- Drug/Regimen
- Benefit and Safety of Sodium-Glucose Co-Transporter 2 Inhibitors in Older Patients with Type 2 Diabetes Mellitus
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Ja Young Jeon, Dae Jung Kim
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Diabetes Metab J. 2024;48(5):837-846. Published online September 12, 2024
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DOI: https://doi.org/10.4093/dmj.2024.0317
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- People with type 2 diabetes mellitus (T2DM) are at higher risk of developing cardiovascular disease, heart failure, chronic kidney disease, and premature death than people without diabetes. Therefore, treatment of diabetes aims to reduce these complications. Sodium-glucose co-transporter 2 (SGLT2) inhibitors have shown beneficial effects on cardiorenal and metabolic health beyond glucose control, making them a promising class of drugs for achieving the ultimate goals of diabetes treatment. However, despite their proven benefits, the use of SGLT2 inhibitors in eligible patients with T2DM remains suboptimal due to reports of adverse events. The use of SGLT2 inhibitors is particularly limited in older patients with T2DM because of the lack of treatment experience and insufficient long-term safety data. This article comprehensively reviews the risk-benefit profile of SGLT2 inhibitors in older patients with T2DM, drawing on data from prospective randomized controlled trials of cardiorenal outcomes, original studies, subgroup analyses across different age groups, and observational cohort studies.
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- Trends in prescribing sodium‐glucose cotransporter 2 inhibitors for individuals with type 2 diabetes with and without cardiovascular‐renal disease in South Korea, 2015–2021
Kyoung Hwa Ha, Soyoung Shin, EunJi Na, Dae Jung Kim Journal of Diabetes Investigation.2024;[Epub] CrossRef
- Drug/Regimen
- Cardiovascular Safety of Sodium Glucose Cotransporter 2 Inhibitors as Add-on to Metformin Monotherapy in Patients with Type 2 Diabetes Mellitus
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Ja Young Jeon, Kyoung Hwa Ha, Dae Jung Kim
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Diabetes Metab J. 2021;45(4):505-514. Published online October 30, 2020
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DOI: https://doi.org/10.4093/dmj.2020.0057
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- Background
Using real-world data, cardiovascular safety was investigated in metformin users newly starting sodium glucose cotransporter 2 (SGLT2) inhibitors compared with other glucose-lowering drugs in Korea.
Methods This was a retrospective observational study using the National Health Insurance Service claims database in Korea. The study period was from September 2014 to December 2016. The study included subjects who were newly prescribed SGLT2 inhibitors or other glucose-lowering drugs while on metformin monotherapy; cohort 1 was composed of new users of SGLT2 inhibitors versus dipeptidyl peptidase-4 (DPP-4) inhibitors and cohort 2 included new users of SGLT2 inhibitors versus sulfonylureas. To balance the patient characteristics, propensity score matching was performed at a 1:1 ratio. Cardiovascular outcomes included hospitalization for heart failure (HHF), all-cause mortality, HHF plus all-cause mortality, myocardial infarction (MI), stroke, and modified major adverse cardiovascular events (MACEs).
Results After propensity score matching, each cohort group was well balanced at baseline (21,688 pairs in cohort 1 and 20,120 pairs in cohort 2). As the second-line treatment, use of SGLT2 inhibitors was associated with a lower risk of HHF and HHF plus all-cause mortality compared with DPP-4 inhibitors. In addition, use of SGLT2 inhibitors versus sulfonylurea as add-on therapy to metformin was associated with decreased risks of HHF, all-cause mortality, HHF plus all-cause mortality, MI, stroke, and modified MACEs.
Conclusion SGLT2 inhibitors can be a good second-line drug to reduce the incidence of cardiovascular diseases compared with DPP-4 inhibitors or sulfonylureas in people with type 2 diabetes mellitus.
