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Choon Hee Chung  (Chung CH) 32 Articles
Relationship Between Metabolic Syndrome and Risk of Chronic Complications in Koreans with Type 2 Diabetes.
Hye Soo Chung, Ji A Seo, Sin Gon Kim, Nan Hee Kim, Doo Man Kim, Choon Hee Chung, Dong seop Choi
Korean Diabetes J. 2009;33(5):392-400.   Published online October 1, 2009
DOI: https://doi.org/10.4093/kdj.2009.33.5.392
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  • 26 Download
  • 6 Crossref
AbstractAbstract PDF
BACKGROUND
We examined the relationships between components of metabolic syndrome at the time of diagnosis of type 2 diabetes, and the development of chronic complications in Korean patients with type 2 diabetes. METHODS: The medical records of patients with type 2 diabetes who had undergone treatment for at least five years prior were collected from 10 general hospitals in Korea. Among a total of 1,418 patients reviewed for possible inclusion in this study, 603 patients were selected, and the occurrence of complications among these patients was evaluated. RESULTS: Among the 603 patients (male, 253; female, 350), 154 males (60.8%) and 266 females (76.0%) were diagnosed with metabolic syndrome at the time of initial diagnosis of type 2 diabetes. The incidence of chronic complications (average follow-up 15.2 +/- 4.9 years) included 60 cases of coronary artery disease (CAD), 57 cases of cerebrovascular accident (CVA), 268 cases of diabetic retinopathy (DR), 254 cases of diabetic nephropathy (DN), and 238 cases of diabetic peripheral neuropathy (DPN). As compared to patients without metabolic syndrome, the adjusted relative risks (95% CI) of incidental diabetic complications in patients with metabolic syndrome were 3.28 (1.40~7.71) for CAD, 2.04 (0.86~4.82) for CVA, 1.53 (1.10~2.14) for DR, 1.90 (1.29~2.80) for DN, and 1.51, (1.06~2.14) for DPN. With the addition of just one constituent of metabolic syndrome, the relative risk of developing CAD, CVD, DR, DN, and DPN increased by 2.08 (95% CI, 1.27~3.40), 1.16 (0.80~1.66), 1.09 (0.93~1.26), 1.29 (1.06~1.57) and 1.06 (0.87~1.26), respectively. CONCLUSION: Metabolic syndrome in Korean patients with type 2 diabetes increases the risk of developing both macrovascular and microvascular complications.

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  • The Relationship between Metabolic Syndrome and Quality of Life in Korean Adult Women
    Hyung-Su Park, Jong Park
    The Journal of the Korea institute of electronic communication sciences.2013; 8(4): 639.     CrossRef
  • Diabetes Risk Analysis Model with Personalized Food Intake Preference
    So-Hye Jeon, Nam-Hyun Kim
    Journal of the Korea Academia-Industrial cooperation Society.2013; 14(11): 5771.     CrossRef
  • Comorbidity Study on Type 2 Diabetes Mellitus Using Data Mining
    Hye Soon Kim, A Mi Shin, Mi Kyung Kim, Yoon Nyun Kim
    The Korean Journal of Internal Medicine.2012; 27(2): 197.     CrossRef
  • Cardio-Metabolic Features of Type 2 Diabetes Subjects Discordant in the Diagnosis of Metabolic Syndrome
    Sa Rah Lee, Ying Han, Ja Won Kim, Ja Young Park, Ji Min Kim, Sunghwan Suh, Mi-Kyoung Park, Hye-Jeong Lee, Duk Kyu Kim
    Diabetes & Metabolism Journal.2012; 36(5): 357.     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
  • 2,756 View
  • 55 Download
  • 43 Crossref
AbstractAbstract 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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    International Journal of Diabetes in Developing Countries.2015; 35(S3): 431.     CrossRef
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Prevalence of the Metabolic Syndrome in Type 2 Diabetic Patients.
Tae Ho Kim, Dae Jung Kim, Soo Lim, 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):40-47.   Published online February 1, 2009
DOI: https://doi.org/10.4093/kdj.2009.33.1.40
  • 2,372 View
  • 27 Download
  • 13 Crossref
AbstractAbstract PDF
BACKGROUND
The aim of this study was to analyze the prevalence of metabolic syndrome in Korean type 2 diabetic patients. METHODS: A total of 4,240 diabetic patients (male 2,033, female 2,207; mean age 58.7 +/- 11.3 years; DM duration 8.9 +/- 7.6 years) were selected from the data of endocrine clinics of 13 university hospitals in 2006. Metabolic syndrome was defined using the criteria of the American Heart Association/National Heart Lung and Blood Institute and the criteria of waist circumference from the Korean Society for the Study of Obesity. RESULTS: The prevalence of metabolic syndrome was 77.9% (76.7% of males, 78.9% of females). The average number of the components of metabolic syndrome was 2.4 +/- 1.1. Abdominal obesity was seen in 56.8% of the patients, hypertriglyceridemia in 42.0%, low HDL cholesterol in 65.1%, and high blood pressure in 74.9%. Abdominal obesity and high blood pressure were much more prevalent among females than males, and low HDL cholesterol was much more prevalent among males than females. The prevalence of metabolic syndrome was not different according to the duration of diabetes. Metabolic syndrome was strongly related with obesity (odds ratio, 6.3) and increased age (odds ratio in the over 70 group, 3.4). CONCLUSION: The prevalence of metabolic syndrome was 77.9% in Korean type 2 diabetic patients. Its prevalence was greater in obese patients and in those over 40 years of age.

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    Sa Rah Lee, Ying Han, Ja Won Kim, Ja Young Park, Ji Min Kim, Sunghwan Suh, Mi-Kyoung Park, Hye-Jeong Lee, Duk Kyu Kim
    Diabetes & Metabolism Journal.2012; 36(5): 357.     CrossRef
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    Hye Soon Kim, A Mi Shin, Mi Kyung Kim, Yoon Nyun Kim
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Relationship between Menopausal Status and Metabolic Syndrome Components in Korean Women.
Jang Hyun Koh, Mi Young Lee, Soo Min Nam, Joong Kyung Sung, Pil Moon Jung, Jin Kyu Noh, Jang Yel Shin, Young Goo Shin, Choon Hee Chung
Korean Diabetes J. 2008;32(3):243-251.   Published online June 1, 2008
DOI: https://doi.org/10.4093/kdj.2008.32.3.243
  • 2,324 View
  • 35 Download
  • 7 Crossref
AbstractAbstract PDF
BACKGROUND
Postmenopausal status is associated with a 60% increased risk for metabolic syndrome. It is thought to be associated with decreased estrogens and increased abdominal obesity in postmenopausal women with metabolic syndrome. The purpose of this study was to investigate the association between metabolic syndrome components and menopausal status. METHODS: A total of 1,926 women were studied and divided into three groups according to their menstrual stage (premenopausal, perimenopausal or postmenopausal). The presence of metabolic syndrome was assessed using the National Cholesterol Education Program's (NCEP) Adult Treatment Panel III criteria. RESULTS: The prevalence of metabolic syndrome was 7.1% in premenopause, 9.8% in perimenopause, and 24.2% in postmenopause. The strong correlation was noted between the metabolic syndrome score and waist circumference in postmenopause (r = 0.56, P < 0.01) and perimenopause (r = 0.60, P < 0.01). Along the menopausal transition, the risk of metabolic syndrome increased with high triglyceride after the age-adjusted (odds ratio (OR) 1.517 [95% confidence interval (CI) 1.014~2.269] in perimenopausal women and OR 1.573 [95% CI 1.025~2.414] in postmenopausal women). In addition, the prevalence of metabolic syndromeincreased in accordance with elevated alanine aminotransferase (ALT) and gamma-glutamyl transpeptidase (GGT) levels. CONCLUSION: Triglyceride and waist circumference were important metabolic syndrome components, though ALT and GGT may also be related for predicting metabolic syndrome during the transition to menopause.

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The Role of Glomerular Podocytes in Diabetic Nephropathy.
Eun Young Lee, Choon Hee Chung
Korean Diabetes J. 2007;31(6):451-454.   Published online November 1, 2007
DOI: https://doi.org/10.4093/jkda.2007.31.6.451
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AbstractAbstract PDF
Diabetic nephropathy is the most common cause of end-stage renal disease and accounts for significant morbidity and mortality among individuals with diabetes mellitus. Therefore, the clarification of the pathogenesis of diabetic nephropathy is an urgent issue. Podocytes cover the outer layer of the glomerulus and maintain its integrity so that fluid and toxins exit in urine, but cells and important proteins are kept in the blood stream. Diabetes mellitus alters this structure, it becomes scarred and then the ability of the kidney to clear toxins is lost. Recent evidence shows that early in diabetes the podocyte number is reduced, areas of the glomerular basement membrane are denuded, and podocyte number predicts long-term urinary albumin excretion in the patients with diabetes and microalbuminuria. These results suggest that podocytes play a critical role in the early stage of diabetic nephropathy. It is the purpose of this article to review the pathogenetic role of podocytes in diabetic nephropathy.

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    Maryam A. AL-Ghamdi, Said S. Moselhy
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    Ran Choi, Bo Hwan Kim, Jarinyaporn Naowaboot, Mi Young Lee, Mi Ri Hyun, Eun Ju Cho, Eun Soo Lee, Eun Young Lee, Young Chul Yang, Choon Hee Chung
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Current Status of Diabetes Management in Korea Using National Health Insurance Database.
