Diabetes & Metabolism Journal

Original Article

Lifesytle
Changes in the Quality of Life in Patients with Type 2 Diabetes Mellitus According to Physician and Patient Behaviors: Young-Joo Kim, In-Kyung Jeong, Sin-Gon Kim, Dong Hyeok Cho, Chong-Hwa Kim, Chul-Sik Kim, Won-Young Lee, Kyu-Chang Won, Jin-Hye Cha, Juneyoung Lee, Doo-Man Kim; Diabetes Metab J. 2020;44(1):91-102. Published online October 23, 2019; DOI: https://doi.org/10.4093/dmj.2018.0251

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Background

Diabetes mellitus (DM) is the most common chronic metabolic disorder with an increasing prevalence worldwide. According to a previous study, physicians' treatment patterns or patients' behaviors change when they become aware of the risk for cardiovascular (CV) disease in patients with DM. However, there exist controversial reports from previous studies in the impact of physicians' behaviors on the patients' quality of life (QoL) improvements. So we investigate the changes in QoL according to physicians and patients' behavioral changes after the awareness of CV risks in patients with type 2 DM.

Methods

Data were obtained from a prospective, observational study where 799 patients aged ≥40 years with type 2 DM were recruited at 24 tertiary hospitals in Korea. Changes in physicians' behaviors were defined as changes in the dose/type of antihypertensive, lipid-lowering, and anti-platelet therapies within 6-month after the awareness of CV risks in patients. Changes in patients' behaviors were based on lifestyle modifications. Audit of Diabetes Dependent Quality of Life comprising 19-life-domains was used.

Results

The weighted impact score change for local or long-distance journey (P=0.0049), holidays (P=0.0364), and physical health (P=0.0451) domains significantly differed between the two groups; patients whose physician's behaviors changed showed greater improvement than those whose physician's behaviors did not change.

Conclusion

This study demonstrates that changes in physicians' behaviors, as a result of perceiving CV risks, improve QoL in some domains of life in DM patients. Physicians should recognize the importance of understanding CV risks and implement appropriate management.

Citations

Citations to this article as recorded by

Spline Longitudinal Multi-response Model for the Detection of Lifestyle- Based Changes in Blood Glucose of Diabetic Patients
Anna Islamiyati
Current Diabetes Reviews.2022;[Epub] CrossRef
Characteristics of Glycemic Control and Long-Term Complications in Patients with Young-Onset Type 2 Diabetes
Han-sang Baek, Ji-Yeon Park, Jin Yu, Joonyub Lee, Yeoree Yang, Jeonghoon Ha, Seung Hwan Lee, Jae Hyoung Cho, Dong-Jun Lim, Hun-Sung Kim
Endocrinology and Metabolism.2022; 37(4): 641. CrossRef
Agriophyllum Oligosaccharides Ameliorate Diabetic Insulin Resistance Through INS-R/IRS/Glut4-Mediated Insulin Pathway in db/db Mice and MIN6 Cells
Shuyin Bao, Xiuzhi Wang, Sung Bo Cho, Yan-Ling Wu, Chengxi Wei, Shuying Han, Liming Bao, Qiong Wu, Wuliji Ao, Ji-Xing Nan
Frontiers in Pharmacology.2021;[Epub] CrossRef
Glycolipid metabolism and liver transcriptomic analysis of the therapeutic effects of pressed degreased walnut meal extracts on type 2 diabetes mellitus rats
Yulan Li, Dan Chen, Chengmei Xu, Qingyujing Zhao, Yage Ma, Shenglan Zhao, Chaoyin Chen
Food & Function.2020; 11(6): 5538. CrossRef
Cause-of-death statistics in 2018 in the Republic of Korea
Hyun-Young Shin, Jin Kim, Seokmin Lee, Min Sim Park, Sanghee Park, Sun Huh
Journal of the Korean Medical Association.2020; 63(5): 286. CrossRef

Response

Response: Association between Diabetic Polyneuropathy and Chronic Complications in Type 2 Diabetic Patients (Diabetes Metab J 2011;35:390-6): Jin Ook Chung, Dong Hyeok Cho, Dong Jin Chung, Min Young Chung; Diabetes Metab J. 2011;35(6):640-641. Published online December 26, 2011; DOI: https://doi.org/10.4093/dmj.2011.35.6.640

