- Guideline/Fact Sheet
- Dyslipidemia Fact Sheet in South Korea, 2022
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Eun-Sun Jin, Jee-Seon Shim, Sung Eun Kim, Jae Hyun Bae, Shinae Kang, Jong Chul Won, Min-Jeong Shin, Heung Yong Jin, Jenny Moon, Hokyou Lee, Hyeon Chang Kim, In-Kyung Jeong, on Behalf of the Committee of Public Relation of the Korean Society of Lipid and Atherosclerosis
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Diabetes Metab J. 2023;47(5):632-642. Published online August 2, 2023
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DOI: https://doi.org/10.4093/dmj.2023.0135
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- Background
This study aimed to investigate the prevalence and status of dyslipidemia management among South Korean adults, as performed by the Korean Society of Lipid and Atherosclerosis under the name Dyslipidemia Fact Sheet 2022.
Methods We analyzed the lipid profiles, age-standardized and crude prevalence, management status of hypercholesterolemia and dyslipidemia, and health behaviors among Korean adults aged ≥20 years, using the Korea National Health and Nutrition Examination Survey data between 2007 and 2020.
Results In South Korea, the crude prevalence of hypercholesterolemia (total cholesterol ≥240 mg/dL or use of a lipid-lowering drug) in 2020 was 24%, and the age-standardized prevalence of hypercholesterolemia more than doubled from 2007 to 2020. The crude treatment rate was 55.2%, and the control rate was 47.7%. The crude prevalence of dyslipidemia—more than one out of three conditions (low-density lipoprotein cholesterol ≥160 or the use of a lipid-lowering drug, triglycerides ≥200, or high-density lipoprotein cholesterol [HDL-C] [men and women] <40 mg/dL)—was 40.2% between 2016 and 2020. However, it increased to 48.2% when the definition of hypo-HDL-cholesterolemia in women changed from <40 to <50 mg/dL.
Conclusion Although the prevalence of hypercholesterolemia and dyslipidemia has steadily increased in South Korea, the treatment rate remains low. Therefore, continuous efforts are needed to manage dyslipidemia through cooperation between the national healthcare system, patients, and healthcare providers.
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Citations
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- Big Data Research for Diabetes-Related Diseases Using the Korean National Health Information Database
Kyung-Soo Kim, Bongseong Kim, Kyungdo Han Diabetes & Metabolism Journal.2025; 49(1): 13. CrossRef - Automated process assessment of primary healthcare for hyperlipidemia: preliminary findings and implications form Anhui, China
Ningjing Yang, Yuning Wang, Ying Li, Dongying Xiao, Ruirui Cui, Nana Li, Rong Liu, Jing Chai, Xingrong Shen, Debin Wang Lipids in Health and Disease.2025;[Epub] CrossRef - Oxidative Balance Score and New-Onset Type 2 Diabetes Mellitus in Korean Adults without Non-Alcoholic Fatty Liver Disease: Korean Genome and Epidemiology Study-Health Examinees (KoGES-HEXA) Cohort
Mid-Eum Moon, Dong Hyuk Jung, Seok-Jae Heo, Byoungjin Park, Yong Jae Lee Antioxidants.2024; 13(1): 107. CrossRef - Comparison of metabolic and neurological comorbidities in Asian patients with psoriasis and atopic dermatitis
Hee Joo Yang, Mi Young Lee, Jeong Hyeon Lee, Chang Jin Jung, Woo Jin Lee, Chong Hyun Won, Mi Woo Lee, Joon Min Jung, Sung Eun Chang Scientific Reports.2024;[Epub] CrossRef - Effect of Adding Apolipoprotein B Testing on the Prevalence of Dyslipidemia and Risk of Cardiovascular Disease in the Korean Adult Population
Rihwa Choi, Sang Gon Lee, Eun Hee Lee Metabolites.2024; 14(3): 169. CrossRef - Body Weight Variability and Risk of Suicide Mortality: A Nationwide Population-Based Study
Jeongmin Lee, Jin-Hyung Jung, Dong Woo Kang, Min-Hee Kim, Dong-Jun Lim, Hyuk-Sang Kwon, Jung Min Lee, Sang-Ah Chang, Kyungdo Han, Seung-Hwan Lee, Fuquan Zhang Depression and Anxiety.2024; 2024: 1. CrossRef - Association of atherosclerosis indices, serum uric acid to high‐density lipoprotein cholesterol ratio and triglycerides‐glucose index with hypertension: A gender‐disaggregated analysis
Rana Kolahi Ahari, Toktam Sahranavard, Amin Mansoori, Zahra Fallahi, Negin Babaeepoor, Gordon Ferns, Majid Ghayour‐Mobarhan The Journal of Clinical Hypertension.2024; 26(6): 645. CrossRef - A Machine Learning Approach to Identify of Dyslipidemia based on Body Composition Indices in Men
Mi Hong Yim, Sanghun Lee The Journal of Korean Institute of Information Technology.2024; 22(6): 153. CrossRef - Association of aerobic and muscle-strengthening physical activity with chronic kidney disease in participants with hypertension
Yunmin Han, Younghwan Choi, Yeon Soo Kim Clinical Hypertension.2024;[Epub] CrossRef - Recent trends of low-density lipoprotein cholesterol control and lipid-lowering therapy in patients with atherosclerotic cardiovascular disease in Taiwan: 2015–2020
Tzu-Yang Chen, Yu-Chung Hsiao, Yen-Wen Wu, Tsung-Hsien Lin, Wayne Huey-Herng Sheu, Thung-Lip Lee, I-Chang Hsieh, Yi-Heng Li, Wei-Hsian Yin, Hung-I Yeh, Jaw-Wen Chen, Fang-Ju Lin, Chau-Chung Wu Journal of the Formosan Medical Association.2024;[Epub] CrossRef - Study Design and Protocol for a Randomized Controlled Trial to Assess Long-Term Efficacy and Safety of a Triple Combination of Ezetimibe, Fenofibrate, and Moderate-Intensity Statin in Patients with Type 2 Diabetes and Modifiable Cardiovascular Risk Factor
Nam Hoon Kim, Juneyoung Lee, Suk Chon, Jae Myung Yu, In-Kyung Jeong, Soo Lim, Won Jun Kim, Keeho Song, Ho Chan Cho, Hea Min Yu, Kyoung-Ah Kim, Sang Soo Kim, Soon Hee Lee, Chong Hwa Kim, Soo Heon Kwak, Yong‐ho Lee, Choon Hee Chung, Sihoon Lee, Heung Yong J Endocrinology and Metabolism.2024; 39(5): 722. CrossRef - Exploring Utilization and Establishing Reference Intervals for the Apolipoprotein B Test in the Korean Population
Rihwa Choi, Sang Gon Lee, Eun Hee Lee Diagnostics.2023; 13(20): 3194. CrossRef
- Complications
- Influence of Glucose Fluctuation on Peripheral Nerve Damage in Streptozotocin-Induced Diabetic Rats
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Yu Ji Kim, Na Young Lee, Kyung Ae Lee, Tae Sun Park, Heung Yong Jin
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Diabetes Metab J. 2022;46(1):117-128. Published online September 9, 2021
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DOI: https://doi.org/10.4093/dmj.2020.0275
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- Background
It is unclear whether glycemic variability (GV) is a risk factor for diabetic peripheral neuropathy (DPN), and whether control of GV is beneficial for DPN. The purpose of this study was to investigate the effect of GV on peripheral nerve damage by inducing glucose fluctuation in streptozotocin-induced diabetic rats.
