- Lifestyle
- Enhancing Diabetes Care through a Mobile Application: A Randomized Clinical Trial on Integrating Physical and Mental Health among Disadvantaged Individuals
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Jae Hyun Bae, Eun Hee Park, Hae Kyung Lee, Kun Ho Yoon, Kyu Chang Won, Hyun Mi Kim, Sin Gon Kim
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Diabetes Metab J. 2024;48(4):790-801. Published online February 2, 2024
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DOI: https://doi.org/10.4093/dmj.2023.0298
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Abstract
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- Background
This study examines integrating physical and mental healthcare for disadvantaged persons with type 2 diabetes mellitus and mild-to-moderate depression in the community, using a mobile application within a public-private-academic partnership.
Methods The Korean Diabetes Association has developed a mobile application combining behavioral activation for psychological well-being and diabetes self-management, with conventional medical therapy. Participants were randomly assigned to receive the application with usual care or only usual care. Primary outcomes measured changes in psychological status and diabetes selfmanagement through questionnaires at week 12 from the baseline. Secondary outcomes assessed glycemic and lipid control, with psychological assessments at week 16.
Results Thirty-nine of 73 participants completed the study (20 and 19 in the intervention and control groups, respectively) and were included in the analysis. At week 12, the intervention group showed significant reductions in depression severity and perceived stress compared to the control group. Additionally, they reported increased perceived social support and demonstrated improved diabetes self-care behavior. These positive effects persisted through week 16, with the added benefit of reduced anxiety. While fasting glucose levels in the intervention group tended to improve, no other significant differences were observed in laboratory assessments between the groups.
Conclusion This study provides compelling evidence for the potential efficacy of a mobile application that integrates physical and mental health components to address depressive symptoms and enhance diabetes self-management in disadvantaged individuals with type 2 diabetes mellitus and depression. Further research involving larger and more diverse populations is warranted to validate these findings and solidify their implications.
- Drug/Regimen
- Efficacy and Safety of Metformin and Atorvastatin Combination Therapy vs. Monotherapy with Either Drug in Type 2 Diabetes Mellitus and Dyslipidemia Patients (ATOMIC): Double-Blinded Randomized Controlled Trial
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Jie-Eun Lee, Seung Hee Yu, Sung Rae Kim, Kyu Jeung Ahn, Kee-Ho Song, In-Kyu Lee, Ho-Sang Shon, In Joo Kim, Soo Lim, Doo-Man Kim, Choon Hee Chung, Won-Young Lee, Soon Hee Lee, Dong Joon Kim, Sung-Rae Cho, Chang Hee Jung, Hyun Jeong Jeon, Seung-Hwan Lee, Keun-Young Park, Sang Youl Rhee, Sin Gon Kim, Seok O Park, Dae Jung Kim, Byung Joon Kim, Sang Ah Lee, Yong-Hyun Kim, Kyung-Soo Kim, Ji A Seo, Il Seong Nam-Goong, Chang Won Lee, Duk Kyu Kim, Sang Wook Kim, Chung Gu Cho, Jung Han Kim, Yeo-Joo Kim, Jae-Myung Yoo, Kyung Wan Min, Moon-Kyu Lee
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Diabetes Metab J. 2024;48(4):730-739. Published online May 20, 2024
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DOI: https://doi.org/10.4093/dmj.2023.0077
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Abstract
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- Background
It is well known that a large number of patients with diabetes also have dyslipidemia, which significantly increases the risk of cardiovascular disease (CVD). This study aimed to evaluate the efficacy and safety of combination drugs consisting of metformin and atorvastatin, widely used as therapeutic agents for diabetes and dyslipidemia.
Methods This randomized, double-blind, placebo-controlled, parallel-group and phase III multicenter study included adults with glycosylated hemoglobin (HbA1c) levels >7.0% and <10.0%, low-density lipoprotein cholesterol (LDL-C) >100 and <250 mg/dL. One hundred eighty-five eligible subjects were randomized to the combination group (metformin+atorvastatin), metformin group (metformin+atorvastatin placebo), and atorvastatin group (atorvastatin+metformin placebo). The primary efficacy endpoints were the percent changes in HbA1c and LDL-C levels from baseline at the end of the treatment.
Results After 16 weeks of treatment compared to baseline, HbA1c showed a significant difference of 0.94% compared to the atorvastatin group in the combination group (0.35% vs. −0.58%, respectively; P<0.0001), whereas the proportion of patients with increased HbA1c was also 62% and 15%, respectively, showing a significant difference (P<0.001). The combination group also showed a significant decrease in LDL-C levels compared to the metformin group (−55.20% vs. −7.69%, P<0.001) without previously unknown adverse drug events.
Conclusion The addition of atorvastatin to metformin improved HbA1c and LDL-C levels to a significant extent compared to metformin or atorvastatin alone in diabetes and dyslipidemia patients. This study also suggested metformin’s preventive effect on the glucose-elevating potential of atorvastatin in patients with type 2 diabetes mellitus and dyslipidemia, insufficiently controlled with exercise and diet. Metformin and atorvastatin combination might be an effective treatment in reducing the CVD risk in patients with both diabetes and dyslipidemia because of its lowering effect on LDL-C and glucose.
- Metabolic Risk/Epidemiology
- Role of Fenofibrate Use in Dyslipidemia and Related Comorbidities in the Asian Population: A Narrative Review
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Chaicharn Deerochanawong, Sin Gon Kim, Yu-Cheng Chang
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Diabetes Metab J. 2024;48(2):184-195. Published online January 26, 2024
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DOI: https://doi.org/10.4093/dmj.2023.0168
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- Hypertriglyceridemia and decreased high-density lipoprotein cholesterol (HDL-C) persist despite statin therapy, contributing to residual atherosclerotic cardiovascular disease (ASCVD) risk. Asian subjects are metabolically more susceptible to hypertriglyceridemia than other ethnicities. Fenofibrate regulates hypertriglyceridemia, raises HDL-C levels, and is a recommended treatment for dyslipidemia. However, data on fenofibrate use across different Asian regions are limited. This narrative review summarizes the efficacy and safety data of fenofibrate in Asian subjects with dyslipidemia and related comorbidities (diabetes, metabolic syndrome, diabetic retinopathy, and diabetic nephropathy). Long-term fenofibrate use resulted in fewer cardiovascular (CV) events and reduced the composite of heart failure hospitalizations or CV mortality in type 2 diabetes mellitus. Fenofibrate plays a significant role in improving irisin resistance and microalbuminuria, inhibiting inflammatory responses, and reducing retinopathy incidence. Fenofibrate plus statin combination significantly reduced composite CV events risk in patients with metabolic syndrome and demonstrated decreased triglyceride and increased HDL-C levels with an acceptable safety profile in those with high CV or ASCVD risk. Nevertheless, care is necessary with fenofibrate use due to possible hepatic and renal toxicities in vulnerable individuals. Long-term trials and real-world studies are needed to confirm the clinical benefits of fenofibrate in the heterogeneous Asian population with dyslipidemia.
