Diabetes & Metabolism Journal

Volume 33(1); February 2009

Reviews

Double Diabetes.: Sang Youl Rhee, Young Seol Kim; Korean Diabetes J. 2009;33(1):1-8. Published online February 1, 2009; DOI: https://doi.org/10.4093/kdj.2009.33.1.1

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Abstract PDF: Generally, most cases of diabetes mellitus (DM) are classified as either type 1 DM or type 2 DM based on their pathophysiolgic features. However, it is not always possible to classify this disease clearly according to current diagnostic criteria. Recently, the existence of non-typical diabetes has been found in patients with simultaneous features of both type 1 and type 2 DM. In these patients, obvious evidence of insulin resistance, positivity of islet autoantibody, and progressive beta cell loss are observed concurrently. Moreover, this non-typical diabetes that usually occurs among children and adolescents has been defined as 'double diabetes', and its worldwide incidence has been on the increase as of late. Thus, there has been heightened interest among researchers about this ambiguous condition.

Diabetic Cardiomyopathy.: Sung Ai Kim, Jong Won Ha; Korean Diabetes J. 2009;33(1):9-12. Published online February 1, 2009; DOI: https://doi.org/10.4093/kdj.2009.33.1.9

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Abstract PDF: Cardiovascular disease is the most common cause of death in patients with diabetes mellitus (DM). In particular, the focus of many studies has been on ischemic heart disease, as it is a eading cause of death in diabetic patients. However, independent of coronary artery disease, DM can also lead to cardiac structural and functional changes, supporting the presence of diabetic cardiomyopathy. The pathologic mechanismin the development of diabetic cardiomyopathy is multifactorial including metabolic disturbance, myocardial fibrosis, microvascular disease, and autonomic dysfunction. Functionally, diabetic patients have a higher prevalence of LV (left ventricle) diastolic dysfunction. Because most diabetic patients with early myocardial disease have a wide spectrum of diastolic dysfunction at rest, assessment of LV functional reserve during exercise is helpful for early identification of myocardial dysfunction. Recent research has demonstrated that LV diastolic functional reserve (DFR) assessed by diastolic stress echocardiography was significantly reduced in patients with DM, compared with a control group, suggesting DFR might be an early indicator of diabetic cardiomyopathy. Glycemic control might be the most important and basic therapeutic strategy for preventing the development of diabetic cardiomyopathy. However, more extensive studies are needed to garner further evidence of preventive and therapeutic strategies of diabetic cardiomyopathy.

Editorial

Anti-GAD Antibody in Patients with Adult-Onset Diabetes in Korea.: Eun Gyoung Hong; Korean Diabetes J. 2009;33(1):13-15. Published online February 1, 2009; DOI: https://doi.org/10.4093/kdj.2009.33.1.13

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Abstract PDF

No abstract available.

Citations

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Management of Adults with Type 1 Diabetes: Current Status and Suggestions
Sang-Man Jin, Jae Hyeon Kim
The Journal of Korean Diabetes.2014; 15(1): 1. CrossRef

Original Articles

Anti-GAD Antibody in Patients with Adult-Onset Diabetes in Korea.: Sang Ah Lee, Eui Young Kim, Eun Hee Kim, Ji Yun Jeong, Eun Heui Jeong, Dong Woo Kim, Eun Hee Cho, Eun Hee Koh, Min Seon Kim, Joong Yeol Park, Ki Up Lee; Korean Diabetes J. 2009;33(1):16-23. Published online February 1, 2009; DOI: https://doi.org/10.4093/kdj.2009.33.1.16

