Diabetes & Metabolism Journal

Kyoung Hwa Ha (Ha KH)

16 Articles

Lifestyle
Ultra-Processed Food Consumption and Obesity in Korean Adults: Jee-Seon Shim, Kyoung Hwa Ha, Dae Jung Kim, Hyeon Chang Kim; Diabetes Metab J. 2023;47(4):547-558. Published online April 26, 2023; DOI: https://doi.org/10.4093/dmj.2022.0026

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Background
This study aimed to investigate the association between consumption of ultra-processed foods (UPF) and obesity in Korean adults.
Methods
We included the Cardiovascular and Metabolic Diseases Etiology Research Center cohort study baseline data of adults aged 30 to 64 years who completed a validated food frequency questionnaire. UPF was defined using the NOVA food classification. Multivariable linear and logistic regression analyses were performed to assess the association of dietary energy contribution of UPF with obesity indicators (body mass index [BMI], obesity, waist circumference [WC], and abdominal obesity).
Results
Consumption of UPF accounted for 17.9% of total energy intake and obesity and abdominal obesity prevalence was 35.4% and 30.2%, respectively. Compared with those in the lowest quartile of UPF consumption, adults in the highest quartile had greater BMI (β=0.36; 95% confidence interval [CI], 0.15 to 0.56), WC (β=1.03; 95% CI, 0.46 to 1.60), higher odds of having obesity (odds ratio [OR], 1.24; 95% CI, 1.07 to 1.45), and abdominal obesity (OR, 1.34; 95% CI, 1.14 to 1.57), after adjusting for sociodemographic characteristics, health-related behaviors, and family history of diseases. Dose-response associations between UPF consumption and obesity indicators were consistently found (all P trend <0.01). However, the strength of association was halved for all obesity indicators after further adjustments for total energy intake and overall diet quality score, and the trend toward association for obesity and WC disappeared.
Conclusion
Our finding supports the evidence that consumption of UPF is positively associated with obesity among Korean adults.

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Ultra-processed food consumption and increased risk of metabolic syndrome in Korean adults: A cross-sectional analysis of the KNHANES 2016–2020
Hansol Park, Youngmi Lee, Jinah Hwang, Yujin Lee
Nutrition.2024; 122: 112374. CrossRef
Navigating Ultra-Processed Foods with Insight
Ji A Seo
Diabetes & Metabolism Journal.2024; 48(4): 713. CrossRef
Association of maternal ultra-processed food consumption during pregnancy with atopic dermatitis in infancy: Korean Mothers and Children’s Environmental Health (MOCEH) study
Won Jang, Minji Kim, Eunhee Ha, Hyesook Kim
Nutrition Journal.2024;[Epub] CrossRef
Associations of Ultra-Processed Food Intake with Body Fat and Skeletal Muscle Mass by Sociodemographic Factors
Sukyoung Jung, Jaehee Seo, Jee Young Kim, Sohyun Park
Diabetes & Metabolism Journal.2024; 48(4): 780. CrossRef
Association Between Ultraprocessed Food Consumption and Metabolic Disorders in Children and Adolescents with Obesity
Gyeong-yoon Lee, Joo Hyun Lim, Hyojee Joung, Dankyu Yoon
Nutrients.2024; 16(20): 3524. CrossRef
Diet quality partially mediates the association between ultraprocessed food consumption and adiposity indicators
Jee‐Seon Shim, Kyoung Hwa Ha, Dae Jung Kim, Hyeon Chang Kim
Obesity.2023; 31(9): 2430. CrossRef
Development of a Semi-Quantitative Food-Frequency Questionnaire for Korean Adults with Obesity
Jina Chung, Seoeun Ahn, Hyojee Joung, Sangah Shin
Nutrients.2023; 15(22): 4848. CrossRef

Metabolic Risk/Epidemiology
Rising Incidence of Diabetes in Young Adults in South Korea: A National Cohort Study: Hyun Ho Choi, Giwoong Choi, Hojun Yoon, Kyoung Hwa Ha, Dae Jung Kim; Diabetes Metab J. 2022;46(5):803-807. Published online January 11, 2022; DOI: https://doi.org/10.4093/dmj.2021.0236

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We investigated the incidence of diagnosed diabetes in South Korean adults (aged ≥20 years) by analyzing data for the National Health Insurance Service–National Sample Cohort. From 2006 to 2015, the overall incidence rate of diagnosed diabetes decreased by approximately 0.1% per year until 2015. Although, this trend was observed in individuals aged 40 years or over, the rate increased slightly in the 20–29 and 30–39 years age groups, from 0.5 to 0.7 and 2.0 to 2.6 per 1,000 individuals, respectively. The proportion of obese young adults with diabetes increased remarkably, from 51.4% in 2006 to 72.4% in 2015. Thus, young adults need early identification and weight-control strategies to prevent diabetes.

