Diabetes & Metabolism Journal

Duk Kyu Kim (Kim DK)

10 Articles

Cause-of-Death Trends for Diabetes Mellitus over 10 Years (Korean Diabetes J 33(1):65-72, 2009).: Su Kyung Park, Duk Kyu Kim; Korean Diabetes J. 2009;33(2):166-166. Published online April 1, 2009; DOI: https://doi.org/10.4093/kdj.2009.33.2.166

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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 J. 2009;33(1):65-72. Published online February 1, 2009; DOI: https://doi.org/10.4093/kdj.2009.33.1.65

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BACKGROUND
Recently, diabetic mortality is lower than ever before, likely due to dramatic improvements in diabetes care. This study set to analyze changes in the cause of death in type 2 diabetes mellitus (T2DM) in the past 10 years. METHODS: All subjects were T2DM patients over the age of 30 whose death certificates were issued at six hospitals in the Busan metropolitan area from 2000 to 2004. The patients were excluded if they had been clinically diagnosed with significant tuberculosis, liver, thyroid, renal, connective tissue diseases and cancers, prior to T2DM diagnosis. We classified the cause of death into several groups by KCD-4. The results were compared with published data on the period from 1990 to 1994. RESULTS: The study comprised 680 patients, of which 374 (55.0%) were male. The average age of death was 66.3 +/- 10.7 years. The most common cause of death was cardiovascular disease (30.6%), followed by infectious disease (25.3%), cancer (21.9%), congestive heart failure (7.1%), renal disease (4.7%), liver disease (2.7%), and T2DM itself (1.9%). In the study from the earlier period, the most common cause of death was also cardiovascular disease (37.6%), followed by infectious disease (24.2%), T2DM (6.0%), liver disease (5.4%), cancer (4.7%), and renal disease (3.3%). CONCLUSION: Over both study periods, the first and second cause of death in T2DM were cardiovascular disease and infectious disease, respectively. However, death by cerebral infarction among cardiovascular disease patients was significantly lower in the latter period, while death by malignancy was markedly increased.

