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2023 Clinical Practice Guidelines for Diabetes Mellitus of the Korean Diabetes Association
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
Diabetes Metab J. 2023;47(5):575-594.   Published online September 26, 2023
DOI: https://doi.org/10.4093/dmj.2023.0282
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  • 7 Web of Science
  • 14 Crossref
AbstractAbstract PDFPubReader   ePub   
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.

Citations

Citations to this article as recorded by  
  • Mortality in metabolic dysfunction-associated steatotic liver disease: A nationwide population-based cohort study
    Eugene Han, Byung-Wan Lee, Eun Seok Kang, Bong-Soo Cha, Sang Hoon Ahn, Yong-ho Lee, Seung Up Kim
    Metabolism.2024; 152: 155789.     CrossRef
  • Letter by In-Kyung Jeong Regarding Article, Trends in Prevalence of Hypertriglyceridemia and Related Factors in Korean Adults: A Serial Cross-Sectional Study
    In-Kyung Jeong
    Journal of Lipid and Atherosclerosis.2024; 13(1): 80.     CrossRef
  • Association between cardiovascular disease risk and incident type 2 diabetes mellitus in individuals with prediabetes: A retrospective cohort study
    Myung Jin Kim, Yun Kyung Cho, Chang Hee Jung, Woo Je Lee
    Diabetes Research and Clinical Practice.2024; 208: 111125.     CrossRef
  • Korea Hypertension Fact Sheet 2023: analysis of nationwide population-based data with a particular focus on hypertension in special populations
    Hyeon Chang Kim, Hokyou Lee, Hyeok-Hee Lee, Dasom Son, Minsung Cho, Sojung Shin, Yeeun Seo, Eun-Jin kim, Song Vogue Ahn, Sun Ha Jee, Sungha Park, Hae-Young Lee, Min Ho Shin, Sang-Hyun Ihm, Seung Won Lee, Jong Ku Park, Il Suh, Tae-Yong Lee
    Clinical Hypertension.2024;[Epub]     CrossRef
  • Diabetes Duration, Cholesterol Levels, and Risk of Cardiovascular Diseases in Individuals With Type 2 Diabetes
    Mee Kyoung Kim, Kyu Na Lee, Kyungdo Han, Seung-Hwan Lee
    The Journal of Clinical Endocrinology & Metabolism.2024;[Epub]     CrossRef
  • Effect of Adding Apolipoprotein B Testing on the Prevalence of Dyslipidemia and Risk of Cardiovascular Disease in the Korean Adult Population
    Rihwa Choi, Sang Gon Lee, Eun Hee Lee
    Metabolites.2024; 14(3): 169.     CrossRef
  • A Self-powered and Supercapacitive Microneedle Continuous Glucose Monitoring System with a Wide Range of Glucose Detection Capabilities
    Hye-Jun Kil, Jang Hyeon Kim, Kanghae Lee, Tae-Uk Kang, Ju-Hyun Yoo, Yong-ho Lee, Jin-Woo Park
    Biosensors and Bioelectronics.2024; : 116297.     CrossRef
  • Cardiorenal outcomes and mortality after sodium‐glucose cotransporter‐2 inhibitor initiation in type 2 diabetes patients with percutaneous coronary intervention history
    Jin Hwa Kim, Young Sang Lyu, BongSeong Kim, Mee Kyung Kim, Sang Yong Kim, Ki‐Hyun Baek, Ki‐Ho Song, Kyungdo Han, Hyuk‐Sang Kwon
    Diabetes, Obesity and Metabolism.2024;[Epub]     CrossRef
  • 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
  • A 33-Year-Old Man Presented with Abdominal Pain and Vomiting Starting a Day Ago
    Jong Han Choi
    The Korean Journal of Medicine.2023; 98(6): 289.     CrossRef
  • Comorbidity Patterns and Management in Inpatients with Endocrine Diseases by Age Groups in South Korea: Nationwide Data
    Sung-Soo Kim, Hun-Sung Kim
    Journal of Personalized Medicine.2023; 14(1): 42.     CrossRef
Original Articles
Drug Regimen
Efficacy and Safety of Evogliptin Add-on Therapy to Dapagliflozin/Metformin Combinations in Patients with Poorly Controlled Type 2 Diabetes Mellitus: A 24-Week Multicenter Randomized Placebo-Controlled Parallel-Design Phase-3 Trial with a 28-Week Extension
Jun Sung Moon, Il Rae Park, Hae Jin Kim, Choon Hee Chung, Kyu Chang Won, Kyung Ah Han, Cheol-Young Park, Jong Chul Won, Dong Jun Kim, Gwan Pyo Koh, Eun Sook Kim, Jae Myung Yu, Eun-Gyoung Hong, Chang Beom Lee, Kun-Ho Yoon
Diabetes Metab J. 2023;47(6):808-817.   Published online September 26, 2023
DOI: https://doi.org/10.4093/dmj.2022.0387
  • 2,553 View
  • 279 Download
AbstractAbstract PDFSupplementary MaterialPubReader   ePub   
Background
This study investigates the long-term efficacy and safety of evogliptin add-on therapy in patients with inadequately controlled type 2 diabetes mellitus (T2DM) previously received dapagliflozin and metformin (DAPA/MET) combination.
Methods
In this multicenter randomized placebo-controlled phase 3 trial, patients with glycosylated hemoglobin (HbA1c) levels 7.0% to 10.5% (n=283) previously used DAPA 10 mg plus MET (≥1,000 mg) were randomly assigned to the evogliptin 5 mg once daily or placebo group (1:1). The primary endpoint was the difference in the HbA1c level from baseline at week 24, and exploratory endpoints included the efficacy and safety of evogliptin over 52 weeks (trial registration: ClinicalTrials.gov NCT04170998).
Results
Evogliptin add-on to DAPA/MET therapy was superior in HbA1c reduction compared to placebo at weeks 24 and 52 (least square [LS] mean difference, –0.65% and –0.55%; 95% confidence interval [CI], –0.79 to –0.51 and –0.71 to –0.39; P<0.0001). The proportion of patients achieving HbA1c <7% was higher in the triple combination group at week 52 (32.14% vs. 8.51% in placebo; odds ratio, 5.62; P<0.0001). Evogliptin significantly reduced the fasting glucose levels and mean daily glucose levels with improvement in homeostatic model assessment of β-cell function (LS mean difference, 9.04; 95% CI, 1.86 to 16.21; P=0.0138). Adverse events were similar between the groups, and no serious adverse drug reactions were reported in the evogliptin group.
Conclusion
Long-term triple combination with evogliptin added to DAPA/MET showed superior HbA1c reduction and glycemic control compared to placebo at 52 weeks and was well tolerated.
Cardiovascular Risk/Epidemiology
Cardiovascular Outcomes according to Comorbidities and Low-Density Lipoprotein Cholesterol in Korean People with Type 2 Diabetes Mellitus
Min Kyong Moon, Junghyun Noh, Eun-Jung Rhee, Sang Hyun Park, Hyeon Chang Kim, Byung Jin Kim, Hae Jin Kim, Seonghoon Choi, Jin Oh Na, Young Youl Hyun, Bum Joon Kim, Kyung-Do Han, In-Kyung Jeong, on Behalf of the Committee of Practice Guideline of Korean Lipid and Atheroscelerosis
Diabetes Metab J. 2023;47(1):45-58.   Published online January 26, 2023
DOI: https://doi.org/10.4093/dmj.2021.0344
  • 2,924 View
  • 258 Download
  • 4 Web of Science
  • 7 Crossref
AbstractAbstract PDFSupplementary MaterialPubReader   ePub   
Background
There are no clear data to support the cardiovascular (CV) risk categories and low-density lipoprotein cholesterol (LDL-C) treatment goals in Korean people with type 2 diabetes mellitus (T2DM). We evaluated the incidence of cardiovascular disease (CVD) according to comorbidities and suggested LDL-C treatment goals in Korean people with T2DM in nationwide cohort data.
Methods
Using the Korean National Health Insurance Service database, 248,002 people aged 30 to 90 years with T2DM who underwent routine health check-ups during 2009 were included. Subjects with previous CVD were excluded from the study. The primary outcome was incident CVD, defined as a composite of myocardial infarction and ischemic stroke during the follow-up period from 2009 to 2018.
Results
The mean age of the study participants was 59.6±10.9 years, and median follow-up period was 9.3 years. CVD incidence increased in the order of DM duration of 5 years or more (12.04/1,000 person-years), hypertension (HT) (12.27/1,000 personyears), three or more CV risk factors (14.10/1,000 person-years), and chronic kidney disease (18.28/1,000 person-years). The risk of incident CVD increased linearly from an LDL-C level of ≥70 mg/dL in most patients with T2DM. In T2DM patients without HT or with a DM duration of less than 5 years, the CVD incidence increased from LDL-C level of ≥100 mg/dL.
Conclusion
For primary prevention of CVD in Korean adults with T2DM, it can be helpful to lower LDL-C targets when there are chronic kidney disease, HT, a long duration of diabetes mellitus, or three or more CV risk factors.

