Diabetes & Metabolism Journal

Review

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

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

Original Article

Technology/Device
Clinical and Lifestyle Determinants of Continuous Glucose Monitoring Metrics in Insulin-Treated Patients with Type 2 Diabetes Mellitus: Da Young Lee, Namho Kim, Inha Jung, So Young Park, Ji Hee Yu, Ji A Seo, Jihee Kim, Kyeong Jin Kim, Nam Hoon Kim, Hye Jin Yoo, Sin Gon Kim, Kyung Mook Choi, Sei Hyun Baik, Sung-Min Park, Nan Hee Kim; Diabetes Metab J. 2023;47(6):826-836. Published online August 24, 2023; DOI: https://doi.org/10.4093/dmj.2022.0273

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Background
There was limited evidence to evaluate the association between lifestyle habits and continuous glucose monitoring (CGM) metrics. Thus, we aimed to depict the behavioral and metabolic determinants of CGM metrics in insulin-treated patients with type 2 diabetes mellitus (T2DM).
Methods
This is a prospective observational study. We analyzed data from 122 insulin-treated patients with T2DM. Participants wore Dexcom G6 and Fitbit, and diet information was identified for 10 days. Multivariate-adjusted logistic regression analysis was performed for the simultaneous achievement of CGM-based targets, defined by the percentage of time in terms of hyper, hypoglycemia and glycemic variability (GV). Intake of macronutrients and fiber, step counts, sleep, postprandial C-peptide-to-glucose ratio (PCGR), information about glucose lowering medications and metabolic factors were added to the analyses. Additionally, we evaluated the impact of the distribution of energy and macronutrient during a day, and snack consumption on CGM metrics.
Results
Logistic regression analysis revealed that female, participants with high PCGR, low glycosylated hemoglobin (HbA1c) and daytime step count had a higher probability of achieving all targets based on CGM (odds ratios [95% confidence intervals] which were 0.24 [0.09 to 0.65], 1.34 [1.03 to 1.25], 0.95 [0.9 to 0.99], and 1.15 [1.03 to 1.29], respectively). And participants who ate snacks showed a shorter period of hyperglycemia and less GV compared to those without.
Conclusion
We confirmed that residual insulin secretion, daytime step count, HbA1c, and women were the most relevant determinants of adequate glycemic control in insulin-treated patients with T2DM. In addition, individuals with snack consumption were exposed to lower times of hyperglycemia and GV.

Citations

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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

Letter

Association of Body Mass Index and Fracture Risk Varied by Affected Bones in Patients with Diabetes: A Nationwide Cohort Study (Diabetes Metab J 2023;47:242-54): So Young Park; Diabetes Metab J. 2023;47(3):437-438. Published online May 26, 2023; DOI: https://doi.org/10.4093/dmj.2023.0100; [Original]

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Original Article

Others
Fasting Glucose Variability and the Risk of Dementia in Individuals with Diabetes: A Nationwide Cohort Study: Da Young Lee, Jaeyoung Kim, Sanghyun Park, So Young Park, Ji Hee Yu, Ji A Seo, Nam Hoon Kim, Hye Jin Yoo, Sin Gon Kim, Kyung Mook Choi, Sei Hyun Baik, Kyungdo Han, Nan Hee Kim; Diabetes Metab J. 2022;46(6):923-935. Published online May 24, 2022; DOI: https://doi.org/10.4093/dmj.2021.0346

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Background
We investigated whether fasting glucose (FG) variability could predict the risk of dementia.
Methods
This cohort study analyzed data from Koreans with diabetes after at least three health examinations by the Korean National Health Insurance Corporation between 2005 and 2010, which included at least one examination between 2009 and 2010. A total of 769,554 individuals were included, excluding those aged <40 years and those with dementia. FG variability was measured using the variability independent of the mean (FG-VIM). The incidence of dementia was defined by the International Classification of Diseases 10th Revision codes and prescription of anti-dementia medication and was subdivided into Alzheimer’s disease (AD) and vascular dementia (VD).
Results
During the 6.9-year follow-up, 54,837, 41,032, and 6,892 cases of all-cause dementia, AD, and VD, respectively, were identified. Cox proportional regression analyses showed that as the FG-VIM quartile increased, the risk of dementia serially increased after adjustment for metabolic factors, income status, and diabetes-related characteristics, including the mean FG. Participants in FG-VIM quartile 4 showed a 18%, 19%, and 17% higher risk for all-cause dementia, AD, and VD, respectively, than those in quartile 1; this particularly included non-obese patients with a longer duration of diabetes, high FG levels, dyslipidemia, and those taking glucose-lowering medications. Conversely, the baseline FG status and dementia showed a U-shaped association.
Conclusion
Increased FG variability over 5 years can predict the risk of dementia in individuals with diabetes in Korea. This finding was more pronounced in patients with less favorable metabolic profiles.