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- Fenofibrate to prevent amputation and reduce vascular complications in patients with diabetes: FENO-PREVENT
Eu Jeong Ku, Bongseong Kim, Kyungdo Han, Seung-Hwan Lee, Hyuk-Sang Kwon Cardiovascular Diabetology.2024;[Epub] CrossRef - The role of DGAT1 and DGAT2 in tumor progression via fatty acid metabolism: A comprehensive review
Leisheng Wang, Shiwei Xu, Mengzhen Zhou, Hao Hu, Jinyou Li International Journal of Biological Macromolecules.2024; 278: 134835. CrossRef -
An exploratory investigation of lipid-lowering potential of spirulina (
Arthrospira platensis
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wistar albino
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- Pathophysiology
- Attention to Innate Circadian Rhythm and the Impact of Its Disruption on Diabetes
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Da Young Lee, Inha Jung, So Young Park, Ji Hee Yu, Ji A Seo, Kyeong Jin Kim, Nam Hoon Kim, Hye Jin Yoo, Sin Gon Kim, Kyung Mook Choi, Sei Hyun Baik, Nan Hee Kim
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Diabetes Metab J. 2024;48(1):37-52. Published online January 3, 2024
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DOI: https://doi.org/10.4093/dmj.2023.0193
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- Novel strategies are required to reduce the risk of developing diabetes and/or clinical outcomes and complications of diabetes. In this regard, the role of the circadian system may be a potential candidate for the prevention of diabetes. We reviewed evidence from animal, clinical, and epidemiological studies linking the circadian system to various aspects of the pathophysiology and clinical outcomes of diabetes. The circadian clock governs genetic, metabolic, hormonal, and behavioral signals in anticipation of cyclic 24-hour events through interactions between a “central clock” in the suprachiasmatic nucleus and “peripheral clocks” in the whole body. Currently, circadian rhythmicity in humans can be subjectively or objectively assessed by measuring melatonin and glucocorticoid levels, core body temperature, peripheral blood, oral mucosa, hair follicles, rest-activity cycles, sleep diaries, and circadian chronotypes. In this review, we summarized various circadian misalignments, such as altered light-dark, sleep-wake, rest-activity, fasting-feeding, shift work, evening chronotype, and social jetlag, as well as mutations in clock genes that could contribute to the development of diabetes and poor glycemic status in patients with diabetes. Targeting critical components of the circadian system could deliver potential candidates for the treatment and prevention of type 2 diabetes mellitus in the future.
- Cardiovascular Risk/Epidemiology
- Comparison of on-Statin Lipid and Lipoprotein Levels for the Prediction of First Cardiovascular Event in Type 2 Diabetes Mellitus
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Ji Yoon Kim, Jimi Choi, Sin Gon Kim, Nam Hoon Kim
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Diabetes Metab J. 2023;47(6):837-845. Published online August 23, 2023
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DOI: https://doi.org/10.4093/dmj.2022.0217
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Abstract
PDFSupplementary MaterialPubReader ePub
- Background
A substantial cardiovascular disease risk remains even after optimal statin therapy. Comparative predictiveness of major lipid and lipoprotein parameters for cardiovascular events in patients with type 2 diabetes mellitus (T2DM) who are treated with statins is not well documented.
Methods From the Korean Nationwide Cohort, 11,900 patients with T2DM (≥40 years of age) without a history of cardiovascular disease and receiving moderate- or high-intensity statins were included. The primary outcome was the first occurrence of major adverse cardiovascular events (MACE) including ischemic heart disease, ischemic stroke, and cardiovascular death. The risk of MACE was estimated according to on-statin levels of low-density lipoprotein cholesterol (LDL-C), triglyceride (TG), highdensity lipoprotein cholesterol (HDL-C), and non-HDL-C.
Results MACE occurred in 712 patients during a median follow-up period of 37.9 months (interquartile range, 21.7 to 54.9). Among patients achieving LDL-C levels less than 100 mg/dL, the hazard ratios for MACE per 1-standard deviation change in ontreatment values were 1.25 (95% confidence interval [CI], 1.07 to 1.47) for LDL-C, 1.31 (95% CI, 1.09 to 1.57) for non-HDL-C, 1.05 (95% CI, 0.91 to 1.21) for TG, and 1.16 (95% CI, 0.98 to 1.37) for HDL-C, after adjusting for potential confounders and lipid parameters mutually. The predictive ability of on-statin LDL-C and non-HDL-C for MACE was prominent in patients at high cardiovascular risk or those with LDL-C ≥70 mg/dL.
Conclusion On-statin LDL-C and non-HDL-C levels are better predictors of the first cardiovascular event than TG or HDL-C in patients with T2DM.
- Technology/Device
- Clinical and Lifestyle Determinants of Continuous Glucose Monitoring Metrics in Insulin-Treated Patients with Type 2 Diabetes Mellitus
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Da Young Lee, Namho Kim, Inha Jung, So Young Park, Ji Hee Yu, Ji A Seo, Jihee Kim, Kyeong Jin Kim, Nam Hoon Kim, Hye Jin Yoo, Sin Gon Kim, Kyung Mook Choi, Sei Hyun Baik, Sung-Min Park, Nan Hee Kim
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Diabetes Metab J. 2023;47(6):826-836. Published online August 24, 2023
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DOI: https://doi.org/10.4093/dmj.2022.0273
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- Background
There was limited evidence to evaluate the association between lifestyle habits and continuous glucose monitoring (CGM) metrics. Thus, we aimed to depict the behavioral and metabolic determinants of CGM metrics in insulin-treated patients with type 2 diabetes mellitus (T2DM).
Methods This is a prospective observational study. We analyzed data from 122 insulin-treated patients with T2DM. Participants wore Dexcom G6 and Fitbit, and diet information was identified for 10 days. Multivariate-adjusted logistic regression analysis was performed for the simultaneous achievement of CGM-based targets, defined by the percentage of time in terms of hyper, hypoglycemia and glycemic variability (GV). Intake of macronutrients and fiber, step counts, sleep, postprandial C-peptide-to-glucose ratio (PCGR), information about glucose lowering medications and metabolic factors were added to the analyses. Additionally, we evaluated the impact of the distribution of energy and macronutrient during a day, and snack consumption on CGM metrics.
Results Logistic regression analysis revealed that female, participants with high PCGR, low glycosylated hemoglobin (HbA1c) and daytime step count had a higher probability of achieving all targets based on CGM (odds ratios [95% confidence intervals] which were 0.24 [0.09 to 0.65], 1.34 [1.03 to 1.25], 0.95 [0.9 to 0.99], and 1.15 [1.03 to 1.29], respectively). And participants who ate snacks showed a shorter period of hyperglycemia and less GV compared to those without.
Conclusion We confirmed that residual insulin secretion, daytime step count, HbA1c, and women were the most relevant determinants of adequate glycemic control in insulin-treated patients with T2DM. In addition, individuals with snack consumption were exposed to lower times of hyperglycemia and GV.
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Citations
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- Explanatory variables of objectively measured 24-h movement behaviors in people with prediabetes and type 2 diabetes: A systematic review
Lotte Bogaert, Iris Willems, Patrick Calders, Eveline Dirinck, Manon Kinaupenne, Marga Decraene, Bruno Lapauw, Boyd Strumane, Margot Van Daele, Vera Verbestel, Marieke De Craemer Diabetes & Metabolic Syndrome: Clinical Research & Reviews.2024; 18(4): 102995. CrossRef
- Drug Regimen
- The Efficacy and Safety of Moderate-Intensity Rosuvastatin with Ezetimibe versus High-Intensity Rosuvastatin in High Atherosclerotic Cardiovascular Disease Risk Patients with Type 2 Diabetes Mellitus: A Randomized, Multicenter, Open, Parallel, Phase 4 Study
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Jun Sung Moon, Il Rae Park, Sang Soo Kim, Hye Soon Kim, Nam Hoon Kim, Sin Gon Kim, Seung Hyun Ko, Ji Hyun Lee, Inkyu Lee, Bo Kyeong Lee, Kyu Chang Won
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Diabetes Metab J. 2023;47(6):818-825. Published online November 24, 2023
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DOI: https://doi.org/10.4093/dmj.2023.0171
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Abstract
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- Background
To investigate the efficacy and safety of moderate-intensity rosuvastatin/ezetimibe combination compared to highintensity rosuvastatin in high atherosclerotic cardiovascular disease (ASCVD) risk patients with type 2 diabetes mellitus (T2DM).
Methods This study was a randomized, multicenter, open, parallel phase 4 study, and enrolled T2DM subjects with an estimated 10-year ASCVD risk ≥7.5%. The primary endpoint was the low-density lipoprotein cholesterol (LDL-C) change rate after 24-week rosuvastatin 10 mg/ezetimibe 10 mg treatment was non-inferior to that of rosuvastatin 20 mg. The achievement proportion of 10-year ASCVD risk <7.5% or comprehensive lipid target (LDL-C <70 mg/dL, non-high-density lipoprotein cholesterol <100 mg/dL, and apolipoprotein B <80 mg/dL) without discontinuation, and several metabolic parameters were explored as secondary endpoints.
