Diabetes & Metabolism Journal

Most-read articles are from the articles published in 2024 during the last three month.

Review

Metabolic Risk/Epidemiology
Glucagon-Like Peptide-1: New Regulator in Lipid Metabolism: Tong Bu, Ziyan Sun, Yi Pan, Xia Deng, Guoyue Yuan; Diabetes Metab J. 2024;48(3):354-372. Published online April 1, 2024; DOI: https://doi.org/10.4093/dmj.2023.0277

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Glucagon-like peptide-1 (GLP-1) is a 30-amino acid peptide hormone that is mainly expressed in the intestine and hypothalamus. In recent years, basic and clinical studies have shown that GLP-1 is closely related to lipid metabolism, and it can participate in lipid metabolism by inhibiting fat synthesis, promoting fat differentiation, enhancing cholesterol metabolism, and promoting adipose browning. GLP-1 plays a key role in the occurrence and development of metabolic diseases such as obesity, nonalcoholic fatty liver disease, and atherosclerosis by regulating lipid metabolism. It is expected to become a new target for the treatment of metabolic disorders. The effects of GLP-1 and dual agonists on lipid metabolism also provide a more complete treatment plan for metabolic diseases. This article reviews the recent research progress of GLP-1 in lipid metabolism.

Citations

Citations to this article as recorded by

Incretin hormones: Revolutionizing the treatment landscape for kidney and liver diseases in type 2 diabetes and obesity
Jae Hyun Bae, Young Min Cho
Journal of Diabetes Investigation.2025; 16(2): 183. CrossRef
Lipoprotein(a) in atherosclerotic cardiovascular disease, type 2 diabetes, and liver disease
Kathryn L. Williams, Maya Augustine, Eru Sujakhu, Justine Magadia, Lindsay Crawford, Aimee Knott, Skyler Hamilton, Uzoma Obiaka
Progress in Pediatric Cardiology.2025; 76: 101775. CrossRef
The protective effects of liraglutide in reducing lipid droplets accumulation and myocardial fibrosis in diabetic cardiomyopathy
Chien-Yin Kuo, Sing-Hua Tsou, Edy Kornelius, Kuei-Chuan Chan, Kai-Wei Chang, Jung-Chi Li, Chien-Ning Huang, Chih-Li Lin
Cellular and Molecular Life Sciences.2025;[Epub] CrossRef
An oral liraglutide nanomicelle formulation conferring reduced insulin-resistance and long-term hypoglycemic and lipid metabolic benefits
Laxman Subedi, Arjun Dhwoj Bamjan, Susmita Phuyal, Jung-Hyun Shim, Seung-Sik Cho, Jong Bae Seo, Kwan-Young Chang, Youngro Byun, Seho Kweon, Jin Woo Park
Journal of Controlled Release.2025; 378: 637. CrossRef
Engineering a high‐throughput clone for industrial‐scale production of long‐acting GLP‐1 analogue with retained bio‐efficacy
Praveen Kumar Reddy J, Murali Tummuru, Kunka Mohanram Ramkumar
Biotechnology Progress.2025;[Epub] CrossRef
Role of molecular hydrogen in obesity treatment: modulation of GLP-1, irisin, and PGC-1α for improved metabolism
Nikola Todorović, Jovan Kuzmanovic, Dejan Javorac, Sergej M. Ostojic
Medical Gas Research.2025; 15(3): 442. CrossRef
Association between GLP-1 RAs and DPP-4 inhibitors with biliary disorders: pharmacovigilance analysis
Long He, Jinwei Li, Xiong Cheng, Li Luo, Yilan Huang
Frontiers in Pharmacology.2025;[Epub] CrossRef
Glucagon like peptide-1 receptor agonists as a promising therapeutic option of metabolic dysfunction associated steatotic liver disease and obesity: hitting two targets with one shot
Eda Kaya, Wing-Kin Syn, Paul Manka
Current Opinion in Gastroenterology.2025; 41(3): 104. CrossRef
2FA-Platform Generates Dual Fatty Acid-Conjugated GLP-1 Receptor Agonist TE-8105 with Enhanced Diabetes, Obesity, and NASH Efficacy Compared to Semaglutide
Mun-Teng Wong, Pei-Hsuan Lin, Wei-Chen Lin, Chi-Jiun Peng, Jon D. Wright, Hui-Ju Lee, Hsing-Mao Chu, Carmay Lim, Tse Wen Chang
Journal of Medicinal Chemistry.2025; 68(6): 6178. CrossRef
Perioperative Considerations of Novel Antidiabetic Agents in Heart Failure Patients Undergoing Cardiac Surgery
Ashley Wang, Savannah Bitzas, Dilsa Perez, Jonathon Schwartz, Saleem Zaidi, Jonathan Oster, Sergio D. Bergese
Life.2025; 15(3): 427. CrossRef
The Role of GLP-1RA Medications in Medical Weight Loss and the Positive Impacts on Lipid Management
Blair Suter, Allison Rhodes, Allison Bigeh, Timothy Frommeyer, Laxmi S. Mehta
