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Volume 38(2); April 2014
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Reviews
Dose Adjustment for Normal Eating: A Role for the Expert Patient?
Harold David McIntyre
Diabetes Metab J. 2014;38(2):87-91.   Published online April 18, 2014
DOI: https://doi.org/10.4093/dmj.2014.38.2.87
  • 3,132 View
  • 47 Download
  • 8 Web of Science
  • 5 Crossref
AbstractAbstract PDFPubReader   

The Dose Adjustment for Normal Eating (DAFNE) programme of intensive insulin therapy for type 1 diabetes provides a structured educational intervention to improve glycemic control, reduce hypoglycemia and improve quality of life. Enhancement of self-management skills is a key element of DAFNE and patients acquire detailed skills in insulin dose adjustment. Following DAFNE training, patients report improved confidence in their ability to manage their own insulin dosing, but generally still seek and require the assistance of health professionals when making substantial changes to their insulin regimens. Some DAFNE trained patients may be able to assist their peers in aspects of diabetes management within a group environment, but widespread introduction of the expert patient/peer educator role in the self-management of type 1 diabetes, in particular related to insulin dose management, would require formal and detailed evaluation, preferably in randomized controlled clinical trials, before being introduced into routine clinical practice.

Citations

Citations to this article as recorded by  
  • Factors Associated With Resilience During Long-Term Hemodialysis
    Pedro García-Martínez, Rafa Ballester-Arnal, Kavita Gandhi-Morar, María D. Temprado-Albalat, Eladio Collado-Boira, Carlos Saus-Ortega, Jesús Castro-Calvo
    Nursing Research.2023; 72(1): 58.     CrossRef
  • Association Between Management of Continuous Subcutaneous Basal Insulin Administration and HbA1C
    Harry Rubin-Falcone, Ian Fox, Emily Hirschfeld, Lynn Ang, Rodica Pop-Busui, Joyce M. Lee, Jenna Wiens
    Journal of Diabetes Science and Technology.2022; 16(5): 1120.     CrossRef
  • Perceived Stress in Relation to Quality of Life and Resilience in Patients with Advanced Chronic Kidney Disease Undergoing Hemodialysis
    Pedro García-Martínez, Rafael Ballester-Arnal, Kavita Gandhi-Morar, Jesús Castro-Calvo, Vicente Gea-Caballero, Raúl Juárez-Vela, Carlos Saus-Ortega, Raimunda Montejano-Lozoya, Eva María Sosa-Palanca, María del Rosario Gómez-Romero, Eladio Collado-Boira
    International Journal of Environmental Research and Public Health.2021; 18(2): 536.     CrossRef
  • Determinants of blood glucose control among people with Type 2 diabetes in a regional hospital in Ghana
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    Medical Journal of Australia.2015; 203(7): 290.     CrossRef
Altered Transendothelial Transport of Hormones as a Contributor to Diabetes
Nanyoung Yoon, Thanh Q. Dang, Helen Chasiotis, Scott P. Kelly, Gary Sweeney
Diabetes Metab J. 2014;38(2):92-99.   Published online April 18, 2014
DOI: https://doi.org/10.4093/dmj.2014.38.2.92
  • 4,209 View
  • 36 Download
  • 8 Web of Science
  • 8 Crossref
AbstractAbstract PDFPubReader   

The vascular endothelium is a dynamic structure responsible for the separation and regulated movement of biological material between circulation and interstitial fluid. Hormones and nutrients can move across the endothelium either via a transcellular or paracellular route. Transcellular endothelial transport is well understood and broadly acknowledged to play an important role in the normal and abnormal physiology of endothelial function. However, less is known about the role of the paracellular route. Although the concept of endothelial dysfunction in diabetes is now widely accepted, we suggest that alterations in paracellular transport should be studied in greater detail and incorporated into this model. In this review we provide an overview of endothelial paracellular permeability and discuss its potential importance in contributing to the development of diabetes and associated complications. Accordingly, we also contend that if better understood, altered endothelial paracellular permeability could be considered as a potential therapeutic target for diabetes.