Methods Rats were divided into four groups: normal (normal glucose group [NOR]), diabetes without treatment (sustained severe hyperglycemia group; diabetes mellitus [DM]), diabetes+once daily insulin glargine (stable hyperglycemia group; DM+LAN), and diabetes+once daily insulin glargine with twice daily insulin glulisine (unstable glucose fluctuation group; DM+Lantus [LAN]+Apidra [API]). We measured anti-oxidant enzyme levels and behavioral responses against tactile, thermal, and pressure stimuli in the plasma of rats. We also performed a quantitative comparison of cutaneous and sciatic nerves according to glucose fluctuation.
Results At week 24, intraepidermal nerve fiber density was less reduced in the insulin-administered groups compared to the DM group (P<0.05); however, a significant difference was not observed between the DM+LAN and DM+LAN+API groups irrespective of glucose fluctuation (P>0.05; 16.2±1.6, 12.4±2.0, 14.3±0.9, and 13.9±0.6 for NOR, DM, DM+LAN, and DM+LAN+API, respectively). The DM group exhibited significantly decreased glutathione levels compared to the insulin-administered groups (2.64±0.10 μmol/mL, DM+LAN; 1.93±0.0 μmol/mL, DM+LAN+API vs. 1.25±0.04 μmol/mL, DM; P<0.05).
Conclusion Our study suggests that glucose control itself is more important than glucose fluctuation in the prevention of peripheral nerve damage, and intra-day glucose fluctuation has a limited effect on the progression of peripheral neuropathy in rats with diabetes.
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Citations
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- Glucose Fluctuation Inhibits Nrf2 Signaling Pathway in Hippocampal Tissues and Exacerbates Cognitive Impairment in Streptozotocin-Induced Diabetic Rats
Haiyan Chi, Yujing Sun, Peng Lin, Junyu Zhou, Jinbiao Zhang, Yachao Yang, Yun Qiao, Deshan Liu, Eusebio Chiefari Journal of Diabetes Research.2024; 2024: 1. CrossRef - Artesunate Inhibits Apoptosis and Promotes Survival in Schwann Cells via the PI3K/AKT/mTOR Axis in Diabetic Peripheral Neuropathy
Xin Zhang, Zhifang Liang, Ying Zhou, Fang Wang, Shan Wei, Bing Tan, Yujie Guo Biological and Pharmaceutical Bulletin.2023; 46(6): 764. CrossRef - The Potential of Glucose Treatment to Reduce Reactive Oxygen Species Production and Apoptosis of Inflamed Neural Cells In Vitro
Juin-Hong Cherng, Shu-Jen Chang, Hsin-Da Tsai, Chung-Fang Chun, Gang-Yi Fan, Kenneth Dean Reeves, King Hei Stanley Lam, Yung-Tsan Wu Biomedicines.2023; 11(7): 1837. CrossRef - Relationship between acute glucose variability and cognitive decline in type 2 diabetes: A systematic review and meta-analysis
Haiyan Chi, Min Song, Jinbiao Zhang, Junyu Zhou, Deshan Liu, Victor Manuel Mendoza-Nuñez PLOS ONE.2023; 18(9): e0289782. CrossRef
- Drug/Regimen
- Efficacy and Safety of Treatment with Quadruple Oral Hypoglycemic Agents in Uncontrolled Type 2 Diabetes Mellitus: A Multi-Center, Retrospective, Observational Study
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Jun Sung Moon, Sunghwan Suh, Sang Soo Kim, Heung Yong Jin, Jeong Mi Kim, Min Hee Jang, Kyung Ae Lee, Ju Hyung Lee, Seung Min Chung, Young Sang Lyu, Jin Hwa Kim, Sang Yong Kim, Jung Eun Jang, Tae Nyun Kim, Sung Woo Kim, Eonju Jeon, Nan Hee Cho, Mi-Kyung Kim, Hye Soon Kim, Il Seong Nam-Goong, Eun Sook Kim, Jin Ook Chung, Dong-Hyeok Cho, Chang Won Lee, Young Il Kim, Dong Jin Chung, Kyu Chang Won, In Joo Kim, Tae Sun Park, Duk Kyu Kim, Hosang Shon
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Diabetes Metab J. 2021;45(5):675-683. Published online August 12, 2020
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DOI: https://doi.org/10.4093/dmj.2020.0107
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Background
Only few studies have shown the efficacy and safety of glucose-control strategies using the quadruple drug combination. Therefore, the aim of the present study was to investigate the usefulness of the quadruple combination therapy with oral hypoglycemic agents (OHAs) in patients with uncontrolled type 2 diabetes mellitus (T2DM).