Citations

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Effects of a Diabetic Microenvironment on Neurodegeneration: Special Focus on Neurological Cells
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Brain Sciences.2024; 14(3): 284. CrossRef
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Heather Cuevas, Elizabeth Muñoz, Divya Nagireddy, Jeeyeon Kim, Grace Ganucheau, Fathia Alomoush
Clinical Nursing Research.2023; 32(2): 249. CrossRef
The effects of long-term cumulative HbA1c exposure on the development and onset time of dementia in the patients with type 2 diabetes mellitus: Hospital based retrospective study (2005–2021)
Sunyoung Cho, Choon Ok Kim, Bong-soo Cha, Eosu Kim, Chung Mo Nam, Min-Gul Kim, Min Soo Park
Diabetes Research and Clinical Practice.2023; 201: 110721. CrossRef
Physiological Mechanisms Inherent to Diabetes Involved in the Development of Dementia: Alzheimer’s Disease
Himan Mohamed-Mohamed, Victoria García-Morales, Encarnación María Sánchez Lara, Anabel González-Acedo, Teresa Pardo-Moreno, María Isabel Tovar-Gálvez, Lucía Melguizo-Rodríguez, Juan José Ramos-Rodríguez
Neurology International.2023; 15(4): 1253. CrossRef
Cumulative effect of impaired fasting glucose on the risk of dementia in middle-aged and elderly people: a nationwide cohort study
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Scientific Reports.2023;[Epub] CrossRef

Short Communication

Technology/Device
Comparison of Laser and Conventional Lancing Devices for Blood Glucose Measurement Conformance and Patient Satisfaction in Diabetes Mellitus: Jung A Kim, Min Jeong Park, Eyun Song, Eun Roh, So Young Park, Da Young Lee, Jaeyoung Kim, Ji Hee Yu, Ji A Seo, Kyung Mook Choi, Sei Hyun Baik, Hye Jin Yoo, Nan Hee Kim; Diabetes Metab J. 2022;46(6):936-940. Published online March 30, 2022; DOI: https://doi.org/10.4093/dmj.2021.0293

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Self-monitoring of capillary blood glucose is important for controlling diabetes. Recently, a laser lancing device (LMT-1000) that can collect capillary blood without skin puncture was developed. We enrolled 150 patients with type 1 or 2 diabetes mellitus. Blood sampling was performed on the same finger on each hand using the LMT-1000 or a conventional lancet. The primary outcome was correlation between glucose values using the LMT-1000 and that using a lancet. And we compared the pain and satisfaction of the procedures. The capillary blood sampling success rates with the LMT-1000 and lancet were 99.3% and 100%, respectively. There was a positive correlation (r=0.974, P<0.001) between mean blood glucose levels in the LMT-1000 (175.8±63.0 mg/dL) and conventional lancet samples (172.5±63.6 mg/dL). LMT-1000 reduced puncture pain by 75.0% and increased satisfaction by 80.0% compared to a lancet. We demonstrated considerable consistency in blood glucose measurements between samples from the LMT-1000 and a lancet, but improved satisfaction and clinically significant pain reduction were observed with the LMT-1000 compared to those with a lancet.