Seok Won Park, Dae Jung Kim, Kyung Wan Min, Sei Hyun Baik, Kyung Mook Choi, Ie Byung Park, Jeong Hyun Park, Hyun Shik Son, Chul Woo Ahn, Jee Young Oh, Juneyoung Lee, Choon Hee Chung, Jaiyong Kim, Hwayoung Kim
Korean Diabetes J. 2007;31(4):362-367.   Published online July 1, 2007
DOI: https://doi.org/10.4093/jkda.2007.31.4.362
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AbstractAbstract PDF
BACKGROUND
The prevalence of diabetes is steadily increasing in Korea. The increase in number of people with diabetes would ultimately result in premature death, poor quality of life, and increasing economic burden. However, in our country, researches regarding on the quality of diabetes management are lacking. This study was conducted in 2005 using National Health Insurance Database to know the current status of diabetes management in Korea. METHODS: We have randomly selected 3,902 subjects out of 2,503,754 subjects who had claims with diagnosis of diabetes between January 2003 to December 2003 by using two staged cluster sampling method. Field survey with review of medical records and telephone survey was conducted with standardized record forms developed by Korean Diabetes Association; Task Force Team For Basic Statistical Study of Korean Diabetes Mellitus. RESULTS: The age of diabetic subjects was 58.1 +/- 12.6 years and the duration of diabetes was 6.2 +/- 5.5 years. Hypertension was present in 54% of diabetic subjects. Among those with hypertension, 59% were controlled with blood pressure below 140/90 mmHg, but only 19% were controlled with blood pressure below 130/80 mmHg. Hyperlipidemia was present in 29% of diabetic subjects. Only 38% of those with hyperlipidemia were controlled with LDL-cholesterol below 100 mg/dL. For glycemic control, only 40% of diabetic subjects achieved the goal of HbA1c less than 7%, which was suggested by ADA. CONCLUSION: We found that only 20~40% of diabetic subjects in Korea achieved the management goal for glucose, blood pressure, and lipids. It seems urgent to develop a quality management program for diabetes subjects in Korea.

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The Effect of Rosiglitazone on Gluose Metabolism and Insulin Sensitivity in Non Obese Type 2 Diabetic Rat Models.
Mi Jin Kim, Eui Jong Chung, Byung Wook Ha, Ji Hoon Kim, Su Min Nam, Mi Young Lee, Jang Hyun Kho, Young Goo Shin, Choon Hee Chung
Korean Diabetes J. 2007;31(4):319-325.   Published online July 1, 2007
DOI: https://doi.org/10.4093/jkda.2007.31.4.319
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AbstractAbstract PDF
BACKGROUND
In Korea, most of type 2 diabetic patients are non obese. We made non obese type 2 diabetic rat models, which were characterized by insulin resistance and insulin secretion defect. Our study aimed to investigate the effect of rosiglitazone on glucose metabolism and insulin sensitivity in non obese type 2 diabetic rat models. Furthermore, we may estimate the effect of rosiglitazone treatment in non obese type 2 diabetic patients in Korea. METHODS: 20 male newborn (12 hours old) Sprague-Dawley rats were made diabetes by streptozotocin (75 mg/kg, intraperitoneal injection). At 16 weeks old, diabetes were confirmed by intraperitoneal glucose tolerance test (IPGTT, 30% D/W, 2 kg/kg). After that, diabetic groups were divided into two groups. One group was fed on normal chow and rosiglitazone (3 mg/kg/day) and the other group was fed on normal chow for eight weeks. At the age of 24 weeks, we measured body weight (BW), plasma glucose, insulin, C-peptide levels. And we performed IPGTT and insulin tolerance test (ITT) in two groups. Thereafter, we determined the insulin content of pancreas and epididymal fat weight. RESULTS: Body weight was significantly higher in rosiglitazone group than control group. On IPGTT, plasma glucose, insulin and C-peptide levels were not significantly different between two groups. But, on insulin tolerance test, Kitt (%/min) values of rosiglitazone group were significantly higher than control group (2.7 vs. 1.8). The insulin content of pancreas and epididymal fat weight was not different between two groups. CONCLUSION: These results suggested that rosiglitazone improved insulin sensitivity in non obese type 2 diabetes rat models independent of glucose level.
Alcohol Consumption, Liver Enzymes, and Prevalence of Metabolic Syndrome in Korean Adult Men.
Soo Min Nam, Ho Yeol Yu, Mi Young Lee, Jang Hyun Koh, Jang Yel Shin, Young Goo Shin, Choon Hee Chung
Korean Diabetes J. 2007;31(3):253-260.   Published online May 1, 2007
DOI: https://doi.org/10.4093/jkda.2007.31.3.253
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AbstractAbstract PDF
BACKGROUND
Metabolic syndrome is associated with an increasing incidence of diabetes and cardiovascular disease. The relationship between the amount of alcohol consumption and the prevalence of metabolic syndrome is controversial. Our study was performed to evaluate the relationship between alcohol consumption and the prevalence of metabolic syndrome in Korean men. Also we examined the correlation of liver markers, including alanine transaminase (ALT) and gamma-glutamyl transferase (GGT) with the development of metabolic syndrome. METHODS: We enrolled 1,775 Korean men (mean age 40.0 +/- 5.8 years) who were undergone health check-ups in our hospital. Each component of metabolic syndrome was measured by using the American Association of Clinical Endocrinologists (AACE) criteria. The subjects were divided into 4 subgroups according to the amount of alcohol consumption; Group 1: no consumption, 2 (mild): those consumed less than 200 g/week, 3 (moderate): those consumed 200~399 g/week, 4 (heavy): those consumed more than 400 g/week. RESULTS: The prevalence of metabolic syndrome was 24.6%. There were significant positive correlations between the amount of alcohol consumption blood pressure, triglyceride, fasting blood glucose, GGT levels and HDL cholesterol levels. But the odds ratios for metabolic syndrome were not significantly increased in subjects with moderate alcohol consumption. The odds ratios for the metabolic syndrome significantly increased in proportion to the increasing levels of ALT and GGT. CONCLUSION: Although alcohol consumption didn't increase the prevalence of metabolic syndrome, the amount of alcohol consumption had significant positive correlation with components of metabolic syndrome in Korean men, and elevated ALT and GGT levels could strongly associate with the prevalence of metabolic syndrome.

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Comparison of the Efficacy and Safety of Glimepiride/Metformin Fixed Combination Versus Free Combination in Patients with Type 2 Diabetes: Multicenter, Randomized, Controlled Trial.
Seung Hwan Lee, In Kyu Lee, Sei Hyun Baik, Dong Seop Choi, Kyong Soo Park, Ki Ho Song, Kwan Woo Lee, Bong Soo Cha, Chul Woo Ahn, Hyoung Woo Lee, Choon Hee Chung, Moon Suk Nam, Hong Sun Baek, Yong Ki Kim, Hyo Young Rhim, Ho Young Son
Korean Diabetes J. 2006;30(6):466-475.   Published online November 1, 2006
DOI: https://doi.org/10.4093/jkda.2006.30.6.466
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AbstractAbstract PDF
BACKGROUND
Failure to manage diabetes mellitus receiving monotherapy increases as the duration of the disease is protracted, and in many cases it becomes inevitable to introduce combined therapies. However, compliance of the patients tends to decrease. We conducted a clinical study to compare the efficacy and safety of preconstituted and fixed combination therapy of glimepiride plus metformin to those of free combination therapy. METHODS: Two hundred and thirteen patients with type 2 diabetes who had been diagnosed at least six months ago were randomly assigned either to a fixed group or a free group. The initial dosage was chosen according to the previous treatment history and then adjusted every two weeks following a predefined titration algorithm to meet the target mean fasting glucose levels (140 mg/dL). The medications were given for 16 weeks. The primary endpoint was the change in HbA1c level from baseline to week 16. Various parameters were checked as secondary outcome measures and safety criteria. RESULTS: HbA1c level of the fixed group and the free group decreased by 1.09% and 1.08%, respectively. The 95% CI of the changes' difference between the two groups (-0.21%, +0.19%) was within the predefined equivalence interval (-0.5%, +0.5%). Secondary outcome measures (the changes of fasting and postprandial plasma glucose level, response rate and compliance) and safety criteria (frequency of hypoglycemia and adverse reactions) were similar between the two groups. CONCLUSION: Fixed combination of glimepiride/metformin is as effective and safe therapy as free combination in type 2 diabetes patients.

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  • Efficacy and safety of glimepiride/metformin sustained release once daily vs. glimepiride/metformin twice daily in patients with type 2 diabetes
    Y.-C. Hwang, M. Kang, C. W. Ahn, J. S. Park, S. H. Baik, D. J. Chung, H. C. Jang, K.-A. Kim, I.-K. Lee, K. W. Min, M. Nam, T. S. Park, S. M. Son, Y.-A. Sung, J.-T. Woo, K. S. Park, M.-K. Lee
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Current Status of the Continuity of Ambulatory Diabetes Care and its Impact on Health Outcomes and Medical Cost in Korea Using National Health Insurance Database.