Citations

Citations to this article as recorded by

Cumulative exposure to hypertriglyceridemia and risk of type 2 diabetes in young adults
Min-Kyung Lee, Kyungdo Han, Bongsung Kim, Jong-Dai Kim, Moon Jung Kim, Byungpyo Kim, Jung Heo, Jiyeon Ahn, Seo-Young Sohn, Jae-Hyuk Lee
Diabetes Research and Clinical Practice.2024; 208: 111109. CrossRef
Young-Onset Diabetes in East Asians: From Epidemiology to Precision Medicine
Juliana C.N. Chan, Chun-Kwan O, Andrea O.Y. Luk
Endocrinology and Metabolism.2024; 39(2): 239. CrossRef
Epidemiological Association of Current Smoking Status with Hypertension and Obesity among Adults Including the Elderly in Korea: Multivariate Analysis of a Nationwide Cross-Sectional Study Excluding Grades 2–3 Hypertension Cases
Sung-Eun Park, Seyong Jang, Wi-Young So, Junsu Kim
Journal of Cardiovascular Development and Disease.2024; 11(7): 212. CrossRef
Do Type 1 and Type 2 Diabetes Have the Same Vascular Complications?
Yun Kyung Cho
The Journal of Korean Diabetes.2024; 25(2): 62. CrossRef
Korean National Burden of Disease: The Importance of Diabetes Management
Chung-Nyun Kim, Yoon-Sun Jung, Young-Eun Kim, Minsu Ock, Seok-Jun Yoon
Diabetes & Metabolism Journal.2024; 48(4): 518. CrossRef
Prevalence, Awareness, Treatment, and Control of Type 2 Diabetes in South Korea (1998 to 2022): Nationwide Cross-Sectional Study
Wonwoo Jang, Seokjun Kim, Yejun Son, Soeun Kim, Hyeon Jin Kim, Hyesu Jo, Jaeyu Park, Kyeongmin Lee, Hayeon Lee, Mark A Tully, Masoud Rahmati, Lee Smith, Jiseung Kang, Selin Woo, Sunyoung Kim, Jiyoung Hwang, Sang Youl Rhee, Dong Keon Yon
JMIR Public Health and Surveillance.2024; 10: e59571. CrossRef
Changes in the Epidemiological Landscape of Diabetes in South Korea: Trends in Prevalence, Incidence, and Healthcare Expenditures
Kyoung Hwa Ha, Dae Jung Kim
Endocrinology and Metabolism.2024; 39(5): 669. CrossRef
Income-Related Disparities in Mortality Among Young Adults With Type 2 Diabetes
Ji Yoon Kim, Sojeong Park, Minae Park, Nam Hoon Kim, Sin Gon Kim
JAMA Network Open.2024; 7(11): e2443918. CrossRef
Diabetes screening in South Korea: a new estimate of the number needed to screen to detect diabetes
Kyoung Hwa Ha, Kyung Ae Lee, Kyung-Do Han, Min Kyong Moon, Dae Jung Kim
The Korean Journal of Internal Medicine.2023; 38(1): 93. CrossRef
Revisiting the Diabetes Crisis in Korea: Call for Urgent Action
Jun Sung Moon
The Journal of Korean Diabetes.2023; 24(1): 1. CrossRef
Position Statement on the Appropriateness and Significance of Adding the Glycated Hemoglobin Test to the National Health Examination
Ji Hye Kim, Dae Jung Kim, Jaehyun Kim, Sangjoon Park, Kyunghoon Lee, Jun Goo Kang, Eu Jeong Ku, Su Kyoung Kwon, Won Jun Kim, Young Sang Lyu, Jang Won Son, Young Sil Eom, Kyung Ae Lee, Jeongrim Lee, Jung Min Lee, Jung Hwa Lee, Jung Hwa Jung, Hochan Cho, Da
The Journal of Korean Diabetes.2023; 24(4): 178. CrossRef
Diabetes Fact Sheet in Korea 2021
Jae Hyun Bae, Kyung-Do Han, Seung-Hyun Ko, Ye Seul Yang, Jong Han Choi, Kyung Mook Choi, Hyuk-Sang Kwon, Kyu Chang Won
Diabetes & Metabolism Journal.2022; 46(3): 417. CrossRef
젊은 2형 당뇨병 환자의 관리
재현 배
Public Health Weekly Report.2022; 15(35): 2474. CrossRef
Screening for Prediabetes and Diabetes in Korean Nonpregnant Adults: A Position Statement of the Korean Diabetes Association, 2022
Kyung Ae Lee, Dae Jung Kim, Kyungdo Han, Suk Chon, Min Kyong Moon
Diabetes & Metabolism Journal.2022; 46(6): 819. CrossRef

Drug/Regimen
Cardiovascular Safety of Sodium Glucose Cotransporter 2 Inhibitors as Add-on to Metformin Monotherapy in Patients with Type 2 Diabetes Mellitus: Ja Young Jeon, Kyoung Hwa Ha, Dae Jung Kim; Diabetes Metab J. 2021;45(4):505-514. Published online October 30, 2020; 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.

