Diabetes & Metabolism Journal

Original Articles

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Clinical Implications of Using Post-Challenge Plasma Glucose Levels for Early Diagnosis of Type 2 Diabetes Mellitus in Older Individuals: Kyong Hye Joung, Sang Hyun Ju, Ji Min Kim, Sorim Choung, Jae Min Lee, Kang Seo Park, Hyun Jin Kim, Bon Jeong Ku; Diabetes Metab J. 2018;42(2):147-154. Published online February 13, 2018; DOI: https://doi.org/10.4093/dmj.2018.42.2.147

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Background

The aim of this study was to explore the differences in the clinical characteristics and diagnostic rates of diabetes mellitus (DM) according to various criteria in different age groups and to evaluate the efficacy of each criterion for screening older patients.

Methods

We studied 515 patients and measured the fasting plasma glucose level (FPG), 2-hour plasma glucose level after the 75 g oral glucose tolerance test (2-hour postload glucose [2-h PG]), and glycosylated hemoglobin (HbA1c) for re-evaluation of hyperglycemia without a history of diabetes. Patients with newly diagnosed DM were grouped by age as younger (<65 years) or older (≥65 years).

Results

Older patients had significantly lower HbA1c, FPG, and 2-h PG levels and a higher homeostatic level of pancreatic β-cell function compared with younger patients (P<0.001). The older group had the lowest diagnostic rate when using the FPG level (45.5%) and the highest diagnostic rate when using the 2-h PG level (84.6%). These results were mostly due to the higher frequency of isolated post-challenge hyperglycemia in the older patients than in the younger group (28.8% vs. 9.2%). The use of both the FPG and HbA1c levels significantly enhanced the low diagnostic power when employing only the FPG levels in the older group (71.2% vs. 45.5%).

Conclusion

In the older patients, the 2-h PG level was the most accurate diagnostic criterion. When we consider the costs and convenience, a combination of the FPG and HbA1c criteria may be recommended as a screening test for DM in older people.

Citations

Citations to this article as recorded by

International Diabetes Federation Position Statement on the 1-hour post-load plasma glucose for the diagnosis of intermediate hyperglycaemia and type 2 diabetes
Michael Bergman, Melania Manco, Ilhan Satman, Juliana Chan, Maria Inês Schmidt, Giorgio Sesti, Teresa Vanessa Fiorentino, Muhammad Abdul-Ghani, Ram Jagannathan, Pramod Kumar Thyparambil Aravindakshan, Rafael Gabriel, Viswanathan Mohan, Martin Buysschaert,
Diabetes Research and Clinical Practice.2024; 209: 111589. CrossRef
Development and validation of a machine learning‐based model to predict isolated post‐challenge hyperglycemia in middle‐aged and elder adults: Analysis from a multicentric study
Rui Hou, Jingtao Dou, Lijuan Wu, Xiaoyu Zhang, Changwei Li, Weiqing Wang, Zhengnan Gao, Xulei Tang, Li Yan, Qin Wan, Zuojie Luo, Guijun Qin, Lulu Chen, Jianguang Ji, Yan He, Wei Wang, Yiming Mu, Deqiang Zheng
Diabetes/Metabolism Research and Reviews.2024;[Epub] CrossRef
A unified technique for entropy enhancement based diabetic retinopathy detection using hybrid neural network
Fatima, Muhammad Imran, Anayat Ullah, Muhammad Arif, Rida Noor
Computers in Biology and Medicine.2022; 145: 105424. CrossRef
In-silico identification of peroxisome proliferator-activated receptor (PPAR)α/γ agonists from Ligand Expo Components database
Xiao-Yan Feng, Ting-Ting Ding, Ya-Ya Liu, Wei-Ren Xu, Xian-Chao Cheng
Journal of Biomolecular Structure and Dynamics.2021; 39(5): 1853. CrossRef

Arterial Stiffness by Aerobic Exercise Is Related with Aerobic Capacity, Physical Activity Energy Expenditure and Total Fat but not with Insulin Sensitivity in Obese Female Patients with Type 2 Diabetes: Ji Yeon Jung, Kyung Wan Min, Hee Jung Ahn, Hwi Ryun Kwon, Jae Hyuk Lee, Kang Seo Park, Kyung Ah Han; Diabetes Metab J. 2014;38(6):439-448. Published online December 15, 2014; DOI: https://doi.org/10.4093/dmj.2014.38.6.439

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Background

Arterial stiffness is an important factor in atherosclerosis. Thus we examined whether aerobic exercise could reduce arterial stiffness in obese women with type 2 diabetes without diabetic complication.

Methods

A total of 35 women with type 2 diabetes (body mass index, 26.6±2.8 kg/m²; age, 56.4±1.9 years; duration of diabetes, 4.7±4.8 years) were assigned to aerobic exercise group (AEG) or control group (CG). AEG completed a 12-week exercise program (3.6 to 5.2 metabolic equivalents, 3 day/week, 60 min/day), with their exercise activities monitored by accelerometers. We measured abdominal total fat area (TFA), visceral fat area (VFA), and subcutaneous fat area (SFA) by computed tomography, insulin sensitivity by insulin tolerance test (K_ITT), and augmentation index (AIx) by SphygmoCor at baseline and at the end of the 12-week program.

Results

The AIx was improved in the AEG compared with the CG (P<0.001). The percent change of AIx had significant correlation with the improvement of physical activity energy expenditure (PAEE), aerobic capacity, TFA, and SFA (r=-0.416, P=0.013; r=0.560, P<0.001; r=0.489, P=0.003; r=0.531, P=0.001, respectively), but not with insulin sensitivity, energy intake, or VFA.

Conclusion

Improvement in aortic stiffness by aerobic exercise is related with the improvement of aerobic capacity, PAEE, and total fat but not with insulin sensitivity or energy intake in obese women with type 2 diabetes.

