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Original Article
Genetics
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Evaluation of Sex-Stratified Polygenic Risk Scores for Type 2 Diabetes Mellitus and Glycemic Traits in the Framingham Heart Study
Ningyuan Wang, Yixin Zhang, Philip Schroeder, Alicia Huerta-Chagoya, Ravi Mandla, James B. Meigs, Alisa K. Manning, Ching-Ti Liu, Josée Dupuis, Josep M. Mercader
Received June 25, 2025  Accepted October 14, 2025  Published online December 9, 2025  
DOI: https://doi.org/10.4093/dmj.2025.0557    [Epub ahead of print]
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AbstractAbstract PDFSupplementary MaterialPubReader   ePub   
Background
Diabetes is a multifactorial disease with significant genetic predisposition. Polygenic risk scores (PRS) have been developed to estimate an individual’s genetic risk of a disease. Traditionally, PRS utilize sex-combined genome-wide association studies (GWAS) due to the limited availability of sex-stratified summary statistics. This study explores sex-dimorphic genetic effects and evaluates the potential benefits of incorporating sex-stratified effects in PRS for type 2 diabetes mellitus (T2DM) and glycemic traits by comparing PRS performance derived from sex-combined versus sex-stratified GWAS.
Methods
We performed a sex-heterogeneity test across sex-specific GWAS and identified nine signals with sex-dimorphic effects for T2DM. PRS[sex-combined] and PRS[sex-stratified] were developed using sex-combined and sex-stratified GWAS results for T2DM (41,444 cases and 354,539 controls), fasting glucose (n=120,595) and fasting insulin (n=98,210). We evaluated these PRS models in 8,379 participants (1,303 cases and 7,076 controls) from the Framingham Heart Study not included in the PRS derivation.
Results
Our findings suggest that sex-combined PRS currently offer better predictive performance for T2DM and glycemic traits.
Conclusion
These results highlight the need for larger sex-stratified studies and the optimization of sex-stratified risk models for clinical practice.
Brief Report
Technology/Device
Article image
Effectiveness of the Stage 4 Smart Insulin Pen DIA:CONN P8 for Glycemic Control in a Real-World Setting
So Yoon Kwon, Hyoseon Kwak, Jae Hyeon Kim
Received February 11, 2025  Accepted March 23, 2025  Published online September 3, 2025  
DOI: https://doi.org/10.4093/dmj.2025.0112    [Epub ahead of print]
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  • 64 Download
AbstractAbstract PDFSupplementary MaterialPubReader   ePub   
This study evaluated whether a stage 4 smart insulin pen (SIP) provides superior glycemic control compared with a traditional insulin pen (TIP) in individuals with intensively insulin-treated diabetes. Forty-two adults with continuous glucose monitoring (CGM), multiple daily insulin injections, and no prior SIP use were included. After diabetes self-management education (DSME), the SIP group (n=21) initiated SIP, whereas the TIP group (n=21) continued their usual regimens. Glycemic metrics were assessed using CGM before and 2 weeks after DSME. Both groups demonstrated significant improvements in glycemic outcomes. However, SIP users exhibited superior improvements in the percentage of time in range, percentage of time below range (%TBR) <70 mg/dL, %TBR <54 mg/dL, and glycemic risk index compared with TIP users (between-group difference [BD] 11.0%, P=0.046; BD –2.6%, P=0.024; BD –0.9%, P=0.027; BD –18.2, P=0.022, respectively). These findings suggest that SIP, with its bolus calculation and CGM integration, is associated with improved glycemic outcomes in adults with intensively insulin-treated diabetes.
Original Articles
Basic and Translational Research
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Effect of 4 Weeks Resonance Frequency Breathing on Glucose Metabolism and Autonomic Tone in Healthy Adults
Benedict Herhaus, Andreas Peter, Julia Hummel, Thomas Kubiak, Martin Heni, Katja Petrowski
Diabetes Metab J. 2025;49(6):1219-1228.   Published online April 3, 2025
DOI: https://doi.org/10.4093/dmj.2024.0647
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  • 110 Download
  • 1 Web of Science
  • 1 Crossref
AbstractAbstract PDFSupplementary MaterialPubReader   ePub   
Background
The autonomic nervous system plays a crucial role in the brain’s communication with metabolically important peripheral organs, modulating insulin sensitivity and secretion. Increased sympathetic tone is a common feature in prediabetes and diabetes. The parasympathetic nervous system activity might be improvable through resonance frequency breathing (RFB) with heart rate variability biofeedback (HRV-BF) training.
Methods
We here investigated the effect of a 4-week mobile RFB-HRV-BF intervention on glucose metabolism and HRV of 30 healthy adults (17 females; mean age 25.77±3.64 years; mean body mass index 22.65±2.95 kg/m2). Before and after the intervention, glucose metabolism was assessed by 75 g oral glucose tolerance tests (with blood sampling every 30 minutes over 2 hours) and HRV was measured through electrocardiography.
Results
RFB-HRV-BF training did not influence glucose metabolism in healthy adults but reduced fasting as well as 2-hour-postload glucose in participants categorized as more insulin resistant before the intervention. In addition, RFB-HRV-BF training was associated with an increase in the time and frequency domain HRV parameters standard deviation of all NN-intervals, root mean square successive differences, HRV high-frequency and HRV low-frequency after 4 weeks of intervention.
Conclusion
Our findings introduce RFB-HRV-BF training as an effective tool to modulate the autonomic nervous system with a shift towards the parasympathetic tone. Along with the observed decrease in glycemia in those with lower insulin sensitivity, RFB-HRV-BF training emerges as a promising non-pharmacological approach to improve glucose metabolism which has to be further investigated in prediabetes and diabetes.

Citations

Citations to this article as recorded by  
  • The autonomic nervous system in the regulation of glucose and lipid metabolism
    Sabrina Wangler, Marc N. Jarczok, Matthew Ennis, Benedict Herhaus, Róbert Wagner, Ratika Sehgal, Martin Heni
    Nature Reviews Endocrinology.2026;[Epub]     CrossRef
Others
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Contributions of Hepatic Insulin Resistance and Islet β-Cell Dysfunction to the Blood Glucose Spectrum in Newly Diagnosed Type 2 Diabetes Mellitus
Mengge Yang, Ying Wei, Jia Liu, Ying Wang, Guang Wang
Diabetes Metab J. 2025;49(4):883-892.   Published online February 13, 2025
DOI: https://doi.org/10.4093/dmj.2024.0537
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  • 6 Web of Science
  • 9 Crossref
AbstractAbstract PDFSupplementary MaterialPubReader   ePub   
Background
Our previous studies have investigated the role of hepatic insulin resistance (hepatic IR) and islet β-cell function in the pathogenesis of diabetes. This study aimed to explore the contributions of hepatic IR and islet β-cell dysfunction to the blood glucose spectrum in patients with newly diagnosed type 2 diabetes mellitus.
Methods
Hepatic IR was assessed by the hepatic insulin resistance index (HIRI). Islet β-cell function was assessed by insulin secretion- sensitivity index-2 (ISSI2). The associations between blood glucose spectrum and hepatic IR and ISSI2 were analyzed.
Results
A total of 707 patients with new-onset diabetes were included. The fasting blood glucose (FBG) and 30 minutes postload blood glucose elevated with rising HIRI (both P for trend <0.001). The FBG, 30 minutes, 2 hours, and 3 hours post-load blood glucose elevated with decreasing ISSI2 quartiles (all P for trend <0.001). There was a negative correlation between ISSI2 and HIRI after adjusting blood glucose levels (r=–0.199, P<0.001).
Conclusion
Hepatic IR mainly contributed to FBG and early-phase postprandial plasma glucose, whereas β-cell dysfunction contributed to fasting and postprandial plasma glucose at each phase.

Citations

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  • GLDC attenuates liver ischemia-reperfusion injury by inhibiting macrophage recruitment and activation via PTBP1/P2RY6
    Zhitao Li, Li Jin, Yuan Fang, Siming Qu, Bo Yuan, Kai Gan, Hanfei Huang
    Cellular Signalling.2025; 135: 111976.     CrossRef
  • The Physiological and Pathological Mechanisms of LIN2, LIN7, LIN10 and Their Tripartite Complex
    Yangyang Shang, Xinyi Gan, Yue Dang, Jie Liu, Peijun Liu
    Journal of Cellular and Molecular Medicine.2025;[Epub]     CrossRef
  • Cinnamic Acid: A Shield Against High-Fat-Diet-Induced Liver Injury—Exploring Nrf2’s Protective Mechanisms
    Asmahan Taher Alahdal, Laila Naif Al-Harbi, Ghedeir M. Alshammari, Ali Saleh, Mohammed Abdo Yahya
    International Journal of Molecular Sciences.2025; 26(16): 7940.     CrossRef
  • Sodium Butyrate Ameliorated Bile Acid Metabolism in Diabetes Mellitus by PI3K/AKT Signaling Pathway via the Gut–Liver Axis
    Tingting Zhao, Xi Zhang, Qian Xiang, Yadi Liu, Xuling Li, Junling Gu, Wenqian Zhang, Zhe Wang, Yiran Li, Xiaoshan Lai, Yonghua Zhao, Youhua Xu
    Current Issues in Molecular Biology.2025; 47(9): 732.     CrossRef
  • Chronic Intermittent Low-Pressure Hypoxia Suppresses Inflammation and Regulates Glycolipids by Modulating Mitochondrial Respiration in db/db Mice
    Xin Jiang, Keqing Yuan, Xiaofeng Ge, Lili Yu, Yufei Cui, Lianhai Jin, Ying Chang
    Metabolites.2025; 15(11): 707.     CrossRef
  • Expanding horizons: the role of robotic surgery in modern transplantation practices
    Arya Afrooghe, Pedram Pirmoradian, Moein Ghasemi, Benyamin Mohammadi, Mahya Soleymani Mehranjani, Elham Ahmadi, Seyed Amir Miratashi Yazdi
    Journal of Robotic Surgery.2025;[Epub]     CrossRef
  • Elevated PEDF promotes the occurrence of diabetes mellitus via suppressing GSIS by downregulating the SNARE complex
    Zhen Zhao, Yandan Tan, Jie Fang, Gan Xia, Junchen Li, Qilong Tang, Wanting Xie, Tianxiao Gao, Zhenzhen Fang, Ti Zhou, Xia Yang, Guoquan Gao, Weiwei Qi
    Communications Biology.2025;[Epub]     CrossRef
  • Distinct Circulating Biomarker Profiles Associated with Type 2 Diabetes in a Regional Cohort—A Cross-Sectional Study
    Abdullah Alsrhani, Muhammad Atif, Aisha Farhana
    Metabolites.2025; 15(12): 776.     CrossRef
  • Application and Predictive Potential of Novel Insulin Resistance Assessment Indices in Metabolic Diseases
    莹莹 郑
    Advances in Clinical Medicine.2025; 15(12): 2174.     CrossRef
Brief Report
Technology/Device
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Effectiveness of Predicted Low-Glucose Suspend Pump Technology in the Prevention of Hypoglycemia in People with Type 1 Diabetes Mellitus: Real-World Data Using DIA:CONN G8
Jee Hee Yoo, Ji Yoon Kim, Jae Hyeon Kim
Diabetes Metab J. 2025;49(1):144-149.   Published online August 28, 2024
DOI: https://doi.org/10.4093/dmj.2024.0039
  • 4,582 View
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AbstractAbstract PDFSupplementary MaterialPubReader   ePub   
We evaluated the effectiveness of the predictive low-glucose suspend (PLGS) algorithm in the DIA:CONN G8. Forty people with type 1 diabetes mellitus (T1DM) who used a DIA:CONN G8 for at least 2 months with prior experience using pumps without and with PLGS were retrospectively analyzed. The objective was to assess the changes in time spent in hypoglycemia (percent of time below range [%TBR]) before and after using PLGS. The mean age, sensor glucose levels, glucose threshold for suspension, and suspension time were 31.1±22.8 years, 159.7±23.2 mg/dL, 81.1±9.1 mg/dL, and 111.9±79.8 min/day, respectively. Overnight %TBR <70 mg/dL was significantly reduced after using the algorithm (differences=0.3%, from 1.4%±1.5% to 1.1%±1.2%, P=0.045). The glycemia risk index (GRI) improved significantly by 4.2 (from 38.8±20.9 to 34.6±19.0, P=0.002). Using the PLGS did not result in a change in the hyperglycemia metric (all P>0.05). Our findings support the PLGS in DIA:CONN G8 as an effective algorithm to improve night-time hypoglycemia and GRI in people with T1DM.

