- Guideline/Fact Sheet
- Diabetes Mellitus in the Elderly Adults in Korea: Based on Data from the Korea National Health and Nutrition Examination Survey 2019 to 2020
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Seung-Hyun Ko, Kyung Do Han, Yong-Moon Park, Jae-Seung Yun, Kyuho Kim, Jae-Hyun Bae, Hyuk-Sang Kwon, Nan-Hee Kim
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Diabetes Metab J. 2023;47(5):643-652. Published online August 7, 2023
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DOI: https://doi.org/10.4093/dmj.2023.0041
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- Background
We evaluated the prevalence and management of diabetes mellitus (DM) in elderly Korean patients based on data from the Korea National Health and Nutrition Examination Survey (KNHANES).
Methods
A total of 3,068 adults aged 65 years and older (19.8% of total population) were analyzed using KNHANES from 2019 to 2020. Prevalence, awareness, treatment, and control rates, and comorbidities were analyzed. Lifestyle behaviors and energy intake were also measured.
Results
The prevalence of DM and prediabetes was 29.6% and 50.5%, respectively. The awareness, treatment and control rates were 76.4%, 73.3%, and 28.3%, respectively. The control rate was 77.0% if A1C <7.5% criteria was used. The mean A1C value of individuals with known DM was 7.1%, and 14.5% of the known DM patients had A1C ≥8.0%. Abdominal obesity, hypertension, and hypercholesterolemia were combined with DM in 63.9%, 71.7%, and 70.7%, respectively, and the rate of integrated management was 36.0% (A1C <7.5% criteria). A total of 40.1% of those with DM walked regularly. The percentage of energy intake from carbohydrates was higher in those with DM than in those without DM (P=0.044), while those of fat (P=0.003) and protein (P=0.025) were lower in those with DM than in those without DM in women.
Conclusion
In 2019 to 2020, three of 10 adults aged 65 years and older in Korea had DM, and approximately 70% of them had comorbidities. A strategy for more individualized comprehensive care for the elderly patients with DM is urgently needed.
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Citations
Citations to this article as recorded by  - Association Between High Blood Folate Levels and Glaucoma in a Representative Korean Population
Ji Young Lee, Jin A. Choi, Sung Pyo Park, Donghyun Jee
Investigative Opthalmology & Visual Science.2024; 65(1): 6. CrossRef - Is the change in longitudinal cognitive function in older adults with diabetes affected by trajectory classes of depressive symptoms?
Gyeong A Kang, Ju Young Yoon
Public Health Nursing.2024; 41(5): 1006. CrossRef - Holistic and Personalized Strategies for Managing in Elderly Type 2 Diabetes Patients
Jae-Seung Yun, Kyuho Kim, Yu-Bae Ahn, Kyungdo Han, Seung-Hyun Ko
Diabetes & Metabolism Journal.2024; 48(4): 531. CrossRef - Association and interaction effect of shift work and the risk for obstructive sleep apnea on diabetes mellitus in middle-aged Korean workers
Kyusung Kim, Hi-Ju Kim, Seunghyun Lee, Wanhyung Lee
Sleep and Breathing.2024; 28(6): 2721. CrossRef - Benefit and Safety of Sodium-Glucose Co-Transporter 2 Inhibitors in Older Patients with Type 2 Diabetes Mellitus
Ja Young Jeon, Dae Jung Kim
Diabetes & Metabolism Journal.2024; 48(5): 837. CrossRef - National trends in type 2 diabetes mellitus stratified by central adiposity using waist-to-height ratio in South Korea, 2005–2022
Hyunjee Kim, Seoyoung Park, Jaeyu Park, Yejun Son, Soeun Kim, Yesol Yim, Hyesu Jo, Kyeongmin Lee, Yi Deun Jeong, Jiyeon Oh, Hanseul Cho, Damiano Pizzol, Jiyoung Hwang, Lee Smith, Dong Keon Yon
Scientific Reports.2024;[Epub] 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 - Osteoporosis incidence and its associated factors in the older Korean population: findings from a population-based cohort study
Tanmoy Das, Md Abdullah Al Jubayer Biswas, Prosanta Mondal, Sabuj Sarker, Hyun J.“June” Lim
Archives of Osteoporosis.2024;[Epub] CrossRef - Association of Uterine Leiomyoma with Type 2 Diabetes Mellitus in Young Women: A Population-Based Cohort Study
Ji-Hee Sung, Kyung-Soo Kim, Kyungdo Han, Cheol-Young Park
Diabetes & Metabolism Journal.2024; 48(6): 1105. CrossRef - Socioeconomic inequalities in the prevalence, non-awareness, non-treatment, and non-control of diabetes among South Korean adults in 2021
Seongju Kim, Dong Jun Kim, Hooyeon Lee, Dong Keon Yon
PLOS ONE.2024; 19(11): e0313988. 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 - The Growing Challenge of Diabetes Management in an Aging Society
Seung-Hwan Lee
Diabetes & Metabolism Journal.2023; 47(5): 630. CrossRef
- Guideline/Fact Sheet
- 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
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Jong Ha Baek, Yong-Moon Park, Kyung Do Han, Min Kyong Moon, Jong Han Choi, Seung-Hyun Ko
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Diabetes Metab J. 2023;47(2):201-210. Published online February 8, 2023
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DOI: https://doi.org/10.4093/dmj.2022.0375
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Abstract
PDFSupplementary MaterialPubReader ePub
- Background
We evaluated the validity and reliability of the operational definition of type 2 diabetes mellitus (T2DM) based on the Korean National Health Insurance Service (NHIS) database.
Methods
Adult subjects (≥40 years old) included in the Korea National Health and Nutrition Examination Survey (KNHANES) from 2008 to 2017 were merged with those from the NHIS health check-up database, producing a cross-sectional dataset. We evaluated the sensitivity, specificity, accuracy, and agreement of the NHIS criteria for defining T2DM by comparing them with the KNHANES criteria as a standard reference.
Results
In the study population (n=13,006), two algorithms were devised to determine from the NHIS dataset whether the diagnostic claim codes for T2DM were accompanied by prescription codes for anti-diabetic drugs (algorithm 1) or not (algorithm 2). Using these algorithms, the prevalence of T2DM was 14.9% (n=1,942; algorithm 1) and 20.8% (n=2,707; algorithm 2). Good reliability in defining T2DM was observed for both algorithms (Kappa index, 0.73 [algorithm 1], 0.63 [algorithm 2]). However, the accuracy (0.93 vs. 0.89) and specificity (0.96 vs. 0.90) tended to be higher for algorithm 1 than for algorithm 2. The validity (accuracy, ranging from 0.91 to 0.95) and reliability (Kappa index, ranging from 0.68 to 0.78) of defining T2DM by NHIS criteria were independent of age, sex, socioeconomic status, and accompanied hypertension or dyslipidemia.
Conclusion
The operational definition of T2DM based on population-based NHIS claims data, including diagnostic codes and prescription codes, could be a valid tool to identify individuals with T2DM in the Korean population.