Citations

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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

Trends in Cardiovascular Complications and Mortality among Patients with Diabetes in South Korea: Jung Hwan Park, Kyoung Hwa Ha, Bo Yeon Kim, Jae Hyuk Lee, Dae Jung Kim; Diabetes Metab J. 2021;45(2):283. Published online March 25, 2021; DOI: https://doi.org/10.4093/dmj.2021.0026; Corrects: Diabetes Metab J 2021;45(1):120

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Changes in serum uteroglobin level in type 2 diabetes mellitus patients
Joung Youl Lim, Sang-Hyeon Ju, Ji Min Kim, Hyon-Seung Yi, Ju Hee Lee, Hyun Jin Kim, Bon Jeong Ku, Kyong Hye Joung
Frontiers in Endocrinology.2024;[Epub] CrossRef
Cardiovascular Outcomes according to Comorbidities and Low-Density Lipoprotein Cholesterol in Korean People with Type 2 Diabetes Mellitus
Min Kyong Moon, Junghyun Noh, Eun-Jung Rhee, Sang Hyun Park, Hyeon Chang Kim, Byung Jin Kim, Hae Jin Kim, Seonghoon Choi, Jin Oh Na, Young Youl Hyun, Bum Joon Kim, Kyung-Do Han, In-Kyung Jeong
Diabetes & Metabolism Journal.2023; 47(1): 45. CrossRef
Rising Incidence of Diabetes in Young Adults in South Korea: A National Cohort Study
Hyun Ho Choi, Giwoong Choi, Hojun Yoon, Kyoung Hwa Ha, Dae Jung Kim
Diabetes & Metabolism Journal.2022; 46(5): 803. CrossRef
Epidemiological characteristics of diabetes mellitus in Korea
Soon Young Lee
Journal of the Korean Medical Association.2022; 65(10): 640. CrossRef
2021 Clinical Practice Guidelines for Diabetes: Management of Cardiovascular Risk
Min Kyong Moon
The Journal of Korean Diabetes.2021; 22(4): 259. CrossRef

Complications
Trends in Cardiovascular Complications and Mortality among Patients with Diabetes in South Korea: Jung Hwan Park, Kyoung Hwa Ha, Bo Yeon Kim, Jae Hyuk Lee, Dae Jung Kim; Diabetes Metab J. 2021;45(1):120-124. Published online December 9, 2020; DOI: https://doi.org/10.4093/dmj.2020.0175; Correction in: Diabetes Metab J 2021;45(2):283

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We investigated the cardiovascular complications and mortality rates of patients with diabetes in South Korea. The rates of hospitalization due to cardiovascular complications and mortality were analyzed using the Korean National Health Insurance Service-National Sample Cohort. From 2006 to 2015, the rates of hospitalization due to major cardiovascular complications decreased, while those due to heart failure (from 72 to 146 and 124 to 161 per 10,000 men and women, respectively) and peripheral artery disease (from 39 to 55 and 19 to 35 per 10,000 men and women, respectively) increased. In the period 2007 to 2015, the mortality rates for cancer, cerebrovascular disease, diabetes, heart disease, and hypertensive disease all decreased. However, the mortality rate for pneumonia increased. We observed a continuous reduction in cardiovascular complications and mortality in adults with diabetes. However, with the increase in some diabetes complications, more efforts are needed to prevent diabetes complications.