Citations

Citations to this article as recorded by  
  • Scoping review of subcutaneous glucose monitoring techniques
    Eva Hrubá, Jan Kubíček, Martin Augustynek
    Measurement.2026; 261: 119940.     CrossRef
  • Current Status of Continuous Glucose Monitoring Use in South Korean Type 1 Diabetes Mellitus Population–Pronounced Age-Related Disparities: Nationwide Cohort Study
    Ji Yoon Kim, Seohyun Kim, Jae Hyeon Kim
    Diabetes & Metabolism Journal.2025; 49(5): 1040.     CrossRef
Original Articles
Type 1 Diabetes
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Optimal Coefficient of Variance Threshold to Minimize Hypoglycemia Risk in Individuals with Well-Controlled Type 1 Diabetes Mellitus
Jee Hee Yoo, Seung Hee Yang, Sang-Man Jin, Jae Hyeon Kim
Diabetes Metab J. 2024;48(3):429-439.   Published online March 4, 2024
DOI: https://doi.org/10.4093/dmj.2023.0083
  • 9,240 View
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  • 5 Web of Science
  • 5 Crossref
AbstractAbstract PDFSupplementary MaterialPubReader   ePub   
Background
This study investigated the optimal coefficient of variance (%CV) for preventing hypoglycemia based on real-time continuous glucose monitoring (rt-CGM) data in people with type 1 diabetes mellitus (T1DM) already achieving their mean glucose (MG) target.
Methods
Data from 172 subjects who underwent rt-CGM for at least 90 days and for whom 439 90-day glycemic profiles were available were analyzed. Receiver operator characteristic analysis was conducted to determine the cut-off value of %CV to achieve time below range (%TBR)<54 mg/dL <1 and =0.
Results
Overall mean glycosylated hemoglobin was 6.8% and median %TBR<54 mg/dL was 0.2%. MG was significantly higher and %CV significantly lower in profiles achieving %TBR<54 mg/dL <1 compared to %TBR<54 mg/dL ≥1 (all P<0.001). The cut-off value of %CV for achieving %TBR<54 mg/dL <1 was 37.5%, 37.3%, and 31.0%, in the whole population, MG >135 mg/dL, and ≤135 mg/dL, respectively. The cut-off value for %TBR<54 mg/dL=0% was 29.2% in MG ≤135 mg/dL. In profiles with MG ≤135 mg/dL, 94.2% of profiles with a %CV <31 achieved the target of %TBR<54 mg/dL <1, and 97.3% with a %CV <29.2 achieved the target of %TBR<54 mg/ dL=0%. When MG was >135 mg/dL, 99.4% of profiles with a %CV <37.3 achieved %TBR<54 mg/dL <1.
Conclusion
In well-controlled T1DM with MG ≤135 mg/dL, we suggest a %CV <31% to achieve the %TBR<54 mg/dL <1 target. Furthermore, we suggest a %CV <29.2% to achieve the target of %TBR<54 mg/dL =0 for people at high risk of hypoglycemia.

Citations

Citations to this article as recorded by  
  • Glycemic variability before and during Ramadan fasting among adults with type 2 diabetes and hepatic cirrhosis: a prospective paired cohort using real‑time CGM
    Sarah Firdausa, Irsan Hasan, Dicky L. Tahapary, Ignatius Bima Prasetya, Suharko Soebardi, Cleopas Martin Rumende, Hamzah Shatri, Cosphiadi Irawan, Wismandari Wisnu
    Diabetes Research and Clinical Practice.2026; 231: 112955.     CrossRef
  • Plasma C-Peptide Level and Continuous Glucose Monitoring-Derived Coefficient of Variation as a Predictable Risk Factor for Hypoglycemia in Koreans with Diabetes
    Seung-Hyun Ko
    Endocrinology and Metabolism.2025; 40(2): 198.     CrossRef
  • Time in tight range and time in range for predicting the achievement of typical glucose management indicator and HbA1c targets
    Seohyun Kim, Sang Ho Park, Jin A. Lee, So Hyun Cho, Rosa Oh, Ji Yoon Kim, You-Bin Lee, Gyuri Kim, Kyu Yeon Hur, Jae Hyeon Kim, Sang-Man Jin
    Diabetologia.2025; 68(8): 1674.     CrossRef
  • Associations of time in tight range, time in range, and glycated hemoglobin with albuminuria in type 1 diabetes: A cross-sectional study
    Ji Yoon Kim, Seohyun Kim, Sang Ho Park, Jin A Lee, So Hyun Cho, Rosa Oh, Myunghwa Jang, You-Bin Lee, Gyuri Kim, Kyu Yeon Hur, Jae Hyeon Kim, Sang-Man Jin
    Diabetes Research and Clinical Practice.2025; 226: 112325.     CrossRef
  • When would I be surprised? Variability in predicted probability of survival for being “surprised” and “not surprised” to the surprise question
    David Hui, Amy Ontai, Clark Andersen, John P. Maxwell, Yusuke Hiratsuka, Sang-Yeon Suh, Sun Hyun Kim, Eduardo Bruera
    Supportive Care in Cancer.2025;[Epub]     CrossRef
Technology/Device
Article image
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
  • 7,681 View
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  • 3 Web of Science
  • 4 Crossref
AbstractAbstract PDFSupplementary MaterialPubReader   ePub   
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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  • Clinical, genetic, and proteomic characteristics of type 2 diabetes complicated with exogenous insulin antibody syndrome: a case-control study
    Jinjing Wan, Leiluo Geng, Yiwen Fu, Qianting Zhang, Gaopeng Guan, Xue Jiang, Aimin Xu, Ping Jin
    Diabetes Research and Clinical Practice.2025; 225: 112262.     CrossRef
  • Expanding the Use of Continuous Glucose Monitoring in Type 2 Diabetes Mellitus: Impact on Glycemic Control and Metabolic Health
    Mi-Joon Lee, Bum-Jeun Seo, Jae-Hyoung Cho
    Life.2025; 15(10): 1543.     CrossRef
  • Utility of continuous glucose monitoring in people with type 2 diabetes on insulin-based regimens in clinical practice: A case series and expert opinion
    Soo Lim, Rimei Nishimura, Jothydev Kesavadev, Alice Pik Shan Kong, Margaret J McGill, Horng-Yih Ou, Chun-Kwan O, Chun-Chuan Lee, Xiaomei Zhang, Linong Ji, Chih-Yuan Wang
    Diabetes Research and Clinical Practice.2025; : 113054.     CrossRef
  • 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
Technology/Device
Article image
Glycemia according to the Use of Continuous Glucose Monitoring among Adults with Type 1 Diabetes Mellitus in Korea: A Real-World Study
You-Bin Lee, Minjee Kim, Jae Hyeon Kim
Diabetes Metab J. 2023;47(3):405-414.   Published online March 6, 2023
DOI: https://doi.org/10.4093/dmj.2022.0032
  • 8,792 View
  • 198 Download
  • 6 Web of Science
  • 6 Crossref
AbstractAbstract PDFSupplementary MaterialPubReader   ePub   
Background
We explored the association between continuous glucose monitoring (CGM) use and glycemia among adults with type 1 diabetes mellitus (T1DM) and determined the status of CGM metrics among adults with T1DM using CGM in the real-world.
Methods
For this propensity-matched cross-sectional study, individuals with T1DM who visited the outpatient clinic of the Endocrinology Department of Samsung Medical Center between March 2018 and February 2020 were screened. Among them, 111 CGM users (for ≥9 months) were matched based on propensity score considering age, sex, and diabetes duration in a 1:2 ratio with 203 CGM never-users. The association between CGM use and glycemic measures was explored. In a subpopulation of CGM users who had been using official applications (not “do-it-yourself” software) such that Ambulatory Glucose Profile data for ≥1 month were available (n=87), standardized CGM metrics were summarized.
Results
Linear regression analyses identified CGM use as a determining factor for log-transformed glycosylated hemoglobin. The fully-adjusted odds ratio (OR) and 95% confidence interval (CI) for uncontrolled glycosylated hemoglobin (>8%) were 0.365 (95% CI, 0.190 to 0.703) in CGM users compared to never-users. The fully-adjusted OR for controlled glycosylated hemoglobin (<7%) was 1.861 (95% CI, 1.119 to 3.096) in CGM users compared to never-users. Among individuals who had been using official applications for CGM, time in range (TIR) values within recent 30- and 90-day periods were 62.45%±16.63% and 63.08%±15.32%, respectively.
Conclusion
CGM use was associated with glycemic control status among Korean adults with T1DM in the real-world, although CGM metrics including TIR might require further improvement among CGM users.