Citations

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Comparison between a laser-lancing device and automatic incision lancet for capillary blood sampling from the heel of newborn infants: a randomized feasibility trial
Chul Kyu Yun, Eui Kyung Choi, Hyung Jin Kim, Jaeyoung Kim, Byung Cheol Park, Kyuhee Park, Byung Min Choi
Journal of Perinatology.2024;[Epub] CrossRef

Review

Technology/Device
Assessment of Insulin Secretion and Insulin Resistance in Human: So Young Park, Jean-François Gautier, Suk Chon; Diabetes Metab J. 2021;45(5):641-654. Published online September 30, 2021; DOI: https://doi.org/10.4093/dmj.2021.0220

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Graphical Abstract Abstract PDF PubReader ePub

The impaired insulin secretion and increased insulin resistance (or decreased insulin sensitivity) play a major role in the pathogenesis of all types of diabetes mellitus (DM). It is very important to assess the pancreatic β-cell function and insulin resistance/ sensitivity to determine the type of DM and to plan an optimal management and prevention strategy for DM. So far, various methods and indices have been developed to assess the β-cell function and insulin resistance/sensitivity based on static, dynamic test and calculation of their results. In fact, since the metabolism of glucose and insulin is made through a complex process related with various stimuli in several tissues, it is difficult to fully reflect the real physiology. In order to solve the theoretical and practical difficulties, research on new index is still in progress. Also, it is important to select the appropriate method and index for the purpose of use and clinical situation. This review summarized a variety of traditional methods and indices to evaluate pancreatic β-cell function and insulin resistance/sensitivity and introduced novel indices.

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Response

Response: Cardio-Ankle Vascular Index as a Surrogate Marker of Early Atherosclerotic Cardiovascular Disease in Koreans with Type 2 Diabetes Mellitus (Diabetes Metab J 2018;42:285-95): So Young Park, Suk Chon; Diabetes Metab J. 2018;42(5):449-450. Published online October 22, 2018; DOI: https://doi.org/10.4093/dmj.2018.0206

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Original Articles

Clinical Diabetes and Therapeutics
Cardio-Ankle Vascular Index as a Surrogate Marker of Early Atherosclerotic Cardiovascular Disease in Koreans with Type 2 Diabetes Mellitus: So Young Park, Sang Ook Chin, Sang Youl Rhee, Seungjoon Oh, Jeong-Taek Woo, Sung Woon Kim, Suk Chon; Diabetes Metab J. 2018;42(4):285-295. Published online July 27, 2018; DOI: https://doi.org/10.4093/dmj.2017.0080

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Background

Carotid artery intima medial thickness (IMT), brachial-ankle pulse wave velocity (baPWV), and ankle-brachial index (ABI) are commonly used surrogate markers of subclinical atherosclerosis in patients with type 2 diabetes mellitus (T2DM). The cardio-ankle vascular index (CAVI) is a complement to the baPWV, which is affected by blood pressure. However, it is unclear which marker is the most sensitive predictor of atherosclerotic cardiovascular disease (ASCVD).

Methods

This was a retrospective non-interventional study that enrolled 219 patients with T2DM. The correlations among IMT, ABI, and CAVI as well as the relationship of these tests to the 10-year ASCVD risk were also analyzed.

Results

Among the 219 patients, 39 (17.8%) had ASCVD. In the non-ASCVD group, CAVI correlated significantly with IMT after adjusting for confounding variables, but ABI was not associated with CAVI or IMT. The analyses after dividing the non-ASCVD group into three subgroups according to the CAVI score (<8, ≥8 and <9, and ≥9) demonstrated the significant increase in the mean IMT, 10-year ASCVD risk and number of metabolic syndrome risk factors, and decrease in the mean ABI in the high-CAVI group. A high CAVI was an independent risk factor in the non-ASCVD group for both a high 10-year ASCVD risk (≥7.5%; odds ratio [OR], 2.42; P<0.001) and atherosclerosis (mean IMT ≥1 mm; OR, 1.53; P=0.007).

Conclusion

In Korean patients with T2DM without ASCVD, CAVI was the most sensitive of several surrogate markers for the detection of subclinical atherosclerosis.