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The Socio-Economic Cost of Diabetes Mellitus in Korea Using National Health Insurance Claim Data, 2017
Heesun Kim, Eun-Jung Kim
Healthcare.2022; 10(9): 1601. CrossRef
Arterial stiffness is an independent predictor for risk of mortality in patients with type 2 diabetes mellitus: the REBOUND study
Jeong Mi Kim, Sang Soo Kim, In Joo Kim, Jong Ho Kim, Bo Hyun Kim, Mi Kyung Kim, Soon Hee Lee, Chang Won Lee, Min Chul Kim, Jun Hyeob Ahn, Jinmi Kim
Cardiovascular Diabetology.2020;[Epub] CrossRef
The Mentors, The Social Support and Patients with Diabetes Mellitus
Yu Jeong Park
The Journal of Korean Diabetes.2019; 20(2): 112. CrossRef
How to build nomogram for type 2 diabetes using a naïve Bayesian classifier technique
Jae-Cheol Park, Jea-Young Lee
Journal of Applied Statistics.2018; 45(16): 2999. CrossRef
Impact of change in job status on mortality for newly onset type II diabetes patients: 7 years follow-up using cohort data of National Health Insurance, Korea
Donggyo Shin, Ji Man Kim, Tinyami Erick Tandi, Eun-Cheol Park
Diabetes & Metabolic Syndrome: Clinical Research & Reviews.2016; 10(1): S1. CrossRef
Factors Associated with Poor Glycemic Control among Patients with Type 2 Diabetes Mellitus: The Fifth Korea National Health and Nutrition Examination Survey (2010-2012)
Jinhyun Park, Seungji Lim, Eunshil Yim, Youngdae Kim, Woojin Chung
Health Policy and Management.2016; 26(2): 125. CrossRef
Mortality and causes of death in a national sample of type 2 diabetic patients in Korea from 2002 to 2013
Yu Mi Kang, Ye-Jee Kim, Joong-Yeol Park, Woo Je Lee, Chang Hee Jung
Cardiovascular Diabetology.2016;[Epub] CrossRef
Development of Cell Phone Application for Blood Glucose Self-Monitoring Based on ISO/IEEE 11073 and HL7 CCD
Hyun Sang Park, Hune Cho, Hwa Sun Kim
Healthcare Informatics Research.2015; 21(2): 83. CrossRef
Cost-Utility Analysis of Screening Strategies for Diabetic Retinopathy in Korea
Sang-Won Kim, Gil-Won Kang
Journal of Korean Medical Science.2015; 30(12): 1723. CrossRef
Quality characteristics of brown rice boiled with medicinal herbs extract for diabetes prevention
Kyung-Mi Yang, Jung-Ran Park, Su-Jung Hwang
Korean Journal of Food Preservation.2014; 21(1): 55. CrossRef
Does Diabetes Mellitus Influence Standardized Uptake Values of Fluorodeoxyglucose Positron Emission Tomography in Colorectal Cancer?
Da Yeon Oh, Ji Won Kim, Seong-Joon Koh, Mingoo Kim, Ji Hoon Park, Su Yeon Cho, Byeong Gwan Kim, Kook Lae Lee, Jong Pil Im
Intestinal Research.2014; 12(2): 146. CrossRef
The Relationship between Metformin and Cancer in Patients with Type 2 Diabetes
Hyun Hee Chung, Jun Sung Moon, Ji Sung Yoon, Hyoung Woo Lee, Kyu Chang Won
Diabetes & Metabolism Journal.2013; 37(2): 125. CrossRef
Relationship between Milk and Calcium Intake and Lipid Metabolism in Female Patients with Type 2 Diabetes
JaeHee Kim, Ji-Yun Hwang, Ki Nam Kim, Young-Ju Choi, Namsoo Chang, Kap-Bum Huh
Yonsei Medical Journal.2013; 54(3): 626. 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
Glucose, Blood Pressure, and Lipid Control in Korean Adults with Diagnosed Diabetes
Sun-Joo Boo
Korean Journal of Adult Nursing.2012; 24(4): 406. CrossRef
A Comparative Study of Eating Habits and Food Intake in Women with Gestational Diabetes according to Early Postpartum Glucose Tolerance Status
You Jeong Hwang, Bo Kyung Park, Sunmin Park, Sung-Hoon Kim
Diabetes & Metabolism Journal.2011; 35(4): 354. CrossRef
Diabetes and Cancer: Is Diabetes Causally Related to Cancer?
Sunghwan Suh, Kwang-Won Kim
Diabetes & Metabolism Journal.2011; 35(3): 193. CrossRef
The Association between Type 2 Diabetes Mellitus and Colorectal Cancer
Byeong Do Yi, Young Pil Bae, Bong Gun Kim, Jong Wha Park, Dong Hyun Kim, Ja Young Park, Seong Ho Choi, Hee Seung Park, Jae Seung Lee, Chang Won Lee, Sang Soo Kim, Bo Hyun Kim, Moon Ki Choi, In Joo Kim
Endocrinology and Metabolism.2011; 26(2): 126. CrossRef
The Hypoglycemic Effect of Complex of Chinese Traditional Herbs (CTH) and Macelignan in Type 2 Diabetic Animal Model

Journal of Life Science.2010; 20(7): 1113. CrossRef
The Relationship Between Coronary Artery Calcification and Serum Apolipoprotein A-1 in Patients with Type 2 Diabetes
Hyun Ae Seo, Yeon Kyung Choi, Jae Han Jeon, Jung Eun Lee, Ji Yun Jeong, Seong Su Moon, In Kyu Lee, Bo Wan Kim, Jung Guk Kim
Korean Diabetes Journal.2009; 33(6): 485. CrossRef
Epidemiologic Characteristics of Diabetes Mellitus in Korea: Current Status of Diabetic Patients Using Korean Health Insurance Database
Ie Byung Park, Sei Hyun Baik
Korean Diabetes Journal.2009; 33(5): 357. CrossRef
Cause-of-Death Trends for Diabetes Mellitus over 10 Years (Korean Diabetes J 33(1):65-72, 2009)
Hae Jin Kim
Korean Diabetes Journal.2009; 33(2): 164. CrossRef

Adiponectin Concentrations in Type 2 Diabetic Patients with or without Metabolic Syndrome.: Ja Young Park, Ja Won Kim, Ji Min Kim, Ying Han, Soo Kyung Park, Ji Young Mok, Mi Kyoung Park, Hye Jeong Lee, Duk Kyu Kim; Korean Diabetes J. 2008;32(3):224-235. Published online June 1, 2008; DOI: https://doi.org/10.4093/kdj.2008.32.3.224