Jaiyong Kim, Hyeyoung Kim, Hwayoung Kim, Kyung Wan Min, Seok Won Park, Ie Byung Park, Jeong Hyun Park, Sei Hyun Baik, Hyun Shik Son, Chul Woo Ahn, Jee Young Oh, Sunhee Lee, Juneyoung Lee, Choon Hee Chung, Kyung Mook Choi, Injeoung Choi, Dae Jung Kim
Korean Diabetes J. 2006;30(5):377-387.   Published online September 1, 2006
DOI: https://doi.org/10.4093/jkda.2006.30.5.377
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AbstractAbstract PDF
BACKGROUND
The continuity of care in chronic diseases, especially in diabetes, was emphasized from many studies. But large scale studies with long-term observation which confirm the impact of continuity of care on health outcomes are rare. This study tried national level 3 year observation to find differences in hospitalization, mortality and medical costs among patient groups with different utilization pattern. METHODS: The 1,088,564 patients with diabetes diagnosis and diabetes drug prescription in 2002, from 20 to 79 years old, and survived until the end of 2004 were included. Annual drug prescription days, number of visited clinics and quarterly continuity of care were measured. Gender, age group, living area, health insurance premium level (as a proxy of the income level), years of first DM diagnosis, five co-morbidities (hypertension, heart disease, stroke, renal disease, admission with DM), hospitalization experience and the type of main attending clinic were adjusted. Hospitalization, mortality and high costs group (top quintile) in 2005 were predicted by multiple logistic regression model. RESULTS: Patients who failed in continuity of care in 2003 and 2004 showed higher hospitalization (OR =1.29), higher mortality (OR =1.75) and they are more likely to be high costs group (OR =1.34) in 2005 than who fulfilled the continuity of care. Patients who have single attending clinic also showed lower hospitalization, lower mortality and lower cost. Completeness in diabetic drug prescription were correlated with lower hospitalization, lower mortality but with higher cost. Possible cost saving from continual care with single attending clinic was estimated at Won 417 billion (Dollar 1 = Won 943.7). Possible expenditure from complete drug prescription was Won 228 billion. So, net saving was Won 139 billion in our study population. CONCLUSION: Continual care and single attending clinic saves patient's life and national costs. Fragmented primary care system in Korea should be reformed for more effective care of chronic diseases. National Health Insurance Database in Korea enables nationwide long-term observation study which overcomes the many limitations found in hospital-based studies and cross-sectional surveys.

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    Hyeongsu Kim, Minjung Lee, Haejoon Kim, Kunsei Lee, Sounghoon Chang, Vitna Kim, Jun Pyo Myong, Soyoun Jeon
    Asian Nursing Research.2013; 7(2): 67.     CrossRef
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    N. J. Sung, J. F. Markuns, K. H. Park, K. Kim, H. Lee, J. H. Lee
    Family Practice.2013; 30(5): 568.     CrossRef
  • Diabetes Epidemics in Korea: Reappraise Nationwide Survey of Diabetes "Diabetes in Korea 2007"
    Ie Byung Park, Jaiyong Kim, Dae Jung Kim, Choon Hee Chung, Jee-Young Oh, Seok Won Park, Juneyoung Lee, Kyung Mook Choi, Kyung Wan Min, Jeong Hyun Park, Hyun Shik Son, Chul Woo Ahn, Hwayoung Kim, Sunhee Lee, Im Bong Lee, Injeoung Choi, Sei Hyun Baik
    Diabetes & Metabolism Journal.2013; 37(4): 233.     CrossRef
  • Continuity of ambulatory care and health outcomes in adult patients with type 2 diabetes in Korea
    Jae-Seok Hong, Hee-Chung Kang
    Health Policy.2013; 109(2): 158.     CrossRef
  • Strategies for improvement of primary care in Korea
    Heui Sug Jo
    Journal of the Korean Medical Association.2012; 55(10): 959.     CrossRef
  • Factors associated with diabetes outpatient use of tertiary or general hospitals as their usual source of care in Korea
    Jung Chan Lee, Kye Hyun Kim, Han Nah Kim, Nam Soon Kim
    Journal of the Korean Medical Association.2012; 55(12): 1215.     CrossRef
  • Factors associated with the hypertension outpatients' choice of healthcare providers in Korea
    Jung Chan Lee, Kye Hyun Kim, Han Nah Kim, Yoon Hyung Park
    Journal of the Korean Medical Association.2011; 54(9): 961.     CrossRef
  • Analysis of the Continuity of Outpatient among Adult Patients with hypertension and its Influential Factors in Korea
    Kyung-Ae Son, Yoon-Shin Kim, Min-Hee Hong, Mi-As Jeong
    Journal of the Korea Academia-Industrial cooperation Society.2010; 11(6): 2161.     CrossRef
  • Continuity of Care for Elderly Patients with Diabetes Mellitus, Hypertension, Asthma, and Chronic Obstructive Pulmonary Disease in Korea
    Jae Seok Hong, Hee Chung Kang, Jaiyong Kim
    Journal of Korean Medical Science.2010; 25(9): 1259.     CrossRef
Current Status of Diabetic Foot in Korean Patients Using National Health Insurance Database.
Choon Hee Chung, Dae Jung Kim, Jaiyong Kim, Hyeyoung Kim, Hwayoung Kim, Kyung Wan Min, Seok Won Park, Jeong Hyun Park, Sei Hyun Baik, Hyun Shik Son, Chul Woo Ahn, Jee Young Oh, Sunhee Lee, Juneyoung Lee, Kyung Mook Choi, Injeoung Choi, Ie Byung Park
Korean Diabetes J. 2006;30(5):372-376.   Published online September 1, 2006
DOI: https://doi.org/10.4093/jkda.2006.30.5.372
  • 2,678 View
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AbstractAbstract PDF
BACKGROUND
Foot ulcer diseases are more prevalent in diabetic patients than that those of non-diabetic patients. Several reports showed the risk of amputation and the medical cost were increased when foot ulcer developed. Therefore, strict glycemic control from the initial period of diabetes is necessary. Since there is no enough epidemiologic data, large scaled studies for medical and economic consequences about diabetic foot ulcer are needed. METHODS: This study was based on health insurance claims submitted to the National Health Insurance Review Agency during the period from December 1994 through December 2002. We investigated the incidence and medical cost of foot disorders in Korean population using the disease-classification codes on the health insurance claim forms. RESULTS: The incidences of foot disorders (per 100,000 of population) were 49.7 for amputations, 99.7 for ulcers, and 1,051 for injuries in diabetic patients, and 4.2 for amputations, 10.3 for ulcers, and 943 for injuries in non-diabetic patients. Relative risk of the incidences of foot amputation, ulcer, and injury in diabetic patients comparing with non-diabetic patients were 11.7, 9.7, and 1.1, respectively. Total medical costs (per capita) of foot amputation, ulcer, and injury in diabetic patients were 2.0, 1.7, and 2.1 times higher, respectively, than those of non-diabetic patients. Mean hospital stay of foot amputation, ulcer, and injury in diabetic patients were 1.6, 1.3, and 1.7 times more, respectively, than those of non-diabetic patients. CONCLUSION: In diabetic patients, the incidences of foot amputation and ulcer are higher than those of non-diabetic patients. To reduce those incidences, we need to early strict glycemic control as well as government based management.

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  • Efficacy of a povidone‐iodine foam dressing (Betafoam) on diabetic foot ulcer
    Heui C. Gwak, Seung H. Han, Jinwoo Lee, Sejin Park, Ki‐Sun Sung, Hak‐Jun Kim, Dongil Chun, Kyungmin Lee, Jae‐Hoon Ahn, Kyunghee Kwak, Hyung‐Jin Chung
    International Wound Journal.2020; 17(1): 91.     CrossRef
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    Sung Hun Won, Jahyung Kim, Dong-Il Chun, Young Yi, Suyeon Park, Kwang-Young Jung, Gun-Hyun Park, Jaeho Cho
    Journal of Korean Foot and Ankle Society.2019; 23(3): 121.     CrossRef
  • Depth and combined infection is important predictor of lower extremity amputations in hospitalized diabetic foot ulcer patients
    Eun-Gyo Jeong, Sung Shim Cho, Sang-Hoon Lee, Kang-Min Lee, Seo-Kyung Woo, Yoongoo Kang, Jae-Seung Yun, Seon-Ah Cha, Yoon-Jung Kim, Yu-Bae Ahn, Seung-Hyun Ko, Jung-Min Lee
    The Korean Journal of Internal Medicine.2018; 33(5): 952.     CrossRef
  • Risk factors for diabetic foot ulcer recurrence: A prospective 2-year follow-up study in Egypt
    Walaa A. Khalifa
    The Foot.2018; 35: 11.     CrossRef
  • Microbiology and Antimicrobial Therapy for Diabetic Foot Infections
    Ki Tae Kwon, David G. Armstrong
    Infection & Chemotherapy.2018; 50(1): 11.     CrossRef
  • Diagnosis and Management of Diabetic Foot
    Chang Won Lee
    The Journal of Korean Diabetes.2018; 19(3): 168.     CrossRef
  • Effects of foot complications in patients with Type 2 diabetes mellitus on public healthcare: An analysis based on the Korea National Diabetes Program Cohort
    So Young Park, Sang Youl Rhee, Suk Chon, Kyu Jeung Ahn, Sung-Hoon Kim, Sei Hyun Baik, Yongsoo Park, Moon Suk Nam, Kwan Woo Lee, Jeong-taek Woo, Ki Hong Chun, Young Seol Kim
    Journal of Diabetes and its Complications.2017; 31(2): 375.     CrossRef
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    Jae-Ik Bae, Je Hwan Won, Jun Su Kim, Man Deuk Kim, Chang Jin Yoon, Yun Ku Cho
    Journal of the Korean Society of Radiology.2016; 74(3): 169.     CrossRef
  • Lifestyle, Diet, Self-care, and Diabetes Fatalism of Diabetic Patients with and without Diabetic Foot
    Jungha Choi, Juhee Kang, Hongmie Lee
    Korean Journal of Community Nutrition.2014; 19(3): 241.     CrossRef
  • The Quality of Medical Care Provided to Homeless Diabetes Patients in a General Hospital in Seoul, and the Prevalence of Diabetes Comorbidities
    Sun Hee Beom, Moo Kyung Oh, Chul Woo Ahn
    Korean Journal of Medicine.2014; 86(5): 585.     CrossRef
  • Advanced Glycation End Products and Management of Diabetes Diet
    Hyun-Sun Lee
    The Journal of Korean Diabetes.2013; 14(2): 90.     CrossRef
  • Cost-effectiveness Analysis of Home Care Services for Patients with Diabetic Foot
    Chong Rye Song, Yong Soon Kim, Jin Hyun Kim
    Journal of Korean Academy of Nursing Administration.2013; 19(4): 437.     CrossRef
  • Diabetes Epidemics in Korea: Reappraise Nationwide Survey of Diabetes "Diabetes in Korea 2007"
    Ie Byung Park, Jaiyong Kim, Dae Jung Kim, Choon Hee Chung, Jee-Young Oh, Seok Won Park, Juneyoung Lee, Kyung Mook Choi, Kyung Wan Min, Jeong Hyun Park, Hyun Shik Son, Chul Woo Ahn, Hwayoung Kim, Sunhee Lee, Im Bong Lee, Injeoung Choi, Sei Hyun Baik
    Diabetes & Metabolism Journal.2013; 37(4): 233.     CrossRef
  • Treatment of Diabetic Foot Ulcer Using Matriderm In Comparison with a Skin Graft
    Hyojin Jeon, Junhyung Kim, Hyeonjung Yeo, Hoijoon Jeong, Daegu Son, Kihwan Han
    Archives of Plastic Surgery.2013; 40(04): 403.     CrossRef
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    Nam Soo Han, Hyung-Cheol Park
    Korean Journal of Otorhinolaryngology-Head and Neck Surgery.2013; 56(9): 588.     CrossRef
  • Diabetic Foot: Past and Present
    Ji Ho Lee, Choon Hee Chung
    Journal of Korean Diabetes.2011; 12(2): 69.     CrossRef
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    Kyu Jeung Ahn
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Current Status of Aspirin User in Korean Diabetic Patients Using Korean Health Insurance Database.