Citations

Citations to this article as recorded by

Relationship between objectively measured physical activity and subclinical cardiovascular disease: a systematic review
Aparna Narendrula, Ellen Brinza, Christine Horvat Davey, Chris T Longenecker, Allison R Webel
BMJ Open Sport & Exercise Medicine.2024; 10(1): e001596. CrossRef
The Effects of Exercise Interventions on Ectopic and Subcutaneous Fat in Patients with Type 2 Diabetes Mellitus: A Systematic Review, Meta-Analysis, and Meta-Regression
Fatemeh Kazeminasab, Ali Bahrami Kerchi, Nasim Behzadnejad, Saba Belyani, Sara K. Rosenkranz, Reza Bagheri, Fred Dutheil
Journal of Clinical Medicine.2024; 13(17): 5005. CrossRef
Aerobic training reduces pancreatic fat content and improves β‐cell function: A randomized controlled trial using IDEAL‐IQ magnetic resonance imaging
Min Li, Qidong Zheng, Joshua D. Miller, Panpan Zuo, Xiaodan Yuan, Jitao Feng, Chao Liu, Shan Bao, Qingqing Lou
Diabetes/Metabolism Research and Reviews.2022;[Epub] CrossRef
Effect of aerobic exercise on waist circumference in adults with overweight or obesity: A systematic review and meta‐analysis
Alex Armstrong, Klaus Jungbluth Rodriguez, Angelo Sabag, Yorgi Mavros, Helen M. Parker, Shelley E. Keating, Nathan A. Johnson
Obesity Reviews.2022;[Epub] CrossRef
Aortic waveform responses to insulin in late versus early chronotype with metabolic syndrome
Mary‐Margaret E. Remchak, Emily M. Heiston, Anna Ballantyne, Brielle L. Dotson, Steven K. Malin
Physiological Reports.2022;[Epub] CrossRef
Exercise and ectopic fat in type 2 diabetes: A systematic review and meta-analysis
A. Sabag, K.L. Way, S.E. Keating, R.N. Sultana, H.T. O’Connor, M.K. Baker, V.H. Chuter, J. George, N.A. Johnson
Diabetes & Metabolism.2017; 43(3): 195. CrossRef
Arterial Stiffness Measured with the Cuff Oscillometric Method Is Predictive of Exercise Capacity in Patients with Cardiac Diseases
Yasushi Tazawa, Nobuyoshi Mori, Yoshiko Ogawa, Osamu Ito, Masahiro Kohzuki
The Tohoku Journal of Experimental Medicine.2016; 239(2): 127. CrossRef

Safety and Efficacy of Modern Insulin Analogues: Hye Jin Yoo, Keun Yong Park, Kang Seo Park, Kyu Jeung Ahn, Kyung Wan Min, Jeong Hyun Park, Sang Ah Chang, Bong Soo Cha, Dong-Jun Kim, Yong Seong Kim, Tae Keun Oh, Suk Chon, Il Seong Nam-Goong, Mi Jin Kim, Hye-Soon Kim, Young Sik Choi, You Hern Ahn, Sora Lee, Sei Hyun Baik; Diabetes Metab J. 2013;37(3):181-189. Published online June 14, 2013; DOI: https://doi.org/10.4093/dmj.2013.37.3.181

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Background

A1chieve® was a noninterventional study evaluating the clinical safety and efficacy of biphasic insulin aspart 30, insulin detemir, and insulin aspart.

Methods

Korean type 2 diabetes patients who have not been treated with the study insulin or have started it within 4 weeks before enrollment were eligible for the study. The patient selection and the choice of regimen were at the discretion of the physician. The safety and efficacy information was collected from the subjects at baseline, week 12, and week 24. The number of serious adverse drug reactions (SADRs) was the primary endpoint. The changes of clinical diabetic markers at week 12 and/or at week 24 compared to baseline were the secondary endpoints.

Results

Out of 4,058 exposed patients, 3,003 completed the study. During the study period, three SADRs were reported in three patients (0.1%). No major hypoglycemic episodes were observed and the rate of minor hypoglycemic episodes marginally decreased during 24 weeks (from 2.77 to 2.42 events per patient-year). The overall quality of life score improved (from 66.7±15.9 to 72.5±13.5) while the mean body weight was slightly increased (0.6±3.0 kg). The 24-week reductions in glycated hemoglobin, fasting plasma glucose and postprandial plasma glucose were 1.6%±2.2%, 2.5±4.7 mmol/L, and 4.0±6.4 mmol/L, respectively.

Conclusion

The studied regimens showed improvements in glycemic control with low incidence of SADRs, including no incidence of major hypoglycemic episodes in Korean patients with type 2 diabetes.

Citations

Citations to this article as recorded by

Insulin therapy for adult patients with type 2 diabetes mellitus: a position statement of the Korean Diabetes Association, 2017
Byung-Wan Lee, Jin Hwa Kim, Seung-Hyun Ko, Kyu Yeon Hur, Nan-Hee Kim, Sang Youl Rhee, Hyun Jin Kim, Min Kyong Moon, Seok-O Park, Kyung Mook Choi
The Korean Journal of Internal Medicine.2017; 32(6): 967. CrossRef
Insulin Therapy for Adult Patients with Type 2 Diabetes Mellitus: A Position Statement of the Korean Diabetes Association, 2017
Byung-Wan Lee, Jin Hwa Kim, Seung-Hyun Ko, Kyu-Yeon Hur, Nan-Hee Kim, Sang Youl Rhee, Hyun Jin Kim, Min Kyong Moon, Seok-O Park, Kyung Mook Choi
Diabetes & Metabolism Journal.2017; 41(5): 367. CrossRef
An information and communication technology-based centralized clinical trial to determine the efficacy and safety of insulin dose adjustment education based on a smartphone personal health record application: a randomized controlled trial
Gyuri Kim, Ji Cheol Bae, Byoung Kee Yi, Kyu Yeon Hur, Dong Kyung Chang, Moon-Kyu Lee, Jae Hyeon Kim, Sang-Man Jin
BMC Medical Informatics and Decision Making.2017;[Epub] CrossRef
Characteristics Predictive for a Successful Switch from Insulin Analogue Therapy to Oral Hypoglycemic Agents in Patients with Type 2 Diabetes
Gyuri Kim, Yong-ho Lee, Eun Seok Kang, Bong-Soo Cha, Hyun Chul Lee, Byung-Wan Lee
Yonsei Medical Journal.2016; 57(6): 1395. CrossRef
Avoiding or coping with severe hypoglycemia in patients with type 2 diabetes
Jae-Seung Yun, Seung-Hyun Ko
The Korean Journal of Internal Medicine.2015; 30(1): 6. CrossRef
Clinical Characteristics of Patients Responding to Once-Daily Basal Insulin Therapy in Korean Subjects with Type 2 Diabetes
Sun Ok Song, You-Cheol Hwang, Kyu-Jeung Ahn, Bong Soo Cha, Young Duk Song, Dae Wook Lee, Byung-Wan Lee
Diabetes Therapy.2015; 6(4): 547. CrossRef
The optimal morning:evening ratio in total dose of twice‐daily biphasic insulin analogue in poorly controlled Type 2 diabetes: a 24‐week multi‐centre prospective, randomized controlled, open‐labelled clinical study
C. H. Jung, J.‐Y. Park, J. H. Cho, K.‐H. Yoon, H. K. Yang, Y.‐H. Lee, B. S. Cha, B.‐W. Lee
Diabetic Medicine.2014; 31(1): 68. CrossRef
The glycemic efficacies of insulin analogue regimens according to baseline glycemic status in Korean patients with type 2 diabetes: sub‐analysis from the A 1 chieve ® study
Y.‐C. Hwang, J. G. Kang, K. J. Ahn, B. S. Cha, S.‐H. Ihm, S. Lee, M. Kim, B.‐W. Lee
International Journal of Clinical Practice.2014; 68(11): 1338. CrossRef
Letter: Efficacy and Safety of Biphasic Insulin Aspart 30/70 in Type 2 Diabetes Suboptimally Controlled on Oral Antidiabetic Therapy in Korea: A Multicenter, Open-Label, Single-Arm Study (Diabetes Metab J2013;37:117-24)
Byung-Wan Lee
Diabetes & Metabolism Journal.2013; 37(3): 212. CrossRef

Effects of Aerobic Exercise Intensity on Abdominal and Thigh Adipose Tissue and Skeletal Muscle Attenuation in Overweight Women with Type 2 Diabetes Mellitus: Ji Yeon Jung, Kyung Ah Han, Hee Jung Ahn, Hwi Ryun Kwon, Jae Hyuk Lee, Kang Seo Park, Kyung Wan Min; Diabetes Metab J. 2012;36(3):211-221. Published online June 14, 2012; DOI: https://doi.org/10.4093/dmj.2012.36.3.211

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Background

We investigated the effects of exercise intensity on abdominal and mid-thigh adipose tissue, attenuation of skeletal muscle, and insulin sensitivity in overweight women with type 2 diabetes mellitus (T2DM).

