achievement groups than in the late achievement group (34.5%, 30.0%, and 16.1% in <3, 3 to 6, and ≥6 months, respectively, P=0.039). Early target HbA1c achievement was associated with lower risk of composite diabetic complications (adjusted hazard ratio [HR, 0.47; 95% confidence interval [CI], 0.26 to 0.86 in <3 months group) (adjusted HR, 0.50; 95% CI, 0.23 to 1.10 in 3 to 6 months group, in reference to ≥6 months group). Similar trends were maintained for risks of microvascular and macrovascular complications, although statistical significance was not reached for macrovascular complications.
Conclusion
Early target HbA1c achievement was associated with long-term durable glycemic control and reduced risk of diabetic complications in newly diagnosed T2DM.

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Complications
Association between Sleep Quality and Painless Diabetic Peripheral Neuropathy Assessed by Current Perception Threshold in Type 2 Diabetes Mellitus: Dughyun Choi, Bo-Yeon Kim, Chan-Hee Jung, Chul-Hee Kim, Ji-Oh Mok; Diabetes Metab J. 2021;45(3):358-367. Published online August 6, 2020; DOI: https://doi.org/10.4093/dmj.2019.0219

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Background

It is known that the painful sensation of diabetic peripheral neuropathy (DPN) results in sleep problems in type 2 diabetes mellitus (T2DM). However, it is not known that the painless DPN also is associated with poor sleep quality in T2DM. The purpose of the current study was to investigate the association between painless DPN and poor sleep quality in T2DM.

Methods

A total of 146 patients of T2DM who do not have any painful symptoms of DPN were recruited into the study. Among the patients, painless DPN was diagnosed by using the current perception threshold test. Sleep quality was assessed using the Pittsburgh Sleep Quality Index questionnaire.

Results

The percentage of painless DPN was significantly higher in the poor sleep quality group than the good sleep quality group (70.0% vs. 35.5%, P<0.001). In the subscale results, stimulus values at 2,000 Hz, hypoesthesia and hyperesthesia were more common in the poor sleep quality group than in the good sleep quality group (45.7% vs. 25.0%, P=0.009; 34.3% vs. 18.4%, P=0.029; 40.0% vs. 19.7%, P=0.007, respectively). The association of painless DPN and poor sleep quality remained significant after adjustment for significant covariates (odds ratio, 3.825; 95% confidence interval, 1.674 to 8.742; P<0.001).

Conclusion

The current study showed that painless DPN was associated with poor sleep quality. Future studies are required to clarify the pathophysiologic causal relationship between painless DPN and sleep quality.

Citations

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Sleep quality and diabetic neuropathy: A review and exploratory meta-analysis
Omar Alsatam Alraoui, Mette Krabsmark Borbjerg, David C. Klonoff, Carsten Dahl Mørch, Daniel Ciampi de Andrade, Niels Ejskjaer, Johan Røikjer
Journal of Diabetes and its Complications.2026; 40(5): 109311. CrossRef
Assessment of Peripheral Neuropathy Using Current Perception Threshold Measurement in Patients with Spinocerebellar Ataxia Type 3
Xia-Hua Liu, Wei Lin, Hao-Ling Xu, Mao-Lin Cui, Zhuo-Ying Huang, Ying Li, Nan-Nan Zhang, Ning Wang, Zhi-Yong Wang, Shi-Rui Gan
The Cerebellum.2025;[Epub] CrossRef
Analysis of sleep quality and related factors in patients with Type 2 Diabetes Mellitus
Elif Serap Esen, Güzin Zeren Öztürk
Clinical and Experimental Health Sciences.2025; 15(1): 76. CrossRef
Disordered Sleep and Painful Diabetic Neuropathy (PDN): a Review of the Literature on Pathophysiology, Pharmacologic and Nonpharmacologic Treatment Options, and Future Directions
Sophia Tong, Julia Greenberg, Christina Marini, Azizi Seixas, Lisa V. Doan, Ricardo Osorio, Sujata Thawani
Current Sleep Medicine Reports.2025;[Epub] CrossRef
Evaluation of Complications, Peripheral Neuropathic Pain, and Sleep Quality in Patients With Diabetes Mellitus
Dilek Yildirim, Deniz Aras
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Deteriorated sleep quality and associate factors in patients with type 2 diabetes mellitus complicated with diabetic peripheral neuropathy
Lin Fu, Liping Zhong, Xin Liao, Lingrui Wang, Youyi Wang, Xiuquan Shi, Yanna Zhou
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Lisa Goudman, Ann De Smedt, Julie Jansen, Maxime Billot, Manuel Roulaud, Philippe Rigoard, Maarten Moens
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Type 1 Diabetes
Age at Diagnosis and the Risk of Diabetic Nephropathy in Young Patients with Type 1 Diabetes Mellitus: Jong Ha Baek, Woo Je Lee, Byung-Wan Lee, Soo Kyoung Kim, Gyuri Kim, Sang-Man Jin, Jae Hyeon Kim; Diabetes Metab J. 2021;45(1):46-54. Published online July 10, 2020; DOI: https://doi.org/10.4093/dmj.2019.0134

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Background

The aim of this study was to evaluate characteristics and risk of diabetic complications according to age at diagnosis among young adults with type 1 diabetes mellitus (T1DM).

Methods

A total of 255 T1DM patients aged less than 40 years were included. Patients were categorized into three groups (<20, 20 to 29, and 30 to 40 years) according to age at diagnosis. Diabetic nephropathy (DN) was defined when spot urine-albumin creatinine ratio was 300 mg/g or more and/or estimated glomerular filtration ratio (eGFR) level was 60 mL/min/1.73 m² or less.

Results

Median age at diagnosis was 25 years and disease duration was 14 years. Individuals diagnosed with T1DM at childhood/adolescent (age <20 years) had lower stimulated C-peptide levels. They received more intensive insulin treatment with higher total daily insulin doses compared to older onset groups. The prevalence of DN was higher in the childhood/adolescent-onset group than in older onset groups (25.3% vs. 15.3% vs. 9.6%, P=0.022). The eGFR was inversely associated with disease duration whilst the degree of decrease was more prominent in the childhood/adolescent-onset group than in the later onset group (aged 30 to 40 years; P<0.001). Childhood/adolescent-onset group was independently associated with the risk of DN compared to the older onset group (aged 30 to 40 years; odds ratio, 3.47; 95% confidence interval, 1.45 to 8.33; P=0.005).

Conclusion

In individuals with childhood/adolescent-onset T1DM, the reduction in renal function is more prominent with disease duration. Early age-onset T1DM is an independent risk of DN.

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Brief Report

Complications
Acute Hyperglycemic Crises with Coronavirus Disease-19: Case Reports: Na-young Kim, Eunyeong Ha, Jun Sung Moon, Yong-Hoon Lee, Eun Young Choi; Diabetes Metab J. 2020;44(2):349-353. Published online April 23, 2020; DOI: https://doi.org/10.4093/dmj.2020.0091

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Since the first case was contracted by coronavirus disease-19 (COVID-19) in Daegu, Korea in February 2020, about 6,800 cases and 130 deaths have been reported on April 9, 2020. Recent studies have reported that patients with diabetes showed higher mortality and they had a worse prognosis than the group without diabetes. In poorly controlled patients with diabetes, acute hyperglycemic crises such as diabetic ketoacidosis (DKA) or hyperosmolar hyperglycemic state (HHS) also might be precipitated by COVID-19. Thus, intensive monitoring and aggressive supportive care should be needed to inadequately controlled patients with diabetes and COVID-19 infection. Here, we report two cases of severe COVID-19 patients with acute hyperglycemic crises in Korea.

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Original Articles

Cardiovascular Risk/Epidemiology
Impact of Diabetes Control on Subclinical Atherosclerosis: Analysis from Coronary Computed Tomographic Angiography Registry: Gyung-Min Park, Chang Hoon Lee, Seung-Whan Lee, Sung-Cheol Yun, Young-Hak Kim, Yong-Giun Kim, Ki-Bum Won, Soe Hee Ann, Shin-Jae Kim, Dong Hyun Yang, Joon-Won Kang, Tae-Hwan Lim, Eun Hee Koh, Woo Je Lee, Min-Seon Kim, Joong-Yeol Park, Hong-Kyu Kim, Jaewon Choe, Sang-Gon Lee; Diabetes Metab J. 2020;44(3):470-479. Published online November 22, 2019; DOI: https://doi.org/10.4093/dmj.2019.0073

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Background

There are limited data on the impact of diabetes control on the risk of subclinical coronary atherosclerosis.