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Citations
Citations to this article as recorded by - Big Data Research for Diabetes-Related Diseases Using the Korean National Health Information Database
Kyung-Soo Kim, Bongseong Kim, Kyungdo Han
Diabetes & Metabolism Journal.2025; 49(1): 13. CrossRef - Metabolic dysfunction-associated fatty liver disease increases the risk of type 2 diabetes mellitus in young Korean adults
Junchul Ha, Oak-Kee Hong, Kyungdo Han, Hyuk-Sang Kwon
Diabetes Research and Clinical Practice.2024; 212: 111584. CrossRef - Association between Age at Diagnosis of Type 2 Diabetes and Subsequent Risk of Dementia and Its Major Subtypes
Da Hea Seo, Mina Kim, Yongin Cho, Seong Hee Ahn, Seongbin Hong, So Hun Kim
Journal of Clinical Medicine.2024; 13(15): 4386. CrossRef - Gamma‐glutamyl transferase and the risk of all‐cause and disease‐specific mortality in patients with diabetes: A nationwide cohort study
Goh Eun Chung, Su‐Min Jeong, Su Jong Yu, Jeong‐Ju Yoo, Yuri Cho, Kyu‐na Lee, Dong Wook Shin, Yoon Jun Kim, Jung‐Hwan Yoon, Kyungdo Han, Eun Ju Cho
Journal of Diabetes.2024;[Epub] CrossRef - Association between exercise habits and incident type 2 diabetes mellitus in patients with thyroid cancer: nationwide population-based study
Jiyun Park, Jin-Hyung Jung, Hyunju Park, Young Shin Song, Soo-Kyung Kim, Yong-Wook Cho, Kyungdo Han, Kyung-Soo Kim
BMC Medicine.2024;[Epub] CrossRef - Association Between Benzene and Other Volatile Organic Compounds Exposure and Diabetes Mellitus Among Korean Adults: Findings from the Nationwide Biomonitoring Data
Seong-Uk Baek, Minseo Choi, Yu-Min Lee, Jin-Ha Yoon
Exposure and Health.2024;[Epub] CrossRef - All-cause and cause-specific mortality risks in individuals with diabetes living alone: A large-scale population-based cohort study
Jae-Seung Yun, Kyungdo Han, Bongseong Kim, Seung-Hyun Ko, Hyuk-Sang Kwon, Yu-Bae Ahn, Yong-Moon Mark Park, Seung-Hwan Lee
Diabetes Research and Clinical Practice.2024; 217: 111876. CrossRef - Association between alcohol consumption and risk of developing tuberculosis in patients with diabetes: a nationwide retrospective cohort study
Chiwook Chung, Kyu Na Lee, Kyungdo Han, Junhee Park, Dong Wook Shin, Sei Won Lee
Respiratory Research.2024;[Epub] CrossRef - New-Onset Type 1 and Type 2 Diabetes Among Korean Youths During the COVID-19 Pandemic
Da Hye Lee, Hwa Young Kim, Ji Young Park, Jaehyun Kim, Jae Hyeon Park
JAMA Pediatrics.2024;[Epub] CrossRef - Risk of Cause-Specific Mortality across Glucose Spectrum in Elderly People: A Nationwide Population-Based Cohort Study
Joonyub Lee, Hun-Sung Kim, Kee-Ho Song, Soon Jib Yoo, Kyungdo Han, Seung-Hwan Lee
Endocrinology and Metabolism.2023; 38(5): 525. CrossRef
- Metabolic Risk/Epidemiology
- Reproductive Life Span and Severe Hypoglycemia Risk in Postmenopausal Women with Type 2 Diabetes Mellitus
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Soyeon Kang, Yong-Moon Park, Dong Jin Kwon, Youn-Jee Chung, Jeong Namkung, Kyungdo Han, Seung-Hyun Ko
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Diabetes Metab J. 2022;46(4):578-591. Published online January 24, 2022
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DOI: https://doi.org/10.4093/dmj.2021.0135
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8,711
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Abstract
PDFSupplementary MaterialPubReader ePub
- Background
Estrogen promotes glucose homeostasis, enhances insulin sensitivity, and maintains counterregulatory responses in recurrent hypoglycemia in women of reproductive age. Postmenopausal women with type 2 diabetes mellitus (T2DM) might be more vulnerable to severe hypoglycemia (SH) events. However, the relationship between reproductive factors and SH occurrence in T2DM remains unelucidated.
Methods
This study included data on 181,263 women with postmenopausal T2DM who participated in a national health screening program from January 1 to December 31, 2009, obtained using the Korean National Health Insurance System database. Outcome data were obtained until December 31, 2018. Associations between reproductive factors and SH incidence were assessed using Cox proportional hazards models.
Results
During the mean follow-up of 7.9 years, 11,279 (6.22%) postmenopausal women with T2DM experienced SH episodes. A longer reproductive life span (RLS) (≥40 years) was associated with a lower SH risk compared to a shorter RLS (<30 years) (adjusted hazard ratio [HR], 0.74; 95% confidence interval [CI], 0.69 to 0.80; P for trend <0.001) after multivariable adjustment. SH risk decreased with every 5-year increment of RLS (with <30 years as a reference [adjusted HR, 0.91; 95% CI, 0.86 to 0.95; P=0.0001 for 30−34 years], [adjusted HR, 0.80; 95% CI, 0.76 to 0.84; P<0.001 for 35−39 years], [adjusted HR, 0.74; 95% CI, 0.68 to 0.81; P<0.001 for ≥40 years]). The use of hormone replacement therapy (HRT) was associated with a lower SH risk than HRT nonuse.
Conclusion
Extended exposure to endogenous ovarian hormone during lifetime may decrease the number of SH events in women with T2DM after menopause.
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Citations
Citations to this article as recorded by - Association between serum copper level and reproductive health of Women in the United States: a cross-sectional study
Yi Yuan, Tong-Yu Peng, Guang-Yuan Yu, Zhao Zou, Meng-Ze Wu, Ruofei Zhu, Shuang Wu, Zi Lv, Su-Xin Luo
International Journal of Environmental Health Research.2024; 34(6): 2441. CrossRef - Defining Continuous Glucose Monitor Time in Range in a Large, Community-Based Cohort Without Diabetes
Nicole L Spartano, Naznin Sultana, Honghuang Lin, Huimin Cheng, Sophia Lu, David Fei, Joanne M Murabito, Maura E Walker, Howard A Wolpert, Devin W Steenkamp
The Journal of Clinical Endocrinology & Metabolism.2024;[Epub] CrossRef - Reproductive Lifespan and Motor Progression of Parkinson’s Disease
Ruwei Ou, Qianqian Wei, Yanbing Hou, Lingyu Zhang, Kuncheng Liu, Junyu Lin, Tianmi Yang, Jing Yang, Zheng Jiang, Wei Song, Bei Cao, Huifang Shang
Journal of Clinical Medicine.2022; 11(20): 6163. CrossRef - Menopause and development of Alzheimer’s disease: Roles of neural glucose metabolism and Wnt signaling
Paulina Villaseca, Pedro Cisternas, Nibaldo C. Inestrosa
Frontiers in Endocrinology.2022;[Epub] CrossRef
- Metabolic Risk/Epidemiology
- Importance of Awareness and Treatment for Diabetes in Influenza Vaccination Coverage of Diabetic Patients under 65 Years: A Population-Based Study
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Yu Mi Ko, Seung Hyun Ko, Kyoungdo Han, Yong-Moon Park, Joon Young Choi, Shin Young Kim, So Hyang Song, Chi Hong Kim, Sung Kyoung Kim
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Diabetes Metab J. 2021;45(1):55-66. Published online May 29, 2020
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DOI: https://doi.org/10.4093/dmj.2019.0189
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8,438
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Background
Influenza is a global public health problem causing considerable morbidity and mortality. Although vaccination is the most effective way to prevent infection, vaccination coverage is insufficient in people with chronic disease under 65 years, especially diabetes. The purpose of this study was to evaluate influenza vaccination coverage and identify factors associated with influenza vaccination in Korean diabetic adults under 65 years.