Methods

Twenty-eight patients were randomly assigned to control (CG, n=12), moderate intensity exercise (MEG, n=8), or vigorous intensity exercise (VEG, n=8) group. Subjects in both exercise groups completed a 12-week exercise program (MEG, 3.6 to 5.2 METs; VEG, ≥5.2 METs) that was monitored by accelerometers. We assessed body mass index (BMI), total fat area (TFA), visceral fat area (VFA), subcutaneous fat area (SFA), mid-thigh intramuscular adipose tissue (TIMAT), total skeletal muscle (TTM), low density skeletal muscle (TLDM), and normal density skeletal muscle (TNDM) using computed tomography, and measured insulin sensitivity with an insulin tolerance test (K_ITT), before and after the intervention.

Results

At baseline, the mean age was 53.8±7.9 years, duration of diabetes was 3.8±2.3 years, and BMI was 26.6±2.6 kg/m². After 12 weeks, the percent change (%C) in BMI, TIMAT, and TLDM were not different among three groups. However, %C in TFA and VFA were significantly reduced in MEG compared to CG (P=0.026 and P=0.008, respectively). %C SFA was significantly reduced in VEG compared to CG (P=0.038) and %C TTM, TNDM, and K_ITT were significantly increased in VEG compared to the CG (P=0.044, P=0.007, and P=0.016, respectively).

Conclusion

Although there was no difference in the change in BMI among groups, TFA and VFA were more reduced in MEG, and only VEG increased TTM, TNDM, and insulin sensitivity compared to CG.

Citations

Citations to this article as recorded by

The Effects of Exercise Interventions on Ectopic and Subcutaneous Fat in Patients with Type 2 Diabetes Mellitus: A Systematic Review, Meta-Analysis, and Meta-Regression
Fatemeh Kazeminasab, Ali Bahrami Kerchi, Nasim Behzadnejad, Saba Belyani, Sara K. Rosenkranz, Reza Bagheri, Fred Dutheil
Journal of Clinical Medicine.2024; 13(17): 5005. CrossRef
Intermuscular adipose tissue in metabolic disease
Bret H. Goodpaster, Bryan C. Bergman, Andrea M. Brennan, Lauren M. Sparks
Nature Reviews Endocrinology.2023; 19(5): 285. CrossRef
Dose–response effects of exercise and caloric restriction on visceral adiposity in overweight and obese adults: a systematic review and meta-analysis of randomised controlled trials
Francesco Recchia, Chit K. Leung, Angus P. Yu, Welton Leung, Danny J. Yu, Daniel Y. Fong, David Montero, Chi-Ho Lee, Stephen H.S. Wong, Parco M. Siu
British Journal of Sports Medicine.2023; 57(16): 1035. CrossRef
Muscle quality: the assessment, prognosis, and intervention
翔畑中, 洋祐大須賀
Nippon Ronen Igakkai Zasshi. Japanese Journal of Geriatrics.2023; 60(2): 103. CrossRef
Associations of Muscle Density and Area With Coronary Artery Plaque and Physical Function
Kristine M. Erlandson, Triin Umbleja, Michael T. Lu, Jana Taron, Heather J. Ribaudo, Edgar T. Overton, Rachel M. Presti, David W. Haas, Paul E. Sax, Michael T. Yin, Bingxue Kris Zhai, Rochelle Louis, Namrata Upadhyay, Parastou Eslami, Pamela S. Douglas, M
JAIDS Journal of Acquired Immune Deficiency Syndromes.2023; 94(2): 174. CrossRef
Aerobic training reduces pancreatic fat content and improves β‐cell function: A randomized controlled trial using IDEAL‐IQ magnetic resonance imaging
Min Li, Qidong Zheng, Joshua D. Miller, Panpan Zuo, Xiaodan Yuan, Jitao Feng, Chao Liu, Shan Bao, Qingqing Lou
Diabetes/Metabolism Research and Reviews.2022;[Epub] CrossRef
Effect of aerobic exercise on waist circumference in adults with overweight or obesity: A systematic review and meta‐analysis
Alex Armstrong, Klaus Jungbluth Rodriguez, Angelo Sabag, Yorgi Mavros, Helen M. Parker, Shelley E. Keating, Nathan A. Johnson
Obesity Reviews.2022;[Epub] CrossRef
Effect of exercise on myosteatosis in adults: a systematic review and meta-analysis
Robinson Ramírez-Vélez, Yasmin Ezzatvar, Mikel Izquierdo, Antonio García-Hermoso
Journal of Applied Physiology.2021; 130(1): 245. CrossRef
Effect of exercise intervention dosage on reducing visceral adipose tissue: a systematic review and network meta-analysis of randomized controlled trials
Yu-Hsuan Chang, Hui-Ying Yang, Shiow-Ching Shun
International Journal of Obesity.2021; 45(5): 982. CrossRef
Exercise Training to Decrease Ectopic Intermuscular Adipose Tissue in Individuals With Chronic Diseases: A Systematic Review and Meta-Analysis
Mauro Tuñón-Suárez, Alvaro Reyes-Ponce, Rodrigo Godoy-Órdenes, Nicolás Quezada, Marcelo Flores-Opazo
Physical Therapy.2021;[Epub] CrossRef
Low-attenuation muscle is a predictor of diabetes mellitus: A population-based cohort study
Muhei Tanaka, Hiroshi Okada, Yoshitaka Hashimoto, Muneaki Kumagai, Hiromi Nishimura, Michiaki Fukui
Nutrition.2020; 74: 110752. CrossRef
Drop-out ratio between moderate to high-intensity physical exercise treatment by patients with, or at risk of, type 2 diabetes mellitus: A systematic review and meta-analysis
Guillem Jabardo-Camprubí, Rafel Donat-Roca, Mercè Sitjà-Rabert, Raimon Milà-Villarroel, Judit Bort-Roig
Physiology & Behavior.2020; 215: 112786. CrossRef
High-Intensity Interval Training Versus Moderate-Intensity Continuous Training in Middle-Aged and Older Patients with Type 2 Diabetes: A Randomized Controlled Crossover Trial of the Acute Effects of Treadmill Walking on Glycemic Control
Romeu Mendes, Nelson Sousa, José Luís Themudo-Barata, Victor Machado Reis
International Journal of Environmental Research and Public Health.2019; 16(21): 4163. CrossRef
Trunk muscle quality assessed by computed tomography: Association with adiposity indices and glucose tolerance in men
Alexandre Maltais, Natalie Alméras, Isabelle Lemieux, Angelo Tremblay, Jean Bergeron, Paul Poirier, Jean-Pierre Després
Metabolism.2018; 85: 205. CrossRef
Counting Footsteps with a Pedometer to Improve HMW Adiponectin and Metabolic Syndrome among Young Female Adults in the United Arab Emirates
Hayder Hasan, Amita Attlee, Hamid Jan Bin Jan Mohamed, Norliyana Aris, Wan Abdul Manan Bin Wan Muda
Journal of Obesity.2018; 2018: 1. CrossRef
Exercise and ectopic fat in type 2 diabetes: A systematic review and meta-analysis
A. Sabag, K.L. Way, S.E. Keating, R.N. Sultana, H.T. O’Connor, M.K. Baker, V.H. Chuter, J. George, N.A. Johnson
Diabetes & Metabolism.2017; 43(3): 195. CrossRef
Effect of aerobic exercise intensity on glycemic control in type 2 diabetes: a meta-analysis of head-to-head randomized trials
Yilina Liubaoerjijin, Tasuku Terada, Kevin Fletcher, Normand G. Boulé
Acta Diabetologica.2016; 53(5): 769. CrossRef
A systematic review and meta‐analysis on the effects of exercise training versus hypocaloric diet: distinct effects on body weight and visceral adipose tissue
R. J. H. M. Verheggen, M. F. H. Maessen, D. J. Green, A. R. M. M. Hermus, M. T. E. Hopman, D. H. T. Thijssen
Obesity Reviews.2016; 17(8): 664. CrossRef
Muscle wasting and aging: Experimental models, fatty infiltrations, and prevention
Thomas Brioche, Allan F. Pagano, Guillaume Py, Angèle Chopard
Molecular Aspects of Medicine.2016; 50: 56. CrossRef
Arterial Stiffness by Aerobic Exercise Is Related with Aerobic Capacity, Physical Activity Energy Expenditure and Total Fat but not with Insulin Sensitivity in Obese Female Patients with Type 2 Diabetes
Ji Yeon Jung, Kyung Wan Min, Hee Jung Ahn, Hwi Ryun Kwon, Jae Hyuk Lee, Kang Seo Park, Kyung Ah Han
Diabetes & Metabolism Journal.2014; 38(6): 439. CrossRef
Intermuscular Fat: A Review of the Consequences and Causes
Odessa Addison, Robin L. Marcus, Paul C. LaStayo, Alice S. Ryan
International Journal of Endocrinology.2014; 2014: 1. CrossRef
Relative Skeletal Muscle Mass Is Associated with Development of Metabolic Syndrome
Byung Sam Park, Ji Sung Yoon
Diabetes & Metabolism Journal.2013; 37(6): 458. CrossRef
Effect of exercise on abdominal fat loss in men and women with and without type 2 diabetes
Devon A Dobrosielski, Bethany Barone Gibbs, Sameer Chaudhari, Pamela Ouyang, Harry A Silber, Kerry J Stewart
BMJ Open.2013; 3(11): e003897. CrossRef