Results A hundred and six participants were assigned to each group. Both groups showed significant reduction in % change of LDL-C from baseline at week 24 (–63.90±6.89 vs. –55.44±6.85, combination vs. monotherapy, p=0.0378; respectively), but the combination treatment was superior to high-intensity monotherapy in LDL-C change (%) from baseline (least square [LS] mean difference, –8.47; 95% confidence interval, –16.44 to –0.49; p=0.0378). The combination treatment showed a higher proportion of achieved comprehensive lipid targets rather than monotherapy (85.36% vs. 62.22% in monotherapy, p=0.015). The ezetimibe combination significantly improved homeostasis model assessment of β-cell function even without A1c changes (LS mean difference, 17.13; p=0.0185).
Conclusion In high ASCVD risk patients with T2DM, the combination of moderate-intensity rosuvastatin and ezetimibe was not only non-inferior but also superior to improving dyslipidemia with additional benefits compared to high-intensity rosuvastatin monotherapy.
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Citations
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- Does Rosuvastatin/Ezetimibe Combination Therapy Offer Potential Benefits for Glucose Metabolism beyond Lipid-Lowering Efficacy in T2DM?
Il Rae Park, Jun Sung Moon Diabetes & Metabolism Journal.2024; 48(3): 387. CrossRef - Efficacy and safety of double-dose statin monotherapy versus moderate-intensity statin combined with ezetimibe dual therapy in diabetic patients: a systematic review and meta-analysis of randomized controlled trials
Aman Goyal, Muhammad Daoud Tariq, Hritvik Jain, Abhigan Babu Shrestha, Laveeza Fatima, Romana Riyaz, Hritik Raj Yadav, Darsh Safi, Abdul Qahar K. Yasinzai, Rozi Khan, Amir Humza Sohail, Mohamed Daoud, Abu Baker Sheikh Cardiovascular Endocrinology & Metabolism.2024;[Epub] CrossRef
- Others
- Fasting Glucose Variability and the Risk of Dementia in Individuals with Diabetes: A Nationwide Cohort Study
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Da Young Lee, Jaeyoung Kim, Sanghyun Park, So Young Park, Ji Hee Yu, Ji A Seo, Nam Hoon Kim, Hye Jin Yoo, Sin Gon Kim, Kyung Mook Choi, Sei Hyun Baik, Kyungdo Han, Nan Hee Kim
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Diabetes Metab J. 2022;46(6):923-935. Published online May 24, 2022
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DOI: https://doi.org/10.4093/dmj.2021.0346
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- Background
We investigated whether fasting glucose (FG) variability could predict the risk of dementia.
Methods This cohort study analyzed data from Koreans with diabetes after at least three health examinations by the Korean National Health Insurance Corporation between 2005 and 2010, which included at least one examination between 2009 and 2010. A total of 769,554 individuals were included, excluding those aged <40 years and those with dementia. FG variability was measured using the variability independent of the mean (FG-VIM). The incidence of dementia was defined by the International Classification of Diseases 10th Revision codes and prescription of anti-dementia medication and was subdivided into Alzheimer’s disease (AD) and vascular dementia (VD).
Results During the 6.9-year follow-up, 54,837, 41,032, and 6,892 cases of all-cause dementia, AD, and VD, respectively, were identified. Cox proportional regression analyses showed that as the FG-VIM quartile increased, the risk of dementia serially increased after adjustment for metabolic factors, income status, and diabetes-related characteristics, including the mean FG. Participants in FG-VIM quartile 4 showed a 18%, 19%, and 17% higher risk for all-cause dementia, AD, and VD, respectively, than those in quartile 1; this particularly included non-obese patients with a longer duration of diabetes, high FG levels, dyslipidemia, and those taking glucose-lowering medications. Conversely, the baseline FG status and dementia showed a U-shaped association.
Conclusion Increased FG variability over 5 years can predict the risk of dementia in individuals with diabetes in Korea. This finding was more pronounced in patients with less favorable metabolic profiles.
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- Fasting glucose variability and risk of dementia in Parkinson’s disease: a 9-year longitudinal follow-up study of a nationwide cohort
Sung Hoon Kang, Yunjin Choi, Su Jin Chung, Seok-Joo Moon, Chi Kyung Kim, Ji Hyun Kim, Kyungmi Oh, Joon Shik Yoon, Sang Won Seo, Geum Joon Cho, Seong-Beom Koh Frontiers in Aging Neuroscience.2024;[Epub] CrossRef - Effects of a Diabetic Microenvironment on Neurodegeneration: Special Focus on Neurological Cells
Vishal Chavda, Dhananjay Yadav, Snehal Patel, Minseok Song Brain Sciences.2024; 14(3): 284. CrossRef - The relationship between diabetes and the dementia risk: a meta-analysis
Fang Cao, Fushuang Yang, Jian Li, Wei Guo, Chongheng Zhang, Fa Gao, Xinxin Sun, Yi Zhou, Wenfeng Zhang Diabetology & Metabolic Syndrome.2024;[Epub] CrossRef - Effect of glucose variability on the mortality of adults aged 75 years and over during the first year of the COVID-19 pandemic
Miguel A. Salinero-Fort, F. Javier San Andrés-Rebollo, Juan Cárdenas-Valladolid, José Mostaza, Carlos Lahoz, Fernando Rodriguez-Artalejo, Paloma Gómez-Campelo, Pilar Vich-Pérez, Rodrigo Jiménez-García, José M. de-Miguel-Yanes, Javier Maroto-Rodriguez, Bel BMC Geriatrics.2024;[Epub] CrossRef - Association of remnant cholesterol with risk of dementia: a nationwide population-based cohort study in South Korea
Ji Hye Heo, Han Na Jung, Eun Roh, Kyung-do Han, Jun Goo Kang, Seong Jin Lee, Sung-Hee Ihm The Lancet Healthy Longevity.2024; 5(8): e524. CrossRef - Glycated Hemoglobin A1c Time in Range and Dementia in Older Adults With Diabetes
Patricia C. Underwood, Libin Zhang, David C. Mohr, Julia C. Prentice, Richard E. Nelson, Andrew E. Budson, Paul R. Conlin JAMA Network Open.2024; 7(8): e2425354. CrossRef - The Association of Glucose Variability and Dementia Incidence in Latinx Adults with Type 2 Diabetes: A Retrospective Study
Heather Cuevas, Elizabeth Muñoz, Divya Nagireddy, Jeeyeon Kim, Grace Ganucheau, Fathia Alomoush Clinical Nursing Research.2023; 32(2): 249. CrossRef - The effects of long-term cumulative HbA1c exposure on the development and onset time of dementia in the patients with type 2 diabetes mellitus: Hospital based retrospective study (2005–2021)
Sunyoung Cho, Choon Ok Kim, Bong-soo Cha, Eosu Kim, Chung Mo Nam, Min-Gul Kim, Min Soo Park Diabetes Research and Clinical Practice.2023; 201: 110721. CrossRef - Physiological Mechanisms Inherent to Diabetes Involved in the Development of Dementia: Alzheimer’s Disease
Himan Mohamed-Mohamed, Victoria García-Morales, Encarnación María Sánchez Lara, Anabel González-Acedo, Teresa Pardo-Moreno, María Isabel Tovar-Gálvez, Lucía Melguizo-Rodríguez, Juan José Ramos-Rodríguez Neurology International.2023; 15(4): 1253. CrossRef - Cumulative effect of impaired fasting glucose on the risk of dementia in middle-aged and elderly people: a nationwide cohort study
Jin Yu, Kyu-Na Lee, Hun-Sung Kim, Kyungdo Han, Seung-Hwan Lee Scientific Reports.2023;[Epub] CrossRef - Early detection of Dementia in Type 2 Diabetes population: Predictive analytics using Machine learning approach (Preprint)
Phan Thanh Phuc, Phung-Anh Nguyen, Nam N. Nguyen, Min-Huei Hsu, Khanh NQ. Le, Quoc-Viet Tran, Chih-Wei Huang, Hsuan-Chia Yang, Cheng-Yu Chen, Thi Anh Hoa Le, Minh Khoi Le, Hoang Bac Nguyen, Christine Y. Lu, Jason C. Hsu Journal of Medical Internet Research.2023;[Epub] 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 (Diabetes Metab J 2021;45:368-78)
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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
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Diabetes Metab J. 2021;45(4):617-618. Published online July 30, 2021
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DOI: https://doi.org/10.4093/dmj.2021.0152
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Zhengang Wei, Xiaohua Wang, Liqin Lu, Su Li, Wenyan Long, Lin Zhang, Shaolin Shen CIN: Computers, Informatics, Nursing.2024; 42(9): 665. CrossRef - The effect of close and intensive therapeutic monitoring of patients with poorly controlled type 2 diabetes with different glycemic background
Ayşe Naciye Erbakan, Müzeyyen Arslan Bahadir, Fatoş Nimet Kaya, Büşra Güleç, Miraç Vural Keskinler, Özge Faydaliel, Banu Mesçi, Aytekin Oğuz Medicine.2023; 102(50): e36680. CrossRef - Reduced macula microvascular densities may be an early indicator for diabetic peripheral neuropathy
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- Complications
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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
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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
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Diabetes Metab J. 2021;45(3):368-378. Published online October 20, 2020
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DOI: https://doi.org/10.4093/dmj.2020.0046
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Graphical Abstract
Abstract
PDFSupplementary MaterialPubReader ePub
- Background
To evaluate the association of time to reach the target glycosylated hemoglobin (HbA1c) level with long-term durable glycemic control and risk of diabetic complications in patients with newly diagnosed type 2 diabetes mellitus (T2DM).