Methods
Data were obtained from 24,821 subjects in the Korea National Health and Nutrition Examination Survey (2014 to 2017). Socioeconomic, health-related, and diabetic factors were investigated for their relations with influenza vaccination in diabetic patients under 65 years using univariate and multivariate analyses.
Results
Among 24,821 subjects, 1,185 were diabetic patients under 65 years and their influenza vaccination rate was 36.5%. Socioeconomic (older age, female gender, non-smoker, light alcohol drinker, lower educational level, and employed status), health-related factors (lower fasting glucose and glycosylated hemoglobin level, good self-perceived health status, more comorbidities, recent health screening, more outpatient visits, and diet therapy), and diabetic factors (more awareness and getting treated) were associated with influenza vaccination. In multivariate analysis, more awareness and getting treated for diabetes were associated with influenza vaccination in diabetic patients under 65 years (odds ratio, 1.496 and 1.413; 95% confidence interval, 1.022 to 2.188 and 1.018 to 2.054, respectively).
Conclusion
Influenza vaccination rate was low in diabetic patients under 65 years, especially in those with unawareness and not getting treated for diabetes. Active screening and treatment for diabetes may be helpful to improve the influenza vaccination rate in these patients.
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Citations
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Xiangju Hu, Xin Fang, Minxia Wu
Journal of Diabetes Investigation.2024; 15(8): 1034. CrossRef - Adherence to Advisory Committee on Immunization Practices in diabetes mellitus patients in Saudi Arabia: A multicenter retrospective study
Saleh Fahad Alqifari, Aya K Esmail, Dalal M Alarifi, Ghalya Y Alsuliman, Maram M Alhati, May R Mutlaq, Mohammed Aldhaeefi, Shaden A Alshuaibi, Palanisamy Amirthalingam, Abrar Abdallah, Afaf S Wasel, Heba R Hamad, Shoroq Alamin, Tasneem H Atia, Tariq Alqah
World Journal of Diabetes.2024; 15(3): 440. CrossRef - ЕГДЕ ЖАСТАҒЫ АДАМДАРДА COVID-19 ВАКЦИНАЦИЯСЫНЫҢ ТИІМДІЛІГІ
Ю.Р. АБДУСАТТАРОВА, Д.С. ӘБЕН, Н. АБДОЛЛА, Р.Т. ТЛЕУЛИЕВА, А. КАЛИ, Ю.В. ПЕРФИЛЬЕВА
Vestnik.2023; (2(65)): 48. CrossRef - Comorbidities associated with high-risk obstructive sleep apnea based on the STOP-BANG questionnaire: a nationwide population-based study
Gene Huh, Kyoung do Han, Yong-Moon Park, Chan-Soon Park, Kyu-na Lee, Eun Young Lee, Jung-Hae Cho
The Korean Journal of Internal Medicine.2023; 38(1): 80. CrossRef - Influenza vaccination trend and related factors among patients with diabetes in Korea: Analysis using a nationwide database
Dong-Hwa Lee, Bumhee Yang, Seonhye Gu, Eung-Gook Kim, Youlim Kim, Hyung Koo Kang, Yeong Hun Choe, Hyun Jeong Jeon, Seungyong Park, Hyun Lee
Frontiers in Endocrinology.2023;[Epub] CrossRef - Factors associated with seasonal influenza immunization in people with chronic diseases
Slađana Arsenović, Tatjana Gazibara
Medicinski podmladak.2021; 72(2): 19. CrossRef
- Epidemiology
- Associations between Breastfeeding and Type 2 Diabetes Mellitus and Glycemic Control in Parous Women: A Nationwide, Population-Based Study
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Ga Eun Nam, Kyungdo Han, Do-Hoon Kim, Youn Huh, Byoungduck Han, Sung Jung Cho, Yong Gyu Park, Yong-Moon Park
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Diabetes Metab J. 2019;43(2):236-241. Published online December 21, 2018
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DOI: https://doi.org/10.4093/dmj.2018.0044
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4,940
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We investigated associations between breastfeeding duration and number of children breastfed and type 2 diabetes mellitus (T2DM) and glycemic control among parous women. We performed a cross-sectional analysis of data for 9,960 parous women from the Korea National Health and Nutritional Examination Survey (2010 to 2013). Having ever breastfed was inversely associated with prevalent T2DM (adjusted odds ratio [OR], 0.60; 95% confidence interval [CI], 0.42 to 0.87). All ranges of total and average breastfeeding duration showed inverse associations with T2DM. Even short periods of breastfeeding were inversely associated with T2DM (adjusted OR, 0.61; 95% CI, 0.38 to 0.99 for a total breastfeeding duration ≤12 months; adjusted OR, 0.65; 95% CI, 0.42 to 0.99 for an average breastfeeding duration per child ≤6 months). A longer duration of breastfeeding was associated with better glycemic control in parous women with T2DM (P trend=0.004 for total breastfeeding duration; P trend <0.001 for average breastfeeding duration per child). Breastfeeding may be associated with a lower risk of T2DM and good glycemic control in parous women with T2DM. Breastfeeding may be a feasible method to prevent T2DM and improve glycemic control. -
Citations
Citations to this article as recorded by - Association of Childbirth and Breastfeeding with Diabetes Mellitus in Korean Women
Seulkee Kim, So Yeon Ryu
Journal of Health Informatics and Statistics.2024; 49(2): 109. CrossRef - Integration of nutrigenomics, melatonin, serotonin and inflammatory cytokines in the pathophysiology of pregnancy-specific urinary incontinence in women with gestational diabetes mellitus
Danielle Cristina Honorio França, Eduardo Luzía França, Luis Sobrevia, Angélica Mércia Pascon Barbosa, Adenilda Cristina Honorio-França, Marilza Vieira Cunha Rudge
Biochimica et Biophysica Acta (BBA) - Molecular Basis of Disease.2023; 1869(6): 166737. CrossRef - Association of lactation with maternal risk of type 2 diabetes: A systematic review and meta‐analysis of observational studies
Ana‐Catarina Pinho‐Gomes, Georgia Morelli, Alexandra Jones, Mark Woodward
Diabetes, Obesity and Metabolism.2021; 23(8): 1902. CrossRef - Updates in Gestational Diabetes Prevalence, Treatment, and Health Policy
Laura T. Dickens, Celeste C. Thomas
Current Diabetes Reports.2019;[Epub] CrossRef
- Complications
- Cardiovascular Autonomic Neuropathy Predicts Higher HbA1c Variability in Subjects with Type 2 Diabetes Mellitus
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Yeoree Yang, Eun-Young Lee, Jae-Hyoung Cho, Yong-Moon Park, Seung-Hyun Ko, Kun-Ho Yoon, Moo-Il Kang, Bong-Yun Cha, Seung-Hwan Lee
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Diabetes Metab J. 2018;42(6):496-512. Published online September 28, 2018
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DOI: https://doi.org/10.4093/dmj.2018.0026
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5,164
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Abstract
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- Background
This study aimed to investigate the association between the presence and severity of cardiovascular autonomic neuropathy (CAN) and development of long-term glucose fluctuation in subjects with type 2 diabetes mellitus. MethodsIn this retrospective cohort study, subjects with type 2 diabetes mellitus who received cardiovascular autonomic reflex tests (CARTs) at baseline and at least 4-year of follow-up with ≥6 measures of glycosylated hemoglobin (HbA1c) were included. The severity of CAN was categorized as normal, early, or severe CAN according to the CARTs score. HbA1c variability was measured as the standard deviation (SD), coefficient of variation, and adjusted SD of serial HbA1c measurements. ResultsA total of 681 subjects were analyzed (294 normal, 318 early, and 69 severe CAN). The HbA1c variability index values showed a positive relationship with the severity of CAN. Multivariable logistic regression analysis showed that CAN was significantly associated with the risk of developing higher HbA1c variability (SD) after adjusting for age, sex, body mass index, diabetes duration, mean HbA1c, heart rate, glomerular filtration rate, diabetic retinopathy, coronary artery disease, insulin use, and anti-hypertensive medication (early CAN: odds ratio [OR], 1.65; 95% confidence interval [CI], 1.12 to 2.43) (severe CAN: OR, 2.86; 95% CI, 1.47 to 5.56). This association was more prominent in subjects who had a longer duration of diabetes (>10 years) and lower mean HbA1c (<7%). ConclusionCAN is an independent risk factor for future higher HbA1c variability in subjects with type 2 diabetes mellitus. Tailored therapy for stabilizing glucose fluctuation should be emphasized in subjects with CAN.