Small Rice Bowl-Based Meal Plan for Energy and Marcronutrient Intake in Korean Men with Type 2 Diabetes: A Pilot Study: Hee Jung Ahn, Kyung Ah Han, Jin Young Jang, Jae Hyuk Lee, Kang Seo Park, Kyung Wan Min; Diabetes Metab J. 2011;35(3):273-281. Published online June 30, 2011; DOI: https://doi.org/10.4093/dmj.2011.35.3.273

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Background

Koreans eat rice, which is usually served in a rice bowl. We investigated the effect of a meal plan using small rice bowls on the total energy intake (TEI) and the marcronutrient intake in Korean men with type 2 diabetes.

Methods

A total of 62 men with type 2 diabetes were divided by body mass index (BMI) (normal weight [NW], BMI<23 kg/m²; overweight [OW], 23≤BMI<25 kg/m²; obese [OB], BMI≥25 kg/m²) and proportions of carbohydrate intake to TEI (PCI) (low carbohydrate intake [LC], <55%; recommended carbohydrate intake [RC], ≥55% and ≤60%; high carbohydrate intake [HC], >60%). The 3-day dietary records were analyzed for TEI and proportions of macronutrients, before and 2 weeks after a small-sized (300 mL) rice bowl based education was given.

Results

There were no significant differences in the age and BMI within the sub-groups by BMI and PCI groups. In baseline, the ratio of TEI to recommended total energy intake (RTR) of OW and OB were higher than that of NW. The PCI of HC was higher than that of LC and alcohol intake of HC was lower than that of LC. After education, the reduction of RTREI in OB was higher than that in OW and NW. The reduction of PCI in HC was higher than that of LC.

Conclusion

A small rice bowl based meal plan was effective for the reduction of energy intake and control of marcronutrient intake in Korean obese men with type 2 diabetes consuming a high carbohydrate diet.

Citations

Citations to this article as recorded by

Comprehensive Understanding for Application in Korean Patients with Type 2 Diabetes Mellitus of the Consensus Statement on Carbohydrate-Restricted Diets by Korean Diabetes Association, Korean Society for the Study of Obesity, and Korean Society of Hyperte
Jong Han Choi, Jee-Hyun Kang, Suk Chon
Diabetes & Metabolism Journal.2022; 46(3): 377. CrossRef
The association between measurement sites of visceral adipose tissue and cardiovascular risk factors after caloric restriction in obese Korean women
Hye-Ok Lee, Jung-Eun Yim, Jeong-Sook Lee, Young-Seol Kim, Ryowon Choue
Nutrition Research and Practice.2013; 7(1): 43. CrossRef
Daily Rice Intake Strongly Influences the Incidence of Metabolic Syndrome in Japanese Men Aged 40-59 Years
Yoko Watanabe, Isao Saito, Yasuhiko Asada, Taro Kishida, Tatsuhiro Matsuo, Masamitsu Yamaizumi, Tadahiro Kato
Journal of Rural Medicine.2013; 8(1): 161. CrossRef

The Usefulness of an Accelerometer for Monitoring Total Energy Expenditure and Its Clinical Application for Predicting Body Weight Changes in Type 2 Diabetic Korean Women: Ji Yeon Jung, Kyung Ah Han, Hwi Ryun Kwon, Hee Jung Ahn, Jae Hyuk Lee, Kang Seo Park, Kyung Wan Min; Korean Diabetes J. 2010;34(6):374-383. Published online December 31, 2010; DOI: https://doi.org/10.4093/kdj.2010.34.6.374

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Background

The purpose of this study was to evaluate the usefulness of an accelerometer in predicting body weight (BW) change during a lifestyle intervention and to find out whether exercise or overall physical activity is associated with change in insulin sensitivity and body composition.

