Diabetes & Metabolism Journal

Clinical Characteristics of Diabetic Patients Transferred to Korean Referral Hospitals: Min Young Oh, Sang Soo Kim, In Joo Kim, In Kyu Lee, Hong Sun Baek, Hyoung Woo Lee, Min Young Chung; Diabetes Metab J. 2014;38(5):388-394. Published online October 17, 2014; DOI: https://doi.org/10.4093/dmj.2014.38.5.388

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Background

We evaluated the disease profile and clinical management, including the status of both glycemic control and complications, in patients with diabetes who were transferred to referral hospitals in Korea.

Methods

Patients referred to 20 referral hospitals in Gyeongsangnam/Gyeongsangbuk-do and Jeollanam/Jeollabuk-do with at least a 1-year history of diabetes between January and June 2011 were retrospectively reviewed using medical records, laboratory tests, and questionnaires.

Results

A total of 654 patients were enrolled in the study. In total, 437 patients (67%) were transferred from clinics and 197 (30%) patients were transferred from hospitals. A total of 279 patients (43%) visited higher medical institutions without a written medical request. The main reason for the referral was glycemic control in 433 patients (66%). Seventy-three patients (11%) had received more than one session of diabetic education. Only 177 patients (27%) had been routinely self-monitoring blood glucose, and 146 patients (22%) were monitoring hemoglobin A1c. In addition, proper evaluations for diabetic complications were performed for 74 patients (11%). The most common complication was neuropathy (32%) followed by nephropathy (31%). In total, 538 patients (82%) had been taking oral hypoglycemic agents. A relatively large number of patients (44%) had been taking antihypertensive medications.

Conclusion

We investigated the clinical characteristics of diabetic patients and identified specific problems in diabetic management prior to the transfer. We also found several problems in the medical system, which were divided into three medical institutions having different roles in Korea. Our findings suggested that the relationships among medical institutions have to be improved, particularly for diabetes.

Citations

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PLOS ONE.2024; 19(2): e0287496. CrossRef
Transfers between health facilities of people living with diabetes attending primary health care services in the Western Cape Province of South Africa: A retrospective cohort study
Jasantha Odayar, Jody Rusch, Joel A. Dave, Diederick J. Van Der Westhuizen, Elton Mukonda, Maia Lesosky, Landon Myer
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Nonalbumin proteinuria is a simple and practical predictor of the progression of early-stage type 2 diabetic nephropathy
Jong Ho Kim, Sang Soo Kim, In Joo Kim, Min Jin Lee, Yun Kyung Jeon, Bo Hyun Kim, Sang Heon Song, Yong Ki Kim
Journal of Diabetes and its Complications.2017; 31(2): 395. CrossRef

Response: Association between Diabetic Polyneuropathy and Chronic Complications in Type 2 Diabetic Patients (Diabetes Metab J 2011;35:390-6): Jin Ook Chung, Dong Hyeok Cho, Dong Jin Chung, Min Young Chung; Diabetes Metab J. 2011;35(6):640-641. Published online December 26, 2011; DOI: https://doi.org/10.4093/dmj.2011.35.6.640

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Association between Diabetic Polyneuropathy and Cardiovascular Complications in Type 2 Diabetic Patients: Jin Ook Chung, Dong Hyeok Cho, Dong Jin Chung, Min Young Chung; Diabetes Metab J. 2011;35(4):390-396. Published online August 31, 2011; DOI: https://doi.org/10.4093/dmj.2011.35.4.390

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Background

Diabetes mellitus is a major independent risk factor for cardiovascular disease (CVD), but high cardiovascular risk in diabetes mellitus patients is not completely explained by clustering traditional risk factors. Recently, associations between diabetic polyneuropathy (DPN) and macrovasculopathy have been suggested. We aimed to assess associations between DPN and cardiovascular complications in type 2 diabetic patients.

Methods

Microvascular and cardiovascular complications were evaluated in 1,041 type 2 diabetic patients.

Results

In patients with DPN, the age, prevalence of hypertension, diabetes duration, systolic blood pressure, pulse pressure, and hemoglobin glycation (HbA1c) levels were significantly higher, while the high density lipoprotein cholesterol (HDL-C) levels were lower than in those without DPN. The prevalence of CVD was higher in patients with DPN. In multivariate analysis, DPN was independently associated with CVD (odds ratio, 1.801; 95% confidence interval, 1.009 to 3.214).