Methods

We analyzed 6,434 consecutive asymptomatic individuals without previous history of coronary artery disease who underwent coronary computed tomographic angiography (CCTA) (mean age, 53.7±7.6 years and 4,694 men [73.0%]). The degree and extent of subclinical coronary atherosclerosis were assessed by CCTA, and ≥50% diameter stenosis was defined as significant. A cardiac event was defined as a composite of all-cause death, myocardial infarction, unstable angina, or coronary revascularization. Study participants were categorized as normal (n=5,319), controlled diabetes (glycosylated hemoglobin [HbA1c] <7%, n=747), or uncontrolled diabetes (HbA1c ≥7%, n=368), respectively.

Results

Compared with normal individuals, there were no statistically significant differences in the risk of for any atherosclerotic plaque (odds ratio [OR], 1.16; 95% confidence interval [CI], 0.98 to 1.38; P=0.086) and significant coronary artery stenosis (OR, 1.08; 95% CI, 0.82 to 1.42; P=0.583) in controlled diabetic individuals. In contrast, uncontrolled diabetic individuals had consistently higher risks of any atherosclerotic plaque (OR, 2.16; 95% CI, 1.70 to 2.75; P<0.001) and significant coronary artery stenosis (OR, 3.34; 95% CI, 2.52 to 4.43; P<0.001) than normal individuals. During a follow-up of median 5.4 years, there was no significant difference in cardiac events between normal and controlled diabetic individuals (P=0.365). However, uncontrolled diabetes was associated with an increased risk of cardiac events compared with normal individuals (P<0.001) and controlled diabetic individuals (P=0.023).

Conclusion

Asymptomatic uncontrolled diabetes was associated with significant subclinical coronary atherosclerosis with subsequent high risk for cardiac events.

Citations

Citations to this article as recorded by

Association between atherogenic index of plasma and rapid progression of coronary atherosclerosis in non-diabetic and diabetic adults: Insight from the PARADIGM study
Ki-Bum Won, Byoung Kwon Lee, Martin Hadamitzky, Yong-Jin Kim, Ji Min Sung, Edoardo Conte, Gianluca Pontone, Daniele Andreini, Matthew J. Budoff, Ilan Gottlieb, Eun Ju Chun, Filippo Cademartiri, Erica Maffei, Hugo Marques, Pedro de Araújo Gonçalves, Jonath
Journal of Cardiovascular Computed Tomography.2026;[Epub] CrossRef
Different associations of atherogenic index of plasma, triglyceride glucose index, and hemoglobin A1C levels with the risk of coronary artery calcification progression according to established diabetes
Ki-Bum Won, Su-Yeon Choi, Eun Ju Chun, Sung Hak Park, Jidong Sung, Hae Ok Jung, Hyuk-Jae Chang
Cardiovascular Diabetology.2024;[Epub] CrossRef
Carotid Ultrasound Abnormalities of People Living With HIV in Kunming, China: Multiple Correspondence Analysis Approach to Identify Influencing Factors
Shuishui Pan, Haiyan Fu, Zhiqiong Ai, Chongxi Li, Jinsong Bai
International Journal of STD & AIDS.2023; 34(10): 710. CrossRef
Differential Impact of Degree of Hypertension on Subclinical Coronary Atherosclerosis in Asymptomatic Subjects With and Without Diabetes Mellitus
Hyun Woo Park, Sangyong Jo, Kyung Sun Park, Hyeji Lee, Young-Jee Jeon, Sangwoo Park, Soe Hee Ann, Yong-Giun Kim, Seong Hoon Choi, Woon Jung Kwon, Young-Rak Cho, Jon Suh, Gyung-Min Park
The American Journal of Cardiology.2023; 203: 343. CrossRef
Exosomal MALAT1 Derived from High Glucose-Treated Macrophages Up-Regulates Resistin Expression via miR-150-5p Downregulation
Kou-Gi Shyu, Bao-Wei Wang, Wei-Jen Fang, Chun-Ming Pan, Chiu-Mei Lin
International Journal of Molecular Sciences.2022; 23(3): 1095. CrossRef
Comparison of Framingham risk score and pooled cohort equations for the prediction of coronary atherosclerosis in patients who meet the target LDL-C level of Korean dyslipidemia guideline
Su Bin Kim, Hae Won Jung
Medicine.2022; 101(47): e31816. CrossRef
Time to Reach Target Glycosylated Hemoglobin Is Associated with Long-Term Durable Glycemic Control and Risk of Diabetic Complications in Patients with Newly Diagnosed Type 2 Diabetes Mellitus: A 6-Year Observational Study
Kyoung Jin Kim, Jimi Choi, Jae Hyun Bae, Kyeong Jin Kim, Hye Jin Yoo, Ji A Seo, Nan Hee Kim, Kyung Mook Choi, Sei Hyun Baik, Sin Gon Kim, Nam Hoon Kim
Diabetes & Metabolism Journal.2021; 45(3): 368. CrossRef
Frequency and Significance of Right Bundle Branch Block and Subclinical Coronary Atherosclerosis in Asymptomatic Individuals
Hyeji Lee, Young-Jee Jeon, Byung Ju Kang, Tae Young Lee, Eun Ji Park, Sangwoo Park, Soe Hee Ann, Yong-Giun Kim, Yongjik Lee, Seong Hoon Choi, Gyung-Min Park
The American Journal of Cardiology.2021; 158: 30. CrossRef
The association between glucose-related variables and plaque morphology in patients with ST-segment elevated myocardial infarction
Jinxin Liu, Shanjie Wang, Can Cui, Hengxuan Cai, Rong Sun, Weili Pan, Shaohong Fang, Bo Yu
Cardiovascular Diabetology.2020;[Epub] CrossRef
Choosing Antithrombotic Therapy in Patients with Coronary Heart Disease and Type 2 Diabetes Mellitus: How to Reduce the Risk of Death
N. A. Koziolova, P. G. Karavaev, A. S. Veklich
Kardiologiia.2020; 60(4): 109. CrossRef

Clinical Care/Education
Impact of Continuous Care on Health Outcomes and Cost for Type 2 Diabetes Mellitus: Analysis Using National Health Insurance Cohort Database: Ji Hyun Nam, Changwoo Lee, Nayoung Kim, Keun Young Park, Jeonghoon Ha, Jaemoon Yun, Dong Wook Shin, Euichul Shin; Diabetes Metab J. 2019;43(6):776-784. Published online October 21, 2019; DOI: https://doi.org/10.4093/dmj.2018.0189

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Background

The objective of the study was to determine the impact of continuous care on health outcomes and cost of type 2 diabetes mellitus (T2DM) in Korea.

Methods

A nationwide retrospective, observational case-control study was conducted. Continuity of treatment was measured using Continuity of Care (COC) score. Information of all patients newly diagnosed with T2DM in 2004 was retrieved from the National Health Insurance database for the period of 2002 to 2013. The study examined 2,373 patients after applying exclusion criteria, such as for patients who died from conditions not related to T2DM. Statistical analyses were performed using frequency distribution, simple analysis (t-test and chi-squared test), and multi-method analysis (simple linear regression, logistic regression, and survival analysis).

Results

The overall COC score was 0.8±0.24. The average incidence of diabetic complications was 0.39 per patient with a higher COC score, whereas it was 0.49 per patient with a lower COC score. In both survival and logistic analyses, patients who had high COC score were significantly less likely to have diabetic complications (hazard ratio, 0.69; 95% confidence interval, 0.54 to 0.88). The average medical cost was approximately 3,496 United States dollar (USD) per patient for patients with a higher COC score, whereas it was 3,973 USD per patient for patients with a lower COC score during the 2006 to 2013 period, with a difference of around 477 USD, which is statistically significant after adjusting for other factors (β=−0.152).

Conclusion

Continuity of care for diabetes significantly reduced health complications and medical costs from patients with T2DM.

