- Bowl-Based Meal Plan versus Food Exchange-Based Meal Plan for Dietary Intake Control in Korean Type 2 Diabetic Patients.
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Hee Jung Ahn, Boo Kyung Koo, Ji Yeon Jung, Hwi Ryun Kwon, Hyun Jin Kim, Kang Seo Park, Kyung Ah Han, Kyung Wan Min
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Korean Diabetes J. 2009;33(2):155-163. Published online April 1, 2009
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DOI: https://doi.org/10.4093/kdj.2009.33.2.155
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- BACKGROUND
The food exchange-based meal plan is effective in controlling dietary energy intake with a macronutrient balance. However, it is difficult to practice for relatively low-literacy patients. As an alternative, we developed a system employing a standardized-sized bowl and investigated its effectiveness on achieving proper energy intake and macronutrient composition and patient compliance, compared to the conventional food exchange system in Korean type 2 diabetes patients. METHODS: Eighty subjects with type 2 diabetes were assigned to both the novel bowl-based meal plan group (BG) and the food exchange-based meal plan group (ExG). BG received limited simple instructions for the plan. Time spent for plan instruction was 10 min for BG and 40 min for ExG. Dietary energy and macronutrient intake were estimated with 3-day dietary records and patient comprehension of the plan was estimated with a 5-point Likert scale. RESULTS: After 12 weeks, dietary energy compliance showed no difference between the groups (BG: 103 +/- 10%, ExG: 101 +/- 17%). Both groups showed significant reduction in carbohydrate and protein intake and there was no difference in the proportion of carbohydrate, protein and fat in energy intake between the groups despite the shorter instruction time for BG. Following the instruction period, there was no difference in the understanding score between the groups. CONCLUSION: This bowl-based plan was equally effective as the food exchange-based plan in controlling dietary energy intake and macronutrient composition, as well as patient comprehension and compliance. Our novel plan may allow for more cost-effective methods in terms of time needed for plan instruction.
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- Practical Diet Education for Patients with Type 2 Diabetes: Tips for Physicians
Choong Hee Kim, Jun Sung Moon The Journal of Korean Diabetes.2016; 17(4): 253. CrossRef - Effects of Nutrition Education and Personalized Lunch Service Program for Elderly at Senior Welfare Center in Jeonju
Jeong-Sook Bae, Mi-Hyun Kim, Sook-Bae Kim Korean Journal of Community Nutrition.2013; 18(1): 65. CrossRef - Effects of Chronic Disease Management Based on Clinics for Blood Pressure or Glycemic Control in Patients with Hypertension or Type 2 Diabetes Mellitus
Won Cheong, Jun Yim, Dae-Kyu Oh, Jeong-Soo Im, Kwang Pil Ko, Yun Mi Kim Journal of agricultural medicine and community health.2013; 38(2): 108. CrossRef - Small Rice Bowl-Based Meal Plan versus Food Exchange-Based Meal Plan for Weight, Glucose and Lipid Control in Obese Type 2 Diabetic Patients
Hee-Jung Ahn, Kyung-Ah Han, Hwi-Ryun Kwon, Bo-Kyung Koo, Hyun-Jin Kim, Kang-Seo Park, Kyung-Wan Min Korean Diabetes Journal.2010; 34(2): 86. CrossRef - Nutrients and Dish Intake by Fasting Blood Glucose Level
Jihyun Choi, Hyun-Kyung Moon The Korean Journal of Nutrition.2010; 43(5): 463. CrossRef - The Effects of Small Sized Rice Bowl on Carbohydrate Intake and Dietary Patterns in Women with Type 2 Diabetes
Hee-Jung Ahn, Yu-Kyung Eom, Kyung-Ah Han, Hwi-Ryun Kwon, Hyun Jin Kim, Kang Seo Park, Kyung-Wan Min Korean Diabetes Journal.2010; 34(3): 166. CrossRef
- Maintenance of Insulin Therapy by Desensitization in Insulin Allergy Patient.
