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Original Articles
Pattern of Stress-Induced Hyperglycemia according to Type of Diabetes: A Predator Stress Model
Jin-Sun Chang, Young-Hye You, Shin-Young Park, Ji-Won Kim, Hun-Sung Kim, Kun-Ho Yoon, Jae-Hyoung Cho
Diabetes Metab J. 2013;37(6):475-483.   Published online December 12, 2013
DOI: https://doi.org/10.4093/dmj.2013.37.6.475
  • 4,883 View
  • 64 Download
  • 5 Crossref
AbstractAbstract PDFPubReader   
Background

We aimed to quantify stress-induced hyperglycemia and differentiate the glucose response between normal animals and those with diabetes. We also examined the pattern in glucose fluctuation induced by stress according to type of diabetes.

Methods

To load psychological stress on animal models, we used a predator stress model by exposing rats to a cat for 60 minutes and measured glucose level from the beginning to the end of the test to monitor glucose fluctuation. We induced type 1 diabetes model (T1D) for ten Sprague-Dawley rats using streptozotocin and used five Otsuka Long-Evans Tokushima Fatty rats as obese type 2 diabetes model (OT2D) and 10 Goto-Kakizaki rats as nonobese type 2 diabetes model (NOT2D). We performed the stress loading test in both the normal and diabetic states and compared patterns of glucose fluctuation among the three models. We classified the pattern of glucose fluctuation into A, B, and C types according to speed of change in glucose level.

Results

Increase in glucose, total amount of hyperglycemic exposure, time of stress-induced hyperglycemia, and speed of glucose increase were significantly increased in all models compared to the normal state. While the early increase in glucose after exposure to stress was higher in T1D and NOT2D, it was slower in OT2D. The rate of speed of the decrease in glucose level was highest in NOT2D and lowest in OT2D.

Conclusion

The diabetic state was more vulnerable to stress compared to the normal state in all models, and the pattern of glucose fluctuation differed among the three types of diabetes. The study provides basic evidence for stress-induced hyperglycemia patterns and characteristics used for the management of diabetes patients.

Citations

Citations to this article as recorded by  
  • Stress hyperglycemia as first sign of asymptomatic type 1 diabetes: an instructive case
    Wei-De Wang, Chun-Hao Chu, Chiung-Hsi Tien, Shuo-Yu Wang, Shih-Yao Liu, Chien-Ming Lin
    BMC Pediatrics.2021;[Epub]     CrossRef
  • Genetic determinants of obesity heterogeneity in type II diabetes
    Somayeh Alsadat Hosseini Khorami, Mohd Sokhini Abd Mutalib, Mohammad Feili Shiraz, Joseph Anthony Abdullah, Zulida Rejali, Razana Mohd Ali, Huzwah Khaza’ai
    Nutrition & Metabolism.2020;[Epub]     CrossRef
  • Sex Dimorphic Responses of the Hypothalamus–Pituitary–Thyroid Axis to Maternal Separation and Palatable Diet
    Lorraine Jaimes-Hoy, Fidelia Romero, Jean-Louis Charli, Patricia Joseph-Bravo
    Frontiers in Endocrinology.2019;[Epub]     CrossRef
  • Hesperidin protects against stress induced gastric ulcer through regulation of peroxisome proliferator activator receptor gamma in diabetic rats
    Shimaa M. Elshazly, Dalia M. Abd El Motteleb, Islam A.A.E-H. Ibrahim
    Chemico-Biological Interactions.2018; 291: 153.     CrossRef
  • Physiology and Neurobiology of Stress and the Implications for Physical Health
    B Sivaprakash
    Annals of SBV.2014; 3(1): 25.     CrossRef
Predictive Clinical Parameters and Glycemic Efficacy of Vildagliptin Treatment in Korean Subjects with Type 2 Diabetes
Jin-Sun Chang, Juyoung Shin, Hun-Sung Kim, Kyung-Hee Kim, Jeong-Ah Shin, Kun-Ho Yoon, Bong-Yun Cha, Ho-Young Son, Jae-Hyoung Cho
Diabetes Metab J. 2013;37(1):72-80.   Published online February 15, 2013
DOI: https://doi.org/10.4093/dmj.2013.37.1.72
  • 4,472 View
  • 39 Download
  • 2 Crossref
AbstractAbstract PDFPubReader   
Background

The aims of this study are to investigate the glycemic efficacy and predictive parameters of vildagliptin therapy in Korean subjects with type 2 diabetes.

