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- Pathophysiology
- Insulin Resistance: From Mechanisms to Therapeutic Strategies
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Shin-Hae Lee, Shi-Young Park, Cheol Soo Choi
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Diabetes Metab J. 2022;46(1):15-37. Published online December 30, 2021
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DOI: https://doi.org/10.4093/dmj.2021.0280
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- Insulin resistance is the pivotal pathogenic component of many metabolic diseases, including type 2 diabetes mellitus, and is defined as a state of reduced responsiveness of insulin-targeting tissues to physiological levels of insulin. Although the underlying mechanism of insulin resistance is not fully understood, several credible theories have been proposed. In this review, we summarize the functions of insulin in glucose metabolism in typical metabolic tissues and describe the mechanisms proposed to underlie insulin resistance, that is, ectopic lipid accumulation in liver and skeletal muscle, endoplasmic reticulum stress, and inflammation. In addition, we suggest potential therapeutic strategies for addressing insulin resistance.
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Citations
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- Guideline/Fact Sheet
- 2023 Clinical Practice Guidelines for Diabetes Mellitus of the Korean Diabetes Association
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Jong Han Choi, Kyung Ae Lee, Joon Ho Moon, Suk Chon, Dae Jung Kim, Hyun Jin Kim, Nan Hee Kim, Ji A Seo, Mee Kyoung Kim, Jeong Hyun Lim, YoonJu Song, Ye Seul Yang, Jae Hyeon Kim, You-Bin Lee, Junghyun Noh, Kyu Yeon Hur, Jong Suk Park, Sang Youl Rhee, Hae Jin Kim, Hyun Min Kim, Jung Hae Ko, Nam Hoon Kim, Chong Hwa Kim, Jeeyun Ahn, Tae Jung Oh, Soo-Kyung Kim, Jaehyun Kim, Eugene Han, Sang-Man Jin, Won Suk Choi, Min Kyong Moon, Committee of Clinical Practice Guidelines, Korean Diabetes Association
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Diabetes Metab J. 2023;47(5):575-594. Published online September 26, 2023
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DOI: https://doi.org/10.4093/dmj.2023.0282
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- In May 2023, the Committee of Clinical Practice Guidelines of the Korean Diabetes Association published the revised clinical practice guidelines for Korean adults with diabetes and prediabetes. We incorporated the latest clinical research findings through a comprehensive systematic literature review and applied them in a manner suitable for the Korean population. These guidelines are designed for all healthcare providers nationwide, including physicians, diabetes experts, and certified diabetes educators who manage patients with diabetes or individuals at risk of developing diabetes. Based on recent changes in international guidelines and the results of a Korean epidemiological study, the recommended age for diabetes screening has been lowered. In collaboration with the relevant Korean medical societies, recently revised guidelines for managing hypertension and dyslipidemia in patients with diabetes have been incorporated into this guideline. An abridgment containing practical information on patient education and systematic management in the clinic was published separately.
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- Management of Dyslipidemia in Patients with Diabetes Mellitus
Kyung Ae Lee
The Journal of Korean Diabetes.2023; 24(3): 111. CrossRef - 2023 Clinical Practice Guidelines for Diabetes: Recommendations for Pharmacological Treatment of Type 2 Diabetes
Junghyun Noh
The Journal of Korean Diabetes.2023; 24(3): 127. CrossRef - 2023 Clinical Practice Guidelines for Diabetes
Min Kyong Moon
The Journal of Korean Diabetes.2023; 24(3): 120. CrossRef - 2023 Clinical Practice Guidelines for Diabetes: Management of Cardiovascular Risk Factors
Ye Seul Yang
The Journal of Korean Diabetes.2023; 24(3): 135. CrossRef
- Metabolic Risk/Epidemiology
- Gestational Diabetes Mellitus: Diagnostic Approaches and Maternal-Offspring Complications
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Joon Ho Moon, Hak Chul Jang
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Diabetes Metab J. 2022;46(1):3-14. Published online January 27, 2022
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DOI: https://doi.org/10.4093/dmj.2021.0335
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10,476
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- Gestational diabetes mellitus (GDM) is the most common complication during pregnancy and is defined as any degree of glucose intolerance with onset or first recognition during pregnancy. GDM is associated with adverse pregnancy outcomes and long-term offspring and maternal complications. For GDM screening and diagnosis, a two-step approach (1-hour 50 g glucose challenge test followed by 3-hour 100 g oral glucose tolerance test) has been widely used. After the Hyperglycemia and Adverse Pregnancy Outcome study implemented a 75 g oral glucose tolerance test in all pregnant women, a one-step approach was recommended as an option for the diagnosis of GDM after 2010. The one-step approach has more than doubled the incidence of GDM, but its clinical benefit in reducing adverse pregnancy outcomes remains controversial. Long-term complications of mothers with GDM include type 2 diabetes mellitus and cardiovascular disease, and complications of their offspring include childhood obesity and glucose intolerance. The diagnostic criteria of GDM should properly classify women at risk for adverse pregnancy outcomes and long-term complications. The present review summarizes the strengths and weaknesses of the one-step and two-step approaches for the diagnosis of GDM based on recent randomized controlled trials and observational studies. We also describe the long-term maternal and offspring complications of GDM.