Citations

Citations to this article as recorded by  
  • Lipid Management in Korean People with Type 2 Diabetes Mellitus: Korean Diabetes Association and Korean Society of Lipid and Atherosclerosis Consensus Statement
    Ye Seul Yang, Hack-Lyoung Kim, Sang-Hyun Kim, Min Kyong Moon
    Diabetes & Metabolism Journal.2023; 47(1): 1.     CrossRef
  • Optimal Low-Density Lipoprotein Cholesterol Level for Primary Prevention in Koreans with Type 2 Diabetes Mellitus
    Ji Yoon Kim, Nam Hoon Kim
    Diabetes & Metabolism Journal.2023; 47(1): 42.     CrossRef
  • Lipid Management in Korean People With Type 2 Diabetes Mellitus: Korean Diabetes Association and Korean Society of Lipid and Atherosclerosis Consensus Statement
    Ye Seul Yang, Hack-Lyoung Kim, Sang-Hyun Kim, Min Kyong Moon
    Journal of Lipid and Atherosclerosis.2023; 12(1): 12.     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
  • 2023 Clinical Practice Guidelines for Diabetes Mellitus of the Korean Diabetes Association
    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 J
    Diabetes & Metabolism Journal.2023; 47(5): 575.     CrossRef
  • Management of Dyslipidemia in Patients with Diabetes Mellitus
    Kyung Ae Lee
    The Journal of Korean Diabetes.2023; 24(3): 111.     CrossRef
  • Significant Gap Between Guidelines and Practice in the Management of LDL Cholesterol: Insight From the Survey of the Korean Society of Myocardial Infarction
    Sang Yeub Lee, Kyung Hoon Cho, Jang Hoon Lee, Young Joon Hong, Jin yong Hwang, Myung Ho Jeong, Weon Kim
    Journal of Korean Medical Science.2023;[Epub]     CrossRef
Cardiovascular Risk/Epidemiology
Association between Low-Density Lipoprotein Cholesterol Level and Cardiovascular Outcomes in Korean Adults: A Nationwide Cohort Study
Junghyun Noh, Min Kyong Moon, Eun-Jung Rhee, Sang Hyun Park, Hyeon Chang Kim, Byung Jin Kim, Hae Jin Kim, Seonghoon Choi, Jin Oh Na, Young Youl Hyun, Bum Joon Kim, Kyung-Do Han, In-Kyung Jeong, on Behalf of the Committee of Practice Guideline of Korean Lipid and Atheroscelerosis
Diabetes Metab J. 2023;47(1):59-71.   Published online January 26, 2023
DOI: https://doi.org/10.4093/dmj.2021.0320
  • 2,700 View
  • 224 Download
  • 1 Web of Science
  • 1 Crossref
AbstractAbstract PDFSupplementary MaterialPubReader   ePub   
Background
To validate the treatment target of low-density lipoprotein cholesterol (LDL-C) level according to the cardiovascular disease (CVD) risk which was recommended by Korean dyslipidemia guideline.
Methods
We used the Korean National Health Insurance Service database which included 3,958,048 people aged 20 to 89 years who underwent regular health screening. The primary outcome was incident CVD, defined as a composite of myocardial infarction and stroke during the follow-up period from 2009 to 2018.
Results
The risk of CVD increased from LDL-C level of 70 mg/dL in very high-risk and high-risk groups and from 130 mg/dL in moderate-risk and low-risk groups. Adjusted hazard ratios (HRs) of LDL-C ranges 70–99, 100–129, 130–159, 160–189, and ≥190 mg/dL were 1.20 (95% confidence interval [CI], 1.08–1.33), 1.27 (1.15–1.42), 1.39 (1.23–1.56), 1.69 (1.45–1.96), and 1.84 (1.49– 2.27) in very high-risk group, and 1.07 (1.02–1.13), 1.16 (1.10–1.21), 1.29 (1.22–1.36), 1.45 (1.36–1.55), and 1.73 (1.58–1.90) in high-risk group. Adjusted HRs (95% CI) of LDL-C ranges 130–159, 160–189, and ≥190 mg/dL were 1.15 (1.11–1.20), 1.28 (1.22– 1.34), and 1.45 (1.36–1.54) in moderate-risk group and 1.07 (1.02–1.13), 1.20 (1.13–1.26), and 1.47 (1.37–1.57) in low-risk group.
Conclusion
We confirmed the incidence of CVD was increased in higher LDL-C range. The risk of CVD increased from ≥70 mg/dL of LDL-C in very high-risk and high-risk groups, and from ≥130 mg/dL of LDL-C in moderate-risk and low-risk groups in Korean adults.

Citations

Citations to this article as recorded by  
  • Efficacy and Safety of a Single-Pill Triple Combination of Olmesartan, Amlodipine, and Rosuvastatin in Hypertensive Patients with Low-to-Moderate Cardiovascular Risk: A Multicenter, Randomized, Open-Label, Active-Control, Phase IV Clinical Trial
    Byung Jin Kim, Kwang Soo Cha, Wook Hyun Cho, Eung Ju Kim, Seung-Hyuk Choi, Moo Hyun Kim, Sang-Hyun Kim, Jun-Bean Park, Seong-Mi Park, Il Suk Sohn, Kyu Hyung Ryu, In-Ho Chae
    Journal of Cardiovascular Pharmacology and Therapeutics.2023;[Epub]     CrossRef
Drug/Regimen
Comparison of Efficacy of Glimepiride, Alogliptin, and Alogliptin-Pioglitazone as the Initial Periods of Therapy in Patients with Poorly Controlled Type 2 Diabetes Mellitus: An Open-Label, Multicenter, Randomized, Controlled Study
Hae Jin Kim, In Kyung Jeong, Kyu Yeon Hur, Soo-Kyung Kim, Jung Hyun Noh, Sung Wan Chun, Eun Seok Kang, Eun-Jung Rhee, Sung Hee Choi
Diabetes Metab J. 2022;46(5):689-700.   Published online March 17, 2022
DOI: https://doi.org/10.4093/dmj.2021.0183
  • 5,635 View
  • 377 Download
  • 2 Web of Science
  • 2 Crossref
AbstractAbstract PDFSupplementary MaterialPubReader   ePub   
Background
The choice of an optimal oral hypoglycemic agent in the initial treatment periods for type 2 diabetes mellitus (T2DM) patients remains difficult and deliberate. We compared the efficacy and safety of glimepiride (GLIM), alogliptin (ALO), and alogliptin-pioglitazone (ALO-PIO) in poorly controlled T2DM patients with drug-naïve or metformin failure.
Methods
In this three-arm, multicenter, open-label, randomized, controlled trial, poorly controlled T2DM patients were randomized to receive GLIM (n=35), ALO (n=31), or ALO-PIO (n=33) therapy for 24 weeks. The primary endpoint was change in the mean glycosylated hemoglobin (HbA1c) levels at week 24 from baseline. Secondary endpoints were changes in HbA1c level at week 12 from baseline, fasting plasma glucose (FPG) levels, lipid profiles at weeks 12 and 24, and parameters of glycemic variability, assessed by continuous glucose monitoring for 24 weeks.
Results
At weeks 12 and 24, the ALO-PIO group showed significant reduction in HbA1c levels compared to the ALO group (–0.96%±0.17% vs. –0.37%±0.17% at week 12; –1.13%±0.19% vs. –0.18%±0.2% at week 24). The ALO-PIO therapy caused greater reduction in FPG levels and significant increase in high-density lipoprotein cholesterol levels at weeks 12 and 24 than the ALO therapy. Compared to low-dose GLIM therapy, ALO-PIO therapy showed greater improvement in glycemic variability. The adverse events were similar among the three arms.
Conclusion
ALO-PIO combination therapy during the early period exerts better glycemic control than ALO monotherapy and excellency in glycemic variability than low-dose sulfonylurea therapy in uncontrolled, drug-naïve or metformin failed T2DM patients.