Ie Byung Park, Dae Jung Kim, Jaiyong Kim, Hyeyoung Kim, Hwayoung Kim, Kyung Wan Min, Seok Won Park, Jeong Hyun Park, Sei Hyun Baik, Hyun Shik Son, Chul Woo Ahn, Jee Young Oh, Sunhee Lee, Juneyoung Lee, Choon Hee Chung, Injeoung Choi, Kyung Mook Choi
Korean Diabetes J. 2006;30(5):363-371.   Published online September 1, 2006
DOI: https://doi.org/10.4093/jkda.2006.30.5.363
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AbstractAbstract PDF
AIMS: ADA guidelines recommend aspirin for all patients with diabetes who have had a prior CHD events as well as a primary prevention strategy among those with at least one other risk factor. We examined the current status of regular aspirin intake among Korean adults who diagnosed as diabetes. METHODS: This study examined the characteristics of aspirin user in new-onset diabetes over 40 years based on health insurance claims submitted to the Health Insurance Review Agency (HIRA) of Korea during the period from January 2001 through December 2003. New onset diabetes defined as the first health insurance claim of antidiabetic drugs submitted to HIRA for the three months (January to March 2001) that never submitted for previous 6 years. RESULTS: The number of total new-onset diabetic patients was 30,014 in 2001, 29,819 in 2002, and 32,061 in 2003. The incidence rate of diabetes over 40 years for 3 months in 2001, 2002 and 2003 were 0.172%, 0.167% and 0.18. Mean age of women who diagnosed diabetes were significant higher than that of men in 2001 (women 59.2+/-10.6 yrs, men 54.8+/-9.8 yrs), in 2002 (women 59.5+/-10.6 yrs, men 54.6+/-9.3 yrs) and in 2003 (women 59.6+/-10.7 yrs, men 54.7+/-9.9 yrs) (p < 0.001). The number of aspirin user increased from 2,065 (6.9%) in 2001, 2,638 (8.9%) in 2002 and 3,711 (11.6%) in 2003. 30.5% of new-onset diabetics in 2001 had hypertension, 12.4% of them had hypercholesterolemia, 11.8% of them had cerebral infarct, 2.6% of them had cerebral hemorrhage, 3.8% of them had coronary heart disease and, but, 55.6% of them had not any CVD. Logistic regression analysis using aspirin use as a dependent variable showed that the number of aspirin use in patients with hypertension, hypercholesterolemia, cerebral infarct and coronary heart disease was higher than in patients without those (hypertension [OR], 3.89 (95% CI, 3.52~4.31); hypercholesterolemia [OR], 2.16 (95% CI, 1.90~2.46; cerebral infarct [OR], 2.05 (95% CI, 1.82~2.30); coronary heart disease [OR], 9.41 (95% CI, 8.20~10.80), respectively). Coronary heart disease was the most important associated factor of aspirin use. CONCLUSIONS: We found significant underuse of aspirin therapy among our population compared with that of America. Major efforts are needed to increase aspirin use in diabetic patients.

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  • Evaluation of low-dose aspirin for primary prevention of ischemic stroke among patients with diabetes: a retrospective cohort study
    Ye-Jee Kim, Nam-Kyong Choi, Mi-Sook Kim, Joongyub Lee, Yoosoo Chang, Jong-Mi Seong, Sun-Young Jung, Ju-Young Shin, Ji-Eun Park, Byung-Joo Park
    Diabetology & Metabolic Syndrome.2015;[Epub]     CrossRef
  • Current Status of Prescription in Type 2 Diabetic Patients from General Hospitals in Busan
    Ji Hye Suk, Chang Won Lee, Sung Pyo Son, Min Cheol Kim, Jun Hyeob Ahn, Kwang Jae Lee, Ja Young Park, Sun Hye Shin, Min Jeong Kwon, Sang Soo Kim, Bo Hyun Kim, Soon Hee Lee, Jeong Hyun Park, In Joo Kim
    Diabetes & Metabolism Journal.2014; 38(3): 230.     CrossRef
  • Epidural Hematoma Related with Low-Dose Aspirin : Complete Recovery without Surgical Treatment
    Kyoung-Tae Kim, Dae-Chul Cho, Suk-Won Ahn, Suk-Hyung Kang
    Journal of Korean Neurosurgical Society.2012; 51(5): 308.     CrossRef
  • The Prevalence and Features of Korean Gout Patients Using the National Health Insurance Corporation Database
    Chan Hee Lee, Na Young Sung
    Journal of Rheumatic Diseases.2011; 18(2): 94.     CrossRef
  • Overlapping Medication Associated with Healthcare Switching among Korean Elderly Diabetic Patients
    Ju-Young Shin, Nam-Kyong Choi, Sun-Young Jung, Ye-Jee Kim, Jong-Mi Seong, Byung-Joo Park
    Journal of Korean Medical Science.2011; 26(11): 1461.     CrossRef
  • Cause-of-Death Trends for Diabetes Mellitus over 10 Years
    Su Kyung Park, Mi-Kyoung Park, Ji Hye Suk, Mi Kyung Kim, Yong Ki Kim, In Ju Kim, Yang Ho Kang, Kwang Jae Lee, Hyun Seung Lee, Chang Won Lee, Bo Hyun Kim, Kyung Il Lee, Mi Kyoung Kim, Duk Kyu Kim
    Korean Diabetes Journal.2009; 33(1): 65.     CrossRef
  • The Current Status of Type 2 Diabetes Management at a University Hospital
    Young Sil Lee
    Korean Diabetes Journal.2009; 33(3): 241.     CrossRef
Current Status of Diabetic End-Stage Renal Disease Using Korean Health Insurance Database.
Dae Jung Kim, Jaiyong Kim, Hyeyoung Kim, Kyung Wan Min, Seok Won Park, Ie Byung Park, Jeong Hyun Park, Sei Hyun Baik, Hyun Shik Son, Chul Woo Ahn, Jee Young Oh, Sunhee Lee, Juneyoung Lee, Choon Hee Chung, Kyung Mook Choi, Injeoung Choi, Hwayoung Kim
Korean Diabetes J. 2006;30(5):355-362.   Published online September 1, 2006
DOI: https://doi.org/10.4093/jkda.2006.30.5.355
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AbstractAbstract PDF
BACKGROUND
Diabetes is becoming one of the main causes of end-stage renal disease (ESRD) worldwide. We studied the prevalence and incidence of end-stage renal disease (ESRD) in the Korean population based on health insurance claims submitted to the Health Insurance Review Agency. We also investigated the proportion of medications taken by the ESRD patients, and frequency of hospital admission or visits, and medical expenses between ESRD patients with and without diabetes. METHODS: This study was based on health insurance claims submitted to the Health Insurance Review Agency during the period from January 2001 through December 2003. Using the disease-classification codes on the health insurance claim forms, those who were diagnosed with chronic renal disease (N18 or N19) and received dialysis-related treatment (Z49), treatment with a kidney dialysis machine (Z99.2), or kidney transplantation (Z94.0) were defined as ESRD patients. Among the ESRD patients, those who were diagnosed with diabetes (E10-E14) and/or took anti-diabetic drugs were defined as ESRD patients with diabetes. RESULTS: The ESRD patients totaled 33,870 in 2001, 37,894 in 2002, and 41,167 (858.3 per million population) in 2003. ESRD patients with diabetes increased to 56.7% in 2003. The number of ESRD patients in whom renal replacement therapy was initiated was 8,134 in 2002 and 8,322 (173.5 per million population) in 2003. ESRD patients with diabetes used more anti-hypertensive drugs (1.2 times as many), lipid-lowering drugs (1.6 times), and anti-platelet agents (1.8 times) than did ESRD patients without diabetes. In 2003, 66.5% of the ESRD patients with diabetes were hospitalized, which was 1.6 times the hospital admissions of ESRD patients without diabetes. ESRD patients with diabetes also had hospital stays that were 1.6 times longer per patient and inpatient service expenses that were 1.6times greater per patient, compared with those reported for ESRD patients without diabetes. CONCLUSION: The incidence of ESRD accompanied by diabetes has risen rapidly. Given the burden of medical treatment costs placed on ESRD patients with diabetes, more aggressive interventions should be implemented to prevent diabetes and renal complications among patients with diabetes.

