Diabetes & Metabolism Journal

Original Articles

The Correlation and Accuracy of Glucose Levels between Interstitial Fluid and Venous Plasma by Continuous Glucose Monitoring System: Young Ha Baek, Heung Yong Jin, Kyung Ae Lee, Seon Mee Kang, Woong Ji Kim, Min Gul Kim, Ji Hyun Park, Soo Wan Chae, Hong Sun Baek, Tae Sun Park; Korean Diabetes J. 2010;34(6):350-358. Published online December 31, 2010; DOI: https://doi.org/10.4093/kdj.2010.34.6.350

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Background

Clinical experience with the continuous glucose monitoring systems (CGMS) is limited in Korea. The objective of this study is to evaluate the accuracy of the CGMS and the correlation between interstitial fluid and venous plasma glucose level in Korean healthy male subjects.

Methods

Thirty-two subjects were served with glucose solution contained same amount of test food's carbohydrate and test foods after separate overnight fasts. CGMS was performed over 3 days during hopitalization for each subjects. Venous plasma glucose measurements were carried out during 4 hours (0, 0.25, 0.5, 0.75, 1, 2, 4 hours) just before and after glucose solution and test food load. The performance of the CGMS was evaluated by comparing its readings to those obtained at the same time by the hexokinase method using the auto biochemistry machine (Hitachi 7600-110). Also, correlations between glucose recorded with CGMS and venous plasma glucose value were examined.

Results

CGMS slightly underestimated the glucose value as compared with the venous plasma glucose level (16.3 ± 22.2 mg/dL). Correlation between CGMS and venous plasma glucose values throughout sensor lifetime is 0.73 (regression analysis: slope = 1.08, intercept = 8.38 mg/dL). Sensor sensitivity can deteriorate over time, with correlations between venous blood glucose and CGMS values dropping from 0.77 during 1st day to 0.65 during 2nd and 3rd day.

Conclusion

The accuracy of data provided by CGMS may be less than expected. CGMS sensor sensitivity is decreased with the passage of time. But, from this study, CGMS can be used for glucose variability tendency monitoring conveniently to the Korean.

Citations

Citations to this article as recorded by

Evaluation of the performance and usability of a novel continuous glucose monitoring system
Li Yan, Qiang Li, Qingbo Guan, Mingsong Han, Yu Zhao, Junfei Fang, Jiajun Zhao
International Journal of Diabetes in Developing Countries.2023; 43(4): 551. CrossRef
Correlation between short- and mid-term hemoglobin A1c and glycemic control determined by continuous glucose monitoring
Jen-Hung Huang, Yung-Kuo Lin, Ting-Wei Lee, Han-Wen Liu, Yu-Mei Chien, Yu-Chun Hsueh, Ting-I Lee, Yi-Jen Chen
Diabetology & Metabolic Syndrome.2021;[Epub] CrossRef
Accuracy of Flash Glucose Monitoring During Postprandial Rest and Different Walking Conditions in Overweight or Obese Young Adults
Xiaoyuan Zhang, Fenghua Sun, Waris Wongpipit, Wendy Y. J. Huang, Stephen H. S. Wong
Frontiers in Physiology.2021;[Epub] CrossRef
The MEDGICarb-Study: Design of a multi-center randomized controlled trial to determine the differential health-promoting effects of low- and high-glycemic index Mediterranean-style eating patterns
Robert E. Bergia, Izabela Biskup, Rosalba Giacco, Giuseppina Costabile, Savanna Gray, Amy Wright, Marilena Vitale, Wayne W. Campbell, Rikard Landberg, Gabriele Riccardi
Contemporary Clinical Trials Communications.2020; 19: 100640. CrossRef
A genetic programming-based regression for extrapolating a blood glucose-dynamics model from interstitial glucose measurements and their first derivatives
I. De Falco, A. Della Cioppa, A. Giugliano, A. Marcelli, T. Koutny, M. Krcma, U. Scafuri, E. Tarantino
Applied Soft Computing.2019; 77: 316. CrossRef
Genetic Programming-based induction of a glucose-dynamics model for telemedicine
Ivanoe De Falco, Antonio Della Cioppa, Tomas Koutny, Michal Krcma, Umberto Scafuri, Ernesto Tarantino
Journal of Network and Computer Applications.2018; 119: 1. CrossRef
A high-accuracy measurement method of glucose concentration in interstitial fluid based on microdialysis
Dachao Li, Qingmei Xu, Yu Liu, Ridong Wang, Kexin Xu, Haixia Yu
Measurement Science and Technology.2017; 28(11): 115701. CrossRef
Effects of Higher Dietary Protein and Fiber Intakes at Breakfast on Postprandial Glucose, Insulin, and 24-h Interstitial Glucose in Overweight Adults
Akua Amankwaah, R. Sayer, Amy Wright, Ningning Chen, Megan McCrory, Wayne Campbell
Nutrients.2017; 9(4): 352. CrossRef
High Surface Area Electrodes Generated via Electrochemical Roughening Improve the Signaling of Electrochemical Aptamer-Based Biosensors
Netzahualcóyotl Arroyo-Currás, Karen Scida, Kyle L. Ploense, Tod E. Kippin, Kevin W. Plaxco
Analytical Chemistry.2017; 89(22): 12185. CrossRef
Hyperglycemia-Induced Changes in Hyaluronan Contribute to Impaired Skin Wound Healing in Diabetes: Review and Perspective
Sajina Shakya, Yan Wang, Judith A. Mack, Edward V. Maytin
International Journal of Cell Biology.2015; 2015: 1. CrossRef
Hypoglycemia in everyday life after gastric bypass and duodenal switch
Niclas Abrahamsson, Britt Edén Engström, Magnus Sundbom, F Anders Karlsson
European Journal of Endocrinology.2015; 173(1): 91. CrossRef
The use of reinforcement learning algorithms to meet the challenges of an artificial pancreas
Melanie K Bothe, Luke Dickens, Katrin Reichel, Arn Tellmann, Björn Ellger, Martin Westphal, Ahmed A Faisal
Expert Review of Medical Devices.2013; 10(5): 661. CrossRef
Continuous glucose monitoring: current clinical use
Hun‐Sung Kim, Jeong‐Ah Shin, Jin‐Sun Chang, Jae‐Hyoung Cho, Ho‐Young Son, Kun‐Ho Yoon
Diabetes/Metabolism Research and Reviews.2012; 28(s2): 73. CrossRef
Correlations of Glucose Levels in Interstitial Fluid Estimated by Continuous Glucose Monitoring Systems and Venous Plasma
Byung-Joon Kim
Korean Diabetes Journal.2010; 34(6): 338. CrossRef