Methods In a longitudinal observational cohort, 194 patients with T2DM newly diagnosed between January 2011 and March 2013 were followed up over 6 years. Patients were classified according to the time needed to reach the target HbA1c (<7.0%): <3, 3 to 6 (early achievement group), and ≥6 months (late achievement group). Risks of microvascular complications including diabetic retinopathy, nephropathy, and neuropathy as well as macrovascular events including ischemic heart disease, ischemic stroke, and peripheral arterial disease were assessed by multivariable Cox proportional hazards analysis.
Results During a median follow-up of 6.53 years, 66 microvascular and 14 macrovascular events occurred. Maintenance of durable glycemic control over 6 years was more likely in the early achievement groups than in the late achievement group (34.5%, 30.0%, and 16.1% in <3, 3 to 6, and ≥6 months, respectively, P=0.039). Early target HbA1c achievement was associated with lower risk of composite diabetic complications (adjusted hazard ratio [HR, 0.47; 95% confidence interval [CI], 0.26 to 0.86 in <3 months group) (adjusted HR, 0.50; 95% CI, 0.23 to 1.10 in 3 to 6 months group, in reference to ≥6 months group). Similar trends were maintained for risks of microvascular and macrovascular complications, although statistical significance was not reached for macrovascular complications.
Conclusion Early target HbA1c achievement was associated with long-term durable glycemic control and reduced risk of diabetic complications in newly diagnosed T2DM.
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Yuqin Gan, Fengxiang Tian, Xinxin Fan, Hui Wang, Jian Zhou, Naihui Yang, Hong Qi Frontiers in Endocrinology.2024;[Epub] CrossRef - Prediction factors and models for chronic kidney disease in type 2 diabetes mellitus: A review of the literature
Yan Yang, Bixia Yang, Bin Wang, Hua Zhou, Min Yang, Bicheng Liu Clinical and Translational Discovery.2024;[Epub] CrossRef - Cost‐effectiveness of the tandem t: Slim X2 with control‐IQ technology automated insulin delivery system in children and adolescents with type 1 diabetes in Sweden
Peter Adolfsson, Alina Heringhaus, Karin Sjunnesson, Laila Mehkri, Kristian Bolin Diabetic Medicine.2024;[Epub] CrossRef - The Association Between Triglyceride Glucose-Body Mass Index and Kidney Impairment in Patients with Type 2 Diabetes Mellitus
Nan Huang, Bing Lu, Zhuan-Zhuan Zhu, Xiang-Yun Zhu, Sheng Chen, Zhi-Yi Shu, Gai-Fang Liu, You-Fan Peng, Ling Li Diabetes, Metabolic Syndrome and Obesity.2024; Volume 17: 3447. CrossRef - Glycemic control and cardiovascular complications of type 2 diabetes mellitus
I. V. Druk, S. S. Safronova Meditsinskiy sovet = Medical Council.2023; (13): 130. CrossRef - Effect of viscous soluble dietary fiber on glucose and lipid metabolism in patients with type 2 diabetes mellitus: a systematic review and meta-analysis on randomized clinical trials
Kun Lu, Tingqing Yu, Xinyi Cao, Hui Xia, Shaokang Wang, Guiju Sun, Liang Chen, Wang Liao Frontiers in Nutrition.2023;[Epub] CrossRef - Construction and validation of a clinical prediction model for asymptomatic obstructive coronary stenosis in patients with carotid stenosis
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- COVID-19
- Use of Renin-Angiotensin-Aldosterone System Inhibitors and Severe COVID-19 Outcomes in Patients with Hypertension: A Nationwide Cohort Study
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Jae Hyun Bae, Sun Kyu Choi, Nam Hoon Kim, Juneyoung Lee, Sin Gon Kim
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Diabetes Metab J. 2021;45(3):430-438. Published online February 22, 2021
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DOI: https://doi.org/10.4093/dmj.2020.0279
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Abstract
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- Background
Angiotensin-converting enzyme 2 facilitates the entry of severe acute respiratory syndrome coronavirus 2 into the human body. We investigated the association of renin-angiotensin-aldosterone system (RAAS) inhibitor use with severe coronavirus disease 2019 (COVID-19) outcomes in hypertensive patients.
Methods We identified hypertensive patients with confirmed COVID-19 from the Korean Health Insurance Review and Assessment Service from inception to May 15, 2020. The primary outcome was the composite of intensive care unit (ICU) admission, invasive mechanical ventilation (IMV), continuous renal replacement therapy (CRRT), extracorporeal membrane oxygenation (ECMO), and death from COVID-19. The individual components were evaluated as secondary outcomes.
Results Of 1,374 hypertensive patients with COVID-19, 1,076 (78.3%) and 298 (21.7%) were users and never-users of RAAS inhibitors, respectively. The RAAS inhibitor users were not associated with the risk of the primary outcome (adjusted odds ratio [aOR], 0.72; 95% confidence interval [CI], 0.46 to 1.10). The risk of ICU admission was significantly lower in the users than the never-users (aOR, 0.44; 95% CI, 0.24 to 0.84). The RAAS inhibitors were beneficial only in ICU admissions that did not require IMV (aOR, 0.28; 95% CI, 0.14 to 0.58). The risk of death from COVID-19 was comparable between the groups (aOR, 1.09; 95% CI, 0.64 to 1.85). We could not evaluate the risks of CRRT and ECMO owing to the small number of events.
Conclusion RAAS inhibitor use was not associated with the composite of severe outcomes in the hypertensive patients with COVID-19 but significantly lowered the risk of ICU admission, particularly in patients who did not require IMV.
