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- Cardiovascular Disease Predicts Severe Hypoglycemia in Patients with Type 2 Diabetes
- Jae-Seung Yun, Seung-Hyun Ko, Sun-Hye Ko, Ki-Ho Song, Ki-Dong Yoo, Kun-Ho Yoon, Yong-Moon Park, Yu-Bae Ahn
- Diabetes Metab J. 2015;39(6):498-506. Published online July 8, 2015
- DOI: https://doi.org/10.4093/dmj.2015.39.6.498
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Abstract
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PubReader Background To investigate whether a history of prior cardiovascular disease (CVD) is associated with severe hypoglycemia (SH) in patients with type 2 diabetes.
Methods We 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.Results Among 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.Conclusion A 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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Citations
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- Concomitant Use of Sulfonylureas and β-Blockers and the Risk of Severe Hypoglycemia Among Patients With Type 2 Diabetes: A Population-Based Cohort Study
Jenny Dimakos, Ying Cui, Robert W. Platt, Christel Renoux, Kristian B. Filion, Antonios Douros
Diabetes Care.2023; 46(2): 377. CrossRef - Evaluating the effect of Roxadustat on ventricular repolarization in patients undergoing peritoneal dialysis
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The Journal of Korean Diabetes.2022; 23(4): 245. 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
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Journal of Diabetes and its Complications.2018; 32(5): 480. CrossRef - Depth and combined infection is important predictor of lower extremity amputations in hospitalized diabetic foot ulcer patients
Eun-Gyo Jeong, Sung Shim Cho, Sang-Hoon Lee, Kang-Min Lee, Seo-Kyung Woo, Yoongoo Kang, Jae-Seung Yun, Seon-Ah Cha, Yoon-Jung Kim, Yu-Bae Ahn, Seung-Hyun Ko, Jung-Min Lee
The Korean Journal of Internal Medicine.2018; 33(5): 952. CrossRef - Time- and frequency-domain measures of heart rate variability predict cardiovascular outcome in patients with type 2 diabetes
Seon-Ah Cha, Yong-Moon Park, Jae-Seung Yun, Seung-Hwan Lee, Yu-Bae Ahn, Sung-Rae Kim, Seung-Hyun Ko
Diabetes Research and Clinical Practice.2018; 143: 159. CrossRef - Risk Factors for Severe Hypoglycemia in Black and White Adults With Diabetes: The Atherosclerosis Risk in Communities (ARIC) Study
Alexandra K. Lee, Clare J. Lee, Elbert S. Huang, A. Richey Sharrett, Josef Coresh, Elizabeth Selvin
Diabetes Care.2017; 40(12): 1661. CrossRef - Early inner retinal thinning and cardiovascular autonomic dysfunction in type 2 diabetes
Jin A. Choi, Hyo Won Kim, Jin-Woo Kwon, Yun-sub Shim, Dong Hyun Jee, Jae-Seung Yun, Yu-Bae Ahn, Chan Kee Park, Seung-Hyun Ko, Patrice E. Fort
PLOS ONE.2017; 12(3): e0174377. CrossRef - Cardiovascular Autonomic Dysfunction Predicts Diabetic Foot Ulcers in Patients With Type 2 Diabetes Without Diabetic Polyneuropathy
Jae-Seung Yun, Seon-Ah Cha, Tae-Seok Lim, Eun-Young Lee, Ki-Ho Song, Yu-Bae Ahn, Ki-Dong Yoo, Joon-Sung Kim, Yong-Moon Park, Seung-Hyun Ko
Medicine.2016; 95(12): e3128. CrossRef - Clinical Course and Risk Factors of Diabetic Retinopathy in Patients with Type 2 Diabetes Mellitus in Korea
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Diabetes & Metabolism Journal.2016; 40(6): 482. CrossRef - Diabetic Cardiovascular Autonomic Neuropathy Predicts Recurrent Cardiovascular Diseases in Patients with Type 2 Diabetes
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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)
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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
- Concomitant Use of Sulfonylureas and β-Blockers and the Risk of Severe Hypoglycemia Among Patients With Type 2 Diabetes: A Population-Based Cohort Study
- Clinical Care/Education
- Insulin Initiation in Insulin-Naïve Korean Type 2 Diabetic Patients Inadequately Controlled on Oral Antidiabetic Drugs in Real-World Practice: The Modality of Insulin Treatment Evaluation Study
- Sang Soo Kim, In Joo Kim, Yong Ki Kim, Kun Ho Yoon, Ho Young Son, Sung Woo Park, Yeon Ah Sung, Hong Sun Baek
- Diabetes Metab J. 2015;39(6):481-488. Published online November 25, 2015
- DOI: https://doi.org/10.4093/dmj.2015.39.6.481
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Abstract
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Background The Modality of Insulin Treatment Evaluation (MOTIV) study was performed to provide real-world data concerning insulin initiation in Korean type 2 diabetes mellitus (T2DM) patients with inadequate glycemic control with oral hypoglycemic agents (OHAs).