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PLOS ONE.2024; 19(2): e0299035. CrossRef
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Food Frontiers.2024; 5(6): 2756. CrossRef
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
Cardiovascular Disease & Diabetes Statistics in Korea: Nationwide Data 2010 to 2019
Jin Hwa Kim, Junyeop Lee, Kyungdo Han, Jae-Taek Kim, Hyuk-Sang Kwon
Diabetes & Metabolism Journal.2024; 48(6): 1084. CrossRef
Global trends in the incidence of hospital admissions for diabetes-related foot disease and amputations: a review of national rates in the 21st century
Peter A. Lazzarini, Susanna M. Cramb, Jonathan Golledge, Jedidiah I. Morton, Dianna J. Magliano, Jaap J. Van Netten
Diabetologia.2023; 66(2): 267. CrossRef
Inequalities in cancer mortality trends in people with type 2 diabetes: 20 year population-based study in England
Suping Ling, Francesco Zaccardi, Eyad Issa, Melanie J. Davies, Kamlesh Khunti, Karen Brown
Diabetologia.2023; 66(4): 657. CrossRef
Lipid Management in Korean People With Type 2 Diabetes Mellitus: Korean Diabetes Association and Korean Society of Lipid and Atherosclerosis Consensus Statement
Ye Seul Yang, Hack-Lyoung Kim, Sang-Hyun Kim, Min Kyong Moon
Journal of Lipid and Atherosclerosis.2023; 12(1): 12. CrossRef
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International Journal of Heart Failure.2023; 5(1): 1. CrossRef
Empagliflozin is associated with lower risk of cardiovascular events and all‐cause mortality in routine care in East Asia: Results from the EMPRISE study
Dae Jung Kim, Wayne H‐H Sheu, Wook‐Jin Chung, Daisuke Yabe, Kyoung Hwa Ha, Masaomi Nangaku, Elise Chia‐Hui Tan, Koichi Node, Atsutaka Yasui, Weiyu Lei, Sunwoo Lee, Laura Saarelainen, Anouk Deruaz‐Luyet, Moe H Kyaw, Yutaka Seino
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Lipid Management in Korean People with Type 2 Diabetes Mellitus: Korean Diabetes Association and Korean Society of Lipid and Atherosclerosis Consensus Statement
Ye Seul Yang, Hack-Lyoung Kim, Sang-Hyun Kim, Min Kyong Moon
Diabetes & Metabolism Journal.2023; 47(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
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The effect of metabolic dysfunction-associated fatty liver disease and diabetic kidney disease on the risk of hospitalization of heart failure in type 2 diabetes: a retrospective cohort study
Seung Eun Lee, Juhwan Yoo, Bong-Seong Kim, Han Seok Choi, Kyungdo Han, Kyoung-Ah Kim
Diabetology & Metabolic Syndrome.2023;[Epub] CrossRef
Comparison of Operational Definition of Type 2 Diabetes Mellitus Based on Data from Korean National Health Insurance Service and Korea National Health and Nutrition Examination Survey
Jong Ha Baek, Yong-Moon Park, Kyung Do Han, Min Kyong Moon, Jong Han Choi, Seung-Hyun Ko
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Chronic disease management program applied to type 2 diabetes patients and prevention of diabetic complications: a retrospective cohort study using nationwide data
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The Present and Future of Artificial Intelligence-Based Medical Image in Diabetes Mellitus: Focus on Analytical Methods and Limitations of Clinical Use
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The Role of Echocardiography in Evaluating Cardiovascular Diseases in Patients with Diabetes Mellitus
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Long-term Effectiveness of the National Diabetes Quality Assessment Program in South Korea
Ji Hye Huh, Serim Kwon, Gui Ok Kim, Bo Yeon Kim, Kyoung Hwa Ha, Dae Jung Kim
Diabetes Care.2023; 46(9): 1700. CrossRef
Management of Dyslipidemia in Patients with Diabetes Mellitus
Kyung Ae Lee
The Journal of Korean Diabetes.2023; 24(3): 111. CrossRef
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Advanced Glycation End Products and Their Effect on Vascular Complications in Type 2 Diabetes Mellitus
Jeongmin Lee, Jae-Seung Yun, Seung-Hyun Ko
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Renoprotective Mechanism of Sodium-Glucose Cotransporter 2 Inhibitors: Focusing on Renal Hemodynamics
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Association between carotid atherosclerosis and presence of intracranial atherosclerosis using three-dimensional high-resolution vessel wall magnetic resonance imaging in asymptomatic patients with type 2 diabetes
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Hyun-Jin Kim, Kwang-il Kim
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Joshua Kuan Tan, Nur Nasyitah Mohamed Salim, Gek Hsiang Lim, Sing Yi Chia, Julian Thumboo, Yong Mong Bee, Ferdinando Carlo Sasso
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Seung Min Chung, Ji-In Lee, Eugene Han, Hyun-Ae Seo, Eonju Jeon, Hye Soon Kim, Ji Sung Yoon
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Impact of hypoglycemia at the time of hospitalization for heart failure from emergency department on major adverse cardiovascular events in patients with and without type 2 diabetes
Seon-Ah Cha, Jae-Seung Yun, Gee-Hee Kim, Yu-Bae Ahn
Cardiovascular Diabetology.2022;[Epub] CrossRef
Heart Failure and Diabetes Mellitus: Dangerous Liaisons
Hae-Young Lee
International Journal of Heart Failure.2022; 4(4): 163. CrossRef
Diabetes and Stroke
Junghyun Noh
The Journal of Korean Diabetes.2021; 22(1): 26. CrossRef
Current trends in epidemiology of cardiovascular disease and cardiovascular risk management in type 2 diabetes
Jae-Seung Yun, Seung-Hyun Ko
Metabolism.2021; 123: 154838. CrossRef

Complications
Diabetic Retinopathy and Related Clinical Practice for People with Diabetes in Korea: A 10-Year Trend Analysis: Yoo-Ri Chung, Kyoung Hwa Ha, Kihwang Lee, Dae Jung Kim; Diabetes Metab J. 2020;44(6):928-932. Published online July 10, 2020; DOI: https://doi.org/10.4093/dmj.2020.0096

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We performed a retrospective cohort study including people diagnosed with diabetes from 2006 to 2015 according to the Korean National Health Insurance Service-National Sample Cohort database, to analyze the changes in the prevalence, screening rate, and treatment patterns for diabetic retinopathy (DR) over 10 years. The proportion of people who underwent fundus screening for DR steadily increased over the past decade. The prevalence of DR increased from 13.4% in 2006 to 15.9% in 2015, while that of proliferative DR steadily decreased from 1.29% in 2006 to 1.16% in 2015. The proportion of patients undergoing retinal photocoagulation constantly decreased. The prevalence of DR increased over the past decade, while its severity seemed to have improved, with a decreased rate of proliferative DR and retinal photocoagulation. A higher proportion of patients underwent ophthalmic screening using fundus examination, but still less than 30% of patients with diabetes underwent comprehensive examination in 2015.