Methods

A total of 49 overweight (body mass index [BMI] ≥ 23 kg/m²) women with diabetes were enrolled and performed lifestyle intervention while monitoring BW, total energy expenditure (TEE) and physical activity energy expenditure (PAEE) using an accelerometer, and energy intake (EI) using a three-day dietary record at baseline and every 2 weeks for 12 weeks. We assessed body composition using bioimpedance analysis and compared the actual BW change to the predicted BW change, which was calculated from the energy deficit (ED) between EI and TEE (ED = EI-TEE).

Results

Mean age was 57.2 years, duration of diabetes was 8.0 years, and BMI was 27.8 kg/m². There was no significant difference between EI and TEE at baseline. For 12 weeks, the ED was 474.0 kcal·day^-1, which was significantly correlated with BW change (-3.1 kg) (r = 0.725, P < 0.001). However, the actual BW change was 50% lower than the predicted BW change. Both TEE and PAEE correlated with change in K_ITT (r = 0.334, P = 0.019; r = 0.358, P = 0.012, respectively), BMI (r = -0.395, P = 0.005; r = -0.347, P = 0.015, respectively), and fat mass (r = -0.383, P = 0.007; r = -0.395, P = 0.005, respectively), but only TEE correlated with fat free mass change (r = -0.314, P = 0.030).

Conclusion

The accelerometer appears to be a useful tool for measuring TEE under free-living conditions for both short- and long-term periods.

Citations

Citations to this article as recorded by

Whether Smaller Plates Reduce Consumption Depends on Who’s Serving and Who’s Looking: A Meta-Analysis
Stephen S. Holden, Natalina Zlatevska, Chris Dubelaar
Journal of the Association for Consumer Research.2016; 1(1): 134. CrossRef

The Effects of Small Sized Rice Bowl on Carbohydrate Intake and Dietary Patterns in Women with Type 2 Diabetes: Hee-Jung Ahn, Yu-Kyung Eom, Kyung-Ah Han, Hwi-Ryun Kwon, Hyun Jin Kim, Kang Seo Park, Kyung-Wan Min; Korean Diabetes J. 2010;34(3):166-173. Published online June 30, 2010; DOI: https://doi.org/10.4093/kdj.2010.34.3.166

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Background

The main source of carbohydrate in the Korean diet is rice, which is usually served in a rice bowl. This study investigated the impact of a meal plan using smaller rice bowls on dietary energy intake and macronutrient composition in overweight or obese patients with type 2 diabetes mellitus.

Methods

A total of 67 women with type 2 diabetes were enrolled in our study. We divided these participants into three groups: a normal-weight group (NW; body mass index [BMI] < 23 kg/m²; n = 17), an overweight group (OW; 23 ≤ BMI < 25 kg/m²; n = 24) and an obese group (OB; BMI ≥ 25 kg/m²; n = 26). Three-day dietary records were analyzed for total energy intake (TEI) and macronutrient composition both before enrollment and two weeks after patients received instruction in a dietary plan based on using a small (200 mL) rice bowl.

Results

After the intervention, TEI decreased in the OW and OB groups. Decreased carbohydrate (NW, -4 ± 5%; OW, -4 ± 5%; OB, -3 ± 6%) and increased fat intakes were found in all three groups, which complies with Korean Diabetes Association recommendations. The protein proportion of TEI significantly increased only in the OW group. Body weight decreased both in the OW and OB groups.

Conclusion

A short-term, small-rice-bowl-based meal plan was effective for body weight control and macronutrient balance in overweight or obese women in Korea with type 2 diabetes.

Citations

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Diet Therapy Using a Small Rice Bowl among Japanese Men with Diabetes: A Randomized Controlled Trial
Misa Shimpo, Shiori Toga-Sato, Takahiro Tosaki
Journal of Obesity & Metabolic Syndrome.2022; 31(4): 345. CrossRef
A traditional Asian diet modified to meet nutritional requirements of diabetes, has anything changed? A cross-sectional dietary survey
Arjuna Medagama, Heshan Widanapathirana
BMC Nutrition.2015;[Epub] CrossRef
Relationship between Milk and Calcium Intake and Lipid Metabolism in Female Patients with Type 2 Diabetes
JaeHee Kim, Ji-Yun Hwang, Ki Nam Kim, Young-Ju Choi, Namsoo Chang, Kap-Bum Huh
Yonsei Medical Journal.2013; 54(3): 626. CrossRef
The Small Rice Bowl-Based Meal Plan was Effective at Reducing Dietary Energy Intake, Body Weight, and Blood Glucose Levels in Korean Women with Type 2 Diabetes Mellitus
Hee Jung Ahn, Kyung Ah Han, Hwi Ryun Kwon, Kyung Wan Min
Korean Diabetes Journal.2010; 34(6): 340. CrossRef

Bowl-Based Meal Plan versus Food Exchange-Based Meal Plan for Dietary Intake Control in Korean Type 2 Diabetic Patients.: Hee Jung Ahn, Boo Kyung Koo, Ji Yeon Jung, Hwi Ryun Kwon, Hyun Jin Kim, Kang Seo Park, Kyung Ah Han, Kyung Wan Min; Korean Diabetes J. 2009;33(2):155-163. Published online April 1, 2009; DOI: https://doi.org/10.4093/kdj.2009.33.2.155

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Abstract PDF

BACKGROUND
The food exchange-based meal plan is effective in controlling dietary energy intake with a macronutrient balance. However, it is difficult to practice for relatively low-literacy patients. As an alternative, we developed a system employing a standardized-sized bowl and investigated its effectiveness on achieving proper energy intake and macronutrient composition and patient compliance, compared to the conventional food exchange system in Korean type 2 diabetes patients. METHODS: Eighty subjects with type 2 diabetes were assigned to both the novel bowl-based meal plan group (BG) and the food exchange-based meal plan group (ExG). BG received limited simple instructions for the plan. Time spent for plan instruction was 10 min for BG and 40 min for ExG. Dietary energy and macronutrient intake were estimated with 3-day dietary records and patient comprehension of the plan was estimated with a 5-point Likert scale. RESULTS: After 12 weeks, dietary energy compliance showed no difference between the groups (BG: 103 +/- 10%, ExG: 101 +/- 17%). Both groups showed significant reduction in carbohydrate and protein intake and there was no difference in the proportion of carbohydrate, protein and fat in energy intake between the groups despite the shorter instruction time for BG. Following the instruction period, there was no difference in the understanding score between the groups. CONCLUSION: This bowl-based plan was equally effective as the food exchange-based plan in controlling dietary energy intake and macronutrient composition, as well as patient comprehension and compliance. Our novel plan may allow for more cost-effective methods in terms of time needed for plan instruction.