Methods
From March 2014 to December 2018, data of patients with T2DM, who were treated with quadruple hypoglycemic medications for over 12 months in 11 hospitals in South Korea, were reviewed retrospectively. We compared glycosylated hemoglobin (HbA1c) levels before and 12 months after quadruple treatment with OHAs. The safety, maintenance rate, and therapeutic patterns after failure of the quadruple therapy were also evaluated.
Results
In total, 357 patients were enrolled for quadruple OHA therapy, and the baseline HbA1c level was 9.0%±1.3% (74.9±14.1 mmol/mol). After 12 months, 270 patients (75.6%) adhered to the quadruple therapy and HbA1c was significantly reduced from 8.9%±1.2% to 7.8%±1.3% (mean change, −1.1%±1.2%; P<0.001). The number of patients with HbA1c <7% increased significantly from 5 to 68 (P<0.005). In addition, lipid profiles and liver enzyme levels were also improved whereas no changes in body weight. There was no significant safety issue in patients treated with quadruple OHA therapy.
Conclusion
This study shows the therapeutic efficacy of the quadruple OHA regimen T2DM and demonstrates that it can be an option for the management of T2DM patients who cannot use insulin or reject injectable therapy.
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- Empagliflozin-based quadruple oral therapy for type 2 diabetes: a prospective cohort study
Fatemeh Moosaie, Shiva Abedinzadeh, Soghra Rabizadeh, Kimia Daneshvar, Mohammadamin Noorafrooz, Fatemeh Alsadat Mojtahedi, Niloofar Deravi, Seyede Marzie Fatemi Abhari, Akam Ramezani, Alipasha Meysamie, Marzieh Hajibabaei, Sahar Karimpour Reyhan, Mahsa Ab Scientific Reports.2025;[Epub] CrossRef - Estimating Type 2 Diabetes Prevalence: A Model of Drug Consumption Data
Rita Oliveira, Matilde Monteiro-Soares, José Pedro Guerreiro, Rúben Pereira, António Teixeira-Rodrigues Pharmacy.2024; 12(1): 18. CrossRef - Disease burden and symptom management in type 2 diabetic patients: A phenomenological study
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Nadia Gul, Inayat Ur Rehman, Yasar shah, Arbab Muhammad Ali, Zahid Ali, Omer Shehzad, Khang Wen Goh, Long Chiau Ming, Amal K. Suleiman, Nimesh Lageju PLOS ONE.2024; 19(11): e0311435. CrossRef - Efficacy and safety of enavogliflozin versus dapagliflozin added to metformin plus gemigliptin treatment in patients with type 2 diabetes: A double-blind, randomized, comparator-active study: ENHANCE-D study
Kyung-Soo Kim, Kyung Ah Han, Tae Nyun Kim, Cheol-Young Park, Jung Hwan Park, Sang Yong Kim, Yong Hyun Kim, Kee Ho Song, Eun Seok Kang, Chul Sik Kim, Gwanpyo Koh, Jun Goo Kang, Mi Kyung Kim, Ji Min Han, Nan Hee Kim, Ji Oh Mok, Jae Hyuk Lee, Soo Lim, Sang S Diabetes & Metabolism.2023; 49(4): 101440. CrossRef - Effectiveness and safety of teneligliptin added to patients with type 2 diabetes inadequately controlled by oral triple combination therapy: A multicentre, randomized, double‐blind, and placebo‐controlled study
Minyoung Lee, Woo‐je Lee, Jae Hyeon Kim, Byung‐Wan Lee Diabetes, Obesity and Metabolism.2022; 24(6): 1105. CrossRef - A double‐blind, Randomized controlled trial on glucose‐lowering EFfects and safety of adding 0.25 or 0.5 mg lobeglitazone in type 2 diabetes patients with INadequate control on metformin and dipeptidyl peptidase‐4 inhibitor therapy: REFIND study
Soree Ryang, Sang Soo Kim, Ji Cheol Bae, Ji Min Han, Su Kyoung Kwon, Young Il Kim, Il Seong Nam‐Goong, Eun Sook Kim, Mi‐kyung Kim, Chang Won Lee, Soyeon Yoo, Gwanpyo Koh, Min Jeong Kwon, Jeong Hyun Park, In Joo Kim Diabetes, Obesity and Metabolism.2022; 24(9): 1800. CrossRef - Glycaemic control with add‐on thiazolidinedione or a sodium‐glucose co‐transporter‐2 inhibitor in patients with type 2 diabetes after the failure of an oral triple antidiabetic regimen: A 24‐week, randomized controlled trial
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- Lost in Translation? Measuring Diabetic Neuropathy in Humans and Animals (Diabetes Metab J 2021;45:27-42)
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Heung Yong Jin, Seong-Su Moon, Nigel A. Calcutt
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Diabetes Metab J. 2021;45(3):457-458. Published online May 25, 2021
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DOI: https://doi.org/10.4093/dmj.2021.0034
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- Multimodal Comparison of Diabetic Neuropathy in Aged Streptozotocin-Treated Sprague–Dawley and Zucker Diabetic Fatty Rats
Annalisa Canta, Valentina A. Carozzi, Alessia Chiorazzi, Cristina Meregalli, Norberto Oggioni, Virginia Rodriguez-Menendez, Barbara Sala, Roberto Cosimo Melcangi, Silvia Giatti, Raffaella Lombardi, Roberto Bianchi, Paola Marmiroli, Guido Cavaletti Biomedicines.2022; 11(1): 20. CrossRef
- Complications
- Lost in Translation? Measuring Diabetic Neuropathy in Humans and Animals
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Heung Yong Jin, Seong-Su Moon, Nigel A. Calcutt
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Diabetes Metab J. 2021;45(1):27-42. Published online December 15, 2020
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DOI: https://doi.org/10.4093/dmj.2020.0216
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- The worldwide diabetes epidemic is estimated to currently afflict almost 500 million persons. Long-term diabetes damages multiple organ systems with the blood vessels, eyes, kidneys and nervous systems being particularly vulnerable. These complications of diabetes reduce lifespan, impede quality of life and impose a huge social and economic burden on both the individual and society. Peripheral neuropathy is a debilitating complication that will impact over half of all persons with diabetes. There is no treatment for diabetic neuropathy and a disturbingly long history of therapeutic approaches showing promise in preclinical studies but failing to translate to the clinic. These failures have prompted re-examination of both the animal models and clinical trial design. This review focuses on the functional and structural parameters used as indices of peripheral neuropathy in preclinical and clinical studies and the extent to which they share a common pathogenesis and presentation. Nerve conduction studies in large myelinated fibers have long been the mainstay of preclinical efficacy screening programs and clinical trials, supplemented by quantitative sensory tests. However, a more refined approach is emerging that incorporates measures of small fiber density in the skin and cornea alongside these traditional assays at both preclinical and clinical phases.