Citations

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Variations in Electronic Health Record-Based Definitions of Diabetic Retinopathy Cohorts
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Complications
Trends in the Incidence, Prevalence, and Mortality of End-Stage Kidney Disease in South Korea: Min-Jeong Lee, Kyoung Hwa Ha, Dae Jung Kim, Inwhee Park; Diabetes Metab J. 2020;44(6):933-937. Published online December 23, 2020; DOI: https://doi.org/10.4093/dmj.2020.0156

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Knowledge of the epidemiologic characteristics of end-stage kidney disease (ESKD) patients is essential. The trends in the prevalence, incidence, and mortality rates of ESKD were analyzed retrospectively using the Korean National Health Insurance ServiceNational Sample Cohort database between 2006 and 2015. From 2006 to 2015, the incidence of ESKD decreased from 28.6 to 24.0 per 100,000 people and showed a decreasing pattern with or without diabetes mellitus. However, the incidence of those aged ≥75 years increased, as did the mean age at the onset of ESKD. From 2007 to 2015, the prevalence of ESKD increased in all age groups, but particularly in those aged ≥75 years. The prevalence of ESKD differed by sex and diabetes mellitus status and this gap widened over time. Mortality rates in ESKD patients remained relatively constant throughout the study period. However, mortality rates in ESKD without diabetes decreased over the same period.

Citations

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Epidemiology
Diabetes and the Risk of Infection: A National Cohort Study: Eun Jin Kim, Kyoung Hwa Ha, Dae Jung Kim, Young Hwa Choi; Diabetes Metab J. 2019;43(6):804-814. Published online October 21, 2019; DOI: https://doi.org/10.4093/dmj.2019.0071

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Background

Several studies have shown that people with diabetes are vulnerable to infection. This study compared the risk of infection-related hospitalizations, intensive care unit (ICU) admission, and deaths between the person with diabetes and the general population in South Korea.

Methods

We conducted a cohort study of 66,426 diabetes and 132,852 age-sex-region-matched non-diabetes controls from the general population using a sample of data from the National Health Insurance Service-National Sample Cohort. The cohort was followed up for 9 years. Infections were classified into 17 separate categories. We used Poisson regression, with adjustment for household income and other comorbidities, to estimate incidence rate ratios (IRRs) in order to compare of infection-related hospitalizations, ICU admissions, and deaths.

Results

Compared to non-diabetes controls, diabetes group had a greater risk of almost all the types of infections considered, with the adjusted IRRs (aIRRs) for infection-related hospitalizations being the highest for hepatic abscess (aIRR, 10.17; 95% confidence interval [CI], 7.04 to 14.67), central nervous system (CNS) infections (aIRR, 8.72; 95% CI, 6.64 to 11.45), and skin and soft tissue infections other than cellulitis (SSTIs) (aIRR, 3.52; 95% CI, 3.20 to 3.88). Diabetes group also had a greater risk of ICU admission and death due to SSTIs (aIRR, 11.75; 95% CI, 7.32 to 18.86), CNS infections (aIRR, 5.25; 95% CI, 3.53 to 7.79), and bone and joint infections (aIRR, 4.78; 95% CI, 3.09 to 7.39).

Conclusion

In South Korea, people with diabetes has a considerably higher incidence of infection-related hospitalizations and deaths than the general population.

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Response: Dipeptidyl Peptidase-4 Inhibitors versus Other Antidiabetic Drugs Added to Metformin Monotherapy in Diabetic Retinopathy Progression: A Real World-Based Cohort Study (Diabetes Metab J 2019;43:640–8): Yoo-Ri Chung, Kyoung Hwa Ha, Kihwang Lee, Dae Jung Kim; Diabetes Metab J. 2019;43(6):917-918. Published online December 26, 2019; DOI: https://doi.org/10.4093/dmj.2019.0216

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Complications
Dipeptidyl Peptidase-4 Inhibitors versus Other Antidiabetic Drugs Added to Metformin Monotherapy in Diabetic Retinopathy Progression: A Real World-Based Cohort Study: Yoo-Ri Chung, Kyoung Hwa Ha, Hyeon Chang Kim, Sang Jun Park, Kihwang Lee, Dae Jung Kim; Diabetes Metab J. 2019;43(5):640-648. Published online February 20, 2019; DOI: https://doi.org/10.4093/dmj.2018.0137

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Background

To investigate the effects of dipeptidyl peptidase-4 inhibitor (DPP4i) as add-on medications to metformin on progression of diabetic retinopathy (DR) in patients with type 2 diabetes mellitus, compared with sulfonylurea (SU) or thiazolidinedione (TZD).