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Abstract PDF

BACKGROUND
It is well known that the clinical characteristics of diabetes mellitus in Korean people are different from those of Western people. The purpose of this study was to investigate the prevalence of the anti-GAD antibody (GADA) in a large number of Korean patients with adult-onset diabetes. METHODS: The GADA was measured by radioimmunoassay for 11,472 adult-onset diabetic patients who visited the Asan Medical Center from 1998 to 2007. According to the fasting C-peptide levels, we classified the patients into an insulin dependent diabetes mellitus group (IDDM; C-peptide < 0.6 ng/mL) and non-insulin dependent diabetes mellitus group (NIDDM; C-peptide > or = 1.0 ng/mL). Other clinical and laboratory data were obtained from medical records. RESULTS: Among the 11,147 diabetic patients, 9,250 patients were classified as NIDDM, 922 patients were classified as IDDM and 975 patients excluded. Within the latter group 472 patients were to absolute insulin deficient (C-peptide < 0.1 ng/mL). The prevalence of GADA was 22.0% in the IDDM group and 4.7% in the NIDDM group. GADA was more prevalent in younger-onset NIDDM patients (25~40 years of age; 12.4%) than in older-onset NIDDM patients (> or = 40 years of age; 3.8%). The GADA-positive NIDDM patients had lower C-peptide and BMI levels, and higher rates of typical diabetic symptoms and insulin treatment. CONCLUSION: The prevalence of GADA in Korean patients with IDDM and NIDDM was lower than that reported in Western populations. It is thus suggested that autoimmunity is a rarer cause of diabetes in Korean people. However, since over 10% of younger-onset NIDDM patients were positive for GADA, routine GADA measurement in such patients is recommended.

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Distinct changes to pancreatic volume rather than pancreatic autoantibody positivity: insights into immune checkpoint inhibitors induced diabetes mellitus
Hung-Hui Wei, Ying-Chieh Lai, Gigin Lin, Cheng-Wei Lin, Ya-Chu Chang, John Wen-Cheng Chang, Miaw-Jene Liou, I-Wen Chen
Diabetology & Metabolic Syndrome.2024;[Epub] CrossRef
Recent information on test utilization and intraindividual change in anti-glutamic acid decarboxylase antibody in Korea: a retrospective study
Rihwa Choi, Wonseo Park, Gayoung Chun, Jiwon Lee, Sang Gon Lee, Eun Hee Lee
BMJ Open Diabetes Research & Care.2022; 10(3): e002739. CrossRef
The effect of glargine versus glimepiride on pancreatic β-cell function in patients with type 2 diabetes uncontrolled on metformin monotherapy: open-label, randomized, controlled study
Jun Sung Moon, Kyoung Soo Ha, Ji Sung Yoon, Hyoung Woo Lee, Hyun Chul Lee, Kyu Chang Won
Acta Diabetologica.2014; 51(2): 277. CrossRef
Successful treatment of latent autoimmune diabetes in adults with Traditional Chinese Medicine: a case report
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Journal of Traditional Chinese Medicine.2013; 33(6): 766. CrossRef
The prevalence and characteristics of latent autoimmune diabetes in adults (LADA) and its relation with chronic complications in a clinical department of a university hospital in Korea
Mi-Oh Roh, Chan-Hee Jung, Bo-Yeon Kim, Ji-Oh Mok, Chul-Hee Kim
Acta Diabetologica.2013; 50(2): 129. CrossRef
Prevalence and Clinical Characteristics of Recently Diagnosed Type 2 Diabetes Patients with Positive Anti-Glutamic Acid Decarboxylase Antibody
Yul Hwangbo, Jin Taek Kim, Eun Ky Kim, Ah Reum Khang, Tae Jung Oh, Hak Chul Jang, Kyong Soo Park, Seong Yeon Kim, Hong Kyu Lee, Young Min Cho
Diabetes & Metabolism Journal.2012; 36(2): 136. CrossRef
Body Composition Analysis in Newly Diagnosed Diabetic Adolescent Girls
Yong Hyuk Kim, Min Kyoung Song, Sochung Chung
Journal of Korean Society of Pediatric Endocrinology.2011; 16(3): 172. CrossRef
Increasing Trend in the Number of Severe Hypoglycemia Patients in Korea
Jin Taek Kim, Tae Jung Oh, Ye An Lee, Jun Ho Bae, Hyo Jeong Kim, Hye Seung Jung, Young Min Cho, Kyong Soo Park, Soo Lim, Hak Chul Jang, Hong Kyu Lee
Diabetes & Metabolism Journal.2011; 35(2): 166. CrossRef
Progression to insulin deficiency in Korean patients with Type 2 diabetes mellitus positive for anti‐GAD antibody
S. A. Lee, W. J. Lee, E. H. Kim, J. H. Yu, C. H. Jung, E. H. Koh, M.‐S. Kim, J.‐Y. Park, K.‐U. Lee
Diabetic Medicine.2011; 28(3): 319. CrossRef
Anti-GAD Antibody in Patients with Adult-Onset Diabetes in Korea
Eun-Gyoung Hong
Korean Diabetes Journal.2009; 33(1): 13. CrossRef