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- Effects of sodium-glucose cotransporter 2 inhibitors on cardiovascular and cerebrovascular diseases: a meta-analysis of controlled clinical trials
Fei Wang, Chunyu Li, Lili Cui, Shuo Gu, Junyu Zhao, Haipeng Wang Frontiers in Endocrinology.2024;[Epub] CrossRef - Evaluation and Management of Patients With Diabetes and Heart Failure: A Korean Diabetes Association and Korean Society of Heart Failure Consensus Statement
Kyu-Sun Lee, Junghyun Noh, Seong-Mi Park, Kyung Mook Choi, Seok-Min Kang, Kyu-Chang Won, Hyun-Jai Cho, Min Kyong Moon International Journal of Heart Failure.2023; 5(1): 1. CrossRef - Evaluation and Management of Patients with Diabetes and Heart Failure: A Korean Diabetes Association and Korean Society of Heart Failure Consensus Statement
Kyu-Sun Lee, Junghyun Noh, Seong-Mi Park, Kyung Mook Choi, Seok-Min Kang, Kyu-Chang Won, Hyun-Jai Cho, Min Kyong Moon Diabetes & Metabolism Journal.2023; 47(1): 10. CrossRef - Advances in Research on Type 2 Diabetes Mellitus Targets and Therapeutic Agents
Jingqian Su, Yingsheng Luo, Shan Hu, Lu Tang, Songying Ouyang International Journal of Molecular Sciences.2023; 24(17): 13381. CrossRef - Cardioprotective effects of dipeptidyl peptidase-4 inhibitors versus sulfonylureas in addition to metformin: A nationwide cohort study of patients with type 2 diabetes
Jui Wang, Hon-Yen Wu, Kuo-Liong Chien Diabetes & Metabolism.2022; 48(3): 101299. CrossRef - Cardiovascular disease in patients with type 2 diabetes
Ja Young Jeon, Dae Jung Kim Journal of Diabetes Investigation.2022; 13(4): 614. CrossRef - The Impact of Novel Anti-Diabetic Medications on CV Outcomes: A New Therapeutic Horizon for Diabetic and Non-Diabetic Cardiac Patients
Israel Mazin, Fernando Chernomordik, Paul Fefer, Shlomi Matetzky, Roy Beigel Journal of Clinical Medicine.2022; 11(7): 1904. CrossRef - Effect of Sodium-Glucose Cotransporter Inhibitors on Major Adverse Cardiovascular Events and Hospitalization for Heart Failure in Patients With Type 2 Diabetes Mellitus and Atrial Fibrillation
Chang Hee Kwon, Ye-Jee Kim, Min-Ju Kim, Myung-Jin Cha, Min Soo Cho, Gi-Byoung Nam, Kee-Joon Choi, Jun Kim The American Journal of Cardiology.2022; 178: 35. CrossRef - Using real-world data for supporting regulatory decision making: Comparison of cardiovascular and safety outcomes of an empagliflozin randomized clinical trial versus real-world data
Ha Young Jang, In-Wha Kim, Jung Mi Oh Frontiers in Pharmacology.2022;[Epub] CrossRef - Cardiovascular Safety of SGLT2 Inhibitors Compared to DPP4 Inhibitors and Sulfonylureas as the Second-Line of Therapy in T2DM Using Large, Real-World Clinical Data in Korea
Kyuho Kim, Sung Hee Choi Diabetes & Metabolism Journal.2021; 45(4): 502. CrossRef - The effect of sodium‐glucose transport protein 2 inhibitors on mortality and heart failure in randomized trials versus observational studies
Jesper Krogh, Carsten Hjorthøj, Søren L. Kristensen, Christian Selmer, Steen B. Haugaard Diabetic Medicine.2021;[Epub] CrossRef - Outcomes of patients with type 2 diabetes treated with SGLT-2 inhibitors versus DPP-4 inhibitors. An Italian real-world study in the context of other observational studies
Enrico Longato, Benedetta Maria Bonora, Barbara Di Camillo, Giovanni Sparacino, Lara Tramontan, Angelo Avogaro, Gian Paolo Fadini Diabetes Research and Clinical Practice.2021; 179: 109024. CrossRef
- Letter: Acute Hyperglycemic Crises with Coronavirus Disease-19: Case Reports (Diabetes Metab J 2020;44:349–53)