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Corinne G. Jolivalt, May Madi Han, Annee Nguyen, Fiona Desmond, Carlos Henrique Alves Jesus, Daniela C. Vasconselos, Andrea Pedneault, Natalie Sandlin, Sage Dunne-Cerami, Katie E. Frizzi, Nigel A. Calcutt Journal of Clinical Medicine.2022; 11(9): 2307. CrossRef - Glycyrrhizic acid promotes sciatic nerves recovery in type 1 diabetic rats and protects Schwann cells from high glucose-induced cytotoxicity
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Ioannis N. Petropoulos, Georgios Ponirakis, Maryam Ferdousi, Shazli Azmi, Alise Kalteniece, Adnan Khan, Hoda Gad, Bilal Bashir, Andrew Marshall, Andrew J.M. Boulton, Handrean Soran, Rayaz A. Malik Clinical Therapeutics.2021; 43(9): 1457. CrossRef - Lost in Translation? Measuring Diabetic Neuropathy in Humans and Animals (Diabetes Metab J 2021;45:27-42)
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- Drug/Regimen
- Metformin Preserves Peripheral Nerve Damage with Comparable Effects to Alpha Lipoic Acid in Streptozotocin/High-Fat Diet Induced Diabetic Rats
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Sun Hee Kim, Tae Sun Park, Heung Yong Jin
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Diabetes Metab J. 2020;44(6):842-853. Published online May 28, 2020
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DOI: https://doi.org/10.4093/dmj.2019.0190
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Background
Metformin is widely marketed medication for the treatment of diabetes, but its pharmacological effect on diabetic peripheral neuropathy remains unclear. In this study, the effect of metformin on peripheral nerves in diabetic rats was investigated using diverse neuronal parameters of nerve fibers.
Methods
Rats were assigned to one of four groups (n=7 to 10 per group): normal, diabetes mellitus (DM), DM+metformin (100 mg/kg), and DM+alpha lipoic acid (ALA, 100 mg/kg). DM was induced by streptozotocin/high-fat diet (STZ/HFD). After 12 weeks, the sensory thresholds to mechanical and heat stimuli were assessed. Repeated sensory tests, immunofluorescence microscopic comparison of peripheral nerves, and biochemical blood analysis were performed after 24 weeks.
Results
Both DM+metformin and DM+ALA groups showed similar trends to diverse sensory tests at 24 weeks compared to DM group although the degree of change were different according to the stimulated senses. There was no significant difference in the comparison of the intraepidermal nerve fiber density (IENFD) of peripheral nerves between the DM+metformin and DM+ALA groups (11.83±0.07 fibers/mm vs. 12.37±1.82 fibers/mm, respectively). Both groups showed preserved IENFD significantly compared with DM group (8.46±1.98 fibers/mm, P<0.05). Sciatic nerve morphology of the experimental animals showed a similar trend to the IENFD, with respect to axonal diameter, myelin sheath thickness, and myelinated fiber diameter.
Conclusion
Metformin has beneficial pharmacological effects on the preservation of peripheral nerves in diabetic rats and its effects are comparable to those of ALA.
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Jonathan M. Hagedorn, Alyson M. Engle, Tony K. George, Jay Karri, Newaj Abdullah, Erik Ovrom, Jhon E. Bocanegra-Becerra, Ryan S. D'Souza Diabetes Research and Clinical Practice.2022; 188: 109928. CrossRef - The role of MicroRNA networks in tissue-specific direct and indirect effects of metformin and its application
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Bo Kyung Koo Diabetes & Metabolism Journal.2021; 45(1): 125. CrossRef - Metformin Preserves Peripheral Nerve Damage with Comparable Effects to Alpha Lipoic Acid in Streptozotocin/High-Fat Diet Induced Diabetic Rats (Diabetes Metab J 2020;44:842-53)
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- Complications
- Effect of Empagliflozin, a Selective Sodium-Glucose Cotransporter 2 Inhibitor, on Kidney and Peripheral Nerves in Streptozotocin-Induced Diabetic Rats
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Kyung Ae Lee, Heung Yong Jin, Na Young Lee, Yu Ji Kim, Tae Sun Park
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Diabetes Metab J. 2018;42(4):338-342. Published online April 25, 2018
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DOI: https://doi.org/10.4093/dmj.2017.0095
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The effect of sodium-glucose cotransporter 2 inhibitors on peripheral nerves and kidneys in diabetes mellitus (DM) remains unexplored. Therefore, this study aimed to explore the effect of empagliflozin in diabetic rats. DM in rats was induced by streptozotocin injection, and diabetic rats were treated with empagliflozin 3 or 10 mg/kg. Following 24-week treatment, response thresholds to four different stimuli were tested and found to be lower in diabetic rats than in normal rats. Empagliflozin significantly prevented hypersensitivity (P<0.05) and the loss of skin intraepidermal nerve fibers, and mesangial matrix expansion in diabetic rats. Results of this study demonstrate the potential therapeutic effects of empagliflozin for the treatment of diabetic peripheral neuropathy and nephropathy.