Citations

Citations to this article as recorded by  
  • A Comprehensive Review on Weight Loss Associated with Anti-Diabetic Medications
    Fatma Haddad, Ghadeer Dokmak, Maryam Bader, Rafik Karaman
    Life.2023; 13(4): 1012.     CrossRef
  • Role of Dipeptidyl Peptidase 4 Inhibitors in Antidiabetic Treatment
    Ruili Yin, Yongsong Xu, Xin Wang, Longyan Yang, Dong Zhao
    Molecules.2022; 27(10): 3055.     CrossRef
Lifestyle
Body Fat Is Related to Sedentary Behavior and Light Physical Activity but Not to Moderate-Vigorous Physical Activity in Type 2 Diabetes Mellitus
Keun Hee An, Kyung Ah Han, Tae Seo Sohn, Ie Byung Park, Hae Jin Kim, Sung Dae Moon, Kyung Wan Min
Diabetes Metab J. 2020;44(2):316-325.   Published online November 12, 2019
DOI: https://doi.org/10.4093/dmj.2019.0029
  • 5,462 View
  • 138 Download
  • 9 Web of Science
  • 10 Crossref
AbstractAbstract PDFPubReader   
Background

Sedentary behavior (SB) has emerged as a new risk factor for cardiovascular accidents. We investigated whether physical activity levels or SB were related to percent body fat (%BF) in type 2 diabetes mellitus (T2DM).

Methods

In this cross sectional study, we measured the duration of SB, light physical activity (LPA), moderate to vigorous physical activity (MVPA), total energy expenditure, and step counts using a wireless activity tracker (Fitbit HR; FB) for 7 days in free-living conditions, along with %BF using a bio impedance analyzer (Inbody; Biospace) in 120 smartphone users with T2DM. Subjects were divided into exercise (Exe, n=68) and non-exercise (nonExe, n=52) groups based on self-reports of whether the recommended exercises (30 min/day, 3 days/week for 3 months) were performed. SBt, LPAt, MVPAt were transformed from SB, LPA, MVPA for normally distributed variables.

Results

Participants were: female, 59.2%; age, 59.3±8.4 years; body mass index, 25.5±3.4 kg/m2; glycosylated hemoglobin (HbA1c), 7.6%±1.2%; %BF, 30.4%±7.1%. They performed SB for 15.7±3.7 hr/day, LPA for 4.4±1.7 hr/day, and MVPA for 0.9±0.8 hr/day. The %BF was related to SBt and LPAt, but not to MVPA after adjustments for age, gender, and HbA1c. VPA was significantly higher in the Exe group than in the nonExe group, but SB, LPA, and moderate physical activity were not different. Predicted %BF was 89.494 to 0.105 (age), −13.047 (gender), −0.507 (HbA1c), −7.655 (LPAt) (F[4, 64]=62.929, P<0.001), with an R2 of 0.785 in multiple linear regression analysis.

Conclusion

Reduced body fat in elderly diabetic patients might be associated with reduced inactivity and increased LPA.

Citations

Citations to this article as recorded by  
  • Explanatory variables of objectively measured 24-h movement behaviors in people with prediabetes and type 2 diabetes: A systematic review
    Lotte Bogaert, Iris Willems, Patrick Calders, Eveline Dirinck, Manon Kinaupenne, Marga Decraene, Bruno Lapauw, Boyd Strumane, Margot Van Daele, Vera Verbestel, Marieke De Craemer
    Diabetes & Metabolic Syndrome: Clinical Research & Reviews.2024; 18(4): 102995.     CrossRef
  • Association between depression, anemia and physical activity using isotemporal substitution analysis
    Hee-kyoung Nam, Jungmi Park, Sung-il Cho
    BMC Public Health.2023;[Epub]     CrossRef
  • The Impact of Wearable Technologies in Health Research: Scoping Review
    Sophie Huhn, Miriam Axt, Hanns-Christian Gunga, Martina Anna Maggioni, Stephen Munga, David Obor, Ali Sié, Valentin Boudo, Aditi Bunker, Rainer Sauerborn, Till Bärnighausen, Sandra Barteit
    JMIR mHealth and uHealth.2022; 10(1): e34384.     CrossRef
  • The Correlation of Prediabetes and Type 2 Diabetes With Adiposity in Adults
    Juan Sun, Zhen Liu, Zimu Zhang, Ziyang Zeng, Weiming Kang
    Frontiers in Nutrition.2022;[Epub]     CrossRef
  • The Physical Activity Assessment of Adults With Type 2 Diabetes Using Accelerometer-Based Cut Points: Scoping Review
    Ioana A Moldovan, Alexa Bragg, Anna S Nidhiry, Barbara A De La Cruz, Suzanne E Mitchell
    Interactive Journal of Medical Research.2022; 11(2): e34433.     CrossRef
  • Effects of 4 Weeks of a Technique-Specific Protocol with High-Intensity Intervals on General and Specific Physical Fitness in Taekwondo Athletes: An Inter-Individual Analysis
    Alex Ojeda-Aravena, Tomás Herrera-Valenzuela, Pablo Valdés-Badilla, Jorge Cancino-López, José Zapata-Bastias, José Manuel García-García
    International Journal of Environmental Research and Public Health.2021; 18(7): 3643.     CrossRef
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    Alex Ojeda-Aravena, Tomás Herrera-Valenzuela, Pablo Valdés-Badilla, Jorge Cancino-López, José Zapata-Bastias, José Manuel García-García
    Frontiers in Physiology.2021;[Epub]     CrossRef
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    Chunyan Fan
    Revista Brasileira de Medicina do Esporte.2021; 27(7): 714.     CrossRef
  • Validation of the effectiveness of a digital integrated healthcare platform utilizing an AI-based dietary management solution and a real-time continuous glucose monitoring system for diabetes management: a randomized controlled trial
    Sung Woon Park, Gyuri Kim, You-Cheol Hwang, Woo Je Lee, Hyunjin Park, Jae Hyeon Kim
    BMC Medical Informatics and Decision Making.2020;[Epub]     CrossRef
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    Ju-Yeon Jung, Hwi-Young Cho, Chang-Ki Kang
    Ergonomics.2020; 63(11): 1359.     CrossRef
Clinical Complications
Hypoglycemia and Dementia Risk in Older Patients with Type 2 Diabetes Mellitus: A Propensity-Score Matched Analysis of a Population-Based Cohort Study
Young-Gun Kim, Dong Gyu Park, So Young Moon, Ja Young Jeon, Hae Jin Kim, Dae Jung Kim, Kwan-Woo Lee, Seung Jin Han
Diabetes Metab J. 2020;44(1):125-133.   Published online October 23, 2019
DOI: https://doi.org/10.4093/dmj.2018.0260
  • 6,425 View
  • 207 Download
  • 28 Web of Science
  • 28 Crossref
AbstractAbstract PDFPubReader   
Background