Citations

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  • The role of continuous glucose monitoring in improving glycemic control in adolescents with type 1 diabetes
    Minkyu Seo, Kyu Hyun Park, Ji Won Park, EunJeong Kim, Do young Shin, Eungu Kang, Hyo-Kyoung Nam, Young-Jun Rhie, Kee-Hyoung Lee
    Annals of Pediatric Endocrinology & Metabolism.2025; 30(5): 268.     CrossRef
  • Real-World Continuous Glucose Monitoring Data from a Population with Type 1 Diabetes in South Korea: Nationwide Single-System Analysis
    Ji Yoon Kim, Sang-Man Jin, Sarah B. Andrade, Boyang Chen, Jae Hyeon Kim
    Diabetes Technology & Therapeutics.2024; 26(6): 394.     CrossRef
  • Accuracy and Safety of the 15-Day CareSens Air Continuous Glucose Monitoring System
    Kyung-Soo Kim, Seung-Hwan Lee, Won Sang Yoo, Cheol-Young Park
    Diabetes Technology & Therapeutics.2024; 26(4): 222.     CrossRef
  • Disparities in Diabetes Technology Uptake in Youth and Young Adults With Type 1 Diabetes: A Global Perspective
    Rebecca Baqiyyah Conway, Janet Snell-Bergeon, Kyoko Honda-Kohmo, Anil Kumar Peddi, Salbiah Binti Isa, Shakira Sulong, Laurien Sibomana, Andrea Gerard Gonzalez, Jooyoun Song, Kate Elizabeth Lomax, Ching-Nien Lo, Wondong Kim, Aveni Haynes, Martin de Bock, M
    Journal of the Endocrine Society.2024;[Epub]     CrossRef
  • Navigating the Seas of Glycemic Control: The Role of Continuous Glucose Monitoring in Type 1 Diabetes Mellitus
    Jun Sung Moon
    Diabetes & Metabolism Journal.2023; 47(3): 345.     CrossRef
  • Smart Insulin Pen: Managing Insulin Therapy for People with Diabetes in the Digital Era
    Jee Hee Yoo, Jae Hyeon Kim
    The Journal of Korean Diabetes.2023; 24(4): 190.     CrossRef
Reviews
Technology/Device
Article image
Advances in Continuous Glucose Monitoring and Integrated Devices for Management of Diabetes with Insulin-Based Therapy: Improvement in Glycemic Control
Jee Hee Yoo, Jae Hyeon Kim
Diabetes Metab J. 2023;47(1):27-41.   Published online January 12, 2023
DOI: https://doi.org/10.4093/dmj.2022.0271
  • 24,655 View
  • 780 Download
  • 43 Web of Science
  • 49 Crossref
AbstractAbstract PDFPubReader   ePub   
Continuous glucose monitoring (CGM) technology has evolved over the past decade with the integration of various devices including insulin pumps, connected insulin pens (CIPs), automated insulin delivery (AID) systems, and virtual platforms. CGM has shown consistent benefits in glycemic outcomes in type 1 diabetes mellitus (T1DM) and type 2 diabetes mellitus (T2DM) treated with insulin. Moreover, the combined effect of CGM and education have been shown to improve glycemic outcomes more than CGM alone. Now a CIP is the expected future technology that does not need to be worn all day like insulin pumps and helps to calculate insulin doses with a built-in bolus calculator. Although only a few clinical trials have assessed the effectiveness of CIPs, they consistently show benefits in glycemic outcomes by reducing missed doses of insulin and improving problematic adherence. AID systems and virtual platforms made it possible to achieve target glycosylated hemoglobin in diabetes while minimizing hypoglycemia, which has always been challenging in T1DM. Now fully automatic AID systems and tools for diabetes decisions based on artificial intelligence are in development. These advances in technology could reduce the burden associated with insulin treatment for diabetes.

Citations

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  • Impact of missed insulin doses on glycaemic parameters in people with diabetes using smart insulin pens
    Malavika Varma, David J T Campbell
    Evidence Based Nursing.2026; 29(1): 48.     CrossRef
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    Shuang Wen, Hongru Li, Yinghua Yang
    Biomedical Signal Processing and Control.2025; 101: 107204.     CrossRef
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    Ellen M. Murrin, Antonio F. Saad, Scott Sullivan, Yuri Millo, Menachem Miodovnik
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    Ji Yoon Kim, Jee Hee Yoo, Nam Hoon Kim, Jae Hyeon Kim
    Journal of Diabetes Science and Technology.2025;[Epub]     CrossRef
  • Real-World Life Analysis of a Continuous Glucose Monitoring and Smart Insulin Pen System in Type 1 Diabetes: A Cohort Study
    Paola Pantanetti, Giovanni Cangelosi, Sara Morales Palomares, Gaetano Ferrara, Federico Biondini, Stefano Mancin, Gabriele Caggianelli, Mauro Parozzi, Marco Sguanci, Fabio Petrelli
    Diabetology.2025; 6(1): 7.     CrossRef
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    Myoung Ju Kim, Jae Min Park, Jun Su Lee, Ji Yang Lee, Juhui Lee, Chang Hee Min, Min Ji Kim, Jae Hoon Han, Eun Jung Kwon, Young Bin Choy
    Biomedical Engineering Letters.2025; 15(2): 427.     CrossRef
  • Unlocking Real-Time Data Access in Diabetes Management: Toward an Interoperability Model
    Pietro Randine, Miriam Kopperstad Wolff, Matthias Pocs, Ian R. O. Connell, Joseph A. Cafazzo, Eirik Årsand
    Journal of Diabetes Science and Technology.2025;[Epub]     CrossRef
  • Harnessing Machine Learning, a Subset of Artificial Intelligence, for Early Detection and Diagnosis of Type 1 Diabetes: A Systematic Review
    Rahul Mittal, Matthew B. Weiss, Alexa Rendon, Shirin Shafazand, Joana R N Lemos, Khemraj Hirani
    International Journal of Molecular Sciences.2025; 26(9): 3935.     CrossRef
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    Diana Cristina Henao, Ana María Gómez, Sofía Robledo, Ricardo Rosero
    Mini-invasive Surgery.2025;[Epub]     CrossRef
  • Comparison of Real-Time and Intermittently-Scanned Continuous Glucose Monitoring for Glycemic Control in Type 1 Diabetes Mellitus: Nationwide Cohort Study
    Ji Yoon Kim, Seohyun Kim, Jae Hyeon Kim
    Diabetes & Metabolism Journal.2025; 49(3): 436.     CrossRef
  • Associations of time in tight range, time in range, and glycated hemoglobin with albuminuria in type 1 diabetes: A cross-sectional study
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Guideline/Fact Sheet
Article image
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 Hypertension
Jong Han Choi, Jee-Hyun Kang, Suk Chon
Diabetes Metab J. 2022;46(3):377-390.   Published online May 25, 2022
DOI: https://doi.org/10.4093/dmj.2022.0051
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AbstractAbstract PDFPubReader   ePub   
The Joint Committee of the Korean Diabetes Association, the Korean Society for the Study of Obesity, and the Korean Society of Hypertension announced a consensus statement on carbohydrate-restricted diets and intermittent fasting, representing an emerging and popular dietary pattern. In this statement, we recommend moderately-low-carbohydrate or low-carbohydrate diets, not a very-low-carbohydrate diet, for patients with type 2 diabetes mellitus. These diets can be considered a dietary regimen to improve glycemic control and reduce body weight in adults with type 2 diabetes mellitus. This review provides the detailed results of a meta-analysis and systematic literature review on the potential harms and benefits of carbohydrate-restricted diets in patients with diabetes. We expect that this review will help experts and patients by fostering an in-depth understanding and appropriate application of carbohydrate-restricted diets in the comprehensive management of diabetes.

Citations

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    Wende Tian, Shuyu Cao, Yongxin Guan, Zihao Zhang, Qiyu Liu, Jianqing Ju, Ruixi Xi, Ruina Bai
    Frontiers in Nutrition.2025;[Epub]     CrossRef
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    Ashley Berthoumieux, Sarah Linke, Melinda Merry, Alison Megliola, Jessie Juusola, Jenna Napoleone
    The Science of Diabetes Self-Management and Care.2024; 50(1): 19.     CrossRef
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    Suk Chon
    Journal of the Korean Medical Association.2023; 66(7): 421.     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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AbstractAbstract PDFPubReader   ePub   
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.

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    Hea Jin Lee, Myoung Soo Kim, Mi Lim Chung
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    Pete Gregory
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    Chul Kyu Yun, Eui Kyung Choi, Hyung Jin Kim, Jaeyoung Kim, Byung Cheol Park, Kyuhee Park, Byung Min Choi
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Original Article
Technology/Device
Article image
Glucose Profiles Assessed by Intermittently Scanned Continuous Glucose Monitoring System during the Perioperative Period of Metabolic Surgery
Kyuho Kim, Sung Hee Choi, Hak Chul Jang, Young Suk Park, Tae Jung Oh
Diabetes Metab J. 2022;46(5):713-721.   Published online January 24, 2022
DOI: https://doi.org/10.4093/dmj.2021.0164
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AbstractAbstract PDFSupplementary MaterialPubReader   ePub   
Background
Continuous glucose monitoring (CGM) has been widely used in the management of diabetes. However, the usefulness and detailed data during perioperative status were not well studied. In this study, we described the immediate changes of glucose profiles after metabolic surgery using intermittently scanned CGM (isCGM) in individuals with type 2 diabetes mellitus (T2DM).
Methods
This was a prospective, single-center, single-arm study including 20 participants with T2DM. The isCGM (FreeStyle Libre CGM) implantation was performed within 2 weeks before surgery. We compared CGM metrics of 3 days before surgery and 3 days after surgery, and performed the correlation analyses with clinical variables.
Results
The mean glucose significantly decreased after surgery (147.0±40.4 to 95.5±17.1 mg/dL, P<0.001). Time in range (TIR; 70 to 180 mg/dL) did not significantly change after surgery in total. However, it was significantly increased in a subgroup of individuals with glycosylated hemoglobin (HbA1c) ≥8.0%. Time above range (>250 or 180 mg/dL) was significantly decreased in total. In contrast, time below range (<70 or 54 mg/dL) was significantly increased in total and especially in a subgroup of individuals with HbA1c <8.0% after surgery. The coefficient of variation significantly decreased after surgery. Higher baseline HbA1c was correlated with greater improvement in TIR (rho=0.607, P=0.005).
Conclusion
The isCGM identified improvement of mean glucose and glycemic variability, and increase of hypoglycemia after metabolic surgery, but TIR was not significantly changed after surgery. We detected an increase of TIR only in individuals with HbA1c ≥8.0%.