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Aqsa Ashfaq, Myriam Meineck, Andrea Pautz, Ebru Arioglu-Inan, Julia Weinmann-Menke, Martin C. Michel Pharmacology & Therapeutics.2023; 249: 108503. CrossRef - The impact of canagliflozin on the risk of neuropathy events: A post-hoc exploratory analysis of the CREDENCE trial
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- Complication
- Morphologic Comparison of Peripheral Nerves in Adipocyte Tissue from db/db Diabetic versus Normal Mice
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Kyung Ae Lee, Na Young Lee, Tae Sun Park, Heung Yong Jin
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Diabetes Metab J. 2018;42(2):169-172. Published online March 21, 2018
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DOI: https://doi.org/10.4093/dmj.2018.42.2.169
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Present study investigated the morphologic changes of autonomic nerves in the adipose tissue in diabetic animal model. Male obese type 2 diabetic db/db mice and age matched non-diabetic db/m control mice were used. Epididymal adipose tissue from diabetic db/db mice with that from control heterozygous db/m mice was compared using confocal microscopy-based method to visualize intact whole adipose tissue. Immunohistochemistry with tyrosine hydroxylase for sympathetic (SP), choline acetyltransferase for parasympathetic (PSP), and protein gene product 9.5 (PGP 9.5) for whole autonomic nerves was performed. The quantity of immunostained portion of SP, PSP, and PGP 9.5 stained nerve fibers showed decreased trend in diabetic group; however, the ratio of SP/PSP of adipose tissue was higher in diabetic group compared with control group as follows (0.70±0.30 vs. 0.95±0.25, P<0.05; normal vs. diabetic, respectively). Both SP and PSP nerve fibers were observed in white adipose tissue and PSP nerve fibers were suggested as more decreased in diabetes based on our observation.
- Pathophysiology
- Morphologic Changes in Autonomic Nerves in Diabetic Autonomic Neuropathy
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Heung Yong Jin, Hong Sun Baek, Tae Sun Park
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Diabetes Metab J. 2015;39(6):461-467. Published online December 11, 2015
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DOI: https://doi.org/10.4093/dmj.2015.39.6.461
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Diabetic neuropathy is one of the major complications of diabetes, and it increases morbidity and mortality in patients with both type 1 diabetes mellitus (T1DM) and type 2 diabetes mellitus (T2DM). Because the autonomic nervous system, for example, parasympathetic axons, has a diffuse and wide distribution, we do not know the morphological changes that occur in autonomic neural control and their exact mechanisms in diabetic patients with diabetic autonomic neuropathy (DAN). Although the prevalence of sympathetic and parasympathetic neuropathy is similar in T1DM versus T2DM patients, sympathetic nerve function correlates with parasympathetic neuropathy only in T1DM patients. The explanation for these discrepancies might be that parasympathetic nerve function was more severely affected among T2DM patients. As parasympathetic nerve damage seems to be more advanced than sympathetic nerve damage, it might be that parasympathetic neuropathy precedes sympathetic neuropathy in T2DM, which was Ewing's concept. This could be explained by the intrinsic morphologic difference. Therefore, the morphological changes in the sympathetic and parasympathetic nerves of involved organs in T1DM and T2DM patients who have DAN should be evaluated. In this review, evaluation methods for morphological changes in the epidermal nerves of skin, and the intrinsic nerves of the stomach will be discussed.
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- Impaired Cardiovagal Activity as a Link Between Hyperglycemia and Arterial Stiffness in Adults With Type 2 Diabetes Mellitus Among an Eastern Indian Population: A Cross-sectional Study
Nibedita Priyadarsini, Devineni Likhitha, Madumathy Ramachandran, Kishore Kumar Behera Canadian Journal of Diabetes.2024; 48(3): 147. CrossRef - Diabetic visceral neuropathy of gastroparesis: Gastric mucosal innervation and clinical significance
Ping‐Huei Tseng, Chi‐Chao Chao, Ya‐Yin Cheng, Chieh‐Chang Chen, Ping‐Hao Yang, Wei‐Kang Yang, Shao‐Wei Wu, Yen‐Wen Wu, Mei‐Fang Cheng, Wei‐Shiung Yang, Ming‐Shiang Wu, Sung‐Tsang Hsieh European Journal of Neurology.2022; 29(7): 2097. CrossRef - Pathogenesis of Distal Symmetrical Polyneuropathy in Diabetes
Sasha Smith, Pasha Normahani, Tristan Lane, David Hohenschurz-Schmidt, Nick Oliver, Alun Huw Davies Life.2022; 12(7): 1074. CrossRef - Diabetic Cardiomyopathy and Ischemic Heart Disease: Prevention and Therapy by Exercise and Conditioning
Antonio Crisafulli, Pasquale Pagliaro, Silvana Roberto, Lucia Cugusi, Giuseppe Mercuro, Antigone Lazou, Christophe Beauloye, Luc Bertrand, Derek J. Hausenloy, Manuela Aragno, Claudia Penna International Journal of Molecular Sciences.2020; 21(8): 2896. CrossRef - Distribution characteristics of sweat gland nerve fibres in normal humans identified by acetylcholinesterase histochemical staining
Li Ling, Yongdan Liu, Yifei Sun, Yun Cai, Ye Jiang, Longjian Chen, Long He, Jinwei Xue Clinical Neurology and Neurosurgery.2020; 189: 105620. CrossRef - Diabetes abolish cardioprotective effects of remote ischemic conditioning: evidences and possible mechanisms
Sakshi Tyagi, Nirmal Singh, Jasleen kaur Virdi, Amteshwar Singh Jaggi Journal of Physiology and Biochemistry.2019; 75(1): 19. CrossRef - Regulation of glucose metabolism by bioactive phytochemicals for the management of type 2 diabetes mellitus
Chao Zhao, Chengfeng Yang, Sydney Tang Chi Wai, Yanbo Zhang, Maria P. Portillo, Paolo Paoli, Yijing Wu, Wai San Cheang, Bin Liu, Christian Carpéné, Jianbo Xiao, Hui Cao Critical Reviews in Food Science and Nutrition.2019; 59(6): 830. CrossRef - Pulse pressure amplification and cardiac autonomic dysfunction in patients with type 2 diabetes mellitus
Ioanna Eleftheriadou, George C. Drosos, Anastasios Tentolouris, Giorgios Konstantonis, Petros P. Sfikakis, Athanasios D. Protogerou, Nikolaos Tentolouris Journal of Human Hypertension.2018; 32(8-9): 531. CrossRef - Exposure to hypoglycemia and risk of stroke
