Diabetes & Metabolism Journal

Review

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 Metab J. 2011;35(6):571-577. Published online December 26, 2011; DOI: https://doi.org/10.4093/dmj.2011.35.6.571

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The prevalence of diabetes in Korea has increased six- to sevenfold over the past 40 years with its complications becoming major causes of morbidity and mortality. The rate of death among patients with diabetes is about twice as high as that among persons without diabetes and the most common cause of death is cardiovascular disease (30.6%). Despite the seriousness of diabetic complications, 30 to 70% of patients receive inadequate care, and only 40% of treated diabetic patients achieve the optimal control with HbA1c level <7% in Korea. In 2006, over 30 to 40% of patients with diabetes have microvascular complications and around 10% of them have macrovascular complications from our national data. Despite there are some debates about intensive glycemic control resulting in the deterioration of macrovascular complication, multifactorial treatment approaches including proper glycemic control are important to prevent diabetic complications. There have been needs for finding proper biomarkers for predicting diabetic complications properly but we still need more longitudinal studies to find this correlation with causal relationship. In this article, we wanted to review the recent status of micro- and macrovascular complications of type 2 diabetes in Korea from integration of many epidemiologic studies.

Citations

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Original Articles

Higher Glycated Hemoglobin Level Is Associated with Increased Risk for Ischemic Stroke in Non-Diabetic Korean Male Adults: Hyung Geun Oh, Eun-Jung Rhee, Tae-Woong Kim, Kyung Bok Lee, Jeong-Ho Park, Kwang-Ik Yang, Dushin Jeong, Hyung-Kook Park; Diabetes Metab J. 2011;35(5):551-557. Published online October 31, 2011; DOI: https://doi.org/10.4093/dmj.2011.35.5.551

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Abstract PDF PubReader

Background

The role of glycated hemoglobin (HbA1c) in the prediction of ischemic stroke in non-diabetic subjects is not clear. We performed a study to analyze the role of HbA1c in the risk prediction of ischemic stroke in non-diabetic Korean males adult.

Methods

A total of 307 non-diabetic male patients with ischemic stroke were enrolled, and 253 age-matched control subjects without a history of diabetes, hypertension, or cardiovascular disease were selected from a Health Check-up database. Anthropometric measurement data, fasting glucose level, lipid profile, and HbA1c level were available for all subjects. Associations of the variables and the presence or absence of ischemic stroke were analyzed.

Results

The ischemic stroke patient group had significantly higher HbA1c levels (5.8±0.5% vs. 5.5±0.5%, P<0.01) and mean systolic and diastolic blood pressure compared with the control group. Among the variables, smoking, low high density lipoprotein cholesterol, systolic blood pressure, and HbA1c were the significant determinants for ischemic stroke. The highest quartile of HbA1c showed a 9.6-fold increased odds ratio for ischemic stroke compared with the lowest quartile of HbA1c (odds ratio, 9.596; 95% confidence interval, 3.859 to 23.863, P<0.01). The proportion of ischemic stroke patients showed a significant trend for increment as the deciles of HbA1c increased (P for trend <0.01).

Conclusion

Higher HbA1c indicated a significantly increased risk for ischemic stroke after adjusting for other confounding variables in non-diabetic Korean adult males. HbA1c might have significance in predicting the risk for ischemic stroke even in the non-diabetic range.