Citations

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  • Use of 2-dimensional cell monolayers and 3-dimensional microvascular networks on microfluidic devices shows that iron increases transendothelial adiponectin flux via inducing ROS production
    Nanyoung Yoon, Seunggyu Kim, Hye Kyoung Sung, Thanh Q. Dang, Jessie S. Jeon, Gary Sweeney
    Biochimica et Biophysica Acta (BBA) - General Subjects.2021; 1865(2): 129796.     CrossRef
  • Adiponectin Synthesis, Secretion and Extravasation from Circulation to Interstitial Space
    Simone C. da Silva Rosa, Meilian Liu, Gary Sweeney
    Physiology.2021; 36(3): 134.     CrossRef
  • Tracking adiponectin biodistribution via fluorescence molecular tomography indicates increased vascular permeability after streptozotocin-induced diabetes
    Nanyoung Yoon, Keith Dadson, Thanh Dang, Teresa Chu, Nina Noskovicova, Boris Hinz, Adeline Raignault, Eric Thorin, Seunggyu Kim, Jessie S. Jeon, James Jonkman, Trevor D. McKee, Justin Grant, Jeffrey D. Peterson, Scott P. Kelly, Gary Sweeney
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  • Overview of the Components of Cardiac Metabolism
    Elizabeth A. Hausner, Susan A. Elmore, Xi Yang
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  • Emerging Roles of Vascular Endothelium in Metabolic Homeostasis
    Xinchun Pi, Liang Xie, Cam Patterson
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  • Transendothelial movement of adiponectin is restricted by glucocorticoids
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  • Insulin access to skeletal muscle is impaired during the early stages of diet‐induced obesity
    Josiane L. Broussard, Ana V.B. Castro, Malini Iyer, Rebecca L. Paszkiewicz, Isaac Asare Bediako, Lidia S. Szczepaniak, Edward W. Szczepaniak, Richard N. Bergman, Cathryn M. Kolka
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  • Temporal and Molecular Analyses of Cardiac Extracellular Matrix Remodeling following Pressure Overload in Adiponectin Deficient Mice
    Keith Dadson, Subat Turdi, Stellar Boo, Boris Hinz, Gary Sweeney, Nikolaos Frangogiannis
    PLOS ONE.2015; 10(4): e0121049.     CrossRef
The Role of Heat Shock Response in Insulin Resistance and Diabetes
Tatsuya Kondo, Hiroyuki Motoshima, Motoyuki Igata, Junji Kawashima, Takeshi Matsumura, Hirofumi Kai, Eiichi Araki
Diabetes Metab J. 2014;38(2):100-106.   Published online April 18, 2014
DOI: https://doi.org/10.4093/dmj.2014.38.2.100
  • 4,918 View
  • 32 Download
  • 7 Web of Science
  • 10 Crossref
AbstractAbstract PDFPubReader   

The expansion of life-style related diseases, such as metabolic syndrome (MS) and type 2 diabetes mellitus (T2DM), appears to be unstoppable. It is also difficult to cease their complications in spite of many antidiabetic medications or intervention of public administration. We and our collaborators found that physical medicine using simultaneous stimulation of heat with mild electric current activates heat shock response, thereby reducing visceral adiposity, insulin resistance, chronic inflammation and improving glucose homeostasis in mice models of T2DM, as well as in humans with MS or T2DM. This combination therapy exerts novel action on insulin signaling, β-cell protection and body compositions, and may provide a new therapeutic alternative in diabetic treatment strategy.