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Special Editorial
Review
- Basic Research
- Adipose Tissue and Metabolic Health
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Sung-Min An, Seung-Hee Cho, John C. Yoon
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Diabetes Metab J. 2023;47(5):595-611. Published online July 24, 2023
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DOI: https://doi.org/10.4093/dmj.2023.0011
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- In this review, we provide a brief synopsis of the connections between adipose tissue and metabolic health and highlight some recent developments in understanding and exploiting adipocyte biology. Adipose tissue plays critical roles in the regulation of systemic glucose and lipid metabolism and secretes bioactive molecules possessing endocrine, paracrine, and autocrine functions. Dysfunctional adipose tissue has a detrimental impact on metabolic health and is intimately involved in key aspects of metabolic diseases such as insulin resistance, lipid overload, inflammation, and organelle stress. Differences in the distribution of fat depots and adipose characteristics relate to divergent degrees of metabolic dysfunction found in metabolically healthy and unhealthy obese individuals. Thermogenic adipocytes increase energy expenditure via mitochondrial uncoupling or adenosine triphosphate-consuming futile substrate cycles, while functioning as a metabolic sink and participating in crosstalk with other metabolic organs. Manipulation of adipose tissue provides a wealth of opportunities to intervene and combat the progression of associated metabolic diseases. We discuss current treatment modalities for obesity including incretin hormone analogs and touch upon emerging strategies with therapeutic potential including exosome-based therapy, pharmacological activation of brown and beige adipocyte thermogenesis, and administration or inhibition of adipocyte-derived factors.
Original Articles
- Type 1 Diabetes
- Identification of Key Genes and Pathways in Peripheral Blood Mononuclear Cells of Type 1 Diabetes Mellitus by Integrated Bioinformatics Analysis
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Xing Li, Mingyu Liao, Jiangheng Guan, Ling Zhou, Rufei Shen, Min Long, Jiaqing Shao
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Diabetes Metab J. 2022;46(3):451-463. Published online April 1, 2022
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DOI: https://doi.org/10.4093/dmj.2021.0018
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5,879
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- Background
The onset and progression of type 1 diabetes mellitus (T1DM) is closely related to autoimmunity. Effective monitoring of the immune system and developing targeted therapies are frontier fields in T1DM treatment. Currently, the most available tissue that reflects the immune system is peripheral blood mononuclear cells (PBMCs). Thus, the aim of this study was to identify key PBMC biomarkers of T1DM.
Methods
Common differentially expressed genes (DEGs) were screened from the Gene Expression Omnibus (GEO) datasets GSE9006, GSE72377, and GSE55098, and PBMC mRNA expression in T1DM patients was compared with that in healthy participants by GEO2R. Gene Ontology, Kyoto Encyclopedia of Genes and Genomes (KEGG) pathway and protein-protein interaction (PPI) network analyses of DEGs were performed using the Cytoscape, DAVID, and STRING databases. The vital hub genes were validated by reverse transcription-polymerase chain reaction using clinical samples. The disease-gene-drug interaction network was built using the Comparative Toxicogenomics Database (CTD) and Drug Gene Interaction Database (DGIdb).
Results
We found that various biological functions or pathways related to the immune system and glucose metabolism changed in PBMCs from T1DM patients. In the PPI network, the DEGs of module 1 were significantly enriched in processes including inflammatory and immune responses and in pathways of proteoglycans in cancer. Moreover, we focused on four vital hub genes, namely, chitinase-3-like protein 1 (CHI3L1), C-X-C motif chemokine ligand 1 (CXCL1), matrix metallopeptidase 9 (MMP9), and granzyme B (GZMB), and confirmed them in clinical PBMC samples. Furthermore, the disease-gene-drug interaction network revealed the potential of key genes as reference markers in T1DM.