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Abstract PDF

BACKGROUND
Adipocytes produce several adipokines that modulate insulin action as well as glucose and lipid metabolism. The aim of this study was to evaluate the relationship between serum adiponectin concentrations and metabolic syndrome (MS) in patients with type 2 diabetes mellitus. METHODS: This study included 127 type 2 diabetic patients (males 63, females 64). The subjects were divided into two groups as with or without metabolic syndrome (MS(+) or MS(-)). The MS was diagnosed by International Diabetes Federation. Serum adiponectin, leptin, fasting plasma insulin, glucose, glycated hemoglobin, lipid profile, white blood corpuscle (WBC), aspartate aminotransferase (AST), alanine aminotransferase (ALT), uric acid and C-reactive protein (CRP) were examined. RESULTS: Serum adiponectin concentrations were significantly lower in MS(+) than MS(-) (4.8 +/- 2.4 microgram/mL vs 7.6 +/- 5.8 microgram/mL, 7.6 +/- 3.7 microgram/mL vs 11.5 +/- 7.2 microgram/mL, P < 0.05 in males and females). After adjustment for age and body mass index (BMI), in MS (+), the serum levels of adiponectin correlated positively with high density lipoprotein - cholesterol (HDL-C) and negatively with height, body weight, ALT and CRP. In MS(-), the serum levels of adiponectin correlated positively with HDL-C and negatively with diastolic blood pressure (DBP), triglyceride and CRP. By multiple regression analysis, no parameters were independently correlated with serum adiponectin concentrations in MS(+), while DBP and HDL-C were independently related to serum adiponectin concentrations in MS(-). CONCLUSION: Serum adiponectin concentrations were lower in type 2 diabetic patients with MS than without MS. There were no significant parameters related to decrease serum adiponectin concentrations in MS. But further study is needed to confirm this result.

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Urinary adiponectin concentration is positively associated with micro- and macro-vascular complications
Won Seon Jeon, Ji Woo Park, Namseok Lee, Se Eun Park, Eun Jung Rhee, Won Young Lee, Ki Won Oh, Sung Woo Park, Cheol-Young Park, Byung-Soo Youn
Cardiovascular Diabetology.2013;[Epub] CrossRef
Association of Plasma Osteoprotegerin with Adiponectin and Difference according to Obesity in Men with Metabolic Syndrome
Woori Na, Cheongmin Sohn
Korean Journal of Community Nutrition.2011; 16(6): 762. CrossRef
The Effects of 12-Weeks Intensive Intervention Program on Cardiovascular Risk Factors, Adipocytokines and Nutrients Intakes in Industrial Male Workers
Kieun Moon, Ill Keun Park, Yeon Sang Jo, Yun Kyun Chang, Yun Mi Paek, Tae In Choi
The Korean Journal of Nutrition.2011; 44(4): 292. CrossRef
Relationship between Nutrients Intakes, Dietary Quality, and Serum Concentrations of Inflammatory Markers in Metabolic Syndrome Patients
Misung Kim, Juyoung Kim, Wookyung Bae, Sohye Kim, Yesong Lee, Woori Na, Cheongmin Sohn
Korean Journal of Community Nutrition.2011; 16(1): 51. CrossRef
Prevalence of Pancreatic Cancer in Diabetics and Clinical Characteristics of Diabetes-associated with Pancreatic Cancer - Comparison between Diabetes with and without Pancreatic Cancer -
Seung Goun Hong, Jae Seon Kim, Sung Joo Jung, Moon Kyung Joo, Beom Jae Lee, Jong Eun Yeon, Jong-Jae Park, Kwan Soo Byun, Young-Tae Bak
The Korean Journal of Gastroenterology.2009; 54(3): 167. CrossRef

Prevention of Diabetes by Fenofibrate in OLETF Rats: Hepatic Mechanism for Reducing Visceral Adiposity.: Hye Jeong Lee, Mi Kyoung Park, Kyung Il Lee, Young Jun An, Ji Min Kim, Ja Young Park, Young Han, Sook Hee Hong, Sun Seob Choi, Young Hyun Yoo, Joon Duk Suh, Duk Kyu Kim; Korean Diabetes J. 2007;31(1):63-74. Published online January 1, 2007; DOI: https://doi.org/10.4093/jkda.2007.31.1.63