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Ja Young Jeon
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Diabetes Metab J. 2020;44(3):480-481. Published online June 29, 2020
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DOI: https://doi.org/10.4093/dmj.2020.0121
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Natasha F. Daniels, Raiiq Ridwan Internal Medicine Journal.2021; 51(3): 442. CrossRef
- Clinical Complications
- Hypoglycemia and Dementia Risk in Older Patients with Type 2 Diabetes Mellitus: A Propensity-Score Matched Analysis of a Population-Based Cohort Study
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Young-Gun Kim, Dong Gyu Park, So Young Moon, Ja Young Jeon, Hae Jin Kim, Dae Jung Kim, Kwan-Woo Lee, Seung Jin Han
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Diabetes Metab J. 2020;44(1):125-133. Published online October 23, 2019
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DOI: https://doi.org/10.4093/dmj.2018.0260
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- Background
Type 2 diabetes mellitus (T2DM) is associated with an increased risk for dementia. The effects of hypoglycemia on dementia are controversial. Thus, we evaluated whether hypoglycemia increases the risk for dementia in senior patients with T2DM. MethodsWe used the Korean National Health Insurance Service Senior cohort, which includes >10% of the entire senior population of South Korea. In total, 5,966 patients who had ever experienced at least one episode of hypoglycemia were matched with those who had not, using propensity score matching. The risk of dementia was assessed through a survival analysis of matched pairs. ResultsPatients with underlying hypoglycemic events had an increased risk for all-cause dementia, Alzheimer's dementia (AD), and vascular dementia (VaD) compared with those who had not experienced a hypoglycemic event (hazard ratio [HR], 1.254; 95% confidence interval [CI], 1.166 to 1.349; P<0.001 for all-cause dementia; HR, 1.264; 95% CI, 1.162 to 1.375; P<0.001 for AD; HR, 1.286; 95% CI, 1.110 to 1.490; P<0.001 for VaD). According to number of hypoglycemic episodes, the HRs of dementia were 1.170, 1.201, and 1.358 in patients with one hypoglycemic episode, two or three episodes, and more than three episodes, respectively. In the subgroup analysis, hypoglycemia was associated with an increased risk for dementia in both sexes with or without T2DM microvascular or macrovascular complications. ConclusionOur findings suggest that patients with a history of hypoglycemia have a higher risk for dementia. This trend was similar for AD and VaD, the two most important subtypes of dementia.
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Ruonan Gao, Menglan Zhan, Sujie Ke, Kejun Wu, Guanlian He, Liqin Qi, Xiaoying Liu, Xiaohong Liu, Lijing Wang, Libin Liu Diabetes Research and Clinical Practice.2024; 207: 111036. CrossRef - Association of hypoglycemic events with cognitive impairment in patients with type 2 diabetes mellitus: Protocol for a dose-response meta-analysis
Min Ye, Ai Hong Yuan, Qi Qi Yang, Qun Wei Li, Fei Yue Li, Yan Wei, Muhammad Shahzad Aslam PLOS ONE.2024; 19(2): e0296662. CrossRef - AGE, DISEASE DURATION AND MULTIMORBIDITY AS PREDICTORS OF HYPOGLYCEMIA IN ELDERLY AND SENILE WOMEN WITH TYPE 2 DIABETES MELLITUS
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Zhongtao Zhou, Jiajia Ren, Qiankun Liu, Shuoshuo Li, Jiahui Xu, Xiaoyan Wu, Yuanxiang Xiao, Zipu Zhang, Wanchen Jia, Huaiyu Bai, Jing Zhang Scientific Reports.2024;[Epub] CrossRef - Взаимосвязь гипогликемии и когнитивных нарушений у пожилых пациентов с сахарным диабетом 2 типа