Type 2 diabetes mellitus (T2DM) is associated with an increased risk for dementia. The effects of hypoglycemia on dementia are controversial. Thus, we evaluated whether hypoglycemia increases the risk for dementia in senior patients with T2DM.

Methods

We used the Korean National Health Insurance Service Senior cohort, which includes >10% of the entire senior population of South Korea. In total, 5,966 patients who had ever experienced at least one episode of hypoglycemia were matched with those who had not, using propensity score matching. The risk of dementia was assessed through a survival analysis of matched pairs.

Results

Patients with underlying hypoglycemic events had an increased risk for all-cause dementia, Alzheimer's dementia (AD), and vascular dementia (VaD) compared with those who had not experienced a hypoglycemic event (hazard ratio [HR], 1.254; 95% confidence interval [CI], 1.166 to 1.349; P<0.001 for all-cause dementia; HR, 1.264; 95% CI, 1.162 to 1.375; P<0.001 for AD; HR, 1.286; 95% CI, 1.110 to 1.490; P<0.001 for VaD). According to number of hypoglycemic episodes, the HRs of dementia were 1.170, 1.201, and 1.358 in patients with one hypoglycemic episode, two or three episodes, and more than three episodes, respectively. In the subgroup analysis, hypoglycemia was associated with an increased risk for dementia in both sexes with or without T2DM microvascular or macrovascular complications.

Conclusion

Our findings suggest that patients with a history of hypoglycemia have a higher risk for dementia. This trend was similar for AD and VaD, the two most important subtypes of dementia.

Citations

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  • Potential risk factors for mild cognitive impairment among patients with type 2 diabetes experiencing hypoglycemia
    Ruonan Gao, Menglan Zhan, Sujie Ke, Kejun Wu, Guanlian He, Liqin Qi, Xiaoying Liu, Xiaohong Liu, Lijing Wang, Libin Liu
    Diabetes Research and Clinical Practice.2024; 207: 111036.     CrossRef
  • Association of hypoglycemic events with cognitive impairment in patients with type 2 diabetes mellitus: Protocol for a dose-response meta-analysis
    Min Ye, Ai Hong Yuan, Qi Qi Yang, Qun Wei Li, Fei Yue Li, Yan Wei, Muhammad Shahzad Aslam
    PLOS ONE.2024; 19(2): e0296662.     CrossRef
  • Hypoglycaemia and the risk of dementia: a population-based cohort study using exposure density sampling
    Wajd Alkabbani, Colleen J Maxwell, Ruth Ann Marrie, Suzanne L Tyas, Iliana C Lega, John-Michael Gamble
    International Journal of Epidemiology.2023; 52(3): 908.     CrossRef
  • Type 2 diabetes mellitus and cognitive function: understanding the connections
    Lisa Dao, Sarah Choi, Matthew Freeby
    Current Opinion in Endocrinology, Diabetes & Obesity.2023; 30(1): 7.     CrossRef
  • Associations of Mid- and Late-Life Severe Hypoglycemic Episodes With Incident Dementia Among Patients With Type 2 Diabetes: A Population-Based Cohort Study
    Wajd Alkabbani, Colleen J. Maxwell, Ruth Ann Marrie, Suzanne L. Tyas, Iliana C. Lega, John-Michael Gamble
    Diabetes Care.2023; 46(2): 331.     CrossRef
  • Nocturnal hypoglycemia is underdiagnosed in older people with insulin‐treated type 2 diabetes: The HYPOAGE observational study
    Anne‐Sophie Boureau, Béatrice Guyomarch, Pierre Gourdy, Ingrid Allix, Cédric Annweiler, Nathalie Cervantes, Guillaume Chapelet, Isabelle Delabrière, Sophie Guyonnet, Rachel Litke, Marc Paccalin, Alfred Penfornis, Pierre‐Jean Saulnier, Matthieu Wargny, Sam
    Journal of the American Geriatrics Society.2023; 71(7): 2107.     CrossRef
  • Dementia in Diabetes: The Role of Hypoglycemia
    Khaled Hameed Husain, Saud Faisal Sarhan, Haya Khaled Ali Abdulla AlKhalifa, Asal Buhasan, Abu Saleh Md Moin, Alexandra E. Butler
    International Journal of Molecular Sciences.2023; 24(12): 9846.     CrossRef
  • Association Between Trajectory of Severe Hypoglycemia and Dementia in Patients With Type 2 Diabetes: A Population-based Study
    Chung-Yi Li, Chia-Lun Kuo, Ya-Hui Chang, Chin-Li Lu, Santi Martini, Wen-Hsuan Hou
    Journal of Epidemiology.2022; 32(9): 423.     CrossRef
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The Relationship between Diabetes Mellitus and Health-Related Quality of Life in Korean Adults: The Fourth Korea National Health and Nutrition Examination Survey (2007-2009)
Yong Jun Choi, Min Suk Lee, So Yeon An, Tae Ho Kim, Seung Jin Han, Hae Jin Kim, Yoon-Sok Chung, Kwan Woo Lee, Dae Jung Kim
Diabetes Metab J. 2011;35(6):587-594.   Published online December 26, 2011
DOI: https://doi.org/10.4093/dmj.2011.35.6.587
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AbstractAbstract PDFPubReader   
Background