Logan Smith, Diya Chakraborty, Pallab Bhattacharya, Deepaneeta Sarmah, Sebastian Koch, Kunjan R. Dave Annals of the New York Academy of Sciences.2018; 1431(1): 25. CrossRef - Association between the risk of falls and osteoporotic fractures in patients with type 2 diabetes mellitus
Maki Yokomoto-Umakoshi, Ippei Kanazawa, Shiori Kondo, Toshitsugu Sugimoto Endocrine Journal.2017; 64(7): 727. CrossRef - Diabetes‐induced mechanophysiological changes in the esophagus
Jingbo Zhao, Hans Gregersen Annals of the New York Academy of Sciences.2016; 1380(1): 139. CrossRef
- The Relationship between Anemia and the Initiation of Dialysis in Patients with Type 2 Diabetic Nephropathy
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Sun Hee Kim, Kyung Ae Lee, Heung Yong Jin, Hong Sun Baek, Tae Sun Park
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Diabetes Metab J. 2015;39(3):240-246. Published online April 22, 2015
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DOI: https://doi.org/10.4093/dmj.2015.39.3.240
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4,694
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- Background
Anemia is associated with various poor clinical outcomes in chronic kidney disease patients. The aim of this study was to investigate the relationship between anemia and the initiation degree and time of dialysis in type 2 diabetic nephropathy patients. MethodsThis observational retrospective study included 130 type 2 diabetic nephropathy patients in Korea. The existence of anemia, the degree and time of dialysis initiation were reviewed. Clinical characteristics and variables were also compared. ResultsThe levels of hemoglobin and serum creatinine were significantly correlated with the dialysis initiation (P<0.05) during the 10-year follow-up period. Patients with anemia showed rapid decline of renal function, causing significantly more dialysis initiation (54.1% vs. 5.4%, P<0.05) compare to the patients without anemia. Average time to initiate dialysis in patients with anemia was 45.1 months (range, 8.0 to 115.8 months), which was significantly faster than that (68.3 months [range, 23.3 to 108.8 months]) in patients without anemia (P<0.01). The risk to dialysis initiation was significantly increased in patients with anemia compared to the patients without anemia (adjusted hazard ratio, 8.1; 95% confidence interval, 2.4 to 27.0; P<0.05). ConclusionAnemia is associated with rapid decline of renal dysfunction and faster initiation of dialysis in diabetic nephropathy patients. Therefore, clinicians should pay an earlier attention to anemia during the management of diabetes.
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- Research Progress on Regulation of Nrf2/Keap1 Signaling Pathway by Traditional Chinese Medicine in the Treatment of Diabetic Nephropathy
Lei Haung, YanLin Ding, XiaoYong Yu Journal of Contemporary Medical Practice.2024; 6(9): 37. CrossRef - Microalbuminuria as the Tip of Iceberg in Type 2 Diabetes Mellitus: Prevalence, Risk Factors, and Associated Diabetic Complications
Sohaib Asghar, Shoaib Asghar, Tayyab Mahmood, Syed Muhammad Hassan Bukhari, Muhammad Habib Mumtaz, Ali Rasheed Cureus.2023;[Epub] CrossRef - The Association between Serum Hemoglobin and Renal Prognosis of IgA Nephropathy
Tae Ryom Oh, Su Hyun Song, Hong Sang Choi, Chang Seong Kim, Seung Hyeok Han, Kyung Pyo Kang, Young Joo Kwon, Soo Wan Kim, Seong Kwon Ma, Eun Hui Bae Journal of Clinical Medicine.2021; 10(2): 363. CrossRef - Prevalence of anemia in diabetic adult outpatients in Northeast Ethiopia
Temesgen Fiseha, Aderaw Adamu, Melkam Tesfaye, Angesom Gebreweld, Jennifer A. Hirst PLOS ONE.2019; 14(9): e0222111. CrossRef - Targeted Clinical Metabolite Profiling Platform for the Stratification of Diabetic Patients
Linda Ahonen, Sirkku Jäntti, Tommi Suvitaival, Simone Theilade, Claudia Risz, Risto Kostiainen, Peter Rossing, Matej Orešič, Tuulia Hyötyläinen Metabolites.2019; 9(9): 184. CrossRef - Effect of high density lipoprotein cholesterol on the relationship of serum iron and hemoglobin with kidney function in diabetes
Ashley N. Williams, Baqiyyah N. Conway Journal of Diabetes and its Complications.2017; 31(6): 958. CrossRef
- Relationship between the Korean Version Survey of the Autonomic Symptoms Score and Cardiac Autonomic Neuropathy Parameters in Patients with Diabetic Peripheral Neuropathy
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Sun Hee Kim, Kyung Ae Lee, Heung Yong Jin, Hong Sun Baek, Tae Sun Park
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Diabetes Metab J. 2014;38(5):349-355. Published online October 17, 2014
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DOI: https://doi.org/10.4093/dmj.2014.38.5.349
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- Background
The Survey of Autonomic Symptom (SAS) scale was reported as an easy instrument to assess the autonomic symptoms in patients with early diabetic neuropathy. In this study, we investigated the relationship between the SAS scale and the parameters of cardiac autonomic neuropathy (CAN) in Korean patients with diabetic peripheral neuropathy (DPN). MethodsThe SAS scale was tested in 30 healthy controls and 73 patients with DPN at Chonbuk National University Hospital, in Korea. The SAS score was compared to the parameters of the CAN test and the total symptom score (TSS) for DPN in patients with DPN. ResultsThe SAS symptom score and total impact score were increased in patients with DPN compared to the control group (P=0.01), particularly in sudomotor dysfunction (P=0.01), and vasomotor dysfunction (P=0.01). The SAS score was increased in patients with CAN compared to patients without CAN (P<0.05). Among the diverse CAN parameters, the valsalva ratio and postural hypotension were associated with the SAS score (P<0.05). However, there was no association between the SAS scale and TSS for DPN, and TSS for DPN did not differ between patients with and without CAN. ConclusionSAS is a simple instrument that can be used to assess autonomic symptoms in patients with diabetes and can be used as a screening tool for autonomic neuropathy, particularly for CAN.