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Citations
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Jingyang Chen, Dong Yin, Kefei Dou
Cardiovascular Diabetology.2023;[Epub] CrossRef - Long-Term Risk of Cardiovascular Disease Among Type 2 Diabetes Patients According to Average and Visit-to-Visit Variations of HbA1c Levels During the First 3 Years of Diabetes Diagnosis
Hyunah Kim, Da Young Jung, Seung-Hwan Lee, Jae-Hyoung Cho, Hyeon Woo Yim, Hun-Sung Kim
Journal of Korean Medical Science.2023;[Epub] CrossRef - Factors Associated with Diabetic Complication Index among Type 2 Diabetes Patients: Focusing on Regular Outpatient Follow-up and HbA1c Variability
Haejung Lee, Gaeun Park, Ah Reum Khang
Asian Nursing Research.2023; 17(5): 259. CrossRef - The Association of Postprandial Triglyceride Variability with Renal Dysfunction and Microalbuminuria in Patients with Type 2 Diabetic Mellitus: A Retrospective and Observational Study
Natsumi Matsuoka-Uchiyama, Haruhito A. Uchida, Shugo Okamoto, Yasuhiro Onishi, Katsuyoshi Katayama, Mariko Tsuchida-Nishiwaki, Hidemi Takeuchi, Rika Takemoto, Yoshiko Hada, Ryoko Umebayashi, Naoko Kurooka, Kenji Tsuji, Jun Eguchi, Hirofumi Nakajima, Kenic
Journal of Diabetes Research.2022; 2022: 1. CrossRef - Perspectives of glycemic variability in diabetic neuropathy: a comprehensive review
Xiaochun Zhang, Xue Yang, Bao Sun, Chunsheng Zhu
Communications Biology.2021;[Epub] CrossRef - Assessment of Functions of the Autonomic Nervous System in the Elderly with Different Comorbid Factors
Sushma S., Medha Y. Rao, Shaikh Mohammed Aslam
Journal of Neurosciences in Rural Practice.2020; 12: 80. CrossRef - Prognostic irrelevance of plaque vulnerability following plaque sealing in high-risk patients with type 2 diabetes: an optical coherence tomography study
Rosalia Dettori, Andrea Milzi, Kathrin Burgmaier, Mohammad Almalla, Martin Hellmich, Nikolaus Marx, Sebastian Reith, Mathias Burgmaier
Cardiovascular Diabetology.2020;[Epub] CrossRef - HbA1C Variability Is Strongly Associated With the Severity of Cardiovascular Autonomic Neuropathy in Patients With Type 2 Diabetes After Longer Diabetes Duration
Yun-Ru Lai, Chih-Cheng Huang, Wen-Chan Chiu, Rue-Tsuan Liu, Nai-Wen Tsai, Hung-Chen Wang, Wei-Che Lin, Ben-Chung Cheng, Yu-Jih Su, Chih-Min Su, Sheng-Yuan Hsiao, Pei-Wen Wang, Jung-Fu Chen, Cheng-Hsien Lu
Frontiers in Neuroscience.2019;[Epub] CrossRef - Polyscore of Non-invasive Cardiac Risk Factors
Alexander Steger, Alexander Müller, Petra Barthel, Michael Dommasch, Katharina Maria Huster, Katerina Hnatkova, Daniel Sinnecker, Alexander Hapfelmeier, Marek Malik, Georg Schmidt
Frontiers in Physiology.2019;[Epub] CrossRef
- Epidemiology
- Serum Betatrophin Concentrations and the Risk of Incident Diabetes: A Nested Case-Control Study from Chungju Metabolic Disease Cohort
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Seung-Hwan Lee, Marie Rhee, Hyuk-Sang Kwon, Yong-Moon Park, Kun-Ho Yoon
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Diabetes Metab J. 2018;42(1):53-62. Published online November 3, 2017
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DOI: https://doi.org/10.4093/dmj.2018.42.1.53
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- Background
Betatrophin is a newly identified hormone derived from the liver and adipose tissue, which has been suggested to regulate glucose and lipid metabolism. Circulating levels of betatrophin are altered in various metabolic diseases, although the results are inconsistent. We aimed to examine whether betatrophin is a useful biomarker in predicting the development of diabetes. MethodsA nested case-control study was performed using a prospective Chungju Metabolic disease Cohort Study. During a 4-year follow-up period, we analyzed 167 individuals who converted to diabetes and 167 non-converters, who were matched by age, sex, and body mass index. Serum betatrophin levels were measured by an ELISA (enzyme-linked immunosorbent assay). ResultsBaseline serum betatrophin levels were significantly higher in the converter group compared to the non-converter group (1,315±598 pg/mL vs. 1,072±446 pg/mL, P<0.001). After adjusting for age, sex, body mass index, fasting plasma glucose, systolic blood pressure, total cholesterol, and family history of diabetes, the risk of developing diabetes showed a stepwise increase across the betatrophin quartile groups. Subjects in the highest baseline quartile of betatrophin levels had more than a threefold higher risk of incident diabetes than the subjects in the lowest quartile (relative risk, 3.275; 95% confidence interval, 1.574 to 6.814; P=0.010). However, no significant relationships were observed between serum betatrophin levels and indices of insulin resistance or β-cell function. ConclusionCirculating levels of betatrophin could be a potential biomarker for predicting new-onset diabetes. Further studies are needed to understand the underlying mechanism of this association.