Citations

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    Raquel do A. P. Quevedo, Maria Edna de Melo, Cintia Cercato, Ariana E. Fernandes, Anna Carolina B. Dantas, Marco Aurélio Santo, Denis Pajecki, Marcio C. Mancini
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    Adriana D. Oprea, Smita K. Kalra, Elizabeth W. Duggan, Linda L. Russell, Richard D. Urman, Basem B. Abdelmalak, Preethi Patel, Kurt J. Pfeifer, Paul J. Grant, Marina M. Charitou, Carlos E. Mendez, Jennifer L. Sherr, Guillermo E. Umpierrez, David C. Klonof
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    Julie L.V. Shaw, Raveendhara R. Bannuru, Lori Beach, Nuha A. ElSayed, Guido Freckmann, Anna K. Füzéry, Angela W.S. Fung, Jeremy Gilbert, Yun Huang, Nichole Korpi-Steiner, Samantha Logan, Rebecca Longo, Dylan MacKay, Lisa Maks, Stefan Pleus, Kendall Rogers
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    Sang-Man Jin
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Review
Technology/Device
Article image
Current Advances of Artificial Pancreas Systems: A Comprehensive Review of the Clinical Evidence
Sun Joon Moon, Inha Jung, Cheol-Young Park
Diabetes Metab J. 2021;45(6):813-839.   Published online November 22, 2021
DOI: https://doi.org/10.4093/dmj.2021.0177
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Graphical AbstractGraphical Abstract AbstractAbstract PDFSupplementary MaterialPubReader   ePub   
Since Banting and Best isolated insulin in the 1920s, dramatic progress has been made in the treatment of type 1 diabetes mellitus (T1DM). However, dose titration and timely injection to maintain optimal glycemic control are often challenging for T1DM patients and their families because they require frequent blood glucose checks. In recent years, technological advances in insulin pumps and continuous glucose monitoring systems have created paradigm shifts in T1DM care that are being extended to develop artificial pancreas systems (APSs). Numerous studies that demonstrate the superiority of glycemic control offered by APSs over those offered by conventional treatment are still being published, and rapid commercialization and use in actual practice have already begun. Given this rapid development, keeping up with the latest knowledge in an organized way is confusing for both patients and medical staff. Herein, we explore the history, clinical evidence, and current state of APSs, focusing on various development groups and the commercialization status. We also discuss APS development in groups outside the usual T1DM patients and the administration of adjunct agents, such as amylin analogues, in APSs.

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Short Communication
Type 1 Diabetes
Article image
Real-World Analysis of Therapeutic Outcome in Type 1 Diabetes Mellitus at a Tertiary Care Center
Antonia Kietaibl, Michaela Riedl, Latife Bozkurt
Diabetes Metab J. 2022;46(1):149-153.   Published online July 6, 2021
DOI: https://doi.org/10.4093/dmj.2020.0267
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AbstractAbstract PDFPubReader   ePub   
Insulin replacement in type 1 diabetes mellitus (T1DM) needs intensified treatment, which can either be performed by multiple daily injections (MDI) or continuous subcutaneous insulin infusion (CSII). This retrospective analysis of a real-world scenario aimed to evaluate whether glycaemic and cardiovascular risk factors could be controlled with CSII outclass MDI as suggested by recent evidence. Data from patients with either insulin pump (n=68) or injection (n=224) therapy at an Austrian tertiary care centre were analysed between January 2016 and December 2017. There were no significant differences with regard to the latest glycosylated hemoglobin, cardiovascular risk factor control or diabetes-associated late complications. Hypoglycaemia was less frequent (P<0.001), sensor-augmented therapy was more common (P=0.003) and mean body mass index (BMI) was higher (P=0.002) with CSII treatment. This retrospective analysis of real-world data in T1DM did not demonstrate the superiority of insulin pump treatment with regard to glycaemic control or cardiovascular risk factor control.

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  • Islet Tissue Macrophages in Immunity Homeostasis and Type 1 Diabetes
    Yan Wang, Zhaoran Wang, Wenya Diao, Tong Shi, Jiahe Xu, Tiantian Deng, Chaoying Wen, Jienan Gu, Tingting Deng, Sixuan Wang, Cheng Xiao
    Clinical Reviews in Allergy & Immunology.2025;[Epub]     CrossRef
Original Articles
Drug/Regimen
Article image
Effects of Teneligliptin on HbA1c levels, Continuous Glucose Monitoring-Derived Time in Range and Glycemic Variability in Elderly Patients with T2DM (TEDDY Study)
Ji Cheol Bae, Soo Heon Kwak, Hyun Jin Kim, Sang-Yong Kim, You-Cheol Hwang, Sunghwan Suh, Bok Jin Hyun, Ji Eun Cha, Jong Chul Won, Jae Hyeon Kim
Diabetes Metab J. 2022;46(1):81-92.   Published online June 16, 2021
DOI: https://doi.org/10.4093/dmj.2021.0016
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Graphical AbstractGraphical Abstract AbstractAbstract PDFSupplementary MaterialPubReader   ePub   
Background
To evaluate the effects of teneligliptin on glycosylated hemoglobin (HbA1c) levels, continuous glucose monitoring (CGM)-derived time in range, and glycemic variability in elderly type 2 diabetes mellitus patients.
Methods
This randomized, double-blinded, placebo-controlled study was conducted in eight centers in Korea (clinical trial registration number: NCT03508323). Sixty-five participants aged ≥65 years, who were treatment-naïve or had been treated with stable doses of metformin, were randomized at a 1:1 ratio to receive 20 mg of teneligliptin (n=35) or placebo (n=30) for 12 weeks. The main endpoints were the changes in HbA1c levels from baseline to week 12, CGM metrics-derived time in range, and glycemic variability.
Results
After 12 weeks, a significant reduction (by 0.84%) in HbA1c levels was observed in the teneligliptin group compared to that in the placebo group (by 0.08%), with a between-group least squares mean difference of –0.76% (95% confidence interval [CI], –1.08 to –0.44). The coefficient of variation, standard deviation, and mean amplitude of glycemic excursion significantly decreased in participants treated with teneligliptin as compared to those in the placebo group. Teneligliptin treatment significantly decreased the time spent above 180 or 250 mg/dL, respectively, without increasing the time spent below 70 mg/dL. The mean percentage of time for which glucose levels remained in the 70 to 180 mg/dL time in range (TIR70–180) at week 12 was 82.0%±16.0% in the teneligliptin group, and placebo-adjusted change in TIR70–180 from baseline was 13.3% (95% CI, 6.0 to 20.6).
Conclusion
Teneligliptin effectively reduced HbA1c levels, time spent above the target range, and glycemic variability, without increasing hypoglycemia in our study population.

Citations

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  • Time in range—A new gold standard in type 2 diabetes research?
    Ashni Goshrani, Rose Lin, David O'Neal, Elif I. Ekinci
    Diabetes, Obesity and Metabolism.2025; 27(5): 2342.     CrossRef
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    Xuexin Zhou, Ru Zhang, Shiwei Jiang, Decui Cheng, Hao Wu
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  • Triple arm, prospective, real-world study comparing the efficacy of FDC teneligliptin + dapagliflozin to FDC sitagliptin + dapagliflozin, and FDC linagliptin + empagliflozin in Indian type 2 diabetes mellitus patients using CGM device: the Amplify-TIR stu
    Suhas Erande, Mayur Agrawal, Sanjeev Gulati, Namdev Jagtap, N. S. Praveen Kumar, Vinod Kumar Kapoor, Sumit Bhushan, Rujuta Gadkari, Mayur Jadhav, Sanjay Choudhari, Saiprasad Patil, Hanmant Barkate
    Cardiovascular Diabetology – Endocrinology Reports.2025;[Epub]     CrossRef
  • Comparison of teneligliptin and other gliptin-based regimens in addressing insulin resistance and glycemic control in type 2 diabetic patients: a cross-sectional study
    Harmanjit Singh, Ravi Rohilla, Shivani Jaswal, Mandeep Singla
    Expert Review of Endocrinology & Metabolism.2024; 19(1): 81.     CrossRef
  • Potential approaches using teneligliptin for the treatment of type 2 diabetes mellitus: current status and future prospects
    Harmanjit Singh, Jasbir Singh, Ravneet Kaur Bhangu, Mandeep Singla, Jagjit Singh, Farideh Javid
    Expert Review of Clinical Pharmacology.2023; 16(1): 49.     CrossRef
  • Mechanism of molecular interaction of sitagliptin with human DPP4 enzyme - New Insights
    Michelangelo Bauwelz Gonzatti, José Edvar Monteiro Júnior, Antônio José Rocha, Jonathas Sales de Oliveira, Antônio José de Jesus Evangelista, Fátima Morgana Pio Fonseca, Vânia Marilande Ceccatto, Ariclécio Cunha de Oliveira, José Ednésio da Cruz Freire
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  • A prospective multicentre open label study to assess effect of Teneligliptin on glycemic control through parameters of time in range (TIR) Metric using continuous glucose monitoring (TOP-TIR study)
    Banshi Saboo, Suhas Erande, A.G. Unnikrishnan
    Diabetes & Metabolic Syndrome: Clinical Research & Reviews.2022; 16(2): 102394.     CrossRef
  • Association between Variability of Metabolic Risk Factors and Cardiometabolic Outcomes
    Min Jeong Park, Kyung Mook Choi
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Drug/Regimen
Article image
Efficacy and Safety of Self-Titration Algorithms of Insulin Glargine 300 units/mL in Individuals with Uncontrolled Type 2 Diabetes Mellitus (The Korean TITRATION Study): A Randomized Controlled Trial
Jae Hyun Bae, Chang Ho Ahn, Ye Seul Yang, Sun Joon Moon, Soo Heon Kwak, Hye Seung Jung, Kyong Soo Park, Young Min Cho
Diabetes Metab J. 2022;46(1):71-80.   Published online June 16, 2021
DOI: https://doi.org/10.4093/dmj.2020.0274
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Graphical AbstractGraphical Abstract AbstractAbstract PDFSupplementary MaterialPubReader   ePub   
Background
To compare the efficacy and safety of two insulin self-titration algorithms, Implementing New Strategies with Insulin Glargine for Hyperglycemia Treatment (INSIGHT) and EDITION, for insulin glargine 300 units/mL (Gla-300) in Korean individuals with uncontrolled type 2 diabetes mellitus (T2DM).
Methods
In a 12-week, randomized, open-label trial, individuals with uncontrolled T2DM requiring basal insulin were randomized to either the INSIGHT (adjusted by 1 unit/day) or EDITION (adjusted by 3 units/week) algorithm to achieve a fasting self-monitoring of blood glucose (SMBG) in the range of 4.4 to 5.6 mmol/L. The primary outcome was the proportion of individuals achieving a fasting SMBG ≤5.6 mmol/L without noct urnal hypoglycemia at week 12.
Results
Of 129 individuals (age, 64.1±9.5 years; 66 [51.2%] women), 65 and 64 were randomized to the INSIGHT and EDITION algorithms, respectively. The primary outcome of achievement was comparable between the two groups (24.6% vs. 23.4%, P=0.876). Compared with the EDITION group, the INSIGHT group had a greater reduction in 7-point SMBG but a similar decrease in fasting plasma glucose and glycosylated hemoglobin. The increment of total daily insulin dose was significantly higher in the INSIGHT group than in the EDITION group (between-group difference: 5.8±2.7 units/day, P=0.033). However, body weight was significantly increased only in the EDITION group (0.6±2.4 kg, P=0.038). There was no difference in the occurrence of hypoglycemia between the two groups. Patient satisfaction was significantly increased in the INSIGHT group (P=0.014).
Conclusion
The self-titration of Gla-300 using the INSIGHT algorithm was effective and safe compared with that using the EDITION algorithm in Korean individuals with uncontrolled T2DM (ClinicalTrials.gov number: NCT03406663).