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Practical Diet Education for Patients with Type 2 Diabetes: Tips for Physicians
Choong Hee Kim, Jun Sung Moon
The Journal of Korean Diabetes.2016; 17(4): 253. CrossRef
Effects of Nutrition Education and Personalized Lunch Service Program for Elderly at Senior Welfare Center in Jeonju
Jeong-Sook Bae, Mi-Hyun Kim, Sook-Bae Kim
Korean Journal of Community Nutrition.2013; 18(1): 65. CrossRef
Effects of Chronic Disease Management Based on Clinics for Blood Pressure or Glycemic Control in Patients with Hypertension or Type 2 Diabetes Mellitus
Won Cheong, Jun Yim, Dae-Kyu Oh, Jeong-Soo Im, Kwang Pil Ko, Yun Mi Kim
Journal of agricultural medicine and community health.2013; 38(2): 108. CrossRef
Small Rice Bowl-Based Meal Plan versus Food Exchange-Based Meal Plan for Weight, Glucose and Lipid Control in Obese Type 2 Diabetic Patients
Hee-Jung Ahn, Kyung-Ah Han, Hwi-Ryun Kwon, Bo-Kyung Koo, Hyun-Jin Kim, Kang-Seo Park, Kyung-Wan Min
Korean Diabetes Journal.2010; 34(2): 86. CrossRef
Nutrients and Dish Intake by Fasting Blood Glucose Level
Jihyun Choi, Hyun-Kyung Moon
The Korean Journal of Nutrition.2010; 43(5): 463. CrossRef
The Effects of Small Sized Rice Bowl on Carbohydrate Intake and Dietary Patterns in Women with Type 2 Diabetes
Hee-Jung Ahn, Yu-Kyung Eom, Kyung-Ah Han, Hwi-Ryun Kwon, Hyun Jin Kim, Kang Seo Park, Kyung-Wan Min
Korean Diabetes Journal.2010; 34(3): 166. CrossRef

Case Report

Maintenance of Insulin Therapy by Desensitization in Insulin Allergy Patient.: Jun Hwa Hong, Ji Hye Lee, Jong Ho Shin, Dong Pil Kim, Bong Suk Ko, Byung Joon Kim, Hyun Jin Kim, Kang Seo Park; Korean Diabetes J. 2008;32(6):529-531. Published online December 1, 2008; DOI: https://doi.org/10.4093/kdj.2008.32.6.529

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Abstract PDF

Allergic reaction to human insulin is uncommon. But they can cause mild to severe symptoms such as dyspnea, hypotensive shock, etc. Here we report the case of a patient with type 2 diabetes and insulin allergy successfully managed with desensitization. A 60-year-old man with insulin allergy was transferred. He had poorly controlled type 2 diabetes (fasting blood glucose 230 mg/dL). He developed itching sense and erythema at the injection sites of human insulin in a few minutes. And serum IgE level was elevated to 1618.0 IU/mL. The insulin was changed to other preparations, including short and long-acting insulin analogues, with similar responses. He was commenced on twice a day injection protocol in addition to his oral hypoglycemic agents, and achieved fair control (fasting blood glucose 100 mg/dL) on 24 units of Novomix Flex Pen per day, with little or no skin or systemic reaction. This is the case report of insulin allergy in type 2 diabetes being successfully managed by desensitization.

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Allergic reaction to recombinant human insulin
Seong Jin Choi, Min Kwan Kwon, Moon Park, Soo Ya Bae, Hyun Ho Oh, Jong Ho Lee, Ji In Moon, Chan Sun Park, Jong Chul Won, Kyung Soo Ko, Byoung Doo Rhee, Jung Min Kim
Allergy, Asthma & Respiratory Disease.2015; 3(4): 302. CrossRef
Two Cases of Allergy to Insulin in Gestational Diabetes
Gi Jun Kim, Shin Bum Kim, Seong Il Jo, Jin Kyeong Shin, Hee Sun Kwon, Heekyung Jeong, Jang Won Son, Seong Su Lee, Sung Rae Kim, Byung Kee Kim, Soon Jib Yoo
Endocrinology and Metabolism.2015; 30(3): 402. CrossRef
Successful Management of Insulin Allergy and Autoimmune Polyendocrine Syndrome Type 4 with Desensitization Therapy and Glucocorticoid Treatment: A Case Report and Review of the Literature
Joselyn Rojas, Marjorie Villalobos, María Sofía Martínez, Mervin Chávez-Castillo, Wheeler Torres, José Carlos Mejías, Edgar Miquilena, Valmore Bermúdez
Case Reports in Immunology.2014; 2014: 1. CrossRef
Clinical applications of drug desensitization in the Asia-Pacific region
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Original Articles

Protective Effects of Glucagon Like Peptide-1 on HIT-T15 beta Cell Apoptosis via ER Stress Induced by 2-deoxy-D-glucose.: Ju Young Kim, Seong Kyu Lee, Haing Woon Baik, Ki Ho Lee, Hyun Jin Kim, Kang Seo Park, Byung Joon Kim; Korean Diabetes J. 2008;32(6):477-487. Published online December 1, 2008; DOI: https://doi.org/10.4093/kdj.2008.32.6.477

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Abstract PDF

BACKGROUND
The characteristic feature of pancreatic beta cells is highly developed endoplasmic reticulum (ER) due to a heavy engagement in insulin secretion. The ER serves several important function, including post-translational modification, folding, and assembly of newly synthesized secretory proteins, and its proper function is essential to cell survival. Various stress conditions can interfere with ER function. Pancreatic beta cells may be particularly vulnerable to ER stress that causes to impair insulin biosynthesis and beta cell survival through apoptosis. Glucagon like peptide-1 (GLP-1) is a new drug for treatment of type 2 diabetes and has effects on stimulation of insulin secretion and beta cell preservation. Also, it may have an antiapoptotic effect on beta cells, but detailed mechanisms are not proven. Therefore, we investigated the protective mechanism of GLP-1 in beta cells through ER stress response induced by 2-deoxy-D-glucose (2DG). METHODS: For induction of the ER stress, HIT-T15 cells (hamster beta cell line) were treated with 2DG (10 mM). Apoptosis was evaluated with MTT assay, hoechst 33342 staining and Annexin/PI flow cytometry. Expression of ER stress-related molecules was determined by real-time PCR or western blot. For blocking ER stress, we pretreated HIT-T15 cells with exendin-4 (Ex-4; GLP-1 receptor agonist) for 1 hour before stress induction. RESULTS: After induction with ER stress (2DG), beta cells were lost by apoptosis. We found that Ex-4 had a protective effect through ER stress related molecules (GRP78, GRP94, XBP-1, eIF2alpha, CHOP) modulation. Also, Ex-4 recovered the expression of insulin2 mRNA in beta cells. CONCLUSION: These results suggest that GLP-1 may protect beta cells apoptosis through ER stress modulation.