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Citations
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- Impact of chronic kidney disease on the course and outcome of COVID-19
Andrey M. Sarana, Sergey G. Shcherbak, Dmitry A. Vologzhanin, Aleksandr S. Golota, Tatyana A. Kamilova, Sergey V. Kadin Physical and rehabilitation medicine, medical rehabilitation.2024; 6(3): 280. CrossRef - Systematic review and meta-analysis of the clinical outcomes of ACEI/ARB in East-Asian patients with COVID-19
Nancy Xurui Huang, Qi Yuan, Fang Fang, Bryan P. Yan, John E. Sanderson, Masaki Mogi PLOS ONE.2023; 18(1): e0280280. CrossRef - Renin‐Angiotensin Aldosterone System Inhibitors and COVID‐19: A Systematic Review and Meta‐Analysis Revealing Critical Bias Across a Body of Observational Research
Jordan Loader, Frances C. Taylor, Erik Lampa, Johan Sundström Journal of the American Heart Association.2022;[Epub] CrossRef - Renin-angiotensin-aldosterone system blockers in Bulgarian COVID-19 patients with or without chronic kidney disease
Rumen Filev, Lionel Rostaing, Mila Lyubomirova, Boris Bogov, Krassimir Kalinov, Dobrin Svinarov Medicine.2022; 101(48): e31988. CrossRef
- Metabolic Risk/Epidemiology
- Age- and Sex-Related Differential Associations between Body Composition and Diabetes Mellitus
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Eun Roh, Soon Young Hwang, Jung A Kim, You-Bin Lee, So-hyeon Hong, Nam Hoon Kim, Ji A Seo, Sin Gon Kim, Nan Hee Kim, Kyung Mook Choi, Sei Hyun Baik, Hye Jin Yoo
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Diabetes Metab J. 2021;45(2):183-194. Published online June 16, 2020
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DOI: https://doi.org/10.4093/dmj.2019.0171
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Background
The age- and sex-related differences on the impacts of body composition on diabetes mellitus (DM) remain uncertain.
Methods
The fourth and fifth Korea National Health and Nutrition Examination Survey included 15,586 subjects over 30 years of age who completed dual-energy X-ray absorptiometry. We conducted a cross-sectional study to investigate whether muscle mass index (MMI), defined as appendicular skeletal muscle divided by body mass index (BMI), and fat mass index (FMI), defined as trunk fat mass divided by BMI, were differently associated with DM according to age and sex.
Results
In multivariate logistic regression, the risk for DM significantly increased across quartiles of FMI in men aged ≥70. Meanwhile, MMI showed a protective association with DM in men of the same age. The odds ratios (ORs) for the highest quartile versus the lowest quartile of FMI and MMI were 3.116 (95% confidence interval [CI], 1.405 to 6.914) and 0.295 (95% CI, 0.157 to 0.554), respectively. In women, the ORs of DM was significantly different across FMI quartiles in those over age 50. The highest quartile of FMI exhibited increased ORs of DM in subjects aged 50 to 69 (OR, 1.891; 95% CI, 1.229 to 2.908) and ≥70 (OR, 2.275; 95% CI, 1.103 to 4.69) compared to lowest quartile. However, MMI was not significantly associated with DM in women of all age groups.
Conclusion
Both FMI and MMI were independent risk factors for DM in men aged 70 years or more. In women over 50 years, FMI was independently associated with DM. There was no significant association between MMI and DM in women.
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Citations
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- Research Progress on Correlation between Body Composition Changes and Disease Pro-gression of Type 2 Diabetes
敏 张 Advances in Clinical Medicine.2024; 14(03): 936. CrossRef - Low Skeletal Muscle Mass Accompanied by Abdominal Obesity Additively Increases the Risk of Incident Type 2 Diabetes
Ji Eun Jun, Seung-Eun Lee, You-Bin Lee, Gyuri Kim, Sang-Man Jin, Jae Hwan Jee, Jae Hyeon Kim The Journal of Clinical Endocrinology & Metabolism.2023; 108(5): 1173. CrossRef - Is imaging-based muscle quantity associated with risk of diabetes? A meta-analysis of cohort studies
Shanhu Qiu, Xue Cai, Yang Yuan, Bo Xie, Zilin Sun, Tongzhi Wu Diabetes Research and Clinical Practice.2022; 189: 109939. CrossRef - Whole and segmental body composition changes during mid-follicular and mid-luteal phases of the menstrual cycle in recreationally active young women
Şükran Nazan Koşar, Yasemin Güzel, Mehmet Gören Köse, Ayşe Kin İşler, Tahir Hazır Annals of Human Biology.2022; 49(2): 124. CrossRef - Body Composition and Diabetes
Hye Jin Yoo The Journal of Korean Diabetes.2021; 22(4): 238. CrossRef
- Drug/Regimen
- Fibrates Revisited: Potential Role in Cardiovascular Risk Reduction
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Nam Hoon Kim, Sin Gon Kim
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Diabetes Metab J. 2020;44(2):213-221. Published online April 23, 2020
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DOI: https://doi.org/10.4093/dmj.2020.0001
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Fibrates, peroxisome proliferator-activated receptor-α agonists, are potent lipid-modifying drugs. Their main effects are reduction of triglycerides and increase in high-density lipoprotein levels. Several randomized controlled trials have not demonstrated their benefits on cardiovascular risk reduction, especially as an “add on” to statin therapy. However, subsequent analyses by major clinical trials, meta-analyses, and real-world evidence have proposed their potential in specific patient populations with atherogenic dyslipidemia and metabolic syndrome. Here, we have reviewed and discussed the accumulated data on fibrates to understand their current status in cardiovascular risk management.
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- Clinical Complications
- Incidence and Risk Factors for Dementia in Type 2 Diabetes Mellitus: A Nationwide Population-Based Study in Korea
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Ji Hee Yu, Kyungdo Han, Sanghyun Park, Hanna Cho, Da Young Lee, Jin-Wook Kim, Ji A Seo, Sin Gon Kim, Sei Hyun Baik, Yong Gyu Park, Kyung Mook Choi, Seon Mee Kim, Nan Hee Kim
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Diabetes Metab J. 2020;44(1):113-124. Published online November 12, 2019
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DOI: https://doi.org/10.4093/dmj.2018.0216
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- Background
Diabetes mellitus is associated with an increased risk of dementia. We aimed to comprehensively analyze the incidence and risk factors for dementia and young-onset dementia (YOD) in diabetic patients in Korea using the National Health Insurance Service data. MethodsBetween January 1, 2009 and December 31, 2012, a total of 1,917,702 participants with diabetes were included and followed until the date of dementia diagnosis or until December 31, 2015. We evaluated the incidence and risk factors for all dementia, Alzheimer's disease (AD), and vascular dementia (VaD) by Cox proportional hazards analyses. We also compared the impact of risk factors on the occurrence of YOD and late-onset dementia (LOD). ResultsDuring an average of 5.1 years of follow-up, the incidence of all types of dementia, AD, or VaD was 9.5, 6.8, and 1.3/1,000 person-years, respectively, in participants with diabetes. YOD comprised 4.8% of all dementia occurrence, and the ratio of AD/VaD was 2.1 for YOD compared with 5.5 for LOD. Current smokers and subjects with lower income, plasma glucose levels, body mass index (BMI), and subjects with hypertension, dyslipidemia, vascular complications, depression, and insulin treatment developed dementia more frequently. Vascular risk factors such as smoking, hypertension, and previous cardiovascular diseases were more strongly associated with the development of VaD than AD. Low BMI and a history of stroke or depression had a stronger influence on the development of YOD than LOD. ConclusionThe optimal management of modifiable risk factors may be important for preventing dementia in subjects with diabetes mellitus.