Methods

We identified 4,447 patients with DPP4i, 6,136 with SU, and 617 with TZD in addition to metformin therapy from the database of Korean National Health Insurance Service between January 2013 and December 2015. Cox proportional hazards regression models were used to calculate hazard ratios (HRs) for DR progression. The progression of DR was defined by the procedure code of panretinal photocoagulation, intravitreal injection or vitrectomy; or the addition of diagnostic code of vitreous hemorrhage, retinal detachment, or neovascular glaucoma.

Results

The age and sex-adjusted HR of DR progression was 0.74 for DPP4i add-on group compared with SU add-on group (95% confidence interval [CI], 0.62 to 0.89). This lower risk of DR progression remained significant after additional adjustments for comorbidities, duration of metformin therapy, intravitreal injections and calendar index year (HR, 0.80; 95% CI, 0.66 to 0.97).

Conclusion

This population-based cohort study showed that the use of DPP4i as add-on therapy to metformin did not increase the risk of DR progression compared to SU.

Citations

Citations to this article as recorded by

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Epidemiology
Diabetes Fact Sheets in Korea, 2018: An Appraisal of Current Status: Bo-Yeon Kim, Jong Chul Won, Jae Hyuk Lee, Hun-Sung Kim, Jung Hwan Park, Kyoung Hwa Ha, Kyu Chang Won, Dae Jung Kim, Kyong Soo Park; Diabetes Metab J. 2019;43(4):487-494. Published online July 17, 2019; DOI: https://doi.org/10.4093/dmj.2019.0067

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Background

The objective of this study was to investigate the prevalence, management, and comorbidities of diabetes among Korean adults aged 30 years and older.

Methods

This study used 2013 to 2016 data from the Korea National Health and Nutrition Examination Survey, a nationally-representative survey of the Korean population. Diabetes was defined as fasting glucose ≥126 mg/dL, current use of antidiabetic medication, a previous history of diabetes, or glycosylated hemoglobin (HbA1c) ≥6.5%.

Results

In 2016, 14.4% (approximately 5.02 million) of Korean adults had diabetes. The prevalence of impaired fasting glucose was 25.3% (8.71 million). From 2013 to 2016, the awareness, control, and treatment rates for diabetes were 62.6%, 56.7%, and 25.1%, respectively. People with diabetes had the following comorbidities: obesity (50.4%), abdominal obesity (47.8%), hypertension (55.3%), and hypercholesterolemia (34.9%). The 25.1%, 68.4%, and 44.2% of people with diabetes achieved HbA1c <6.5%, blood pressure <140/85 mm Hg, and low density lipoprotein cholesterol <100 mg/dL. Only 8.4% of people with diabetes had good control of all three targets.

Conclusion

This study confirms that diabetes is as an important public health problem. Efforts should be made to increase awareness, detection, and comprehensive management of diabetes to reduce diabetes-related morbidity and mortality.

Citations

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Epidemiology
Development and Validation of the Korean Diabetes Risk Score: A 10-Year National Cohort Study: Kyoung Hwa Ha, Yong-ho Lee, Sun Ok Song, Jae-woo Lee, Dong Wook Kim, Kyung-hee Cho, Dae Jung Kim; Diabetes Metab J. 2018;42(5):402-414. Published online July 6, 2018; DOI: https://doi.org/10.4093/dmj.2018.0014

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Background

A diabetes risk score in Korean adults was developed and validated.

Methods

This study used the National Health Insurance Service-National Health Screening Cohort (NHIS-HEALS) of 359,349 people without diabetes at baseline to derive an equation for predicting the risk of developing diabetes, using Cox proportional hazards regression models. External validation was conducted using data from the Korean Genome and Epidemiology Study. Calibration and discrimination analyses were performed separately for men and women in the development and validation datasets.

Results

During a median follow-up of 10.8 years, 37,678 cases (event rate=10.4 per 1,000 person-years) of diabetes were identified in the development cohort. The risk score included age, family history of diabetes, alcohol intake (only in men), smoking status, physical activity, use of antihypertensive therapy, use of statin therapy, body mass index, systolic blood pressure, total cholesterol, fasting glucose, and γ glutamyl transferase (only in women). The C-statistics for the models for risk at 10 years were 0.71 (95% confidence interval [CI], 0.70 to 0.73) for the men and 0.76 (95% CI, 0.75 to 0.78) for the women in the development dataset. In the validation dataset, the C-statistics were 0.63 (95% CI, 0.53 to 0.73) for men and 0.66 (95% CI, 0.55 to 0.76) for women.

Conclusion

The Korean Diabetes Risk Score may identify people at high risk of developing diabetes and may be an effective tool for delaying or preventing the onset of condition as risk management strategies involving modifiable risk factors can be recommended to those identified as at high risk.