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The effects of severe periodontitis on arterial stiffness using cardio‐ankle vascular index in patients with type 2 diabetes
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Malathi S, Arockia Raj Y, Abhishek Kumar, V D Ashok Kumar, Ankit Kumar, Elangovan D, V D Ambeth Kumar, Chitra B, a Abirami
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AIDS Care.2023; 35(4): 591. CrossRef
Impact of Fasting Blood Glucose Levels on Blood Pressure Parameters among Older Adults with Prediabetes
Thapanee Roengrit, Ruchada Sri-Amad, Nawiya Huipao, Suphawadee Phababpha, Piyapong Prasertsri, Francesco Giallauria
The Scientific World Journal.2023; 2023: 1. CrossRef
A framework of biomarkers for vascular aging: a consensus statement by the Aging Biomarker Consortium
Le Zhang, Jun Guo, Yuehong Liu, Shimin Sun, Baohua Liu, Qi Yang, Jun Tao, Xiao-Li Tian, Jun Pu, Huashan Hong, Miao Wang, Hou-Zao Chen, Jie Ren, Xiaoming Wang, Zhen Liang, Yuan Wang, Kai Huang, Weiqi Zhang, Jing Qu, Zhenyu Ju, Guang-Hui Liu, Gang Pei, Jian
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The Journal of Clinical Endocrinology & Metabolism.2022; 107(9): e3857. CrossRef
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The Relationship Between Glycemic Control and Concomitant Hypertension on Arterial Stiffness in Type II Diabetes

Teonchit Nuamchit, Duangduan Siriwittayawan, Piyanuch Thitiwuthikiat
Vascular Health and Risk Management.2020; Volume 16: 343. CrossRef
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Association of Kidney Function Tests with a Cardio-Ankle Vascular Index in Community-Dwelling Individuals with a Normal or Mildly Decreased Estimated Glomerular Filtration Rate
Javad Alizargar, Chyi-Huey Bai, Nan-Chen Hsieh, Shu-Fang Vivienne Wu, Shih-Yen Weng, Jia-Ping Wu
Medicina.2019; 55(10): 657. CrossRef
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A. S. Veklich, N. A. Koziolova, P. G. Karavaev
Russian Journal of Cardiology.2019; (11): 42. CrossRef
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Experimental and Therapeutic Medicine.2019;[Epub] CrossRef
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International Journal of Environmental Research and Public Health.2019; 16(10): 1853. CrossRef
Response: Cardio-Ankle Vascular Index as a Surrogate Marker of Early Atherosclerotic Cardiovascular Disease in Koreans with Type 2 Diabetes Mellitus (Diabetes Metab J 2018;42:285-95)
So Young Park, Suk Chon
Diabetes & Metabolism Journal.2018; 42(5): 449. CrossRef
Letter: Cardio-Ankle Vascular Index as a Surrogate Marker of Early Atherosclerotic Cardiovascular Disease in Koreans with Type 2 Diabetes Mellitus (Diabetes Metab J 2018;42:285-95)
Dongwon Yi
Diabetes & Metabolism Journal.2018; 42(5): 447. CrossRef

Complications
Glycated Albumin Is a More Useful Glycation Index than HbA1c for Reflecting Renal Tubulopathy in Subjects with Early Diabetic Kidney Disease: Ji Hye Huh, Minyoung Lee, So Young Park, Jae Hyeon Kim, Byung-Wan Lee; Diabetes Metab J. 2018;42(3):215-223. Published online May 2, 2018; DOI: https://doi.org/10.4093/dmj.2017.0091

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Background

The aim of this study was to investigate which glycemic parameters better reflect urinary N-acetyl-β-D-glucosaminidase (uNAG) abnormality, a marker for renal tubulopathy, in subjects with type 2 diabetes mellitus (T2DM) subjects with normoalbuminuria and a normal estimated glomerular filtration rate (eGFR).

Methods

We classified 1,061 participants with T2DM into two groups according to uNAG level—normal vs. high (>5.8 U/g creatinine)—and measured their biochemical parameters.

Results

Subjects with high uNAG level had significantly higher levels of fasting and stimulated glucose, glycated albumin (GA), and glycosylated hemoglobin (HbA1c) and lower levels of homeostasis model assessment of β-cell compared with subjects with normal uNAG level. Multiple linear regression analyses showed that uNAG was significantly associated with GA (standardized β coefficient [β]=0.213, P=0.016), but not with HbA1c (β=−0.137, P=0.096) or stimulated glucose (β=0.095, P=0.140) after adjusting confounding factors. In receiver operating characteristic analysis, the value of the area under the curve (AUC) for renal tubular injury of GA was significantly higher (AUC=0.634; 95% confidence interval [CI], 0.646 to 0.899) than those for HbA1c (AUC=0.598; 95% CI, 0.553 to 0.640), stimulated glucose (AUC=0.594; 95% CI, 0.552 to 0.636), or fasting glucose (AUC=0.558; 95% CI, 0.515 to 0.600). The optimal GA cutoff point for renal tubular damage was 17.55% (sensitivity 59%, specificity 62%).