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- Effectiveness and Safety of Adding Basal Insulin Glargine in Patients with Type 2 Diabetes Mellitus Exhibiting Inadequate Response to Metformin and DPP-4 Inhibitors with or without Sulfonylurea
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Yu Mi Kang, Chang Hee Jung, Seung-Hwan Lee, Sang-Wook Kim, Kee-Ho Song, Sin Gon Kim, Jae Hyeon Kim, Young Min Cho, Tae Sun Park, Bon Jeong Ku, Gwanpyo Koh, Dol Mi Kim, Byung-Wan Lee, Joong-Yeol Park
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Diabetes Metab J. 2019;43(4):432-446. Published online June 19, 2019
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DOI: https://doi.org/10.4093/dmj.2018.0092
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Abstract
PDFSupplementary MaterialPubReader
- Background
We aimed to investigate the effectiveness and safety of adding basal insulin to initiating dipeptidyl peptidase-4 (DPP-4) inhibitor and metformin and/or sulfonylurea (SU) in achieving the target glycosylated hemoglobin (HbA1c) in patients with type 2 diabetes mellitus (T2DM). MethodsThis was a single-arm, multicenter, 24-week, open-label, phase 4 study in patients with inadequately controlled (HbA1c ≥7.5%) T2DM despite the use of DPP-4 inhibitor and metformin. A total of 108 patients received insulin glargine while continuing oral antidiabetic drugs (OADs). The primary efficacy endpoint was the percentage of subjects achieving HbA1c ≤7.0%. Other glycemic profiles were also evaluated, and the safety endpoints were adverse events (AEs) and hypoglycemia. ResultsThe median HbA1c at baseline (8.9%; range, 7.5% to 11.1%) decreased to 7.6% (5.5% to 11.7%) at 24 weeks. Overall, 31.7% subjects (n=33) achieved the target HbA1c level of ≤7.0%. The mean differences in body weight and fasting plasma glucose were 1.2±3.4 kg and 56.0±49.8 mg/dL, respectively. Hypoglycemia was reported in 36 subjects (33.3%, 112 episodes), all of which were fully recovered. There was no serious AE attributed to insulin glargine. Body weight change was significantly different between SU users and nonusers (1.5±2.5 kg vs. −0.9±6.0 kg, P=0.011). ConclusionThe combination add-on therapy of insulin glargine, on metformin and DPP-4 inhibitors with or without SU was safe and efficient in reducing HbA1c levels and thus, is a preferable option in managing T2DM patients exhibiting dysglycemia despite the use of OADs.
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- 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
Jaehyun Bae, Ji Hye Huh, Minyoung Lee, Yong‐Ho Lee, Byung‐Wan Lee Diabetes, Obesity and Metabolism.2021; 23(2): 609. CrossRef - Beneficial effect of anti-diabetic drugs for nonalcoholic fatty liver disease
Kyung-Soo Kim, Byung-Wan Lee Clinical and Molecular Hepatology.2020; 26(4): 430. CrossRef
- Obesity and Metabolic Syndrome
- Proportion and Characteristics of the Subjects with Low Muscle Mass and Abdominal Obesity among the Newly Diagnosed and Drug-Naïve Type 2 Diabetes Mellitus Patients
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Jung A Kim, Soon Young Hwang, Hye Soo Chung, Nam Hoon Kim, Ji A Seo, Sin Gon Kim, Nan Hee Kim, Kyung Mook Choi, Sei Hyun Baik, Hye Jin Yoo
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Diabetes Metab J. 2019;43(1):105-113. Published online September 28, 2018
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DOI: https://doi.org/10.4093/dmj.2018.0036
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- Background
Sarcopenic obesity (SO) is a serious public health concern, few studies have examined the clinical implications of SO in newly-diagnosed type 2 diabetes mellitus (T2DM) patients. We evaluated the prevalence of the newly diagnosed, drug-naïve T2DM patients with low muscle mass with abdominal obesity and its association with insulin resistance and other diabetic complications. MethodsWe classified 233 drug-naïve T2DM subjects into four groups according to abdominal obesity (waist circumference ≥90 cm in men and ≥85 cm in women) and low muscle mass status (appendicular skeletal muscle <7.0 kg/m2 for men and <5.4 kg/m2 for women). ResultsThe proportion of the subjects with low muscle mass and abdominal obesity among the newly diagnosed, drug-naïve T2DM patients was 8.2%. Homeostasis model assessment of insulin resistance (HOMA-IR) increased linearly according to body composition group from normal to abdominal obesity to both low muscle mass and abdominal obesity. The multiple logistic regression analysis indicated that subjects with low muscle mass and abdominal obesity (odds ratio [OR], 9.39; 95% confidence interval [CI], 2.41 to 36.56) showed a higher risk for insulin resistance, defined as HOMA-IR ≥3, than those with abdominal obesity (OR, 5.36; 95% CI, 2.46 to 11.69), even after adjusting for other covariates. However, there were no differences in lipid profiles, microalbuminuria, or various surrogate markers for atherosclerosis among the four groups. ConclusionSubjects with both low muscle mass and abdominal obesity had a higher risk of insulin resistance than those with low muscle mass or abdominal obesity only.
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- Coexistence of high visceral fat area and sarcopenia is associated with atherosclerotic markers in old‐old patients with diabetes: A cross‐sectional study
Motoya Sato, Yoshiaki Tamura, Yuji Murao, Fumino Yorikawa, Yuu Katsumata, So Watanabe, Shugo Zen, Remi Kodera, Kazuhito Oba, Kenji Toyoshima, Yuko Chiba, Atsushi Araki Journal of Diabetes Investigation.2024; 15(10): 1510. CrossRef - The coexistence of low muscle mass and obesity evaluated by dual energy X‐ray absorptiometry, rather than low muscle mass or obesity alone, is associated with macrovascular but not microvascular complications in patients with type 2 diabetes mellitus
Han Li, Weijuan Su, Zeyu Zheng, Jia Li, Shunhua Wang, Zheng Chen, Yuxian Zhang, Bingkun Huang, Fuping Lyu, Fangfang Yan, Caoxin Huang, Mingzhu Lin, Xiulin Shi, Xuejun Li Diabetes, Obesity and Metabolism.2024;[Epub] CrossRef - Clinical observation on acupuncture for 80 patients with abdominal obesity in Germany: based on the theory of unblocking and regulating the Belt Vessel
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Satoshi Ida, Ryutaro Kaneko, Kanako Imataka, Kaoru Okubo, Kentaro Azuma, Kazuya Murata Endocrine Journal.2023; 70(6): 591. CrossRef - A Novel Anthropometric Parameter, Weight-Adjusted Waist Index Represents Sarcopenic Obesity in Newly Diagnosed Type 2 Diabetes Mellitus
Min Jeong Park, Soon Young Hwang, Nam Hoon Kim, Sin Gon Kim, Kyung Mook Choi, Sei Hyun Baik, Hye Jin Yoo Journal of Obesity & Metabolic Syndrome.2023; 32(2): 130. CrossRef - Prevalence of sarcopenic obesity in patients with diabetes and adverse outcomes: A systematic review and meta-analysis
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Andre E. Modesto, Juyeon Ko, Charlotte E. Stuart, Sakina H. Bharmal, Jaelim Cho, Maxim S. Petrov Diseases.2020; 8(3): 25. CrossRef - Low alanine aminotransferase levels predict low muscle strength in older patients with diabetes: A nationwide cross‐sectional study in Korea
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- Epidemiology
- Ten-Year Mortality Trends for Adults with and without Diabetes Mellitus in South Korea, 2003 to 2013
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Kyeong Jin Kim, Tae Yeon Kwon, Sungwook Yu, Ji A Seo, Nan Hee Kim, Kyung Mook Choi, Sei Hyun Baik, Dong Seop Choi, Sin Gon Kim, Yousung Park, Nam Hoon Kim
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Diabetes Metab J. 2018;42(5):394-401. Published online April 26, 2018
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DOI: https://doi.org/10.4093/dmj.2017.0088
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- Background
To estimate and compare the trends of all-cause and cause-specific mortality rates for subjects with and without diabetes in South Korea, from 2003 to 2013. MethodsUsing a population-based cohort (2003 to 2013), we evaluated annual mortality rates in adults (≥30 years) with and without diabetes. The number of subjects in this analysis ranged from 585,795 in 2003 to 670,020 in 2013. ResultsAge- and sex-adjusted all-cause mortality rates decreased consistently in both groups from 2003 to 2013 (from 14.4 to 9.3/1,000 persons in subjects with diabetes and from 7.9 to 4.4/1,000 persons in those without diabetes). The difference in mortality rates between groups also decreased (6.61 per 1,000 persons in 2003 to 4.98 per 1,000 persons in 2013). The slope associated with the mortality rate exhibited a steeper decrease in subjects with diabetes than those without diabetes (regression coefficients of time: −0.50 and −0.33, respectively; P=0.004). In subjects with diabetes, the mortality rate from cardiovascular disease decreased by 53.5% (from 2.73 to 1.27 per 1,000 persons, P for trend <0.001). Notably, the decrease in mortality from ischemic stroke (79.2%, from 1.20 to 0.25 per 1,000 persowns) was more profound than that from ischemic heart disease (28.3%, from 0.60 to 0.43 per 1,000 persons). ConclusionAll-cause and cardiovascular mortality rates decreased substantially from 2003 to 2013, and the decline in ischemic stroke mortality mainly contributed to the decreased cardiovascular mortality in Korean people with diabetes.