Citations

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  • DNAJB3/HSP-40 cochaperone improves insulin signaling and enhances glucose uptake in vitro through JNK repression
    Mohamed Abu-Farha, Preethi Cherian, Irina Al-Khairi, Ali Tiss, Abdelkrim Khadir, Sina Kavalakatt, Samia Warsame, Mohammed Dehbi, Kazem Behbehani, Jehad Abubaker
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  • Reduced nuclear protein 1 expression improves insulin sensitivity and protects against diet-induced glucose intolerance through up-regulation of heat shock protein 70
    H.C. Barbosa-Sampaio, R. Drynda, B. Liu, A.M. Rodriguez De Ledesma, C. Malicet, J.L. Iovanna, P.M. Jones, D.S. Muller, S.J. Persaud
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  • Mild Electrical Stimulation Increases Stress Resistance and Suppresses Fat Accumulation via Activation of LKB1-AMPK Signaling Pathway in C. elegans
    Shingo Matsuyama, Masataka Moriuchi, Mary Ann Suico, Shuichiro Yano, Saori Morino-Koga, Tsuyoshi Shuto, Kunitoshi Yamanaka, Tatsuya Kondo, Eiichi Araki, Hirofumi Kai, Deyu Fang
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Editorial
Internet-Based Mentoring Program for Patients with Type 1 Diabetes
Sun-Hye Ko, Seung-Hyun Ko
Diabetes Metab J. 2014;38(2):107-108.   Published online April 18, 2014
DOI: https://doi.org/10.4093/dmj.2014.38.2.107
  • 2,751 View
  • 33 Download
PDFPubReader   
Original Articles
Prevalence and Determinants of Diabetic Nephropathy in Korea: Korea National Health and Nutrition Examination Survey
Jae Hee Ahn, Ji Hee Yu, Seung-Hyun Ko, Hyuk-Sang Kwon, Dae Jung Kim, Jae Hyeon Kim, Chul Sik Kim, Kee-Ho Song, Jong Chul Won, Soo Lim, Sung Hee Choi, Kyungdo Han, Bong-Yun Cha, Nan Hee Kim
Diabetes Metab J. 2014;38(2):109-119.   Published online April 18, 2014
DOI: https://doi.org/10.4093/dmj.2014.38.2.109
  • 5,577 View
  • 102 Download
  • 58 Web of Science
  • 59 Crossref
AbstractAbstract PDFPubReader   
Background

Diabetic nephropathy is a leading cause of end stage renal disease and is associated with an increased risk of cardiovascular mortality. It manifests as albuminuria or impaired glomerular filtration rate (GFR), and the prevalence of diabetic nephropathy varies with ethnicity. The prevalence of diabetic nephropathy and its determinants in Korean adults have not previously been studied at the national level. This cross-sectional study was undertaken to ascertain the prevalence and determinants of albuminuria and chronic kidney disease (CKD) in Korean patients with diabetes.

Methods

The Korea National Health and Nutrition Examination Survey (KNHANES) V, conducted in 2011, was used to define albuminuria (n=4,652), and the dataset of KNHANES IV-V (2008-2011) was used to define CKD (n=21,521). Selected samples were weighted to represent the entire civilian population in Korea. Albuminuria was defined as a spot urine albumin/creatinine ratio >30 mg/g. CKD was defined as a GFR <60 mL/min/1.73 m2.

Results

Among subjects with diabetes, 26.7% had albuminuria, and 8.6% had CKD. Diabetes was associated with an approximate 2.5-fold increased risk of albuminuria, with virtually no difference between new-onset and previously diagnosed diabetes. Only systolic blood pressure was significantly associated with albuminuria, and old age, high serum triglyceride levels, and previous cardiovascular disease (CVD) were related with CKD in subjects with diabetes.

Conclusion

Korean subjects with diabetes had a higher prevalence of albuminuria and CKD than those without diabetes. Blood pressure was associated with albuminuria, and age, triglyceride level, and previous CVD were independent determinants of CKD in subjects with diabetes.

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    Mi-Kyung Kim
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The Appropriateness of the Length of Insulin Needles Based on Determination of Skin and Subcutaneous Fat Thickness in the Abdomen and Upper Arm in Patients with Type 2 Diabetes
Kang Hee Sim, Moon Sook Hwang, Sun Young Kim, Hye Mi Lee, Ji Yeun Chang, Moon Kyu Lee
Diabetes Metab J. 2014;38(2):120-133.   Published online April 18, 2014
DOI: https://doi.org/10.4093/dmj.2014.38.2.120
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AbstractAbstract PDFPubReader   
Background

Longer needle and complicated insulin injection technique such as injecting at a 45-degree angle and making skinfolds may decrease patient compliance to insulin injection therapy. In this light, shorter insulin needles have been recently developed. However, it is necessary to ascertain that such shorter needles are appropriate for Korean patients with diabetes as well.