Current Cardiovascular Risk Reports.2025;[Epub] CrossRef
The Role of Short-Chain Fatty Acids in Metabolic Dysfunction-Associated Steatotic Liver Disease and Other Metabolic Diseases
Eliane Münte, Phillipp Hartmann
Biomolecules.2025; 15(4): 469. CrossRef
Vertical sleeve gastrectomy and semaglutide have distinct effects on skeletal health and heart function in obese male mice
Caroline de Carvalho Picoli, Sergey Tsibulnikov, Mavy Ho, Victoria DeMambro, Tiange Feng, May Eltahir, Phuong T. Le, Carolyn Chlebek, Clifford J. Rosen, Sergey Ryzhov, Ziru Li
American Journal of Physiology-Endocrinology and Metabolism.2025; 328(4): E555. CrossRef
Pre-fertilization-origin preservation of brown fat-mediated energy expenditure in humans
Takeshi Yoneshiro, Mami Matsushita, Sayuri Fuse-Hamaoka, Miyuki Kuroiwa, Yuko Kurosawa, Yosuke Yamada, Makoto Arai, Yuchen Wei, Makoto Iida, Kenichi Kuma, Toshimitsu Kameya, Tomoya Harada, Yoshihiro Matsumura, Tsuyoshi Osawa, Yoshiko Aoki, Hisashi Nakamur
Nature Metabolism.2025; 7(4): 778. CrossRef
Comparing Efficacy of Chiglitazar, Pioglitazone, and Semaglutide in Type 2 Diabetes: A Retrospective Study
Wenxuan Li, Yangang Wang, Chuanfeng Liu, Yongzhuo Yu, Lili Xu, Bingzi Dong
Diabetes Therapy.2025; 16(5): 993. CrossRef
Liraglutide Attenuates FFA-Induced Retinal Pigment Epithelium Dysfunction via AMPK Activation and Lipid Homeostasis Regulation in ARPE-19 Cells
Sing-Hua Tsou, Kai-Shin Luo, Chien-Ning Huang, Edy Kornelius, I-Ting Cheng, Hui-Chih Hung, Yu-Chien Hung, Chih-Li Lin, Min-Yen Hsu
International Journal of Molecular Sciences.2025; 26(8): 3704. CrossRef
The effect of GLP-1 receptor agonists on cardiac remodeling in heart failure patients with preserved and reduced ejection fraction: a systematic review and meta-analysis
Hasan Fareed Siddiqui, Saad Ahmed Waqas, Ruqiat Masooma Batool, Hussain Salim, Abdul Mannan Khan Minhas, Syed Farhan Hasni, Amro Alsaid, Anna Sannino, Aasim M. Afzal, Muhammad Shahzeb Khan
Heart Failure Reviews.2025;[Epub] CrossRef
Diabetes and Osteoarthritis: Exploring the Interactions and Therapeutic Implications of Insulin, Metformin, and GLP-1-Based Interventions
Iryna Halabitska, Liliia Babinets, Valentyn Oksenych, Oleksandr Kamyshnyi
Biomedicines.2024; 12(8): 1630. CrossRef
The Effect of Tirzepatide on Body Composition in People with Overweight and Obesity: A Systematic Review of Randomized, Controlled Studies
Vincenzo Rochira, Carla Greco, Stefano Boni, Francesco Costantino, Leonardo Dalla Valentina, Eleonora Zanni, Leila Itani, Marwan El Ghoch
Diseases.2024; 12(9): 204. CrossRef
Glucagon-like peptide-1 receptor: mechanisms and advances in therapy
Zhikai Zheng, Yao Zong, Yiyang Ma, Yucheng Tian, Yidan Pang, Changqing Zhang, Junjie Gao
Signal Transduction and Targeted Therapy.2024;[Epub] CrossRef
Recent Advances and Therapeutic Benefits of Glucagon-Like Peptide-1 (GLP-1) Agonists in the Management of Type 2 Diabetes and Associated Metabolic Disorders
John O Olukorode, Dolapo A Orimoloye, Nwachukwu O Nwachukwu, Chidera N Onwuzo, Praise O Oloyede, Temiloluwa Fayemi, Oluwatobi S Odunaike, Petra S Ayobami-Ojo, Nwachi Divine, Demilade J Alo, Chukwurah U Alex
Cureus.2024;[Epub] CrossRef
Interactions between glucagon like peptide 1 (GLP-1) and estrogens regulates lipid metabolism
Jorge F.A. Model, Rafaella S. Normann, Éverton L. Vogt, Maiza Von Dentz, Marjoriane de Amaral, Rui Xu, Tsvetan Bachvaroff, Poli Mara Spritzer, J. Sook Chung, Anapaula S. Vinagre
Biochemical Pharmacology.2024; 230: 116623. CrossRef
Changes in 24-Hour Urine Chemistry in Patients with Nephrolithiasis during Weight Loss with Glucagon-Like Peptide 1–Based Therapies
Karen Feghali, Xilong Li, Naim M. Maalouf
Kidney360.2024; 5(11): 1706. CrossRef
Liuweizhiji Gegen-Sangshen beverage protects against alcoholic liver disease in mice through the gut microbiota mediated SCFAs/GPR43/GLP-1 pathway
Mingyun Tang, Long Zhao, Fuchun Huang, Tiangang Wang, Xu Wu, Shanshan Chen, Juan Fu, Chaoli Jiang, Shulin Wei, Xuseng Zeng, Xiaoling Zhang, Xin Zhou, Mei Wei, Zhi Li, Guohui Xiao
Frontiers in Nutrition.2024;[Epub] CrossRef
Spotlight on the Mechanism of Action of Semaglutide
Ilias Papakonstantinou, Konstantinos Tsioufis, Vasiliki Katsi
Current Issues in Molecular Biology.2024; 46(12): 14514. CrossRef