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Original Articles

Association between Diabetic Polyneuropathy and Cardiovascular Complications in Type 2 Diabetic Patients: Jin Ook Chung, Dong Hyeok Cho, Dong Jin Chung, Min Young Chung; Diabetes Metab J. 2011;35(4):390-396. Published online August 31, 2011; DOI: https://doi.org/10.4093/dmj.2011.35.4.390

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Abstract PDF PubReader

Background

Diabetes mellitus is a major independent risk factor for cardiovascular disease (CVD), but high cardiovascular risk in diabetes mellitus patients is not completely explained by clustering traditional risk factors. Recently, associations between diabetic polyneuropathy (DPN) and macrovasculopathy have been suggested. We aimed to assess associations between DPN and cardiovascular complications in type 2 diabetic patients.

Methods

Microvascular and cardiovascular complications were evaluated in 1,041 type 2 diabetic patients.

Results

In patients with DPN, the age, prevalence of hypertension, diabetes duration, systolic blood pressure, pulse pressure, and hemoglobin glycation (HbA1c) levels were significantly higher, while the high density lipoprotein cholesterol (HDL-C) levels were lower than in those without DPN. The prevalence of CVD was higher in patients with DPN. In multivariate analysis, DPN was independently associated with CVD (odds ratio, 1.801; 95% confidence interval, 1.009 to 3.214).

Conclusion

Our results showed that DPN was associated with a high prevalence of cardiovascular disease in type 2 diabetic patients, but further studies are needed to investigate the causative nature of associations between DPN and CVD.

Citations

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The Presence of Clonal Hematopoiesis Is Negatively Associated with Diabetic Peripheral Neuropathy in Type 2 Diabetes
Tae Jung Oh, Han Song, Youngil Koh, Sung Hee Choi
Endocrinology and Metabolism.2022; 37(2): 243. CrossRef
Diabetic Peripheral Neuropathy Is Associated With Higher Systolic Blood Pressure in Adults With Type 2 Diabetes With and Without Hypertension in the Chinese Han Population
Lingning Huang, Yongze Zhang, Yunmin Wang, Ximei Shen, Sunjie Yan
Canadian Journal of Diabetes.2020; 44(7): 615. CrossRef
Characterizing distal peripheral neuropathy in type 2 diabetes mellitus in a semi-urban community setting in Peru
Meera F Iyengar, Antonio Bernabe-Ortiz
Journal of Global Health Reports.2019;[Epub] CrossRef
Cardiovascular disease predicts diabetic peripheral polyneuropathy in subjects with type 2 diabetes: A 10-year prospective study
Juan Ybarra-Muñoz, Jeronimo Jurado-Campos, Maria Garcia-Gil, Edurne Zabaleta-del-Olmo, Teresa Mir-Coll, Adelaida Zabalegui, Josep Vidal, June H Romeo
European Journal of Cardiovascular Nursing.2016; 15(4): 248. CrossRef
Diabetic polyneuropathy and the risk of developing diabetic retinopathy: a nationwide, population‐based study
I‐Chan Lin, Yuan–Hung Wang, Cheng‐Li Lin, Yen‐Jung Chang, Shwu‐Huey Lee, I‐Jong Wang
Acta Ophthalmologica.2015; 93(8): 713. CrossRef
Diabetic Peripheral Neuropathy in Ambulatory Patients with Type 2 Diabetes in a General Hospital in a Middle Income Country: A Cross-Sectional Study
María de los Angeles Lazo, Antonio Bernabé-Ortiz, Miguel E. Pinto, Ray Ticse, German Malaga, Katherine Sacksteder, J. Jaime Miranda, Robert H. Gilman, Leighton R. James
PLoS ONE.2014; 9(5): e95403. CrossRef
The co-occurrence of myocardial dysfunction and peripheral insensate neuropathy in a streptozotocin-induced rat model of diabetes
Maria N Marangoni, Scott T Brady, Shamim A Chowdhury, Mariann R Piano
Cardiovascular Diabetology.2014;[Epub] CrossRef
Neovascularization in diabetes and its complications. Unraveling the angiogenic paradox
Paulo Zoé Costa, Raquel Soares
Life Sciences.2013; 92(22): 1037. CrossRef
Diabetic Peripheral Neuropathy in Type 2 Diabetes Mellitus in Korea
Seung-Hyun Ko, Bong-Yun Cha
Diabetes & Metabolism Journal.2012; 36(1): 6. 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.