Citations

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Response: Clinical Characteristics of People with Newly Diagnosed Type 2 Diabetes between 2015 and 2016: Difference by Age and Body Mass Index (Diabetes Metab J 2018;42:137-46): Kyoung Hwa Ha, Dae Jung Kim, Sungrae Kim; Diabetes Metab J. 2018;42(3):251-253. Published online June 19, 2018; DOI: https://doi.org/10.4093/dmj.2018.0099

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Citations

Citations to this article as recorded by

Rising Incidence of Diabetes in Young Adults in South Korea: A National Cohort Study
Hyun Ho Choi, Giwoong Choi, Hojun Yoon, Kyoung Hwa Ha, Dae Jung Kim
Diabetes & Metabolism Journal.2022; 46(5): 803. CrossRef

Epidemiology
Clinical Characteristics of People with Newly Diagnosed Type 2 Diabetes between 2015 and 2016: Difference by Age and Body Mass Index: Kyoung Hwa Ha, Cheol Young Park, In Kyung Jeong, Hyun Jin Kim, Sang-Yong Kim, Won Jun Kim, Ji Sung Yoon, In Joo Kim, Dae Jung Kim, Sungrae Kim; Diabetes Metab J. 2018;42(2):137-146. Published online February 14, 2018; DOI: https://doi.org/10.4093/dmj.2018.42.2.137

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Background

We evaluated the clinical characteristics of insulin resistance and β-cell dysfunction in newly diagnosed, drug-naive people with type 2 diabetes by analyzing nationwide cross-sectional data.

Methods

We collected the clinical data of 912 participants with newly diagnosed diabetes from 83 primary care clinics and hospitals nationwide from 2015 to 2016. The presence of insulin resistance and β-cell dysfunction was defined as a homeostatic model assessment of insulin resistance (HOMA-IR) value ≥2.5 and fasting C-peptide levels <1.70 ng/mL, respectively.

Results

A total of 75.1% and 22.6% of participants had insulin resistance and β-cell dysfunction, respectively. The proportion of participants with insulin resistance but no β-cell dysfunction increased, and the proportion of participants with β-cell dysfunction but no insulin resistance decreased as body mass index (BMI) increased. People diagnosed with diabetes before 40 years of age had significantly higher HOMA-IR and BMI than those diagnosed over 65 years of age (HOMA-IR, 5.0 vs. 3.0; BMI, 28.7 kg/m² vs. 25.1 kg/m²). However, the β-cell function indices were lower in people diagnosed before 40 years of age than in those diagnosed after 65 years of age (homeostatic model assessment of β-cell function, 39.3 vs. 64.9; insulinogenic index, 10.3 vs. 18.7; disposition index, 0.15 vs. 0.25).

Conclusion

We observed that the main pathogenic mechanism of type 2 diabetes is insulin resistance in participants with newly diagnosed type 2 diabetes. In addition, young adults with diabetes are more likely to have higher insulin resistance with obesity and have higher insulin secretory defect with severe hyperglycemia in the early period of diabetes than older populations.

Citations

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Davis Kibirige, Isaac Sekitoleko, Priscilla Balungi, William Lumu, Moffat J. Nyirenda
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Hyun Ho Choi, Giwoong Choi, Hojun Yoon, Kyoung Hwa Ha, Dae Jung Kim
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A Real-World Study of Long-Term Safety and Efficacy of Lobeglitazone in Korean Patients with Type 2 Diabetes Mellitus
Bo-Yeon Kim, Hyuk-Sang Kwon, Suk Kyeong Kim, Jung-Hyun Noh, Cheol-Young Park, Hyeong-Kyu Park, Kee-Ho Song, Jong Chul Won, Jae Myung Yu, Mi Young Lee, Jae Hyuk Lee, Soo Lim, Sung Wan Chun, In-Kyung Jeong, Choon Hee Chung, Seung Jin Han, Hee-Seok Kim, Ju-Y
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Liyun Duan, De Jin, Xuedong An, Yuehong Zhang, Shenghui Zhao, Rongrong Zhou, Yingying Duan, Yuqing Zhang, Xinmin Liu, Fengmei Lian, Wen yi Kang
Evidence-Based Complementary and Alternative Medicine.2021; 2021: 1. CrossRef
PRKAA2variation and the clinical characteristics of patients newly diagnosed with type 2 diabetes mellitus in Yogyakarta, Indonesia
Dita Maria Virginia, Mae Sri Hartati Wahyuningsih, Dwi Aris Agung Nugrahaningsih
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Efficacy and Safety of Pioglitazone versus Glimepiride after Metformin and Alogliptin Combination Therapy: A Randomized, Open-Label, Multicenter, Parallel-Controlled Study
Jeong Mi Kim, Sang Soo Kim, Jong Ho Kim, Mi Kyung Kim, Tae Nyun Kim, Soon Hee Lee, Chang Won Lee, Ja Young Park, Eun Sook Kim, Kwang Jae Lee, Young Sik Choi, Duk Kyu Kim, In Joo Kim
Diabetes & Metabolism Journal.2020; 44(1): 67. CrossRef
Favorable Glycemic Control with Once-Daily Insulin Degludec/Insulin Aspart after Changing from Basal Insulin in Adults with Type 2 Diabetes
Han Na Jang, Ye Seul Yang, Seong Ok Lee, Tae Jung Oh, Bo Kyung Koo, Hye Seung Jung
Endocrinology and Metabolism.2019; 34(4): 382. CrossRef
Insulin Resistance versus β-Cell Failure: Is It Changing in Koreans?
Mi-kyung Kim
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Response: Clinical Characteristics of People with Newly Diagnosed Type 2 Diabetes between 2015 and 2016: Difference by Age and Body Mass Index (Diabetes Metab J2018;42:137-46)
Kyoung Hwa Ha, Dae Jung Kim, Sungrae Kim
Diabetes & Metabolism Journal.2018; 42(3): 251. CrossRef
Letter: Clinical Characteristics of People with Newly Diagnosed Type 2 Diabetes between 2015 and 2016: Difference by Age and Body Mass Index (Diabetes Metab J 2018;42:137-46)
Ah Reum Khang
Diabetes & Metabolism Journal.2018; 42(3): 249. CrossRef