Citations

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Continuity of care for patients with hypertension or diabetes mellitus reduced medical utilization, total medical costs, and cardiovascular events based on the Korean NHIS-HEALS cohort
Eun-Kyeong Yun, Jae Yong Shim, Sang-Jun Shin, Hee-Taik Kang
Nutrition, Metabolism and Cardiovascular Diseases.2026; 36(6): 104527. CrossRef
Is avoidable diabetes-related hospitalization in older patients with type 2 diabetes mellitus associated with increased health expenditure?: A nationwide retrospective cohort study in South Korea
Woo-Ri Lee, Gyeong-Min Lee, Noorhee Son, Kyu-Tae Han, Sungyoun Chun, Yehrhee Son, Ki-Bong Yoo
Preventive Medicine Reports.2025; 49: 102946. CrossRef
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Galih Kunarso, Ngiap Chuan Tan
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Impact of Health Insurance Status on HbA1c Control Among United States Adults With Type 2 Diabetes: A Cross-Sectional Analysis of Nationally Representative Data
Basit O Bolarinwa, Chiamaka J Ohiri, Rasheedat A Sadiq-Onilenla, Sunday P Iziogo, Okelue E Okobi
Cureus.2025;[Epub] CrossRef
Continuity of primary care for type 2 diabetes and hypertension and its association with health outcomes and disease control: insights from Central Vietnam
Quynh-Anh Le Ho Thi, Peter Pype, Johan Wens, Huy Nguyen Vu Quoc, Anselme Derese, Wim Peersman, Nhon Bui, Huyen Nguyen Thi Thanh, Tam Nguyen Minh
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RETRACTED: Application of continuing nursing intervention on wound infection and ulcers in patients with diabetic foot: A meta‐analysis
Xu‐Xiang Li, Jing Xu, Juan Chen, Feng Gao, Qing‐Ju Wang, Shi‐Hu Yang
International Wound Journal.2024;[Epub] CrossRef
Out-of-pocket direct cost of ambulatory care of type 2 diabetes in Delhi: Estimates from the Delhi diabetes community-II (DEDICOM-II) survey
Swapnil Rawat, Neetu Bansal, Ramasheesh Yadav, Siddhi Goyal, Jitender Nagpal
Diabetes & Metabolic Syndrome: Clinical Research & Reviews.2024; 18(7): 103089. CrossRef
Impact of the family doctor system on the continuity of care for diabetics in urban China: a difference-in-difference analysis
Xinyi Liu, Luying Zhang, Wen Chen
BMJ Open.2023; 13(2): e065612. CrossRef
The associations of continuity of care with inpatient, outpatient, and total medical care costs among older adults with urinary incontinence
Eunkyung Han, Wankyo Chung, Antonio Trujillo, Joel Gittelsohn, Leiyu Shi
BMC Health Services Research.2023;[Epub] CrossRef
Association between initial continuity of care status and diabetes-related health outcomes in older patients with type 2 diabetes mellitus: A nationwide retrospective cohort study in South Korea
Hyun Woo Jung, Woo-Ri Lee
Primary Care Diabetes.2023; 17(6): 600. CrossRef
Relationship between continuity of care and clinical outcomes in patients with dyslipidemia in Korea: a real world claims database study
Juhee Lee, Eunyoung Choi, Eunjung Choo, Siachalinga Linda, Eun Jin Jang, Iyn-Hyang Lee
Scientific Reports.2022;[Epub] CrossRef
Association Between Team-Based Continuity of Care and Risk of Cardiovascular Diseases Among Patients With Diabetes: A Retrospective Cohort Study
Kam Suen Chan, Eric Yuk Fai Wan, Weng Yee Chin, Esther Yee Tak Yu, Ivy Lynn Mak, Will Ho Gi Cheng, Margaret Kay Ho, Cindy Lo Kuen Lam
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Personal continuity of GP care and outpatient specialist visits in people with type 2 diabetes: A cross-sectional survey
Anne Helen Hansen, May-Lill Johansen, Dylan A. Mordaunt
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Clinical Study Using Healthcare Claims Database
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Kam-Suen Chan, Eric Yuk-Fai Wan, Weng-Yee Chin, Will Ho-Gi Cheng, Margaret Kay Ho, Esther Yee-Tak Yu, Cindy Lo-Kuen Lam
BMC Family Practice.2021;[Epub] CrossRef
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Ye Seul Yang, Kyungdo Han, Tae Seo Sohn, Nam Hoon Kim
The Korean Journal of Internal Medicine.2021; 36(5): 1049. CrossRef

Epidemiology
Diabetes Mellitus and Cause-Specific Mortality: A Population-Based Study: Sen Li, Jiaxin Wang, Biao Zhang, Xinyi Li, Yuan Liu; Diabetes Metab J. 2019;43(3):319-341. Published online April 19, 2019; DOI: https://doi.org/10.4093/dmj.2018.0060

39,237 View
445 Download
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Background

To investigate whether diabetes contributes to mortality for major types of diseases.

Methods

Six National Health and Nutrition Examination Survey data cycles (1999 to 2000, 2001 to 2002, 2003 to 2004, 2005 to 2006, 2007 to 2008, and 2009 to 2010) and their linked mortality files were used. A population of 15,513 participants was included according to the availability of diabetes and mortality status.

Results

Participants with diabetes tended to have higher all-cause mortality and mortality due to cardiovascular disease, cancer, chronic lower respiratory diseases, cerebrovascular disease, influenza and pneumonia, and kidney disease. Confounder-adjusted Cox proportional hazard models showed that both diagnosed diabetes category (yes or no) and diabetes status (diabetes, prediabetes, or no diabetes) were associated with all-cause mortality and with mortality due to cardiovascular disease, chronic lower respiratory diseases, influenza and pneumonia, and kidney disease. No associations were found for cancer-, accidents-, or Alzheimer's disease-related mortality.

Conclusion

The current study's findings provide epidemiological evidence that diagnosed diabetes at the baseline is associated with increased mortality risk due to cardiovascular disease, chronic lower respiratory diseases, influenza and pneumonia, and kidney disease, but not with cancer or Alzheimer's disease.

Citations

Citations to this article as recorded by

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Archives of Physiology and Biochemistry.2026; : 1. CrossRef
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Neurology.2026;[Epub] CrossRef
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Diabetes, Obesity and Metabolism.2026;[Epub] CrossRef
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DIGITAL HEALTH.2026;[Epub] CrossRef
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International Journal of Diabetes in Developing Countries.2025; 45(4): 1078. CrossRef
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The Lancet Regional Health - Europe.2025; 48: 101147. CrossRef
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Diabetes, Metabolic Syndrome and Obesity.2025; Volume 18: 135. CrossRef
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Short Communication

Complications
Glycosylated Hemoglobin in Subjects Affected by Iron-Deficiency Anemia: Jari Intra, Giuseppe Limonta, Fabrizio Cappellini, Maria Bertona, Paolo Brambilla; Diabetes Metab J. 2019;43(4):539-544. Published online November 28, 2018; DOI: https://doi.org/10.4093/dmj.2018.0072

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Previous studies have suggested that iron-deficiency anemia affects glycosylated hemoglobin (HbA1c) measurements, but the results were contradictory. We conducted a retrospective case-control study to determine the effects of iron deficiency on HbA1c levels. Starting with the large computerized database of the Italian Hospital of Desio, including data from 2000 to 2016, all non-pregnant individuals older than 12 years of age with at least one measurement of HbA1c, cell blood count, ferritin, and fasting blood glucose on the same date of blood collection were enrolled. A total of 2,831 patients met the study criteria. Eighty-six individuals were diagnosed with iron-deficiency anemia, while 2,745 had a normal iron state. The adjusted means of HbA1c were significantly higher in anemic subjects (5.59% [37.37 mmol/mol]), than those measured in individuals without anemia (5.34% [34.81 mmol/mol]) (P<0.0001). These results suggest that clinicians should be cautious about diagnosing prediabetes and diabetes in individuals with anemia.

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Original Article

Complications
Association between Serum Cystatin C and Vascular Complications in Type 2 Diabetes Mellitus without Nephropathy: Hye Jeong Kim, Dong Won Byun, Kyoil Suh, Myung Hi Yoo, Hyeong Kyu Park; Diabetes Metab J. 2018;42(6):513-518. Published online October 15, 2018; DOI: https://doi.org/10.4093/dmj.2018.0006

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Background

Recent studies have correlated serum cystatin C (CysC) with vascular complications, but few studies have investigated this correlation in diabetes patients without nephropathy. This study aimed to evaluate if higher serum CysC levels increase the risk for vascular complications in type 2 diabetes mellitus patients with normal renal function or mild renal impairment.

Methods

A total of 806 consecutive patients with type 2 diabetes mellitus who were admitted to the diabetes center of Soonchunhyang University Hospital for blood glucose control were retrospectively reviewed. Patients with nephropathy were excluded. Subjects were categorized into quartiles of serum CysC levels (Q1, ≤0.65 mg/L; Q2, 0.66 to 0.79 mg/L; Q3, 0.80 to 0.94 mg/L; and Q4, ≥0.95 mg/L).

Results

The proportion of patients with diabetic retinopathy (DR) (P for trend <0.001), coronary heart disease (CHD) (P for trend <0.001), and stroke (P for trend <0.001) increased across the serum CysC quartiles. After adjustment for confounding factors, the highest serum CysC level remained a significant risk factor for DR (odds ratio [OR], 1.929; 95% confidence interval [CI], 1.007 to 4.144; P=0.040). Compared with Q1, a significant positive association was observed between serum CysC and CHD in Q2 (OR, 7.321; 95% CI, 1.114 to 48.114; P=0.012), Q3 (OR, 6.027; 95% CI, 0.952 to 38.161; P=0.020), and Q4 (OR, 8.122; 95% CI, 1.258 to 52.453; P=0.007). No associations were observed between CysC and stroke after additional adjustment for confounding variables.