S. V. Bulgakova, P. Ya. Merzlova, D. P. Kurmaev, E. V. Treneva Russian Journal of Geriatric Medicine.2024; (2): 108. CrossRef - Effect of hypoglycemic events on cognitive function in individuals with type 2 diabetes mellitus: a dose–response meta-analysis
Min Ye, Qiqi Yang, Lele Zhang, Hudie Song, Qin Fu, Jun Qian, Hongyu Xie, Aihong Yuan Frontiers in Neurology.2024;[Epub] CrossRef - Hypoglycaemia and the risk of dementia: a population-based cohort study using exposure density sampling
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Lisa Dao, Sarah Choi, Matthew Freeby Current Opinion in Endocrinology, Diabetes & Obesity.2023; 30(1): 7. CrossRef - Associations of Mid- and Late-Life Severe Hypoglycemic Episodes With Incident Dementia Among Patients With Type 2 Diabetes: A Population-Based Cohort Study
Wajd Alkabbani, Colleen J. Maxwell, Ruth Ann Marrie, Suzanne L. Tyas, Iliana C. Lega, John-Michael Gamble Diabetes Care.2023; 46(2): 331. CrossRef - Nocturnal hypoglycemia is underdiagnosed in older people with insulin‐treated type 2 diabetes: The HYPOAGE observational study
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- Current Status of Glycemic Control of Patients with Diabetes in Korea: The Fifth Korea National Health and Nutrition Examination Survey
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Ja Young Jeon, Dae Jung Kim, Seung-Hyun Ko, Hyuk-Sang Kwon, Soo Lim, Sung Hee Choi, Chul Sik Kim, Jee Hyun An, Nan Hee Kim, Jong Chul Won, Jae Hyeon Kim, Bong-Yun Cha, Kee-Ho Song
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Diabetes Metab J. 2014;38(3):197-203. Published online June 17, 2014
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DOI: https://doi.org/10.4093/dmj.2014.38.3.197
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- Background
The Korea National Health and Nutrition Examination Survey (KNHANES) III (2005) reported that 22.9% of individuals with diabetes have a glycated hemoglobin (HbA1c) <6.5% and that 43.5% have an HbA1c <7%. We investigated the levels of glycemic control and the factors associated with glycemic control using data from the KNHANES V (2010 to 2012). MethodsSubjects with diabetes diagnosed by a physician or those taking antidiabetic medications were classified as individuals with known diabetes. Of 1,498 subjects aged ≥30 years with diabetes, we excluded 157 individuals who were missing HbA1c data. A total of 1,341 subjects were included in the final analysis. ResultsThe prevalence of known diabetes was 7.7% (n=1,498, estimated to be 2.32 million people). The proportions of well-controlled diabetes meeting a HbA1c goal of <6.5% and <7% were 27% and 45.6%, respectively. HbA1c increased as the duration of diabetes increased. HbA1c in subjects with a duration of diabetes ≤5 years was lower than in subjects with a duration >5 years. HbA1c in the group taking only oral hypoglycemic agents (OHAs) was significantly lower than that in the group administered only insulin or OHA and insulin in combination. In logistic regression analysis, a longer duration of diabetes, insulin use and the absence of chronic renal failure were associated with HbA1c levels >6.5%. ConclusionThe level of adequate glycemic control was similar to but slightly improved compared with previous levels. The glycemic control of long-standing diabetes patients is more difficult even though they receive insulin treatment.