Conclusion

Our results showed that DPN was associated with a high prevalence of cardiovascular disease in type 2 diabetic patients, but further studies are needed to investigate the causative nature of associations between DPN and CVD.

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Diabetic Peripheral Neuropathy Is Associated With Higher Systolic Blood Pressure in Adults With Type 2 Diabetes With and Without Hypertension in the Chinese Han Population
Lingning Huang, Yongze Zhang, Yunmin Wang, Ximei Shen, Sunjie Yan
Canadian Journal of Diabetes.2020; 44(7): 615. CrossRef
Characterizing distal peripheral neuropathy in type 2 diabetes mellitus in a semi-urban community setting in Peru
Meera F Iyengar, Antonio Bernabe-Ortiz
Journal of Global Health Reports.2019;[Epub] CrossRef
Cardiovascular disease predicts diabetic peripheral polyneuropathy in subjects with type 2 diabetes: A 10-year prospective study
Juan Ybarra-Muñoz, Jeronimo Jurado-Campos, Maria Garcia-Gil, Edurne Zabaleta-del-Olmo, Teresa Mir-Coll, Adelaida Zabalegui, Josep Vidal, June H Romeo
European Journal of Cardiovascular Nursing.2016; 15(4): 248. CrossRef
Diabetic polyneuropathy and the risk of developing diabetic retinopathy: a nationwide, population‐based study
I‐Chan Lin, Yuan–Hung Wang, Cheng‐Li Lin, Yen‐Jung Chang, Shwu‐Huey Lee, I‐Jong Wang
Acta Ophthalmologica.2015; 93(8): 713. CrossRef
Diabetic Peripheral Neuropathy in Ambulatory Patients with Type 2 Diabetes in a General Hospital in a Middle Income Country: A Cross-Sectional Study
María de los Angeles Lazo, Antonio Bernabé-Ortiz, Miguel E. Pinto, Ray Ticse, German Malaga, Katherine Sacksteder, J. Jaime Miranda, Robert H. Gilman, Leighton R. James
PLoS ONE.2014; 9(5): e95403. CrossRef
The co-occurrence of myocardial dysfunction and peripheral insensate neuropathy in a streptozotocin-induced rat model of diabetes
Maria N Marangoni, Scott T Brady, Shamim A Chowdhury, Mariann R Piano
Cardiovascular Diabetology.2014;[Epub] CrossRef
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Paulo Zoé Costa, Raquel Soares
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Diabetic Peripheral Neuropathy in Type 2 Diabetes Mellitus in Korea
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Diabetes & Metabolism Journal.2011; 35(6): 571. CrossRef

Chronic Complications in Adult Diabetic Patients with and without GAD Antibody.: Jin Ook Chung, Dong Hyeok Cho, Dong Jin Chung, Min Young Chung; Korean Diabetes J. 2009;33(2):124-133. Published online April 1, 2009; DOI: https://doi.org/10.4093/kdj.2009.33.2.124

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Abstract PDF

BACKGROUND
Although the majority of diabetes mellitus (DM) patients diagnosed as adults have non-autoimmune forms of the disease, islet autoimmunity is encountered in some patients initially thought to have type 2 DM. The phenotype of DM patients with glutamic acid decarboxylase (GAD) antibodies is different from that of patients with GAD antibody-negative type 2 DM, with features such as relative leanness and hyperglycemia which may influence the development of complications. We sought to compare the prevalence of chronic complications in patients with and without the GAD antibody. METHODS: We recruited 427 patients (M: 218, F: 209) that were clinically diagnosed with type 2 DM after the age of 35 years. We measured GAD antibody and assessed the factors associated with chronic microvascular and macrovascular complications. RESULTS: Of these patients, 26 were GAD antibody-positive. The patients with GAD antibody had lower systolic blood pressure, higher high-density lipoprotein cholesterol value, and lower level of fasting and stimulated C-peptide than patients without GAD antibody (P < 0.05). Also, the patients with GAD antibody had lower prevalence of retinopathy compared with the patients without GAD antibody (19.2 vs. 47.9%; P < 0.05). The prevalence of nephropathy, peripheral neuropathy and cardiovascular autonomic neuropathy did not differ between the groups. In addition, the prevalence of coronary heart disease, cerebrovascular disease and peripheral arterial disease did not differ between the two groups. CONCLUSION: This study suggests that diabetic patients with GAD antibody have a lower risk for the development of retinopathy compared with patients without GAD antibody.