Conclusion

Serum CysC levels are independently associated with DR and CHD, suggesting that CysC may be useful for identifying type 2 diabetes mellitus patients without nephropathy who are at high risk for vascular complications.

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Sulwon Lecture 2017

Complications
The Role of Advanced Glycation End Products in Diabetic Vascular Complications: Sang Youl Rhee, Young Seol Kim; Diabetes Metab J. 2018;42(3):188-195. Published online May 31, 2018; DOI: https://doi.org/10.4093/dmj.2017.0105

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In cases of chronic hyperglycemia, advanced glycation end-products (AGEs) are actively produced and accumulated in the circulating blood and various tissues. AGEs also accelerate the expression of receptors for AGEs, and they play an important role in the development of diabetic vascular complications through various mechanisms. Active interventions for glucose and related risk factors may help improve the clinical course of patients by reducing AGEs. This review summarizes recent updates on AGEs that have a significant impact on diabetic vascular complications.

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Impact of High Aspartame and High Fructose Diet on Vascular Reactivity, Glucose Metabolism and Liver Structure in Diabetic Rats
Adel Shalaby, Marwa Al-Gholam, Safa Elfiky, Ghada Elgarawany
Open Access Macedonian Journal of Medical Sciences.2022; 10(A): 1433. CrossRef
KITLG Promotes Glomerular Endothelial Cell Injury in Diabetic Nephropathy by an Autocrine Effect
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Comparative Evaluation of the Antiglycation and Anti-α-Glucosidase Activities of Baicalein, Baicalin (Baicalein 7-O-Glucuronide) and the Antidiabetic Drug Metformin
Guglielmina Froldi, Francine Medjiofack Djeujo, Nadia Bulf, Emma Caparelli, Eugenio Ragazzi
Pharmaceutics.2022; 14(10): 2141. CrossRef
Reduced coupling between the global blood-oxygen-level-dependent signal and cerebrospinal fluid inflow is associated with the severity of small vessel disease
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To Investigate the Protective Effect and Mechanism of Isoorientin on Aortic in T2DM Macrovascular Disease Mice
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Low grade intravascular hemolysis associates with peripheral nerve injury in type 2 diabetes
Sylvain Le Jeune, Sihem Sadoudi, Dominique Charue, Salwa Abid, Jean-Michel Guigner, Dominique Helley, Hélène Bihan, Camille Baudry, Hélène Lelong, Tristan Mirault, Eric Vicaut, Robin Dhote, Jean-Jacques Mourad, Chantal M. Boulanger, Olivier P. Blanc-Brude
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Vascular contributions to cognitive impairment/dementia in diabetes: role of endothelial cells and pericytes
Mia Edgerton-Fulton, Adviye Ergul
American Journal of Physiology-Cell Physiology.2022; 323(4): C1177. CrossRef
The Potential Effect of Sildenafil Citrate on Some Hematological and Biochemical Parameters in Hyperglycemic Rats
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Pharmacophore.2022; 13(3): 98. CrossRef
Aqueous extract of Massularia acuminata exerts erectogenic effect by modulating critical enzymes and hormones in streptozotocin‐induced erectile dysfunction in rats
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Andrologia.2022;[Epub] CrossRef
The Synthetic Flavonoid Hidrosmin Improves Endothelial Dysfunction and Atherosclerotic Lesions in Diabetic Mice
Luna Jiménez-Castilla, Lucas Opazo-Ríos, Gema Marin-Royo, Macarena Orejudo, Raquel Rodrigues-Diez, Constanza Ballesteros-Martínez, Manuel Soto-Catalán, Teresa Caro-Ordieres, Inés Artaiz, Tatiana Suarez-Cortés, Arturo Zazpe, Gonzalo Hernández, Marcelino Co
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DIABETES COMPLICATIONS AS DIABETES PATIENTS PREDICTORS OF REFERRAL
Nugroho Susanto, Yelli Yani Rusyani
Jurnal Berkala Epidemiologi.2022; 10(1): 68. CrossRef
Protective effects of Vitex pseudo-negundo leaves on diabetic-induced nephropathy in rats
Hasan Rezaei Seresht, Esrafil Mansouri, Mahsa Daei Milani, Bahareh Vahidiyanfar, Arash Ramezanpour Shahi, Mohammad Javad Namazi, Hossein Moallaei, Maryam Latifnia, Mojtaba Fattahi Abdizadeh
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Oxidative stress mitigation by antioxidants - An overview on their chemistry and influences on health status
Aurelia Magdalena Pisoschi, Aneta Pop, Florin Iordache, Loredana Stanca, Gabriel Predoi, Andreea Iren Serban
European Journal of Medicinal Chemistry.2021; 209: 112891. CrossRef
Diabetes, insulin resistance, and asthma: a review of potential links
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Current Opinion in Pulmonary Medicine.2021; 27(1): 29. CrossRef
Translational insight into prothrombotic state and hypercoagulation in nonalcoholic fatty liver disease
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A review on mechanism of inhibition of advanced glycation end products formation by plant derived polyphenolic compounds
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Acetoacetate enhancement of glucose mediated DNA glycation
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Macrophage inflammatory state in Type 1 diabetes: triggered by NLRP3/iNOS pathway and attenuated by docosahexaenoic acid
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Model studies of advanced glycation end product modification of heterograft biomaterials: The effects of in vitro glucose, glyoxal, and serum albumin on collagen structure and mechanical properties
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Acta Biomaterialia.2021; 123: 275. CrossRef
Intestinal microbiota and diabetic kidney diseases: the Role of microbiota and derived metabolites inmodulation of renal inflammation and disease progression
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Best Practice & Research Clinical Endocrinology & Metabolism.2021; 35(3): 101484. CrossRef
Attenuation of protein glycation by functional polyphenolics of dragon fruit (Hylocereus polyrhizus); an in vitro and in silico evaluation
Guna Ravichandran, Dinesh Kumar Lakshmanan, Selvakumar Murugesan, Abbirami Elangovan, Namakkal S. Rajasekaran, Sivasudha Thilagar
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Sex May Modulate the Effects of Combined Polyphenol Extract and L-citrulline Supplementation on Ambulatory Blood Pressure in Adults with Prehypertension: A Randomized Controlled Trial
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Biological variation of glycated albumin, glucose and albumin in healthy Turkish subjects
Osman Oğuz, Hilal Mercan, F. Sinem Hocaoglu-Emre
Turkish Journal of Biochemistry.2021; 46(2): 197. CrossRef
Platelet Indices and Its Association with Microvascular Complications Among Type 2 Diabetes Mellitus Patients in Northeast Ethiopia: A Cross-Sectional Study
Mitku Mammo Taderegew, Gashaw Garedew Woldeamanuel, Mamo Solomon Emeria, Melkamu Tilahun, Getachew Yideg Yitbarek, Betregiorgis Zegeye
Diabetes, Metabolic Syndrome and Obesity: Targets and Therapy.2021; Volume 14: 865. CrossRef
Protective role of Clitoria ternatea L. flower extract on methylglyoxal-induced protein glycation and oxidative damage to DNA
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Phytochemicals against anti‐diabetic complications: targeting the advanced glycation end product signaling pathway
Amna Parveen, Razia Sultana, Seung Min Lee, Tae Hun Kim, Sun Yeou Kim
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Sesamin suppresses advanced glycation end products induced microglial reactivity using BV2 microglial cell line as a model
Sasimol Udomruk, Benjawan Wudtiwai, Thuzar Hla Shwe, Thanyaluck Phitak, Peraphan Pothacharoen, Mattabhorn Phimphilai, Prachya Kongtawelert
Brain Research Bulletin.2021; 172: 190. CrossRef
The Role of Sarcopenic Obesity in Cancer and Cardiovascular Disease: A Synthesis of the Evidence on Pathophysiological Aspects and Clinical Implications
Erika Aparecida Silveira, Rômulo Roosevelt da Silva Filho, Maria Claudia Bernardes Spexoto, Fahimeh Haghighatdoost, Nizal Sarrafzadegan, Cesar de Oliveira
International Journal of Molecular Sciences.2021; 22(9): 4339. CrossRef
Pterostilbene prevents methylglyoxal-induced cytotoxicity in endothelial cells by regulating glyoxalase, oxidative stress and apoptosis
Dan Tang, Wei Xiao, Wen-Ting Gu, Zhi-Tong Zhang, Shu-Hong Xu, Zhi-Quan Chen, You-Hua Xu, Lu-Yong Zhang, Shu-Mei Wang, Hong Nie
Food and Chemical Toxicology.2021; 153: 112244. CrossRef
Therapeutic Potential of Polyphenols in the Management of Diabetic Neuropathy
Md. Tanvir Kabir, Nuzhat Tabassum, Md. Sahab Uddin, Faissal Aziz, Tapan Behl, Bijo Mathew, Md. Habibur Rahman, Raushanara Akter, Abdur Rauf, Lotfi Aleya, Rajeev K Singla
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EndMT Regulation by Small RNAs in Diabetes-Associated Fibrotic Conditions: Potential Link With Oxidative Stress
Roberta Giordo, Yusra M. A. Ahmed, Hilda Allam, Salah Abusnana, Lucia Pappalardo, Gheyath K. Nasrallah, Arduino Aleksander Mangoni, Gianfranco Pintus
Frontiers in Cell and Developmental Biology.2021;[Epub] CrossRef
Novel advances in inhibiting advanced glycation end product formation using natural compounds
Qinghe Song, Junjun Liu, Liyuan Dong, Xiaolei Wang, Xiandang Zhang
Biomedicine & Pharmacotherapy.2021; 140: 111750. CrossRef
Inhibitory effect of Salvia coccinea on inflammatory responses through NF-κB signaling pathways in THP-1 cells and acute rat diabetes mellitus
Arun Sudaramoorthy, Gobinath Shanmugam, Narkunaraja Shanmugam
Acta Histochemica.2021; 123(5): 151735. CrossRef
The effects of different accumulated pressure-time integral stimuli on plantar blood flow in people with diabetes mellitus
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Piperine exhibits preventive and curative effect on erythrocytes membrane modifications and oxidative stress against in vitro albumin glycation
Rashmi S. Tupe, Nilima Bangar, Akib Nisar, Amruta Kulkarni, Neena Sankhe, Rohan Chauhan, Nidhi Mistry, Shamim Shaikh
Journal of Food Biochemistry.2021;[Epub] CrossRef
An Integrated Peptidomics and In Silico Approach to Identify Novel Anti-Diabetic Peptides in Parmigiano-Reggiano Cheese
Serena Martini, Lisa Solieri, Alice Cattivelli, Valentina Pizzamiglio, Davide Tagliazucchi
Biology.2021; 10(6): 563. CrossRef
The Effect of Dietary Supplements on Oxidative Stress in Pregnant Women with Gestational Diabetes Mellitus: A Network Meta-Analysis
Christos Chatzakis, Alexandros Sotiriadis, Evangelia Tsakmaki, Maria Papagianni, George Paltoglou, Konstantinos Dinas, George Mastorakos
Nutrients.2021; 13(7): 2284. CrossRef
Hydroxytyrosol Selectively Affects Non-Enzymatic Glycation in Human Insulin and Protects by AGEs Cytotoxicity
Ivana Sirangelo, Margherita Borriello, Maria Liccardo, Marika Scafuro, Paola Russo, Clara Iannuzzi
