Diabetes & Metabolism Journal

Jee Hyun An (An JH)

2 Articles

Clinical Diabetes & Therapeutics
Determinants of Long-Term Durable Glycemic Control in New-Onset Type 2 Diabetes Mellitus: Kyoung Jin Kim, Ju Hee Choi, Kyeong Jin Kim, Jee Hyun An, Hee Young Kim, Sin Gon Kim, Nam Hoon Kim; Diabetes Metab J. 2017;41(4):284-295. Published online August 3, 2017; DOI: https://doi.org/10.4093/dmj.2017.41.4.284

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Background

Long-term durable glycemic control is a difficult goal in the management of type 2 diabetes mellitus (T2DM). We evaluated the factors associated with durable glycemic control in a real clinical setting.

Methods

We retrospectively reviewed the medical records of 194 new-onset, drug-naïve patients with T2DM who were diagnosed between January 2011 and March 2013, and were followed up for >2 years. Glycemic durability was defined as the maintenance of optimal glycemic control (glycosylated hemoglobin [HbA1c] <7.0%) for 2 years without substitution or adding other glucose-lowering agents. Clinical factors and glycemic markers associated with glycemic durability were compared between two groups: a durability group and a non-durability group.

Results

Patients in the durability group had a higher baseline body mass index (26.1 kg/m² vs. 24.9 kg/m²) and lower HbA1c (8.6% vs. 9.7%) than the non-durability group. The initial choice of glucose-lowering agents was similar in both groups, except for insulin and sulfonylureas, which were more frequently prescribed in the non-durability group. In multiple logistic regression analyses, higher levels of education, physical activity, and homeostasis model assessment of β-cell function (HOMA-β) were associated with glycemic durability. Notably, lower HbA1c (<7.0%) at baseline and first follow-up were significantly associated with glycemic durability (adjusted odds ratio [OR], 7.48; 95% confidence interval [CI], 2.51 to 22.3) (adjusted OR, 9.27; 95% CI, 1.62 to 53.1, respectively), after adjusting for confounding variables including the types of glucose-lowering agents.

Conclusion

Early achievement of HbA1c level within the glycemic target was a determinant of long-term glycemic durability in new-onset T2DM, as were higher levels of education, physical activity, and HOMA-β.

Citations

Citations to this article as recorded by

Initial Combination Therapy in Type 2 Diabetes
Ji Yoon Kim, Nam Hoon Kim
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International Journal of Diabetes in Developing Countries.2022; 42(3): 451. CrossRef
Greater Glycemic Burden Is Associated with Further Poorer Glycemic Control in Newly-Diagnosed Type 2 Diabetes Mellitus Patients
Wei-Lun Wen, Hui-Chun Huang, Hsiu-Chu Lin, Wan-Ching Lo, Szu-Chia Chen, Mei-Yueh Lee
Nutrients.2022; 14(2): 320. CrossRef
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Hwi Seung Kim, Yun Kyung Cho, Myung Jin Kim, Chang Hee Jung, Joong-Yeol Park, Woo Je Lee
Frontiers in Endocrinology.2022;[Epub] CrossRef
Durability of glycaemic control in type 2 diabetes: A systematic review and meta‐analysis for its association with body weight changes
Danpei Li, HuaJie Zou, Ping Yin, Wenjun Li, Junyu He, Shuyun Wang, Li Huang, Shiying Shao, Yong Chen, Yan Yang, Xuefeng Yu
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Early combination versus initial metformin monotherapy in the management of newly diagnosed type 2 diabetes: AnEast Asianperspective
Linong Ji, Juliana C. N. Chan, Miao Yu, Kun Ho Yoon, Sin Gon Kim, Sung Hee Choi, Chien‐Ning Huang, Shih Te Tu, Chih‐Yuan Wang, Päivi Maria Paldánius, Wayne H. H. Sheu
Diabetes, Obesity and Metabolism.2021; 23(1): 3. CrossRef
Time to Reach Target Glycosylated Hemoglobin Is Associated with Long-Term Durable Glycemic Control and Risk of Diabetic Complications in Patients with Newly Diagnosed Type 2 Diabetes Mellitus: A 6-Year Observational Study
Kyoung Jin Kim, Jimi Choi, Jae Hyun Bae, Kyeong Jin Kim, Hye Jin Yoo, Ji A Seo, Nan Hee Kim, Kyung Mook Choi, Sei Hyun Baik, Sin Gon Kim, Nam Hoon Kim
Diabetes & Metabolism Journal.2021; 45(3): 368. CrossRef
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Time to Reach Target Glycosylated Hemoglobin Is Associated with Long-Term Durable Glycemic Control and Risk of Diabetic Complications in Patients with Newly Diagnosed Type 2 Diabetes Mellitus: A 6-Year Observational Study (Diabetes Metab J 2021;45:368-78)
Ja Young Jeon
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Factors Associated with Poor Hemoglobin A1c Control in Patients with Type 2 Diabetes
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Current Status of Glycemic Control of Patients with Diabetes in Korea: The Fifth Korea National Health and Nutrition Examination Survey: 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; Diabetes Metab J. 2014;38(3):197-203. Published online June 17, 2014; 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).

Methods

Subjects 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.

Results

The 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%.

Conclusion

The 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.

Citations

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