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    Kansak Boonpattharatthiti, Kirana Wechkunanukul, Noramon Mayang, E Lyn Lee, Anjana Fuangchan, Alice Y.Y. Cheng, Nathorn Chaiyakunapruk, Teerapon Dhippayom
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Review
Type 1 Diabetes
Article image
Time in Range from Continuous Glucose Monitoring: A Novel Metric for Glycemic Control
Jee Hee Yoo, Jae Hyeon Kim
Diabetes Metab J. 2020;44(6):828-839.   Published online December 23, 2020
DOI: https://doi.org/10.4093/dmj.2020.0257
Correction in: Diabetes Metab J 2021;45(5):795
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AbstractAbstract PDFPubReader   ePub   
Glycosylated hemoglobin (HbA1c) has been the sole surrogate marker for assessing diabetic complications. However, consistently reported limitations of HbA1c are that it lacks detailed information on short-term glycemic control and can be easily interfered with by various clinical conditions such as anemia, pregnancy, or liver disease. Thus, HbA1c alone may not represent the real glycemic status of a patient. The advancement of continuous glucose monitoring (CGM) has enabled both patients and healthcare providers to monitor glucose trends for a whole single day, which is not possible with HbA1c. This has allowed for the development of core metrics such as time spent in time in range (TIR), hyperglycemia, or hypoglycemia, and glycemic variability. Among the 10 core metrics, TIR is reported to represent overall glycemic control better than HbA1c alone. Moreover, various evidence supports TIR as a predictive marker of diabetes complications as well as HbA1c, as the inverse relationship between HbA1c and TIR reveals. However, there are more complex relationships between HbA1c, TIR, and other CGM metrics. This article provides information about 10 core metrics with particular focus on TIR and the relationships between the CGM metrics for comprehensive understanding of glycemic status using CGM.

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Original Article
Basic Research
Article image
Role of Intestinal Microbiota in Metabolism of Voglibose In Vitro and In Vivo
Mahesh Raj Nepal, Mi Jeong Kang, Geon Ho Kim, Dong Ho Cha, Ju-Hyun Kim, Tae Cheon Jeong
Diabetes Metab J. 2020;44(6):908-918.   Published online April 6, 2020
DOI: https://doi.org/10.4093/dmj.2019.0147
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AbstractAbstract PDFSupplementary MaterialPubReader   ePub   
Background

Voglibose, an α-glucosidase inhibitor, inhibits breakdown of complex carbohydrates into simple sugar units in intestine. Studies showed that voglibose metabolism in the liver might be negligible due to its poor intestinal absorption. Numerous microorganisms live in intestine and have several roles in metabolism and detoxification of various xenobiotics. Due to the limited information, the possible metabolism of voglibose by intestinal microbiota was investigated in vitro and in vivo.

Methods

For the in vitro study, different concentrations of voglibose were incubated with intestinal contents, prepared from both vehicle- and antibiotics-treated mice, to determine the decreased amount of voglibose over time by using liquid chromatography-mass spectrometry. Similarly, in vivo pharmacodynamic effect of voglibose was determined following the administration of voglibose and starch in vehicle- and antibiotic-pretreated non-diabetic and diabetic mice, by measuring the modulatory effects of voglibose on blood glucose levels.

Results

The in vitro results indicated that the remaining voglibose could be significantly decreased when incubated with the intestinal contents from normal mice compared to those from antibiotic-treated mice, which had less enzyme activities. The in vivo results showed that the antibiotic pretreatment resulted in reduced metabolism of voglibose. This significantly lowered blood glucose levels in antibiotic-pretreated mice compared to the control animals.

Conclusion

The present results indicate that voglibose would be metabolized by the intestinal microbiota, and that this metabolism might be pharmacodynamically critical in lowering blood glucose levels in mice.

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Review
Others
Continuous Glucose Monitoring Sensors for Diabetes Management: A Review of Technologies and Applications
Giacomo Cappon, Martina Vettoretti, Giovanni Sparacino, Andrea Facchinetti
Diabetes Metab J. 2019;43(4):383-397.   Published online July 25, 2019
DOI: https://doi.org/10.4093/dmj.2019.0121
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AbstractAbstract PDFPubReader   ePub   

By providing blood glucose (BG) concentration measurements in an almost continuous-time fashion for several consecutive days, wearable minimally-invasive continuous glucose monitoring (CGM) sensors are revolutionizing diabetes management, and are becoming an increasingly adopted technology especially for diabetic individuals requiring insulin administrations. Indeed, by providing glucose real-time insights of BG dynamics and trend, and being equipped with visual and acoustic alarms for hypo- and hyperglycemia, CGM devices have been proved to improve safety and effectiveness of diabetes therapy, reduce hypoglycemia incidence and duration, and decrease glycemic variability. Furthermore, the real-time availability of BG values has been stimulating the realization of new tools to provide patients with decision support to improve insulin dosage tuning and infusion. The aim of this paper is to offer an overview of current literature and future possible developments regarding CGM technologies and applications. In particular, first, we outline the technological evolution of CGM devices through the last 20 years. Then, we discuss about the current use of CGM sensors from patients affected by diabetes, and, we report some works proving the beneficial impact provided by the adoption of CGM. Finally, we review some recent advanced applications for diabetes treatment based on CGM sensors.

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    Jee Hee Yoo, Min Sun Choi, Jiyeon Ahn, Sung Woon Park, Yejin Kim, Kyu Yeon Hur, Sang-Man Jin, Gyuri Kim, Jae Hyeon Kim
    Diabetes Technology & Therapeutics.2020; 22(10): 768.     CrossRef
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    Medicine - Programa de Formación Médica Continuada Acreditado.2020; 13(17): 943.     CrossRef
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    Jae Hyun Kim
    Annals of Pediatric Endocrinology & Metabolism.2020; 25(3): 145.     CrossRef
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    Anita Z Chang, David L Swain, Mark G Trotter
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    Hazhir Teymourian, Abbas Barfidokht, Joseph Wang
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    Nunzio Camerlingo, Martina Vettoretti, Andrea Facchinetti, Giovanni Sparacino, Julia K. Mader, Pratik Choudhary, Simone Del Favero
    Scientific Reports.2020;[Epub]     CrossRef
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    Florian Philipp Raber, Rokas Gerbutavicius, Armin Wolf, Karsten Kortüm
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    Ilaria Malandrucco, Benedetta Russo, Fabiana Picconi, Marika Menduni, Simona Frontoni
    International Journal of Molecular Sciences.2020; 21(21): 8243.     CrossRef
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    Mee Ra Kweon
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    Martina Vettoretti, Cristina Battocchio, Giovanni Sparacino, Andrea Facchinetti
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Short Communication
Epidemiology
Low-Normal Free Thyroxine Levels in Euthyroid Male Are Associated with Prediabetes
Sung Woo Kim, Jae-Han Jeon, Jun Sung Moon, Eon Ju Jeon, Mi-Kyung Kim, In-Kyu Lee, Jung Beom Seo, Keun-Gyu Park
Diabetes Metab J. 2019;43(5):718-726.   Published online March 19, 2019
DOI: https://doi.org/10.4093/dmj.2018.0222
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AbstractAbstract PDFSupplementary MaterialPubReader   ePub   

Abnormal thyroid function is associated with impaired glucose homeostasis. This study aimed to determine whether free thyroxine (FT4) influences the prevalence of prediabetes in euthyroid subjects using a cross-sectional survey derived from the Korea National Health and Nutrition Examination Survey, conducted between 2013 and 2015. We studied 2,399 male participants of >20 years of age who were euthyroid and non-diabetic. Prediabetic participants had lower FT4 concentrations than those without prediabetes, but their thyrotropin concentrations were similar. We stratified the population into tertiles according to FT4 concentration. After adjusting for multiple confounding factors, glycosylated hemoglobin (HbA1c) levels significantly decreased with increasing FT4 tertile, whereas fasting plasma glucose (FPG) levels were not associated with FT4 tertiles (HbA1c, P<0.01 in T3 vs. T1; FPG, P=0.489 in T3 vs. T1). The prevalence of prediabetes was significantly higher in T1 (odds ratio, 1.426; 95% confidence interval, 1.126 to 1.806; P<0.01) than in T3. In conclusion, subjects with low-normal serum FT4 had high HbA1c and were more likely to have prediabetes. These results suggest that low FT4 concentration is a risk factor for prediabetes in male, even when thyroid function is within the normal range.