Conclusion
These results provide new insight into T1DM pathogenesis and novel biomarkers that could be widely representative reference indicators or potential therapeutic targets for clinical applications.
-
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- Identification of Comorbidities, Genomic Associations, and Molecular Mechanisms for COVID-19 Using Bioinformatics Approaches
Shudeb Babu Sen Omit, Salma Akhter, Humayan Kabir Rana, A. R. M. Mahamudul Hasan Rana, Nitun Kumar Podder, Mahmudul Islam Rakib, Ashadun Nobi, Ali Imran
BioMed Research International.2023; 2023: 1. CrossRef - Advanced Delivery Strategies for Immunotherapy in Type I Diabetes Mellitus
Mingshu Huang, Weixing Chen, Min Wang, Yisheng Huang, Hongyu Liu, Yue Ming, Yuanxin Chen, Zhengming Tang, Bo Jia
BioDrugs.2023; 37(3): 331. CrossRef - Identification of the key genes of tuberculosis and construction of a diagnostic model via weighted gene co-expression network analysis
Baiying Li, Lifang Sun, Yaping Sun, Libo Zhen, Qi Qi, Ting Mo, Huijie Wang, Meihua Qiu, Qingshan Cai
Journal of Infection and Chemotherapy.2023; 29(11): 1046. CrossRef - Probing biological network in concurrent carcinomas and Type-2 diabetes for potential biomarker screening: An advanced computational paradigm
Abdullah Al Marzan, Shatila Shahi, Md Sakil Arman, Md Zafrul Hasan, Ajit Ghosh
Advances in Biomarker Sciences and Technology.2023; 5: 89. CrossRef - Transcriptional analysis of human peripheral blood mononuclear cells stimulated by Mycobacterium tuberculosis antigen
Jing Wei, Fangzheng Guo, Yamin Song, Kun Xu, Feiyang Lin, Kangsheng Li, Baiqing Li, Zhongqing Qian, Xiaojing Wang, Hongtao Wang, Tao Xu
Frontiers in Cellular and Infection Microbiology.2023;[Epub] CrossRef - Transcriptome analysis of peripheral blood mononuclear cells in patients with type 1 diabetes mellitus
Zhaoxiang Wang, Li Zhang, Fengyan Tang, Zhongming Yang, Mengzhu Wang, Jue Jia, Dong Wang, Ling Yang, Shao Zhong, Guoyue Yuan
Endocrine.2022; 78(2): 270. CrossRef
- Guideline/Fact Sheet
- Diabetes Fact Sheet in Korea 2021
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Jae Hyun Bae, Kyung-Do Han, Seung-Hyun Ko, Ye Seul Yang, Jong Han Choi, Kyung Mook Choi, Hyuk-Sang Kwon, Kyu Chang Won, on Behalf of the Committee of Media-Public Relation of the Korean Diabetes Association
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Diabetes Metab J. 2022;46(3):417-426. Published online May 25, 2022
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DOI: https://doi.org/10.4093/dmj.2022.0106
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10,695
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- Background
This study aimed to investigate the prevalence and management of diabetes mellitus, risk-factor control, and comorbidities among Korean adults.
Methods
We conducted a cross-sectional analysis of data from the Korea National Health and Nutrition Examination Survey to assess the prevalence, treatment, risk factors, comorbidities, and self-management behaviors of diabetes mellitus from 2019 to 2020. We also analyzed data from the Korean National Health Insurance Service to evaluate the use of antidiabetic medications in people with diabetes mellitus from 2002 through 2018.
Results
Among Korean adults aged 30 years or older, the estimated prevalence of diabetes mellitus was 16.7% in 2020. From 2019 through 2020, 65.8% of adults with diabetes mellitus were aware of the disease and treated with antidiabetic medications. The percentage of adults with diabetes mellitus who achieved glycosylated hemoglobin (HbA1c) <6.5% was 24.5% despite the increased use of new antidiabetic medications. We found that adults with diabetes mellitus who achieved all three goals of HbA1c <6.5%, blood pressure (BP) <140/85 mm Hg, and low-density lipoprotein cholesterol <100 mg/dL were 9.7%. The percentage of self-management behaviors was lower in men than women. Excess energy intake was observed in 16.7% of adults with diabetes mellitus.