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Abstract PDF

BACKGROUND
The aim of this study is to evaluate the hepatic mechanism of fenofibrate that has the diabetes protective action in rats. METHODS: We chose OLETF rats and divided them into three groups. Fenofibrate (DF) group was fed with diet and fenofibrate (300 mg/kg/day). Paired feeding (Dd) group and free diet (DD) group were fed with diet. After 36 weeks of treatment, all the rats were sacrificed. RESULTS: The fasting blood glucose level of DF group (8.5 +/- 0.9 mmol/L) showed normal. The fasting blood glucose level of Dd group (22.4 +/- 3.0 mmol/L) and DD group (16.9 +/- 3.7 mmol/L) showed significantly increased than that of DF group (P < 0.01, respectively). The body weight, visceral adipose tissue and subcutaneous adipose tissue of DF group were significantly decreased compared to those of Dd and DD groups (P < 0.01, P < 0.05, P < 0.05). DF group showed significantly increased state-3 respiration rate, ATP synthetic activity, state-4 respiration rate and their blood beta-keton body levels than those of control groups (P < 0.01, respectively). DF group showed normal morphology of hepatocytes but DD and Dd groups showed hepatic steatosis with mitochondrial swellings. CONCLUSION: Chronic fenofibrate treatment prevents the development of diabetes in OLETF rats with inhibiting gain of body weight and abdominal adiposity. The hepatic mechanism for reducing visceral adiposity is that fenofibrate leads to increasing oxidative phosphorylation, uncoupling and ketogenesis as well as increasing beta-oxidation of fatty acids. Moreover, fenofibrate treatment prevents the development of hepatic steatosis.

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The Differences of Metabolic Syndrome Risk Factors according to Obesity and Abdominal Obesity in Elderly Korean Women
Kyung-A Shin
The Korean Journal of Clinical Laboratory Science.2016; 48(4): 304. CrossRef
Effects of Soybean and DJI Chungkukjang Powder on Blood Glucose and Serum Lipid Reduction in db/db Mice
Jae-Joon Lee, Ah-Ra Kim, Hae-Choon Chang, Hae-Ok Jung, Myung-Yul Lee
Journal of the Korean Society of Food Science and Nutrition.2012; 41(8): 1086. CrossRef
Comparative analysis of fat and muscle proteins in fenofibratefed type II diabetic OLETF rats: the fenofibrate-dependent expression of PEBP or C11orf59 protein
Jong-Ryeal Hahm, Jin-Sook Ahn, Hae-Sook Noh, Seon-Mi Baek, Ji-Hye Ha, Tae-Sik Jung, Yong-Jun An, Duk-Kyu Kim, Deok-Ryong Kim
BMB Reports .2010; 43(5): 337. CrossRef
Comparative analysis of fat and muscle proteins in fenofibratefed type II diabetic OLETF rats: the fenofibrate-dependent expression of PEBP or C11orf59 protein
Jong-Ryeal Hahm, Jin-Sook Ahn, Hae-Sook Noh, Seon-Mi Baek, Ji-Hye Ha, Tae-Sik Jung, Yong-Jun An, Duk-Kyu Kim, Deok-Ryong Kim
BMB Reports.2010; 43(5): 337. CrossRef

Prevalence of Metabolic Syndrome in Type 2 DM Patients with Non-alcoholic Fatty Liver.: Ji Min Kim, Ja Young Park, Hyn Kyung Nam, Ja Won Kim, Su Kyung Park, Kyung Jin Nam, Mi Kyoung Park, Hye Jeong Lee, Duk Kyu Kim; Korean Diabetes J. 2006;30(6):442-449. Published online November 1, 2006; DOI: https://doi.org/10.4093/jkda.2006.30.6.442