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Tinospora cordifolia activates PPARγ pathway and mitigates glomerular and tubular cell injury in diabetic kidney disease
Vikram Patial, Swati Katoch, Jyoti Chhimwal, Prithvi Pal Singh, Patil Shivprasad Suresh, Yogendra Padwad
Phytomedicine.2021; 91: 153663. CrossRef
Phloroglucinol prevents albumin glycation as well as diminishes ROS production, glycooxidative damage, nitrosative stress and inflammation in hepatocytes treated with high glucose
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Advanced glycation end products (AGEs) and its receptor, RAGE, modulate age-dependent COVID-19 morbidity and mortality. A review and hypothesis
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Phytochemical Composition, Antiglycation, Antioxidant Activity and Methylglyoxal-Trapping Action of Brassica Vegetables
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Plant Foods for Human Nutrition.2021; 76(3): 340. CrossRef
Chlorophytum alismifolium mitigates microvascular complications of type 2 diabetes mellitus: the involvement of oxidative stress and aldose reductase
Abdulhakim Abubakar, Abdullahi Balarabe Nazifi, Idris Mohammed Maje, Yusuf Tanko, Joseph Akpojo Anuka, Ezzeldin Mukthar Abdurahman
Drug Metabolism and Personalized Therapy.2021;[Epub] CrossRef
Dietary advanced glycation end-products elicit toxicological effects by disrupting gut microbiome and immune homeostasis
Yingjia Chen, Tai L. Guo
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Antioxidant compounds of Kielmeyera coriacea Mart. with α-amylase, lipase and advanced glycation end-product inhibitory activities
Allisson Benatti Justino, Eder C. Santana, Rodrigo Rodrigues Franco, Julia Silveira Queiroz, Heitor Cappato Guerra Silva, Joed Pires de Lima, André Lopes Saraiva, Mário Machado Martins, Sérgio Antônio Lemos de Morais, Alberto de Oliveira, Luiz Ricardo Gou
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Association of Novel Advanced Glycation End-Product (AGE10) with Complications of Diabetes as Measured by Enzyme-Linked Immunosorbent Assay
Agnieszka Bronowicka-Szydełko, Małgorzata Krzystek-Korpacka, Małgorzata Gacka, Jadwiga Pietkiewicz, Urszula Jakobsche-Policht, Andrzej Gamian
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Glycyrrhizic Acid Scavenges Reactive Carbonyl Species and Attenuates Glycation‐Induced Multiple Protein Modification: An In Vitro and In Silico Study
Sahir Sultan Alvi, Rabia Nabi, Mohd. Shahnawaz Khan, Firoz Akhter, Saheem Ahmad, M. Salman Khan, Carla Tatone
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Skin Autofluorescence as a Novel and Noninvasive Technology for Advanced Glycation End Products in Diabetic Foot Ulcers: A Systematic Review and Meta-analysis
Seshadri Reddy Varikasuvu, Saurabh Varshney, Harish Sulekar
Advances in Skin & Wound Care.2021; 34(11): 1. CrossRef
Characterization of the Oral Microbiome Among Children With Type 1 Diabetes Compared With Healthy Children
Moti Moskovitz, Mira Nassar, Nadav Moriel, Avital Cher, Sarit Faibis, Diana Ram, David Zangen, Moran Yassour, Doron Steinberg
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Methylglyoxal-Derived Advanced Glycation End Products (AGE4) Promote Cell Proliferation and Survival in Renal Cell Carcinoma Cells through the RAGE/Akt/ERK Signaling Pathways
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A Tale of Two Bioconjugations: pH Controlled Divergent Reactivity of Protein α-oxo-Aldehydes in Competing α-oxo-Mannich and Catalyst-Free Aldol Ligations
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Skin Advanced Glycation End Products among Subjects with Type 2 Diabetes Mellitus with or without Distal Sensorimotor Polyneuropathy
Stella Papachristou, Kalliopi Pafili, Grigorios Trypsianis, Dimitrios Papazoglou, Konstantinos Vadikolias, Nikolaos Papanas, Bernd Stratmann
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Liver fibrosis indices are related to diabetic peripheral neuropathy in individuals with type 2 diabetes
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Isolation of Anti-Diabetic Active Compounds from Benincasae Exocarpium and Development of Simultaneous Analysis by HPLC-PDA
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Association of Oxidative Stress Markers with Vascular Stiffness Parameters in Patients with Diabetic Neuropathy
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Gly-LysPred: Identification of Lysine Glycation Sites in Protein Using Position Relative Features and Statistical Moments Via Chou’s 5 Step Rule
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Prevalence and Prevention of Rheumatologic Manifestations and their Relationship with Blood Glucose Control in Patients with Type II Diabetes
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International Journal of Preventive Medicine.2021;[Epub] CrossRef
Multiple fingerprint profiling for quality evaluation of polysaccharides and related biological activity analysis of Chinese patent drugs: Zishen Yutai Pills as a case study
Hongyi Li, Jiliang Cao, Xu Wu, Yun Deng, Na Ning, Chunxian Geng, Ting Lei, Ruizhen Lin, Dingtao Wu, Shengpeng Wang, Peng Li, Yitao Wang
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Association Between Continuous Glucose Monitoring-Derived Time in Range, Other Core Metrics, and Albuminuria in Type 2 Diabetes
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Diabetes Technology & Therapeutics.2020; 22(10): 768. CrossRef
Dimethyl fumarate ameliorates diabetes-associated vascular complications through ROS-TXNIP-NLRP3 inflammasome pathway
Fatma M. Amin, Rania R. Abdelaziz, Mohamed F. Hamed, Manar A. Nader, George S.G. Shehatou
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Aliskiren – A promising antioxidant agent beyond hypertension reduction
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Glycation of fibronectin inhibits VEGF‐induced angiogenesis by uncoupling VEGF receptor‐2‐c‐Src crosstalk
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Association between carbonyl stress markers and the risk of acute coronary syndrome in patients with type 2 diabetes mellitus–A pilot study
Sushmita Bora, Prashant S. Adole, Nissy Motupalli, Vinay R. Pandit, Kolar V. Vinod
Diabetes & Metabolic Syndrome: Clinical Research & Reviews.2020; 14(6): 1751. CrossRef
A biochemical & biophysical study on in-vitro anti-glycating potential of iridin against d-Ribose modified BSA
Rabia Nabi, Sahir Sultan Alvi, Mohammad Shafi Shah, Saheem Ahmad, Mohammad Faisal, Abdulrahman A. Alatar, M. Salman Khan
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Esculin reduces P2X7 and reverses mitochondrial dysfunction in the renal cortex of diabetic rats
R.S. Serralha, I.F. Rodrigues, A. Bertolini, D.Y. Lima, M. Nascimento, M.G. Mouro, G.R. Punaro, I. Visoná, A.M. Rodrigues, E.M.S. Higa
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Mitochondrial Alterations and Enhanced Human Leukocyte/Endothelial Cell Interactions in Type 1 Diabetes
Francesca Iannantuoni, Aranzazu M. de Marañon, Zaida Abad-Jiménez, Francisco Canet, Pedro Díaz-Pozo, Sandra López-Domènech, Carlos Morillas, Milagros Rocha, Víctor M. Víctor
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Comparative Evaluation of Dental Implant Failure among Healthy and Well-Controlled Diabetic Patients—A 3-Year Retrospective Study
Mohammed Ghazi Sghaireen, Abdulrahman A. Alduraywish, Kumar Chandan Srivastava, Deepti Shrivastava, Santosh R Patil, Selham Al Habib, May Hamza, Saifulizan Ab Rahman, Edward Lynch, Mohammad Khursheed Alam
International Journal of Environmental Research and Public Health.2020; 17(14): 5253. CrossRef
Allithiamine Alleviates Hyperglycaemia-Induced Endothelial Dysfunction
Attila Biró, Arnold Markovics, Mónika Éva Fazekas, Gábor Fidler, Gábor Szalóki, Melinda Paholcsek, János Lukács, László Stündl, Judit Remenyik
Nutrients.2020; 12(6): 1690. CrossRef
Endothelial Dysfunction in Diabetic Retinopathy
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Diabetes affects endothelial cell function and alters fibrin clot formation in a microvascular flow model: A pilot study
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Measures of lung function and their relationship with advanced glycation end-products
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LSEC model of aging
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Mitochondrial superoxide/hydrogen peroxide: An emerging therapeutic target for metabolic diseases
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Hepatic fibrosis is associated with total proteinuria in Korean patients with type 2 diabetes
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Cognitive impairments in type 2 diabetes, risk factors and preventive strategies
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Recent Updates on Vascular Complications in Patients with Type 2 Diabetes Mellitus
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Pathophysiology of atherosclerosis: Association of risk factors and treatment strategies using plant‐based bioactive compounds
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Association of Glycemic Indices (Hyperglycemia, Glucose Variability, and Hypoglycemia) with Oxidative Stress and Diabetic Complications
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Comparing the incidence of major cardiovascular events and severe microvascular complications in patients with type 2 diabetes mellitus: A systematic review and meta-analysis
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Influence of melatonin on the kidneys of rats with experimental diabetes mellitus type 2
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Regulatory Mechanisms in Biosystems.2020; 11(3): 384. CrossRef
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Future Journal of Pharmaceutical Sciences.2020;[Epub] CrossRef
In Vitro Antioxidant and Anti-Glycation Activity of Resveratrol and Its Novel Triester with Trolox
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Blood–Nerve Barrier (BNB) Pathology in Diabetic Peripheral Neuropathy and In Vitro Human BNB Model
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International Journal of Molecular Sciences.2020; 22(1): 62. CrossRef
Prediction of Antiglycation Activity by Calculating the Energies of Frontier Molecular Orbitals for New 4-Hydroxy-1,4-Dihydroazolo[5,1-c]-1,2,4-Triazines Used as an Example
R. A. Litvinov, R. A. Drokin, D. D. Shamshina, M. Yu. Kalenova, L. E. Usmianova, E. A. Muraveva, P. M. Vasiliev, E. K. Voinkov, E. N. Ulomskiy, A. A. Spasov, V. L. Rusinov
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Obesity and Comorbidity: Could Simultaneous Targeting of esRAGE and sRAGE Be the Panacea?
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Glucose Variability and Coronary Artery Disease
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Short Communication