Conclusion
The prevalence of diabetes mellitus among Korean adults remained high. Only 9.7% of adults with diabetes mellitus achieved all glycemic, BP, and lipid controls from 2019 to 2020. Continuous evaluation of national diabetes statistics and a national effort to increase awareness of diabetes mellitus and improve comprehensive diabetes care are needed.
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Mee Kyoung Kim, Kyungdo Han, Hyuk-Sang Kwon, Soon Jib Yoo
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Kyoung Hwa Ha, Kyung Ae Lee, Kyung-Do Han, Min Kyong Moon, Dae Jung Kim
The Korean Journal of Internal Medicine.2023; 38(1): 93. CrossRef - Sex differences in the impact of diabetes mellitus on tuberculosis recurrence: a retrospective national cohort study
Dararat Eksombatchai, Dawoon Jeong, Jeongha Mok, Doosoo Jeon, Hee-Yeon Kang, Hee Jin Kim, Hee-Sun Kim, Hongjo Choi, Young Ae Kang
International Journal of Infectious Diseases.2023; 127: 1. CrossRef - Response to Letter to the Editor From Han and Xu: “Association Between DPP4 Inhibitor Use and the Incidence of Cirrhosis, ESRD, and Some Cancers in Patients With Diabetes”
Dae Ho Lee
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Ye Seul Yang, Hack-Lyoung Kim, Sang-Hyun Kim, Min Kyong Moon
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Eun-Jung Rhee
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Gi Yeon Lee
The Journal of Korean Diabetes.2022; 23(3): 201. CrossRef - Recent Updates on Phytoconstituent Alpha-Glucosidase Inhibitors: An Approach towards the Treatment of Type Two Diabetes
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Reviews
- Others
- Links between Thyroid Disorders and Glucose Homeostasis
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Young Sil Eom, Jessica R. Wilson, Victor J. Bernet
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Diabetes Metab J. 2022;46(2):239-256. Published online March 24, 2022
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DOI: https://doi.org/10.4093/dmj.2022.0013
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- Thyroid disorders and diabetes mellitus often coexist and are closely related. Several studies have shown a higher prevalence of thyroid disorders in patients with diabetes mellitus and vice versa. Thyroid hormone affects glucose homeostasis by impacting pancreatic β-cell development and glucose metabolism through several organs such as the liver, gastrointestinal tract, pancreas, adipose tissue, skeletal muscles, and the central nervous system. The present review discusses the effect of thyroid hormone on glucose homeostasis. We also review the relationship between thyroid disease and diabetes mellitus: type 1, type 2, and gestational diabetes, as well as guidelines for screening thyroid function with each disorder. Finally, we provide an overview of the effects of antidiabetic drugs on thyroid hormone and thyroid disorders.
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Citations
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- Managing Adults With Hypoglycemia
Christopher James Watson, Jonathan A. Edlow
Annals of Emergency Medicine.2023; 82(6): 705. CrossRef - Relationship of Glucose, C-peptide, Leptin, and BDNF in Maternal and Umbilical Vein Blood in Type-1 Diabetes
Josip Delmis, Slavko Oreskovic, Vesna Elvedji Gasparovic, Mirta Starcevic, Mislav Herman, Nada Dessardo, Vito Starcevic, Marina Ivanisevic
Nutrients.2023; 15(3): 600. CrossRef - Isolated Maternal Hypothyroxinemia May be Associated with Insulin
Requirement in Gestational Diabetes Mellitus
Ömercan Topaloğlu, Mehmet Uzun, Seda Nur Topaloğlu, Ibrahim Sahin
Hormone and Metabolic Research.2023; 55(04): 245. CrossRef - Association of urinary iodine concentration with prediabetes/diabetes in adults: Analysis of the NHANES 2005–2016
Jingmin Chen, Huanzhu Liang, Yuxuan Tan, Lin Wen, Ziang Guo, Jiyu Nie, Xiaoxiao Lin, Feng Huang, Jie Wang, Puyi Xing, Lihong Nie, Lihong Wang, Chunxia Jing
Journal of Trace Elements in Medicine and Biology.2023; 77: 127144. CrossRef - Central sensitivity to thyroid hormones is reduced in youths with overweight or obesity and impaired glucose tolerance
Procolo Di Bonito, Domenico Corica, Maria Rosaria Licenziati, Anna Di Sessa, Emanuele Miraglia del Giudice, Maria Felicia Faienza, Valeria Calcaterra, Francesca Franco, Giulio Maltoni, Giuliana Valerio, Malgorzata Wasniewska
Frontiers in Endocrinology.2023;[Epub] CrossRef - Association of thyroid stimulating hormone and time in range with risk of diabetic retinopathy in euthyroid type 2 diabetes
Yaxin Wang, Jingyi Lu, Jiaying Ni, Ming Wang, Yun Shen, Wei Lu, Wei Zhu, Yuqian Bao, Jian Zhou
Diabetes/Metabolism Research and Reviews.2023;[Epub] CrossRef - The circadian rhythm: an influential soundtrack in the diabetes story