Methods

First, the diverse demographic and diabetic features of 156 Korean adults with diabetes were collected by a questionnaire and a device unit of body fat measurement. The skin and subcutaneous fat thicknesses of each subject were measured by Ultrasound device with a 7- to 12-MHz probe. Data were analyzed using analysis of variance and multiple linear regression.

Results

The mean skin thickness was 2.29±0.37 mm in the abdomen and 2.00±0.34 mm in the upper arms, and the mean subcutaneous fat thickness was to 10.15±6.54 mm in the abdomen and 5.50±2.68 mm in the upper arms. Our analysis showed that the factors affecting the skin thickness of the abdomen and upper arms were gender and body mass index (BMI), whereas the factors influencing the subcutaneous fat thickness in the abdomen were gender and BMI, and the factors influencing the subcutaneous fat thickness in the upper arms were gender, BMI, and age. Insulin fluids may not appear to be intradermally injected into the abdomen and upper arms at any needle lengths. The risk of intramuscular injection is likely to increase with longer insulin needles and lower BMI.

Conclusion

It is recommended to fully inform the patients about the lengths of needles for insulin injections. As for the recommended needle length, the findings of this study indicate that needles as short as 4 mm are sufficient to deliver insulin for Korean patients with diabetes.

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A Randomized Controlled Trial of an Internet-Based Mentoring Program for Type 1 Diabetes Patients with Inadequate Glycemic Control
Sunghwan Suh, Cheol Jean, Mihyun Koo, Sun Young Lee, Min Ja Cho, Kang-Hee Sim, Sang-Man Jin, Ji Cheol Bae, Jae Hyeon Kim
Diabetes Metab J. 2014;38(2):134-142.   Published online April 18, 2014
DOI: https://doi.org/10.4093/dmj.2014.38.2.134
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AbstractAbstract PDFPubReader   
Background

To determine whether an internet-based mentoring program can improve glycemic control in subjects with type 1 diabetes mellitus (T1DM).

Methods

Subjects with T1DM on intensive insulin therapy and with hemoglobin A1c (HbA1c) ≥8.0% were randomized to mentored (glucometer transmission with feedback from mentors) or control (glucometer transmission without feedback) groups and were examined for 12 weeks. Five mentors were interviewed and selected, of which two were T1DM patients themselves and three were parents with at least one child diagnosed with T1DM since more than 5 years ago.

Results

A total of 57 T1DM adult subjects with a mean duration after being diagnosed with diabetes of 7.4 years were recruited from Samsung Medical Center. Unfortunately, the mentored group failed to show significant improvements in HbA1c levels or other outcomes, including the quality of life, after completion of the study. However, the mentored group monitored their blood glucose (1.41 vs. 0.30) and logged into our website (http://ubisens.co.kr/) more frequently (20.59 times vs. 5.07 times) than the control group.

Conclusion

A 12-week internet-based mentoring program for T1DM patients with inadequate glycemic control did not prove to be superior to the usual follow-up. However, the noted increase in the subjects' frequency of blood glucose monitoring may lead to clinical benefits.

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Association of Vaspin with Metabolic Syndrome: The Pivotal Role of Insulin Resistance
Alireza Esteghamati, Sina Noshad, Mostafa Mousavizadeh, Ali Zandieh, Manouchehr Nakhjavani
Diabetes Metab J. 2014;38(2):143-149.   Published online April 18, 2014
DOI: https://doi.org/10.4093/dmj.2014.38.2.143
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AbstractAbstract PDFPubReader   
Background

Previous studies evaluating the relationship between serum vaspin concentrations and metabolic syndrome (MetS) have yielded contrasting results. Additionally, contribution of general and abdominal obesity, chronic inflammation, and insulin resistance to this relationship remains unknown.