Diabetes is a major health problem in Korea. However, interest in the quality of life in patients with diabetes is low. We examined the effects of diabetes on health-related quality of life (HRQoL) and compared it with HRQoL in the general Korean population using the Fourth Korea National Health and Nutrition Examination Survey (KNHANES IV) (2007-2009).

Methods

Using KNHANES IV data, we compared EuroQol (EQ)-5D and EQ-visual analogue scale (VAS) scores after adjusting for sociodemographic and psychosocial factors as well as for comorbidities (hypertension, heart disease, stroke, arthritis, and chronic renal disease). Logistic regressions were used to explore determinants for the lowest quintile HRQoL scales in the diabetes group.

Results

The mean age of the 14,441 enrolled subjects (6,129 men and 8,312 women) was 52.5±14.5 years. The mean EQ-5D and EQ-VAS scores were significantly lower in the diabetes group (EQ-5D. 0.87; EQ-VAS, 71.94) than in the non-diabetes group (EQ-5D, 0.94; EQ-VAS, 77.40) (P<0.001). Self-reported depressive symptom had a significant effect on lowering the EQ-VAS (odds ratio [OR], 1.7; 95% confidence interval [CI], 1.1 to 2.6) in the diabetes group. Stress level had a significant effect in lowering both the EQ-5D (OR, 2.0; 95% CI, 1.3 to 2.9) and the EQ-VAS (OR, 1.9; 95% CI, 1.3 to 2.9). HbA1c, diabetes duration, and treatment modalities had no significant effect on lowering HRQoL.

Conclusion

Diabetes was clearly associated with impaired HRQoL compared with the non-diabetic population regardless of comorbidities. Therapeutic approaches should focus much more on the subjective perception of health in patients with diabetes.

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Review
2011 Clinical Practice Guidelines for Type 2 Diabetes in Korea
Seung-Hyun Ko, Sung-Rea Kim, Dong-Joon Kim, Seung-Joon Oh, Hye-Jin Lee, Kang-Hee Shim, Mi-Hye Woo, Jun-Young Kim, Nan-Hee Kim, Jae-Taik Kim, Chong Hwa Kim, Hae Jin Kim, In-Kyung Jeong, Eun-Kyung Hong, Jae-Hyoung Cho, Ji-Oh Mok, Kun-Ho Yoon
Diabetes Metab J. 2011;35(5):431-436.   Published online October 31, 2011
DOI: https://doi.org/10.4093/dmj.2011.35.5.431
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AbstractAbstract PDFPubReader   

As in other countries, type 2 diabetes is major health concern in Korea. A dramatic increase in the prevalence of type 2 diabetes and its chronic complications has led to an increase in health costs and economic burdens. Early detection of high risk individuals, hidden diabetic patients, and improvement in the quality of care for the disease are the first steps to mitigate the increase in prevalence. The Committee of Clinical Practice Guidelines of the Korean Diabetes Association revised and updated the '3rd Clinical Practice Guidelines' at the end of 2010. In the guidelines, the committee recommended active screening of high risk individuals for early detection and added the hemoglobin A1c level to the diagnostic criteria for type 2 diabetes based on clinical studies performed in Korea. Furthermore, the committee members emphasized that integrating patient education and self-management is an essential part of care. The drug treatment algorithm based on the degree of hyperglycemia and patient characteristics were also updated.