Citations

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  • Hypothyroidism: playing the cardiometabolic risk concerto
    George J. Kahaly, Youshuo Liu, Luca Persani
    Thyroid Research.2025;[Epub]     CrossRef
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    Jingjing Yu, Keke Tang, Yan Song
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Original Articles
Clinical Diabetes & Therapeutics
Efficacy and Safety of Sodium-Glucose Cotransporter-2 Inhibitors in Korean Patients with Type 2 Diabetes Mellitus in Real-World Clinical Practice
A Ram Hong, Bo Kyung Koo, Sang Wan Kim, Ka Hee Yi, Min Kyong Moon
Diabetes Metab J. 2019;43(5):590-606.   Published online February 28, 2019
DOI: https://doi.org/10.4093/dmj.2018.0134
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AbstractAbstract PDFSupplementary MaterialPubReader   ePub   
Background

This study aimed to evaluate the efficacy and safety of sodium-glucose cotransporter-2 (SGLT2) inhibitors in Korean patients who had inadequately controlled type 2 diabetes mellitus (T2DM) in real-world clinical practice.

Methods

We included 410 patients who started SGLT2 inhibitors (empagliflozin or dapagliflozin) as add-on therapy or switch therapy between February 2015 and June 2017. The primary efficacy endpoint was a change in glycosylated hemoglobin (HbA1c) from baseline to week 12. The secondary endpoints were patients achieving HbA1c <7.0% and changes in the fasting plasma glucose (FPG), lipid profiles, body weight, and blood pressure (BP).

Results

The mean HbA1c at baseline was 8.5% (8.6% in the add-on group and 8.4% in the switch group). At week 12, the mean adjusted HbA1c decreased by −0.68% in the overall patients (P<0.001), by −0.94% in the add-on group, and by −0.42% in the switch group. Significant reductions in FPG were also observed both in the add-on group and switch group (−30.3 and −19.8 mg/dL, respectively). Serum triglyceride (−16.5 mg/dL), body weight (−2.1 kg), systolic BP (−4.7 mm Hg), and diastolic BP (−1.3 mm Hg) were significantly improved in the overall patients. Approximately 18.3% of the patients achieved HbA1c <7.0% at week 12. A low incidence of hypoglycemia and genital tract infection was observed (6.3% and 2.2%, respectively).

Conclusion

SGLT2 inhibitors can be a suitable option as either add-on or switch therapy for Korean patients with inadequately controlled T2DM.

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    Yesol Hong, Yoomin Jeon, Yoona Choi, Tae Kyu Chung, Howard Lee
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    Bipin Sethi, Subhankar Chowdhury, Supratik Bhattacharya, Sagar Katare, Sachin Suryawanshi, Hanmant Barkate
    International Journal of Diabetes in Developing Countries.2023; 43(2): 214.     CrossRef
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    Hyeong Kyu Park, Kyoung‐Ah Kim, Kyung‐Wan Min, Tae‐Seo Sohn, In Kyung Jeong, Chul Woo Ahn, Nan‐Hee Kim, Ie Byung Park, Ho Chan Cho, Choon Hee Chung, Sung Hee Choi, Kang Seo Park, Seoung‐Oh Yang, Kwan Woo Lee
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    Jaydip V. Revale, Preeti J. Revale
    International Journal of Diabetes and Technology.2023; 2(2): 60.     CrossRef
  • Sodium glucose co-transporter-2 inhibitor, Empagliflozin, is associated with significant reduction in weight, body mass index, fasting glucose, and A1c levels in Type 2 diabetic patients with established coronary heart disease: the SUPER GATE study
    Satilmis Bilgin, Ozge Kurtkulagi, Tuba Taslamacioglu Duman, Burcin Meryem Atak Tel, Gizem Kahveci, Murat Kiran, Eray Erge, Gulali Aktas
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    Diabetic Medicine.2022;[Epub]     CrossRef
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    Da Hea Seo, Young Ju Suh, Yongin Cho, Seong Hee Ahn, Seongha Seo, Seongbin Hong, Yong-ho Lee, Young Ju Choi, Eunjig Lee, So Hun Kim
    Yonsei Medical Journal.2022; 63(9): 825.     CrossRef
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    Ha Young Jang, In-Wha Kim, Jung Mi Oh
    Frontiers in Pharmacology.2022;[Epub]     CrossRef
  • Study comparing the efficacy and renal safety for patients with diabetes switching from dapagliflozin to empagliflozin
    Ai-Yu Yang, Hung-Chun Chen
    International Journal of Clinical Pharmacy.2021; 43(4): 1015.     CrossRef
  • Empagliflozin Regulates the AdipoR1/p-AMPK/p-ACC Pathway to Alleviate Lipid Deposition in Diabetic Nephropathy
    Zhiqin Zhang, Lihua Ni, Lian Zhang, Dongqing Zha, Chun Hu, Lingli Zhang, Huiling Feng, Xiaobao Wei, Xiaoyan Wu
    Diabetes, Metabolic Syndrome and Obesity: Targets and Therapy.2021; Volume 14: 227.     CrossRef
  • Efficacy and Safety of Luseogliflozin in Patients with Type 2 Diabetes Complicated by Hepatic Dysfunction: A Single-Site, Single-Arm, Open-Label, Exploratory Trial
    Hiroaki Seino
    Diabetes Therapy.2021; 12(3): 863.     CrossRef
  • Sodium–Glucose Cotransporter 2 Inhibitors and Risk of Retinal Vein Occlusion Among Patients With Type 2 Diabetes: A Propensity Score–Matched Cohort Study
    Min-Kyung Lee, Bongsung Kim, Kyungdo Han, Jae-Hyuk Lee, Minhee Kim, Mee Kyoung Kim, Ki-Hyun Baek, Ki-Ho Song, Hyuk-Sang Kwon, Young-Jung Roh
    Diabetes Care.2021; 44(10): 2419.     CrossRef
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    Muhammad Afzal, Fahad Al-Abbasi, Muhammad Nadeem, Sultan Alshehri, Mohammed Ghoneim, Syed Imam, Waleed Almalki, Imran Kazmi
    Metabolites.2021; 11(11): 794.     CrossRef
  • Sodium-Glucose Cotransporter-2 Inhibitor for Renal Function Preservation in Patients with Type 2 Diabetes Mellitus: A Korean Diabetes Association and Korean Society of Nephrology Consensus Statement
    Tae Jung Oh, Ju-Young Moon, Kyu Yeon Hur, Seung Hyun Ko, Hyun Jung Kim, Taehee Kim, Dong Won Lee, Min Kyong Moon
    Diabetes & Metabolism Journal.2020; 44(4): 489.     CrossRef
  • Sodium-glucose cotransporter-2 inhibitor for renal function preservation in patients with type 2 diabetes mellitus: A Korean Diabetes Association and Korean Society of Nephrology consensus statement
    Tae Jung Oh, Ju-Young Moon, Kyu Yeon Hur, Seung Hyun Ko, Hyun Jung Kim, Taehee Kim, Dong Won Lee, Min Kyong Moon
    Kidney Research and Clinical Practice.2020; 39(3): 269.     CrossRef
  • Use and effectiveness of dapagliflozin in patients with type 2 diabetes mellitus: a multicenter retrospective study in Taiwan
    Jung-Fu Chen, Yun-Shing Peng, Chung-Sen Chen, Chin-Hsiao Tseng, Pei-Chi Chen, Ting-I Lee, Yung-Chuan Lu, Yi-Sun Yang, Ching-Ling Lin, Yi-Jen Hung, Szu-Ta Chen, Chieh-Hsiang Lu, Chwen-Yi Yang, Ching-Chu Chen, Chun-Chuan Lee, Pi-Jung Hsiao, Ju-Ying Jiang, S
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  • Long-Term Effectiveness and Safety of SGLT-2 Inhibitors in an Italian Cohort of Patients with Type 2 Diabetes Mellitus
    Maria Mirabelli, Eusebio Chiefari, Patrizia Caroleo, Raffaella Vero, Francesco Saverio Brunetti, Domenica Maria Corigliano, Biagio Arcidiacono, Daniela Patrizia Foti, Luigi Puccio, Antonio Brunetti
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Clinical Diabetes & Therapeutics
Predictors of the Therapeutic Efficacy and Consideration of the Best Combination Therapy of Sodium-Glucose Co-transporter 2 Inhibitors
Ji-Yeon Lee, Yongin Cho, Minyoung Lee, You Jin Kim, Yong-ho Lee, Byung-Wan Lee, Bong-Soo Cha, Eun Seok Kang
Diabetes Metab J. 2019;43(2):158-173.   Published online January 25, 2019
DOI: https://doi.org/10.4093/dmj.2018.0057
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AbstractAbstract PDFSupplementary MaterialPubReader   ePub   
Background

We investigated the predictive markers for the therapeutic efficacy and the best combination of sodium-glucose co-transporter 2 (SGLT2) inhibitors (empagliflozin, dapagliflozin, and ipragliflozin) therapy in patients with type 2 diabetes mellitus (T2DM).

Methods

A total of 804 patients with T2DM who had taken SGLT2 inhibitor as monotherapy or an add-on therapy were analyzed. Multivariate regression analyses were performed to identify the predictors of SGLT2 inhibitor response including the classes of baseline anti-diabetic medications.

Results

After adjusting for age, sex, baseline body mass index (BMI), diabetes duration, duration of SGLT2 inhibitor use, initial glycosylated hemoglobin (HbA1c) level, estimated glomerular filtration rate (eGFR), and other anti-diabetic agent usage, multivariate analysis revealed that shorter diabetes duration, higher initial HbA1c and eGFR were associated with better glycemic response. However, baseline BMI was inversely correlated with glycemic status; lean subjects with well-controlled diabetes and obese subjects with inadequately controlled diabetes received more benefit from SGLT2 inhibitor treatment. In addition, dipeptidyl peptidase 4 (DPP4) inhibitor use was related to a greater reduction in HbA1c in patients with higher baseline HbA1c ≥7%. Sulfonylurea users experienced a larger change from baseline HbA1c but the significance was lost after adjustment for covariates and metformin and thiazolidinedione use did not affect the glycemic outcome.