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Citations
Citations to this article as recorded by - Maternal and cord blood betatrophin (angiopoietin‐like protein 8) in pregnant women with gestational diabetes and normoglycemic controls: A systematic review, meta‐analysis, and meta‐regression
Faustino R. Pérez‐López, Junhua Yuan, Manuel Sánchez‐Prieto, María T. López‐Baena, Gonzalo R. Pérez‐Roncero, Seshadri Reddy Varikasuvu
Diabetes/Metabolism Research and Reviews.2023;[Epub] CrossRef - Evaluation of Adiponectin and ANGPTL8 in Women With Metabolic Syndrome in the Madinah Region of Saudi Arabia
Walaa Mohammedsaeed, Ahmed Ahmed, Nada Alharbi, Amjaad Aljohani, Razan Alruwaithi, Reem Alharbi, Shatha Alahmadi
Cureus.2023;[Epub] CrossRef - Associations Between Betatrophin with Irisin and Metabolic Factors: Effects of Two Exercise Trainings in Diabetic Rats
Hassan Tavassoli, Ali Heidarianpour
The American Journal of the Medical Sciences.2021; 362(5): 496. CrossRef - Evidences for Expression and Location of ANGPTL8 in Human Adipose Tissue
Leonardo Catalano-Iniesta, Virginia Sánchez Robledo, María Carmen Iglesias-Osma, Amparo Galán Albiñana, Sixto Carrero, Enrique J. Blanco, Marta Carretero-Hernández, José Carretero, María José García-Barrado
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- Complications
- Baseline-Corrected QT (QTc) Interval Is Associated with Prolongation of QTc during Severe Hypoglycemia in Patients with Type 2 Diabetes Mellitus
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Seon-Ah Cha, Jae-Seung Yun, Tae-Seok Lim, Yoon-Goo Kang, Kang-Min Lee, Ki-Ho Song, Ki-Dong Yoo, Yong-Moon Park, Seung-Hyun Ko, Yu-Bae Ahn
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Diabetes Metab J. 2016;40(6):463-472. Published online October 5, 2016
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DOI: https://doi.org/10.4093/dmj.2016.40.6.463
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- Background
We investigated an association between baseline heart rate-corrected QT (QTc) interval before severe hypoglycemia (SH) and prolongation of QTc interval during SH in patients with type 2 diabetes mellitus (T2DM). MethodsBetween January 2004 and June 2014, 208 patients with T2DM, who visited the emergency department because of SH and underwent standard 12-lead electrocardiography within the 6-month period before SH were consecutively enrolled. The QTc interval was analyzed during the incidence of SH, and 6 months before and after SH. QTc intervals of 450 ms or longer in men and 460 ms or longer in women were considered abnormally prolonged. ResultsThe mean age and diabetes duration were 68.1±12.1 and 14.1±10.1 years, respectively. The mean QTc intervals at baseline and SH episodes were 433±33 and 460±33 ms, respectively (P<0.001). One hundred and fourteen patients (54.8%) had a prolonged QTc interval during SH. There was a significant decrease in the prolonged QTc interval within 6 months after SH (QTc interval prolongation during SH vs. after recovery, 54.8% vs. 33.8%, P<0.001). The prolonged QTc interval was significantly associated with baseline QTc interval prolongation (odds ratio, 2.92; 95% confidence interval, 1.22 to 6.96; P=0.016) after adjusting for multiple confounders. ConclusionA prolonged QTc interval at baseline was significantly associated with prolongation of the QTc interval during SH in patients with T2DM, suggesting the necessity of QTc interval monitoring and attention to those with a prolonged QTc interval to prevent SH.
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Citations
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Shanshan Shi, Yanjun Song, Zechen Liu, Jining He, Zhihao Zheng, Chenxi Song, Lei Jia, Guofeng Gao, Qiuting Dong, Rui Fu, Min Yang, Wenjia Zhang, Kefei Dou
Nutrition, Metabolism and Cardiovascular Diseases.2024; : 103826. CrossRef - Prevalence of QT prolongation and its risk factors in patients with type 2 diabetes
Khaled Aburisheh, Mohammad F. AlKheraiji, Saleh I. Alwalan, Arthur C. Isnani, Mohamed Rafiullah, Muhammad Mujammami, Assim A. Alfadda
BMC Endocrine Disorders.2023;[Epub] CrossRef - U-shaped association between the triglyceride–glucose index and atrial fibrillation incidence in a general population without known cardiovascular disease
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Anniek F. Lubberding, Christian R. Juhl, Emil Z. Skovhøj, Jørgen K. Kanters, Thomas Mandrup‐Poulsen, Signe S. Torekov
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Seung-Hyun Ko
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Seon-Ah Cha
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Soo-Yeon Choi, Seung-Hyun Ko
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Cristina Amione, Sara Giunti, Paolo Fornengo, Sabita S. Soedamah-Muthu, Nish Chaturvedi, J. H. Fuller, Federica Barutta, Gabriella Gruden, Graziella Bruno
Acta Diabetologica.2017; 54(9): 871. CrossRef
- Complications
- Clinical Course and Risk Factors of Diabetic Retinopathy in Patients with Type 2 Diabetes Mellitus in Korea
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Jae-Seung Yun, Tae-Seok Lim, Seon-Ah Cha, Yu-Bae Ahn, Ki-Ho Song, Jin A Choi, Jinwoo Kwon, Donghyun Jee, Yang Kyung Cho, Yong-Moon Park, Seung-Hyun Ko
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Diabetes Metab J. 2016;40(6):482-493. Published online October 5, 2016
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DOI: https://doi.org/10.4093/dmj.2016.40.6.482
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- Background
We investigated clinical course and risk factors for diabetic retinopathy (DR) in patients with type 2 diabetes mellitus (T2DM). MethodsA total of 759 patients with T2DM without DR were included from January 2001 to December 2004. Retinopathy evaluation was performed at least annually by ophthalmologists. The severity of the DR was classified into five categories according to the International Clinical Diabetic Retinopathy Severity Scales. ResultsOf the 759 patients, 523 patients (68.9%) completed the follow-up evaluation. During the follow-up period, 235 patients (44.9%) developed DR, and 32 patients (13.6%) progressed to severe nonproliferative DR (NPDR) or proliferative DR (PDR). The mean duration of diabetes at the first diagnosis of mild NPDR, moderate NPDR, and severe NPDR or PDR were 14.8, 16.7, and 17.3 years, respectively. After adjusting multiple confounding factors, the significant risk factors for the incidence of DR risk in patients with T2DM were old age, longer duration of diabetes, higher mean glycosylated hemoglobin (HbA1c), and albuminuria. Even in the patients who had been diagnosed with diabetes for longer than 10 years at baseline, a decrease in HbA1c led to a significant reduction in the risk of developing DR (hazard ratio, 0.73 per 1% HbA1c decrement; 95% confidence interval, 0.58 to 0.91; P=0.005). ConclusionThis prospective cohort study demonstrates that glycemic control, diabetes duration, age, and albuminuria are important risk factors for the development of DR. More aggressive retinal screening for T2DM patients diagnosed with DR should be required in order to not miss rapid progression of DR.