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Lei Chen, Rakibul M. Islam, Joanna Wang, Thomas R. Hird, Meda E. Pavkov, Edward W. Gregg, Agus Salim, Maryam Tabesh, Digsu N. Koye, Jessica L. Harding, Julian W. Sacre, Elizabeth L. M. Barr, Dianna J. Magliano, Jonathan E. Shaw Diabetologia.2020; 63(9): 1718. CrossRef - Diabetic ketoacidosis precipitated by COVID-19: A report of two cases and review of literature
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Tae Seo Sohn Diabetes & Metabolism Journal.2019; 43(6): 909. CrossRef - Diabetes Mellitus, Still Major Threat to Mortality from Various Causes
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- Clinical Diabetes & Therapeutics
- Effects of Lobeglitazone, a Novel Thiazolidinedione, on Bone Mineral Density in Patients with Type 2 Diabetes Mellitus over 52 Weeks
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Soo Lim, Kyoung Min Kim, Sin Gon Kim, Doo Man Kim, Jeong-Taek Woo, Choon Hee Chung, Kyung Soo Ko, Jeong Hyun Park, Yongsoo Park, Sang Jin Kim, Hak Chul Jang, Dong Seop Choi
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Diabetes Metab J. 2017;41(5):377-385. Published online October 24, 2017
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DOI: https://doi.org/10.4093/dmj.2017.41.5.377
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- Background
The aim of this multicenter, randomized, double-blind study was to examine the effect of lobeglitazone, a novel thiazolidinedione, on the changes in bone mineral density (BMD) in patients with type 2 diabetes mellitus. MethodsA 24-week, double-blinded phase was followed by a 28-week, open-label phase, in which the placebo group also started to receive lobeglitazone. A total of 170 patients aged 34 to 76 years were randomly assigned in a 2:1 ratio to receive lobeglitazone 0.5 mg or a matching placebo orally, once daily. BMD was assessed using dual-energy X-ray absorptiometry at week 24 and at the end of the study (week 52). ResultsDuring the double-blinded phase, the femur neck BMD showed decreasing patterns in both groups, without statistical significance (−0.85%±0.36% and −0.78%±0.46% in the lobeglitazone and placebo groups, respectively). The treatment difference between the groups was 0.07%, which was also not statistically significant. Further, minimal, nonsignificant decreases were observed in both groups in the total hip BMD compared to values at baseline, and these differences also did not significantly differ between the groups. During the open-label phase, the BMD was further decreased, but not significantly, by −0.32% at the femur neck and by −0.60% at the total hip in the lobeglitazone group, and these changes did not significantly differ compared with the original placebo group switched to lobeglitazone. ConclusionOur results indicate that treatment with lobeglitazone 0.5 mg over 52 weeks showed no detrimental effect on the BMD compared to the placebo.
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Laraib Javed, Aemen Khakwani, Uzair Khan, Mary Beth Humphrey The American Journal of the Medical Sciences.2024;[Epub] CrossRef - Efficacy and safety of novel thiazolidinedione lobeglitazone for managing type-2 diabetes a meta-analysis
Deep Dutta, Saptarshi Bhattacharya, Manoj Kumar, Priyankar K. Datta, Ritin Mohindra, Meha Sharma Diabetes & Metabolic Syndrome: Clinical Research & Reviews.2023; 17(1): 102697. CrossRef - Efficacy and safety of lobeglitazone, a new Thiazolidinedione, as compared to the standard of care in type 2 diabetes mellitus: A systematic review and meta-analysis
Shashank R. Joshi, Saibal Das, Suja Xaviar, Shambo Samrat Samajdar, Indranil Saha, Sougata Sarkar, Shatavisa Mukherjee, Santanu Kumar Tripathi, Jyotirmoy Pal, Nandini Chatterjee Diabetes & Metabolic Syndrome: Clinical Research & Reviews.2023; 17(1): 102703. CrossRef - The benefits of adipocyte metabolism in bone health and regeneration
Lisa-Marie Burkhardt, Christian H. Bucher, Julia Löffler, Charlotte Rinne, Georg N. Duda, Sven Geissler, Tim J. Schulz, Katharina Schmidt-Bleek Frontiers in Cell and Developmental Biology.2023;[Epub] CrossRef - Will lobeglitazone rival pioglitazone? A systematic review and critical appraisal
Kalyan Kumar Gangopadhyay, Awadhesh Kumar Singh Diabetes & Metabolic Syndrome: Clinical Research & Reviews.2023; 17(4): 102747. CrossRef - Comparison of therapeutic efficacy and safety of sitagliptin, dapagliflozin, or lobeglitazone adjunct therapy in patients with type 2 diabetes mellitus inadequately controlled on sulfonylurea and metformin: Third agent study
Jun Hwa Hong, Jun Sung Moon, Kayeon Seong, Soo Lim Diabetes Research and Clinical Practice.2023; 203: 110872. CrossRef - Bone Mineral Density Evaluation Among Type 2 Diabetic Patients in Rural Haryana, India: An Analytical Cross-Sectional Study
Nitish Khandelwal, Surbhi Rajauria, Siddhesh Pandurang Kanjalkar, Omkar Shivaji Chavanke, Sanjay Rai Cureus.2023;[Epub] CrossRef - Lobeglitazone and Its Therapeutic Benefits: A Review
Balamurugan M, Sarumathy S, Robinson R Cureus.2023;[Epub] 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 - 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 Diabetes & Metabolism Journal.2022; 46(6): 855. CrossRef - Comparative Efficacy of Lobeglitazone Versus Pioglitazone on Albuminuria in Patients with Type 2 Diabetes Mellitus
Kyung-Soo Kim, Sangmo Hong, Hong-Yup Ahn, Cheol-Young Park Diabetes Therapy.2021; 12(1): 171. CrossRef - Lobeglitazone: A Novel Thiazolidinedione for the Management of Type 2 Diabetes Mellitus
Jaehyun Bae, Taegyun Park, Hyeyoung Kim, Minyoung Lee, Bong-Soo Cha Diabetes & Metabolism Journal.2021; 45(3): 326. CrossRef - Effect of lobeglitazone on motor function in rat model of Parkinson’s disease with diabetes co-morbidity
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- Clinical Diabetes & Therapeutics
- Determinants of Long-Term Durable Glycemic Control in New-Onset Type 2 Diabetes Mellitus
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Kyoung Jin Kim, Ju Hee Choi, Kyeong Jin Kim, Jee Hyun An, Hee Young Kim, Sin Gon Kim, Nam Hoon Kim
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Diabetes Metab J. 2017;41(4):284-295. Published online August 3, 2017
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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. MethodsWe 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. ResultsPatients 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. ConclusionEarly 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.