Citations

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Association of Glycated Hemoglobin With Acute Ischemic Stroke in a Tertiary Care Center in a Tribal Region of Jharkhand
Shimpy Priya, Vikas Mardi, Siddharth Kapoor, Abhay Kumar, Usha Saroj, Ajit Dungdung, Raunak Rishu
Cureus.2024;[Epub] CrossRef
Machine learning algorithms identify demographics, dietary features, and blood biomarkers associated with stroke records
Jundong Liu, Elizabeth L. Chou, Kui Kai Lau, Peter Y.M. Woo, Jun Li, Kei Hang Katie Chan
Journal of the Neurological Sciences.2022; 440: 120335. CrossRef
HbA1c and clinical outcomes after endovascular treatment in patients with posterior circulation large vessel occlusion: a subgroup analysis of a nationwide registry (BASILAR)
Feixue Yue, Zhongxiu Wang, Jie Pu, Min Zhang, Yong Liu, Hongxing Han, Wenhua Liu, Xianjun Wang, Rongzong Li, Dongzhang Xue, Jiaming Cao, Zhizhong Yan, Guozhong Niu, Hao Zhang, Haitao Guan, Hongliang Zeng, Feng You, Qian Yang, Wenjie Zi, Yi Zhang, Zetao Sh
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Jorge Navarro-Pérez, Domingo Orozco-Beltran, Vicente Gil-Guillen, Vicente Pallares, Francisco Valls, Antonio Fernandez, Ana María Perez-Navarro, Carlos Sanchis, Alejandro Dominguez-Lucas, Jose M. Martin-Moreno, Josep Redon, Maria Tellez-Plaza
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Early New Ischemic Lesions Located Outside the Initially Affected Vascular Territory Appear More Often in Stroke Patients with Elevated Glycated Hemoglobin (HbA1c)
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Frontiers in Neurology.2017;[Epub] CrossRef
Blood Pressure Is the Determinant for the Increased Risk for Intracranial Arterial Stenosis in Subjects with Elevated Glycated Hemoglobin Levels: The Kangbuk Samsung Health Study
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Journal of Stroke and Cerebrovascular Diseases.2016; 25(11): 2729. CrossRef
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Jing Jing, Yuesong Pan, Xingquan Zhao, Huaguang Zheng, Qian Jia, Hao Li, Ling Guan, Liping Liu, Chunxue Wang, Xia Meng, Yan He, Yilong Wang, Yongjun Wang
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Yun-Yu Chen, Yenn-Jiang Lin, Eric Chong, Pei-Chun Chen, Taz-Fan Chao, Shih-Ann Chen, Kuo-Liong Chien, An Pan
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Elizabeth Guerrero-Berroa, Ramit Ravona-Springer, Anthony Heymann, James Schmeidler, Andrew Levy, Derek Leroith, Michal S. Beeri
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So Ra Yoon, Jae Hyang Lee, Ga Yoon Na, Yu Jeong Seo, Seongho Han, Min-Jeong Shin, Oh Yoen Kim
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Diabetes & Metabolism Journal.2014; 38(1): 58. CrossRef
Glycated Hemoglobin and All-Cause and Cause-Specific Mortality in Singaporean Chinese Without Diagnosed Diabetes: The Singapore Chinese Health Study
Michael P. Bancks, Andrew O. Odegaard, James S. Pankow, Woon-Puay Koh, Jian-Min Yuan, Myron D. Gross, Mark A. Pereira
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Letter: Higher Glycated Hemoglobin Level Is Associated with Increased Risk of Ischemic Stroke in Non-Diabetic Korean Male Adults (Diabetes Metab J 2011;35:551-7)
Seok Hong Lee, Jihyun Ahn, Jaetaek Kim
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Evaluation of Stress in Korean Patients with Diabetes Mellitus Using the Problem Areas in Diabetes-Korea Questionnaire: Young Sil Eom, Hwa Sun Park, Sei-Hyun Kim, Sun Mee Yang, Moon Suk Nam, Hyoung Woo Lee, Ki Young Lee, Sihoon Lee, Yeun Sun Kim, Ie Byung Park; Diabetes Metab J. 2011;35(2):182-187. Published online April 30, 2011; DOI: https://doi.org/10.4093/dmj.2011.35.2.182

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Background

It is known that diabetes and stress are directly or indirectly related, and that it is important to evaluate stress in patients with diabetes. The relationship between Korean diabetics and diabetes-related stress has never been reported. The objective of this study was to develop a stress questionnaire suitable for use with Korean diabetics and to evaluate its utility.

Methods

This study subjects were 307 Korean diabetics, aged 40 to 74 years old, who visited the Department of Endocrinology and Metabolism at Gachon University Gil Hospital, Yeungnam University Medical Center, and Inha University Hospital in Korea between March 2006 and February 2008. We developed a Korean version of Polonsky's Problem Areas in Diabetes (PAID) stress questionnaire (PAID-K) and used it to assess degrees of stress in our sample of Korean patients. We evaluated the utility of the questionnaire and analyzed the relationships between clinical characteristics of the study subjects and degrees of stress.

Results

Cronbach's alpha for PAID-K was 0.95, and PAID-K scores were significantly correlated with Hypoglycemia Fear Survey scores (r=0.44, P<0.05) and State Trait Anxiety Inventory-6 scores (r=0.21, P<0.05). PAID-K scores were significantly higher in patients with longer durations of diabetes, patients using insulin, and female patients (P=0.02, P=0.038, and P=0.001, respectively). The score also tended to increase as HbA1c levels increased, except for very high HbA1c levels (above 11%) (P for trend<0.05).

Conclusion

We developed the PAID-K questionnaire and demonstrated its utility to evaluate levels of stress in diabetic patients in Korea.