The Effect of Alpha-Lipoic Acid on the Protection of Epidermal Nerve Fibers and Microcapillaries in the Streptozotocin-Induced Diabetic Rats.: Ming Han Piao, Heung Yong Jin, Sun Kyung Song, Seun Mi Kang, So Young Kim, Ji Hyun Park, Hong Sun Baek, Tae Sun Park; Korean Diabetes J. 2007;31(6):488-497. Published online November 1, 2007; DOI: https://doi.org/10.4093/jkda.2007.31.6.488

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Abstract PDF: BACKGROUND
Diabetic neuropathy is associated with risk factors for macrovascular diseases and other microvascular complications. Alpha-lipoic acid (ALA) administration has been reported to improve metabolic abnormalities and ameliorate peripheral polyneuropathy in diabetic patients. In addition, ALA improves endoneurial nutritive neural blood flow and nerve conduction velocity in diabetic rats. But it is not clear whether ALA has a preservation effect on microvasculature in addition to the effect on intraepidermal nerve fibers (IENFs). We investigated the effect of ALA on intraepidermal nerve fiber density (numbers/mm) and cutaneous capillary length in streptozotocin-induced diabetic rats. METHODS: The rats were randomly divided into 3 groups: diabetes without diet control, diabetes with diet control, and diabetes with ALA treatment. Diabetes was induced by a single intraperitoneal injection of streptozotocin (60 mg/kg) and the effect of ALA treatment was assessed by IENF immunostained with protein gene product 9.5 and by quantification of total cutaneous capillary length with mouse anti-rat reca-1 immunostaining. RESULTS: The value of IENF density significantly increased in ALA treatment group compared with other groups (P < 0.05). Quantification of microvascularity was also significantly increased in ALA treatment group compared with other groups (P < 0.05). CONCLUSION: The results of this study suggest that ALA administration in diabetic rats may be beneficial in the prevention of peripheral neuropathy associated with improvement of microvascularity. And the symptomatic amelioration after ALA treatment may be attributed to this morphological improvement.