Conclusion

A better response to SGLT2 inhibitors is expected in Korean T2DM patients who have higher baseline HbA1c and eGFR with a shorter diabetes duration. Moreover, the add-on of an SGLT2 inhibitor to a DPP4 inhibitor is likely to show the greatest glycemic response.

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    Daniele Scoccimarro, Giacomo Cipani, Ilaria Dicembrini, Edoardo Mannucci
    Diabetes/Metabolism Research and Reviews.2024;[Epub]     CrossRef
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    M. L. Morieri, I. Raz, A. Consoli, M. Rigato, A. Lapolla, F. Broglio, E. Bonora, A. Avogaro, G. P. Fadini, Federica Ginestra, Gloria Formoso, Agostino Consoli, Francesco Andreozzi, Giorgio Sesti, Salvatore Turco, Luigi Lucibelli, Adriano Gatti, Raffaella
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  • Treatment effect heterogeneity following type 2 diabetes treatment with GLP1-receptor agonists and SGLT2-inhibitors: a systematic review
    Katherine G. Young, Eram Haider McInnes, Robert J. Massey, Anna R. Kahkoska, Scott J. Pilla, Sridharan Raghavan, Maggie A. Stanislawski, Deirdre K. Tobias, Andrew P. McGovern, Adem Y. Dawed, Angus G. Jones, Ewan R. Pearson, John M. Dennis, Deirdre K. Tobi
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    Wei Ying Tan, Wynne Hsu, Mong Li Lee, Ngiap Chuan Tan
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  • Effect of Dapagliflozin as an Add-on Therapy to Insulin on the Glycemic Variability in Subjects with Type 2 Diabetes Mellitus (DIVE): A Multicenter, Placebo-Controlled, Double-Blind, Randomized Study
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  • Angiotensin II up-regulates sodium-glucose co-transporter 2 expression and SGLT2 inhibitor attenuates Ang II-induced hypertensive renal injury in mice
    Kana N. Miyata, Chao-Sheng Lo, Shuiling Zhao, Min-Chun Liao, Yuchao Pang, Shiao-Ying Chang, Junzheng Peng, Matthias Kretzler, Janos G. Filep, Julie R. Ingelfinger, Shao-Ling Zhang, John S.D. Chan
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  • Letter: Predictors of the Therapeutic Efficacy and Consideration of the Best Combination Therapy of Sodium-Glucose Co-transporter 2 Inhibitors (Diabetes Metab J 2019;43:158–73)
    Kyung-Soo Kim
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  • Response: Predictors of the Therapeutic Efficacy and Consideration of the Best Combination Therapy of Sodium-Glucose Co-transporter 2 Inhibitors (Diabetes Metab J 2019;43:158–73)
    Ji-Yeon Lee, Eun Seok Kang
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Short Communication
Epidemiology
Associations between Breastfeeding and Type 2 Diabetes Mellitus and Glycemic Control in Parous Women: A Nationwide, Population-Based Study
Ga Eun Nam, Kyungdo Han, Do-Hoon Kim, Youn Huh, Byoungduck Han, Sung Jung Cho, Yong Gyu Park, Yong-Moon Park
Diabetes Metab J. 2019;43(2):236-241.   Published online December 21, 2018
DOI: https://doi.org/10.4093/dmj.2018.0044
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AbstractAbstract PDFPubReader   ePub   

We investigated associations between breastfeeding duration and number of children breastfed and type 2 diabetes mellitus (T2DM) and glycemic control among parous women. We performed a cross-sectional analysis of data for 9,960 parous women from the Korea National Health and Nutritional Examination Survey (2010 to 2013). Having ever breastfed was inversely associated with prevalent T2DM (adjusted odds ratio [OR], 0.60; 95% confidence interval [CI], 0.42 to 0.87). All ranges of total and average breastfeeding duration showed inverse associations with T2DM. Even short periods of breastfeeding were inversely associated with T2DM (adjusted OR, 0.61; 95% CI, 0.38 to 0.99 for a total breastfeeding duration ≤12 months; adjusted OR, 0.65; 95% CI, 0.42 to 0.99 for an average breastfeeding duration per child ≤6 months). A longer duration of breastfeeding was associated with better glycemic control in parous women with T2DM (P trend=0.004 for total breastfeeding duration; P trend <0.001 for average breastfeeding duration per child). Breastfeeding may be associated with a lower risk of T2DM and good glycemic control in parous women with T2DM. Breastfeeding may be a feasible method to prevent T2DM and improve glycemic control.

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Original Articles
Epidemiology
Discrepancies between Glycosylated Hemoglobin and Fasting Plasma Glucose for Diagnosing Impaired Fasting Glucose and Diabetes Mellitus in Korean Youth and Young Adults
Jieun Lee, Young Ah Lee, Jae Hyun Kim, Seong Yong Lee, Choong Ho Shin, Sei Won Yang
Diabetes Metab J. 2019;43(2):174-182.   Published online November 2, 2018
DOI: https://doi.org/10.4093/dmj.2018.0046
  • 10,546 View
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AbstractAbstract PDFSupplementary MaterialPubReader   ePub   
Background

Glycosylated hemoglobin (HbA1c) has been recommended as a diagnostic test for prediabetes and diabetes. Here, we evaluated the level of agreement between diagnoses based on fasting plasma glucose (FPG) versus HbA1c levels and determined optimal HbA1c cutoff values for these diseases in youth and young adults.

Methods

The study included 7,332 subjects (n=4,129, aged 10 to 19 years in youth group; and n=3,203 aged 20 to 29 years in young adult group) from the 2011 to 2016 Korea National Health and Nutrition Examination Survey. Prediabetes and diabetes were defined as 100 to 125 mg/dL (impaired fasting glucose [IFG]) and ≥126 mg/dL for FPG (diabetes mellitus [DM] by FPG [DMFPG]), and 5.7% to 6.4% and ≥6.5% for HbA1c, respectively.

Results

In the youth group, 32.5% with IFG had an HbA1c level of 5.7% to 6.4%, and 72.2% with DMFPG had an HbA1c ≥6.5%. In the young adult group, 27.5% with IFG had an HbA1c level of 5.7% to 6.4%, and 66.6% with DMFPG had an HbA1c ≥6.5%. Kappa coefficients for agreement between the FPG and HbA1c results were 0.12 for the youth group and 0.19 for the young adult group. In receiver operating characteristic curve analysis, the optimal HbA1c cutoff for IFG and DMFPG were 5.6% and 5.9% in youths and 5.5% and 5.8% in young adults, respectively.

Conclusion

Usefulness of HbA1c for diagnosis of IFG and DMFPG in Koreans aged <30 years remains to be determined due to discrepancies between the results of glucose- and HbA1c-based tests. Additional testing might be warranted at lower HbA1c levels to detect IFG and DMFPG in this age group.

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  • Clinical utility of glycated albumin and 1,5-anhydroglucitol in the screening and prediction of diabetes: A multi-center study
    Kam-Ching Ku, Junda Zhong, Erfei Song, Carol Ho-Yi Fong, Karen Siu-Ling Lam, Aimin Xu, Chi-Ho Lee, Chloe Yu-Yan Cheung
    World Journal of Diabetes.2025;[Epub]     CrossRef
  • Artificial intelligence-based multiclass diabetes risk stratification for big data embedded with explainability: From machine learning to attention models
    Ekta Tiwari, Siddharth Gupta, Anudeep Pavulla, Mustafa Al-Maini, Rajesh Singh, Esma R. Isenovic, Sumit Chaudhary, John L. Laird, Laura Mantella, Amer M. Johri, Luca Saba, Jasjit S. Suri
    Biomedical Signal Processing and Control.2025; 106: 107672.     CrossRef
  • Lower Dietary Magnesium Is Associated with a Higher Hemoglobin Glycation Index in the National Health and Nutrition Examination Survey
    Juan Chen, Song Lin, Xingzhou Wang, Xiwei Wang, Pengxia Gao
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  • Glycemic traits and colorectal cancer survival in a cohort of South Korean patients: A Mendelian randomization analysis
    So Yon Jun, Sooyoung Cho, Min Jung Kim, Ji Won Park, Seung‐Bum Ryoo, Seung Yong Jeong, Kyu Joo Park, Aesun Shin
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    Scandinavian Journal of Clinical and Laboratory Investigation.2022; 82(3): 192.     CrossRef
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    Seung Eun Yoo, Ji Hyen Lee, Jung Won Lee, Hye Sook Park, Hye Ah Lee, Hae Soon Kim
    Annals of Pediatric Endocrinology & Metabolism.2022; 27(1): 60.     CrossRef
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    EunKyo Kang
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    Ziad Arabi, Muhammad Bukhari, Abdullah Hamad, Abdulrahman Altheaby, Saleh Kaysi
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    Jieun Lee, Jae Hyun Kim
    Clinical and Experimental Pediatrics.2021; 64(12): 619.     CrossRef
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    Kyoung Kon Kim, Kyu Rae Lee, In Cheol Hwang
    Journal of Pediatric Endocrinology and Metabolism.2020; 33(9): 1213.     CrossRef
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    O. Ya. Korolyuk, O. M. Radchenko
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    Stanisław Głuszek, Arkadiusz Bociek, Edyta Suliga, Jarosław Matykiewicz, Magdalena Kołomańska, Piotr Bryk, Przemysław Znamirowski, Łukasz Nawacki, Martyna Głuszek-Osuch, Iwona Wawrzycka, Dorota Kozieł
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    O. Ya. Korolyuk
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Clinical Care/Education
Frequency of Self-Monitoring of Blood Glucose during the School Day Is Associated with the Optimal Glycemic Control among Korean Adolescents with Type 1 Diabetes
Eun Young Joo, Ji-Eun Lee, Hee Sook Kang, Shin Goo Park, Yong Hee Hong, Young-Lim Shin, Min Sohn
Diabetes Metab J. 2018;42(6):480-487.   Published online June 29, 2018
DOI: https://doi.org/10.4093/dmj.2018.0018
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AbstractAbstract PDFPubReader   ePub   
Background

This study aimed to evaluate the relationship between the frequency of self-monitoring of blood glucose (SMBG) and glycosylated hemoglobin (HbA1c) levels among Korean adolescents with type 1 diabetes mellitus (T1DM). Factors affecting the SMBG frequency were analyzed in order to improve their glycemic control.