An Association between 609 C --> T Polymorphism in NAD(P)H: Quinone Oxidoreductase 1 (NQO1) Gene and Blood Glucose Levels in Korean Population.: Dohee Kim; Korean Diabetes J. 2009;33(1):24-30. Published online February 1, 2009; DOI: https://doi.org/10.4093/kdj.2009.33.1.24

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Abstract PDF

BACKGROUND
NAD(P)H: quinone oxidoreductase 1 (NQO1), which is an obligate two-electron reductase that utilizes NAD(P)H as an electron donor and is involved in the protection against oxidative stress, is likely involved in beta-cell destruction. We evaluated the frequency of the NQO1 polymorphism and its association with blood glucose levels. METHODS: Genotypes were determined using a polymerase chain reaction restriction fragment length polymorphism-based assay in 56 patients and 48 healthy subjects. Fasting blood glucose, insulin, and lipid profiles were measured and homeostasis model assessment (HOMA)-insulin resistance (IR) was calculated from fasting glucose and insulin levels in the healthy subjects. RESULTS: The genotype frequencies of NQO1 polymorphism were C/C (56.7%), C/T (42.3%), and T/T (1.0%). There were no associations between the NQO1 polymorphism and body mass index, blood pressure, lipid profile, HbA1c, postprandial glucose, and HOMA-IR. However, NQO1 mutants (C/T and T/T) showed weak but significantly higher fasting blood glucose levels compared with wild type (C/C). CONCLUSION: Our data suggest that NQO1 609 C --> T polymorphism may be associated with glucose metabolism.

Citations

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Association of Nuclear Factor-Erythroid 2-Related Factor 2, Thioredoxin Interacting Protein, and Heme Oxygenase-1 Gene Polymorphisms with Diabetes and Obesity in Mexican Patients
Angélica Saraí Jiménez-Osorio, Susana González-Reyes, Wylly Ramsés García-Niño, Hortensia Moreno-Macías, Martha Eunice Rodríguez-Arellano, Gilberto Vargas-Alarcón, Joaquín Zúñiga, Rodrigo Barquera, José Pedraza-Chaverri
Oxidative Medicine and Cellular Longevity.2016; 2016: 1. CrossRef

Average Daily Risk Range-Index of Glycemic Variability-Related Factor in Type 2 Diabetic Inpatients.: Shin Ae Park, Seung Hyun Ko, Seung Hwan Lee, Jae Hyung Cho, Sung Dae Moon, Sang A Jang, Ki Ho Song, Hyun Shik Son, Kun Ho Yoon, Bong Yun Cha, Ho Young Son, Yu Bae Ahn; Korean Diabetes J. 2009;33(1):31-39. Published online February 1, 2009; DOI: https://doi.org/10.4093/kdj.2009.33.1.31

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Abstract PDF

BACKGROUND
It is known that chronic sustained hyperglycemia and its consequent oxidative stress causes diabetic complication in type 2 diabetes. It has been further proven that glycemic variability causes oxidative stress. The aim of this study is to measure the average daily risk range (ADDR)-index of glycemic variability, and to evaluate relevant variables. METHODS: We measured the blood glucose level of type 2 diabetic patients who were treated with multiple daily injections from January to July, 2008. The blood glucose levels were checked four times a day for 14 days and were conversed according to the ADRR formula. The degree of glycemic variability was categorized into non-fluctuation and fluctuation groups. We collected patient data on age, sex, duration of diabetes, body mass index, HOMA(IR), HOMA(betacell) and HbA1c. RESULTS: A total of 97 patients were enrolled in this study. The mean age, duration of diabetes, HbA1c and mean ADRR were 57.6 +/- 13.4, 11.5 +/- 8.5 years, 10.7 +/- 2.5%, and 26.6 +/- 9.8, respectively. We classified 18.5% of the patients to the non-fluctuation group, and 81.5% to the fluctuation group. ADRR was significantly correlated with duration of diabetes, fasting and postprandial glucose, fructosamine, HbA1c and BMI and HOMAbetacell. In addition, this study confirmed that BMI, HOMAbetacell and HbA1c were ADRR-related independent variables. CONCLUSION: ADRR can be used as an index for blood glucose fluctuation in type 2 diabetic patients. Measuring ADRR in patients with low BMI and a long duration of diabetes is helpful to improve the effectiveness of their care.