Original Article

Guideline/Fact Sheet
2023 Clinical Practice Guidelines for Diabetes Management in Korea: Full Version Recommendation of the Korean Diabetes Association: Jun Sung Moon, Shinae Kang, Jong Han Choi, Kyung Ae Lee, Joon Ho Moon, Suk Chon, Dae Jung Kim, Hyun Jin Kim, Ji A Seo, Mee Kyoung Kim, Jeong Hyun Lim, Yoon Ju Song, Ye Seul Yang, Jae Hyeon Kim, You-Bin Lee, Junghyun Noh, Kyu Yeon Hur, Jong Suk Park, Sang 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, Jaehyun Bae, Eonju Jeon, Ji Min Kim, Seon Mee Kang, Jung Hwan Park, Jae-Seung Yun, Bong-Soo Cha, Min Kyong Moon, Byung-Wan Lee; Diabetes Metab J. 2024;48(4):546-708. Published online July 26, 2024; DOI: https://doi.org/10.4093/dmj.2024.0249

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Citations

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Pharmacological management of diabetes in older adults
Junghyun Noh
Cardiovascular Prevention and Pharmacotherapy.2025; 7(1): 13. CrossRef
Effects of e-health literacy on health-related quality of life in young adults with type 2 diabetes: Parallel mediation of diabetes self-efficacy and self-care behaviors
Yura Jang, Youngran Yang
Applied Nursing Research.2025; 82: 151917. CrossRef
Prevalence, Incidence, and Metabolic Characteristics of Young Adults with Type 2 Diabetes Mellitus in South Korea (2010–2020)
Ji Yoon Kim, Jiyoon Lee, Joon Ho Moon, Se Eun Park, Seung-Hyun Ko, Sung Hee Choi, Nam Hoon Kim
Diabetes & Metabolism Journal.2025; 49(2): 172. CrossRef
Workplace‐based continuous glucose monitoring with structured education for pre‐diabetes and type 2 diabetes: A prospective community cohort study
Ji‐Hee Ko, Sun‐Joon Moon, Ramzi A. Ajjan, Mi Yeon Lee, Hae‐Jeong Lee, Boram Choi, JiYeon Park, Seung‐Eun Lee, Jae‐Hyeon Kang, Cheol‐Young Park
Diabetes, Obesity and Metabolism.2025;[Epub] CrossRef
Adherence to the nutritional recommendations according to diabetes status in Korean adults: a cross-sectional study
Jong Han Choi, Chen Lulu, Seon-Joo Park, Hae-Jeung Lee
BMC Public Health.2024;[Epub] CrossRef
당뇨병 치료의 진화: 관해를 향해가는 혁신적 약물치료와 첨단 관리기기의 결합
종한 최, 민경 문
Public Health Weekly Report.2024; 17(44): 1905. CrossRef
The Impact of the Dietary Inflammatory Index, Fasting Blood Glucose, and Smoking Status on the Incidence and Survival of Pancreatic Cancer: A Retrospective Case–Control Study and a Prospective Study
Ga Hyun Lee, Yeon Hee Kim, Sang Myung Woo, Woo Jin Lee, Sung-Sik Han, Sang-Jae Park, Sherry Price, Penias Tembo, James R. Hébert, Mi Kyung Kim
Nutrients.2024; 16(22): 3941. CrossRef
Enhancing Large Language Model Reliability: Minimizing Hallucinations with Dual Retrieval-Augmented Generation Based on the Latest Diabetes Guidelines
Jaedong Lee, Hyosoung Cha, Yul Hwangbo, Wonjoong Cheon
Journal of Personalized Medicine.2024; 14(12): 1131. CrossRef
High-Intensity Interval Training and Diabetes
Yunjung Cho, Eun Sook Kim
The Journal of Korean Diabetes.2024; 25(4): 224. CrossRef
SIGNIFICANCE OF URINARY AMINOPEPTIDASE N AND DIPEPTIDYL PEPTIDASE IV IN EARLY DIAGNOSIS OF KIDNEY DAMAGE IN CHILDREN WITH TYPE 1 DIABETES MELLITUS IN NORTH-EASTERN REGION OF UKRAINE
Iryna Vikhrova, Andrii Loboda, Igor Zmyslia
Eastern Ukrainian Medical Journal.2024; 12(4): 808. CrossRef

Review

Cardiovascular Risk/Epidemiology
Artificial Light at Night and Type 2 Diabetes Mellitus: Jong-Ha Baek, Yong Zhu, Chandra L. Jackson, Yong-Moon Mark Park; Diabetes Metab J. 2024;48(5):847-863. Published online September 1, 2024; DOI: https://doi.org/10.4093/dmj.2024.0237

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The widespread and pervasive use of artificial light at night (ALAN) in our modern 24-hour society has emerged as a substantial disruptor of natural circadian rhythms, potentially leading to a rise in unhealthy lifestyle-related behaviors (e.g., poor sleep; shift work). This phenomenon has been associated with an increased risk of type 2 diabetes mellitus (T2DM), which is a pressing global public health concern. However, to date, reviews summarizing associations between ALAN and T2DM have primarily focused on the limited characteristics of exposure (e.g., intensity) to ALAN. This literature review extends beyond prior reviews by consolidating recent studies from 2000 to 2024 regarding associations between both indoor and outdoor ALAN exposure and the incidence or prevalence of T2DM. We also described potential biological mechanisms through which ALAN modulates glucose metabolism. Furthermore, we outlined knowledge gaps and investigated how various ALAN characteristics beyond only light intensity (including light type, timing, duration, wavelength, and individual sensitivity) influence T2DM risk. Recognizing the detrimental impact of ALAN on sleep health and the behavioral correlates of physical activity and dietary patterns, we additionally summarized studies investigating the potential mediating role of each component in the relationship between ALAN and glucose metabolism. Lastly, we proposed implications of chronotherapies and chrononutrition for diabetes management in the context of ALAN exposure.

Citations

Citations to this article as recorded by

Impact of bedroom light exposure on glucose metabolic markers and the role of circadian-dependent meal timing: A population-based cross-sectional study
Qi Li, Yu-xiang Xu, Xiu-zhen Lu, Yu-ting Shen, Yu-hui Wan, Pu-yu Su, Fang-biao Tao, Xin Chen, Ying Sun
Ecotoxicology and Environmental Safety.2025; 290: 117589. CrossRef
The impact of environmental pollution on metabolic health and the risk of non-communicable chronic metabolic diseases in humans
Caterina Formichi, Sonia Caprio, Laura Nigi, Francesco Dotta
Nutrition, Metabolism and Cardiovascular Diseases.2025; 35(6): 103975. CrossRef
Synergistic effects of air pollution and artificial light at night on diabetes risk: A prospective cohort study
Desong Wen, Fei Lin, Chaowei Zhang, Ziyu Ge, Xiaohang Li, Zhenzhou Liu, Hanqing Zhao, Weimin Wang, Zhigang Chen, Guoan Zhao
Environmental Pollution.2025; : 126472. CrossRef
Circadian Deregulation: Back Facing the Sun Toward Metabolic Dysfunction-Associated Steatotic Liver Disease (MASLD) Development
Mariana Verdelho Machado
Nutrients.2024; 16(24): 4294. CrossRef

Original Articles

Lifestyle and Behavioral Interventions
Impact of Meal Frequency on Insulin Resistance in Middle-Aged and Older Adults: A Prospective Cohort Study: Ha-Eun Ryu, Jong Hee Lee, Byoungjin Park, Seok-Jae Heo, Yu-Jin Kwon; Diabetes Metab J. 2025;49(2):311-320. Published online November 13, 2024; DOI: https://doi.org/10.4093/dmj.2024.0407