Methods

In this retrospective study, we retrieved data for subjects who were on twice-daily 50 mg vildagliptin for at least 6 months, and classified the subjects into five treatment groups. In three of the groups, we added vildagliptin to their existing medication regimen; in the other two groups, we replaced one of their existing medications with vildagliptin. We then analyzed the changes in glucose parameters and clinical characteristics.

Results

Ultimately, 327 subjects were analyzed in this study. Vildagliptin significantly improved hemoglobin A1c (HbA1c) levels over 6 months. The changes in HbA1c levels (ΔHbA1c) at month 6 were -2.24% (P=0.000), -0.77% (P=0.000), -0.80% (P=0.001), -0.61% (P=0.000), and -0.34% (P=0.025) for groups 1, 2, 3, 4, and 5, respectively, with significance. We also found significant decrements in fasting plasma glucose levels in groups 1, 2, 3, and 4 (P<0.05). Of the variables, initial HbA1c levels (P=0.032) and history of sulfonylurea use (P=0.026) were independently associated with responsiveness to vildagliptin treatment.

Conclusion

Vildagliptin was effective when it was used in subjects with poor glycemic control. It controlled fasting plasma glucose levels as well as sulfonylurea treatment in Korean type 2 diabetic subjects.

Citations

Citations to this article as recorded by  
  • Predictive clinical parameters for the hemoglobin A1c-lowering effect of vildagliptin in Japanese patients with type 2 diabetes
    Yukihiro Bando, Masayuki Yamada, Keiko Aoki, Hideo Kanehara, Azusa Hisada, Kazuhiro Okafuji, Daisyu Toya, Nobuyoshi Tanaka
    Diabetology International.2014; 5(4): 229.     CrossRef
  • The Efficacy of Vildagliptin in Korean Patients with Type 2 Diabetes
    Jun Sung Moon, Kyu Chang Won
    Diabetes & Metabolism Journal.2013; 37(1): 36.     CrossRef
Effects of a 6-Month Exenatide Therapy on HbA1c and Weight in Korean Patients with Type 2 Diabetes: A Retrospective Cohort Study
Juyoung Shin, Jin-Sun Chang, Hun-Sung Kim, Sun-Hee Ko, Bong-Yun Cha, Ho-Young Son, Kun-Ho Yoon, Jae-Hyoung Cho
Diabetes Metab J. 2012;36(5):364-370.   Published online October 18, 2012
DOI: https://doi.org/10.4093/dmj.2012.36.5.364
  • 4,151 View
  • 40 Download
  • 10 Crossref
AbstractAbstract PDFPubReader   
Background

While many studies have shown the good efficacy and safety of exenatide in patients with diabetes, limited information is available about exenatide in clinical practice in Korean populations. Therefore, this retrospective cohort study was designed to analyze the effects of exenatide on blood glucose level and body weight in Korean patients with type 2 diabetes mellitus.

Methods

We reviewed the records of the patients with diabetes who visited Seoul St. Mary's Hospital and for whom exenatide was prescribed from June 2009 to October 2011. After excluding subjects based on their race/ethnicity, medical history, whether or not they changed more than 2 kinds of oral hypoglycemic agents with exenatide treatment, loss to follow-up, or whether they stopped exenatide therapy within 6 months, a total of 52 subjects were included in the final analysis.

Results

The mean glycated hemoglobin (HbA1c) level and weight remarkably decreased from 8.5±1.7% to 6.7±1.0% (P<0.001) and from 82.3±15.8 kg to 78.6±16.3 kg (P<0.001), respectively. The multiple regression analysis indicated that the reduction in HbA1c level was significantly associated with a shorter duration of diabetes, a higher baseline HbA1c level, and greater weight reduction, whereas weight loss had no significant correlation with other factors. No severe adverse events were observed.