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  • Health-Related Quality of Life Based on Comorbidities Among Patients with End-Stage Renal Disease
    Jieun Cha, Dallong Han
    Osong Public Health and Research Perspectives.2020; 11(4): 194.     CrossRef
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    Hwa Jeong Seo
    Journal of Health Informatics and Statistics.2020; 45(4): 356.     CrossRef
  • The Impact of Physical, Psychological, Social Factors on Illness Burden of Long-term Hemodialysis Patients in South Korea
    Jieun Cha
    Journal of Health Informatics and Statistics.2018; 43(3): 159.     CrossRef
  • Effect of diabetic case management intervention on health service utilization in Korea
    Soon Ae Shin, Hyeongsu Kim, Kunsei Lee, Vivian Lin, George Liu
    International Journal of Nursing Practice.2015; 21(6): 780.     CrossRef
  • The Quality of Medical Care Provided to Homeless Diabetes Patients in a General Hospital in Seoul, and the Prevalence of Diabetes Comorbidities
    Sun Hee Beom, Moo Kyung Oh, Chul Woo Ahn
    Korean Journal of Medicine.2014; 86(5): 585.     CrossRef
  • Diabetes Epidemics in Korea: Reappraise Nationwide Survey of Diabetes "Diabetes in Korea 2007"
    Ie Byung Park, Jaiyong Kim, Dae Jung Kim, Choon Hee Chung, Jee-Young Oh, Seok Won Park, Juneyoung Lee, Kyung Mook Choi, Kyung Wan Min, Jeong Hyun Park, Hyun Shik Son, Chul Woo Ahn, Hwayoung Kim, Sunhee Lee, Im Bong Lee, Injeoung Choi, Sei Hyun Baik
    Diabetes & Metabolism Journal.2013; 37(4): 233.     CrossRef
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    Hye Soo Kim, Suk Young Kim
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Efficacy Evaluation of Atorvastatin in Korean Hyperlipidemic Patients with Type 2 Diabetes Mellitus.
Dong Seop Choi, Duk Kyu Kim, Doo Man Kim, Seong Yeon Kim, Moon Suk Nam, Yong Soo Park, Ho Sang Shon, Chul Woo Ahn, Kwan Woo Lee, Ki Up Lee, Moon Kyu Lee, Choon Hee Chung, Bong Yeon Cha
Korean Diabetes J. 2006;30(4):292-302.   Published online July 1, 2006
DOI: https://doi.org/10.4093/jkda.2006.30.4.292
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AbstractAbstract PDF
BACKGROUND
NCEP ATP III Guideline recommends aggressive treatments of diabetic dyslipidemia, recognizing diabetes mellitus as CHD risk equivalents. This study was conducted to evaluate the effectiveness and safety of atorvastatin in hyperlipidemic patients with Type 2 diabetes mellitus through post-marketing drug use investigation of atorvastatin. METHODS: An open, multi-center, non-comparison, titrated dosage study was conducted in hyperlipidemic patients, who were treated with atorvastatin at first visiting hospitals from Mar. 2004 to Sep. 2004. 96 endocrinologists participated from 66 centers in this study. Total 2,182 hyperlipidemic patients were enrolled and 1,514 patients among them were accompanied by diabetes mellitus. Efficacy was evaluated at later than 4-week treatment by % change of total cholesterol, triglycerides, HDL-cholesterol and LDL-cholesterol from baseline. Percent of patients reaching LDL-cholesterol level less than 100 mg/dL was also analyzed. The adverse events incidence and abnormalities of clinical laboratory values were evaluated for safety monitoring. RESULTS: Total cholesterol, triglycerides, and LDL-cholesterol level were reduced by 26.6%, 12.0%, and 34.8%, respectively, in diabetic hyperlipidemic patients after atorvastatin treatment. The patients with LDL-cholesterol level of less than 100 mg/dL were increased from 2.8% to 52.6%. Atorvastatin was considered to be safe because adverse drug reactions were reported in 32 patients (1.5%) of total 2,182 patients. CONCLUSION: Atorvastatin was effective and safe in hyperlipidemic patients with type 2 diabetes mellitus.

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  • Response: A Retrospective Study on the Efficacy of a Ten-Milligram Dosage of Atorvastatin for Treatment of Hypercholesterolemia in Type 2 Diabetes Mellitus Patients (Korean Diabetes J 2010;34:359-67)
    Dong Kyun Kim, Sa Rah Lee, Min Sik Kim, Suk Hyang Bae, Jin Yeon Hwang, Jung-Min Kim, Sung Hwan Suh, Hye-Jeong Lee, Mi Kyoung Park, Duk Kyu Kim
    Diabetes & Metabolism Journal.2011; 35(1): 88.     CrossRef
  • A Retrospective Study on the Efficacy of a Ten-Milligram Dosage of Atorvastatin for Treatment of Hypercholesterolemia in Type 2 Diabetes Mellitus Patients
    Dong Kyun Kim, Sa Rah Lee, Min Sik Kim, Suk Hyang Bae, Jin Yeon Hwang, Jung-Min Kim, Sung Hwan Suh, Hye-Jeong Lee, Mi Kyoung Park, Duk Kyu Kim
    Korean Diabetes Journal.2010; 34(6): 359.     CrossRef
  • The Association of Plasma HDL-Cholesterol Level with Cardiovascular Disease Related Factors in Korean Type 2 Diabetic Patients
    Hye Sook Hong, Jong Suk Park, Han Kyoung Ryu, Wha Young Kim
    Korean Diabetes Journal.2008; 32(3): 215.     CrossRef
Association Between Impaired Vascular Endothelial Function and High Sensitivity C-reactive Protein, a Chronic Inflammatory Marker, in Patients with Type 2 Diabetes Mellitus.
Jang Yel Shin, Mi Young Lee, Jang Hyun Koh, Jang Young Kim, Young Goo Shin, Choon Hee Chung
Korean Diabetes J. 2005;29(5):469-478.   Published online September 1, 2005
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AbstractAbstract PDF
BACKGOUND: Eighty percents of diabetes-related mortalities are due to atherosclerotic vascular complications. The accelerated atherosclerosis in type 2 diabetic patients is partly due to the increased incidences of cardiovascular risk factors, such as hypertension, obesity, dyslipidemia, insulin resistance and oxidative stress. Endothelial dysfunction is known as an early marker of cardiovascular disease and a predictor of cardiovascular events. The flow mediated dilation (FMD) of the brachial artery has been documented as being reduced in type 2 diabetic patients. Inflammatory markers, such as C-reactive protein(CRP) and interleukin-6(IL-6), are associated with the risk of cardiovascular disease. Endothelial dysfunction has a direct correlation with the levels of CRP, which are elevated in patients with diabetes compared with non-diabetic subjects. In this study, the FMD in diabetic and non-diabetic subjects were compared, and the association of cardiovascular risk factors and endothelial function examined in type 2 diabetic patients. METHODS: 57 consecutive diabetic subjects and 29 non-diabetic subjects, aged 35 to 69(54.0+/-1.0 years), without proven macrovascular complications, were enrolled in this study. Cardiovascular risk factors, such as body weight, height, waist and hip circumference, fasting plasma glucose and insulin levels, lipid profiles, inflammatory and coagulation markers were measured. The FMD of the brachial artery and the intima-media thickness(IMT) of the carotid artery were determined using high-resolution B-mode ultrasound. RESULTS: The FMD values were significantly lower in the diabetic compared with the non-diabetic subjects(7.6+/-0.2% vs. 8.9+/-0.4%, P=0.004). The homocysteine levels were significantly higher in the diabetic than non-diabetic subjects(12.4+/-0.4micromol/L vs. 9.5+/-0.6micromol/L, P<0.0001). In diabetic subjects, the FMD was shown to be significantly negatively correlated with high sensitivity C-reactive protein(hsCRP)(P=0.006), fibrinogen(P=0.024) and homocysteine (P=0.038). A multiple regression analysis, after adjusted for age, sex, body mass index(BMI), hypertension, and smoking, showed that hsCRP(beta=-0.424, P=0.002) and fibrinogen(beta=-0.324, P=0.025) had significant inverse association with the FMD in diabetic subjects. CONCLUSION: Diabetic subjects have an impaired endothelial function compared with the non-diabetic subjects, and the vascular endothelial function has a significant negative correlation with hsCRP and fibrinogen. These findings suggest that hsCRP might be an independent predictor of endothelial dysfunction and atherosclerosis, and chronic inflammation might play a pivotal role in the impairment of the endothelial function in diabetic patients.
Effect of Pinitol on Glucose Metabolism and Adipocytokines in Uncontrolled Type 2 Diabetes Mellitus.