Methods

In a cross-sectional setting, we investigated the association between vaspin and MetS in 145 subjects ranging from normoglycemia to type 2 diabetes. Vaspin concentrations were measured using enzyme-linked immunosorbent assay.

Results

Women had 29% higher vaspin concentrations compared with men. Subjects with MetS (51% of all participants) had higher vaspin concentrations (P=0.019 in women and P<0.001 in men). In logistic regression, vaspin significantly predicted raised fasting plasma glucose (P<0.001), and raised triglycerides (P<0.001) after controlling for age in both sexes. Moreover, vaspin was the significant predictor for reduced high-density lipoprotein cholesterol and raised waist circumference in women and men, respectively. Considering MetS as a whole, vaspin predicted MetS even after adjustment for age, medications, diabetes, total cholesterol, and waist circumference in both sexes (odds ratio [OR], 3.88; 95% confidence interval [CI], 1.36 to 11.05; P=0.011 for women; OR, 3.16; 95% CI, 1.28 to 7.78; P=0.012 for men). However, this relationship rendered nonsignificant after introducing homeostasis model assessment of insulin resistance (HOMA-IR) in women (P=0.089) and high-sensitivity C-reactive protein (P=0.073) or HOMA-IR in men (P=0.095).

Conclusion

Vaspin is associated with some but not all components of MetS. Vaspin is a predictor of MetS as a single entity, independent of obesity. This relationship is largely ascribed to the effects of insulin resistance and chronic inflammation.

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Factors Associated for Mild Cognitive Impairment in Older Korean Adults with Type 2 Diabetes Mellitus
Yun Jeong Lee, Hye Mi Kang, Na Kyung Kim, Ju Yeon Yang, Jung Hyun Noh, Kyung Soo Ko, Byoung Doo Rhee, Dong-Jun Kim
Diabetes Metab J. 2014;38(2):150-157.   Published online April 18, 2014
DOI: https://doi.org/10.4093/dmj.2014.38.2.150
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AbstractAbstract PDFPubReader   
Background

The aim of this study was to identify factors associated with mild cognitive impairment (MCI) in older Korean adults with type 2 diabetes mellitus.

Methods

A total of 226 older (age ≥65 years) adults without a history of cerebrovascular disease or dementia participated in this study. Cognitive function was assessed with the Montreal Cognitive Assessment-Korean version (MoCA-K). A MoCA-K score <23 was defined as MCI.

Results

The prevalence of MCI was 32.7%. In a logistic regression analysis, age (≥74 years old vs. 65-68 years old; odds ratio [OR], 3.69; 95% confidence interval [CI], 1.55 to 8.82; P=0.003), educational background (college graduation vs. no school or elementary school graduation; OR, 0.16; 95% CI, 0.05 to 0.46; P=0.001), and systolic blood pressure (≥135 mm Hg vs. ≤120 mm Hg; OR, 3.25; 95% CI, 1.29 to 8.17; P=0.012) were associated with MCI.

Conclusion

More concentrated efforts focused on early detection and appropriate management of MCI may be required in older Korean adults with type 2 diabetes mellitus.

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Letter
Letter: Clinical Marker of Platelet Hyperreactivity in Diabetes Mellitus (Diabetes Metab J 2013;37:423-8)
Cengiz Beyan, Esin Beyan
Diabetes Metab J. 2014;38(2):158-159.   Published online April 18, 2014
DOI: https://doi.org/10.4093/dmj.2014.38.2.158
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Response
Response: Clinical Marker of Platelet Hyperreactivity in Diabetes Mellitus (Diabetes Metab J 2013;37:423-8)
Jin Hwa Kim, Hak Yeon Bae, Sang Yong Kim
Diabetes Metab J. 2014;38(2):160-161.   Published online April 18, 2014
DOI: https://doi.org/10.4093/dmj.2014.38.2.160
  • 3,310 View
  • 30 Download
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