Complications
Single Sensor Gait Analysis to Detect Diabetic Peripheral Neuropathy: A Proof of Principle Study: Patrick Esser, Johnny Collett, Kevin Maynard, Dax Steins, Angela Hillier, Jodie Buckingham, Garry D. Tan, Laurie King, Helen Dawes; Diabetes Metab J. 2018;42(1):82-86. Published online January 3, 2018; DOI: https://doi.org/10.4093/dmj.2018.42.1.82

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This study explored the potential utility of gait analysis using a single sensor unit (inertial measurement unit [IMU]) as a simple tool to detect peripheral neuropathy in people with diabetes. Seventeen people (14 men) aged 63±9 years (mean±SD) with diabetic peripheral neuropathy performed a 10-m walk test instrumented with an IMU on the lower back. Compared to a reference healthy control data set (matched by gender, age, and body mass index) both spatiotemporal and gait control variables were different between groups, with walking speed, step time, and SDa (gait control parameter) demonstrating good discriminatory power (receiver operating characteristic area under the curve >0.8). These results provide a proof of principle of this relatively simple approach which, when applied in clinical practice, can detect a signal from those with known diabetes peripheral neuropathy. The technology has the potential to be used both routinely in the clinic and for tele-health applications. Further research should focus on investigating its efficacy as an early indicator of or effectiveness of the management of peripheral neuropathy. This could support the development of interventions to prevent complications such as foot ulceration or Charcot's foot.

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Original Article

Complications
Features of Long-Standing Korean Type 2 Diabetes Mellitus Patients with Diabetic Retinopathy: A Study Based on Standardized Clinical Data: Sejeong Park, Sang Youl Rhee, Su Jin Jeong, Kiyoung Kim, Suk Chon, Seung-Young Yu, Jeong-Taek Woo; Diabetes Metab J. 2017;41(5):393-404. Published online September 5, 2017; DOI: https://doi.org/10.4093/dmj.2017.41.5.393

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Background

This is part of a prospective study carried out as a national project to secure standardized public resources for type 2 diabetes mellitus (T2DM) patients in Korea. We compared various characteristics of long-standing T2DM patients with diabetic retinopathy (DR) and macular edema (ME).

Methods

From September 2014 to July 2015, T2DM patients with disease duration of at least 15 years were recruited at a single university hospital. Clinical data and samples were collected according to the common data elements and standards of procedure developed by the Korean Diabetes Association Research Council. Each participant was assessed by ophthalmologists for DR and ME.

Results

Among 220 registered patients, 183 completed the ophthalmologic assessment. DR was associated with longer disease duration (odds ratio [OR], 1.071; 95% confidence interval [CI], 1.001 to 1.147 for non-proliferative diabetic retinopathy [NPDR]) (OR, 1.142; 95% CI, 1.051 to 1.242 for proliferative diabetic retinopathy [PDR]) and the use of long-acting insulin (OR, 4.559; 95% CI, 1.672 to 12.427 for NPDR) (OR, 4.783; 95% CI, 1.581 to 14.474 for PDR), but a lower prevalence of a family history of cancer (OR, 0.310; 95% CI, 0.119 to 0.809 for NPDR) (OR, 0.206; 95% CI, 0.063 to 0.673 for PDR). ME was associated with higher glycosylated hemoglobin levels (OR, 1.380; 95% CI, 1.032 to 1.845) and the use of rapid-acting insulin (OR, 5.211; 95% CI, 1.445 to 18.794).

Conclusion

Various clinical features were associated with DR and ME. Additional epidemiological and biorepository-based studies using this cohort are being conducted to deepen our understanding of diabetic complications in Korea.

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Reviews

Glycemic Variability: How Do We Measure It and Why Is It Important?: Sunghwan Suh, Jae Hyeon Kim; Diabetes Metab J. 2015;39(4):273-282. Published online August 17, 2015; DOI: https://doi.org/10.4093/dmj.2015.39.4.273

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Chronic hyperglycemia is the primary risk factor for the development of complications in diabetes mellitus (DM); however, it is believed that frequent or large glucose fluctuations may independently contribute to diabetes-related complications. Postprandial spikes in blood glucose, as well as hypoglycemic events, are blamed for increased cardiovascular events in DM. Glycemic variability (GV) includes both of these events; hence, minimizing GV can prevent future cardiovascular events. Correcting GV emerges as a target to be pursued in clinical practice to safely reduce the mean blood glucose and to determine its direct effects on vascular complications in diabetes. Modern diabetes management modalities, including glucagon-related peptide-1-based therapy, newer insulins, modern insulin pumps and bariatric surgery, significantly reduce GV. However, defining GV remains a challenge primarily due to the difficulty of measuring it and the lack of consensus regarding the optimal approach for its management. The purpose of this manuscript was not only to review the most recent evidence on GV but also to help readers better understand the available measurement options and how the various definitions relate differently to the development of diabetic complications.