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- Complications
- Severe Hypoglycemia and Cardiovascular or All-Cause Mortality in Patients with Type 2 Diabetes
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Seon-Ah Cha, Jae-Seung Yun, Tae-Seok Lim, Seawon Hwang, Eun-Jung Yim, Ki-Ho Song, Ki-Dong Yoo, Yong-Moon Park, Yu-Bae Ahn, Seung-Hyun Ko
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Diabetes Metab J. 2016;40(3):202-210. Published online April 5, 2016
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DOI: https://doi.org/10.4093/dmj.2016.40.3.202
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- Background
We investigated the association between severe hypoglycemia (SH) and the risk of cardiovascular (CV) or all-cause mortality in patients with type 2 diabetes. MethodsThe study included 1,260 patients aged 25 to 75 years with type 2 diabetes from the Vincent Type 2 Diabetes Resgistry (VDR), who consecutively enrolled (n=1,260) from January 2000 to December 2010 and were followed up until May 2015 with a median follow-up time of 10.4 years. Primary outcomes were death from any cause or CV death. We investigated the association between the CV or all-cause mortality and various covariates using Cox proportional hazards regression analysis. ResultsAmong the 906 participants (71.9%) who completed follow-up, 85 patients (9.4%) had at least one episode of SH, and 86 patients (9.5%) died (9.1 per 1,000 patient-years). Patients who had died were older, had a longer duration of diabetes and hypertension, received more insulin, and had more diabetic microvascular complications at baseline, as compared with surviving patients. The experience of SH was significantly associated with an increased risk of all-cause mortality (hazard ratio [HR], 2.64; 95% confidence interval [CI], 1.39 to 5.02; P=0.003) and CV mortality (HR, 6.34; 95% CI, 2.02 to 19.87; P=0.002) after adjusting for sex, age, diabetic duration, hypertension, mean glycosylated hemoglobin levels, diabetic nephropathy, lipid profiles, and insulin use. ConclusionWe found a strong association between SH and increased risk of all-cause and CV mortality in patients with type 2 diabetes.
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Citations
Citations to this article as recorded by
- Complications
- Cardiovascular Disease Predicts Severe Hypoglycemia in Patients with Type 2 Diabetes
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Jae-Seung Yun, Seung-Hyun Ko, Sun-Hye Ko, Ki-Ho Song, Ki-Dong Yoo, Kun-Ho Yoon, Yong-Moon Park, Yu-Bae Ahn
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Diabetes Metab J. 2015;39(6):498-506. Published online July 8, 2015
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DOI: https://doi.org/10.4093/dmj.2015.39.6.498
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- Background
To investigate whether a history of prior cardiovascular disease (CVD) is associated with severe hypoglycemia (SH) in patients with type 2 diabetes. MethodsWe conducted a prospective cohort study from January 2001 to December 2012 with a median follow-up time of 9.5 years (5,814 person-years). Patients aged 25 to 75 years with type 2 diabetes and without chronic kidney disease were enrolled (n=894), and 624 patients completed follow-up. SH was defined as hypoglycemic episodes requiring hospitalization or medical care in an emergency department. We used the Cox proportional hazards regression analysis to test associations between SH episodes and potential explanatory variables. ResultsAmong the 624 participants who completed follow-up, 60 patients (9.6%) had previous CVD. Compared to patients without CVD, patients with previous CVD were older, had a longer duration of diabetes and hypertension, received more insulin, and had more diabetic microvascular complications at baseline. During follow-up, 62 patients (9.9%) experienced at least one SH episode (incidence of 1.33 per 100 patient-years). The development of SH was associated with a history of CVD (hazard ratio, 1.99; 95% confidence interval, 1.07 to 3.72; P=0.031) after adjusting for sex, age, diabetic duration, hypertension, hemoglobin A1c levels, diabetic complications, cardiovascular autonomic neuropathy, and insulin use. ConclusionA history of CVD was an independent risk factor for the development of SH in patients with type 2 diabetes mellitus. For patients with CVD, modulation of glycemic targets and diabetic education for the prevention of hypoglycemia should be implemented.
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PLOS ONE.2016; 11(10): e0164807. CrossRef - Meta-analysis: Association between hypoglycaemia and serious adverse events in older patients
Katharina Mattishent, Yoon Kong Loke
Journal of Diabetes and its Complications.2016; 30(5): 811. CrossRef - Letter: Cardiovascular Disease Predicts Severe Hypoglycemia in Patients with Type 2 Diabetes (Diabetes Metab J 2015;39:498-506)
Mi-Kyung Kim
Diabetes & Metabolism Journal.2016; 40(1): 83. CrossRef - Response: Cardiovascular Disease Predicts Severe Hypoglycemia in Patients with Type 2 Diabetes (Diabetes Metab J 2015;39:498-506)
Jae-Seung Yun, Yu-Bae Ahn
Diabetes & Metabolism Journal.2016; 40(1): 85. CrossRef - Lipoprotein(a) predicts a new onset of chronic kidney disease in people with Type 2 diabetes mellitus
J.‐S. Yun, Y.‐B. Ahn, K.‐H. Song, K.‐D. Yoo, Y.‐M. Park, H.‐W. Kim, S.‐H. Ko
Diabetic Medicine.2016; 33(5): 639. CrossRef - Severe Hypoglycemia and Cardiovascular Disease in Type 2 Diabetes
Hyeong Kyu Park
Diabetes & Metabolism Journal.2015; 39(6): 478. CrossRef
- Intensive Individualized Reinforcement Education Is Important for the Prevention of Hypoglycemia in Patients with Type 2 Diabetes
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Yun-Mi Yong, Kyung-Mi Shin, Kang-Min Lee, Jae-Young Cho, Sun-Hye Ko, Min-Hyang Yoon, Tae-Won Kim, Jong-Hyun Jeong, Yong-Moon Park, Seung-Hyun Ko, Yu-Bae Ahn
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Diabetes Metab J. 2015;39(2):154-163. Published online March 10, 2015
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DOI: https://doi.org/10.4093/dmj.2015.39.2.154
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PDFSupplementary MaterialPubReader
- Background
We investigated whether an intensive individualized reinforcement education program could influence the prevention of hypoglycemic events in patients with type 2 diabetes. MethodsFrom March 2013 to September 2013, patients aged 35 to 75 years with type 2 diabetes who had not previously participated in diabetes education, and treated with insulin or a sulfonylurea-containing regimen were included in the study. After structured group education, the patients assigned to the intensive individualized education group (IT) were requested to visit for reinforcement. All subjects in the IT were encouraged to self-manage dose adjustments. Participants in both groups (control group [CG, group education only; n=22] and IT [n=24]) attended follow-up visits at 2, 8, 12, and 24 weeks. At each visit, all patients were asked whether they had experienced hypoglycemia. ResultsThe total study population consisted of 20 men (43.5%; mean age and diabetic duration of 55.9±11.0 and 5.1±7.3 years, respectively). At 24 weeks, there were no significant differences in hemoglobin A1c values between the CG and IT. The total number of hypoglycemic events per patient was 5.26±6.5 in the CG and 2.58±2.3 times in the IT (P=0.004). Adherence to lifestyle modification including frequency of exercise, self-monitoring of blood glucose, or dietary habit was not significantly different between the groups. However, adherence to hypoglycemia management, especially the dose adjustment of medication, was significantly higher in the IT compared with the CG. ConclusionCompared with the structured group education, additional IT resulted in additional benefits in terms of avoidance of hypoglycemia and treating hypoglycemia in patients with type 2 diabetes.