Methods This multicenter, non-interventional, prospective, observational study enrolled T2DM patients with inadequate glycemic control (glycosylated hemoglobin [HbA1c] ≥7.0%) who had been on OHAs for ≥3 months and were already decided to introduce basal insulin by their physician prior to the start of the study. All treatment decisions were at the physician's discretion to reflect real-world practice.
Results A total of 9,196 patients were enrolled, and 8,636 patients were included in the analysis (mean duration of diabetes, 8.9 years; mean HbA1c, 9.2%). Basal insulin plus one OHA was the most frequently (51.0%) used regimen. After 6 months of basal insulin treatment, HbA1c decreased to 7.4% and 44.5% of patients reached HbA1c <7%. Body weight increased from 65.2 kg to 65.5 kg, which was not significant. Meanwhile, there was significant increase in the mean daily insulin dose from 16.9 IU at baseline to 24.5 IU at month 6 (
P <0.001). Overall, 17.6% of patients experienced at least one hypoglycemic event.Conclusion In a real-world setting, the initiation of basal insulin is an effective and well-tolerated treatment option in Korean patients with T2DM who are failing to meet targets with OHA therapy.
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Citations
Citations to this article as recorded by- Clinical Evidence and Practice-Based Guidelines on the Utility of Basal
Insulin Combined Oral Therapy (Metformin and Glimepiride) in the
Current Era
Abhishek Shrivastava, Jothydev Kesavadev, Viswanathan Mohan, Banshi Saboo, Dina Shrestha, Anuj Maheshwari, Brij Mohan Makkar, Kirtikumar D. Modi, Ashok Kumar Das
Current Diabetes Reviews.2023;[Epub] CrossRef - Where to Initiate Basal Insulin Therapy: Inpatient or Outpatient Department? Real-World Observation in China
Minyuan Chen, Puhong Zhang, Yang Zhao, Nadila Duolikun, Linong Ji
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The Journal of Korean Diabetes.2019; 20(2): 117. CrossRef - Use of Insulin Glargine 100 U/mL for the Treatment of Type 2 Diabetes Mellitus in East Asians: A Review
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The Korean Journal of Internal Medicine.2017; 32(6): 967. CrossRef - Insulin Therapy for Adult Patients with Type 2 Diabetes Mellitus: A Position Statement of the Korean Diabetes Association, 2017
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Journal of Diabetes Research.2017; 2017: 1. CrossRef - Comparison of Antidiabetic Regimens in Patients with Type 2 Diabetes Uncontrolled by Combination Therapy of Sulfonylurea and Metformin: Results of the MOHAS Disease Registry in Korea
Sung Hee Choi, Tae Jung Oh, Hak Chul Jang
Diabetes & Metabolism Journal.2017; 41(3): 170. CrossRef - Instauration d’une insulinothérapie chez le patient diabétique de type 2 en médecine générale : Comparaison de l’étude belge InsuStar avec quelques études françaises et internationales
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- Clinical Evidence and Practice-Based Guidelines on the Utility of Basal
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- Epidemiology
- Changing Clinical Characteristics according to Insulin Resistance and Insulin Secretion in Newly Diagnosed Type 2 Diabetic Patients in Korea
- Jang Won Son, Cheol-Young Park, Sungrae Kim, Han-Kyu Lee, Yil-Seob Lee
- Diabetes Metab J. 2015;39(5):387-394. Published online October 22, 2015
- DOI: https://doi.org/10.4093/dmj.2015.39.5.387
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- 22 Citations
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Abstract
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Background The role of increased insulin resistance in the pathogenesis of type 2 diabetes has been emphasized in Asian populations. Thus, we evaluated the proportion of insulin resistance and the insulin secretory capacity in patients with early phase type 2 diabetes in Korea.