Mi Jin Kim, Kwang Ha Yoo, Hyung Suk Park, Sang Man Chung, Choon Jo Chin, Young Sook Choi, Choon Hee Chung
Korean Diabetes J. 2005;29(4):344-351.   Published online July 1, 2005
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AbstractAbstract PDF
BACKGROUND
Pinitol(3-O-methyl-D-chiro-inositol) has been identified in putative insulin mediator fractions possessing hypoglycemic activity, and appears to act downstream in the insulin-signaling pathway to mimic the effects of insulin. We evaluated the effect of pinitol therapy in type 2 diabetic patients who were poorly controlled with hypoglycemic drugs such as sulfonylurea, metformin and/or insulin. METHODS: Twenty type 2 diabetic patients were enrolled in this our study. The fasting glucose and c-peptide, total cholesterol, triglyceride, HDL-and LDL-cholesterols were checked before and after treatment with 20mg.kg(-1).day(-1) pinitol for twelve weeks. All subjects continued their current medications during the study. Adipocytokines, such as adiponectin, leptin, free fatty acid and CRP, were checked before and after the pinitol treatment. RESULTS: After the pinitol treatment, the fasting and post-prandial glucose levels and hemoglobin A1c were significantly decreased(P<0.05). The fasting serum adiponectin, leptin, free fatty acid and CRP levels remained unchanged after the pinitol treatment. In the non-responder groups, the serum c-peptide levels were higher than those in the responder groups. CONCLUSION: Twelve weeks of pinitol treatment altered glucose metabolism, but not the lipid profiles or adipocytokine levels. Additional research will be required are needed to define the physiological and potential therapeutic effects of pinitol.
Self-Management and Health-Related Quality of Life in Adolescent and Adulthood Diabetic Patients.
Bong Suk Park, Gi Nam Jin, Youn Chung Choi, Ji Hee Chung, Kyoung Hoe Kim, Mi Young Lee, Jang Hyun Koh, Choon Hee Chung
Korean Diabetes J. 2005;29(3):254-261.   Published online May 1, 2005
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AbstractAbstract PDF
BACKGROUND
The purposes of this study are to analyze the factors that influence selfmanagement and health-related QOL, and to provide useful informations to improve the QOL in adolescent and adult diabetic patients. METHODS: For this study, we interviewed 126 adolescent and adult diabetic patients who visited the Yonsei University Wonju Christian Hospital from March 4th, 2004 to April 5th, 2004. RESULTS: We examined the relationship between the socio-demographic characteristics and the health-related quality of life(QOL). There were statistically significant relationships between the QOL-and employment, years of education, income level and marriage status, but not between the health-related QOL and age and gender. Furthermore, there were no statistically significant relationships between the health-related QOL and smoking or drinking, nor between type 1 and 2 diabetic patients. The health-related QOL was significantly higher for an increased diabetes duration and for a greater number of symptoms, but the QOL was significantly lower in the presence of complications and hospital admission. The health-related QOL was lower when the preprandial blood glucose levels and HbA1c concentrations were higher, but it was higher when the hemoglobin and hematocrit levels were higher. Regarding the treatment methods, the health-related QOL was significantly lower for those patients who took insulin injection. The QOL was higher when the general self-management and diet therapy were well-controlled. Meanwhile, those subjects who had obtained medical informations from doctors, the media(including the internet and TV) and nurses in that order, they selected diet therapy as the hardest factor in the management of their diabetes. CONCLUSION: Adolescent and adult diabetic patients need continuous education and assistance to improve their health-related QOL and to keep from developing complications
Development of Diabetes Mellitus in Married Couples According to Environmental Factors.
Yong Mi Lee, Hyon Ju Yon, Yeon Lee, Byoung Jun Lee, Jang Hyun Koh, Choon Hee Chung
Korean Diabetes J. 2005;29(2):133-139.   Published online March 1, 2005
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AbstractAbstract PDF
BACKGROUND
The prevalence of diabetes has been rapidly increasing on a global scale. Genetic factors are important in the development of type 2 diabetes, but this alone cannot explain the rapid increase. Environmental factors are also known to have a major influence on the development of diabetes. This is especially common in those couples with a diabetic spouse, as both the people tend to share the same environmental factors such as nutrition, lifestyle and physical activity. This study intends to examine what environmental factors affect the development of diabetes mellitus in a healthy couple. METHODS: This study examined 21 couples where both people were diabetic and 20 couples where only one of the spouses was diabetic. Among the 21 diabetic couples, 12 males and 9 females became diabetic later than their spouses. Among the control group couples, 10 males and 10 females spouses didn't have diabetes. Both groups underwent basic checkups including measuring their height, weight, body fat, waist hip circumference, the difference in weight change after getting married, blood pressure and pulse rates. We also measured fasting glucose levels, cholesterol levels, total daily calorie intake and physical activity. RESULTS: In the comparison of the two groups, the patient group had a higher calorie consumption than control group(patient group: 1859.04+/-269.46kcal, vs. the control group: 1605.95+/-301.34 kcal, P<0.05). CONCLUSION: This study suggest that high calorie consumption could be an important factor in the development of a couple's diabetes
Effect of Peroxisome Proliferator Activated Receptor-gamma Agonist, Angiotensin II Receptor Blocker and alpha-lipoic Acid on Renal VEGF Expression in Diabetic Nephropathy.
Jang Hyun Koh, Yeon Lee, Mi Jin Kim, Young Goo Shin, Eun Young Lee, Choon Hee Chung
Korean Diabetes J. 2004;28(5):367-376.   Published online October 1, 2004
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BACKGROUND
Diabetic nephropathy is one of the most serious complications in diabetes mellitus, and it is the leading cause of end stage renal disease. It has been reported that angiotensin converting enzyme inhibitor (ACEi) reduces the vascular endothelial growth factor (VEGF) expression, and so it plays an important role in reducing the renal damage. Peroxisome proliferator activated receptor-gamma (PPAR-gamma) agonist is known to reduce insulin resistance in type 2 diabetic patients. In the previous study, PPAR-gamma agonist was shown to lower VEGF expression in the retina, but it increased the plasma VEGF level. Alpha-lipoic acid (alpha-LA), which is an antioxidant, lowers the increased level of VEGF in retina as well. The precise role of PPAR-gamma agonist and alpha-LA on renal VEGF expression in diabetic nephropathy is still uncertain. We studied the effect of PPAR-gamma agonist, angiotensin II receptor blocker (ATIIRB) and alpha-LA on the renal VEGF expression in diabetic rats. METHODS: We used 60 Sprague-Dawley male rats, those were 8 weeks old and weighted about 300 g each as the study subjects. Among them, 48 rats were chosen and injected with streptozotocin (70 mg/kg) into peritoneal cavity to induce diabetes mellitus. The rast were than divided into 5 groups. Group I was a normal control group (n=12), group II was diabetic control group (n=12), group III was diabetic group that was given with PPAR-gamma agonist (n=12), group IV was the diabetic group that was given ATIIRB (n=12), and group V was the diabetic rats that were given alpha-LA (n=12). We measured their body weight, blood glucose levels, 24 hour urine protein and albumin levels at the baseline, the 8th and the 16th weeks of the experiment. On the 16th weeks of our experiment we extracted the kidneys to measure the glomerular volume, the optical density of the VEGF staining and VEGF mRNA expression. RESULTS: At the beginning of the study, the 5 groups all showed similar 24 hour urine albumin levels. At the 8th week, group II showed an increased urine albumin level of 143.4 +/- 117.2 mg/day; this was greater than that of group IV (60.7+/-30.6 mg/day) (p<0.05). The glomerular volume and optical densities of VEGF expression were significantly reduced in group III, IV and V compared to group II. For group IV and V, the renal VEGF mRNA expression was significantly lower than that of group II, but group III showed no significant difference. from group II. CONCLUSION: Angiotensin II receptor blocker delayed the progression of diabetic nephropathy. PPAR-gamma agonist and alpha-lipoic acid did not have any protective effect against the progression of diabetic nephropathy in spite of the decreased VEGF expression noted in this study.
Mechanism of Podocyte Injury in Diabetic Nephropathy.
Eun Young Lee, Jae sook Song, Choon Hee Chung, Sae Yong Hong
Korean Diabetes J. 2003;27(4):343-351.   Published online August 1, 2003
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BACKGROUND
Since podocytes are involved in the maintenance of filtration barrier and normal structure in the kidney, podocyte injury can cause the disturbance of glomerular permselectivity and resultant proteinuria, and recent evidence shows that podocyte injury is associated with oxidative stress. However, the pathogenetic mechanism of podocyte injury in the development of diabetic nephropathy is not known. Thus, the present study examined the effect of high glucose level on cytoskeleton, slit diaphragm, podocyte-glomerular basement membrane interaction, and oxidative stress in cultured podocytes. METHODS: Differentiated cultured podocytes were used in this study. Quiescent cells were incubated with culture media containing 30 mM glucose for 48 hours. The amounts of integrin alpha3, vinculin, zona occludens (ZO)-1 and fibronectin protein expressed by podocytes were measured by Western blot analysis. Dichlorofluorescein diacetate-sensitive intracellular reactive oxygen species (ROS) were observed by confocal microscope and quantified by quantification software. Thiobarbituric acid reactive substances were also measured. Podocytes incubated with culture media containing 5.6 mM glucose were used as control. RESULTS: Integrin alpha3 expression was significantly decreased in podocytes cultured under high glucose level compared to control. However, vinculin and ZO-1 expressions were significantly increased in podocytes cultured under high glucose level compared to control. Fibronectin protein secreted by podocytes was also increased in podocytes cultured under high glucose level compared to control. ROS and thiobarbituric acid reactive substances in podocytes were also increased in high glucose medium compared to control. CONCLUSION: High glucose-induced oxidative stress and the changes of integrin a3, ZO-1 and vinculin lead to the alterations of cytoskeleton, intercellular or cell-matrix interactions. This podocyte injury may play a major role in the disturbance of the urinary filtration barrier and the development of proteinuria. These results confirmed the important role of podocyte injury in the development of diabetic nephropathy.
Plasma Adiponectin Concentration and Insulin Resistance in Type 2 Diabetes.