Erythropoietin Levels According to the Presence of Peripheral Neuropathy in Diabetic Patients with Anemia.: Heung Yong Jin, Su Jin Jeung, Chong Hwa Kim, Ji Hyun Park, Hong Sun Baek, Tae Sun Park; Korean Diabetes J. 2007;31(2):151-156. Published online March 1, 2007; DOI: https://doi.org/10.4093/jkda.2007.31.2.151

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Abstract PDF

BACKGROUND
Peripheral neuropathy is a common complication of diabetes mellitus, contributing the greatest morbidity and mortality and impairing the quality of life. Recently the receptor of erythropoietin (Epo) was proven to be expressed in neuronal cell and recombinant human Epo (rhEpo) has been shown to have neuroprotective and neurotrophic potential in peripheral neuropathy. But there is no report about baseline Epo level in blood before rhEpo treatment with diabetic peripheral neuropathy. METHODS: From Jan. 2000 to Sep. 2006, diabetic patients were reviewed about Epo level in blood, anemia, and peripheral neuropathy in Chonbuk National University Hospital. And we compared the mean value of baseline Epo level in diabetic patients with anemia according to the peripheral neuropathy. RESULTS: The mean value of Epo of patients with peripheral neuropathy was lower than that of patients without peripheral neuropathy (16.3 +/- 7.1 vs 26.1 +/- 29.7 mU/mL, P < 0.05). There was no significance in the correlation between hemoglobin and Epo level in diabetic patients with anemia irrespective of presence of peripheral neuropathy (r = -0.02, P = 0.81). CONCLUSION: We suggest that decreased Epo level in blood is possible to be an additional cause in the development of peripheral neuropathy. However, simultaneously another possibility that neuropathy causes reduced Epo level should be considered, so further studies are warranted in this field.

Citations

Citations to this article as recorded by

The Association between Serum GGT Concentration and Diabetic Peripheral Polyneuropathy in Type 2 Diabetic Patients
Ho Chan Cho
Korean Diabetes Journal.2010; 34(2): 111. CrossRef

Case Report

A Case of Vancomycin-induced Pancytopenia in the Diabetic Patient with Infected Foot Ulcer.: Heung Yong Jin, Su Jin Jung, Ji Hyun Park, Tae Sun Park, Hong Sun Back; Korean Diabetes J. 2006;30(5):403-407. Published online September 1, 2006; DOI: https://doi.org/10.4093/jkda.2006.30.5.403

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Abstract PDF: Diabetic foot ulcer is a common complication in diabetic patients and the outcome of foot ulcer depends on the severity of ulcer and combined infection such as osteomyelitis. So antibiotics targeting Gram positive cocci including Staphylococcus aureus have been used frequently. However, during the antibiotic therapy, diverse adverse reactions could be happened including red man syndrome, chest pain, hypotension, thrombocytopenia, neutropenia and drug eruption. Among these reactions, hematologic adverse events such as pancytopenia are rare and it could be lethal if happened. This article reports a case of pancytopenia associated with vancomycin in treating the diabetic patient with infected foot ulcer.

Original Article

The Effects of Alpha-Lipoic Acid on Epidermal Nerve Preservation in the Diabetic Neuropathy of OLETF Rats.: Ming Han Piao, Ji Hyun Park, Hong Sun Baek, Tae Sun Park; Korean Diabetes J. 2006;30(3):170-176. Published online May 1, 2006; DOI: https://doi.org/10.4093/jkda.2006.30.3.170

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Abstract PDF: BACKGROUND
Alpha-Lipoic acid (ALA) administration has been reported to ameliorate some of symptoms of peripheral polyneuropathy in diabetic patients and to improve endoneurial nutritive neural blood flow and nerve conduction velocity in diabetic rats. But it is not clear whether ALA has the preservation effect on epidermal nerve fibers (ENFs) density. METHODS: We tested the efficacy of ALA in preserving current perception thresholds (CPTs) and ENFs (numbers/mm) in OLETF (Otsuka Long-Evans Tokushima Fatty) rats, an animal model of type 2 diabetes, which were fed with sucrose until diabetes mellitus developed. Thereafter, one group of OLETF rats was fed with ALA and the other was not for 40 weeks. Diabetic rats were administered with ALA (80 mg/kg of body weight/day) by oral feeding for 40 weeks. The effect of ALA treatment on ENFs preservation was assessed by protein gene product 9.5 immunostaining. Quantification of neuropathic symptoms on the dorsum of hind paws of rat was measured by CPT test every 4 weeks. RESULTS: Numbers of ENF significantly decreased in OLETF rats fed without ALA compared with OLETF rats fed with ALA (P < 0.01). The thresholds at 2000, 250 and 5 Hz in OLETF rats fed with ALA did not increased and OLETF rats without ALA significantly increased at 80 weeks (P < 0.01). CONCLUSION: These observations suggest that administrations of ALA may be useful for preserving ENFs and CPTs in OLETF rats dorsum of hind paws skin.