Methods We performed a cross-sectional analysis of 1,314 drug-naive patients with newly diagnosed diabetes from primary care clinics nationwide. The homeostasis model assessment of insulin resistance (HOMA-IR) was used as an index to measure insulin resistance, which was defined as a HOMA-IR ≥2.5. Insulin secretory defects were classified based on fasting plasma C-peptide levels: severe (<1.1 ng/mL), moderate (1.1 to 1.7 ng/mL) and mild to non-insulin secretory defect (≥1.7 ng/mL).
Results The mean body mass index (BMI) was 25.2 kg/m2; 77% of patients had BMIs >23.0 kg/m2. Up to 50% of patients had central obesity based on their waist circumference (≥90 cm in men and 85 cm in women), and 70.6% had metabolic syndrome. Overall, 59.5% of subjects had insulin resistance, and 20.2% demonstrated a moderate to severe insulin secretory defect. Among those with insulin resistance, a high proportion of subjects (79.0%) had a mild or no insulin secretory defect. Only 2.6% of the men and 1.9% of the women had both insulin resistance and a moderate to severe insulin secretory defect.
Conclusion In this study, patients with early phase type 2 diabetes demonstrated increased insulin resistance, but preserved insulin secretion, with a high prevalence of obesity and metabolic syndrome.
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Citations
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Diabetes & Metabolism Journal.2019; 43(4): 461. CrossRef - Pathophysiology‐based phenotyping in type 2 diabetes: A clinical classification tool
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The American Journal of the Medical Sciences.2018; 355(1): 54. CrossRef - Does Weight Gain Associated with Thiazolidinedione Use Negatively Affect Cardiometabolic Health?
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Journal of Obesity & Metabolic Syndrome.2017; 26(2): 102. CrossRef - Glucagon-Like Peptide-1 Receptor Agonists for the Treatment of Type 2 Diabetes Mellitus: A Position Statement of the Korean Diabetes Association
Hyun Jin Kim, Seok O Park, Seung-Hyun Ko, Sang Youl Rhee, Kyu-Yeon Hur, Nan-Hee Kim, Min Kyong Moon, Byung-Wan Lee, Jin Hwa Kim, Kyung Mook Choi
Diabetes & Metabolism Journal.2017; 41(6): 423. CrossRef - Prevalence of Pancreatic Cystic Lesions Is Associated With Diabetes Mellitus and Obesity
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Pancreas.2017; 46(6): 801. CrossRef - Anatomic fat depots and cardiovascular risk: a focus on the leg fat using nationwide surveys (KNHANES 2008–2011)
Eugene Han, Yong-ho Lee, Byung-Wan Lee, Eun Seok Kang, In-Kyu Lee, Bong-Soo Cha
Cardiovascular Diabetology.2017;[Epub] CrossRef - Exenatide versus Insulin Lispro Added to Basal Insulin in a Subgroup of Korean Patients with Type 2 Diabetes Mellitus
Kun-Ho Yoon, Elise Hardy, Jenny Han
Diabetes & Metabolism Journal.2017; 41(1): 69. CrossRef - Protective effects of exercise training on endothelial dysfunction induced by total sleep deprivation in healthy subjects
Fabien Sauvet, Pierrick J Arnal, Pierre Emmanuel Tardo-Dino, Catherine Drogou, Pascal Van Beers, Clément Bougard, Arnaud Rabat, Garance Dispersyn, Alexandra Malgoyre, Damien Leger, Danielle Gomez-Merino, Mounir Chennaoui
International Journal of Cardiology.2017; 232: 76. CrossRef - Efficacy of Body Weight Reduction on the SGLT2 Inhibitor in People with Type 2 Diabetes Mellitus
Hyun A Cho, Young Lee Jung, Yong Hoon Lee, Yu Chang Lee, Jung Eun Lee, Sol Jae Lee, Su Jin Jeong, Chong Hwa Kim
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Jong-Dai Kim, Won-Young Lee