Conclusion

GA is a more useful glycation index than HbA1c for reflecting renal tubulopathy in subjects with T2DM with normoalbuminuria and normal eGFR.

Citations

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Glucagon-Like Peptide 1 Receptor Agonist Improves Renal Tubular Damage in Mice with Diabetic Kidney Disease
Ran Li, Dunmin She, Zhengqin Ye, Ping Fang, Guannan Zong, Yong Zhao, Kerong Hu, Liya Zhang, Sha Lei, Keqin Zhang, Ying Xue
Diabetes, Metabolic Syndrome and Obesity: Targets and Therapy.2022; Volume 15: 1331. CrossRef
Use of glycated albumin for the identification of diabetes in subjects from northeast China
Guo-Yan Li, Hao-Yu Li, Qiang Li
World Journal of Diabetes.2021; 12(2): 149. CrossRef
Diabetic Kidney Disease, Cardiovascular Disease and Non-Alcoholic Fatty Liver Disease: A New Triumvirate?
Carolina M. Perdomo, Nuria Garcia-Fernandez, Javier Escalada
Journal of Clinical Medicine.2021; 10(9): 2040. CrossRef
Empagliflozin reduces high glucose-induced oxidative stress and miR-21-dependent TRAF3IP2 induction and RECK suppression, and inhibits human renal proximal tubular epithelial cell migration and epithelial-to-mesenchymal transition
Nitin A. Das, Andrea J. Carpenter, Anthony Belenchia, Annayya R. Aroor, Makoto Noda, Ulrich Siebenlist, Bysani Chandrasekar, Vincent G. DeMarco
Cellular Signalling.2020; 68: 109506. CrossRef
Glycated Plasma Proteins as More Sensitive Markers for Glycemic Control in Type 1 Diabetes
Lina Zhang, Qibin Zhang
PROTEOMICS – Clinical Applications.2020;[Epub] CrossRef
Glycated albumin and its variability: Clinical significance, research progress and overall review
Dongjun Dai, Yifei Mo, Jian Zhou
Obesity Medicine.2020; 19: 100256. CrossRef
Hepatic fibrosis is associated with total proteinuria in Korean patients with type 2 diabetes
Eugene Han, Yongin Cho, Kyung-won Kim, Yong-ho Lee, Eun Seok Kang, Bong-Soo Cha, Byung-wan Lee
Medicine.2020; 99(33): e21038. CrossRef
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Yongin Cho, Yong-ho Lee, Eun Seok Kang, Bong-soo Cha, Byung-wan Lee
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Obesity and Metabolic Syndrome
Air Pollution Has a Significant Negative Impact on Intentional Efforts to Lose Weight: A Global Scale Analysis: Morena Ustulin, So Young Park, Sang Ouk Chin, Suk Chon, Jeong-taek Woo, Sang Youl Rhee; Diabetes Metab J. 2018;42(4):320-329. Published online April 24, 2018; DOI: https://doi.org/10.4093/dmj.2017.0104

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Background

Air pollution causes many diseases and deaths. It is important to see how air pollution affects obesity, which is common worldwide. Therefore, we analyzed data from a smartphone application for intentional weight loss, and then we validated them.

Methods

Our analysis was structured in two parts. We analyzed data from a cohort registered to a smartphone application in 10 large cities of the world and matched it with the annual pollution values. We validated these results using daily pollution data in United States and matching them with user information. Body mass index (BMI) variation between final and initial login time was considered as outcome in the first part, and daily BMI in the validation. We analyzed: daily calories intake, daily weight, daily physical activity, geographical coordinates, seasons, age, gender. Weather Underground application programming interface provided daily climatic values. Annual and daily values of particulate matter PM10 and PM2.5 were extracted. In the first part of the analysis, we used 2,608 users and then 995 users located in United States.