Citations

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Exendin-4 Protects Against Sulfonylurea-Induced β-Cell Apoptosis
Ju-Young Kim, Dong-Mee Lim, Hyung-Seo Park, Chan-Il Moon, Kyung-Jin Choi, Seong-Kyu Lee, Haing-Woon Baik, Keun-Young Park, Byung-Joon Kim
Journal of Pharmacological Sciences.2012; 118(1): 65. CrossRef
GLP-1 Can Protect Proinflammatory Cytokines Induced Beta Cell Apoptosis through the Ubiquitination
Dong Mee Lim, Ju Young Kim, Kang Woo Lee, Keun Young Park, Byung Joon Kim
Endocrinology and Metabolism.2011; 26(2): 142. CrossRef
Exendin-4 Protects Oxidative Stress-Induced β-Cell Apoptosis through Reduced JNK and GSK3β Activity
Ju-Young Kim, Dong-Mee Lim, Chan Il Moon, Kyung-Jin Jo, Seong-Kyu Lee, Haing-Woon Baik, Ki-Ho Lee, Kang-Woo Lee, Keun-Young Park, Byung-Joon Kim
Journal of Korean Medical Science.2010; 25(11): 1626. CrossRef

The Effects of D-Chiro-Inositol on Glucose Metabolism in 3T3-L1 Cells.: Kang Seo Park, Jae Min Lee, Bon Jeong Ku, Young Suk Jo, Seong Kyu Lee, Kyung Wan Min, Kyung Ah Han, Hyo Jeong Kim, Hyun Jin Kim; Korean Diabetes J. 2008;32(3):196-203. Published online June 1, 2008; DOI: https://doi.org/10.4093/kdj.2008.32.3.196

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Abstract PDF

BACKGROUND
The target of the treatment of metabolic syndrome and diabetes is an improvement of insulin resistance. D-chiro-inositol (DCI) plays a role in a phospholipid mediating intracellular insulin action. In the previous studies, the urine level of DCI were decreased in the diabetic animal with insulin resistance. Some clinical studies showed that DCI improved a glucose level and HbA1c. Therefore we studied the relationship between DCI and glucose metabolism, especially insulin resistance. METHODS: To investigate the mechanism of DCI affecting the glucose metabolism, we examined the effects of DCI on 2-deoxyglucose uptake, gene expression of adipocytokines and AMPK pathway by using RT-PCR and western blot in 3T3-L1 cells. RESULTS: Insulin-stimulated 2-deoxyglucose uptake increased in DCI-treated cells by about 1.2-fold (relative to the control) and was inhibited by phosphoinositide 3-kinase (PI3 Kinase) inhibitors (Wortmanin, LY294002) and AMPK inhibitor (STO-609). In Western blot analysis, it didn't show the difference of phosphorylation of Akt and AMPK between DCI-treated group and control in 3T3-L1 cells. However, DCI decreased the gene expression of resistin in 3T3-L1 cells. CONCLUSION: DCI may involve other pathway of insulin signaling, but not PI3 Kinase and AMPK signaling pathways and it may be useful in managing metabolic syndrome by improving insulin resistance through increasing glucose uptake and decreasing resistin relevant to insulin resistance.

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Variation of Pinitol Content for Domestic Legume Species in Korea
Seung-Min Seo, Yeon-Shin Jeong, Dhakal Krisna Hari, Dong-Hyun Shin, In-Jung Lee, Eun-Sook Park, Jeong-Dong Lee, Young-Hyun Hwang
Korean Journal of Crop Science.2011; 56(1): 50. CrossRef

Analysis of Meal Habits from the Viewpoint of Regularity in Korean Type 2 Diabetic Patients.: Hee Jung Ahn, Kyung Ah Han, Boo Kyung Koo, Hyun Jin Kim, Hyo Jeong Kim, Kang Seo Park, Kyung Wan Min; Korean Diabetes J. 2008;32(1):68-76. Published online February 1, 2008; DOI: https://doi.org/10.4093/kdj.2008.32.1.68

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Abstract PDF

BACKGROUND
The regular meal pattern with consistent day-to-day calorie and carbohydrate intake is one of the most important determinants of good glycemic control in diabetes. This study was aimed to investigate the meal pattern and their relationships with total energy intake, nutrients intake and glycemic and lipid profile in type 2 diabetes. METHODS: 1,084 subjects were divided according to glycemic status into three groups: the diabetes (DM), dysglycemia (DG) and normal (N). The meal frequency (MF), meal interval (MI) and daily intake of total energy, macronutrient and micronutrient were estimated with the 24 hours dietary recall from the Korean National Health and Nutrition Examination Survey (KNHANES) in 2001 and Eulji hospital. For analysis of meal pattern and it's relations with the nutrients intake, we regrouped into meal skipper (G1), non-meal skipper with unreasonable MI (G2), and non-meal skipper with reasonable MI (G3). RESULTS: 17.5% of DM, 21.8% of DG, 23.3% of N skipped at least one meal a day without significant difference across the groups. 55.9% of non-meal skipper had unreasonable MI. Meal was more regular in older age, lower educated person, employee, and female. G1 took higher fat, and more calories form snack and less micronutrient density, compared with G3 (P < 0.05). HbA1c, total cholesterol and triglyceride values were higher in G1 compared with other two groups (P < 0.05). CONCLUSION: Many type 2 diabetics had the irregular meal patterns, which was associated with poor glycemic control, lipid profiles and less micronutrient density. This suggested that another treatment strategy might be required for those who had irregular lifestyle.

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Adherence to Dietary Guidelines among Diabetes Patients: Comparison between Elderly and Non-Elderly Groups
Haeun Jang, Jihyun Im, Kyong Park
Clinical Nutrition Research.2021; 10(1): 14. CrossRef
Effect of Diabetic Dietary Education Program on Diabetes Knowledge and Dietary Behaviors of Elderly Diabetic Patients
Ji Young Ye, Sung Hee Min, Min June Lee
Korean Journal of Food & Cookery Science.2017; 33(5): 601. CrossRef
Five Year's Follow-up of the Cardiovascular Disease Risk Factors among the Low Level Organic Solvent Exposure Workers
Mi-Ae Kim
Korean Journal of Occupational Health Nursing.2015; 24(2): 67. CrossRef
A Predictive Model of Health Outcomes for Young People with Type 2 Diabetes
Sun Young Jung, Sook Ja Lee, Sun Hee Kim, Kyung Mi Jung
Asian Nursing Research.2015; 9(1): 73. CrossRef
Need for Development of a List of Meals for Diabetic Patients and Development of Barley-Based Diabetic Meals
Ji Hye Ryu, Jeong Ok Rho
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Comorbidity Study on Type 2 Diabetes Mellitus Using Data Mining
Hye Soon Kim, A Mi Shin, Mi Kyung Kim, Yoon Nyun Kim
The Korean Journal of Internal Medicine.2012; 27(2): 197. CrossRef
Factors that Affect Medication Adherence in Elderly Patients with Diabetes Mellitus
Kyung-Ae Park, Jung-Guk Kim, Bo-Wan Kim, Sin Kam, Keon-Yeop Kim, Sung-Woo Ha, Sung-Taek Hyun
Korean Diabetes Journal.2010; 34(1): 55. CrossRef
Nutrients and Dish Intake by Fasting Blood Glucose Level
Jihyun Choi, Hyun-Kyung Moon
The Korean Journal of Nutrition.2010; 43(5): 463. CrossRef