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Letter
Letter: Basal C-peptide Level as a Surrogate Marker of Subclinical Atherosclerosis in Type 2 Diabetes Patients (Diabetes Metab J 2011;35:41-9)
Min Suk Lee, Hae Jin Kim
Diabetes Metab J. 2011;35(2):188-189.   Published online April 30, 2011
DOI: https://doi.org/10.4093/dmj.2011.35.2.188
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Original Article
A Survey of Diabetic Educators and Patients for the Revision of Korean Food Exchange Lists
Jae Won Cho, Mee Ra Kweon, Young Mi Park, Mi Hye Woo, Hye Sook Yoo, Jeong Hyun Lim, Bo Kyung Koo, Chong Hwa Kim, Hae Jin Kim, Tae Sun Park, Choong Ho Shin, Kyu Chang Won, Soo Lim, Hak Chul Jang
Diabetes Metab J. 2011;35(2):173-181.   Published online April 30, 2011
DOI: https://doi.org/10.4093/dmj.2011.35.2.173
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Background

Food exchange lists are one of the main methods of nutritional education. However, Korean food exchange lists have not been revised since 1994. Therefore, we surveyed the opinions of diabetes educators and patients with diabetes regarding the need for revision of the current food exchange lists.

Methods

For two weeks beginning on 10 March 2008, a 12-item questionnaire regarding the opinion and need for revision of the current food exchange lists was e-mailed to diabetes educators nationwide. Another 15-question survey was administered to patients with diabetes in 13 hospitals located in the Seoul and Gyeonggi regions of Korea.

Results

We obtained survey responses from 101 diabetes educators and 209 patients; 65 (64.3%) of the educators answered that the current food exchange lists should be revised. The items that needed revision were the glycemic index, addition of new foods and reaffirmation of exchange standard amounts. The patients demanded specific education about choosing appropriate foods, a balanced meal plan, proper snacks, and dining intake.

Conclusion

Our survey results demonstrate the need to revise the Korean food exchange lists. This process should focus on glycemic index, the addition of new foods and reconfirmation of one exchange reference unit.

Citations

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  • Mediterranean Diet and Naltrexone/Bupropion Treatment for Weight Loss in Overweight and Obese Breast Cancer Survivors and Non-Cancer Participants: A Pilot Randomized Controlled Trial