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Jun Hwa Hong, Ji Hye Lee, Jong Ho Shin, Dong Pil Kim, Bong Suk Ko, Byung Joon Kim, Hyun Jin Kim, Kang Seo Park
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Korean Diabetes J. 2008;32(6):529-531. Published online December 1, 2008
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DOI: https://doi.org/10.4093/kdj.2008.32.6.529
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2,750
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- Allergic reaction to human insulin is uncommon. But they can cause mild to severe symptoms such as dyspnea, hypotensive shock, etc. Here we report the case of a patient with type 2 diabetes and insulin allergy successfully managed with desensitization. A 60-year-old man with insulin allergy was transferred. He had poorly controlled type 2 diabetes (fasting blood glucose 230 mg/dL). He developed itching sense and erythema at the injection sites of human insulin in a few minutes. And serum IgE level was elevated to 1618.0 IU/mL. The insulin was changed to other preparations, including short and long-acting insulin analogues, with similar responses. He was commenced on twice a day injection protocol in addition to his oral hypoglycemic agents, and achieved fair control (fasting blood glucose 100 mg/dL) on 24 units of Novomix Flex Pen per day, with little or no skin or systemic reaction. This is the case report of insulin allergy in type 2 diabetes being successfully managed by desensitization.
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- Allergic reaction to recombinant human insulin
Seong Jin Choi, Min Kwan Kwon, Moon Park, Soo Ya Bae, Hyun Ho Oh, Jong Ho Lee, Ji In Moon, Chan Sun Park, Jong Chul Won, Kyung Soo Ko, Byoung Doo Rhee, Jung Min Kim Allergy, Asthma & Respiratory Disease.2015; 3(4): 302. CrossRef - Two Cases of Allergy to Insulin in Gestational Diabetes
Gi Jun Kim, Shin Bum Kim, Seong Il Jo, Jin Kyeong Shin, Hee Sun Kwon, Heekyung Jeong, Jang Won Son, Seong Su Lee, Sung Rae Kim, Byung Kee Kim, Soon Jib Yoo Endocrinology and Metabolism.2015; 30(3): 402. CrossRef - Successful Management of Insulin Allergy and Autoimmune Polyendocrine Syndrome Type 4 with Desensitization Therapy and Glucocorticoid Treatment: A Case Report and Review of the Literature
Joselyn Rojas, Marjorie Villalobos, María Sofía Martínez, Mervin Chávez-Castillo, Wheeler Torres, José Carlos Mejías, Edgar Miquilena, Valmore Bermúdez Case Reports in Immunology.2014; 2014: 1. CrossRef - Clinical applications of drug desensitization in the Asia-Pacific region
Bernard Yu-Hor Thong Asia Pacific Allergy.2011; 1(1): 2. CrossRef
- Protective Effects of Glucagon Like Peptide-1 on HIT-T15 beta Cell Apoptosis via ER Stress Induced by 2-deoxy-D-glucose.