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Abstract PDF Supplementary Material PubReader ePub: Background
Insulin resistance (IR) is central to metabolic disorders and significantly influenced by diet. Studies on meal frequency (MF) and metabolic indicators have shown mixed results. This study explores the link between MF and IR in middle-aged and older adults.
Methods
This prospective cohort study included 4,570 adults aged 40 to 69 years from the Korean Genome and Epidemiologic Study. MF were divided into two groups based on whether they consumed three or more, or fewer than three, meals daily. IR was evaluated using the homeostasis model assessment of insulin resistance (HOMA-IR); participants were classified as IR if their HOMA-IR value was ≥2.5. Multiple Cox proportional hazard regression analyses were conducted to examine the association between MF and the incidence of IR.
Results
After adjusting for all variables, individuals in the MF ≥3 group showed a reduced incidence of IR compared to those in the MF <3 group (hazard ratio, 0.880; 95% confidence interval, 0.782 to 0.990). Additionally, subgroup analyses by sex, diabetes mellitus (DM), and body mass index (BMI) showed that this association persisted only in men, individuals without DM, and those with a BMI <25.
Conclusion
Our findings indicate that a higher MF among middle-aged and older adults is associated with a reduced incidence of IR. However, this association was maintained only in men, individuals without DM, and those without obesity.

Guideline/Statement/Fact Sheet
Diabetes Fact Sheets in Korea 2024: Se Eun Park, Seung-Hyun Ko, Ji Yoon Kim, Kyuho Kim, Joon Ho Moon, Nam Hoon Kim, Kyung Do Han, Sung Hee Choi, Bong Soo Cha; Diabetes Metab J. 2025;49(1):24-33. Published online January 1, 2025; DOI: https://doi.org/10.4093/dmj.2024.0818; Correction in: Diabetes Metab J 2025;49(3):524

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Background
This study aimed to investigate the prevalence, management, and comorbidities of diabetes mellitus among Korean adults.
Methods
Data from the Korea National Health and Nutrition Examination Survey (2019–2022) were analyzed to assess the prevalence, treatment, risk factors, and comorbidities of diabetes. Comparisons between young and older adults with diabetes were emphasized.
Results
Among Korean adults aged ≥30 years, the prevalence of diabetes is 15.5% during 2021–2022. Of these, 74.7% were aware of their condition, 70.9% received antidiabetic treatment, and only 32.4% achieved glycosylated hemoglobin (HbA1c) <6.5%. Moreover, 15.9% met the integrated management targets, which included HbA1c <6.5%, blood pressure <140/85 mm Hg, and low-density lipoprotein cholesterol <100 mg/dL. In young adults aged 19 to 39 years, the prevalence of diabetes was 2.2%. Among them, 43.3% were aware of their condition, 34.6% received treatment, and 29.6% achieved HbA1c <6.5%. Obesity affected 87.1%, and 26.9% had both hypertension and hypercholesterolemia. Among adults aged ≥65 years, the prevalence of diabetes was 29.3%, with awareness, treatment, and control rates of 78.8%, 75.7%, and 31.2%, respectively. Integrated management targets (HbA1c <7.5%, hypertension, and lipids) were achieved by 40.1%.
Conclusion
Diabetes mellitus remains highly prevalent among Korean adults, with significant gaps in integrated glycemic, blood pressure, and lipid control. Older adults with diabetes show higher awareness and treatment rates but limited integrated management outcomes. Young adults with diabetes bear a significant burden of obesity and comorbidities, alongside low awareness and treatment rates. Therefore, early intervention programs, education, and strategies tailored to younger populations are urgently required.

Citations

Citations to this article as recorded by

Diabetes in Korean Adults: Prevalence, Management, and Comorbidities
Sung Hoon Yu
Diabetes & Metabolism Journal.2025; 49(1): 22. CrossRef
Effectiveness of adding glucagon-like peptide-1 receptor agonist on diabetes complications and mortality among basal insulin-treated people with type 2 diabetes: A real-world Korean study
Kyoung Hwa Ha, Won Kim, Dong Han Kim, Dae Jung Kim
Journal of Diabetes and its Complications.2025; 39(5): 108983. CrossRef
A Machine Learning-Based Prediction Model for Diabetic Kidney Disease in Korean Patients with Type 2 Diabetes Mellitus
Kyung Ae Lee, Jong Seung Kim, Yu Ji Kim, In Sun Goak, Heung Yong Jin, Seungyong Park, Hyejin Kang, Tae Sun Park
Journal of Clinical Medicine.2025; 14(6): 2065. CrossRef
Glucagon-Like Peptide-1 Receptor Agonists: What’s the Optimizing Policies for Obesity-Related Metabolic Diseases?
Tae Sun Park
Diabetes & Metabolism Journal.2025; 49(2): 169. CrossRef
Older Adults with Diabetes in Korea: Latest Clinical and Epidemiologic Trends
Kyuho Kim, Bongseong Kim, Kyuna Lee, Yu-Bae Ahn, Seung-Hyun Ko, Sung Hee Choi, Kyungdo Han, Jae-Seung Yun
Diabetes & Metabolism Journal.2025; 49(2): 183. CrossRef
How Do We Diagnose Diabetes in Primary Care?
Hyeong Jin Kim
The Journal of Korean Diabetes.2025; 26(1): 10. CrossRef
Prevention and Management of Prediabetes
Jae Min Lee
The Journal of Korean Diabetes.2025; 26(1): 18. CrossRef
Feasibility of a Structured Calorie-Restricted Dietary Intervention in Korean Adults with Early Type 2 Diabetes and Obesity: A Pilot Study
Su-Jeong Park, Mee Kyung Kim, Jinyoung Kim, Ji-Yeon Choi, YoonJu Song, Hyuk-Sang Kwon
Nutrients.2025; 17(9): 1530. CrossRef
Prevalence and Current Status of Cardiometabolic Risk Factors in Korean Adults Based on Fact Sheets 2024
Eun-Jung Rhee
Endocrinology and Metabolism.2025; 40(2): 174. CrossRef