    A-Ra Cho, Won-Jun Choi, Yu-Jin Kwon, Hye Sun Lee, Sung Gwe Ahn, Ji-Won Lee
    Diabetes, Metabolic Syndrome and Obesity: Targets and Therapy.2020; Volume 13: 3325.     CrossRef
  • Development of a Spanish Food Exchange List: Application of Statistical Criteria to a Rationale Procedure
    Iva Marques-Lopes, Susana Menal-Puey, J. Alfredo Martínez, Giuseppe Russolillo
    Journal of the Academy of Nutrition and Dietetics.2018; 118(7): 1161.     CrossRef
  • A Practical Approach to the Management of Micronutrients and Other Nutrients of Concern in Food Exchange Lists for Meal Planning
    Giuseppe Russolillo-Femenías, Susana Menal-Puey, J. Alfredo Martínez, Iva Marques-Lopes
    Journal of the Academy of Nutrition and Dietetics.2018; 118(11): 2029.     CrossRef
  • How much fruit should diabetic patients eat?
    Jeong Hyun Lim
    The Journal of Korean Diabetes.2014; 15(4): 185.     CrossRef
  • Korean Food Exchange Lists for Diabetes: Revised 2010
    Dal Lae Ju, Hak Chul Jang, Young Yun Cho, Jae Won Cho, Hye Sook Yoo, Kyung Suk Choi, Mi Hye Woo, Cheong Min Sohn, Yoo Kyoung Park, Ryo Won Choue
    Journal of Korean Diabetes.2011; 12(4): 228.     CrossRef
  • Korean Food Exchange Lists for Diabetes: Revised 2010
    Dal Lae Ju, Hak Chul Jang, Young Yun Cho, Jae Won Cho, Hye Sook Yoo, Kyung Suk Choi, Mi Hye Woo, Cheong Min Sohn, Yoo Kyoung Park, Ryowon Choue
    The Korean Journal of Nutrition.2011; 44(6): 577.     CrossRef
Randomized Controlled Trial
Effects of Adding omega-3 Fatty Acids to Simvastatin on Lipids, Lipoprotein Size and Subspecies in Type 2 Diabetes Mellitus with Hypertriglyceridemia.
Won Jun Kim, Chang Beom Lee, Cheol Young Park, Se Eun Park, Eun Jung Rhee, Won Young Lee, Ki Won Oh, Sung Woo Park, Dae Jung Kim, Hae Jin Kim, Seung Jin Han, Hong Keum Cho
Korean Diabetes J. 2009;33(6):494-502.   Published online December 1, 2009
DOI: https://doi.org/10.4093/kdj.2009.33.6.494
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BACKGROUND
omega-3 fatty acids are known to improve lipid profiles, the distribution of lipoprotein subclasses, and secondary prevention against post-myocardial infarction. Rare reports have emerged of synergistic results of omega-3 fatty acids with simvastatin in cases of type 2 diabetes mellitus with hypertriglyceridemia. The purpose of this study was to determine the combined relationship of omega-3 fatty acids plus simvastatin on lipid, lipoprotein size and the types of subspecies. METHODS: This randomized, multi-center, comparison study evaluated eight weeks of combination therapy (omega-3 fatty acids (Omacor) 4 g/day plus simvastatin 20 mg/day) or monotherapy (simvastatin 20 mg/day) for at least six weeks in 62 diabetic patients. Subjects with a triglyceride concentration of more than 200 mg/dL were eligible for inclusion. RESULTS: No significant differences for omega-3 fatty acids + simvastatin versus simvastatin alone were observed for triglycerides (-22.7% vs. -14.3%, P = 0.292), HDL peak particle size (+2.8% vs. -0.4%, P = 0.076), LDL mean particle size (+0.4% vs -0.1%, P = 0.376) or LDL subspecies types, although the combination therapy showed a tendency toward lower triglycerides, larger HDL, and LDL particle sizes than did the monotherapy. There were no significant differences between the two groups in regard to HDL-C, LDL-C, or HbA1c levels. There were no serious adverse events and no abnormalities in the laboratory values associated with this study. CONCLUSION: omega-3 fatty acids were a safeform of treatment in hypertriglyceridemic patients with type 2 diabetes mellitus. But, regarding efficacy, a much larger sample size and longer-term follow-up may be needed to distinguish between the effects of combination therapy and monotherapy.
Letter
Cause-of-Death Trends for Diabetes Mellitus over 10 Years (Korean Diabetes J 33(1):65-72, 2009).
Hae Jin Kim
Korean Diabetes J. 2009;33(2):164-165.   Published online April 1, 2009
DOI: https://doi.org/10.4093/kdj.2009.33.2.164
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AbstractAbstract PDF
No abstract available.
Original Articles
Effect of Valsartan on Blood Pressure and Urinary Albumin Excretion in Hypertensive Type 2 Diabetic Patients: An Open-Label, Multicenter Study.
Se Jun Park, Dae Jung Kim, Hae Jin Kim, Soo Yeon Park, Ji A Seo, Nan Hee Kim, Sung Hee Choi, Soo Lim, Hak Chul Jang, Seung Hyun Ko, Ki Ho Song, Yu Bae Ahn, Soo Kyoung Kim, Yong Wook Cho, Jun Goo Kang, Sung Hee Ihm, Cheol Young Park, Sung Woo Park, Dong Hyun Shin, Yong Hyun Kim, Kwan Woo Lee