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- Prevalence of Diabetes and Prediabetes according to Fasting Plasma Glucose and HbA1c
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Ja Young Jeon, Seung-Hyun Ko, Hyuk-Sang Kwon, Nan Hee Kim, Jae Hyeon Kim, Chul Sik Kim, Kee-Ho Song, Jong Chul Won, Soo Lim, Sung Hee Choi, Myoung-jin Jang, Yuna Kim, Kyungwon Oh, Dae Jung Kim, Bong-Yun Cha
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Diabetes Metab J. 2013;37(5):349-357. Published online October 17, 2013
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DOI: https://doi.org/10.4093/dmj.2013.37.5.349
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Abstract
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- Background
Due to the inconvenience of performing oral glucose tolerance tests and day to day variability in glucose level, glycated hemoglobin (HbA1c) has been recommended by the American Diabetes Association as a method to diagnose diabetes. In addition, the Korean Diabetes Association has also recommended the use of HbA1c as a diagnostic test for diabetes. In this study, we evaluated the prevalence of diabetes according to fasting plasma glucose (FPG) level only or the combination of FPG and HbA1c tests. MethodsData from the 2011 Korea National Health and Nutrition Examination Survey (KNHANES) were analyzed. Among 5,811 subjects aged 30 years or older, 5,020 were selected after excluding the data of fasting time <8 hours, missing values from fasting glucose or HbA1c level, previous diagnosis of diabetes made by physicians, or current use of antidiabetic medications. Diabetes was defined as FPG ≥126 mg/dL, previous diagnosis of diabetes made by a medical doctor, current use of antidiabetic medications, and/or HbA1c ≥6.5%. Prediabetes was defined as FPG of 100 to 125 mg/dL and/or HbA1c of 5.7% to 6.4%. ResultsWhen we used FPG only, the prevalence of diabetes and prediabetes were 10.5% (men, 12.6%; women, 8.5%) and 19.3% (men, 23.8%; women, 14.9%), respectively. When HbA1c was included as a diagnostic test, the prevalence of diabetes and prediabetes increased to 12.4% (men, 14.5%; women, 10.4%) and 38.3% (men, 41%; women, 35.7%), respectively. Participants with HbA1c ≥6.5% and fasting glucose level <126 mg/dL were older and had lower estimated glomerular filtration rate. ConclusionWe concluded that using fasting glucose level only may result in an underestimation of diabetes and prediabetes. HbA1c is an acceptable complementary diagnostic test for diabetes in Korean patients. However, national standardization is needed to order to use HbA1c as a diagnostic method of diabetes and prediabetes.
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Hye Min Choi, Kyungdo Han, Yong Gyu Park, Jun-Beom Park Medicine.2016; 95(34): e4681. CrossRef - Associations between the number of natural teeth in postmenopausal women and duration of lactation: The 2010–2012 Korea National Health and Nutrition Examination Survey
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Darye Lee, Choon Young Kim Journal of Nutrition and Health.2016; 49(4): 233. CrossRef - Associations between the number of natural teeth in postmenopausal women and hormone replacement therapy
Kyungdo Han, Youngkyung Ko, Yong-Gyu Park, Jun-Beom Park Maturitas.2016; 94: 125. CrossRef - Is an Oral Glucose Tolerance Test Still Valid for Diagnosing Diabetes Mellitus?
Dong-Lim Kim, Sun-Doo Kim, Suk Kyeong Kim, Sooyoun Park, Kee-Ho Song Diabetes & Metabolism Journal.2016; 40(2): 118. CrossRef - Are We in the Same Risk of Diabetes Mellitus? Gender- and Age-Specific Epidemiology of Diabetes in 2001 to 2014 in the Korean Population
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Min Jung Kim, Misoon Song Perspectives in Nursing Science.2015; 12(1): 33. CrossRef - Secular Changes in Prediabetes Indicators Among Older-Adult Americans, 1999−2010
Carl J. Caspersen, G. Darlene Thomas, Gloria L.A. Beckles, Kai McKeever Bullard American Journal of Preventive Medicine.2015; 48(3): 253. CrossRef - Low transferrin saturation is associated with impaired fasting glucose and insulin resistance in the South Korean adults: the 2010 Korean National Health and Nutrition Examination Survey
R. J. Park, J. D. Moon Diabetic Medicine.2015; 32(5): 673. CrossRef - Role of habitual physical activity in modulating vascular actions of insulin
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Annalise E. Zemlin, Tandi E. Matsha, Andre P. Kengne, Rajiv T. Erasmus Clinica Chimica Acta.2015; 448: 215. CrossRef - Change in Corneal Biomechanical Parameters in Diabetes Mellitus
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W.A. Scherbaum Der Diabetologe.2014; 10(5): 363. CrossRef - Higher Prevalence and Awareness, but Lower Control Rate of Hypertension in Patients with Diabetes than General Population: The Fifth Korean National Health and Nutrition Examination Survey in 2011
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