Endocrinology and Metabolism.2016; 31(3): 354. CrossRef - Long-Term Single and Joint Effects of Excessive Daytime Napping on the HOMA-IR Index and Glycosylated Hemoglobin
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Medicine.2016; 95(5): e2734. CrossRef - Current status of managing diabetes mellitus in Korea
Kyoung Hwa Ha, Dae Jung Kim
The Korean Journal of Internal Medicine.2016; 31(5): 845. CrossRef - A Pilot Study Evaluating Steroid-Induced Diabetes after Antiemetic Dexamethasone Therapy in Chemotherapy-Treated Cancer Patients
Yusook Jeong, Hye Sook Han, Hyo Duk Lee, Jiyoul Yang, Jiwon Jeong, Moon Ki Choi, Jihyun Kwon, Hyun-Jung Jeon, Tae-Keun Oh, Ki Hyeong Lee, Seung Taik Kim
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Diabetes Research and Clinical Practice.2016; 122: 71. CrossRef - Sleep extension increases IGF-I concentrations before and during sleep deprivation in healthy young men
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Applied Physiology, Nutrition, and Metabolism.2016; 41(9): 963. CrossRef - 4-Hydroxyisoleucine: A Potential New Treatment for Type 2 Diabetes Mellitus
Mohammad Ishraq Zafar, Feng Gao
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Josep M del Bas, Antoni Caimari, Maria Isabel Rodriguez-Naranjo, Caroline E Childs, Carolina Paras Chavez, Annette L West, Elizabeth A Miles, Lluis Arola, Philip C Calder
The American Journal of Clinical Nutrition.2016; 104(2): 266. CrossRef
- Differences in health behavior and nutrient intake status between diabetes-aware and unaware Korean adults based on the Korea national health and nutrition examination survey 2016–18 data: A cross-sectional study
- Normal Glucose Tolerance with a High 1-Hour Postload Plasma Glucose Level Exhibits Decreased β-Cell Function Similar to Impaired Glucose Tolerance
- Tae Jung Oh, Se Hee Min, Chang Ho Ahn, Eun Ky Kim, Soo Heon Kwak, Hye Seung Jung, Kyong Soo Park, Young Min Cho
- Diabetes Metab J. 2015;39(2):147-153. Published online March 9, 2015
- DOI: https://doi.org/10.4093/dmj.2015.39.2.147
- 3,259 View
- 40 Download
- 12 Citations
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Abstract
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Background Subjects with normal glucose tolerance (NGT) who have a high 1-hour postload plasma glucose level (≥155 mg/dL; NGT 1 hour-high) have been shown to be at higher risk for type 2 diabetes than subjects with NGT 1 hour-low postload plasma glucose level (<155 mg/dL). We compared β-cell function in subjects with NGT 1 hour-high, NGT 1 hour-low, and impaired glucose tolerance (IGT).
Methods We classified subjects into NGT 1 hour-low (
n =149), NGT 1 hour-high (n =43), and IGT (n =52). The β-cell function was assessed based on insulinogenic index (IGI), oral disposition index (DI), and insulin secretion-sensitivity index-2 (ISSI-2).Results Insulin sensitivity was comparable between the subjects with NGT 1 hour-high and NGT 1 hour-low. The β-cell function with/without adjusting insulin sensitivity was significantly different among the three groups. The IGI (pmol/mmol) was 116.8±107.3 vs. 64.8±47.8 vs. 65.8±80.6 (
P =0.141), oral DI was 3.5±4.2 vs. 1.8±1.4 vs. 1.8±3.1 (P <0.001), and ISSI-2 was 301.2±113.7 vs. 213.2±67.3 vs. 172.5±87.5 (P <0.001) in NGT 1 hour-low, NGT 1 hour-high, and IGT, respectively.Post hoc analyses revealed that oral DI and ISSI-2 were significantly different between NGT 1 hour-low and NGT 1 hour-high but comparable between NGT 1 hour-high and IGT.Conclusion Among Korean subjects with NGT, those who have a higher 1-hour postload glucose level have a compromised insulin-sensitivity adjusted β-cell function to a similar degree as IGT subjects.