Drug/Regimen
Efficacy and Safety of Metformin and Atorvastatin Combination Therapy vs. Monotherapy with Either Drug in Type 2 Diabetes Mellitus and Dyslipidemia Patients (ATOMIC): Double-Blinded Randomized Controlled Trial: Jie-Eun Lee, Seung Hee Yu, Sung Rae Kim, Kyu Jeung Ahn, Kee-Ho Song, In-Kyu Lee, Ho-Sang Shon, In Joo Kim, Soo Lim, Doo-Man Kim, Choon Hee Chung, Won-Young Lee, Soon Hee Lee, Dong Joon Kim, Sung-Rae Cho, Chang Hee Jung, Hyun Jeong Jeon, Seung-Hwan Lee, Keun-Young Park, Sang Youl Rhee, Sin Gon Kim, Seok O Park, Dae Jung Kim, Byung Joon Kim, Sang Ah Lee, Yong-Hyun Kim, Kyung-Soo Kim, Ji A Seo, Il Seong Nam-Goong, Chang Won Lee, Duk Kyu Kim, Sang Wook Kim, Chung Gu Cho, Jung Han Kim, Yeo-Joo Kim, Jae-Myung Yoo, Kyung Wan Min, Moon-Kyu Lee; Diabetes Metab J. 2024;48(4):730-739. Published online May 20, 2024; DOI: https://doi.org/10.4093/dmj.2023.0077

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Background
It is well known that a large number of patients with diabetes also have dyslipidemia, which significantly increases the risk of cardiovascular disease (CVD). This study aimed to evaluate the efficacy and safety of combination drugs consisting of metformin and atorvastatin, widely used as therapeutic agents for diabetes and dyslipidemia.
Methods
This randomized, double-blind, placebo-controlled, parallel-group and phase III multicenter study included adults with glycosylated hemoglobin (HbA1c) levels >7.0% and <10.0%, low-density lipoprotein cholesterol (LDL-C) >100 and <250 mg/dL. One hundred eighty-five eligible subjects were randomized to the combination group (metformin+atorvastatin), metformin group (metformin+atorvastatin placebo), and atorvastatin group (atorvastatin+metformin placebo). The primary efficacy endpoints were the percent changes in HbA1c and LDL-C levels from baseline at the end of the treatment.
Results
After 16 weeks of treatment compared to baseline, HbA1c showed a significant difference of 0.94% compared to the atorvastatin group in the combination group (0.35% vs. −0.58%, respectively; P<0.0001), whereas the proportion of patients with increased HbA1c was also 62% and 15%, respectively, showing a significant difference (P<0.001). The combination group also showed a significant decrease in LDL-C levels compared to the metformin group (−55.20% vs. −7.69%, P<0.001) without previously unknown adverse drug events.
Conclusion
The addition of atorvastatin to metformin improved HbA1c and LDL-C levels to a significant extent compared to metformin or atorvastatin alone in diabetes and dyslipidemia patients. This study also suggested metformin’s preventive effect on the glucose-elevating potential of atorvastatin in patients with type 2 diabetes mellitus and dyslipidemia, insufficiently controlled with exercise and diet. Metformin and atorvastatin combination might be an effective treatment in reducing the CVD risk in patients with both diabetes and dyslipidemia because of its lowering effect on LDL-C and glucose.

Citations

Citations to this article as recorded by

Real-world safety evaluation of atorvastatin: insights from the US FDA adverse event reporting system (FAERS)
Hongbing Wan, Xiuxiu Xu, Dasong Yi, Kexin Shuai
Expert Opinion on Drug Safety.2025; 24(3): 305. CrossRef
Exploration of metformin-based drug combination for mitigating diabetes-associated atherosclerotic diseases
Biao Qu, Zheng Li, Wei Hu
World Journal of Diabetes.2025;[Epub] CrossRef

Reviews

Lifestyle
Ultra-Processed Foods and the Impact on Cardiometabolic Health: The Role of Diet Quality: Xiaowen Wang, Qi Sun; Diabetes Metab J. 2024;48(6):1047-1055. Published online November 1, 2024; DOI: https://doi.org/10.4093/dmj.2024.0659

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The consumption of ultra-processed foods (UPFs) has surged globally, raising significant public health concerns due to their associations with a range of adverse health outcomes. This review aims to elucidate potential health impacts of UPF intake and underscore the importance of considering diet quality when interpreting study findings. UPF group, as classified by the Nova system based on the extent of industrial processing, contains numerous individual food items with a wide spectrum of nutrient profiles, as well as differential quality as reflected by their potential health effects. The quality of a given food may well misalign with the processing levels so that a UPF food can be nutritious and healthful whereas a non-UPF food can be of low quality and excess intake of which may lead to adverse health consequences. The current review argues that it is critical to focus on the nutritional content and quality of foods and their role within the overall dietary pattern rather than only the level of processing. Further research should dissect health effects of diet quality and food processing, investigate the health impacts of ingredients that render the UPF categorization, understand roles of metabolomics and the gut microbiome in mediating and modulating the health effects of food processing, and consider environmental sustainability in UPF studies. Emphasizing nutrient-dense healthful foods and dietary patterns shall remain the pivotal strategy for promoting overall health and preventing chronic diseases.

Citations

Citations to this article as recorded by

Social determinants of health and type 2 diabetes in Asia
Kyunghun Sung, Seung‐Hwan Lee
Journal of Diabetes Investigation.2025;[Epub] CrossRef

Others
Holistic and Personalized Strategies for Managing in Elderly Type 2 Diabetes Patients: Jae-Seung Yun, Kyuho Kim, Yu-Bae Ahn, Kyungdo Han, Seung-Hyun Ko; Diabetes Metab J. 2024;48(4):531-545. Published online July 26, 2024; DOI: https://doi.org/10.4093/dmj.2024.0310

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Due to increased life expectancy and lifestyle changes, the prevalence of diabetes among the elderly in Korea is continuously rising, as is the associated public health burden. Diabetes management in elderly patients is complicated by age-related physiological changes, sarcopenia characterized by loss of muscle mass and function, comorbidities, and varying levels of functional, cognitive, and mobility abilities that lead to frailty. Moreover, elderly patients with diabetes frequently face multiple chronic conditions that elevate their risk of cardiovascular diseases, cancer, and mortality; they are also prone to complications such as hyperglycemic hyperosmolar state, diabetic ketoacidosis, and severe hypoglycemia. This review examines the characteristics of and management approaches for diabetes in the elderly, and advocates for a comprehensive yet personalized strategy.