Obesity and Metabolic Syndrome
Association between Blood Mercury Level and Visceral Adiposity in Adults: Jong Suk Park, Kyoung Hwa Ha, Ka He, Dae Jung Kim; Diabetes Metab J. 2017;41(2):113-120. Published online December 21, 2016; DOI: https://doi.org/10.4093/dmj.2017.41.2.113

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Background

Few studies have examined the association between mercury exposure and obesity. The aim of this study is to investigate the association between blood mercury concentrations and indices of obesity in adults.

Methods

A total of 200 healthy subjects, aged 30 to 64 years, who had no history of cardiovascular or malignant disease, were examined. Anthropometric and various biochemical profiles were measured. Visceral adipose tissue (VAT) was measured using dual-energy X-ray absorptiometry (DXA).

Results

All subjects were divided into three groups according to blood mercury concentrations. Compared with the subjects in the lowest tertile of mercury, those in the highest tertile were more likely to be male; were current alcohol drinkers and smokers; had a higher body mass index (BMI), waist circumference (WC), and VAT; had higher levels of blood pressure, fasting glucose, and insulin resistance; and consumed more fish. The blood mercury concentration was significantly associated with anthropometric parameters, showing relationships with BMI, WC, and VAT. After adjusting for multiple risk factors, the odds ratios (ORs) for high mercury concentration was significantly higher in the highest VAT tertile than in the lowest VAT tertile (OR, 2.66; 95% confidence interval, 1.05 to 6.62; P<0.05).

Conclusion

The blood mercury concentration was significantly associated with VAT in healthy adults. Further studies are warranted to confirm our findings.

Citations

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Epidemiology
Serum 25-Hydroxyvitamin D Concentration Is Independently Inversely Associated with Insulin Resistance in the Healthy, Non-Obese Korean Population: So Young Ock, Kyoung Hwa Ha, Bu Kyung Kim, Hyeon Chang Kim, Jee-Seon Shim, Myung Ha Lee, Young Me Yoon, Dae Jung Kim; Diabetes Metab J. 2016;40(5):367-375. Published online July 26, 2016; DOI: https://doi.org/10.4093/dmj.2016.40.5.367

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Background

We evaluated the associations between 25-hydroxyvitamin D (25(OH)D) concentrations in serum and insulin resistance in the healthy Korean population.

Methods

We conducted this cross-sectional analysis in 1,807 healthy Korean people (628 men and 1,179 women) aged 30 to 64 years in the Cardiovascular and Metabolic Disease Etiologic Research Center study. All participants were assessed for 25(OH)D, fasting glucose, and insulin levels, and completed a health examination and lifestyle questionnaire according to standard procedures. Insulin resistance was defined as the homeostasis model assessment insulin resistance higher than the 75 percentile.

Results

Compared to those in the highest tertile (≥14.3 ng/mL), the odds ratio (OR) for insulin resistance was 1.37 (95% confidence interval [CI], 1.01 to 1.86) for the 1st tertile (<9.7 ng/mL) and 1.19 (95% CI, 0.08 to 1.62) for the 2nd tertile (9.7 to 14.3 ng/mL) after adjusting for age, gender, waist circumference, alcohol consumption, smoking status, physical exercise, season, and cohort. After stratification of the subjects by adiposity, these associations remained only in non-obese subjects (lowest tertile vs. highest tertile, multivariable OR, 1.64; 95% CI, 1.05 to 2.56).

Conclusion

Serum 25(OH)D has an independent inverse association with insulin resistance in the healthy, non-obese Korean population, even among people with vitamin D insufficiency.

Citations

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