Amirali Hariri, Mina Mirian, Ali Zarrabi, Mohammad Kohandel, Maryam Amini-Pozveh, Amir Reza Aref, Aliye Tabatabaee, Pranav Kumar Prabhakar, Ponnurengam Malliappan Sivakumar
Frontiers in Endocrinology.2023;[Epub] CrossRef - Folate deficiency may increase the risk for elevated TSH in patients with type 2 diabetes mellitus
Lin Lin, Yushan Du, Guanyu Niu, Shuangbo Xia, Jufen Liu
BMC Endocrine Disorders.2023;[Epub] CrossRef - L- Thyroxine ameliorates renal function in thyroidectomized diabetic nephropathy rats through downregulation of TGF- β1, Ang II and ET-1 expression
Zeinab H. El-Said, Sherihan I. Gouda, Hebatallah A. Mahgoub, S El_desouky, Neven A. Ebrahim
Egyptian Journal of Basic and Applied Sciences.2023; 10(1): 632. CrossRef - Thyroid dysfunction in children and adolescents affected by undernourished and overnourished eating disorders
Valeria Calcaterra, Vittoria Carlotta Magenes, Francesca Siccardo, Chiara Hruby, Martina Basso, Veronica Conte, Giulia Maggioni, Valentina Fabiano, Susanna Russo, Pierangelo Veggiotti, Gianvincenzo Zuccotti
Frontiers in Nutrition.2023;[Epub] CrossRef - Preventive Effect of Molecular Iodine in Pancreatic Disorders from Hypothyroid Rabbits
Julia Rodríguez-Castelán, Evangelina Delgado-González, Esteban Rodríguez-Benítez, Francisco Castelán, Estela Cuevas-Romero, Brenda Anguiano, Michael C. Jeziorski, Carmen Aceves
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Recep Soslu, Abdullah Uysal, Meltem Devrilmez, İsmail Can Çuvalcıoğlu, Ali Ahmet Doğan, Sülbiye Karaburgu, Murat Taş
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Francesca Gorini, Cristina Vassalle
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Ping Zhu, Guojuan Lao, Chuping Chen, Lihui Luo, Jing Gu, Jianmin Ran
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Ho Yeop Lee, Byeong Chang Sim, Ha Thi Nga, Ji Sun Moon, Jingwen Tian, Nguyen Thi Linh, Sang Hyeon Ju, Dong Wook Choi, Daiki Setoyama, Hyon-Seung Yi
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- Guideline/Fact Sheet
- Effect of Carbohydrate-Restricted Diets and Intermittent Fasting on Obesity, Type 2 Diabetes Mellitus, and Hypertension Management: Consensus Statement of the Korean Society for the Study of Obesity, Korean Diabetes Association, and Korean Society of Hypertension
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Jong Han Choi, Yoon Jeong Cho, Hyun-Jin Kim, Seung-Hyun Ko, Suk Chon, Jee-Hyun Kang, Kyoung-Kon Kim, Eun Mi Kim, Hyun Jung Kim, Kee-Ho Song, Ga Eun Nam, Kwang Il Kim, Committee of Clinical Practice Guidelines, Korean Society for the Study of Obesity (KSSO), Committee of Clinical Practice Guidelines and Committee of Food and Nutrition, Korean Diabetes Association (KDA), Policy Committee of Korean Society of Hypertension (KSH), Policy Development Committee of National Academy of Medicine of Korea (NAMOK)
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Diabetes Metab J. 2022;46(3):355-376. Published online May 25, 2022
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DOI: https://doi.org/10.4093/dmj.2022.0038
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8,256
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532
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6
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- Carbohydrate-restricted diets and intermittent fasting (IF) have been rapidly gaining interest among the general population and patients with cardiometabolic disease, such as overweight or obesity, diabetes, and hypertension. However, there are limited expert recommendations for these dietary regimens. This study aimed to evaluate the level of scientific evidence on the benefits and harms of carbohydrate-restricted diets and IF to make responsible recommendations. A meta-analysis and systematic literature review of 66 articles on 50 randomized controlled trials (RCTs) of carbohydrate-restricted diets and 10 articles on eight RCTs of IF was performed. Based on the analysis, the following recommendations are suggested. In adults with overweight or obesity, a moderately-low carbohydrate or low carbohydrate diet (mLCD) can be considered as a dietary regimen for weight reduction. In adults with type 2 diabetes mellitus, mLCD can be considered as a dietary regimen for improving glycemic control and reducing body weight. In contrast, a very-low carbohydrate diet (VLCD) and IF are recommended against in patients with diabetes. Furthermore, no recommendations are suggested for VLCD and IF in adults with overweight or obesity, and carbohydrate-restricted diets and IF in patients with hypertension. Here, we describe the results of our analysis and the evidence for these recommendations.