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Ju Young Kim, Seong Kyu Lee, Haing Woon Baik, Ki Ho Lee, Hyun Jin Kim, Kang Seo Park, Byung Joon Kim
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Korean Diabetes J. 2008;32(6):477-487. Published online December 1, 2008
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DOI: https://doi.org/10.4093/kdj.2008.32.6.477
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2,546
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Abstract
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- BACKGROUND
The characteristic feature of pancreatic beta cells is highly developed endoplasmic reticulum (ER) due to a heavy engagement in insulin secretion. The ER serves several important function, including post-translational modification, folding, and assembly of newly synthesized secretory proteins, and its proper function is essential to cell survival. Various stress conditions can interfere with ER function. Pancreatic beta cells may be particularly vulnerable to ER stress that causes to impair insulin biosynthesis and beta cell survival through apoptosis. Glucagon like peptide-1 (GLP-1) is a new drug for treatment of type 2 diabetes and has effects on stimulation of insulin secretion and beta cell preservation. Also, it may have an antiapoptotic effect on beta cells, but detailed mechanisms are not proven. Therefore, we investigated the protective mechanism of GLP-1 in beta cells through ER stress response induced by 2-deoxy-D-glucose (2DG). METHODS: For induction of the ER stress, HIT-T15 cells (hamster beta cell line) were treated with 2DG (10 mM). Apoptosis was evaluated with MTT assay, hoechst 33342 staining and Annexin/PI flow cytometry. Expression of ER stress-related molecules was determined by real-time PCR or western blot. For blocking ER stress, we pretreated HIT-T15 cells with exendin-4 (Ex-4; GLP-1 receptor agonist) for 1 hour before stress induction. RESULTS: After induction with ER stress (2DG), beta cells were lost by apoptosis. We found that Ex-4 had a protective effect through ER stress related molecules (GRP78, GRP94, XBP-1, eIF2alpha, CHOP) modulation. Also, Ex-4 recovered the expression of insulin2 mRNA in beta cells. CONCLUSION: These results suggest that GLP-1 may protect beta cells apoptosis through ER stress modulation.
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- Exendin-4 Protects Against Sulfonylurea-Induced β-Cell Apoptosis
Ju-Young Kim, Dong-Mee Lim, Hyung-Seo Park, Chan-Il Moon, Kyung-Jin Choi, Seong-Kyu Lee, Haing-Woon Baik, Keun-Young Park, Byung-Joon Kim Journal of Pharmacological Sciences.2012; 118(1): 65. CrossRef - GLP-1 Can Protect Proinflammatory Cytokines Induced Beta Cell Apoptosis through the Ubiquitination
Dong Mee Lim, Ju Young Kim, Kang Woo Lee, Keun Young Park, Byung Joon Kim Endocrinology and Metabolism.2011; 26(2): 142. CrossRef - Exendin-4 Protects Oxidative Stress-Induced β-Cell Apoptosis through Reduced JNK and GSK3β Activity
Ju-Young Kim, Dong-Mee Lim, Chan Il Moon, Kyung-Jin Jo, Seong-Kyu Lee, Haing-Woon Baik, Ki-Ho Lee, Kang-Woo Lee, Keun-Young Park, Byung-Joon Kim Journal of Korean Medical Science.2010; 25(11): 1626. CrossRef
- The Effects of D-Chiro-Inositol on Glucose Metabolism in 3T3-L1 Cells.
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Kang Seo Park, Jae Min Lee, Bon Jeong Ku, Young Suk Jo, Seong Kyu Lee, Kyung Wan Min, Kyung Ah Han, Hyo Jeong Kim, Hyun Jin Kim
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Korean Diabetes J. 2008;32(3):196-203. Published online June 1, 2008
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DOI: https://doi.org/10.4093/kdj.2008.32.3.196
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Abstract
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- BACKGROUND
The target of the treatment of metabolic syndrome and diabetes is an improvement of insulin resistance. D-chiro-inositol (DCI) plays a role in a phospholipid mediating intracellular insulin action. In the previous studies, the urine level of DCI were decreased in the diabetic animal with insulin resistance. Some clinical studies showed that DCI improved a glucose level and HbA1c. Therefore we studied the relationship between DCI and glucose metabolism, especially insulin resistance. METHODS: To investigate the mechanism of DCI affecting the glucose metabolism, we examined the effects of DCI on 2-deoxyglucose uptake, gene expression of adipocytokines and AMPK pathway by using RT-PCR and western blot in 3T3-L1 cells. RESULTS: Insulin-stimulated 2-deoxyglucose uptake increased in DCI-treated cells by about 1.2-fold (relative to the control) and was inhibited by phosphoinositide 3-kinase (PI3 Kinase) inhibitors (Wortmanin, LY294002) and AMPK inhibitor (STO-609). In Western blot analysis, it didn't show the difference of phosphorylation of Akt and AMPK between DCI-treated group and control in 3T3-L1 cells. However, DCI decreased the gene expression of resistin in 3T3-L1 cells. CONCLUSION: DCI may involve other pathway of insulin signaling, but not PI3 Kinase and AMPK signaling pathways and it may be useful in managing metabolic syndrome by improving insulin resistance through increasing glucose uptake and decreasing resistin relevant to insulin resistance.