Citations

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Scientific Reports.2024;[Epub] CrossRef
Development and Validation of a Distress Measurement Related to Glucose Monitoring of Diabetes Patients
Eujin Choi, Sooyeon Kim, Juhee Cho, Min-Sun Kim, Eun Kyung Kwon, Youngha Kim, Danbee Kang, Sung Yoon Cho
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Development and validation of a distress measurement for insulin injections among patients with diabetes
Eujin Choi, Min-Sun Kim, Juhee Cho, Sooyeon Kim, Eun Kyung Kwon, Youngha Kim, Danbee Kang, Sung Yoon Cho
Scientific Reports.2023;[Epub] CrossRef
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Kawoun Seo
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Marlous Langendoen-Gort, Lenka Groeneveld, Cecilia A. C. Prinsen, Joline W. Beulens, Petra J. M. Elders, Ilana Halperin, Geetha Mukerji, Caroline B. Terwee, Femke Rutters
Reviews in Endocrine and Metabolic Disorders.2022; 23(5): 931. CrossRef
The Mediating Effect of Acceptance Action in the Relationship between Diabetes Distress and Self-stigma among Old Adults with Diabetes in South Korea
Hyesun Kim, Kawoun Seo
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Tae Jung Oh, Jie-Eun Lee, Seok Kim, Sooyoung Yoo, Hak Chul Jang
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Hyunjin Lee, Myoungjin Kwon, Kawoun Seo
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Adherence to Mediterranean diet and advanced glycation endproducts in patients with diabetes
Marko Grahovac, Marko Kumric, Marino Vilovic, Dinko Martinovic, Ante Kreso, Tina Ticinovic Kurir, Josip Vrdoljak, Karlo Prizmic, Joško Božić
World Journal of Diabetes.2021; 12(11): 1942. CrossRef
The Impact of a Community-Based Food Education Program on Nutrition-Related Knowledge in Middle-Aged and Older Patients with Type 2 Diabetes: Results of a Pilot Randomized Controlled Trial
Carlos Vasconcelos, António Almeida, Maria Cabral, Elisabete Ramos, Romeu Mendes
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Jin Hee Jung, Jung Hwa Lee
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Sebahat Atalikoğlu Başkan, Mehtap Tan
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Jiyeon Lee, Eun-Hyun Lee, Chun-Ja Kim, Seung Hei Moon
International Journal of Nursing Studies.2015; 52(12): 1868. CrossRef
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Seung-Hyun Ko, Sin-Ae Park, Jae-Hyoung Cho, Sun-Hye Ko, Kyung-Mi Shin, Seung-Hwan Lee, Ki-Ho Song, Yong-Moon Park, Yu-Bae Ahn
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A Survey of Diabetic Educators and Patients for the Revision of Korean Food Exchange Lists: Jae Won Cho, Mee Ra Kweon, Young Mi Park, Mi Hye Woo, Hye Sook Yoo, Jeong Hyun Lim, Bo Kyung Koo, Chong Hwa Kim, Hae Jin Kim, Tae Sun Park, Choong Ho Shin, Kyu Chang Won, Soo Lim, Hak Chul Jang; Diabetes Metab J. 2011;35(2):173-181. Published online April 30, 2011; DOI: https://doi.org/10.4093/dmj.2011.35.2.173

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Abstract PDF PubReader

Background

Food exchange lists are one of the main methods of nutritional education. However, Korean food exchange lists have not been revised since 1994. Therefore, we surveyed the opinions of diabetes educators and patients with diabetes regarding the need for revision of the current food exchange lists.

Methods

For two weeks beginning on 10 March 2008, a 12-item questionnaire regarding the opinion and need for revision of the current food exchange lists was e-mailed to diabetes educators nationwide. Another 15-question survey was administered to patients with diabetes in 13 hospitals located in the Seoul and Gyeonggi regions of Korea.

Results

We obtained survey responses from 101 diabetes educators and 209 patients; 65 (64.3%) of the educators answered that the current food exchange lists should be revised. The items that needed revision were the glycemic index, addition of new foods and reaffirmation of exchange standard amounts. The patients demanded specific education about choosing appropriate foods, a balanced meal plan, proper snacks, and dining intake.

Conclusion

Our survey results demonstrate the need to revise the Korean food exchange lists. This process should focus on glycemic index, the addition of new foods and reconfirmation of one exchange reference unit.