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Abstract PDF

BACKGROUND
Non-alcoholic fatty liver is rendered as one component of metabolic syndrome (MS). We evaluated the prevalence of MS as well as clinical and laboratory characteristics of Type 2 DM patients with non-alcoholic fatty liver. METHODS: Fatty liver group (n = 71) who showed significant fatty change by ultrasonography and age, sex matched control group (n = 40) were studied retrospectively. We compared demographic and laboratory findings and prevalence of MS by modified WHO criteria and new IDF criteria between both groups. RESULTS: There were no significant difference in age, DM duration, BMI, prevalence of hypertension, coronary artery disease, CVA, diabetic retinopathy, neuropathy, nephropathy between both groups. In fatty liver group, the plasma level of FBS, TG, ALT, total protein, albumin and GGT were significantly higher than those of control group (P = 0.033, P = 0.000, P = 0.002, P = 0.008, P = 0.003, P = 0.001). The plasma levels of HDL-C in fatty liver group were significantly lower than those of control group (P = 0.013). The plasma level of FBS, FFA, TG, total protein, albumin, ALT, HOMA(IR) and BMI were significantly related to the severity of fatty liver. The prevalence of MS in fatty liver group was significantly higher than that of control group by modified WHO criteria (P = 0.001) or new IDF criteria (P = 0.036). CONCLUSION: Type 2 DM patients with nonalcoholic fatty liver frequently accompanied the metabolic syndrome. They showed nonspecific changes in the liver function tests.

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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
Metabolic Syndrome and Serum Alanine Aminotransferase Levels in Korean Adults : The Third Korea National Health and Nutrition Examination Survey (KNHANES III), 2005.
Mi Ah Han, So Yeon Ryu, Jong Park, Myung Geun Kang, Ki Soon Kim
Korean Journal of Epidemiology.2008; 30(1): 25. CrossRef

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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Abstract 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

Exercise and Fenofibrate Reduces Body Adiposity Synergistically in OLETF Rats.: Young Jun An, Hre Jeong Lee, Mi Kyoung Park, Kyung Il Lee, In Young Koh, Dong Sik Jung, Ah Young Kang, Duk Kyu Kim; Korean Diabetes J. 2004;28(2):131-138. Published online April 1, 2004

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Abstract PDF: BACKGROUND
The PPAR alpha activator, Fenofibrate, is a pharmacological ligand, which induces beta-oxidation of long chain fatty acids in the mitochondria of hepatocytes. The beta-oxidation induced by exogenous PPAR alpha activators may be operated maximally when the sustained production of energy substrate in the liver is required by working muscles due to continued exercise. The aim of this study was to determine whether the combination therapy of exercise and Fenofibrate could synergistically reduce body adiposity in OLETF rats. METHODS: Twenty-eight male OLETF rats(13 wk old) were divided into four groups. The diet(n=7) and exercise groups(n=7) were fed with chow for 12 weeks. The Fenofibrate(n=7) and combined treatment(exercise and Fenofibrate) groups (n=7) were fed with Fenofibrate(32mg/kg/day) mixed chow for 12 weeks. The animals in the exercise and combined treatment groups were exercised by running on a treadmill for 12 weeks. At 24 weeks of age, all the rats were sacrificed, and examined by biochemical tests and had their adipose tissue weight measured. RESULTS: There were no significant changes in the retroperitoneal and subcutaneous fats between the diet and Fenofibrate groups, but there were between the diet and combined treatment groups(P<0.05). CONCLUSION: Exercise combined with Fenofibrate synergistically reduces body adiposity in OLETF rats

The Efficiency of Routine 99mTc-MIBI Myocardial SPECT for Detecting Silent IHD in Type 2 Diabetic Patients.: Duk Kyu Kim, Mi Kyoung Park, Do Young Kang; Korean Diabetes J. 2001;25(4):297-306. Published online August 1, 2001

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Diastolic Dysfunction of Left Ventricle by Cardiovascular Autonomic Neuropathy in Type 2 Diabetic Patients Without Cardiovascular Symptom.: Duk Kyu Kim, Mi Kyoung Park, Do Young Kang; Korean Diabetes J. 2001;25(3):230-239. Published online June 1, 2001