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- Variation of Pinitol Content for Domestic Legume Species in Korea
Seung-Min Seo, Yeon-Shin Jeong, Dhakal Krisna Hari, Dong-Hyun Shin, In-Jung Lee, Eun-Sook Park, Jeong-Dong Lee, Young-Hyun Hwang Korean Journal of Crop Science.2011; 56(1): 50. CrossRef
- Analysis of Meal Habits from the Viewpoint of Regularity in Korean Type 2 Diabetic Patients.
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Hee Jung Ahn, Kyung Ah Han, Boo Kyung Koo, Hyun Jin Kim, Hyo Jeong Kim, Kang Seo Park, Kyung Wan Min
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Korean Diabetes J. 2008;32(1):68-76. Published online February 1, 2008
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DOI: https://doi.org/10.4093/kdj.2008.32.1.68
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Abstract
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- BACKGROUND
The regular meal pattern with consistent day-to-day calorie and carbohydrate intake is one of the most important determinants of good glycemic control in diabetes. This study was aimed to investigate the meal pattern and their relationships with total energy intake, nutrients intake and glycemic and lipid profile in type 2 diabetes. METHODS: 1,084 subjects were divided according to glycemic status into three groups: the diabetes (DM), dysglycemia (DG) and normal (N). The meal frequency (MF), meal interval (MI) and daily intake of total energy, macronutrient and micronutrient were estimated with the 24 hours dietary recall from the Korean National Health and Nutrition Examination Survey (KNHANES) in 2001 and Eulji hospital. For analysis of meal pattern and it's relations with the nutrients intake, we regrouped into meal skipper (G1), non-meal skipper with unreasonable MI (G2), and non-meal skipper with reasonable MI (G3). RESULTS: 17.5% of DM, 21.8% of DG, 23.3% of N skipped at least one meal a day without significant difference across the groups. 55.9% of non-meal skipper had unreasonable MI. Meal was more regular in older age, lower educated person, employee, and female. G1 took higher fat, and more calories form snack and less micronutrient density, compared with G3 (P < 0.05). HbA1c, total cholesterol and triglyceride values were higher in G1 compared with other two groups (P < 0.05). CONCLUSION: Many type 2 diabetics had the irregular meal patterns, which was associated with poor glycemic control, lipid profiles and less micronutrient density. This suggested that another treatment strategy might be required for those who had irregular lifestyle.
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Citations
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- Adherence to Dietary Guidelines among Diabetes Patients: Comparison between Elderly and Non-Elderly Groups
Haeun Jang, Jihyun Im, Kyong Park Clinical Nutrition Research.2021; 10(1): 14. CrossRef - Effect of Diabetic Dietary Education Program on Diabetes Knowledge and Dietary Behaviors of Elderly Diabetic Patients
Ji Young Ye, Sung Hee Min, Min June Lee Korean Journal of Food & Cookery Science.2017; 33(5): 601. CrossRef - Five Year's Follow-up of the Cardiovascular Disease Risk Factors among the Low Level Organic Solvent Exposure Workers
Mi-Ae Kim Korean Journal of Occupational Health Nursing.2015; 24(2): 67. CrossRef - A Predictive Model of Health Outcomes for Young People with Type 2 Diabetes
Sun Young Jung, Sook Ja Lee, Sun Hee Kim, Kyung Mi Jung Asian Nursing Research.2015; 9(1): 73. CrossRef - Need for Development of a List of Meals for Diabetic Patients and Development of Barley-Based Diabetic Meals
Ji Hye Ryu, Jeong Ok Rho Family and Environment Research.2013; 51(5): 551. 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 - Factors that Affect Medication Adherence in Elderly Patients with Diabetes Mellitus
Kyung-Ae Park, Jung-Guk Kim, Bo-Wan Kim, Sin Kam, Keon-Yeop Kim, Sung-Woo Ha, Sung-Taek Hyun Korean Diabetes Journal.2010; 34(1): 55. CrossRef - Nutrients and Dish Intake by Fasting Blood Glucose Level
Jihyun Choi, Hyun-Kyung Moon The Korean Journal of Nutrition.2010; 43(5): 463. CrossRef
- Relationship between Endothelial-dependent/-independent Vasodilation and Carotid Intimal- media Thickness in Newly-diagnosed Korean Type 2 Diabetic Patients.