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Relationships between Thigh and Waist Circumference, Hemoglobin Glycation Index, and Carotid Plaque in Patients with Type 2 Diabetes
Myung Ki Yoon, Jun Goo Kang, Seong Jin Lee, Sung-Hee Ihm, Kap Bum Huh, Chul Sik Kim
Endocrinology and Metabolism.2020; 35(2): 319. CrossRef
Reversal of Hypoglycemia Unawareness with a Single-donor, Marginal Dose Allogeneic Islet Transplantation in Korea: A Case Report
Hae Kyung Yang, Dong-Sik Ham, Heon-Seok Park, Marie Rhee, Young Hye You, Min Jung Kim, Ji-Won Kim, Seung-Hwan Lee, Tae Ho Hong, Byung Gil Choi, Jae Hyoung Cho, Kun-Ho Yoon
Journal of Korean Medical Science.2015; 30(7): 991. CrossRef

Prevalence of the Metabolic Syndrome in Type 2 Diabetic Patients.: Tae Ho Kim, Dae Jung Kim, Soo Lim, In Kyung Jeong, Hyun Shik Son, Choon Hee Chung, Gwanpyo Koh, Dae Ho Lee, Kyu Chang Won, Jeong Hyun Park, Tae Sun Park, Jihyun Ahn, Jaetaek Kim, Keun Gyu Park, Seung Hyun Ko, Yu Bae Ahn, Inkyu Lee; Korean Diabetes J. 2009;33(1):40-47. Published online February 1, 2009; DOI: https://doi.org/10.4093/kdj.2009.33.1.40

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Abstract PDF

BACKGROUND
The aim of this study was to analyze the prevalence of metabolic syndrome in Korean type 2 diabetic patients. METHODS: A total of 4,240 diabetic patients (male 2,033, female 2,207; mean age 58.7 +/- 11.3 years; DM duration 8.9 +/- 7.6 years) were selected from the data of endocrine clinics of 13 university hospitals in 2006. Metabolic syndrome was defined using the criteria of the American Heart Association/National Heart Lung and Blood Institute and the criteria of waist circumference from the Korean Society for the Study of Obesity. RESULTS: The prevalence of metabolic syndrome was 77.9% (76.7% of males, 78.9% of females). The average number of the components of metabolic syndrome was 2.4 +/- 1.1. Abdominal obesity was seen in 56.8% of the patients, hypertriglyceridemia in 42.0%, low HDL cholesterol in 65.1%, and high blood pressure in 74.9%. Abdominal obesity and high blood pressure were much more prevalent among females than males, and low HDL cholesterol was much more prevalent among males than females. The prevalence of metabolic syndrome was not different according to the duration of diabetes. Metabolic syndrome was strongly related with obesity (odds ratio, 6.3) and increased age (odds ratio in the over 70 group, 3.4). CONCLUSION: The prevalence of metabolic syndrome was 77.9% in Korean type 2 diabetic patients. Its prevalence was greater in obese patients and in those over 40 years of age.

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Ah Young Kang, Su Kyung Park, So Young Park, Hye Jeong Lee, Ying Han, Sa Ra Lee, Sung Hwan Suh, Duk Kyu Kim, Mi Kyoung Park
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A Nationwide Survey about the Current Status of Glycemic Control and Complications in Diabetic Patients in 2006: The Committee of the Korean Diabetes Association on the Epidemiology of Diabetes Mellitus.: Soo Lim, Dae Jung Kim, In Kyung Jeong, Hyun Shik Son, Choon Hee Chung, Gwanpyo Koh, Dae Ho Lee, Kyu Chang Won, Jeong Hyun Park, Tae Sun Park, Jihyun Ahn, Jaetaek Kim, Keun Gyu Park, Seung Hyun Ko, Yu Bae Ahn, Inkyu Lee; Korean Diabetes J. 2009;33(1):48-57. Published online February 1, 2009; DOI: https://doi.org/10.4093/kdj.2009.33.1.48