Citations

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Dal Lae Ju, Hak Chul Jang, Young Yun Cho, Jae Won Cho, Hye Sook Yoo, Kyung Suk Choi, Mi Hye Woo, Cheong Min Sohn, Yoo Kyoung Park, Ryo Won Choue
Journal of Korean Diabetes.2011; 12(4): 228. CrossRef
Korean Food Exchange Lists for Diabetes: Revised 2010
Dal Lae Ju, Hak Chul Jang, Young Yun Cho, Jae Won Cho, Hye Sook Yoo, Kyung Suk Choi, Mi Hye Woo, Cheong Min Sohn, Yoo Kyoung Park, Ryowon Choue
The Korean Journal of Nutrition.2011; 44(6): 577. CrossRef

R1467H Variants of Rho Guanine Nucleotide Exchange Factor 11 (ARHGEF11) are Associated with Type 2 Diabetes Mellitus in Koreans: Qing Song Jin, So Hun Kim, Shan-Ji Piao, Hyun Ae Lim, Seung Youn Lee, Seong Bin Hong, Yong Seong Kim, Hun-Jae Lee, Moonsuk Nam; Korean Diabetes J. 2010;34(6):368-373. Published online December 31, 2010; DOI: https://doi.org/10.4093/kdj.2010.34.6.368

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Background

The human Rho guanine nucleotide exchange factor 11 (ARHGEF11) functions as an activator of Rho GTPases and is thought to influence insulin signaling. The R1467H variant of ARHGEF11 has been reported to be associated with susceptibility to type 2 diabetes mellitus (T2DM) in Western populations.

Methods

We investigated the effects of the R1467H variant on susceptibility to T2DM as well as related traits in a Korean population. We genotyped the R1467H (rs945508) of ARHGEF11 in 689 unrelated T2DM patients and 249 non-diabetic individuals and compared the clinical and biochemical characteristics according to different alleles.

Results

The H allele was significantly more frequent in T2DM cases than in controls (P = 0.037, 17.1% and 13.1%; respectively). H homozygocity was associated with a higher risk of T2DM compared to those with R/R or R/H genotype (odds ratio, 5.24; 95% confidence interval, 1.06 to 25.83; P = 0.042). The fasting plasma glucose, HbA1c, fasting insulin, HOMA2-IR and HOMA2-%β levels did not differ significantly between different genotypes.

Conclusion

Our study replicated associations of the ARHGEF11 polymorphism with increased risk of T2DM in a Korean population and thus supports previous data implicating a potential role of ARHGEF11 in the etiology of T2DM. Further studies revealing the underlying mechanism for this association are needed.

Citations

Citations to this article as recorded by

Epigenetic alteration of Rho guanine nucleotide exchange Factor 11 (ARHGEF11) in cord blood samples in macrosomia exposed to intrauterine hyperglycemia
Jie Yan, Rina Su, Wanyi Zhang, Yumei Wei, Chen Wang, Li Lin, Hui Feng, Huixia Yang
The Journal of Maternal-Fetal & Neonatal Medicine.2021; 34(3): 422. CrossRef
Loss of Arhgef11 in the Dahl Salt-Sensitive Rat Protects Against Hypertension-Induced Renal Injury
Ashley C. Johnson, Wenjie Wu, Esinam M. Attipoe, Jennifer M. Sasser, Erin B. Taylor, Kurt C. Showmaker, Patrick B. Kyle, Merry L. Lindsey, Michael R. Garrett
Hypertension.2020; 75(4): 1012. CrossRef
Transgenerational Obesity and Alteration of ARHGEF11 in the Rat Liver Induced by Intrauterine Hyperglycemia
Wanyi Zhang, Rina Su, Hui Feng, Li Lin, Chen Wang, Huixia Yang
Journal of Diabetes Research.2019; 2019: 1. CrossRef
ARHGEF11 affecting the placental insulin signaling pathway in fetal macrosomia of normal glucose tolerance pregnant women
Wanyi Zhang, Rina Su, Li Lin, Huixia Yang
Placenta.2018; 63: 7. CrossRef
Genetic variants and clinical relevance associated with gestational diabetes mellitus in Chinese women: a case-control study
Jie Yan, Rina Su, Deng Ao, Yan Wang, Haijun Wang, Huixia Yang
The Journal of Maternal-Fetal & Neonatal Medicine.2018; 31(16): 2115. CrossRef
Human Rho Guanine Nucleotide Exchange Factor 11 (ARHGEF11) Regulates Dendritic Morphogenesis
Yutaka Mizuki, Manabu Takaki, Shinji Sakamoto, Sojiro Okamoto, Makiko Kishimoto, Yuko Okahisa, Masahiko Itoh, Norihito Yamada
International Journal of Molecular Sciences.2016; 18(1): 67. CrossRef
Allelic Variants in Arhgef11 via the Rho-Rock Pathway Are Linked to Epithelial–Mesenchymal Transition and Contributes to Kidney Injury in the Dahl Salt-Sensitive Rat
Zhen Jia, Ashley C. Johnson, Xuexiang Wang, Zibiao Guo, Albert W. Dreisbach, Jack R. Lewin, Patrick B. Kyle, Michael R. Garrett, Maria Pia Rastaldi
PLOS ONE.2015; 10(7): e0132553. CrossRef
The Rho-guanine nucleotide exchange factor PDZ-RhoGEF governs susceptibility to diet-induced obesity and type 2 diabetes
Ying-Ju Chang, Scott Pownall, Thomas E Jensen, Samar Mouaaz, Warren Foltz, Lily Zhou, Nicole Liadis, Minna Woo, Zhenyue Hao, Previn Dutt, Philip J Bilan, Amira Klip, Tak Mak, Vuk Stambolic
eLife.2015;[Epub] CrossRef
Human Rho guanine nucleotide exchange factor 11 gene is associated with schizophrenia in a Japanese population
Yutaka Mizuki, Manabu Takaki, Yuko Okahisa, Shinji Sakamoto, Masafumi Kodama, Hiroshi Ujike, Yosuke Uchitomi
Human Psychopharmacology: Clinical and Experimental.2014; 29(6): 552. CrossRef
Small G proteins and their regulators in cellular signalling
Roland Csépányi-Kömi, Magdolna Lévay, Erzsébet Ligeti
Molecular and Cellular Endocrinology.2012; 353(1-2): 10. CrossRef
The Duration of Sulfonylurea Treatment Is Associated withβ-Cell Dysfunction in Patients with Type 2 Diabetes Mellitus
Mi-Seon Shin, Jee Hee Yu, Chang Hee Jung, Jenie Yoonoo Hwang, Woo Je Lee, Min-Seon Kim, Joong-Yeol Park
Diabetes Technology & Therapeutics.2012; 14(11): 1033. CrossRef