Randomized Controlled Trial

Relationship between Carotid Atherosclerosis and Chlamydia Pneumoniae Seropositivity in Type 2 Diabetes.: Su Jin Jung, Ji Hye Kim, Ji Hyun Park, Tae Sun Park, Hong Sun Baek; Korean Diabetes J. 2005;29(4):352-357. Published online July 1, 2005

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Abstract PDF: BACKGROUND
The major causes of death in diabetic patients are atherosclerosis-related diseases. Infection with Chlamydia pneumoniae(C. pneumoniae) has been reported to play a pathogenic role in atherosclerosis. However, data relating to C. pneumoniae exposure are rare in type 2 diabetes that are more susceptible to infection. The aim of this study was to see whether C. pneumoniae seropositivity was associated with carotid atherosclerosis in type 2 diabetic patients. METHODS: The subjects of this study were 135 type 2 diabetic patients. Serum samples from the subjects were assayed for risk factors, including lipid profiles, HbA1c, fibrinogen and CRP. Serum titers of antibodies to C. pneumoniae(IgG, IgM) were measured using microimmunofluorescence(MIF). tests Carotid ultrasound examination was used to measure the intima-media thickness(IMT), plaques and the presence of stenosis in each segment of both carotid arteries. RESULTS: C. pneumoniae seropositivity was detected in 17.8%(n=24), but without any difference between the sexes, in the 135 type 2 diabetic patients. The CRP level was increased in the seropositive group(P=0.041). The presence of carotid stenosis and IMT were significantly from a associated with C. pneumoniae seropositivity from a univariate analysis(IMTmean: IgG(+), 0.93mm vs. IgG(-), 0.85mm, P = 0.038, IMTmax: IgG(+), 1.29mm vs. IgG(-), 1.17mm, P = 0.025, stenosis: IgG (+), 25% vs. IgG(-) 7.2%, P = 0.020). No association was found for the plaque count or score. After controlling for cardiovascular risk factors, including age, sex, hypertension, cholesterol, and CRP, the association of C. pneumonia seropositivity with the IMTmean or carotid stenosis remained significant(IMTmean: P = 0.027, stenosis: P = 0.026). CONCLUSIONS: Serologic evidence of C. pneumoniae infection was detected in 17.8% randomly-assigned type 2 diabetic patients. C. pneumoniae seropositivity may be a risk factor for carotid atherosclerosis in type 2 diabetic patients.

Original Articles

The Clinical Characteristics of Anemia in Type 2 Diabetic Patients Without Overt Nephropathy.: Eun Young Ko, Se In Kim, Yong Bum Jang, Kyoung Hun Min, Sung Hun Kim, Kyu Sun Lee, So Ri Kim, Eun Kyoung Choi, Ji Hyun Park, Tae Sun Park, Hong Sun Paek; Korean Diabetes J. 2004;28(5):425-431. Published online October 1, 2004

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Abstract PDF: BACKGROUND
It is well known that anemia occurs early in diabetic patients before they reach to end stage renal failure. This anemia is considered to be due to the reduced endogenous erythropoietin synthesis, tubulointerstitial damage, autonomic dysfunction, and to the use of angiotensin-converting- enzyme inhibitors. Because anemia has a significant impact on the quality of life for diabetic patients, we examined the clinical characteristics of anemia in those diabetic patients who did not have overt nephropathy. METHODS: We retrospectively reviewed the medical records of 200 type 2 diabetic patients with anemia who had been followed up from 1998 to 2002 by Chonbuk University Medical School Hospital. We measured the total cholesterol, triglycerides, high density lipoprotein, low density lipoprotein, and the presence of complications (retinopathy or neuropathy) for about 90 diabetic patients who were under the age of 65, they were without other underlying disease and they had a hemoglobin concentration 110g/L, GFR 1.0 mL/s. We excluded the causes of anemia as being from malignancy, liver disease, coexisting iron deficiency, chronic inflammatory disease and chronic infection. RESULTS: The clinical characteristics of the patients are as follows; the mean age was 59.6 +/- 8.4 years, the mean HbA1C was 9.4 +/- 2.3%, and the mean Hb concentration was 96 +/- 12 g/L. Our results showed that an inverse relation existeds between Hb concentration and total cholesterol (p<0.04), LDL cholesterol (p<0.05), age (p<0.02), and the duration of diabetes (p<0.01).Our results also showed that a linear relation existed between the Hb concentration, HDL cholesterol (p<0.02), and the GFR (p<0.01). CONCLUSION: Diabrtic patients with anemia are in need of intensive management for the lipid and GFR that causes thair anemia.