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- Papel do Jejum Intermitente e da Dieta Restrita em Carboidratos na Prevenção de Doenças Cardiovasculares em Pacientes Pré-Diabéticos
Mohamed Khalfallah, Basma Elnagar, Shaimaa S. Soliman, Ahmad Eissa, Amany Allaithy
Arquivos Brasileiros de Cardiologia.2023;[Epub] CrossRef - Medical nutrition therapy for diabetes mellitus
Suk Chon
Journal of the Korean Medical Association.2023; 66(7): 421. CrossRef - Euglycemic diabetic ketoacidosis development in a patient with type 2 diabetes receiving a sodium-glucose cotransporter-2 inhibitor and a carbohydrate-restricted diet
Gwanpyo Koh, Jisun Bang, Soyeon Yoo, Sang Ah Lee
Journal of Medicine and Life Science.2023; 20(3): 126. CrossRef - Comprehensive Understanding for Application in Korean Patients with Type 2 Diabetes Mellitus of the Consensus Statement on Carbohydrate-Restricted Diets by Korean Diabetes Association, Korean Society for the Study of Obesity, and Korean Society of Hyperte
Jong Han Choi, Jee-Hyun Kang, Suk Chon
Diabetes & Metabolism Journal.2022; 46(3): 377. CrossRef - The Related Metabolic Diseases and Treatments of Obesity
Ming Yang, Shuai Liu, Chunye Zhang
Healthcare.2022; 10(9): 1616. CrossRef - Updated Meta-Analysis of Studies from 2011 to 2021 Comparing the Effectiveness of Intermittent Energy Restriction and Continuous Energy Restriction
Kyoung-Kon Kim, Jee-Hyun Kang, Eun Mi Kim
Journal of Obesity & Metabolic Syndrome.2022; 31(3): 230. CrossRef
- Lifestyle
- Type 2 Diabetes Mellitus and Sarcopenia as Comorbid Chronic Diseases in Older Adults: Established and Emerging Treatments and Therapies
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Jakub Mesinovic, Jackson J. Fyfe, Jason Talevski, Michael J. Wheeler, Gloria K.W. Leung, Elena S. George, Melkamu T. Hunegnaw, Costas Glavas, Paul Jansons, Robin M. Daly, David Scott
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Diabetes Metab J. 2023;47(6):719-742. Published online September 14, 2023
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DOI: https://doi.org/10.4093/dmj.2023.0112
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Abstract
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- Type 2 diabetes mellitus (T2DM) and sarcopenia (low skeletal muscle mass and function) share a bidirectional relationship. The prevalence of these diseases increases with age and they share common risk factors. Skeletal muscle fat infiltration, commonly referred to as myosteatosis, may be a major contributor to both T2DM and sarcopenia in older adults via independent effects on insulin resistance and muscle health. Many strategies to manage T2DM result in energy restriction and subsequent weight loss, and this can lead to significant declines in muscle mass in the absence of resistance exercise, which is also a first-line treatment for sarcopenia. In this review, we highlight recent evidence on established treatments and emerging therapies targeting weight loss and muscle mass and function improvements in older adults with, or at risk of, T2DM and/or sarcopenia. This includes dietary, physical activity and exercise interventions, new generation incretin-based agonists and myostatin-based antagonists, and endoscopic bariatric therapies. We also highlight how digital health technologies and health literacy interventions can increase uptake of, and adherence to, established and emerging treatments and therapies in older adults with T2DM and/or sarcopenia.
