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The Roles of Glycated Albumin as Intermediate Glycation Index and Pathogenic Protein
Kwang Joon Kim, Byung-Wan Lee
Diabetes Metab J. 2012;36(2):98-107.   Published online April 17, 2012
DOI: https://doi.org/10.4093/dmj.2012.36.2.98
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AbstractAbstract PDFPubReader   

The conventional glycemic indices used in management of diabetic patients includes A1c, fructosamine, 1,5-anhydroglucitol, and glycated albumin (GA). Among these indices, A1c is currently used as the gold standard. However, A1c cannot reflect the glycemic change over a relatively short period of time, and its accuracy is known to decrease when abnormalities in hemoglobin metabolism, such as anemia, coexist. When considering these weaknesses, there have been needs for finding a novel glycemic index for diagnosing and managing diabetes, as well as for predicting diabetic complications properly. Recently, several studies have suggested the potential of GA as an intermediate-term glycation index in covering the short-term effect of treatment. Furthermore, its role as a pathogenic protein affecting the worsening of diabetes and occurrence of diabetic complications is receiving attention as well. Therefore, in this article, we wanted to review the recent status of GA as a glycemic index and as a pathogenic protein.

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Glycemic Index Revisited.
In Joo Kim
Korean Diabetes J. 2009;33(4):261-266.   Published online August 1, 2009
DOI: https://doi.org/10.4093/kdj.2009.33.4.261
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AbstractAbstract PDF
The implementation of effective dietary strategies is important for diabetes management. Dietary carbohydrate is the main factor determining blood sugar level, especially in the postprandial period. Carbohydrate-rich diets can have deleterious effects on glycemic control in diabetic patients and may play an important role in the development of cardiovascular diseases. Low glycemic diets have been reported to have beneficial effects for diabetes control and cardiovascular risk factors. However, according to the American Diabetes Association recommendations for medical nutrition therapy, monitoring carbohydrate intake, whether by carbohydrate counting, exchange, or experience-based estimation, remains a key strategy for achieving glycemic control, with the use of the glycemic index and glycemic load recommended only as an auxiliary method that may provide a modest additional benefit for glycemic control over the effects observed when total carbohydrate is considered alone. Recently, an increasing amount of clinical evidence supports the efficacy of low glycemic diets for the management of diabetes. The development of practical methods to apply the glycemic index and glycemic load to the management of diabetes in clinical settings is warranted.

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Original Articles
Effects of the Glycemic Index of Dietary Carbohydrates on Insulin Requirement in Type 1 Diabetics on Continuous Subcutaneous Insulin Infusion.
Hye Jin Lee, Kwon Beom Kim, Kyung Ah Han, Kyung Wan Min, Eung Jin Kim, Ki Nam Kim
Korean Diabetes J. 2005;29(1):72-77.   Published online January 1, 2005
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AbstractAbstract PDF
BACKGROUND
For ideal glycemic control, the pump user should have a meal planning approach that is as precise and flexible as the pump. Counting carbohydrate is simple and works, but is not a perfect system. Many researches indicate that not all carbohydrates create an equal response when it comes to their effect on blood glucose levels. For a better match between the glucose and insulin profiles, the glycemic index as along with counting carbohydrate might be considered. Therefore, we investigated whether the same amount of carbohydrates with different glycemic indices might require different insulin doses. METHODS: Five type 1 diabetics, using portable external pumps, whose basal rates were correctly set to maintain their blood glucose levels with in the target range under 12 hours fasting conditions, were enrolled. 50 grams of 4 carbohydrate containing foods, with different glycemic indices, were administered for 4 consecutive days to diabetic patients in an overnight fasting state. The test foods were rice, apple, milk and orange juice, for which the glycemic indices were 83, 54, 39 and 97, respectively. The insulin requirement for each food was determined so that the blood glucose level reached the target range four hours after eating. RESULTS: The glycemic indices for each food/rice ratio were significantly correlated with the insulin requirement (r = 0.586, P < 0.01). CONCLUSION: The meal-related insulin dose should be changed according to the glycemic index of the meal. Therefore both amount and source of carbohydrate determine the glucose and insulin responses of type 1 diabetic subjects
Effect of Various Snacks and Meal woth Different Kinds of Staples on Bloos Glucose, Insulin, and C- Peptide Levels in Healthy and Type 2 Diabetic Patients.
Youn Sang Oh, Hye Ok Lee, Ryo Won Cho
Korean Diabetes J. 1999;23(4):601-612.   Published online January 1, 2001
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  • 22 Download
AbstractAbstract PDF
BACKGROUND
There are large differences in the glycemic response among different foods. These differences complicate the glycemic response of foods in diabetic patients. Studies have found that the diet with low glycemic index foods had positive effects on the clinical management of diabetic and hyperlipidemia patients. The concept of glycemic index of foods and the values of glycemic index of meals were measured in this study to suggest the dietary recommendation for type 2 diabetic patients. METHODS: The blood levels of glucose, insulin, C-peptide were measured for healthy subjects and Type 2 diabetic patients after taking various foods and meals. The isocaloric glycemic index of each food and meal was calculated in comparison with standard foods and meals. RESULTS: For the normal subjects, serum glucose, insulin, and C-peptide reached peaks 30 minutes after the meals. The glycemic indices of red bean bread (122.2%),orange juice (106.8%), ice cream (106.3%), and yoghurt (101.6%) were the highest among the respective groups. For the Type 2 diabetic patients, serum glucose reached peaks 60 minutes after the ingestion of meals. The isocaloric glycemic indices were red bean (93.7%), barley (94.6%), mixed cereal (97.9%), Brown rice (98.8%), rice (100%), and milled foxtail (106.9%) in increasing order. CONCLUSION: It is expected that isocaloric glycemic index of Korean foods and meals that are most frequent]y and preferentially eaten by diabetic patients can be used as a guide for menu selection and also to educate the dietary guideline for diabetic patients.

Diabetes Metab J : Diabetes & Metabolism Journal
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