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Abstract PDF

BACKGROUND
The Committee of the Korean Diabetes Association on the Epidemiology of Diabetes Mellitus performed a nationwide survey about the current status of glycemic control and diabetic complications in 2006. METHODS: The current study included 5,652 diabetic patients recruited from the rosters of endocrinology clinics of 13 tertiary hospitals in Korea. Age, gender, height, weight, waist circumference and blood pressure were investigated by standard method. Fasting and postprandial 2 hour glucose, glycosylated hemoglobin (HbA1c), lipid profiles, fasting insulin and c-peptide levels were measured. Microvascular (microalbuminuria, retinopathy and neuropathy) and macrovascular (coronary artery disease [CAD], cerebrovascular disease [CVD] and peripheral artery disease [PAD]) complications were reviewed in their medical records. RESULTS: Mean age of total subjects was 58.7 (+/- 11.6) years and duration of diabetes was 8.8 (0~50) years. Mean fasting and postprandial 2 hour glucose levels were 145.9 +/- 55.0 and 208.0 +/- 84.4 mg/dL, respectively. Their mean HbA1c was 7.9 +/- 1.9%: the percentage of patients within target goal of glycemic control (< 7% of HbA1c) was 36.7%. In this study, 30.3%, 38.3% and 44.6% of patients was found to have microalbuminuria, retinopathy and nephropathy, respectively. Prevalence of CAD, CVD and PAD was 8.7%, 6.7% and 3.0%, respectively. Diabetic complications were closely related with age, duration of diabetes and glycemic control, and this relationship was stronger in microvascular complications than macrovascular ones. CONCLUSION: Only about one third of patients with diabetes was found to reach target glycemic control in tertiary hospitals of Korea. More tight control is needed to reduce deleterious complications of diabetes in Korea.

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Effects of 'Ubiquitous Healthcare' on the Ability of Self-Management in Elderly Diabetic Patients.: Sung Hoon Yu, Sun Hee Kim, So Yeon Kim, Sung Hee Choi, Soo Lim, Yoon Seok Chang, Hak Jong Lee, Young Joo Park, Hak Chul Jang; Korean Diabetes J. 2009;33(1):58-64. Published online February 1, 2009; DOI: https://doi.org/10.4093/kdj.2009.33.1.58

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Abstract PDF

BACKGROUND
The need for a new healthcare system is growing due to the paradigm shift from health supervision to health maintenance. Previously, we performed a pilot study that examined the effectiveness of a ubiquitous healthcare (U-healthcare) diabetes management program which consists of self-monitoring of blood glucose (SMBG) and mobile phone services for elderly patients with type 2 diabetes mellitus. In this study, we investigated the effect of a diabetes management program using U-healthcare based on the self-care skills of elderly patients with diabetes mellitus. METHODS: From July to October 2005, 17 patients were recruited and provided with a blood glucometer with the ZigBee module and a mobile phone. In addition, the patients' understanding of diabetes self-care skills was examined at the beginning and end of the study. At the end of the study, we determined the level of patient satisfaction regarding U-healthcare services. RESULTS: The patients' test scores on their understanding of diabetes mellitus improved from 57.2 +/- 20.7 to 72.7 +/- 13.4%. Specifically, patient knowledge of the basic principles for a proper diabetic diet (52.9% vs. 82.4%, P = 0.046), foods that influence blood sugar level (41.2% vs. 76.5%, P = 0.007) and the influence of beverage choice (41.2% vs. 64.7%, P = 0.007), all increased. In addition, a significant increase in knowledge of living standards regarding diabetes mellitus was observed (64.7% vs. 88.2%, P = 0.0032). CONCLUSION: We conclude that the U-healthcare incorporating SMBG could be promising, as it improves self-management skills of diabetes mellitus patients, as well as their understanding of the disease.