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- Does the Relationship of the Autonomic Symptoms Questionnaire COMPASS 31 with Cardiovascular Autonomic Tests Differ between Type 1 and Type 2 Diabetes Mellitus?
Ilenia D’Ippolito, Marika Menduni, Cinzia D’Amato, Aikaterini Andreadi, Davide Lauro, Vincenza Spallone Diabetes & Metabolism Journal.2024; 48(6): 1114. CrossRef - Autonomic neuropathic symptoms in patients with diabetes: practical tools for screening in daily routine
Ana Raquel Souza de Azevedo Vieira, Lara Benigno Porto-Dantas, Flaviene Alves do Prado Romani, Patrícia Souza Carvalho, Rodica Pop-Busui, Hermelinda Cordeiro Pedrosa Diabetology & Metabolic Syndrome.2023;[Epub] CrossRef - Symptomatic diabetic autonomic neuropathy in type 1 diabetes (T1D): Findings from the T1D exchange
Kara Mizokami-Stout, Ryan Bailey, Lynn Ang, Grazia Aleppo, Carol J. Levy, Michael R. Rickels, Viral N. Shah, Sarit Polsky, Bryce Nelson, Anders L. Carlson, Francesco Vendrame, Rodica Pop-Busui Journal of Diabetes and its Complications.2022; 36(5): 108148. CrossRef - Clinical Assessment Scales in Autonomic Nervous System Disorders
Eun Bin Cho, Ki-Jong Park Journal of the Korean Neurological Association.2021; 39(2 Suppl): 60. CrossRef - Peripheral Nerve Conduction And Sympathetic Skin Response Are Reliable Methods to Detect Diabetic Cardiac Autonomic Neuropathy
Xiaopu Lin, Chuna Chen, Yingshan Liu, Yu Peng, Zhenguo Chen, Haishan Huang, Lingling Xu Frontiers in Endocrinology.2021;[Epub] CrossRef - Predictive model to identify the risk of losing protective sensibility of the foot in patients with diabetes mellitus
Esther Chicharro‐Luna, Francisco José Pomares‐Gómez, Ana Belen Ortega‐Ávila, Ana Marchena‐Rodríguez, José Francisco Javier Blanquer‐Gregori, Emmanuel Navarro‐Flores International Wound Journal.2020; 17(1): 220. CrossRef - The hemodynamic and pain impact of peripheral nerve block versus spinal anesthesia in diabetic patients undergoing diabetic foot surgery
Hou Yee Lai, Li Lian Foo, Siu Min Lim, Chen Fei Yong, Pui San Loh, Sook Hui Chaw, Mohd Shahnaz Hasan, Chew Yin Wang Clinical Autonomic Research.2020; 30(1): 53. CrossRef - Update on the Impact, Diagnosis and Management of Cardiovascular Autonomic Neuropathy in Diabetes: What Is Defined, What Is New, and What Is Unmet
Vincenza Spallone Diabetes & Metabolism Journal.2019; 43(1): 3. CrossRef - Validation of the Composite Autonomic Symptom Score 31 (COMPASS 31) for the assessment of symptoms of autonomic neuropathy in people with diabetes
C. Greco, F. Di Gennaro, C. D'Amato, R. Morganti, D. Corradini, A. Sun, S. Longo, D. Lauro, G. Pierangeli, P. Cortelli, V. Spallone Diabetic Medicine.2017; 34(6): 834. CrossRef - Cardiovascular Autonomic Dysfunction Predicts Diabetic Foot Ulcers in Patients With Type 2 Diabetes Without Diabetic Polyneuropathy
Jae-Seung Yun, Seon-Ah Cha, Tae-Seok Lim, Eun-Young Lee, Ki-Ho Song, Yu-Bae Ahn, Ki-Dong Yoo, Joon-Sung Kim, Yong-Moon Park, Seung-Hyun Ko Medicine.2016; 95(12): e3128. CrossRef - Retinal Neurodegeneration Associated With Peripheral Nerve Conduction and Autonomic Nerve Function in Diabetic Patients
Kiyoung Kim, Seung-Young Yu, Hyung Woo Kwak, Eung Suk Kim American Journal of Ophthalmology.2016; 170: 15. CrossRef - Screening of Autonomic Neuropathy in Patients with Type 2 Diabetes
Bo Kyung Koo Diabetes & Metabolism Journal.2014; 38(5): 346. CrossRef
- Effect of Granulocyte Colony-Stimulating Factor on the Peripheral Nerves in Streptozotocin-Induced Diabetic Rat
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Kyung Ae Lee, Kyung Taek Park, Hea Min Yu, Heung Yong Jin, Hong Sun Baek, Tae Sun Park
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Diabetes Metab J. 2013;37(4):286-290. Published online August 14, 2013
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DOI: https://doi.org/10.4093/dmj.2013.37.4.286
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4,080
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There are controversial reports about the effect of granulocyte colony-stimulating factor (G-CSF) in peripheral nerve protection. Therefore, the present study aimed to investigate the effect of G-CSF on peripheral nerves in streptozotocin (STZ) induced diabetic rats. After STZ or vehicle injection, rats were divided into five groups (n=6) as follows: normal+vehicle, normal+G-CSF (50 µg/kg for 5 days), diabetes mellitus (DM)+vehicle, DM+G-CSF (50 µg/kg for 5 days), and DM+G-CSF extension (50 µg/kg for 5 days and followed by two injections per week up to 24 weeks). Our results showed that the current perception threshold was not significantly different among experimental groups. G-CSF treatment inhibited the loss of cutaneous nerves and gastric mucosal small nerve fibers in morphometric comparison, but statistical significance was not observed. The present results demonstrated that G-CSF has no harmful but minimal beneficial effects with respect to peripheral nerve preservation in diabetic rats.