Results

Air pollution was highest in Seoul and lowest in Detroit. Users decreased BMI by 2.14 kg/m² in average (95% confidence interval, −2.26 to −2.04). From a multilevel model, PM10 (β=0.04, P=0.002) and PM2.5 (β=0.08, P<0.001) had a significant negative effect on weight loss when collected per year. The results were confirmed with the validation (β_AQI*time=1.5×10^–5; P<0.001) by mixed effects model.

Conclusion

This is the first study that shows how air pollution affects intentional weight loss applied on wider area of the world.

Citations

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What could be the reasons for not losing weight even after following a weight loss program?
Jyoti Dabas, S. Shunmukha Priya, Akshay Alawani, Praveen Budhrani
Journal of Health, Population and Nutrition.2024;[Epub] CrossRef
Subchronic exposure to 1,2-naphthoquinone induces adipose tissue inflammation and changes the energy homeostasis of mice, partially due to TNFR1 and TLR4
Clílton Kraüss de Oliveira Ferreira, Clara Machado Campolim, Olívia Pizetta Zordão, Fernando Moreira Simabuco, Chadi Pellegrini Anaruma, Rodrigo Martins Pereira, Vitor Ferreira Boico, Luiz Guilherme Salvino, Maíra Maftoum Costa, Nathalia Quintero Ruiz, Le
Toxicology Reports.2023; 11: 10. CrossRef
Effects of Ambient Particulate Matter (PM2.5) Exposure on Calorie Intake and Appetite of Outdoor Workers
Thavin Kumar Mathana Sundram, Eugenie Sin Sing Tan, Hwee San Lim, Farahnaz Amini, Normina Ahmad Bustami, Pui Yee Tan, Navedur Rehman, Yu Bin Ho, Chung Keat Tan
Nutrients.2022; 14(22): 4858. CrossRef
Efficiency in reducing air pollutants and healthcare expenditure in the Seoul Metropolitan City of South Korea
Subal C. Kumbhakar, Jiyeon An, Masoomeh Rashidghalam, Almas Heshmati
Environmental Science and Pollution Research.2021; 28(20): 25442. CrossRef
Seasonal variation and trends in the Internet searches for losing weight: An infodemiological study
Ying Teng, Shun-Wei Huang, Zhen Li, Qiao-Mei Xie, Man Zhang, Qiu-Yue Lou, Fang Wang, Yan-Feng Zou
Obesity Research & Clinical Practice.2020; 14(3): 225. CrossRef
Estimation of health benefits from air quality improvement using the MODIS AOD dataset in Seoul, Korea
Daeun Kim, Jeongyeong Kim, Jaehwan Jeong, Minha Choi
Environmental Research.2019; 173: 452. CrossRef
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Sang Youl Rhee
The Korean Journal of Medicine.2019; 94(5): 387. CrossRef
Can Air Pollution Biologically Hinder Efforts to Lose Body Weight?
Duk-Hee Lee
Diabetes & Metabolism Journal.2018; 42(4): 282. CrossRef

Clinical Care/Education
Diabetes Camp as Continuing Education for Diabetes Self-Management in Middle-Aged and Elderly People with Type 2 Diabetes Mellitus: So Young Park, Sun Young Kim, Hye Mi Lee, Kyu Yeon Hur, Jae Hyeon Kim, Moon-Kyu Lee, Kang-Hee Sim, Sang-Man Jin; Diabetes Metab J. 2017;41(2):99-112. Published online March 3, 2017; DOI: https://doi.org/10.4093/dmj.2017.41.2.99

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Background

Despite the established benefits of diabetes camps for the continuing education of children with type 1 diabetes mellitus, little is known about the long-term metabolic benefits of diabetes camps for middle-aged and elderly people with type 2 diabetes mellitus (T2DM), especially in terms of glycosylated hemoglobin (HbA1c) variability.

Methods

The 1-year mean and variability of HbA1c before and after the diabetes camp was compared between the participants of the diabetes camp (n=57; median age 65 years [range, 50 to 86 years]; median diabetes duration 14 years [range, 1 to 48 years]). Additional case-control analysis compared the metabolic outcomes of the participants of the diabetes camp and their propensity score-matched controls who underwent conventional diabetes education (n=93).