Plasma Fibrinogen Level is Associated with Carotid Plaque Progression in Type 2 Diabetic Patients.: Seong Hun Kim, Ji Hye Kim, Chong Hwa Kim, Ji Hyun Park, Tae Sun Park, Hong Sun Back; Korean Diabetes J. 2004;28(4):293-303. Published online August 1, 2004

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Abstract PDF: BACKGROUND
The level of plasma fibrinogen has emerged as an important risk factor for cardiovascular diseases. Raised fibrinogen levels result in enhanced fibrin deposition in areas of vessel wall injury, which in turn may accelerate the development of atherosclerotic disease. The aim of present study was to investigate whether the plasma fibrinogen levels was related to carotid atherosclerosis in type 2 diabetic patients. METHODS: The sbjects of this study were 210 type 2 diabetic patients. The intima-media thickness (IMT) and plaques in the each segment of the both carotid arteries were evaluated by a duplex scan. The mean of the total IMT values (7 points on each side), the each mean value of the CCA, bulb and ICA, and the maximal IMT, plaque count and score were measured. The plaque score was defined by the sum of longitudinal diameters of each plaque. RESULTS: The correlation between the plasma fibrinogen level and measured IMT values was statistically insignificant (r<0.15, P>0.05). However, there were significant positive correlations between the level of fibrinogen and the plaque count (r=0.20, P=0.019) or plaque score (r=0.24, P=0.006). Stepwise multiple regression analysis revealed the level of plasma fibrinogen as a predictor of the plaque score. CONCLUSION: These results suggest that an elevated plasma fibrinogen level may be related with carotid atherosclerosis in type 2 diabetic patients. Also, there a need to address the discriminating risk factors for the formation or progression of plaques, or IMT thickening.

The Relation Between Serum and Intracellular Magnesium Level And Diabetic Microvascular Complications.: Kyung Hoon Min, Ji Hye Kim, Eun Kyung Choi, Ji Hyun Park, Hong Sun Baek, Tian Ze Ma, Bing Zhe Hong, Yong Geun Kwak, Hyung Sub Kang, Tae Sun Park; Korean Diabetes J. 2004;28(4):284-292. Published online August 1, 2004

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Abstract PDF: BACKGROUND
Low serum magnesium levels are related to diabetes mellitus (DM), high blood pressure (HBP) and metabolic syndrome (MS). However, as far as is known, there have been no previous studies analyzing the relevance of the serum and intracellular magnesium concentrations in diabetic microvascular complication individuals compared with healthy individuals. SUBJECTS AND METHODS: A pilot study was performed to compare 35 individuals with DM with 22 disease-free control subjects. The serum and intracellular magnesium levels of each group were measured, and found to be elevated in the diabetic group with diabetic microvascular complications. RESULTS: The mean serum magnesium levels among the subjects with DM and the control subjects were 0.0503 +/- 0.0750 and 0.9166 0.1149 mmol/L (p<0.001), respectively. The mean intracellular magnesium levels among the subjects with DM and the control subjects were 3.3548+/-0.1863 and 3.6732 0.2428 mM/mg protein (p<0.001), respectively. In those diabetic subjects whose serum magnesium concentration was measured, 28 had diabetic retinopathy, 30 diabetic nephropathy and 20 diabetic neuropathy. The mean serum magnesium concentrations of each diabetic microvascular complication were 0.9320 0.2813, 0.9259 0.1188 and 0.9305 0.1293 mmol/L, respectively, which that were significantly lower than those of the healthy subjects (p<0.001, p<0.001 and p<0.01). Also, the diabetic subjects whose intracellular magnesium concentrations were measured, 13 had diabetic retinopathy, 15 diabetic nephropathy and 9 diabetic neuropathy. The mean intracellular magnesium concentrations of each diabetic microvascular complication were 3.3484 0.1607, 3.3289 0.1832 and 3.3768 0.2096 mM/mg protein, respectively, and were also significantly lower than those of the healthy subjects (p<0.001and p<0.01). Each diabetic microvascular complication was also negatively correlated with the serum magnesium and intracellular magnesium levels. CONCLUSION: This study reveals that a significant relation ship exists between low serum and intracellular magnesium levels and diabetic microvascular complications, particularly retinopathy and nephropathy. A large scale study on these subjects will be required to generalize our results.

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