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Citations
Citations to this article as recorded by - 2023 Clinical Practice Guidelines for Diabetes Management in Korea: Full Version Recommendation of the Korean Diabetes Association
Jun Sung Moon, Shinae Kang, Jong Han Choi, Kyung Ae Lee, Joon Ho Moon, Suk Chon, Dae Jung Kim, Hyun Jin Kim, Ji A Seo, Mee Kyoung Kim, Jeong Hyun Lim, Yoon Ju Song, Ye Seul Yang, Jae Hyeon Kim, You-Bin Lee, Junghyun Noh, Kyu Yeon Hur, Jong Suk Park, Sang
Diabetes & Metabolism Journal.2024; 48(4): 546. CrossRef - Effectiveness of the SUGAR intervention on hypoglycaemia in elderly patients with type 2 diabetes: A pragmatic randomised controlled trial
Huda Y. Almomani, Carlos Rodriguez Pascual, Paul Grassby, Keivan Ahmadi
Research in Social and Administrative Pharmacy.2023; 19(2): 322. CrossRef - A Cross-Sectional study on risk factors for severe hypoglycemia among Insulin-Treated elderly type 2 diabetes Mellitus (T2DM) patients in Singapore
Michelle Shi Min Ko, Wai Kit Lee, Li Chang Ang, Su-Yen Goh, Yong Mong Bee, Ming Ming Teh
Diabetes Research and Clinical Practice.2022; 185: 109236. CrossRef - Management Status of Patients with Type 2 Diabetes Mellitus at General Hospitals in Korea: A 5-Year Follow-Up Study
Jin Hee Jung, Jung Hwa Lee, Hyang Mi Jang, Young Na, Hee Sun Choi, Yeon Hee Lee, Yang Gyo Kang, Na Rae Kim, Jeong Rim Lee, Bok Rye Song, Kang Hee Sim
The Journal of Korean Diabetes.2022; 23(1): 64. CrossRef - Anti-hyperglycemic Medication Compliance: A Quality Assurance Project
Rayan Mamoon, Md Y Mamoon, Debbie Hermanstyne, Issac Sachmechi
Cureus.2022;[Epub] CrossRef - Randomised controlled trial of pharmacist-led patient counselling in controlling hypoglycaemic attacks in older adults with type 2 diabetes mellitus (ROSE-ADAM): A study protocol of the SUGAR intervention
Huda Y. Almomani, Carlos Rodriguez Pascual, Sayer I. Al-Azzam, Keivan Ahmadi
Research in Social and Administrative Pharmacy.2021; 17(5): 885. CrossRef - Severe hypoglycemia as a preventable risk factor for cardiovascular disease in patients with type 2 diabetes mellitus
Soo-Yeon Choi, Seung-Hyun Ko
The Korean Journal of Internal Medicine.2021; 36(2): 263. CrossRef - Type 2 diabetes patients’ views on prevention of hypoglycaemia – a mixed methods study investigating self-management issues and self-identified causes of hypoglycaemia
Stijn Crutzen, Tessa van den Born-Bondt, Petra Denig, Katja Taxis
BMC Family Practice.2021;[Epub] CrossRef - Cross‐sectional analysis of emergency hypoglycaemia and outcome predictors among people with diabetes in an urban population
Chukwuma Uduku, Valentina Pendolino, Ian Godsland, Nick Oliver, Monika Reddy, Rachael T. Fothergill
Diabetic Medicine.2021;[Epub] CrossRef - Short-term efficacy of high intensity group and individual education in patients with type 2 diabetes: a randomized single-center trial
R. Reale, A. Tumminia, L. Romeo, N. La Spina, R. Baratta, G. Padova, L. Tomaselli, L. Frittitta
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Ahmed Iqbal, Simon R. Heller
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Yasuaki Hayashino, Satoru Tsujii, Hitoshi Ishii
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Byung-Wan Lee, Jin Hwa Kim, Seung-Hyun Ko, Kyu-Yeon Hur, Nan-Hee Kim, Sang Youl Rhee, Hyun Jin Kim, Min Kyong Moon, Seok-O Park, Kyung Mook Choi
Diabetes & Metabolism Journal.2017; 41(5): 367. CrossRef - Antihyperglycemic Agent Therapy for Adult Patients with Type 2 Diabetes Mellitus 2017: A Position Statement of the Korean Diabetes Association
Seung-Hyun Ko, Kyu-Yeon Hur, Sang Youl Rhee, Nan-Hee Kim, Min Kyong Moon, Seok-O Park, Byung-Wan Lee, Hyun Jin Kim, Kyung Mook Choi, Jin Hwa Kim
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Byung-Wan Lee, Jin Hwa Kim, Seung-Hyun Ko, Kyu Yeon Hur, Nan-Hee Kim, Sang Youl Rhee, Hyun Jin Kim, Min Kyong Moon, Seok-O Park, Kyung Mook Choi
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Seung-Hyun Ko, Kyu-Yeon Hur, Sang Youl Rhee, Nan-Hee Kim, Min Kyong Moon, Seok-O Park, Byung-Wan Lee, Hyun Jin Kim, Kyung Mook Choi, Jin Hwa Kim
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Yong-ho Lee, Gyuri Kim, Eun Seok Kang
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Seon-Ah Cha, Seung-Hyun Ko
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- Higher Prevalence and Awareness, but Lower Control Rate of Hypertension in Patients with Diabetes than General Population: The Fifth Korean National Health and Nutrition Examination Survey in 2011
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Seung-Hyun Ko, Hyuk-Sang Kwon, Dae Jung Kim, Jae Hyeon Kim, Nan Hee Kim, Chul Sik Kim, Kee-Ho Song, Jong Chul Won, Soo Lim, Sung Hee Choi, Kyungdo Han, Yong-Moon Park, Bong-Yun Cha
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Diabetes Metab J. 2014;38(1):51-57. Published online February 19, 2014
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DOI: https://doi.org/10.4093/dmj.2014.38.1.51
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- Background
We investigated the prevalence, awareness, treatment, and control rate of hypertension in Korean adults with diabetes using nationally representative data. MethodsUsing data of 5,105 adults from the fifth Korea National Health and Nutrition Examination Survey in 2011 (4,389 nondiabetes mellitus [non-DM]), 242 newly diagnosed with DM (new-DM), and 474 previously diagnosed with DM (known-DM), we analyzed the prevalence of hypertension (mean systolic blood pressure ≥140 mm Hg, diastolic blood pressure ≥90 mm Hg, or use of antihypertensive medication) and control rate of hypertension (blood pressure [BP] <130/80 mm Hg). ResultsThe prevalence of hypertension in diabetic adults was 54.6% (44.4% in new-DM and 62.6% in known-DM, P<0.0001 and P<0.0001, respectively) compared with non-DM adults (26.2%). Compared to non-DM, awareness (85.7%, P<0.001) and treatment (97.0%, P=0.020) rates were higher in known-DM, whereas no differences were found between new-DM and non-DM. Control rate among all hypertensive subjects was lower in new-DM (14.9%), compared to non-DM (35.1%, P<0.001) and known-DM (33.3%, P=0.004). Control rate among treated subjects was also lower in new-DM (25.2%), compared to non-DM (68.4%, P<0.0001) and known-DM (39.9%, P<0.0001). ConclusionHigher prevalence and low control rate of hypertension in adults with diabetes suggest that stringent efforts are needed to control BP in patients with diabetes, particularly in newly diagnosed diabetic patients.