Results

The levels of HbA1c during the first year after the diabetes camp were comparable to those of the matched controls (P=0.341). In an analysis of all participants of the diabetes camp, the 1-year mean±standard deviation (SD) of HbA1c decreased (P=0.010 and P=0.041) after the diabetes camp, whereas the adjusted SD and coefficient of variance (CV) of HbA1c did not decrease. The adjusted SD and CV significantly decreased after the diabetes camp in participants whose 1-year mean HbA1c was ≥6.5% before the diabetes camp (n=40) and those with a duration of diabetes less than 15 years (n=32).

Conclusion

The 1-year mean and SD of HbA1c decreased after the diabetes camp, with significant reduction in the adjusted SD and CV in those with higher baseline HbA1c and a shorter duration of diabetes.

Citations

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Older adults’ experiences of being at a senior summer camp—A phenomenographic study
Veronika Wallroth, Kjerstin Larsson, Agneta Schröder
Qualitative Social Work.2022; 21(5): 956. CrossRef
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Gabriella Nilsson, Lisa Ekstam, Janicke Andersson
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Response

Response: Effects of Rebamipide on Gastrointestinal Symptoms in Patients with Type 2 Diabetes Mellitus (Diabetes Metab J 2016;40:240-7): Sejeong Park, So Young Park, Sang Youl Rhee; Diabetes Metab J. 2016;40(4):336-337. Published online August 18, 2016; DOI: https://doi.org/10.4093/dmj.2016.40.4.336

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Original Articles

Others
Effects of Rebamipide on Gastrointestinal Symptoms in Patients with Type 2 Diabetes Mellitus: Sejeong Park, So Young Park, Yu Jin Kim, Soo Min Hong, Suk Chon, Seungjoon Oh, Jeong-taek Woo, Sung-Woon Kim, Young Seol Kim, Sang Youl Rhee; Diabetes Metab J. 2016;40(3):240-247. Published online April 5, 2016; DOI: https://doi.org/10.4093/dmj.2016.40.3.240

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Background

Gastrointestinal (GI) symptoms are common in patients with type 2 diabetes mellitus (T2DM). Rebamipide is an effective gastric cytoprotective agent, but there are few data on its usefulness in T2DM. The aim of this study is to evaluate the improvement of GI symptoms after rebamipide treatment in patients with T2DM.

Methods

Patients with T2DM and atypical GI symptoms were enrolled. They took rebamipide (100 mg thrice daily) for 12 weeks and filled out the diabetes bowel symptom questionnaire (DBSQ) before and after rebamipide treatment. The DBSQ consisted of 10 questions assessing the severity of GI symptoms by a 1 to 6 scoring system. Changes in the DBSQ scores before and after rebamipide treatment were analyzed to evaluate any improvements of GI symptoms.

Results

A total of 107 patients were enrolled, and 84 patients completed the study. The mean age was 65.0±7.8, 26 patients were male (24.8%), the mean duration of T2DM was 14.71±9.12 years, and the mean glycosylated hemoglobin level was 6.97%±0.82%. The total DBSQ score was reduced significantly from 24.9±8.0 to 20.4±7.3 before and after rebamipide treatment (P<0.001). The DBSQ scores associated with reflux symptoms, indigestion, nausea or vomiting, abdominal bloating or distension, peptic ulcer, abdominal pain, and constipation were improved after rebamipide treatment (P<0.05). However, there were no significant changes in symptoms associated with irritable bowel syndrome, diarrhea, and anal incontinence. No severe adverse events were reported throughout the study.

Conclusion

Rebamipide treatment for 12 weeks improved atypical GI symptoms in patients with T2DM.

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Effectiveness of Rebamipide as a part of the Helicobacter pylori eradication therapy in Russia: a meta-analysis of controlled trials
Dmitry N. Andreev, Igor V. Maev, Dmitry S. Bordin, Svetlana V. Lyamina, Diana T. Dicheva, Aleksei K. Fomenko, Armine S. Bagdasarian
Consilium Medicum.2022; 24(5): 333. CrossRef
Сompliance in patients with coronary heart disease and erosive-ulcerative gastroduodenopathy
A. R. Molchanova, A. I. Dolgushina, A. A. Seljanina
Experimental and Clinical Gastroenterology.2020; (6): 82. CrossRef
Rebamipide: evidence base for use in gastroenterology
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Mohamed Hasif Jaafar, Sher Zaman Safi, Maw-Pin Tan, Sanjay Rampal, Sanjiv Mahadeva
Digestive Diseases and Sciences.2018; 63(5): 1250. CrossRef
Letter: Effects of Rebamipide on Gastrointestinal Symptoms in Patients with Type 2 Diabetes Mellitus (Diabetes Metab J2016;40:240-7)
Jin Hwa Kim
Diabetes & Metabolism Journal.2016; 40(4): 334. CrossRef
Response: Effects of Rebamipide on Gastrointestinal Symptoms in Patients with Type 2 Diabetes Mellitus (Diabetes Metab J 2016;40:240-7)
Sejeong Park, So Young Park, Sang Youl Rhee
Diabetes & Metabolism Journal.2016; 40(4): 336. CrossRef