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- Gene expression in the dorsal root ganglion and the cerebrospinal fluid metabolome in polyneuropathy and opioid tolerance in rats
Fredrik H.G. Ahlström, Hanna Viisanen, Leena Karhinen, Vidya Velagapudi, Kim J. Blomqvist, Tuomas O. Lilius, Pekka V. Rauhala, Eija A. Kalso IBRO Neuroscience Reports.2024; 17: 38. CrossRef - Colony stimulating factors in the nervous system
Violeta Chitu, Fabrizio Biundo, E. Richard Stanley Seminars in Immunology.2021; 54: 101511. CrossRef - Non-glucose risk factors in the pathogenesis of diabetic peripheral neuropathy
Kyung Ae Lee, Tae Sun Park, Heung Yong Jin Endocrine.2020; 70(3): 465. CrossRef - Two to Tango: Dialogue between Adaptive and Innate Immunity in Type 1 Diabetes
Lin Sun, Shugang Xi, Guangyu He, Zhuo Li, Xiaokun Gang, Chenglin Sun, Weiying Guo, Guixia Wang Journal of Diabetes Research.2020; 2020: 1. CrossRef - Transplantation of human mobilized mononuclear cells improved diabetic neuropathy
Se Hee Min, Jung Hee Kim, Yu Mi Kang, Seung Hak Lee, Byung-Mo Oh, Kyou-Sup Han, Meihua Zhang, Hoe Suk Kim, Woo Kyung Moon, Hakmo Lee, Kyong Soo Park, Hye Seung Jung Journal of Endocrinology.2018; 239(3): 277. CrossRef - Granulocyte-colony stimulating factor as a treatment for diabetic neuropathy in rat
Kyung-Soo Kim, Yi-Sun Song, Jiyong Jin, Jun-Ho Joe, Byung-Im So, Jun-Young Park, Cheng-Hu Fang, Mi Jung Kim, Youl-Hee Cho, Sejin Hwang, Young-Suck Ro, Hyuck Kim, You-Hern Ahn, Hak-Joon Sung, Jung-Joon Sung, Sung-Hye Park, Stuart A. Lipton Molecular and Cellular Endocrinology.2015; 414: 64. CrossRef
- The Correlation and Accuracy of Glucose Levels between Interstitial Fluid and Venous Plasma by Continuous Glucose Monitoring System
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Young Ha Baek, Heung Yong Jin, Kyung Ae Lee, Seon Mee Kang, Woong Ji Kim, Min Gul Kim, Ji Hyun Park, Soo Wan Chae, Hong Sun Baek, Tae Sun Park
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Korean Diabetes J. 2010;34(6):350-358. Published online December 31, 2010
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DOI: https://doi.org/10.4093/kdj.2010.34.6.350
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6,309
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- Background
Clinical experience with the continuous glucose monitoring systems (CGMS) is limited in Korea. The objective of this study is to evaluate the accuracy of the CGMS and the correlation between interstitial fluid and venous plasma glucose level in Korean healthy male subjects. MethodsThirty-two subjects were served with glucose solution contained same amount of test food's carbohydrate and test foods after separate overnight fasts. CGMS was performed over 3 days during hopitalization for each subjects. Venous plasma glucose measurements were carried out during 4 hours (0, 0.25, 0.5, 0.75, 1, 2, 4 hours) just before and after glucose solution and test food load. The performance of the CGMS was evaluated by comparing its readings to those obtained at the same time by the hexokinase method using the auto biochemistry machine (Hitachi 7600-110). Also, correlations between glucose recorded with CGMS and venous plasma glucose value were examined. ResultsCGMS slightly underestimated the glucose value as compared with the venous plasma glucose level (16.3 ± 22.2 mg/dL). Correlation between CGMS and venous plasma glucose values throughout sensor lifetime is 0.73 (regression analysis: slope = 1.08, intercept = 8.38 mg/dL). Sensor sensitivity can deteriorate over time, with correlations between venous blood glucose and CGMS values dropping from 0.77 during 1st day to 0.65 during 2nd and 3rd day. ConclusionThe accuracy of data provided by CGMS may be less than expected. CGMS sensor sensitivity is decreased with the passage of time. But, from this study, CGMS can be used for glucose variability tendency monitoring conveniently to the Korean.
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- Drug/Regimen
- Study Design and Protocol for a Randomized Controlled Trial of Enavogliflozin to Evaluate Cardiorenal Outcomes in Type 2 Diabetes (ENVELOP)
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Nam Hoon Kim, Soo Lim, In-Kyung Jeong, Eun-Jung Rhee, Jun Sung Moon, Ohk-Hyun Ryu, Hyuk-Sang Kwon, Jong Chul Won, Sang Soo Kim, Sang Yong Kim, Bon Jeong Ku, Heung Yong Jin, Sin Gon Kim, Bong-Soo Cha, on Behalf of Investigators of ENVELOP Study
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Received May 9, 2024 Accepted August 14, 2024 Published online January 6, 2025
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DOI: https://doi.org/10.4093/dmj.2024.0238
[Epub ahead of print]
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Abstract
PDF Supplementary Material PubReader ePub
- Background
The novel sodium-glucose cotransporter-2 (SGLT2) inhibitor enavogliflozin effectively lowers glycosylated hemoglobin levels and body weights without the increased risk of serious adverse events; however, the long-term clinical benefits of enavogliflozin in terms of cardiovascular and renal outcomes have not been investigated.
Methods This study is an investigator-initiated, multicenter, randomized, pragmatic, open-label, active-controlled, non-inferiority trial. Eligible participants are adults (aged ≥19 years) with type 2 diabetes mellitus (T2DM) who have a history of, or are at risk of, cardiovascular disease. A total of 2,862 participants will be randomly assigned to receive either enavogliflozin or other SGLT2 inhibitors with proven cardiorenal benefits, such as dapagliflozin or empagliflozin. The primary endpoint is the time to the first occurrence of a composite of major adverse cardiovascular or renal events (Clinical Research Information Service registration number: KCT0009243).
Conclusion This trial will determine whether enavogliflozin is non-inferior to dapagliflozin or empagliflozin in terms of cardiorenal outcomes in patients with T2DM and cardiovascular risk factors. This study will elucidate the role of enavogliflozin in preventing vascular complications in patients with T2DM.
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