Citations

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Relationship between β-Cell Autoantibodies and Their Combination with Anthropometric and Metabolic Components and Microvascular Complications in Latent Autoimmune Diabetes in Adults
Tomislav Bulum, Marijana Vučić Lovrenčić, Jadranka Knežević Ćuća, Martina Tomić, Sandra Vučković-Rebrina, Lea Duvnjak
Biomedicines.2023; 11(9): 2561. CrossRef

A Case of Recurrent Hypoglycemic Hemiparesis in an Adult with Type 1 Diabetes Mellitus.: Kyoung Min Kim, Se Hun Kang, Se In Hong, Dong Hyeok Cho, Ho Cheol Kang, Dong Jin Chung, Min Young Chung; Korean Diabetes J. 2006;30(2):136-139. Published online March 1, 2006; DOI: https://doi.org/10.4093/jkda.2006.30.2.136

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Abstract PDF: Transient hypoglycemic hemiparesis is a rare but important presentation of hypoglycemia that is frequently misdiagnosed as stroke. The development of hemiparesis as a result of hypoglycemia was first described in 1928. Thereafter over the years, several cases have been sporadically reported in Korea, but case reports of recurrent hypoglycemic hemiparesis are rare. We recently experienced a case of recurrent hypoglycemic hemiparesis in an adult with type 1 diabetes mellitus. A 30-year-old woman with type 1 diabetes receiving daily multiple subcutaneous insulin injections was admitted with right hemiparesis. She had had admitted with the same symptom and recovered with oral carbohydrates in twice 2 years ago. Her clinical course improved over 2 hours after infusion of dextrose solution. Further investigations such as CT, MRI and MRA revealed no abnormality

Platelet Aggregability in Type 2 Diabetics.: Chang Hun Lee, Nam Il Cheon, Yeon Sang Lee, Dong Hyeok Cho, Hyun Ho Shin, Jung Min Kim, Dae Ho Lee, Dong Jin Chung, Min Young Chung, Tai Hee Lee; Korean Diabetes J. 2000;24(3):300-309. Published online January 1, 2001

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Abstract PDF: BACKGROUND
Increased platelet aggregability is known to be one of the important risk factors for diabetic vascular complications. The relationship between platelet aggregability and diabetic macrovascular complications, varying severity of diabetic microvascular complications and other possible factors was evaluated in Korean adults. METHODS: Platelet aggregability was measured with platelet rich plasma by addition of adenosine diphosphate (ADP) in 45 cases. Normal control group (n=15) was compared with diabetics without macrovascular complications (n=15), diabetics with macrovascular complications (n=15) and several groups divided accoring to the severity of microvascular complications. RESULTS: 1) The mean maximum value of platelet aggregation was 70.3+/-5.3% in control group, and 80.0+/-7.3% in diabetics (p<0.005). 2) The mean maximum value of platelet aggregation was 78.0+/-5.5% in diabetics without macrovascular complications and 83.5+/-7.1% in diabetics with macrovascular complications (p=0.093). 3) The mean maximum value of platelet aggregation was 77.0+/-5.1% in normoproteinuria group, 78.1+/-7.3% in microproteinuria group, and 82.9+/-6.2% in overt proteinuria group (p=0.083). 4) The mean maximum value of platelet aggregation was 77.2+/-6.8% in diabetes without neuropathy group and 82.9+/-6.2% in diabetes with neuropathy group (p=0.114). 5) The mean maximum value of platelet aggregation was 79.3+/-4.9% in diabetes with normal funduscopic findings, 80.2+/-7.3% in diabetes with background retinopathy and 81.6+/-7.9% in diabetes with proliferative retinopathy (p=0.852). 6) Blood glucose showed positive correlations with the mean maximum platelet aggregation ( =0.529, p<0.005). CONCLUSION: The elevated mean maximum value of platelet aggregation was found in diabetics and there were no significant differences between macrovascular complications and between varying severity of retinopathy, neuropathy and proteinuria. Blood glucose showed positive correlations with mean maximum platelet aggregation. Hyperglycemia was a major risk factor affecting platelet aggregation in diabetics and its control may play an important role in prevention of diabetic vascular complications.