Association of Kir6.2 and Peroxisome Proliferator-activated Receptor-gamma (PPARgamma) Polymorphisms with Type 2 Diabetes in Koreans.: Jung Eun Lee, Su Won Kim, Hyun Ae Seo, Jae Han Jeon, Seong Su Moon, Hee Kyung Kim, Yun Jeong Doh, Bo Wan Kim, Jung Guk Kim, Min Yoo, In Kyu Lee; Korean Diabetes J. 2007;31(6):455-464. Published online November 1, 2007; DOI: https://doi.org/10.4093/jkda.2007.31.6.455

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Abstract PDF: BACKGROUND
The type 2 diabetes is a typical polygenic disease complex, for which several common risk alleles have been identified. Several variants may contribute significantly to the risk of type 2 diabetes conferring insulin resistance of liver, muscle and fat (Pro12Ala) and a relative insulin secretory deficiency (Glu23Lys). In this study, we evaluated the association of Pro12Ala variant of the peroxisome proliferator- activated receptor-gamma and the Glu23Lys variant of the ATP-sensitive potassium channel, Kir6.2 (KCNJ11) with the type 2 diabetes in Korean population. METHOD: This study included 331 subjects consisting of 172 patients with type 2 diabetes and 159 non- diabetic control subjects enrolled from the Kyungpook, Keimyung and Catholic university hospital in Daegu, Korea. We genotyped Kir6.2 (Glu23Lys) and PPARgamma (Pro12Ala) polymorphism and examined their association with the type 2 diabetes. RESULT: In the separate analyses, the Kir6.2 Glu23Lys (P = 0.385) and the PPARgamma Pro12Ala (P = 0.191) polymorphism showed no significant association with type 2 diabetes. In addition, the results of our study showed no evidence of a synergistic interaction between Kir6.2 and PPARgamma gene in each group (P = 0.110, P = 0.276). CONCLUSION: In this study, no association was seen between the genetic polymorphisms of Kir6.2, PPARgamma and type 2 diabetes. However, to clarify whether genetic polymorphisms of these genes contribute to the development of type 2 diabetes, further studies involving larger Korean populations may be needed.