Citations

Citations to this article as recorded by

Diabetes Fact Sheets in Korea 2024
Se Eun Park, Seung-Hyun Ko, Ji Yoon Kim, Kyuho Kim, Joon Ho Moon, Nam Hoon Kim, Kyung Do Han, Sung Hee Choi, Bong Soo Cha
Diabetes & Metabolism Journal.2025; 49(1): 24. CrossRef
The effect of multidisciplinary team and experience-based co-design on the care of older adult patients with type 2 diabetes: A randomized controlled trial
Yujun Zhuang, Hongjiang Ye, Xiaoyan Yang, Lifang Zheng, Zhizhen Chen, Jianjia Jiang, Lunpan Mou, Pingping Li, Jiawei Qin, Yaduan Dai, Yanling Mao
Diabetes Research and Clinical Practice.2025; 221: 112028. CrossRef
Older Adults with Diabetes in Korea: Latest Clinical and Epidemiologic Trends
Kyuho Kim, Bongseong Kim, Kyuna Lee, Yu-Bae Ahn, Seung-Hyun Ko, Sung Hee Choi, Kyungdo Han, Jae-Seung Yun
Diabetes & Metabolism Journal.2025; 49(2): 183. CrossRef

Pathophysiology
Attention to Innate Circadian Rhythm and the Impact of Its Disruption on Diabetes: Da Young Lee, Inha Jung, So Young Park, Ji Hee Yu, Ji A Seo, Kyeong Jin Kim, Nam Hoon Kim, Hye Jin Yoo, Sin Gon Kim, Kyung Mook Choi, Sei Hyun Baik, Nan Hee Kim; Diabetes Metab J. 2024;48(1):37-52. Published online January 3, 2024; DOI: https://doi.org/10.4093/dmj.2023.0193

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Abstract PDF PubReader ePub: Novel strategies are required to reduce the risk of developing diabetes and/or clinical outcomes and complications of diabetes. In this regard, the role of the circadian system may be a potential candidate for the prevention of diabetes. We reviewed evidence from animal, clinical, and epidemiological studies linking the circadian system to various aspects of the pathophysiology and clinical outcomes of diabetes. The circadian clock governs genetic, metabolic, hormonal, and behavioral signals in anticipation of cyclic 24-hour events through interactions between a “central clock” in the suprachiasmatic nucleus and “peripheral clocks” in the whole body. Currently, circadian rhythmicity in humans can be subjectively or objectively assessed by measuring melatonin and glucocorticoid levels, core body temperature, peripheral blood, oral mucosa, hair follicles, rest-activity cycles, sleep diaries, and circadian chronotypes. In this review, we summarized various circadian misalignments, such as altered light-dark, sleep-wake, rest-activity, fasting-feeding, shift work, evening chronotype, and social jetlag, as well as mutations in clock genes that could contribute to the development of diabetes and poor glycemic status in patients with diabetes. Targeting critical components of the circadian system could deliver potential candidates for the treatment and prevention of type 2 diabetes mellitus in the future.

Others
T-Cell Senescence in Human Metabolic Diseases: Ha Thi Nga, Thi Linh Nguyen, Hyon-Seung Yi; Diabetes Metab J. 2024;48(5):864-881. Published online August 28, 2024; DOI: https://doi.org/10.4093/dmj.2024.0140

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Immunosenescence denotes a state of dysregulated immune cell function characterized by a confluence of factors, including arrested cell cycle, telomere shortening, markers of cellular stress, mitochondrial dysfunction, loss of proteostasis, epigenetic reprogramming, and secretion of proinflammatory mediators. This state primarily manifests during the aging process but can also be induced in various pathological conditions, encompassing chronic viral infections, autoimmune diseases, and metabolic disorders. Age-associated immune system alterations extend to innate and adaptive immune cells, with T-cells exhibiting heightened susceptibility to immunosenescence. In particular, senescent T-cells have been identified in the context of metabolic disorders such as obesity, diabetes, and cardiovascular diseases. Recent investigations suggest a direct link between T-cell senescence, inflammation, and insulin resistance. The perturbation of biological homeostasis by senescent T-cells appears intricately linked to the initiation and progression of metabolic diseases, particularly through inflammation-mediated insulin resistance. Consequently, senescent T-cells are emerging as a noteworthy therapeutic target. This review aims to elucidate the intricate relationship between metabolic diseases and T-cell senescence, providing insights into the potential roles of senescent T-cells in the pathogenesis of metabolic disorders. Through a comprehensive examination of current research findings, this review seeks to contribute to a deeper understanding of the complex interplay between immunosenescence and metabolic health.

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Current Research in Translational Medicine.2025; 73(3): 103510. CrossRef
The immune health assessment technique of the elderly population and its application and promotion in the prevention and treatment of common aged diseases
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Sulwon Lecture 2023

Metabolic Risk/Epidemiology
Insulin Resistance, Non-Alcoholic Fatty Liver Disease and Type 2 Diabetes Mellitus: Clinical and Experimental Perspective: Inha Jung, Dae-Jeong Koo, Won-Young Lee; Diabetes Metab J. 2024;48(3):327-339. Published online February 2, 2024; DOI: https://doi.org/10.4093/dmj.2023.0350

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Abstract PDF PubReader ePub

It has been generally accepted that insulin resistance (IR) and reduced insulin secretory capacity are the basic pathogenesis of type 2 diabetes mellitus (T2DM). In addition to genetic factors, the persistence of systemic inflammation caused by obesity and the associated threat of lipotoxicity increase the risk of T2DM. In particular, the main cause of IR is obesity and subjects with T2DM have a higher body mass index (BMI) than normal subjects according to recent studies. The prevalence of T2DM with IR has increased with increasing BMI during the past three decades. According to recent studies, homeostatic model assessment of IR was increased compared to that of the 1990s. Rising prevalence of obesity in Korea have contributed to the development of IR, non-alcoholic fatty liver disease and T2DM and cutting this vicious cycle is important. My colleagues and I have investigated this pathogenic mechanism on this theme through clinical and experimental studies over 20 years and herein, I would like to summarize some of our studies with deep gratitude for receiving the prestigious 2023 Sulwon Award.