Mi Jin Kim, Yoen Lee, Byon Jun Lee, Jai Ho Yoen, Sang Youl Shin, Young Goo Shin, Choon Hee Chung
Korean Diabetes J. 2003;27(3):260-271.   Published online June 1, 2003
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BACKGROUND
Insulin resistance, which implies impairment of insulin signaling in target tissues, is a common cause of type 2 diabetes. Adipose tissue plays an important role in insulin resistance through the dysregulated production and secretion of adipose-derived proteins, including tumor necrosis factor- , plas- minogen activator inhibitor-1, leptin, resistin, angiotensinogen and adiponectin. Adiponectin has been estimated to be a protective adipocytokine against atherosclerosis and to have an anti-inflammatory effect. In this study, the relationship between the fasting plasma adiponectin concentration and the adiposity, body composition, insulin sensitivity (ITT, HOMA(IR), QUICK), lipid profile, fasting insulin concentration were examined in type 2 diabetes. The difference in the adiponectin concentrations of diabetic and non-diabetic subjects were also examined, with adjustment for sex, age and body mass index. METHODS: One hundred ans two type 2 diabetes and 50 controls were the subjects of this study. After a 12-h overnight fast, all subjects underwent a 75g oral glucose tolerance test. Baseline blood samples were drawn to determine the fasting plasma glucose, insulin, adiponectin, total cholesterol, triglyceride and the LDL- and HDL- cholesterol levels. The body composition was estimated by a bioelectric impedance analyzer (Inbody 2.0(r)) and the insulin sensitivity by an insulin tolerance test (ITT), HOMA(IR) and QUICKI method. RESULTS: In the diabetic group, the fasting adiponectin concentrations were higher in the women than the men. The fasting adiponectin concentrations were negatively correlated with the BMI (r=-0.453), hip circumference (r=-0.341), fasting glucose concentrations (r=-0.277) and HOMA(IR) (r=-0.233). In addition, they were positively correlated with the systolic blood pressure (r=0.321) and HDL-cholesterol (r=0.291). From a multiple logistic regression analysis the systolic blood pressure and HDL-cholesterol were found to be independent variables that influenced the adiponectin concentration. The adiponectin concentrations were significantly lowered in the diabetic than the non-diabetic group, with the exception of the obese male subjects. CONCLUSION: The plasma adiponectin concentrations were closely related to the insulin resistance parameters in type 2 diabetic patients.
Effect of Mouse Type and Human Type of CpG Oligonucleotide Vaccination on Development of Diabetes in NOD Mice.
Byong Jun Lee, Soo Kie Kim, Eon Sub Park, Hyun Jin Jang, Hyun Chul Cho, Myung Sook Shim, Mi Jin Kim, Young Goo Shin, Choon Hee Chung
Korean Diabetes J. 2002;26(6):451-459.   Published online December 1, 2002
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BACKGROUND
Type 1 diabetes is autoimmune disease and the modulation of immune system could offer breakthrough to the disease. Unmethylated CpG motifs and their oligoneucleotide are potent immunostimulators that can rebalance autoimmune mechanism. To explore DNA based immunotherapy in type 1 diabetes, we vaccinated different types (mouse and human) of CpG ODN to NOD mice. METHODS: Forty 5 week-old female NOD mice were injected with 100 L (10 g) of mouse type CpG ODN or human type CpG ODN or 0.9% normal saline on inguinal area subcutaneously. Seven, 14, and 28 days later we injected to mice same dose of mouse type CpG ODN or human type CpG ODN or normal saline. Blood glucose was measured and mice were sacrificed when they were diabetic. Pancreata and serum were earned from sacrificed NOD mice to evaluate insulitis and insulin immunoassay. RESULTS: Though the final cumulative incidences of diabetes were not significantly different among groups, the tendency of delaying and suppressing the development of diabetes was observed in the early period of vaccination group of CpG ODN. Especially, mouse type CpG ODN was more effective for rodent species than human type CpG ODN. CONCLUSION: This result suggests that immunomodulation therapy using species- specific CpG motif may have a potential to control autoimmune process as well as dissecting T cell milieu in NOD mice.
The Effect of Chronic Alcohol Intake on Insulin Secretion in NIDDM Rats.
Mi Jin Kim, Myoung Sook Shim, Mun Kyu Kim, Dong Gu Kang, Hyung Suk Park, Sang Man Chung, Tae Sun Hwang, Young Goo Shin, Choon Jo Chin, Choon Hee Chung
Korean Diabetes J. 2002;26(5):366-376.   Published online October 1, 2002
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BACKGROUND
The effect of alcohol on glucose metabolism is dependent on the daily amount of alcohol ingestion and the timing of intake. Heavy alcohol consumption in the fasting state may lead to serious hypoglycemia, whereas an excessive alcohol intake during meals may lead to hyperglycemia. In Korea, AIDDM (atypical insulin dependent diabetes mellitus) which shows firstly similar to the NIDDM and progresses slowly into IDDM is related to heavy alcohol drinking. So we studied that the effect of chronic alcohol intake on insulin secretion of beta cell in streptozotocin (STZ)-induced non-insulin dependent diabetic Sprangue- Dawley rats. METHODS: 40 male newborn (12 hours old) Sprague-Dawley rats were made diabetic by streptozotocin (50 mg/kg, intraperitoneal injection) and 20 male newborn (12 hours old) Sprague-Dawley rats were injected by citrate buffer solution. At 14 weeks old, diabetic group were confirmed by intraperitoneal glucose tolerance test (30% D/W, 2 g/kg). After that, diabetic group were divided into two groups. One group were fed on 5% ethanol and the other group were fed on water for 8 weeks. Control groups were divided into two groups. One group were fed on 5% ethanol and the other group were fed on water for 8 weeks. All rats were divided into 4 groups; group I: diabetic and 5% ethanol, group II: non- diabetic and 5% ethanol, group III: diabetic and water, group IV: non-diabetic and water. At the age of 22 weeks, we determined insulin level among 4 groups. After we extracted pancreas, determined the ratio of area of beta cell to islet cell. RESULTS: 1) There was no difference of weight among 4 groups in 22 week old rats. 2) Group I freely ingested 2.08g (5.50 g/kg/day) ethanol daily and group II ingested 2.04g (4.89g/kg/day) ethanol daily. 3) Plasma insulin levels of group I were lower than those of group III but not significant. 4) Plasma insulin levels of group II were higher than those of group IV but not significant. 5) In the light microscopic findings of pancreas, the ratios of area of beta cells to islet cells in group I were the lowest but not significant. CONCLUSION: These findings suggested that chronic moderate alcohol ingestion in NIDDM rats didn't impair insulin secretion and morphology of pancreatic beta cells.
Type 1 diabetes: autoimmune pathogenesis and its heterogeneity.
Choon Hee Chung
Korean Diabetes J. 2002;26(3):153-163.   Published online June 1, 2002
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No abstract available.
The Study of Alteration of Beta Cells in Pancreatic Islets, Glusoce Metabolism and Insulin Secretion in Low Dose Streptozotocin Indeced Type 2 Diabetic Rat Model.
Young Goo Shin, Hong Seung Kim, Mi Deok Lee, Young Uck Kim, Ho Suck Kang, Tae Sun Hwang, Choon Hee Chung
Korean Diabetes J. 1999;23(3):256-268.   Published online January 1, 2001
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BACKGROUND
Korean diabetes is different from western diabetes due to the racial differences in genetic factors and susceptability. It has recently been suggested that thrifty phenotype hypothesis is related to the recent increase in prevalence of Korean diabetes, but we have little evidence about that. We obtained basic materials in the animal model of type 2 diabetes mellitus and conducted a morphologic study of the beta cell change, insulin secreting capacity, and glucose metabolism. METHODS: To obtain the reference data of a non-insulin dependent diabetic animal model, we performed the intraperitoneal glucose tolerance test (IPGTT), hyperinsulinemic euglycemic clamp and immunobistochemical staining on the sacrificed pancreatic tissues on a Sprague-Dawley male rat into which streptozotocin (STZ) had been injected during the early neonatal period. The study groups consisted of a normal control group with citrate buffer injection, a group with injection of 50 ug STZ per kg of weight and a group with injection of 75 ug STZ per kg of weight. STZ was injected within 12 hours after birth. RESULTS: l. Although, STZ injected groups had lower body weight than the control group 7 weeks after birth, there were no differences during 14 weeks. 2. The IPGTT results showed that the average level of whole blood glucose concentration of the group with 50 ug STZ per kg of weight was higher than that of the control group at 7 and 14 weeks after birth. The mean serum insulin concentration of the 75 ug STZ per kg of weight injected group was lower than that of the control group at 7 weeks after birth, but it was higher than that of the control group at 14 weeks. 3. The hyperinsulinemic euglycemic clamp study showed that the average level of peripheral glucose disposal rate of the STZ injected groups was lower than the control group, but there were no differences in the study groups. 4. Pancreatic islet showed decreased beta cell mass and increased beta cell size in the STZ injected groups but the BrdU labelling index was not different between the control and study groups. CONCLUSION: STZ injection into neonatal Sprague-Dawley male rats may result in a diabetic status due to both decreased insulin secretion and increased insulin resistance, which gives us useful reference data for type 2 diabetes mellitus in the animal model.
Plasma Proinsulin Levels among the Control, Impaired Glucose Tolerance and Type 2 Diabetes Mellitus during Oral Glucose Tolerance Test.