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Young-Soon Chung, Yongsuk Kim, Chang Hee Lee
Healthcare Informatics Research.2014; 20(4): 288. CrossRef
Ubiquitous Healthcare Service Has the Persistent Benefit on Glycemic Control and Body Weight in Older Adults With Diabetes
Seon Mee Kang, Min Joo Kim, Hwa Young Ahn, Ji Won Yoon, Min Kyong Moon, Hye Seung Jung, Sung Hee Choi, Soo Lim, Kyong Soo Park, Hak C. Jang
Diabetes Care.2012; 35(3): e19. CrossRef
Improved Glycemic Control Without Hypoglycemia in Elderly Diabetic Patients Using the Ubiquitous Healthcare Service, a New Medical Information System
Soo Lim, Seon Mee Kang, Hayley Shin, Hak Jong Lee, Ji Won Yoon, Sung Hoon Yu, So-Youn Kim, Soo Young Yoo, Hye Seung Jung, Kyong Soo Park, Jun Oh Ryu, Hak C. Jang
Diabetes Care.2011; 34(2): 308. CrossRef
A Survey on Ubiquitous Healthcare Service Demand among Diabetic Patients
Soo Lim, So-Youn Kim, Jung Im Kim, Min Kyung Kwon, Sei Jin Min, Soo Young Yoo, Seon Mee Kang, Hong Il Kim, Hye Seung Jung, Kyong Soo Park, Jun Oh Ryu, Hayley Shin, Hak Chul Jang
Diabetes & Metabolism Journal.2011; 35(1): 50. CrossRef

Cause-of-Death Trends for Diabetes Mellitus over 10 Years.: Su Kyung Park, Mi Kyoung Park, Ji Hye Suk, Mi Kyung Kim, Yong Ki Kim, In Ju Kim, Yang Ho Kang, Kwang Jae Lee, Hyun Seung Lee, Chang Won Lee, Bo Hyun Kim, Kyung Il Lee, Mi Kyoung Kim, Duk Kyu Kim; Korean Diabetes J. 2009;33(1):65-72. Published online February 1, 2009; DOI: https://doi.org/10.4093/kdj.2009.33.1.65

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Abstract PDF

BACKGROUND
Recently, diabetic mortality is lower than ever before, likely due to dramatic improvements in diabetes care. This study set to analyze changes in the cause of death in type 2 diabetes mellitus (T2DM) in the past 10 years. METHODS: All subjects were T2DM patients over the age of 30 whose death certificates were issued at six hospitals in the Busan metropolitan area from 2000 to 2004. The patients were excluded if they had been clinically diagnosed with significant tuberculosis, liver, thyroid, renal, connective tissue diseases and cancers, prior to T2DM diagnosis. We classified the cause of death into several groups by KCD-4. The results were compared with published data on the period from 1990 to 1994. RESULTS: The study comprised 680 patients, of which 374 (55.0%) were male. The average age of death was 66.3 +/- 10.7 years. The most common cause of death was cardiovascular disease (30.6%), followed by infectious disease (25.3%), cancer (21.9%), congestive heart failure (7.1%), renal disease (4.7%), liver disease (2.7%), and T2DM itself (1.9%). In the study from the earlier period, the most common cause of death was also cardiovascular disease (37.6%), followed by infectious disease (24.2%), T2DM (6.0%), liver disease (5.4%), cancer (4.7%), and renal disease (3.3%). CONCLUSION: Over both study periods, the first and second cause of death in T2DM were cardiovascular disease and infectious disease, respectively. However, death by cerebral infarction among cardiovascular disease patients was significantly lower in the latter period, while death by malignancy was markedly increased.

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Letter

Insulin Sensitivity and Insulin Secretion Determined by Homeostasis Model Assessment and Future Risk of Diabetes Mellitus in Korean Men (Korean Diabetes J 32(6):498-505, 2008).: Sang Yong Kim; Korean Diabetes J. 2009;33(1):73-74. Published online February 1, 2009; DOI: https://doi.org/10.4093/kdj.2009.33.1.73

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Abstract PDF

No abstract available.

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Insulin Sensitivity and Insulin Secretion Determined by Homeostasis Model Assessment and Future Risk of Diabetes Mellitus in Korean Men (Korean Diabetes J 32(6):498-505, 2008).: Eun Suk Choi, Eun Jung Rhee; Korean Diabetes J. 2009;33(1):75-76. Published online February 1, 2009; DOI: https://doi.org/10.4093/kdj.2009.33.1.75

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Abstract PDF: No abstract available.

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