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γ-Glutamylcysteine restores glucolipotoxicity-induced islet β-cell apoptosis and dysfunction via inhibiting endoplasmic reticulum stress
Jinyi Zhou, Yingying Shi, Lishuang Zhao, Rong Wang, Lan Luo, Zhimin Yin
Toxicology and Applied Pharmacology.2025; 495: 117206. CrossRef
Comparison of SPISE and METS-IR and Other Markers to Predict Insulin Resistance and Elevated Liver Transaminases in Children and Adolescents
Kyungchul Song, Eunju Lee, Hye Sun Lee, Hana Lee, Ji-Won Lee, Hyun Wook Chae, Yu-Jin Kwon
Diabetes & Metabolism Journal.2025; 49(2): 264. CrossRef
Unraveling the Mystery of Insulin Resistance: From Principle Mechanistic Insights and Consequences to Therapeutic Interventions
Mohammad Muzaffar Mir, Mohammed Jeelani, Muffarah Hamid Alharthi, Syeda Fatima Rizvi, Shahzada Khalid Sohail, Javed Iqbal Wani, Zia Ul Sabah, Waad Fuad BinAfif, Partha Nandi, Abdullah M. Alshahrani, Jaber Alfaifi, Adnan Jehangir, Rashid Mir
International Journal of Molecular Sciences.2025; 26(6): 2770. CrossRef
Investigating the Effects of Gossypetin on Liver Health in Diet-Induced Pre-Diabetic Male Sprague Dawley Rats
Karishma Naidoo, Andile Khathi
Molecules.2025; 30(8): 1834. CrossRef
Associations between cardiometabolic indices and the onset of metabolic dysfunction-associated steatotic liver disease as well as its progression to liver fibrosis: a cohort study
Ziping Song, Xinlei Miao, Shuang Liu, Manling Hu, Xiaoling Xie, Yuting Sun, Song Leng
Cardiovascular Diabetology.2025;[Epub] CrossRef
Hepatoprotective and Antiatherosclerotic Effects of Oleoylethanolamide-Based Dietary Supplement in Dietary-Induced Obesity in Mice
Darya Ivashkevich, Arina Ponomarenko, Igor Manzhulo, Anastasia Egoraeva, Inessa Dyuizen
Pathophysiology.2025; 32(2): 16. CrossRef
Extracellular Vesicle-Mediated Network in the Pathogenesis of Obesity, Diabetes, Steatotic Liver Disease, and Cardiovascular Disease
Joonyub Lee, Won Gun Choi, Marie Rhee, Seung-Hwan Lee
Diabetes & Metabolism Journal.2025; 49(3): 348. CrossRef
Association of cardiometabolic markers with hepatic steatosis and liver fibrosis in population without obesity and diabetes
Zhixing Fan, Chaojun Yang, Xiaojing Zhao, Jing Zhang
Scientific Reports.2025;[Epub] CrossRef
Strategy for treating MAFLD: Electroacupuncture alleviates hepatic steatosis and fibrosis by enhancing AMPK mediated glycolipid metabolism and autophagy in T2DM rats
Haoru Duan, Shanshan Song, Rui Li, Suqin Hu, Shuting Zhuang, Shaoyang liu, Xiaolu Li, Wei Gao
Diabetology & Metabolic Syndrome.2024;[Epub] CrossRef
Metabolic Dysfunction-Associated Steatotic Liver Disease in Type 2 Diabetes Mellitus: A Review and Position Statement of the Fatty Liver Research Group of the Korean Diabetes Association
Jaehyun Bae, Eugene Han, Hye Won Lee, Cheol-Young Park, Choon Hee Chung, Dae Ho Lee, Eun-Hee Cho, Eun-Jung Rhee, Ji Hee Yu, Ji Hyun Park, Ji-Cheol Bae, Jung Hwan Park, Kyung Mook Choi, Kyung-Soo Kim, Mi Hae Seo, Minyoung Lee, Nan-Hee Kim, So Hun Kim, Won-
Diabetes & Metabolism Journal.2024; 48(6): 1015. CrossRef

Brief Report

Complications
Diabetic Ketoacidosis as an Effect of Sodium-Glucose Cotransporter 2 Inhibitor: Real World Insights: Han-Sang Baek, Chaiho Jeong, Yeoree Yang, Joonyub Lee, Jeongmin Lee, Seung-Hwan Lee, Jae Hyoung Cho, Tae-Seo Sohn, Hyun-Shik Son, Kun-Ho Yoon, Eun Young Lee; Diabetes Metab J. 2024;48(6):1169-1175. Published online June 10, 2024; DOI: https://doi.org/10.4093/dmj.2024.0036

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One of the notable adverse effects of sodium-glucose cotransporter 2 (SGLT2) inhibitor is diabetic ketoacidosis (DKA) often characterized by euglycemia. In this retrospective review of patients with DKA from 2015 to 2023, 21 cases of SGLT2 inhibitorassociated DKA were identified. Twelve (57.1%) exhibited euglycemic DKA (euDKA) while nine (42.9%) had hyperglycemic DKA (hyDKA). More than 90% of these cases were patients with type 2 diabetes mellitus. Despite similar age, sex, body mass index, and diabetes duration, individuals with hyDKA showed poorer glycemic control and lower C-peptide levels compared with euDKA. Renal impairment and acidosis were worse in the hyDKA group, requiring hemodialysis in two patients. Approximately one-half of hyDKA patients had concurrent hyperosmolar hyperglycemic state. Common symptoms included nausea, vomiting, general weakness, and dyspnea. Seizure was the initial manifestation of DKA in two cases. Infection and volume depletion were major contributors, while carbohydrate restriction and inadequate insulin treatment also contributed to SGLT2 inhibitor-associated DKA. Despite their beneficial effects, clinicians should be vigilant for SGLT2 inhibitor risk associated with DKA.