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Jung Ho Choi, Kyung Wan Min, Hyo Jeong Kim, Bo kyung Koo, Chae Young Lim, Hyun Jin Kim, Gang Seo Pak, Kyung Ah Han, Eung Jin Kim
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Korean Diabetes J. 2007;31(6):498-506. Published online November 1, 2007
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DOI: https://doi.org/10.4093/jkda.2007.31.6.498
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- BACKGROUND
The relative effect of diabetes on the risk of cardiovascular disease in Asian population is much the same as that in Western populations. Although multiple atherosclerotic risk factors have been documented in Asia, precise estimates of vascular reactivity might provide more critical informations for the prevention and the control of diabetes-related cardiovascular mortality and morbidity. The aims of this study were to estimate the vascular reactivity directly and evaluate its relationship with other cardiovascular risk factors and carotid intimal-media thickness (IMT) in newly-diagnosed Korean type 2 diabetic patients. METHODS: We measured flow-mediated vasodilation (FMD) and endothelial-independent vasodilation (EID) of the brachial artery using high-resolution ultrasonography in total of 121 (M; N = 68, F; N = 53) diabetic patients. We assessed conventional cardiovascular risk factors such as age, smoking, obesity, hypertension, hyperlipidemia or family history of cardiovascular disease and analyzed the association among FMD/EID with cardiovascular risk factors, carotid IMT or the total number of risk factors. RESULTS: The mean values of age, smoking, BMI, waist, systolic blood pressure and diastolic blood pressure were 51.2 +/- 12.3 years, 11.0 +/- 15.8 pack years, 25.0 +/- 3.2 kg/m2, 86 +/- 9 cm, 123 +/- 16 mmHg and 79 +/- 12 mmHg. The mean values of HbA1c, fasting blood glucose, total cholesterol, triglyceride, LDL-cholesterol and HDL-cholesterol were 8.4 +/- 2.0%, 166 +/- 51 mg/dL, 187 +/- 37 mg/dL, 166 +/- 143 mg/dL, 114 +/- 30 mg/dL and 46 +/- 12 mg/dL. FMD and EID were estimated by 6.1 +/- 2.8% and 16.6 +/- 5.6% respectively. The mean/maximal carotid IMT were 0.63 +/- 0.12/0.76 +/- 0.16 mm and the number of risk factors besides diabetes mellitus were 2.3 +/- 1.3. After adjusting age, FMD was associated only with smoking, but EID was associated with smoking, systolic/diastolic blood pressure, mean/maximal carotid IMT and number of risk factors by partial correlations. Age, smoking and EID were independent risk variables for carotid IMT, analyzed by multiple regression test. CONCLUSION: These findings suggest that impaired vascular reactivity detected by EID is closely related to carotid IMT, an useful surrogate marker for atherosclerosis, in newly-diagnosed Korean type 2 diabetic patients.
- Therapeutic Efficacy of Combined Therapy with Once Daily Insulin Glargine and Once Daily Glimepiride in Korean Type 2 Diabetic Patients.