A Smartphone Application Significantly Improved Diabetes Self-Care Activities with High User Satisfaction: Yu Jin Kim, Sang Youl Rhee, Jong Kyu Byun, So Young Park, Soo Min Hong, Sang Ouk Chin, Suk Chon, Seungjoon Oh, Jeong-taek Woo, Sung Woon Kim, Young Seol Kim; Diabetes Metab J. 2015;39(3):207-217. Published online April 22, 2015; DOI: https://doi.org/10.4093/dmj.2015.39.3.207

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Background

We developed for the first time a smartphone application designed for diabetes self-management in Korea and registered a patent for the relevant algorithm. We also investigated the user satisfaction with the application and the change in diabetes related self-care activities after using the application.

Methods

We conducted a questionnaire survey on volunteers with diabetes who were using the application. Ninety subjects responded to the questionnaire between June 2012 and March 2013. A modified version of the Summary of Diabetes Self-Care Activities (SDSCA) was used in this study.

Results

The survey results exhibited a mean subject age of 44.0 years old, and males accounted for 78.9% of the subjects. Fifty percent of the subjects had diabetes for less than 3 years. The majority of respondents experienced positive changes in their clinical course after using the application (83.1%) and were satisfied with the structure and completeness of the application (86.7%). Additionally, the respondents' answers indicated that the application was easy to use (96.7%) and recommendable to others (97.7%) and that they would continue using the application to manage their diabetes (96.7%). After using the Diabetes Notepad application, diabetes related self-care activities assessed by SDSCA displayed statistically significant improvements (P<0.05), except for the number of days of drinking.

Conclusion

This smartphone-based application can be a useful tool leading to positive changes in diabetes related self-care activities and increase user satisfaction.

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Intracerebroventricular Injection of Metformin Induces Anorexia in Rats: Chang Koo Lee, Yoon Jung Choi, So Young Park, Jong Yeon Kim, Kyu Chang Won, Yong Woon Kim; Diabetes Metab J. 2012;36(4):293-299. Published online August 20, 2012; DOI: https://doi.org/10.4093/dmj.2012.36.4.293

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Background

Metformin, an oral biguanide insulin-sensitizing agent, is well known to decrease appetite. Although there is evidence that metformin could affect the brain directly, the exact mechanism is not yet known.

Methods

To evaluate whether metformin induces anorexia via the hypothalamus, various concentrations of metformin were injected into the lateral ventricle of rats through a chronically implanted catheter and food intake was measured for 24 hours. The hypothalamic neuropeptides associated with regulation of food intake were also analyzed following 1 hour of intracerebroventricular (ICV) injections of metformin.

Results

An ICV injection of metformin decreased food intake in a dose-dependent manner in unrestrained conscious rats. Hypothalamic phosphorylated AMP-activated protein kinase (pAMPK) increased by 3 µg with metformin treatment, but there was no further increase in pAMPK with increases in metformin dosage. The hypothalamic phosphorylated signal transducer and activator of transcription 3 (pSTAT3) increased by 3 µg with metformin treatment, but, there was no further increase in pSTAT3 level following increases of metformin dosage. Hypothalamic proopiomelanocortin was elevated with metformin treatment, while neuropeptide Y was not significantly changed.

Conclusion

Our results suggest that metformin induces anorexia via direct action in the hypothalamus and the increase in pSTAT3, at least in part, is involved in the process. However, hypothalamic pAMPK appears not to contribute to metformin-induced appetite reduction in normal rats. Further studies exploring new pathways connecting metformin and feeding regulation are needed.

Citations

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