Randomized Controlled Trial

Efficacy and Safety of Mitiglinide in Korean Type 2 Diabetic Patients: Prospective Randomised Multicenter Comparative Phase III Study.: Se Young Kim, Hyo Jeong Kim, Kyung Ah Han, Se Hyun Baek, Hyun Sik Son, Bong Soo Cha, Kyung Wan Min; Korean Diabetes J. 2007;31(2):163-174. Published online March 1, 2007; DOI: https://doi.org/10.4093/jkda.2007.31.2.163

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Abstract PDF

BACKGROUND
Mitiglinide, one of the meglitinides, is expected to prevent postprandial hyperglycemia of type 2 diabetes by enhancing early phase insulin secretion. The aim of this study was to verify the efficacy and safety of mitiglinide compared to nateglinide. METHODS: One hundred eleven of diabetic patients were randomised and administered of mitiglinide (n = 56) and nateglinide (n = 55) before a meal time for 12 weeks. The changes of HbA1c, fasting plasma glucose (FPG) and postprandial plasma glucose (PPG) were analyzed. The safety of this drug was investigated as well. RESULTS: The change of HbA1c was not significantly different between two groups (-0.77 +/- 1.08% in mitiglinide vs. -0.66 +/- 0.79% in nateglinide, P = 0.57). The reduction of FPG (-12.2 +/- 25.0 mg/dL vs. -6.1 +/- 22.3 mg/dL, P = 0.218), PPG 1 hr (-48.0 +/- 47.1 mg/dL, vs. -29.4 +/- 43.2 mg/dL, P = 0.051), and PPG 2 hr (-59.2 +/- 58.0 mg/dL vs. -43.3 +/- 59.0 mg/dL, P = 0.194) were not significantly different between the mitiglinide and the nateglinide, respectively. Drug-related adverse effects were not different between two groups (16.1% in mitiglinide vs. 27.8% in nateglinide, P = 0.137). The frequency of hypoglycemic events were not different between two groups (8.9% in mitiglinide vs. 14.8% in nateglinide, P = 0.339). There were two patients who had complained shoulder pain in the mitiglinide or deterioration of visual acuity in the nateglinide, but those were found to be unrelated with medications. CONCLUSION: This study showed that mitiglinide had reduced HbA1c as similar to nateglinide and that significantly improved HbA1c, FPG and PPG during 12 weeks of treatment. The safety of mitiglinide was also comparable to nateglinide. Mitiglinide could be used as an effective glucose-lowering agent by enhancing early insulin secretion and reducing postprandial glucose excursion, and thereby might contribute long-term cardioprotective effect in Korean type 2 diabetic patients.

Citations

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Monotherapy in Type 2 Diabetes Mellitus Patients 2017: A Position Statement of the Korean Diabetes Association
Sang Youl Rhee
The Journal of Korean Diabetes.2018; 19(1): 15. CrossRef
Monotherapy in patients with type 2 diabetes mellitus
Sang Youl Rhee, Hyun Jin Kim, Seung-Hyun Ko, Kyu Yeon Hur, Nan-Hee Kim, Min Kyong Moon, Seok-O Park, Byung-Wan Lee, Kyung Mook Choi, Jin Hwa Kim
The Korean Journal of Internal Medicine.2017; 32(6): 959. CrossRef
Monotherapy in Patients with Type 2 Diabetes Mellitus
Sang Youl Rhee, Hyun Jin Kim, Seung-Hyun Ko, Kyu-Yeon Hur, Nan-Hee Kim, Min Kyong Moon, Seok-O Park, Byung-Wan Lee, Kyung Mook Choi, Jin Hwa Kim
Diabetes & Metabolism Journal.2017; 41(5): 349. CrossRef

Original Articles

Relations between Insulin Resistance and Hematologic Parameters in Elderly Koreans: Southwest Seoul (SWS) Study.: Kye Won Lee, Hye Jin Yoo, Soo Yeon Park, Ohk Hyun Ryu, Sang Soo Park, Soon Beom Kwon, Hee Young Kim, Ji A Seo, Jeong Heon Oh, Dong Hyun Shin, Sin Gon Kim, Nan Hee Kim, Kyung Mook Choi, Sei Hyun Baik, Dong Seop Choi, Hyoung Jin Kim; Korean Diabetes J. 2003;27(4):352-361. Published online August 1, 2003