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Abstract PDF: BACKGROUND
We investigated the effect of cardiovascular autonomic neuropathy for left ventricular function in cardiovascular symptom-free type 2 diabetic patients without other major risk factors known to cause cardiac dysfunction, especially diastolic dysfunction. METHODS: Forty seven patients (M:F=20:27, 53+/-10 years) with type 2 DM were enrolled in this study. None of the subjects had the macrovascular diabetic complications, hypertension, hypertrophic cardiomyopathy, valvular heart disease, alcoholic heart disease, congenital heart disease and older age (> 65 years). The patients were tested for cardiovascular autonomic neuropathy using five non-invasive tests of autonomic function. The response to each test was graded as 0, 0.5, 1. A patient was classified as having definite cardiovascular autonomic neuropathy if total score was 2 or more. Using these criteria, 26 patients (Group A) were determined to have cardiovascular autonomic neuropathy. Others were 21 patients (Group B). Tc-99 m RBC gated blood pool scintigraphy was performed as routine standard protocol. RESULTS: The degree of age, sex, body mass index (BMI), duration of diabetes, level of insulin, C-peptide, fructosamine, fasting plasma glucose, total cholesterol (TC), triglyceride (TG), HDL, LDL, BUN, creatinine and incidence of retinopathy, microalbuminuria were not different between group A and B. Heart rate response to Valsalva maneuver, heart rate response to standing were different between Group A and B (p=0.008, p=0.001, respectively). Ejection fraction of left ventricle were normal (> 50%) in all of patients. Maximal filling rate, average filling rate, maximal ejection rate and average ejection rate were increased in patients with cardiac autonomic neuropathy (p=0.03, p=0.05, p=0.02, p=0.04, respectively). Total score of autonomic function was significantly correlated with maximal filling rate (r=0.38, p=0.01), with average filling rate (r=0.37, p=0.01) and with maximal ejection rate (r=0.37, p=0.01). Maximal filling rate was most correlated with resting pulse (r=0.58, p<0.01). CONCLUSION: Cardiovascular autonomic neuropathy as single factor may result in diastolic dysfunction of left ventricle in cardiovascular symptom-free type 2 diabetic patients without other major factor known to cause cardiac diastolic dysfunction.

The Effect of Micronized Fenofibrate on the Plasma Levels of Glycated LDL-C, Lp(a) and Insulin Resistance in Patients with Type 2 Diabetes Mellitus.: Mi Kyoung Park, Duk Kyu Kim; Korean Diabetes J. 2000;24(6):678-688. Published online January 1, 2001

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Abstract PDF: BACKGROUND
It has been indicated that micronized fenofibrate therapy changes the atherogenic lipid profile into more favorable lipid profile in patients with type 2 diabetes and dyslipidemia. The aim of this study is to evaluate the effect of micronized fenofibrate on the plasma levels of glycated LDL-C, Lp(a), FFA and insulin resistance in patients with type 2 diabetes and dyslipidemia. METHODS: Forty-seven patients with type 2 diabetes (M/F=23/24, mean age 57 +/- 7 yrs) were studied who had relatively good glycemic index (HbA1c < 8.0%) but dyslipidemia (i.e., dyslipidemia : TG >2.25 mmol/L or HDL-C < 0.90 mmol/L or LDL-C >3.36 mmol/L). All the patients were maintained by the previous method of glucose control without change during entire period of the study. The patients were randomized to drug group (Lipidil ) or placebo group for 12 weeks and measured for fasting plasma levels of lipid, glycated LDL-C, Lp(a), insulin, C-peptide, glucose. The results were compared before and after the administration. RESULTS: Micronized fenofibrate therapy significantly reduced the plasma levels of triglyceride, total cholesterol, LDL-C, TC/HDL-C (p<0.0001), FFA (p<0.05) and ele vated the level of HDL-C (p<0.0001) after 12 weeks administration. However, no significant(-3.6%) changes were observed in the level of Lp(a) . In both groups, the plasma levels of glycated LDL-C were elevated even though the glycemic controls were good (drug group: 0.09+/-0.05 mmol/L, placebo group: 0.10+/-0.03 mmol/L), but no significant changes were noticed after administration for 12 weeks (-13.5%, +4.8%, respectively). HOMA-IR index was significantly decreased in the drug group after administration (p<0.01). The change of plasma insulin level was significantly different when compared to that of the placebo group (p<0.05). The plasma level of C-peptide and glycemic indexes (FBS and HbA1c) were not changed significant. CONCLUSION: Micronized fenofibrate therapy for 12 weeks was very effective for control of diabetic dyslipidemia. It significantly reduced FFA to improve the insulin resistance, but it didn't improve the elevated plasma level of glycated LDL-C and Lp(a).

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