Conclusion

These results suggest that a 6-month exenatide injection therapy significantly improved patients' HbA1c levels and body weights without causing serious adverse effects in Korean patients with type 2 diabetes.

Citations

Citations to this article as recorded by  
  • Recellularization via electroporation therapy of the duodenum combined with glucagon-like peptide-1 receptor agonist to replace insulin therapy in patients with type 2 diabetes: 12-month results of a first-in-human study
    Celine B.E. Busch, Suzanne Meiring, Annieke C.G. van Baar, Frits Holleman, Max Nieuwdorp, Jacques J.G.H.M. Bergman
    Gastrointestinal Endoscopy.2024; 100(5): 896.     CrossRef
  • Clinical and Genetic Predictors of Glycemic Control and Weight Loss Response to Liraglutide in Patients with Type 2 Diabetes
    Artemis Kyriakidou, Angeliki V. Kyriazou, Theocharis Koufakis, Yiannis Vasilopoulos, Maria Grammatiki, Xanthippi Tsekmekidou, Iakovos Avramidis, Stefanos Baltagiannis, Dimitrios G. Goulis, Pantelis Zebekakis, Kalliopi Kotsa
    Journal of Personalized Medicine.2022; 12(3): 424.     CrossRef
  • Insulin receptor signaling and glucagon-like peptide 1 effects on pancreatic beta cells
    Nunzia Caporarello, Cristina Parrino, Vincenzo Trischitta, Lucia Frittitta, Claudia Miele
    PLOS ONE.2017; 12(8): e0181190.     CrossRef
  • Exenatide versus Insulin Lispro Added to Basal Insulin in a Subgroup of Korean Patients with Type 2 Diabetes Mellitus
    Kun-Ho Yoon, Elise Hardy, Jenny Han
    Diabetes & Metabolism Journal.2017; 41(1): 69.     CrossRef
  • Acarbose reduces body weight irrespective of glycemic control in patients with diabetes: results of a worldwide, non-interventional, observational study data pool
    Oliver Schnell, Jianping Weng, Wayne H.-H. Sheu, Hirotaka Watada, Sanjay Kalra, Sidartawan Soegondo, Noriyuki Yamamoto, Rahul Rathod, Cheryl Zhang, Wladyslaw Grzeszczak
    Journal of Diabetes and its Complications.2016; 30(4): 628.     CrossRef
  • Determining Predictors of Early Response to Exenatide in Patients with Type 2 Diabetes Mellitus
    Muhammad Khan, Jing Ouyang, Karen Perkins, Sunil Nair, Franklin Joseph
    Journal of Diabetes Research.2015; 2015: 1.     CrossRef
  • The Role of Glucagon-Like Peptide-1 Receptor Agonists in Type 2 Diabetes: Understanding How Data Can Inform Clinical Practice in Korea
    Seungjoon Oh, Suk Chon, Kyu Jeong Ahn, In-Kyung Jeong, Byung-Joon Kim, Jun Goo Kang
    Diabetes & Metabolism Journal.2015; 39(3): 177.     CrossRef
  • Tolerability, effectiveness and predictive parameters for the therapeutic usefulness of exenatide in obese, Korean patients with type 2 diabetes
    Sun Ok Song, Kwang Joon Kim, Byung‐Wan Lee, Eun Seok Kang, Bong Soo Cha, Hyun Chul Lee
    Journal of Diabetes Investigation.2014; 5(5): 554.     CrossRef
  • From endocrine to rheumatism: do gut hormones play roles in rheumatoid arthritis?
    C.-Y. Chen, C.-Y. Tsai
    Rheumatology.2014; 53(2): 205.     CrossRef
  • Early use of glucagon-like peptide-1 receptor agonists (GLP-1 RAs) in Type 2 diabetes
    Stuart A. Ross, Jane Ballantine
    Current Medical Research and Opinion.2013; 29(12): 1617.     CrossRef

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