Lipoprotein (a) Level and Vascular Complications in NIDDM.: Ji Youn Kim, Mung Su Kim, Joung Min Kim, Jai Hong Park, Joung Hun Lee, Seung Won Yang, Dong Jin Chung, Min Young Chung, Tai Hee Lee; Korean Diabetes J. 1998;22(1):65-73. Published online January 1, 2001

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Abstract PDF: BACKGROUND
The risk of atherosclerosis is increased in subjects with diabetes mellitus. Lipoprotein(a) [Lp(a)] is an independent risk factor for atherosclerotic vascular disease in subjects without diabetes. The contribution of Lp(a) to the increased risk for atherosclerosis and diabetic complications in subjects with diabetes is not well known. In this report we examined the relationship between Lp(a) levels and development of vascular (macro- and microvascular) complications, and the relationship between Lp(a) and other risk factors for vascular complications in subjects with non-insulin-dependent diabetes mellitus(NIDDM), METHODS: For this study we evaluated 152 patients with NIDDM(72 women and 80 men). Lp(a) level was measured with N-Latex Lp(a) Reagent. Electrocardiography, coronary angiography, brain CT/MRI, doppler velocimetry and peripheral angiography were done for diagnosis of macravascular complieations, and fundus camera, nerve conduction velocity, BBV (beat to beat variation), VPT(vibration perception threshold) and 24-hour urine protein amount were examined for diagnosis of microvascular complications. RESULTS: Lp(a) levels in subjects with ischemic heart disease, cerebrovascular disease and diabetic retinopathy were significantly higher than those in subjects without above mentioned diseases. ApoB/ApoA1 ratio and LDL-cholesterol levels in subjects with Lp(a) level>30mg/dL were significantly higher than those in subjects with Lp(a) level 30mg/dL, and Lp(a) has a positive correlation with ApoB/ApoA1 ratio and LDL-cholesterol in NIDDM patients with vasculopathy. CONCLUSION: These results suggest that high Lp(a) levels seem to be associated with macrovascular and microvascular(especially with retinopathy) complications in subjects with NIDDM and Lp(a) level should be measured in the NIDDM with high level of ApoB/ApoA1 ratio and/or LDL-eholesterol.

Diabetes Mellitus and Cognitive Dysfunction.: Min Young Chung; Korean Diabetes J. 1997;21(1):1-13. Published online January 1, 2001

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Abstract PDF: No abstract available.

Effect of clisapride on gastric emptying in patients with diabetic gastroparesis.: Jae Soo Ahn, Hyun Ju Chang, Eun Jin Choi, Sang Sun Park, Dai Ho Lee, Jae Hyun Cho, Ho Chul Kang, Min Young Chung, Tai Hee Lee; Korean Diabetes J. 1993;17(2):217-223. Published online January 1, 2001

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Abstract PDF: No abstract available.

Clinical study of cilostazol in diabetic patients with peripheralvascular disease.: Tai Hee Lee, Young Kil Choi, Kap Bum Huh, Soon Hyun Shin, Hong Kyu Lee, Ho Young Son, Young Seol Kim, Hyun Chul Lee, Min Young Chung; Korean Diabetes J. 1992;16(4):325-334. Published online January 1, 2001

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Abstract PDF: No abstract available.

A case of NIDDM complicated by acute mediastinitis.: Dae Ho Lee, Ho Cheol Kang, Jae Soo An, Hyun Joo Jang, Eun Jin Choi, Sang Seon Park, Jae Hyun Jho, Min Young Chung, Tai Hee Lee; Korean Diabetes J. 1992;16(3):237-240. Published online January 1, 2001

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Abstract PDF: No abstract available.

Glomerulopathy in vacor-induced diabetic mongolian gerbil.: Phil Woo Chung, Min Young Chung, Tai Hee Lee, Sun Hun Kim, Jae Rhyong Yoon; Korean Diabetes J. 1991;15(1):79-83. Published online January 1, 2001

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Abstract PDF: No abstract available.

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