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Ji Young Park, Hyo Jeong Kim, Bo Kyung Koo, Hyun Jin Kim, Gang Seo Pak, Kyung Ah Han, Kyung Wan Min, Eung Jin Kim
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Korean Diabetes J. 2007;31(5):391-401. Published online September 1, 2007
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DOI: https://doi.org/10.4093/jkda.2007.31.5.391
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- BACKGROUND
Once daily injection and 24 hour lasting glucose lowering effect of insulin glargine had recently changed a perception about the early insulin treatment of type 2 diabetic patients. This study was performed to investigate therapeutic efficacy of combined therapy with insulin glargine and glimepiride in Korean type 2 diabetic patients, who had received oral hypoglycemic agents (OHA) or conventional insulin therapy. METHODS: Total of 192 patients who needed to change the previous therapy because of uncontrolled diabetes or hypoglycemia were included and followed for about 6 months. Two groups of prior treatment modality were analyzed; OHA group (n = 54, 28.1%), conventional insulin therapy group in combination with or without OHA group (n = 138, 71.9%). The primary end point was changes in HbA1c according to baseline characteristics such as prior treatment modality, HbA1C, c-peptide, duration of diabetes mellitus, body mass index and prior used conventional insulin doses. Secondary end point was the dose conversion ratio of insulin glargine to prior used insulin in patients who had one or two insulin therapy. We also evaluated the level of the patients' satisfaction on the glucose lowering effects and the convenience for use of device. RESULTS: The differences of HbA1c according to prior treatment groups were -0.78 +/- 1.76 % in OHA group and 0.07 +/- 1.44 % in conventional insulin group with or without OHA group. The HbA1c improved better when baseline HbA1c was higher than 9%, c-peptide was higher than 0.6 ng/mL, duration of diabetes was shorter than 15 years, BMI was lower than 30 kg/m2 and prior conventional insulin dose was less than 30 IU. However, those effects were attenuated in subjects having duration of diabetes longer than 16 years, BMI higher than 30 kg/m2 and prior insulin dose more than 40 IU. Dose conversion ratio of the insulin glargine to prior insulin was 0.78 +/- 0.30 and showed a tendency to increase in patients who have prior insulin dose more than 40 IU. The scores of the patients' subjective satisfaction on insulin glargine were all high, irrespective of the changes of HbA1c. CONCLUSIONS: Once daily injection of insulin glargine and oral ingestion of glimepiride can be recommended as one of starting insulin regimen for patients who are not adequately controlled by OHA alone or as once daily regimen for whom treated with one or two conventional insulin therapy.
- Titration with an Initially Lower Dose Increased Compliance of Cilostazol (Pletaal(R)) in Diabetic Patients.
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Hyo Jeong Kim, Kyung Ah Han, Hyun Jin Kim, Kang Seo Park, Eung Jin Kim, Kyung Wan Min
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Korean Diabetes J. 2006;30(5):388-397. Published online September 1, 2006
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DOI: https://doi.org/10.4093/jkda.2006.30.5.388
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- BACKGROUND
Headache is frequently reported by patients using cilostazol, which is a potent inhibitor of platelet aggregation with vasodilatory effects, for preventing atherosclerotic disease. The aims of this study were to think out a dosing schedule for improving compliance on headache and to investigate the possible mechanisms of headache associated with atherosclerosis measured as carotid intimal-media thickness (IMT) in Korean diabetic patients. METHODS: We therefore randomized patients into three groups according to the different dosing regimens for 6 weeks (1) group 1; 50 mg once daily, followed by 50 mg twice daily, and then 100 mg twice daily or (2) group 2; 50 mg twice daily, followed by 100 mg twice daily or (3) group 3; 100 mg twice daily without titration. We evaluated severity of the headache by visual analog scaled (VAS) symptom score from zero to ten and measured carotid IMT using high resolution ultrasound. RESULTS: A total of 122 diabetic patients were analyzed. The mean values of age, sex, duration of diabetes, BMI, HbA1c, lipid profiles, blood pressure, and smoking were not different among three groups. The proportion of headache was significantly lower in group 1 than group 2 and 3 (26% vs. 48% and 51%, P < 0.05). The proportion of severe headache was significantly lower in group 1 than group 2 and 3 (3% vs. 19% , 27%, P < 0.05). Among patients who had headache, the proportion of severe headache was significantly lower in group 1 than group 3. (10% vs. 52%, P < 0.05). The VAS symptom score of headache was significantly lower in group 1 than group 3 (4.9+/-2.1 vs. 7.0+/-2.4, P < 0.05). The proportion of the discontinuation of medication due to headache was significantly lower in group 1 than other two groups (8% vs. 24% and 29%, P < 0.05). The patients who had discontinued medication due to headache had lower carotid IMT than in whom were tolerable (Mean carotid IMT; 0.65+/-0.12 vs. 0.77+/-0.16 mm, P < 0.01, Maximal carotid IMT; 0.80+/-0.17 vs. 0.94+/-0.23 mm, P < 0.01). The proportion of patients who had discontinued medication due to headache was significantly lower in group 1 than other two groups (8% vs. 24%, 29%, P < 0.05] CONCLUSION: Titration with an initially lower dose of cilostazol could be considered to reduce the proportion and severity of headache and thereby increase compliance. Atherosclerosis estimated as carotid IMT may contribute to the tolerability of cilostazol.