- Complications
- Pathophysiologic Mechanisms and Potential Biomarkers in Diabetic Kidney Disease
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Chan-Young Jung, Tae-Hyun Yoo
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Diabetes Metab J. 2022;46(2):181-197. Published online March 24, 2022
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DOI: https://doi.org/10.4093/dmj.2021.0329
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8,085
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- Although diabetic kidney disease (DKD) remains the leading cause of end-stage kidney disease eventually requiring chronic kidney replacement therapy, the prevalence of DKD has failed to decline over the past 30 years. In order to reduce disease prevalence, extensive research has been ongoing to improve prediction of DKD onset and progression. Although the most commonly used markers of DKD are albuminuria and estimated glomerular filtration rate, their limitations have encouraged researchers to search for novel biomarkers that could improve risk stratification. Considering that DKD is a complex disease process that involves several pathophysiologic mechanisms such as hyperglycemia induced inflammation, oxidative stress, tubular damage, eventually leading to kidney damage and fibrosis, many novel biomarkers that capture one specific mechanism of the disease have been developed. Moreover, the increasing use of high-throughput omic approaches to analyze biological samples that include proteomics, metabolomics, and transcriptomics has emerged as a strong tool in biomarker discovery. This review will first describe recent advances in the understanding of the pathophysiology of DKD, and second, describe the current clinical biomarkers for DKD, as well as the current status of multiple potential novel biomarkers with respect to protein biomarkers, proteomics, metabolomics, and transcriptomics.
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- Complications
- Dyslipidemia in Patients with Chronic Kidney Disease: An Updated Overview
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Sang Heon Suh, Soo Wan Kim
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Diabetes Metab J. 2023;47(5):612-629. Published online July 24, 2023
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DOI: https://doi.org/10.4093/dmj.2023.0067
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Abstract
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- Dyslipidemia is a potentially modifiable cardiovascular risk factor. Whereas the recommendations for the treatment target of dyslipidemia in the general population are being more and more rigorous, the 2013 Kidney Disease: Improving Global Outcomes clinical practice guideline for lipid management in chronic kidney disease (CKD) presented a relatively conservative approach with respect to the indication of lipid lowering therapy and therapeutic monitoring among the patients with CKD. This may be largely attributed to the lack of high-quality evidence derived from CKD population, among whom the overall feature of dyslipidemia is considerably distinctive to that of general population. In this review article, we cover the characteristic features of dyslipidemia and impact of dyslipidemia on cardiovascular outcomes in patients with CKD. We also review the current evidence on lipid lowering therapy to modify the risk of cardiovascular events in this population. We finally discuss the association between dyslipidemia and CKD progression and the potential strategy to delay the progression of CKD in relation to lipid lowering therapy.
- Complications
- Pharmacological and Nonpharmacological Treatments for Painful Diabetic Peripheral Neuropathy
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Han Na Jang, Tae Jung Oh
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Diabetes Metab J. 2023;47(6):743-756. Published online September 6, 2023
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DOI: https://doi.org/10.4093/dmj.2023.0018
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Abstract
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- Diabetic peripheral neuropathy (DPN) is one of the most prevalent chronic complications of diabetes. The lifetime prevalence of DPN is thought to be >50%, and 15%–25% of patients with diabetes experience neuropathic pain, referred to as “painful DPN.” Appropriate treatment of painful DPN is important because this pain contributes to a poor quality of life by causing sleep disturbance, anxiety, and depression. The basic principle for the management of painful DPN is to control hyperglycemia and other modifiable risk factors, but these may be insufficient for preventing or improving DPN. Because there is no promising diseasemodifying medication for DPN, the pain itself needs to be managed when treating painful DPN. Drugs for neuropathic pain, such as gabapentinoids, serotonin–norepinephrine reuptake inhibitors, tricyclic antidepressants, alpha-lipoic acid, sodium channel blockers, and topical capsaicin, are used for the management of painful DPN. The U.S. Food and Drug Administration (FDA) has approved pregabalin, duloxetine, tapentadol, and the 8% capsaicin patch as drugs for the treatment of painful DPN. Recently, spinal cord stimulation using electrical stimulation is approved by the FDA for the treatment for painful DPN. This review describes the currently available pharmacological and nonpharmacological treatments for painful DPN.