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Abstract PDF: BACKGROUND
The clustering of cardiovascular risk factors is known as insulin resistance syndrome. Hyperinsulinemia has been suggested as a cardiovascular risk factor due to the capacity of insulin to induce vascular endothelial proliferation and atherosclerosis. Insulin also has been shown to stimulate erythroid colony formation independently of erythropoietin. WBC count is one of the major components of the inflammatory process and is increased by IL-6, which is high in those with features of insulin resistance. In this study, we investigated whether insulin resistance affects hematological parameters. METHODS: In this study, 1,314, randomly selected, non-diabetic, elderly subjects over 60 years living in the southwest area of Seoul were recruited. Subjects underwent 75 g OGTT and careful physical examinations during evaluation, and were interviewed using a standardized questionnaire. Biochemical data and hematologic parameters were also measured. Insulin resistance was calculated by HOMA (homeostasis model assessment) method. Analysis of variance, Duncan's multiple comparisons and multiple linear regression analysis were carried out. RESULTS: In the male non-smoking group we found a correlation between insulin resistance and hemoglobin concentration (r=0.20, p=0.0186). In the female non- smoking group we found correlations between insulin resistance and both hemoglobin concentration (r=0.10, p=0.0017) and white blood cell (WBC) count (r=0.15, p=0.001). Hemoglobin concentration and WBC count were also correlated with BMI, systolic and diastolic blood pressure, lipid profiles and fasting insulin levels in female non-smokers. In multiple regression analysis, using HOMA IR as a dependent variable, we found significance in the variables of hemoglobin concentration, WBC count, age, BMI and triglyceride level. CONCLUSION: Our study provided evidence for a relation between insulin resistance and hematological parameters such as hemoglobin concentration and WBC count in elderly Koreans. This suggests that increased hemoglobin level and WBC count could be considered as novel aspects of the met.

The Appropriteness of New ADA Diagnostin Criteria for Diabetes Mellitus in Korean Population.: Moon kyu Lee, Myung Shik Lee, Young Ki Min, Sung Hoon Kim, Byoung Joon Kim, Dong Jun Kim, Jong Ryeal Hahm, Eun Young Oh, Yun Jae Chung, Kyoung Ah Kim, Jae Hoon Chung, Kwang Won Kim; Korean Diabetes J. 1999;23(3):336-351. Published online January 1, 2001

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Abstract PDF: BACKGROUND
The ADA has proposed a new diagnostic criteria for diabetes based on fasting plasma glucose, redefining diabetes as fasting plasma glucose 7.0 mmol/L. Since only a few studies for the appropriateness of tbis new ADA criteria were undertaken in the Korean population, we examined the appropriateness of the new ADA criteria by analyzing the results of oral glucose tolerance tests done in our hospital. METHODS: 507 oral glucose tolerance tests were conducted. Cases with diabetes and diseases that could affect the glucose tolerance were excluded. Plasma glucose was measured by the hexokinase method. Three groups of NGT, IGT, and DM by the WHO criteria of 2 hour-plasma glucose were redivided at each level of fasting plasma glucose. We calculated the sensitivity and specificity of each level of fasting plasma glucose (FPG), and the FPG value of maximum accuracy to diagnose diabetes with reference to the WHO criteria of 2 hour-plasma glucose. RESULTS: Correlation between the levels of fasting plasma glucose and 2 hour-plasma glucose was relatively low (r=0.676). FPG of 7.0 mmol/L for diagnosing diabetes was relatively specific (specificity=0.934), but not sensitive (sensitivity= 0.552). FPG value of maximum accuracy for diagnosing diabetes was 6.8 mmol/L. 39 % of IFG (> 6.1mmol/L and < 7.0mmol/L) was reclassified as diabetes by the criteria of 2 hour plasma glucose 11.1 mmol/L and 34 % of NFG (<6.1mmol/L) was reclassified as impaired glucose tolerance by the criteria of 2 hour plasma glucose > 7.8 mmol/L. CONCLUSION: The fasting plasma glucose of 7.0 mmol/L was relatively specific for diagnosing diabetes. However, the new ADA criteria tended to underestimate the prevalence of diabetes and impaired glucose tolerance in the Korean population. Therefore, oral glucose tolerance test may be needed to diagnose diabetes in high risk subjects. Large-scale cross-sectional and prospective studies will be needed to clarify these points.

Randomized Controlled Trial

Efficacy and Safety of Glimepiride: A Novel Sulfonylurea Drug compared with Gliclazide in the Treatment of Type 2 Diabetes Mellitus: an Open , Randomized Comparative Multi - Center Clinical Study.: Sung Kwan Hong, Ki Up Lee, Yeon Sang Oh, Ho Young Son, Kwang Won Kim, Hyun Chul Lee, Kyung Rae Kim, Dong Seop Choi, Ie Byung Park, Young Seol Kim, Kwan Woo Lee, Hong Kyu Lee, Soon Hyun Shin; Korean Diabetes J. 1999;23(1):87-97. Published online January 1, 2001