- A case of Rhino-Orbital Mucormycosis in Newly Diagnosed type 1 Diabetic patient.
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Jae Min Lee, Kyu Yuop Hwang, Gi Young Choi, Hyo Jung Nam, Dong Hyun Seo, Sun Hyun Park, Jun hwa Hong, Hyun Jin Kim, Kang Seo Park
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Korean Diabetes J. 2005;29(5):495-499. Published online September 1, 2005
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- Rhino-orbital mucormycosis was a rare, but mostly fatal fungal infection, usually found in poorly controlled diabetics or other immunocompromised hosts. This fungal infection begins from the nose, and rapidly spreads to the paranasal sinus (PNS), orbits and central nervous system(CNS), and finally extends to the entire organ. Early diagnosis and treatment is the only way to increase the survival rate. Herein Is reported We experienced a case of rhino-orbital mucormycosis, with type 1 diabetes mellitus, which was confirmed by a maxillary sinus biopsy. A 38-year-old male had been frequently treated for tonsillitis, but with no history of diabetes mellitus. He was admitted with mental change, accompanied by a fever, facial tenderness and swelling, with progressive visual acuity loss. During admission, CT and MRI of the in orbital area were performed. A biopsy in of the nasal cavity was also performed, and the mucormycosis was diagnosed through the pathological finding. The patient was treated with intravenous amphotericn B and an endoscopic antrostomy.
- Effect of Pancreatic Islet Autotransplantation after Pacreatectomy in Patients with Benign Pancreatic Tumor.
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Jae Hwan Jee, Byung Wan Lee, Seung Hoon Oh, Ji Youn Kim, Hyun Jin Kim, Jung Hyun Noh, Sung Ho Choi, Jae Hoon Chung, Yong Ki Min, Myung Sik Lee, Moon Kyu Lee, Kwang Won Kim
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Korean Diabetes J. 2004;28(2):88-100. Published online April 1, 2004
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- BACKGROUND
Previously, in patients suffering from insulin deficient DM after a partial or total pancreatectomy as treatment for a benign pancreatic tumor, insulin treatment has only led to severe fluctuation in the blood glucose level, and frequently to sudden hypoglycemia due to glucagon deficiency and lack of delicate insulin control. Several worldwide reports have suggested that autologous transplantation of islet cells isolated from an unaffected portion of a resected pancreas, mostly for the cure of chronic pancreatitis or a pancreatic tumor without immunosuppressive agent treatment, resulted in good glycemic control, and even in the prevention of DM. Attempts were made to evaluate the effect of islet autotrans-plantation for glycemic control in eight patients undergoing a pancreatectomy for a benign pancreatic tumor. METHOD: Between December 2001 and October 2003, an islet autotransplantation was performed in eight patients patholologically confirmed with benign pancreatic tumors following a pancreatectomy. There was no past medical history of DM in any of the patients, but impaired glucose tolerance(IGT) was detected in 2 patients on a 75g oral glucose tolerance test(oral GTT), and was also suspected in a pre-pancreatectomy state patient. Islets were isolated by ductal perfusion, using the cold collagenase P and semi-automated method, and purified on a density gradients using a COBE 2991 cell processor or tube system of Ficoll solution. After being confirmed as a benign pancreatic tumor, the cultured islet cells were transplanted to the liver through the portal vein. Each patient was transplanted with a mean islet mass of 3,190+/-896 islet equivalents per kilogram of body weight. The median follow-up period was 12 months, with the longest being 36 months. All patients underwent follow-up for oral GTT, HbA1c and complication of DM, pancreatectomy, or