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Mi Jin Kim  (Kim MJ) 8 Articles
A Study on Resistance in Type 2 Diabetic Patient Against Commencement of Insulin Treatment.
Sun Hwa Hong, Mi Jin Kim, Sung Gab Noh, Dae Won Suh, Suk Jung Youn, Kwan Woo Lee, Ho Chae Lee, Yang Soo Chung, Hong Ryang Chung, Hyuk Sang Kwon, Bong Yun Cha, Ho Young Son, Kun Ho Yoon
Korean Diabetes J. 2008;32(3):269-279.   Published online June 1, 2008
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  • 48 Download
  • 8 Crossref
AbstractAbstract PDF
To achieve tight glycemic control in the poorly controlled type 2 diabetic patients with oral hypoglycemic agent, it maybe beneficial to initiate insulin treatment at the early stage. Many patients with type 2 diabetes are often reluctant to begin insulin therapy despite poor glycemic control with oral hypoglycemic agents, this little known phenomenon, often termed 'psychological insulin resistance (PIR)'. This study investigates psychological insulin resistance in Korean patients with type 2 diabetes. METHOD: This study examined a total of 76 type 2 diabetic patients with poor glycemic control during period of April to July 2006. Through questionnaire and telephone survey, total 24 questions were asked about various attitudes on insulin therapy including psychological barriers and patients' acceptance of this treatment. Subjects were asked to allocate points in 5-point scale (from 5 points for 'very true' to 1 point for 'very untrue'). RESULTS: The means of psychological rejection, injection-related anxiety and fear of insulin side effects such as hypoglycemia and weight gain were 3.65 +/- 0.92, 3.17 +/- 0.98 and 2.8 +/- 1.02, respectively. Unwillingness was common in insulin therapy, 67% of patient rejected or was unwilling to take insulin. Main reasons of patients most frequently endorsed beginning insulin indicate that disease is worsening, permanence (once you start insulin you can never quit) and sense of personal failure. Furthermore, study indicates that patients' reasons for avoiding insulin therapy were mainly psychological rejection, which extended far beyond a simple injection related anxiety. CONCLUSION: PIR was psychological reluctance rather than injection related anxiety. To overcome these psychological barriers to insulin treatment, it is necessary to address appropriate diabetes education including training and counseling with excellent interactive communications between patients and clinicians.


Citations to this article as recorded by  
  • Using Motivational Interviewing to Overcome Psychological Insulin Resistance
    Sung-Chul Lim
    The Journal of Korean Diabetes.2023; 24(4): 227.     CrossRef
  • Psychological Insulin Resistance: Key Factors and Intervention
    Yeon Jeong Jang
    The Journal of Korean Diabetes.2021; 22(3): 192.     CrossRef
  • Factors influencing psychological insulin resistance in type 2 diabetes patients
    Ji Hyeon Yu, Hye Young Kim, Sung Reul Kim, Eun Ko, Heung Yong Jin
    International Journal of Nursing Practice.2019;[Epub]     CrossRef
  • Development of a Psychological Insulin Resistance Scale for Korean Patients with Diabetes
    Youngshin Song, Younghee Jeon, Jeonghwa Cho, Bohyun Kim
    Journal of Korean Academy of Nursing.2016; 46(6): 813.     CrossRef
  • Patients' perspectives on taking insulin in diabetes - Perspectives of convergence
    Youngshin Song, Eunkyong Ah
    Journal of Digital Convergence.2016; 14(12): 283.     CrossRef
  • Concept Analysis for Psychological Insulin Resistance in Korean People with Diabetes
    Youngshin Song
    Journal of Korean Academy of Nursing.2016; 46(3): 443.     CrossRef
  • New Insulin Injection Recommendations
    Min Jeong Gu
    The Journal of Korean Diabetes.2016; 17(4): 261.     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
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
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  • 21 Download
AbstractAbstract PDF
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.
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
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 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.
The Effects of Lifestyle Modification on the Metabolic Parameters of Type 2 Diabetes.
So Hun Kim, Eun Seok Kang, So Young Park, Suk Jeong Lee, Mi Jin Kim, Ji Soo Yoo, Chul Woo Ahn, Bong Soo Cha, Sung Kil Lim, Hyun Chul Lee
Korean Diabetes J. 2004;28(5):441-451.   Published online October 1, 2004
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  • 32 Download
AbstractAbstract PDF
Lifestyle modification is known to have positive effects on glycemic control and improving the cardiovascular risk factors. Although lifestyle modification is considered to be important in treating diabetic patients, there are few studies concerning the direct effect of lifestyle modification on the patients with type 2 diabetes (T2DM). The aim of this study is to evaluate the effects of lifestyle modification on glycemic control, lipid profiles, body indices, serum adiponectin and the hsCRP levels for patients with T2DM in Korea. METHODS: Twenty two patients with T2DM who had no medication changes for the recent 3 months and who also had a HbA1c> or =7.0% were enrolled in a lifestyle modification program. These patients visited Severance Hospital Diabetes Center once every week for 12 weeks, and they were educated about exercise and diet control. Their metabolic and anthropometric parameters were compared with 22 control T2DM patients who were not in the program. RESULTS:Lifestyle modification group patients showed significant decrements in HbA1c (-0.62 +/- 1.29 vs. 0.14 +/- 0.91%, p=0.044), total cholesterol (-0.57 +/- 0.54 vs. -0.06 +/- 0.61 mmol/l, p=0.007), LDL cholesterol (-0.57 +/- 0.62 vs. 0.02 +/- 0.59 mmol/l, p=0.003), body weight (-1.5 +/- 19 vs. 0.2 +/- 1.5 kg, p=0.005) and BMI (-0.6 +/- 0.7 vs 0.0 +/- 0.6 kg/m2, p=0.003) compared with the control subjects. HOMAIR, serum triglyceride, adiponectin, and hsCRP levels showed no significant difference compared to the control subjects. CONCLUSION: Lifestyle modification in Korean T2DM patients had positive effects on weight loss, glycemic control, and lipid profiles. These changes imply that lifestyle modification will be helpful for managing DM and its complications.
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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AbstractAbstract PDF
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.
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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AbstractAbstract PDF
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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AbstractAbstract PDF
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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AbstractAbstract PDF
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.

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