Korean Diabetes J. 2008;32(6):513-521.   Published online December 1, 2008
DOI: https://doi.org/10.4093/kdj.2008.32.6.513
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AbstractAbstract PDF
BACKGROUND
Activation of renin-angiotensin system (RAS) has been an important mechanism of microvascular and macrovascular complications in diabetic patients. It has been reported that RAS blockades reduce the development and progression of diabetic nephropathy. The aim of this study was to evaluate whether valsartan, an angiotensin II receptor blocker (ARB), reduced blood pressure and urinary albumin excretion rate (UAER) in hypertensive type 2 diabetic patients. METHOD: Three hundred forty-seven hypertensive type 2 diabetic patients who had not taken angiotensin converting enzyme inhibitors or ARB for 6 months prior to this study were enrolled. We measured blood pressure and UAER before and after 24 weeks of valsartan treatment. RESULT: Baseline mean systolic and diastolic blood pressure was 143 +/- 15 and 87 +/- 11 mmHg, respectively and the median albumin excretion rate was 27 ug/mg. Reduction in systolic and diastolic blood pressure was 16 mmHg/10 mmHg and the median UAER was 19.3 ug/mg after 24 weeks (P < 0.01, respectively). When we divided the subjects into three groups according to the UAER (normoalbuminuria, microalbuminuria and macroalbuminuria), significant changes were reported in the microalbuminuria and the macroalbuminuria groups. Thirty-eight (42%) patients with microalbuminuria improved to normoalbuminuria and twelve (41%) patients with macroalbuminuria improved to microalbuminuria. We found an association between the improvement of blood pressure and UAER (R = 0.165, P = 0.015). CONCLUSION: We concluded that valsartan reduces urinary albumin excretion and blood pressure in hypertensive type 2 diabetic patients.
An Analysis of Medical Costs of Diabetic Patients in a University Hospital (1996~2005).
Ki Hong Chun, Kwan Woo Lee, Dae Jung Kim, Hae Jin Kim, Kyung Won Paek, Soo Jin Lee
Korean Diabetes J. 2008;32(4):366-376.   Published online August 1, 2008
DOI: https://doi.org/10.4093/kdj.2008.32.4.366
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AbstractAbstract PDF
BACKGROUND
The aim of this research was to find out the costs of diabetes, as research in a prospective cohort study looking into the development of diabetic complications followed by treatment intervention by a medical institution. The research compared the changes in medical costs by following-up on the treatment details of diagnosed diabetes for the last 10 years in a university hospital. METHODS: The research used data of outpatient, inpatient, pharmaceutical and total medical costs, from 1996 to 2005, of individual patients who were diagnosed with diabetic patients, to analyze the outpatient and inpatient total medical cost changes over the years. RESULTS: After antidiabetic drug, in the case of outpatient treatment, pharmaceutical costs increased on average by about 25,000 won a month for diabetic patients without complications and by 35,000 won for diabetic patients with microvascular complications. Outpatient medical costs were affected after drug treatment by as much of an increase as created by the pharmaceutical costs. The total medical costs, that is the sum of inpatient and outpatient costs, decreased by 30~40% compared to that before drug treatment. In the case of total medical cost, MI or ESRD cost 2~3 times more in pharmaceutical costs than before the development of complications. The total medical costs of diabetic patients with CVA, MI and ESRD complications increased in the first year after development of the complication, and this was followed by a decrease in the next year, showing a tendency to remain constant with no increase or decrease over subsequent years. This means that the total medical costs of patients with complications remain continuously large throughout the life of the diagnosed patient. CONCLUSION: For diabetic patients, pharmaceutical costs are the most important factor in determining outpatient medical costs.

Citations

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  • Outcome Research in Diabetes
    Kwan Woo Lee
    Journal of Korean Diabetes.2011; 12(1): 2.     CrossRef
  • Costs of Diabetes Mellitus in Korea
    Kwan Woo Lee
    Diabetes & Metabolism Journal.2011; 35(6): 567.     CrossRef

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