transplantation within this period. RESULTS: On the 75g oral GTT, a normal glucose tolerance(NGT) was maintained until the last follow-up month in five of the eight patients undergoing islet autotransplantation. DM recurred in three of the eight patients undergoing islet autotransplantation, with to cases in a state of IGT and 1 case of NGT at the initial stage. The HbA1c levels were not significantly changed between pre-pancreatectomy and post-islet transplantation period. The amplitude of the decrease in the postprandial 2 hour glucose level was larger than that of the fasting glucose level between the pre- and post-transplantation periods, but this was not statistically. Also, the elevation of the postprandial C-peptide level was larger than the fasting C-peptide during the post-transplantation period, but again, this was not significant. No complications occurred in relation with the islet transplantation, portography, DM and hypoglycemia. CONCLUSION: Islet transplantation could prevent and reverse the diabetic process in patients undergoing a pancreatectomy for a benign pancreatic tumor, with some exception such as those with a small transplanted islet mass or with initial insulin resistance. The 2 hour postprandial changes in the glucose and C- peptide levels on the oral GTT somewhat reflected insulin secretory function of the remaining and newly transplanted islet cells. Pancreatic islet autotransplantation is the most prospective method for the prevention or cure of insulin deficient DM following a pancreatectomy for a benign pancreatic tumor.
- Activin A Converts Pancreatic Ductal Cells into Insulin-Secreting Cells.
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Kyoung Hee Lee, Mi Kyung Park, Han Wook Kang, Hyun Jin Kim, In Kyung Jeong, Hyung Joon Yoo, Jae Hoon Jeong, Yong Ki Min, Myung Shik Lee, Kwang Won Kim, Moon Kyu Lee
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Korean Diabetes J. 2004;28(1):20-27. Published online February 1, 2004
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- BACKGROUND
Islet transplantation as a potential treatment for diabetes has been investigated extensively over the past years. One of the major limitations to successful islet transplantation is shortage of insulin-producing tissue, which has stimulated the search for alternative sources, and recently, attention has been focused on the possible use of controlled differentiation of stem cells to obtain specialized cells useful in treating many diseases. It is currently believed that pancreatic progenitor or stem cells exist in the ductal cell population. Activin A is a member of the TGFbeta superfamily, which can block the exocrine pancreatic development and potentiate the endocrine development of the pancreas. In this study, whether activin A could expand and/or differentiate the ductal cells into insulin-producing cells was examined. METHODS: From a collagenase P digested pancreas, ductal tissue was cultured under conditions that allowed expansion as a monolayer, where the cells were overlaid with a rat tail collagen I-coated dish. Activin A cDNA was transfected into rat ductal cells by using Lipofectamine, and the insulin secretion, content and differentiation markers examined. RESULT: The clumps of ductal tissue adhered to the dish 24 hr later, and formed a complete monolayer after 3 days of culture. Activin A overexpression significantly increased both the insulin secretion and content from the ductal cells. The glucose(16.7mM)-induced insulin secretion was also significantly increased. Immunohistochemistry and RT-PCR analyses revealed expression of PDX-1, as well as insulin & GLUT2. CONCLUSION: Activin A overexpression could potentiate the differentiation of pancreatic ductal cells, which might provide a potential new source of cinsulin- producing cells for transplantation
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