Citations

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Dapagliflozin/Empagliflozin/Ertugliflozin

Reactions Weekly.2025; 2042(1): 142. CrossRef
Diabetes Mellitus at an Elderly Age
Andrej Zeyfang, Jürgen Wernecke, Anke Bahrmann
Experimental and Clinical Endocrinology & Diabetes.2025; 133(04): 168. CrossRef
SGLT2 Inhibitors and GLP-1 Receptor Agonists in Diabetic Kidney Disease: Evolving Evidence and Clinical Application
Jae Hyun Bae
Diabetes & Metabolism Journal.2025; 49(3): 386. CrossRef
Diabetes mellitus im Alter
Andrej Zeyfang, Jürgen Wernecke, Anke Bahrmann
Diabetologie und Stoffwechsel.2024; 19(S 02): S226. CrossRef

Original Article

Drug/Regimen
Pioglitazone as Add-on Therapy in Patients with Type 2 Diabetes Mellitus Inadequately Controlled with Dapagliflozin and Metformin: Double-Blind, Randomized, Placebo-Controlled Trial: Ji Hye Heo, Kyung Ah Han, Jun Hwa Hong, Hyun-Ae Seo, Eun-Gyoung Hong, Jae Myung Yu, Hye Seung Jung, Bong-Soo Cha; Diabetes Metab J. 2024;48(5):937-948. Published online February 2, 2024; DOI: https://doi.org/10.4093/dmj.2023.0314

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Background
This study assessed the efficacy and safety of triple therapy with pioglitazone 15 mg add-on versus placebo in patients with type 2 diabetes mellitus (T2DM) inadequately controlled with metformin and dapagliflozin.
Methods
In this multicenter, double-blind, randomized, phase 3 study, patients with T2DM with an inadequate response to treatment with metformin (≥1,000 mg/day) plus dapagliflozin (10 mg/day) were randomized to receive additional pioglitazone 15 mg/day (n=125) or placebo (n=125) for 24 weeks. The primary endpoint was the change in glycosylated hemoglobin (HbA1c) levels from baseline to week 24 (ClinicalTrials.gov identifier: NCT05101135).
Results
At week 24, the adjusted mean change from baseline in HbA1c level compared with placebo was significantly greater with pioglitazone treatment (–0.47%; 95% confidence interval, –0.61 to –0.33; P<0.0001). A greater proportion of patients achieved HbA1c <7% or <6.5% at week 24 with pioglitazone compared to placebo as add-on to 10 mg dapagliflozin and metformin (56.8% vs. 28% for HbA1c <7%, and 23.2% vs. 9.6% for HbA1c <6.5%; P<0.0001 for all). The addition of pioglitazone also significantly improved triglyceride, highdensity lipoprotein cholesterol levels, and homeostatic model assessment of insulin resistance levels, while placebo did not. The incidence of treatment-emergent adverse events was similar between the groups, and the incidence of fluid retention-related side effects by pioglitazone was low (1.5%).
Conclusion
Triple therapy with the addition of 15 mg/day of pioglitazone to dapagliflozin plus metformin was well tolerated and produced significant improvements in HbA1c in patients with T2DM inadequately controlled with dapagliflozin plus metformin.

Citations

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Ideal Combination of Oral Hypoglycemic Agents for Patients with Type 2 Diabetes Mellitus
Hye Soon Kim
Diabetes & Metabolism Journal.2024; 48(5): 882. CrossRef

Editorial

Ideal Combination of Oral Hypoglycemic Agents for Patients with Type 2 Diabetes Mellitus: Hye Soon Kim; Diabetes Metab J. 2024;48(5):882-884. Published online September 1, 2024; DOI: https://doi.org/10.4093/dmj.2024.0479

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Sulwon Lecture 2024

Basic and Translational Research
Overcoming β-Cell Dysfunction in Type 2 Diabetes Mellitus: CD36 Inhibition and Antioxidant System: Il Rae Park, Yong Geun Chung, Kyu Chang Won; Diabetes Metab J. 2025;49(1):1-12. Published online January 1, 2025; DOI: https://doi.org/10.4093/dmj.2024.0796

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Type 2 diabetes mellitus (T2DM) is marked by chronic hyperglycemia, gradually worsening β-cell failure, and insulin resistance. Glucotoxicity and oxidative stress cause β-cell failure by increasing reactive oxygen species (ROS) production, impairing insulin secretion, and disrupting transcription factors such as pancreatic and duodenal homeobox 1 (PDX-1) and musculoaponeurotic fibrosarcoma oncogene family A (MafA). Cluster determinant 36 (CD36), an essential glycoprotein responsible for fatty acid uptake, exacerbates oxidative stress and induces the apoptosis of β-cells under hyperglycemic conditions through pathways involving ceramide, thioredoxin-interacting protein (TXNIP), and Rac1-nicotinamide adenine dinucleotide phosphate oxidase (NOX)-mediated redoxosome formation. Targeting CD36 pathways has emerged as a promising therapeutic strategy. Oral hypoglycemic agents, such as metformin, teneligliptin, and pioglitazone, have shown protective effects on β-cells by enhancing antioxidant defenses. These agents reduce glucotoxicity via mechanisms such as suppressing CD36 expression and stabilizing mitochondrial function. Additionally, novel insights into the glutathione antioxidant system and its role in β-cell survival underscore its therapeutic potential. This review focuses on the key contribution of oxidative stress and CD36 to β-cell impairment, the therapeutic promise of antioxidants, and the need for further research to apply these findings in clinical practice. Promising strategies targeting these mechanisms may help preserve β-cell function and slow T2DM progression.

Citations

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Polygonatum sibiricum polysaccharides enhance pancreatic β-cell function in diabetic zebrafish by mitigating mitochondrial oxidative damage via the AMPK-SIRT1 pathway
Fan Lin, Wenjing Yu, Ping Li, Shuyao Tang, Yitong Ouyang, Liya Huang, Di Wu, Shaowu Cheng, Zhenyan Song
Frontiers in Nutrition.2025;[Epub] CrossRef

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