Original Article
- Guideline/Fact Sheet
- Dyslipidemia Fact Sheet in South Korea, 2022
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Eun-Sun Jin, Jee-Seon Shim, Sung Eun Kim, Jae Hyun Bae, Shinae Kang, Jong Chul Won, Min-Jeong Shin, Heung Yong Jin, Jenny Moon, Hokyou Lee, Hyeon Chang Kim, In-Kyung Jeong, on Behalf of the Committee of Public Relation of the Korean Society of Lipid and Atherosclerosis
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Diabetes Metab J. 2023;47(5):632-642. Published online August 2, 2023
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DOI: https://doi.org/10.4093/dmj.2023.0135
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- Background
This study aimed to investigate the prevalence and status of dyslipidemia management among South Korean adults, as performed by the Korean Society of Lipid and Atherosclerosis under the name Dyslipidemia Fact Sheet 2022.
Methods
We analyzed the lipid profiles, age-standardized and crude prevalence, management status of hypercholesterolemia and dyslipidemia, and health behaviors among Korean adults aged ≥20 years, using the Korea National Health and Nutrition Examination Survey data between 2007 and 2020.
Results
In South Korea, the crude prevalence of hypercholesterolemia (total cholesterol ≥240 mg/dL or use of a lipid-lowering drug) in 2020 was 24%, and the age-standardized prevalence of hypercholesterolemia more than doubled from 2007 to 2020. The crude treatment rate was 55.2%, and the control rate was 47.7%. The crude prevalence of dyslipidemia—more than one out of three conditions (low-density lipoprotein cholesterol ≥160 or the use of a lipid-lowering drug, triglycerides ≥200, or high-density lipoprotein cholesterol [HDL-C] [men and women] <40 mg/dL)—was 40.2% between 2016 and 2020. However, it increased to 48.2% when the definition of hypo-HDL-cholesterolemia in women changed from <40 to <50 mg/dL.
Conclusion
Although the prevalence of hypercholesterolemia and dyslipidemia has steadily increased in South Korea, the treatment rate remains low. Therefore, continuous efforts are needed to manage dyslipidemia through cooperation between the national healthcare system, patients, and healthcare providers.
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Citations
Citations to this article as recorded by

- Exploring Utilization and Establishing Reference Intervals for the Apolipoprotein B Test in the Korean Population
Rihwa Choi, Sang Gon Lee, Eun Hee Lee
Diagnostics.2023; 13(20): 3194. CrossRef
Review
- Drug/Regimen
- New, Novel Lipid-Lowering Agents for Reducing Cardiovascular Risk: Beyond Statins
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Kyuho Kim, Henry N. Ginsberg, Sung Hee Choi
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Diabetes Metab J. 2022;46(4):517-532. Published online July 27, 2022
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DOI: https://doi.org/10.4093/dmj.2022.0198
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Correction in: Diabetes Metab J 2022;46(5):817
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- Statins are the cornerstone of the prevention and treatment of atherosclerotic cardiovascular disease (ASCVD). However, even under optimal statin therapy, a significant residual ASCVD risk remains. Therefore, there has been an unmet clinical need for novel lipid-lowering agents that can target low-density lipoprotein cholesterol (LDL-C) and other atherogenic particles. During the past decade, several drugs have been developed for the treatment of dyslipidemia. Inclisiran, a small interfering RNA that targets proprotein convertase subtilisin/kexin type 9 (PCSK9), shows comparable effects to that of PCSK9 monoclonal antibodies. Bempedoic acid, an ATP citrate lyase inhibitor, is a valuable treatment option for the patients with statin intolerance. Pemafibrate, the first selective peroxisome proliferator-activated receptor alpha modulator, showed a favorable benefit-risk balance in phase 2 trial, but the large clinical phase 3 trial (PROMINENT) was recently stopped for futility based on a late interim analysis. High dose icosapent ethyl, a modified eicosapentaenoic acid preparation, shows cardiovascular benefits. Evinacumab, an angiopoietin-like 3 (ANGPTL3) monoclonal antibody, reduces plasma LDL-C levels in patients with refractory hypercholesterolemia. Novel antisense oligonucleotides targeting apolipoprotein C3 (apoC3), ANGPTL3, and lipoprotein(a) have significantly attenuated the levels of their target molecules with beneficial effects on associated dyslipidemias. Apolipoprotein A1 (apoA1) is considered as a potential treatment to exploit the athero-protective effects of high-density lipoprotein cholesterol (HDL-C), but solid clinical evidence is necessary. In this review, we discuss the mode of action and clinical outcomes of these novel lipid-lowering agents beyond statins.
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Citations
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