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Abstract PDF: BACKGROUND
Glimepiride (HOE490, Amaryl (R)) is a new, third generation sulfonylurea, which binds to a different protein of the sulfonylurea receptor than other sulfonylureas. Although there have been many studies proving the efficacy of glimepiride on Caucasian diabetic patients, only a few studies are available on Asian diabetic patients. We performed an open, randomized, comparative multicenter clinical trial to assess the efficacy and safety of glimepiride in Korean type 2 diabetic patients. METHOD: We recruited 262 type 2 cliabetic patients at 12 different university hospitals whose blood glucose was not controlled effectively with diet alone. Patients were randomized to 1~2mg glimepiride or 40~80mg gliclazide depending on the fasting blood glucose level. Doses were increased stepwise, up to 8mg for glimepiride (once-daily) and 320mg for gliclazide (>80 mg as dividedose) respectively, until metabolic control (fasting blood glucose < 7.9 mmol/L) or maximum dose was achieved. The quality of rnetabolic control was assessed by fasting blood glucose and HbA 1c as primary variables. Insulin, C-peptide and weight were monitored as secondary variables. Safety was assessed by obtaining patient history and laboratory values of relevant variables. RESULTS: Of the 262 patients randomized to treatment, 160(61%) patients completed the 18-week study. The rate of successful blood glucose control (3.9

Original Articles

High Serum Lipoprotein ( a ) Levels in Korean Type 2 Diabetic Patients with Proliferative Diabetic retinopathy.: Hyung Joo Park, Chul Hee Kim, Yun Ey Chung, Sang Wook Kim, Jin Yub Kim, Eun Sook Kim, Sung Kwan Hong, Ki Up Lee; Korean Diabetes J. 1998;22(3):338-343. Published online January 1, 2001

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Abstract PDF: BACKGROUND
To examine the possible association between serum lipoprotein(a) (Lp(a)) concentration and proliferative diabetic retinopathy(PDR) in Korean patients with type 2 diabetes mellitus. METHODS: A total of 412 Korean outpatients with type 2 diabetes were examined. Diabetic retinopathy was determined by fundoscopic examination by an ophthalmologist and/or by fluorecein angiography. Semm Lp(a) levels were measured by one step sandwich ELISA method. RESULTS: The patient with PDR had higher serum Lp(a) levels than those with no retinopathy or non-proliferative diabetic retinopathy(NPDR). Multiple logistic regression analysis showed that serum Lp(a) level and the presence of diabetic nephropathy were independent variables having a statistically significant association with PDR. CONCLUSION: Korean type 2 diabetic patients with PDR had higher serum Lp(a) levels compared with those with no retinopathy or NPDR. Although these results suggested that Lp(a) might play a role in the occlusion of retinal capillaries leading to PDR, further prospective studies are required to prove causal relationship.

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

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

Fasting Serum Insulin Levels in Relation to Age and Body Mass Index and Serum Glucose Level in Healthy Subjects in Korea.: Sang Ah Chang, Ho Young Son, Bong Yun Cha, Sung Dae Moon, Ki Ho Song, Soon Jib Yoo, Kun Ho Yoon, Moo Il Kang, Kwang Woo Lee, Sung Ku Kang; Korean Diabetes J. 1997;21(4):433-443. Published online January 1, 2001

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Abstract PDF: BACKGROUND
Ethnic variability in the relationship between glucose tolerance and insulin secretion has been reported. Clinical characteristics of Korean diabetic patients are different from that of diabetic patients in Western countries. It is generally assumed that typical IDDM or obese diabetic patients are relatively rare among Korean subjects. This study attempted to define the characteristics of fasting serum insulin levels of healthy Korean adult subjects. Futhermore, we tried to evaluate the relationship between fasting serum insulin level and age, body mass index, serum glucose. METHODS: We examined 1917 Korean subjects who had fasting blood glucose within normal range (3.6~6.4mmol/L). The fasting insulin levels, total choiesterol, triglyceride concentrations and anthropometric characteristics(body weight, height and body mass index(BMI)) of these subjects were measured. RESULTS: 1) Mean fasting insulin levels were 33.9+0.5pmol/ L, the fasting insulin levels in men and women were 34.9+0.6 and 31.8+0.6pmol/L, respectively. 2) The fasting insulin levels of obese(BMI>25) subjects were significantly higher than those of non-obese subjects(43.2+ 1.2 pmol/L vs. 30.6+0.6 pmol/L, p<0.001). 3) There were significant differences in the basal insulin levels among the age groups, and fasting blood glucose levels were increased with aging. 4) In a multiple stepwise regression analysis, insulin levels were positively correlated with serum triglycerides, fasting blood glucose, body mass index and negatively correlated with age. Conclusion : The fasting insulin levels of healthy subjects in Korea were relatively lower than the previously measured value of Caucasians. The insulin levels were decreased with aging and increased with the elevation of BMI, fasting blood glucose and triglyceride.

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