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- Statin Discontinuation after Achieving a Target Low Density Lipoprotein Cholesterol Level in Type 2 Diabetic Patients without Cardiovascular Disease: A Randomized Controlled Study
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Seung-Hwan Lee, Hyuk-Sang Kwon, Yong-Moon Park, Seung-Hyun Ko, Yoon-Hee Choi, Kun-Ho Yoon, Yu-Bae Ahn
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Diabetes Metab J. 2014;38(1):64-73. Published online February 19, 2014
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DOI: https://doi.org/10.4093/dmj.2014.38.1.64
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- Background
This study investigated the rate of relapse of dyslipidemia and the factors which could predict relapse following a short-term statin discontinuation after achieving a target low density lipoprotein cholesterol (LDL-C) level in type 2 diabetic patients without cardiovascular disease (CVD). MethodsNinety-nine subjects on rosuvastatin treatment and whose LDL-C level was lower than 100 mg/dL were randomly assigned to discontinue or maintain statin treatment at a 2:1 ratio. The subjects were followed-up after 10 weeks. A relapse of dyslipidemia was defined as a reascent of LDL-C level to greater than 100 mg/dL. ResultsThe statin discontinuation group had a significant rate of relapse compared to the maintenance group (79% vs. 3%, respectively). Pretreatment and baseline lipid levels, their ratios, and hemoglobin A1c level were significantly different between the relapse and nonrelapse groups. The pretreatment and baseline lipid profiles and their ratios were independently associated with relapse. The pretreatment LDL-C level was the most useful parameter for predicting a relapse, with a cutoff of 123 mg/dL. During the follow-up period, no CVD event was noted. ConclusionThe relapse rate of dyslipidemia was high when statins were discontinued in type 2 diabetic patients without CVD. Statin discontinuation should be considered carefully based on the pretreatment lipid profiles of patients.
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Jae-Seung Yun, Seung-Hyun Ko, Ji-Hoon Kim, Keon-Woong Moon, Yong-Moon Park, Ki-Dong Yoo, Yu-Bae Ahn
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Diabetes Metab J. 2013;37(6):488-488. Published online December 12, 2013
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DOI: https://doi.org/10.4093/dmj.2013.37.6.488
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Diabetes Metab J. 2013;37(4):262-269. Published online August 14, 2013
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We investigated the relationship between endothelial dysfunction and diabetic retinopathy (DR) in patients with type 2 diabetes. MethodsWe used a cross-sectional design to examine 167 patients with type 2 diabetes mellitus. All patients underwent biochemical and ophthalmological examination. We assessed endothelial dysfunction by a flow-mediated vasodilation method of the brachial artery. Changes in vasodilation (flow-mediated vasodilatation, %FMD) were expressed as percent change over baseline values. ResultsThe mean±standard deviation of patient age was 54.1±8.6 years. The %FMD was significantly lower in patients with DR than without DR. The prevalence of retinopathy decreased across increasing tertiles of %FMD. After adjusting for patients' age, sex, diabetes duration, use of insulin, use of antihypertensive, antiplatelet, and lipid lowering medications, systolic blood pressure, fasting plasma glucose, 2-hour plasma glucose, glycated hemoglobin, and urinary albumin excretion, participants with a reduced %FMD were more likely to have DR (odds ratio, 11.819; 95% confidence interval, 2.201 to 63.461; P=0.004, comparing the lowest and highest tertiles of %FMD). ConclusionEndothelial dysfunction was associated with DR, which was most apparent when the endothelial dysfunction was severe. Our study provides insights into the possible mechanism of the influence of endothelial dysfunction on the development of DR.
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- Influence of Visceral Adiposity on Cardiovascular Autonomic Neuropathy in Patients with Type 2 Diabetes Mellitus
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Eun-Hee Jang, Na-Young Kim, Yong-Moon Park, Mee-Kyoung Kim, Ki Hyun Baek, Ki-Ho Song, Kwang Woo Lee, Hyuk-Sang Kwon
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Diabetes Metab J. 2012;36(4):285-292. Published online August 20, 2012
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DOI: https://doi.org/10.4093/dmj.2012.36.4.285
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- Background
The aim of this study was to investigate the influences of visceral adiposity on cardiovascular autonomic neuropathy (CAN) in patients with type 2 diabetes mellitus. MethodsTwo hundred eleven patients with type 2 diabetes participated in this study. Anthropometric and metabolic parameters were measured, and the visceral fat area was assessed using computed tomography. CAN was diagnosed using a cardiovascular reflex test. We analyzed the correlation between the visceral fat area and each parameter in this test. ResultsThe mean age, body mass index (BMI), and duration of diabetes of the study population were 60±14 years (mean±standard deviation), 25.1±4.2 kg/m2, and 12.3±8.9 years, respectively. The visceral fat area showed positive correlations with age, BMI, waist circumference, and subcutaneous fat area. There was no statistically significant difference in the cardiovascular reflex test outcome between genders. Univariate linear regression analysis showed that an increased visceral fat area diminished good heart rate response to a Valsalva maneuver (R2=4.9%, P=0.013 in an unadjusted model), but only in women. This statistical association was preserved after adjusting for age and BMI (R2=9.8%, P=0.0072). ConclusionThe results of this study suggest that visceral adiposity contributes to an autonomic imbalance to some degree, as demonstrated by the impaired cardiovascular reflex test among women with type 2 diabetes.
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Citations
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Cardiovascular Diabetology.2014;[Epub] CrossRef
- Influence of the Duration of Diabetes on the Outcome of a Diabetes Self-Management Education Program
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Seung-Hyun Ko, Sin-Ae Park, Jae-Hyoung Cho, Sun-Hye Ko, Kyung-Mi Shin, Seung-Hwan Lee, Ki-Ho Song, Yong-Moon Park, Yu-Bae Ahn
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Diabetes Metab J. 2012;36(3):222-229. Published online June 14, 2012
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DOI: https://doi.org/10.4093/dmj.2012.36.3.222
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Abstract
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- Background
Diabetes education and lifestyle modification are critical components in controlling blood glucose levels of people with type 2 diabetes. Until now, available data on the effectiveness of education with respect to the duration of diabetes are limited. We investigated whether adherence to lifestyle behavior modification prompted by diabetes education was influenced by the duration of diabetes. MethodsTwo hundred and twenty-five people with type 2 diabetes were recruited for an intensive, collaborative, group-based diabetes education program with annual reinforcement. We divided the patients into two groups based on the duration of their diabetes prior to the education program (≤1 year [≤1Y] vs. ≥3 years [≥3Y]). Dietary habits, physical activity, and the frequency of blood glucose self-monitoring were evaluated with a questionnaire prior to education and at the follow-up endpoint. ResultsThe mean follow-up period was 32.2 months. The mean hemoglobin A1c (A1C) value was significantly lower in the ≤1Y group. Self-care behaviors, measured by scores for dietary habits (P=0.004) and physical activity (P<0.001), were higher at the endpoint in the ≤1Y group than in the ≥3Y group. Logistic regression analysis revealed that a longer diabetes duration before education was significantly associated with mean A1C levels greater than or equal to 7.0% (53 mmol/mol). ConclusionDiabetes duration influenced the effectiveness of diabetes education on lifestyle behavior modification and glycemic control. More-intense, regular, and sustained reinforcement with encouragement may be required for individuals with longstanding type 2 diabetes.
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