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Ji Yoon Kim, Nam Hoon Kim Endocrinology and Metabolism.2024; 39(1): 23. CrossRef - Validation of RSSDI therapeutic wheel with clinical experience of Indian physicians
Dhruvi Hasnani, Vipul Chavda, Dinesh Agrawal, Bijay Patni, Ashwin David, Sachin Gathe, Rajeev Chawla, Jothydev Kesavadev, Sunil Gupta, Shriji Hasnani, Banshi Saboo 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 - Durability of glucose-lowering effect of dulaglutide in patients with type 2 diabetes mellitus: A real-world data study
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 Diabetes, Obesity and Metabolism.2021; 23(1): 208. CrossRef - 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 - Effectiveness of Resistance Training and Associated Program Characteristics in Patients at Risk for Type 2 Diabetes: a Systematic Review and Meta-analysis
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Ja Young Jeon Diabetes & Metabolism Journal.2021; 45(4): 613. CrossRef - Association of Habitual Daily Physical Activity With Glucose Tolerance and β-Cell Function in Adults With Impaired Glucose Tolerance or Recently Diagnosed Type 2 Diabetes From the Restoring Insulin Secretion (RISE) Study
Karla A. Temple, Ashley H. Tjaden, Karen M. Atkinson, Elena Barengolts, Tamara S. Hannon, Kieren J. Mather, Kristina M. Utzschneider, Sharon L. Edelstein, David A. Ehrmann, Babak Mokhlesi, Philip S. Zeitler, Jayne Williams, Melanie Cree-Green, Yesenia Gar Diabetes Care.2019; 42(8): 1521. CrossRef - Factors Associated with Poor Hemoglobin A1c Control in Patients with Type 2 Diabetes
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- Increased Selenoprotein P Levels in Subjects with Visceral Obesity and Nonalcoholic Fatty Liver Disease
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Hae Yoon Choi, Soon Young Hwang, Chang Hee Lee, Ho Cheol Hong, Sae Jeong Yang, Hye Jin Yoo, Ji A Seo, Sin Gon Kim, Nan Hee Kim, Sei Hyun Baik, Dong Seop Choi, Kyung Mook Choi
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Diabetes Metab J. 2013;37(1):63-71. Published online February 15, 2013
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DOI: https://doi.org/10.4093/dmj.2013.37.1.63
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- Background
Selenoprotein P (SeP) has recently been reported as a novel hepatokine that regulates insulin resistance and systemic energy metabolism in rodents and humans. We explored the associations among SeP, visceral obesity, and nonalcoholic fatty liver disease (NAFLD). MethodsWe examined serum SeP concentrations in subjects with increased visceral fat area (VFA) or liver fat accumulation measured with computed tomography. Our study subjects included 120 nondiabetic individuals selected from participants of the Korean Sarcopenic Obesity Study. In addition, we evaluated the relationship between SeP and cardiometabolic risk factors, including homeostasis model of insulin resistance (HOMA-IR), high sensitivity C-reactive protein (hsCRP), adiponectin values, and brachial-ankle pulse wave velocity (baPWV). ResultsSubjects with NAFLD showed increased levels of HOMA-IR, hsCRP, VFA, and several components of metabolic syndrome and decreased levels of adiponectin and high density lipoprotein cholesterol than those of controls. Serum SeP levels were positively correlated with VFA, hsCRP, and baPWV and negatively correlated with the liver attenuation index. Not only subjects with visceral obesity but also those with NAFLD exhibited significantly increased SeP levels (P<0.001). In multiple logistic regression analysis, the subjects in the highest SeP tertile showed a higher risk for NAFLD than those in the lowest SeP tertile, even after adjusting for potential confounding factors (odds ratio, 7.48; 95% confidence interval, 1.72 to 32.60; P=0.007). ConclusionCirculating SeP levels were increased in subjects with NAFLD as well as in those with visceral obesity and may be a novel biomarker for NAFLD.
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- Effect of Eplerenone, a Selective Aldosterone Blocker, on the Development of Diabetic Nephropathy in Type 2 Diabetic Rats
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Jae Hee Ahn, Ho Cheol Hong, Myong Jin Cho, Yoon Jung Kim, Hae Yoon Choi, Chai Ryoung Eun, Sae Jeong Yang, Hye Jin Yoo, Hee Young Kim, Ji A Seo, Sin Gon Kim, Kyung Mook Choi, Sei Hyun Baik, Dong Seop Choi, Nan Hee Kim
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Diabetes Metab J. 2012;36(2):128-135. Published online April 17, 2012
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DOI: https://doi.org/10.4093/dmj.2012.36.2.128
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Abstract
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- Background
Aldosterone antagonists are reported to have beneficial effects on diabetic nephropathy by effective blocking of the renin-angiotensin-aldosterone system. We investigated the renoprotective effect of the selective aldosterone receptor blocker eplerenone, the angiotensin converting enzyme inhibitor lisinopril, and combined eplerenone and lisinopril treatment in type 2 diabetic rats. MethodsAnimals were divided into six groups as follows: Otsuka Long-Evans Tokushima Fatty (OLETF) rat control, OLETF rats treated with a low dose of eplerenone (50 mg/kg/day), OLETF rats treated with a high dose of eplerenone (200 mg/kg/day), OLETF rats treated with lisinopril (10 mg/kg/day), OLETF rats treated with a combination of both drugs (eplerenone 200 mg/kg/day and lisinopril 10 mg/kg/day), and obese non-diabetic Long-Evans Tokushima Otsuka rats for 26 weeks. ResultsUrinary albumin excretion was significantly lower in the lisinopril group, but not in the eplerenone group. Urinary albumin excretion was decreased in the combination group than in the lisinopril group. Glomerulosclerosis and renal expression of type I and type IV collagen, plasminogen activator inhibitor-1, transforming growth factor-β1, connective tissue growth factor, and fibronectin mRNA were markedly decreased in the lisinopril, eplerenone, and combination groups. ConclusionEplerenone and lisinopril combination showed additional benefits on type 2 diabetic nephropathy compared to monotherapy of each drug.
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- Pathophysiology
- Recent Glycemia Is a Major Determinant of β-Cell Function in Type 2 Diabetes Mellitus
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Ji Yoon Kim, Jiyoon Lee, Sin Gon Kim, Nam Hoon Kim
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Received October 11, 2023 Accepted March 26, 2024 Published online June 17, 2024
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DOI: https://doi.org/10.4093/dmj.2023.0359
[Epub ahead of print]
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Abstract
PDFSupplementary MaterialPubReader ePub
- Background
Progressive deterioration of β-cell function is a characteristic of type 2 diabetes mellitus (T2DM). We aimed to investigate the relative contributions of clinical factors to β-cell function in T2DM.
Methods In a T2DM cohort of 470 adults (disease duration 0 to 41 years), β-cell function was estimated using insulinogenic index (IGI), disposition index (DI), oral disposition index (DIO), and homeostasis model assessment of β-cell function (HOMA-B) derived from a 75 g oral glucose tolerance test (OGTT). The relative contributions of age, sex, disease duration, body mass index, glycosylated hemoglobin (HbA1c) levels (at the time of the OGTT), area under the curve of HbA1c over time (HbA1c AUC), coefficient of variation in HbA1c (HbA1c CV), and antidiabetic agents use were compared by standardized regression coefficients. Longitudinal analyses of these indices were also performed.
Results IGI, DI, DIO, and HOMA-B declined over time (P<0.001 for all). Notably, HbA1c was the most significant factor affecting IGI, DI, DIO, and HOMA-B in the multivariable regression analysis. Compared with HbA1c ≥9%, DI was 1.9-, 2.5-, 3.7-, and 5.5-fold higher in HbA1c of 8%–<9%, 7%–<8%, 6%–<7%, and <6%, respectively, after adjusting for confounding factors (P<0.001). Conversely, β-cell function was not affected by the type or duration of antidiabetic agents, HbA1c AUC, or HbA1c CV. The trajectories of the IGI, DI, DIO, and HOMA-B mirrored those of HbA1c.
Conclusion β-Cell function declines over time; however, it is flexible, being largely affected by recent glycemia in T2DM.
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