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Oscillating Glucose Induces the Increase in Inflammatory Stress through Ninjurin-1 Up-Regulation and Stimulation of Transport Proteins in Human Endothelial Cells
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Self-Management and Glycemic Targets in Adult Haitian Immigrants With Type 2 Diabetes
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The effect of traditional diet on glucose homoeostasis in carriers and non-carriers of a common TBC1D4 variant in Greenlandic Inuit: a randomised crossover study
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Impact of a Low-Carbohydrate Compared with Low-Fat Breakfast on Blood Glucose Control in Type 2 Diabetes: A Randomized Trial
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Time in Range Estimation in Patients with Type 2 Diabetes is Improved by Incorporating Fasting and Postprandial Glucose Levels
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Effect of Repeated Bolus and Continuous Glucose Infusion on DNA Damage and Oxidative Stress Biomarkers in Healthy Male Volunteers
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Metabolic Stress of Red Blood Cells Induces Hemoglobin Glutathionylation
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The Impact and Clinical Prediction of Hyperglycemia During Parenteral Nutrition for Nondiabetic Patients After Gastrectomy for Gastric Cancer
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Effects of a Novel Blood Glucose Forecasting Feature on Glycemic Management and Logging in Adults With Type 2 Diabetes Using One Drop: Retrospective Cohort Study
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Serum Glucose Variability Increases the Risk of Complications Following Aseptic Revision Hip and Knee Arthroplasty
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Comparison of Glycemic Excursion Using Flash Continuous Glucose Monitoring in Patients with Type 2 Diabetes Mellitus Before and After Treatment with Voglibose
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Comparison of CGM-Derived Measures of Glycemic Variability Between Pancreatogenic Diabetes and Type 2 Diabetes Mellitus
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Probabilistic Model of Transition between Categories of Glucose Profiles in Patients with Type 1 Diabetes Using a Compositional Data Analysis Approach
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Refocusing Peroxisome Proliferator Activated Receptor-α: A New Insight for Therapeutic Roles in Diabetes: Hannah Seok, Bong Soo Cha; Diabetes Metab J. 2013;37(5):326-332. Published online October 17, 2013; DOI: https://doi.org/10.4093/dmj.2013.37.5.326

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Although glucose-lowering treatment shows some risk lowering effects in cardiovascular diseases, risks of macrovascular and microvascular complications have still remained, and development of new therapeutic strategies is needed. Recent data have shown that peroxisome proliferator activated receptor-α (PPAR-α) plays a pivotal role in the regulation of lipid homeostasis, fatty acid oxidation, cellular differentiation, and immune response such as inflammation or vascularization related to diabetic complication. This review will re-examine the metabolic role of PPAR-α, summarize data from clinical studies on the effect of PPAR-α agonist in diabetes, and will discuss the possible therapeutic role of PPAR-α activation.

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Smoking and Type 2 Diabetes Mellitus: Sang Ah Chang; Diabetes Metab J. 2012;36(6):399-403. Published online December 12, 2012; DOI: https://doi.org/10.4093/dmj.2012.36.6.399

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

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Original Articles

Depression and Self-care Behavior in Patients with Diabetes Mellitus.: Su Yoen Kim, Jae Ho Lee, Ha Neul Kim, Dong Kyu Kim, Young Na, Guil Sun Kim, Mee Kyoung Kim, Ki Hyun Baek, Moo IL Kang, Kwang Woo Lee, Ki Ho Song; Korean Diabetes J. 2009;33(5):432-438. Published online October 1, 2009; DOI: https://doi.org/10.4093/kdj.2009.33.5.432

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Abstract PDF

BACKGROUND
Depression is known to be a risk factor for type 2 diabetes mellitus. Conversely, diabetes is also a risk factor for depression, and patients with diabetes have nearly twice the risk of comorbid depression as the general population. Depression in patients with diabetes may cause poor clinical outcomes through lower adherence to self-care activities such as exercise, diet control, and glucose monitoring. Furthermore, diabetic patients with depression are more likely to suffer from microvascular or macrovascular complications. We explored the prevalence of major depressive disorder in Korean diabetic patients and its impact on self-care activities and glucose control. METHODS: We surveyed depressive symptoms and self-care activities in 191 type 2 diabetic patients from the outpatient clinic of the St. Mary's hospital. Two questionnaires were used for assessment, the Harvard Department of Psychiatry/National Depression Screening Day Scale (HANDS) and the Summary of Diabetes Self-Care Activities (SDSCA). RESULTS: Of the 191 respondents who completed questionnaires, 39 (20.4%) patients were categorized as having major depressive disorder. Among the depressed patients, only six (15.3%) had been previously evaluated and managed for their psychiatric problems. The incidence of depression was significantly higher in female diabetic patients compared to patients without depression (74.4% vs. 45.4%, P<0.001). Patients with depression showed significantly poorer diet control (18.5 vs. 15.9, P = 0.046) and less glucose monitoring (4.1 vs. 2.7, P = 0.047). However, there were no differences in exercise, foot care, or smoking status between the two groups. Additionally, metabolic parameters such as HbA1C and lipid profile were not significantly different between the two groups. CONCLUSION: Many diabetic patients are suffering from depression and exhibit poorer self-care activities than patients without depression. Identifying and managing depressed diabetic patients may help improve their self-care activities.

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Mental Health Literacy for Diabetic Patients
Eunji Nam
The Journal of Korean Diabetes.2025; 26(1): 48. CrossRef
The Effects of the 2030 Diabetes Camp Program on Depression, Anxiety, and Stress in Diabetic Patients
Jin Hee Jung, Jung Hwa Lee
The Journal of Korean Diabetes.2019; 20(3): 194. CrossRef
Association of Resilience and Depression with Self-care Competence in Adult Patients with Diabetes Mellitus
Youngrye Park, Eun Hee Jang, Ji Ok Kim
Korean Journal of Adult Nursing.2018; 30(5): 555. CrossRef
Health-Related Quality-of-Life and Diabetes Self-Care Activity in Elderly Patients with Diabetes in Korea
Hacksun Kim, Kisook Kim
Journal of Community Health.2017; 42(5): 998. CrossRef
Associations between Smoking, Drinking and Depression among Korean Adults: The 5th Korea National Health and Nutrition Examination Survey
Sun Mi Park, Mi Ah Han, Jong Park, So Yeon Ryu, Seong Woo Choi, Hwan Ho Shin, Mi Hyun Joo
Korean Journal of Health Promotion.2016; 16(2): 111. CrossRef
Diabetes and Depressive Symptoms in Korean Women: The Fifth Korean National Health and Nutrition Examination Survey (2010-2011)
Han Na Sung, Hong Seok Chae, Eung Soo Kim, Jong Sung Kim
Korean Journal of Family Medicine.2014; 35(3): 127. CrossRef
Effects of Abdominal Circumference, Blood Lipids and Blood Pressure according to Diabetes with VO2peak
Sang-Nam Nam, Jung-Beom Park, Hyoung-Ju Lee
The Journal of the Korea Contents Association.2012; 12(12): 363. CrossRef
Effects of a Cardiovascular Risk Reduction Intervention With Psychobehavioral Strategies for Korean Adults With Type 2 Diabetes and Metabolic Syndrome
Chun-Ja Kim, Dae-Jung Kim, Hyung-Ran Park
Journal of Cardiovascular Nursing.2011; 26(2): 117. CrossRef

Risk Factors for Early Development of Macrovascular Complications in Korean Type 2 Diabetes.: Hae Ri Lee, Jae Myung Yu, Moon Gi Choi, Hyung Joon Yoo, Eun Gyoung Hong; Korean Diabetes J. 2009;33(2):134-142. Published online April 1, 2009; DOI: https://doi.org/10.4093/kdj.2009.33.2.134

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Abstract PDF

BACKGROUND
The average duration of diabetes and predictive factors of macrovascular complications in Korean diabetic patients remain to be elucidated. This study examines the average duration of diabetes up to the onset of macrovascular complications and clinically important factors of early development of these complications in Korean type 2 diabetic patients. METHODS: Clinical characteristics in type 2 diabetics with (n = 121) and without macrovascular complications (n = 115) were analyzed. In addition, early onset (< or = 5 years, n = 54) and late onset groups (> 5 years, n = 67) were compared, as were the clinical characteristics between male and female patients in the macrovascular complications group. RESULTS: The average duration of diabetes was 8.7 +/- 7.8 years in the macrovascular complications group. Average age, systolic and diastolic blood pressures and smoking history were all higher in the macrovascular complications group than the control group. However, HbA1c levels and prevalence of microvascular complications were higher in the controls. Average age was lower in the early onset group and many more patients of that group had a smoking history. In the analysis based on sex, marcrovascular complications developed earlier in male patients. In addition, the prevalence of family history of diabetes was higher in males and 77.8% of male patients had a smoking history (female: 3.4%). CONCLUSION: Our study confirms that older age, high blood pressure and smoking history are major risk factors for the development of macrovascular complications. Moreover, a smoking history in males can be both risk and predictive factors for earlier development of macrovascular complications in Korean type 2 diabetic patients. We also found that several clinical characteristics including age, family history of diabetes, hypertension and smoking history, vary between the sexes, and these findings can provide useful indices for the prevention of macrovascular complications.