The Plasma Adiponectin Levels in Patients with Newly Diagnosed Type 2 Diabetes.: Ihn Suk Lee, Yun Jeung Kim, Jong Im Kim, Jea Hyung Park, Bon Jeong Ku, Kang Seo Park, Tae Yong Lee, Young Kun Kim; Korean Diabetes J. 2007;31(6):507-516. Published online November 1, 2007; DOI: https://doi.org/10.4093/jkda.2007.31.6.507

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Abstract PDF: BACKGROUND
Adiponectin is secreted from adipose tissue and plays an important role in the regulation of glycemia and insulin resistance. In this study, the relationship between adiponectin and the adiposity, body composition, insulin sensitivity, lipid profile were respectively examined in newly diagnosed type 2 diabetes. METHODS: Total 1993 were participated in the Korea Rural Genomic Cohort Study (Geumsan County). After a 12-hour overnight fast, all subjects underwent 75-g oral glucose tolerance test. 105 of those were studied as newly diagnosed type 2 diabetes. The body composition was analyzed by means of bioelectric impedance analysis and the insulin sensitivity was estimated by fasting insulin, HOMA-IR and QUICKI method, respectively. RESULTS: Adiponectin positively correlated with high-density lipoprotein cholesterol (r = 0.246, P < 0.05). Adiponectin inversely associated with waist circumference (r = - 0.408, P < 0.01), triglyceride (r = -0.274, P < 0.05), ferritin (r = -0.260, P < 0.05), visceral fat (r = -0.248, P < 0.05), high sensitivity C-reactive protein (r = -0.228, P < 0.05) and body mass index (r = -0.225, P < 0.05). In multiple linear regression, waist circumference and high-density lipoprotein cholesterol were analyzed as independent variables of serum adiponectin. CONCLUSION: Adiponectin concentrations were closely related to waist circumference in newly diagnosed type 2 diabetes.

Randomized Controlled Trial

Titration with an Initially Lower Dose Increased Compliance of Cilostazol (Pletaal(R)) in Diabetic Patients.: Hyo Jeong Kim, Kyung Ah Han, Hyun Jin Kim, Kang Seo Park, Eung Jin Kim, Kyung Wan Min; Korean Diabetes J. 2006;30(5):388-397. Published online September 1, 2006; DOI: https://doi.org/10.4093/jkda.2006.30.5.388

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Abstract PDF: BACKGROUND
Headache is frequently reported by patients using cilostazol, which is a potent inhibitor of platelet aggregation with vasodilatory effects, for preventing atherosclerotic disease. The aims of this study were to think out a dosing schedule for improving compliance on headache and to investigate the possible mechanisms of headache associated with atherosclerosis measured as carotid intimal-media thickness (IMT) in Korean diabetic patients. METHODS: We therefore randomized patients into three groups according to the different dosing regimens for 6 weeks (1) group 1; 50 mg once daily, followed by 50 mg twice daily, and then 100 mg twice daily or (2) group 2; 50 mg twice daily, followed by 100 mg twice daily or (3) group 3; 100 mg twice daily without titration. We evaluated severity of the headache by visual analog scaled (VAS) symptom score from zero to ten and measured carotid IMT using high resolution ultrasound. RESULTS: A total of 122 diabetic patients were analyzed. The mean values of age, sex, duration of diabetes, BMI, HbA1c, lipid profiles, blood pressure, and smoking were not different among three groups. The proportion of headache was significantly lower in group 1 than group 2 and 3 (26% vs. 48% and 51%, P < 0.05). The proportion of severe headache was significantly lower in group 1 than group 2 and 3 (3% vs. 19% , 27%, P < 0.05). Among patients who had headache, the proportion of severe headache was significantly lower in group 1 than group 3. (10% vs. 52%, P < 0.05). The VAS symptom score of headache was significantly lower in group 1 than group 3 (4.9+/-2.1 vs. 7.0+/-2.4, P < 0.05). The proportion of the discontinuation of medication due to headache was significantly lower in group 1 than other two groups (8% vs. 24% and 29%, P < 0.05). The patients who had discontinued medication due to headache had lower carotid IMT than in whom were tolerable (Mean carotid IMT; 0.65+/-0.12 vs. 0.77+/-0.16 mm, P < 0.01, Maximal carotid IMT; 0.80+/-0.17 vs. 0.94+/-0.23 mm, P < 0.01). The proportion of patients who had discontinued medication due to headache was significantly lower in group 1 than other two groups (8% vs. 24%, 29%, P < 0.05] CONCLUSION: Titration with an initially lower dose of cilostazol could be considered to reduce the proportion and severity of headache and thereby increase compliance. Atherosclerosis estimated as carotid IMT may contribute to the tolerability of cilostazol.

Original Article

The Study of Physical Activity in the Korean with Type 2 Diabetes.: Kyung Wan Min, Keun Hee An, Tae Seo Sohn, Yong Moon Park, Yeong Sun Hong, Yeon Su Kim, Yi Byeong Park, Kang Seo Park, Gwan Woo Lee, In Ju Kim, Kyung Ah Han, Jae Myoung Yu, Hyun Shik Son, Sei Hyun Baik, Won Cheol Lee, Chung Gu Cho, Hyoung Woo Lee, Sung Woo Park; Korean Diabetes J. 2005;29(6):517-525. Published online November 1, 2005

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Abstract PDF: BACKGROUND
Despite the importance of exercise, little is known about the epidemiology of exercise among persons with diabetes in the Korea. We do not have any standard method to evaluate physical activity of diabetics. So exercise committee of Korean diabetic association decided to survey the physical activities of Korean type 2 diabetic patients. METHODS: Cross-sectional study including 1073 type 2 diabetics (509 males, 564 females) over 18 age. 34 general hospitals collected data about physical activity from Dec. 2004 to Feb.2005. Data were randomly collected by interviewers using numeration table. Respondents were asked about the physical activities or exercise during recent 7 days and frequency, duration of each activity. To compare with normal population, we use 2001 KNHANES (Korean National Health and Nutrition Examination Survey) results. RESULTS: People with type 2 diabetes were more likely to report exercising regularly than people without this disease (52.5% vs. 27.5%) (p<0.0001), but 47.5% of type 2 diabetics didn't take exercise. Walking time of type 2 diabetics wasmore than that of people without this disease (p<0.0001). Type 2 diabetics exerting <700kcal/week of energy expenditure with physical activity were 45.5% in the exercising type 2 diabetics (males:44.2%, females:55.8%). Energy expenditure was positively correlated with frequency of physical exercise and exercise period (p<0.001). CONCLUSION: 47.5% of Korean type 2 diabetics and 72.5% of normal population did not take exercise. 45.5% of exercising type 2 diabetics exerted energy expenditure under 700kcal/week with physical activity. Therefore, various programs for initiating physical activity and increasing energy expenditure are required.

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