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Citations
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Sang Ouk Chin, You‐Cheol Hwang, In‐Jin Cho, In‐Kyung Jeong, Kyu Jeung Ahn, Ho Yeon Chung
Diabetes/Metabolism Research and Reviews.2021;[Epub] CrossRef - Indirect insulin resistance detection: Current clinical trends and laboratory limitations
Sylwia Placzkowska, Lilla Pawlik-Sobecka, Izabela Kokot, Agnieszka Piwowar
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Clinical Endocrinology.2018; 89(6): 757. CrossRef - One‐hour postload plasma glucose concentration in people with normal glucose homeostasis predicts future diabetes mellitus: a 12‐year community‐based cohort study
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Clinical Endocrinology.2017; 86(4): 513. CrossRef - An elevated 1-h post- load glucose level during the oral glucose tolerance test detects prediabetes
Martin Buysschaert, Michael Bergman, Donald Yanogo, Ram Jagannathan, Benoit Buysschaert, Vanessa Preumont
Diabetes & Metabolic Syndrome: Clinical Research & Reviews.2017; 11(2): 137. CrossRef - Delayed insulin secretion response during an OGTT is associated with an increased risk for incidence of diabetes in NGT subjects
Yun Sun, Junfeng Han, Ziwei Lin, Lige Song, Chen Wang, Weiping Jia
Journal of Diabetes and its Complications.2016; 30(8): 1537. CrossRef - Postprandial Hyperglycemia
Tae Jung Oh
The Journal of Korean Diabetes.2016; 17(4): 233. CrossRef - β-Cell Function and Insulin Sensitivity in Normal Glucose-Tolerant Subjects Stratified by 1-Hour Plasma Glucose Values
Miranda M. Priya, Anandakumar Amutha, T.A. Pramodkumar, Harish Ranjani, Saravanan Jebarani, Kuppan Gokulakrishnan, Rajendra Pradeepa, Ranjit Unnikrishnan, Ranjit Mohan Anjana, Viswanathan Mohan
Diabetes Technology & Therapeutics.2016; 18(1): 29. CrossRef - Response: Normal Glucose Tolerance with a High 1-Hour Postload Plasma Glucose Level Exhibits Decreased β-Cell Function Similar to Impaired Glucose Tolerance (Diabetes Metab J2015;39:147-53)
Tae Jung Oh, Se Hee Min, Chang Ho Ahn, Eun Ky Kim, Soo Heon Kwak, Hye Seung Jung, Kyong Soo Park, Young Min Cho
Diabetes & Metabolism Journal.2015; 39(3): 270. CrossRef - Letter: Normal Glucose Tolerance with a High 1-Hour Postload Plasma Glucose Level Exhibits Decreased β-Cell Function Similar to Impaired Glucose Tolerance (Diabetes Metab J2015;39:147-53)
Hee Kyung Kim
Diabetes & Metabolism Journal.2015; 39(3): 268. CrossRef
- Pancreatic fat accumulation is associated with decreased β‐cell function and deterioration in glucose tolerance in Korean adults
- The Insulin Resistance but Not the Insulin Secretion Parameters Have Changed in the Korean Population during the Last Decade
- Hae Kyung Yang, Jin Hee Lee, In-Young Choi, Hyuk Sang Kwon, Jeong Ah Shin, Seung Hee Jeong, Seung-Hwan Lee, Jae Hyoung Cho, Ho Young Son, Kun Ho Yoon
- Diabetes Metab J. 2015;39(2):117-125. Published online April 20, 2015
- DOI: https://doi.org/10.4093/dmj.2015.39.2.117
- 3,566 View
- 44 Download
- 8 Citations
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Abstract
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Background This study aimed to compare the patterns of insulin secretion and resistance between Korean subjects in the 1990s and 2000s.
Methods Insulin secretion and resistance indices were calculated from subjects who underwent 75-g oral glucose tolerance tests in the year 1997 to 1999 and 2007 to 2011 at the Seoul St. Mary's Hospital, Korea.
Results A total of 578 subjects from the 1990s (mean age, 48.5 years) and 504 subjects from the 2000s (mean age, 50.2 years) were enrolled. Compared with the subjects from the 1990s, those from the 2000s exhibited increased insulin resistance (increased homeostatic model assessment for insulin resistance), and reduced insulin sensitivity (reduced Matsuda index and quantitative insulin sensitivity check index), regardless of their glucose tolerance status. However, insulinogenic index did not reveal significant differences between the 2 decades in subjects with or without diabetes. A distinct relationship was confirmed between Matsuda index and total area under the curve (insulin/glucose) in each glucose tolerance group. The mean product of the Matsuda index and the total area under the curve (insulin/glucose) as well as the oral disposition index, was lower in subjects with normal glucose tolerance from the 2000s than in those from the 1990s.
Conclusion After rapid economic growth and changes in lifestyle patterns, insulin resistance has worsened across the glucose tolerance status; however, the insulin secretory function remained unchanged, which resulted in an increase in the susceptibility to the development of type 2 diabetes mellitus among Korean subjects without diabetes. We could not rule out the potential selection bias and therefore, further studies in general Korean population are needed.
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