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Impact of new-onset diabetes on clinical outcomes after ST segment-elevated myocardial infarction
Ji-Yeoun Seo, Jin-Sun Park, Kyoung-Woo Seo, Hyoung-Mo Yang, Hong-Seok Lim, Byoung-Joo Choi, So-Yeon Choi, Myeong-Ho Yoon, Gyo-Seung Hwang, Seung-Jea Tahk, Joon-Han Shin
Scandinavian Cardiovascular Journal.2019; 53(6): 379. CrossRef
Associations Between the Continuity of Ambulatory Care of Adult Diabetes Patients in Korea and the Incidence of Macrovascular Complications
Young-Hoon Gong, Seok-Jun Yoon, Hyeyoung Seo, Dongwoo Kim
Journal of Preventive Medicine and Public Health.2015; 48(4): 188. CrossRef
Relationship of Daily Activity and Biochemical Variables in the Elderly with Diabetes Mellitus
Ki-Wol Sung
Journal of Korean Academy of Nursing.2011; 41(2): 182. CrossRef
Epidemiology of Micro- and Macrovascular Complications of Type 2 Diabetes in Korea
Jung Hee Kim, Dae Jung Kim, Hak Chul Jang, Sung Hee Choi
Diabetes & Metabolism Journal.2011; 35(6): 571. CrossRef

Chronic Complications in Adult Diabetic Patients with and without GAD Antibody.: Jin Ook Chung, Dong Hyeok Cho, Dong Jin Chung, Min Young Chung; Korean Diabetes J. 2009;33(2):124-133. Published online April 1, 2009; DOI: https://doi.org/10.4093/kdj.2009.33.2.124

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Abstract PDF

BACKGROUND
Although the majority of diabetes mellitus (DM) patients diagnosed as adults have non-autoimmune forms of the disease, islet autoimmunity is encountered in some patients initially thought to have type 2 DM. The phenotype of DM patients with glutamic acid decarboxylase (GAD) antibodies is different from that of patients with GAD antibody-negative type 2 DM, with features such as relative leanness and hyperglycemia which may influence the development of complications. We sought to compare the prevalence of chronic complications in patients with and without the GAD antibody. METHODS: We recruited 427 patients (M: 218, F: 209) that were clinically diagnosed with type 2 DM after the age of 35 years. We measured GAD antibody and assessed the factors associated with chronic microvascular and macrovascular complications. RESULTS: Of these patients, 26 were GAD antibody-positive. The patients with GAD antibody had lower systolic blood pressure, higher high-density lipoprotein cholesterol value, and lower level of fasting and stimulated C-peptide than patients without GAD antibody (P < 0.05). Also, the patients with GAD antibody had lower prevalence of retinopathy compared with the patients without GAD antibody (19.2 vs. 47.9%; P < 0.05). The prevalence of nephropathy, peripheral neuropathy and cardiovascular autonomic neuropathy did not differ between the groups. In addition, the prevalence of coronary heart disease, cerebrovascular disease and peripheral arterial disease did not differ between the two groups. CONCLUSION: This study suggests that diabetic patients with GAD antibody have a lower risk for the development of retinopathy compared with patients without GAD antibody.

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Relationship between β-Cell Autoantibodies and Their Combination with Anthropometric and Metabolic Components and Microvascular Complications in Latent Autoimmune Diabetes in Adults
Tomislav Bulum, Marijana Vučić Lovrenčić, Jadranka Knežević Ćuća, Martina Tomić, Sandra Vučković-Rebrina, Lea Duvnjak
Biomedicines.2023; 11(9): 2561. CrossRef

A Nationwide Survey about the Current Status of Glycemic Control and Complications in Diabetic Patients in 2006: The Committee of the Korean Diabetes Association on the Epidemiology of Diabetes Mellitus.: Soo Lim, Dae Jung Kim, In Kyung Jeong, Hyun Shik Son, Choon Hee Chung, Gwanpyo Koh, Dae Ho Lee, Kyu Chang Won, Jeong Hyun Park, Tae Sun Park, Jihyun Ahn, Jaetaek Kim, Keun Gyu Park, Seung Hyun Ko, Yu Bae Ahn, Inkyu Lee; Korean Diabetes J. 2009;33(1):48-57. Published online February 1, 2009; DOI: https://doi.org/10.4093/kdj.2009.33.1.48

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Abstract PDF

BACKGROUND
The Committee of the Korean Diabetes Association on the Epidemiology of Diabetes Mellitus performed a nationwide survey about the current status of glycemic control and diabetic complications in 2006. METHODS: The current study included 5,652 diabetic patients recruited from the rosters of endocrinology clinics of 13 tertiary hospitals in Korea. Age, gender, height, weight, waist circumference and blood pressure were investigated by standard method. Fasting and postprandial 2 hour glucose, glycosylated hemoglobin (HbA1c), lipid profiles, fasting insulin and c-peptide levels were measured. Microvascular (microalbuminuria, retinopathy and neuropathy) and macrovascular (coronary artery disease [CAD], cerebrovascular disease [CVD] and peripheral artery disease [PAD]) complications were reviewed in their medical records. RESULTS: Mean age of total subjects was 58.7 (+/- 11.6) years and duration of diabetes was 8.8 (0~50) years. Mean fasting and postprandial 2 hour glucose levels were 145.9 +/- 55.0 and 208.0 +/- 84.4 mg/dL, respectively. Their mean HbA1c was 7.9 +/- 1.9%: the percentage of patients within target goal of glycemic control (< 7% of HbA1c) was 36.7%. In this study, 30.3%, 38.3% and 44.6% of patients was found to have microalbuminuria, retinopathy and nephropathy, respectively. Prevalence of CAD, CVD and PAD was 8.7%, 6.7% and 3.0%, respectively. Diabetic complications were closely related with age, duration of diabetes and glycemic control, and this relationship was stronger in microvascular complications than macrovascular ones. CONCLUSION: Only about one third of patients with diabetes was found to reach target glycemic control in tertiary hospitals of Korea. More tight control is needed to reduce deleterious complications of diabetes in Korea.

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Prevalence and Associated Factors of Diabetic Retinopathy in Rural Korea: The Chungju Metabolic Disease Cohort Study
Ji-Hyun Kim, Hyuk-Sang Kwon, Yong-Moon Park, Jin-Hee Lee, Man-Soo Kim, Kun-Ho Yoon, Won Chul Lee, Bong-Yun Cha, Ho-Young Son
Journal of Korean Medical Science.2011; 26(8): 1068. CrossRef
The Prevalence of Peripheral Arterial Disease in Korean Patients with Type 2 Diabetes Mellitus Attending a University Hospital
Ji Hee Yu, Jenie Yoonoo Hwang, Mi-Seon Shin, Chang Hee Jung, Eun Hee Kim, Sang Ah Lee, Eun Hee Koh, Woo Je Lee, Min-Seon Kim, Joong-Yeol Park, Ki-Up Lee
Diabetes & Metabolism Journal.2011; 35(5): 543. CrossRef
Prevalence, Awareness, and Control of Hypertension among Diabetic Koreans
Hyun Hee Chung, Kyu Chang Won
Diabetes & Metabolism Journal.2011; 35(4): 337. CrossRef
Factors Influencing Physical Activity Behavior among Iranian Women with Type 2 Diabetes Using the Extended Theory of Reasoned Action
Alireza Didarloo, Davoud Shojaeizadeh, Hassan Eftekhar Ardebili, Shamsaddin Niknami, Ebrahim Hajizadeh, Mohammad Alizadeh
Diabetes & Metabolism Journal.2011; 35(5): 513. CrossRef
Factors that Affect Medication Adherence in Elderly Patients with Diabetes Mellitus
Kyung-Ae Park, Jung-Guk Kim, Bo-Wan Kim, Sin Kam, Keon-Yeop Kim, Sung-Woo Ha, Sung-Taek Hyun
Korean Diabetes Journal.2010; 34(1): 55. CrossRef
The Effects of Tailored Diabetes Education on Blood Glucose Control and Self-Care
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Epidemiologic Characteristics of Diabetes Mellitus in Korea: Current Status of Diabetic Patients Using Korean Health Insurance Database
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Korean Diabetes Journal.2009; 33(5): 357. CrossRef

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