Mi Deok Lee, Young Uck Kim, Hong Seung Kim, Young Goo Shin, Choon Hee Chung
Korean Diabetes J. 1999;23(2):147-154.   Published online January 1, 2001
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BACKGROUND
Increased secretion of proinsulin has been associated with beta-cell dysfunction. Hyper-proinsulinemia is suggested to be a predictor for the progression of IGT to type 2 DM. In this study, we compared the concentration of insulin, C-peptide and proinsulin levels among the control group, IGT and type 2 DM group during the oral glucose tolerance test. We investigated whether hyperproinsulinemia was an effective predictor of beta-cell impairment befre the clinical onset of type 2 diabetic subjects. METHODS: We studied proinsulin, insulin(using an assay that display appreciable cross-reactivity with proinsulin) and proinsulin:insulin ratio during the oral glucose tolerance test in 14 controls, 20 IGT and 20 type 2 DM. We also compared proinsulin, proinsulin response areas and proinsulin:insulin ratio among the three groups. RESULTS: There were no significant differences in the baseline and 30min proinsulin levels among three groups. However, proinsulin response areas in IGT were higher than those in other groups. Baseline proinsulin/insulin ratio and post-load proinsulin/ insulin ratio were not significantly different among the three groups. In IGT group, the proinsulin response after glucose loading was rapidly increased, but was blunted in diabetic patients. CONCLUSION: We suggest that pancreatic beta cell dysfunction was ongoing before the clinical onset of DM and hyperproinsulinemia, especially the proinsulin response areas during oral GTT may be a predictor for the development of type 2 DM.
Estimation of Cut-off Point of Fasting Blood Glucose Predicting Pancreaticbeta-cell Decompensation During Oral Glucose Tolerance Test.
Mi Deok Lee, Hong Seung Kim, Young Uk Kim, Young Goo Shin, Chang Ho Song, Young Jun Won, Choon Hee Chung
Korean Diabetes J. 1998;22(4):513-521.   Published online January 1, 2001
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BACKGROUND
The secretory dysfunction of pancreatic B-cell is one of the important in the pathogenesis of NIDDM. And the conversion from IGT to DM is developed by the exhaustion and decompensation of 0-cell. So our purp was estimating the cut-off point of fasting blood sugar predicting B-cell decompensation during OGTT. METHOD: The clinical characteristics and anthropometric parameters were determined in all subjects. 75 g ora] glucose tolerance tests were performed with serial blood sampling to measure plasma glucose levels, insulin and C-peptide levels. And we calcolated insulin response areas and C-peptide response areas. RESULTS: l) The basal C-peptide levels were elevated in IG1' and DM group. however, post-load 30min C-peptide and 30min insulin levels were significantly decreased in DM group compared with normal and IGl. 2) IGT group showed the highest C-peptide response areas among three groups. 3) The relationships between fasting plasma glucose, C-peptide & insulin levels showed that basal C-peptide level had turning point at 6.7 mmol/L of fastiing glucose, basal insulin level at 6.5 mmol/L, 30 min C-peptide at 6.2 mmol/1, 30 min insulin at 5.8 mmol/L and C-peptide response area at 7.0 mmol/L. Conclusion : Above result suggest that the fasting plasma glucose of 7.0 mmol/L may be the cut-off point of pancreatic B-cell decompensation.
Comparison of the New Diagnostic Criteria for Diabetes Mellitus Recommended by the Expert Committee of the American Diabetes Association with the Criteria by the NDDG or WHO in Koreans with Fasting Plasma Glucose between 110 and 139 mg / dL.
Yeo Joo Kim, Moon Suk Nam, Mi Rim Kim, Yong Seong Kim, Kwan Woo Lee, Hyeon Man Kim, Choon Hee Chung, Su Youn Nam, Bong Soo Cha, Kyung Rae Kim, Hyun Chul Lee, Sam Kweon, Yong Wook Cho, Kap Bum Huh
Korean Diabetes J. 1998;22(2):209-217.   Published online January 1, 2001
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BACKGROUND
The current diagnostic criteria for diabetes mellitus announced by National Diabetes Data Group(NDDG) in 1979 were revised by Expert Committee of World Health Organization(WHO) in both 1980 and 1985. However, according to advancement in the knowledge of the etiology and pathogenesis of diabetes mellitus, the International Expert Committee working under the sponsorship of the American Diabetes Association(ADA) decided to adopt the resolution proposing that the criteria of fasting glucose level applied to diagnosis of diabetes mellitus should be lowered at the 57 ADA conference held in Boston, USA in June 1997(97 ADA). Hereupon, by comparing the diagnostic criteria of the former (NDDG/WHO) with the later, the authors have examined the usefulness of new diaignostic criteria, 97 ADA. METHOD: We collected the data from 13 university hospitals in Korea which contain the results of 75 gram oral glucose tolerance test(OGTT) for 532 Kareans between 110 and 139 mg/dL in fasting plasma glucose. We have then evaluated the results by classifying and comparing them in accordance with the criteria of NDDG/WHO and 97 ADA, respectively. RESULTS: 1. The number which tested for oral glucose tolerance was 532 and the majority of tests have been carried out between 110 and 119 mg/dL in fasting plasma glucose. 2. When we have classified the same results of OGTT by respective diagnostic criteria of NDDG/ WHO and 97 ADA, the NDDG/WHO have diagnosed 50.4%(268/532) of the total number of people as diabetes mellitus, while the '97 ADA has shown that only 33.1%(176/532) of it corresponded to the same diagnosis. On the other hand, the diagnosis rate of impaired fasting glucose(IFG) or impaired glucose tolerance(IGT) has shown 28.8~ 31.8%(NDDG/ WHO) and 66.9%(97 ADA), respectively. 3. Following the diagnostic criteria of the 97 ADA, we have separated the results into two groups which were above and below 126 mg/dL in fasting glucose. In addition, when we have again classified two groups by the criteria of the NDDG/WHO, the group above 126mg/dL in fasting glucose, which was all diagnosed as diabetes mellitus in 97 ADA has represented a ratio of 72.2%(127/176) in same diagnosis. However, within the group below 126mg/ dL, in fasting glucose being classitied as IFG in the 97 ADA, its diagnosis rate of diabetes mellitus has also shown 39.7%(141/356) applying to the criteria of the NDDG/WHO. CONCLUSION: The criteria of the 97 ADA can simply make a diagnosis of diabetes mellitus with fasting plasma glucose and additionally fmd out the IFG whose rate is 17.9 20% regarded as a normal condition by NDDG/WHO, whereas the existing criteria of the NDDG/WHO have to carry out the OGTT which is difficult in clinics. However, since among the patients ot 50.4% diagnosed as diabetes mellitus by NDDG/WHO, the 97 ADA classifies 17.3% of them as IFG, it is regarded that the need of OGTT for the diagnosis of diabetes mellitus can not be passed over in the future.
Measurement of Anti-GAD antibody by EIA and RIA Methods in Korean Diabetic patients: Study for pathogenesis of slowly progressive IDDM.
Han Hyo Lee, Young Goo Shin, Hee Sun Kim, Chang Young Kim, Yon Soo Jeong, Hong Seung Kim, Deok Woo Park, Kap Jun Yoon, Choon Hee Chung
Korean Diabetes J. 1997;21(3):231-242.   Published online January 1, 2001
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background
Sometimes it is difficult to discriminate between IDDM and NIDDM among adults with DM. Some NIDDM patients have autaantibodies and follow the course of IDDM, We call them as slowly progressive IDDM(SPII)DM). Since anti-GAD (Glutamic acid decarboxylase') Ab can be detected both before and for a long pe.riod after the diagnosis of DM it is helpful for the diagnosis of autoimmune diabetes. METHODS: The subjects were 68 diabetic patients who were admitted at Wonju Christian Hospital from May 1994 to Feb 1996. We classified them as IDDM, NIDDM and SPIDDM. We analyzed the following: a studied basic clinical study, oral glucose tolerance test, HLA DR typing, IgM anti-viral Abs, ICA, IAA and nti-GAD Ab. RESULTS: In measurement of anti-GAD Ab, IRMA was more sensitive than EIA. Anti-GAD Ab prevalence was significantly higher in IDDM patients than in NIDDM patients. By IRMA method, Anti-GAD titers showed significant correlation among VELISA, HEXT, IRMA and RSR methods(p<0.001). CONCLUSION: As seen by the results above, the positivity of antiGAD Ab by EIA and RIA method was lower for Korean diabetic patients than for Caucasians. We suggest that the other mechanisms as well as autoimmunity may be involved in the pathogenesis of SPIDDM in Koreans. We need follow-up studies about the clinical and immunogenetic characteristics of these patients.
The relationship between renin-aldosterone system and obesity in non-insulin dependent diabetes mellitus(NIDDM).
Kwang Jin Ahn, Yoon Sok Chung, Choon Hee Chung, Eun Jig Lee, Sung Kil Lim, Kyung Rac Kim, Hyun Chul Lee, Kap Bum Huh
Korean Diabetes J. 1993;17(3):283-291.   Published online January 1, 2001
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No abstract available.
Effects of acipimox on lipid and glucose metabolism in NIDDM patients with concomitant hyperlipidemia.
Seog Won Park, Yoon Sok Chung, Hyun Seung Shin, Choon Hee Chung, Kwang Jin Ahn, Sung Kim Lim, Hyun Chul Lee, Kap Bum Huh
Korean Diabetes J. 1993;17(1):99-104.   Published online January 1, 2001
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No abstract available.
A follow-up study of diabetic retinopathy by fundus photography in diabetic patients.
Choon Hee Chung, Kwang Jin Ahn, Young Duk Song, Mi Rim Kim, Kawn Woo Lee, Seung Kil Lim, Kyung Rae Kim, Hyun Chul Lee, Kap Bum Huh, Seung Chul Lee, Oh Woong Kwon, Yong Wook Cho
Korean Diabetes J. 1991;15(1):91-101.   Published online January 1, 2001
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No abstract available.

Diabetes Metab J : Diabetes & Metabolism Journal