Citations

Citations to this article as recorded by

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

Case Report

A Case of Recurrent Hypoglycemic Hemiparesis in an Adult with Type 1 Diabetes Mellitus.: Kyoung Min Kim, Se Hun Kang, Se In Hong, Dong Hyeok Cho, Ho Cheol Kang, Dong Jin Chung, Min Young Chung; Korean Diabetes J. 2006;30(2):136-139. Published online March 1, 2006; DOI: https://doi.org/10.4093/jkda.2006.30.2.136

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Abstract PDF: Transient hypoglycemic hemiparesis is a rare but important presentation of hypoglycemia that is frequently misdiagnosed as stroke. The development of hemiparesis as a result of hypoglycemia was first described in 1928. Thereafter over the years, several cases have been sporadically reported in Korea, but case reports of recurrent hypoglycemic hemiparesis are rare. We recently experienced a case of recurrent hypoglycemic hemiparesis in an adult with type 1 diabetes mellitus. A 30-year-old woman with type 1 diabetes receiving daily multiple subcutaneous insulin injections was admitted with right hemiparesis. She had had admitted with the same symptom and recovered with oral carbohydrates in twice 2 years ago. Her clinical course improved over 2 hours after infusion of dextrose solution. Further investigations such as CT, MRI and MRA revealed no abnormality

Original Article

Platelet Aggregability in Type 2 Diabetics.: Chang Hun Lee, Nam Il Cheon, Yeon Sang Lee, Dong Hyeok Cho, Hyun Ho Shin, Jung Min Kim, Dae Ho Lee, Dong Jin Chung, Min Young Chung, Tai Hee Lee; Korean Diabetes J. 2000;24(3):300-309. Published online January 1, 2001

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Abstract PDF: BACKGROUND
Increased platelet aggregability is known to be one of the important risk factors for diabetic vascular complications. The relationship between platelet aggregability and diabetic macrovascular complications, varying severity of diabetic microvascular complications and other possible factors was evaluated in Korean adults. METHODS: Platelet aggregability was measured with platelet rich plasma by addition of adenosine diphosphate (ADP) in 45 cases. Normal control group (n=15) was compared with diabetics without macrovascular complications (n=15), diabetics with macrovascular complications (n=15) and several groups divided accoring to the severity of microvascular complications. RESULTS: 1) The mean maximum value of platelet aggregation was 70.3+/-5.3% in control group, and 80.0+/-7.3% in diabetics (p<0.005). 2) The mean maximum value of platelet aggregation was 78.0+/-5.5% in diabetics without macrovascular complications and 83.5+/-7.1% in diabetics with macrovascular complications (p=0.093). 3) The mean maximum value of platelet aggregation was 77.0+/-5.1% in normoproteinuria group, 78.1+/-7.3% in microproteinuria group, and 82.9+/-6.2% in overt proteinuria group (p=0.083). 4) The mean maximum value of platelet aggregation was 77.2+/-6.8% in diabetes without neuropathy group and 82.9+/-6.2% in diabetes with neuropathy group (p=0.114). 5) The mean maximum value of platelet aggregation was 79.3+/-4.9% in diabetes with normal funduscopic findings, 80.2+/-7.3% in diabetes with background retinopathy and 81.6+/-7.9% in diabetes with proliferative retinopathy (p=0.852). 6) Blood glucose showed positive correlations with the mean maximum platelet aggregation ( =0.529, p<0.005). CONCLUSION: The elevated mean maximum value of platelet aggregation was found in diabetics and there were no significant differences between macrovascular complications and between varying severity of retinopathy, neuropathy and proteinuria. Blood glucose showed positive correlations with mean maximum platelet aggregation. Hyperglycemia was a major risk factor affecting platelet aggregation in diabetics and its control may play an important role in prevention of diabetic vascular complications.

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