Methods

Sixty-one adolescents aged 13 to 18 years with T1DM were included from one tertiary center. Clinical and biochemical variables were recorded. Factors associated with SMBG frequency were assessed using structured self-reported questionnaires.

Results

Average total daily SMBG frequency was 3.8±2.1 and frequency during the school day was 1.3±1.2. The mean HbA1c level was 8.6%±1.4%. As the daily SMBG frequency increased, HbA1c levels declined (P=0.001). The adjusted odds of achieving the target HbA1c in participants who performed daily SMBG ≥5 significantly increased 9.87 folds (95% confidence interval [CI], 1.58 to 61.70) compared with those performed SMBG four times a day. In the subjects whose SMBG frequency <1/day during the school day, an 80% reduction in the adjusted odds ratio 0.2 (95% CI, 0.05 to 0.86) showed compared to the group with performing two SMBG measurements in the school setting. The number of SMBG testing performed at school was significantly high for individuals assisted by their friends (P=0.031) and for those who did SMBG in the classrooms (P=0.039).

Conclusion

Higher SMBG frequency was significantly associated with lower HbA1c in Korean adolescents with T1DM. It would be necessary to establish the school environments that can facilitate adequate glycemic control, including frequent SMBG.

Citations

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    Yu. A. Kononova, V. B. Bregovskiy, A. Yu. Babenko
    Meditsinskiy sovet = Medical Council.2022; (21-1): 140.     CrossRef
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    Sohayla A. Ibrahim, Maguy Saffouh El Hajj, Yaw B. Owusu, Maryam Al-Khaja, Amel Khalifa, Dalia Ahmed, Ahmed Awaisu
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    Wencong Lv, Jiaxin Luo, Qing Long, Jundi Yang, Xin Wang, Jia Guo
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    Kathleen M. Hanna, Jed R. Hansen
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    Hye Jin Yoo
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Epidemiology
Predictors of Incident Type 2 Diabetes Mellitus in Japanese Americans with Normal Fasting Glucose Level
You-Cheol Hwang, Wilfred Y. Fujimoto, Steven E. Kahn, Donna L. Leonetti, Edward J. Boyko
Diabetes Metab J. 2018;42(3):198-206.   Published online April 25, 2018
DOI: https://doi.org/10.4093/dmj.2017.0100
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AbstractAbstract PDFPubReader   ePub   
Background

Little is known about the natural course of normal fasting glucose (NFG) in Asians and the risk factors for future diabetes.

Methods

A total of 370 Japanese Americans (163 men, 207 women) with NFG levels and no history of diabetes, aged 34 to 75 years, were enrolled. Oral glucose tolerance tests were performed at baseline, 2.5, 5, and 10 years after enrollment.

Results

During 10 years of follow-up, 16.1% of participants met criteria for diabetes diagnosis, and 39.6% of subjects still had NFG levels at the time of diabetes diagnosis. During 5 years of follow-up, age (odds ratio [OR], 1.05; 95% confidence interval [CI], 1.01 to 1.10; P=0.026) and family history of diabetes (OR, 3.24; 95% CI, 1.42 to 7.40; P=0.005) were independently associated with future diabetes diagnosis; however, fasting glucose level was not an independent predictor. During 10 years of follow-up, family history of diabetes (OR, 2.76; 95% CI, 1.37 to 5.54; P=0.004), fasting insulin level (OR, 1.01; 95% CI, 1.00 to 1.02; P=0.037), and fasting glucose level (OR, 3.69; 95% CI, 1.13 to 12.01; P=0.030) were associated with diabetes diagnosis independent of conventional risk factors for diabetes.

Conclusion

A substantial number of subjects with NFG at baseline still remained in the NFG range at the time of diabetes diagnosis. A family history of diabetes and fasting insulin and glucose levels were associated with diabetes diagnosis during 10 years of follow-up; however, fasting glucose level was not associated with diabetes risk within the relatively short-term follow-up period of 5 years in subjects with NFG.

Citations

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  • Associations of the Gap Between 2-Hour Post-Load Plasma Glucose and Fasting Blood Glucose With All-Cause or Cardiovascular Mortality in US Normoglycemic Adults
    Weiwei Liu, Zhiming Liu, Chen Ding, Jie Li, Haifeng Jiang
    Biological Research For Nursing.2025; 27(3): 391.     CrossRef
  • Continuous Glucose Monitoring Metrics in Asians Without Diabetes: Differentiating Prediabetes From Normoglycemia
    Suresh Rama Chandran, Gerald Gui Ren Sng, Celine Yu Hui Wong, Wei Mian Ang, Daphne Gardner
    Journal of Diabetes Science and Technology.2025;[Epub]     CrossRef
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    Linfeng He, Wenbin Zheng, Zeyu Li, Lu Chen, Wen Kong, Tianshu Zeng
    Journal of Translational Medicine.2023;[Epub]     CrossRef
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    Journal of Diabetes.2021; 13(7): 601.     CrossRef
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    Diabetes & Metabolism Journal.2018; 42(3): 196.     CrossRef
Review
Clinical Diabetes & Therapeutics
Recent Updates on Type 1 Diabetes Mellitus Management for Clinicians
Ahmed Iqbal, Peter Novodvorsky, Simon R. Heller
Diabetes Metab J. 2018;42(1):3-18.   Published online February 23, 2018
DOI: https://doi.org/10.4093/dmj.2018.42.1.3
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AbstractAbstract PDFPubReader   ePub   

Type 1 diabetes mellitus (T1DM) is a chronic autoimmune condition that requires life-long administration of insulin. Optimal management of T1DM entails a good knowledge and understanding of this condition both by the physician and the patient. Recent introduction of novel insulin preparations, technological advances in insulin delivery and glucose monitoring, such as continuous subcutaneous insulin infusion (CSII) and continuous glucose monitoring and improved understanding of the detrimental effects of hypoglycaemia and hyperglycaemia offer new opportunities and perspectives in T1DM management. Evidence from clinical trials suggests an important role of structured patient education. Our efforts should be aimed at improved metabolic control with concomitant reduction of hypoglycaemia. Despite recent advances, these goals are not easy to achieve and can put significant pressure on people with T1DM. The approach of physicians should therefore be maximally supportive. In this review, we provide an overview of the recent advances in T1DM management focusing on novel insulin preparations, ways of insulin administration and glucose monitoring and the role of metformin or sodium-glucose co-transporter 2 inhibitors in T1DM management. We then discuss our current understanding of the effects of hypoglycaemia on human body and strategies aimed at mitigating the risks associated with hypoglycaemia.

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    Gassem A Gohal, Aqilah Majhali, Esaam Moafa, Sarah H Talebi, Bushra I Maashi, Amani Mutaen, Walaa J Alhamdan, Ibrahim M Dighriri
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Original Articles
Clinical Care/Education
Improvement of Glycosylated Hemoglobin in Patients with Type 2 Diabetes Mellitus under Insulin Treatment by Reimbursement for Self-Monitoring of Blood Glucose
Young Shin Song, Bo Kyung Koo, Sang Wan Kim, Ka Hee Yi, Kichul Shin, Min Kyong Moon
Diabetes Metab J. 2018;42(1):28-42.   Published online September 28, 2017
DOI: https://doi.org/10.4093/dmj.2018.42.1.28
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AbstractAbstract PDFSupplementary MaterialPubReader   ePub   
Background

In Korea, the costs associated with self-monitoring of blood glucose (SMBG) for patients with type 2 diabetes mellitus (T2DM) under insulin treatment have been reimbursed since November 2015. We investigated whether this new reimbursement program for SMBG has improved the glycemic control in the beneficiaries of this policy.

Methods

Among all adult T2DM patients with ≥3 months of reimbursement (n=854), subjects without any changes in anti-hyperglycemic agents during the study period were selected. The improvement of glycosylated hemoglobin (HbA1c) was defined as an absolute reduction in HbA1c ≥0.6% or an HbA1c level at follow-up <7%.

Results

HbA1c levels significantly decreased from 8.5%±1.3% to 8.2%±1.2% during the follow-up (P<0.001) in all the study subjects (n=409). Among them, 35.5% (n=145) showed a significant improvement in HbA1c. Subjects covered under the Medical Aid system showed a higher prevalence of improvement in HbA1c than those with medical insurance (52.2% vs. 33.3%, respectively, P=0.012). In the improvement group, the baseline HbA1c (P<0.001), fasting C-peptide (P=0.016), and daily dose of insulin/body weight (P=0.024) showed significant negative correlations with the degree of HbA1c change. Multivariate analysis showed that subjects in the Medical Aid system were about 2.5-fold more likely to improve in HbA1c compared to those with medical insurance (odds ratio, 2.459; 95% confidence interval, 1.138 to 5.314; P=0.022).

Conclusion

The reimbursement for SMBG resulted in a significant improvement in HbA1c in T2DM subjects using insulin, which was more prominent in subjects with poor glucose control at baseline or covered under the Medical Aid system.

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    Yerin Hwang, Hyunmin Lee, Moon‐Kyu Lee
    Journal of Diabetes Investigation.2025; 16(8): 1357.     CrossRef
  • The status of blood glucose monitoring and its influencing factors in Chinese patients with type 2 diabetes initiating premixed insulin: A prospective real-world study
    Si Chen, Jingyi Lu, Danfeng Peng, Fengjing Liu, Wei Lu, Wei Zhu, Yuqian Bao, Jian Zhou, Weiping Jia
    Diabetes Research and Clinical Practice.2024; 218: 111895.     CrossRef
  • Immunogenicity and Efficacy of Insulin Glargine Biosimilar Ezelin versus Originator Insulin Glargine in Patients with Type 2 Diabetes
    Tri Juli Edi Tarigan, Adisti Dwijayanti, Susie Setyowati, Melva Louisa
    Diabetes, Metabolic Syndrome and Obesity: Targets and Therapy.2021; Volume 14: 107.     CrossRef
  • Insulin Glargine U100 Utilization in Patients with Type 2 Diabetes in an Italian Real-World Setting: A Retrospective Study
    Luca Degli Esposti, Valentina Perrone, Stefania Saragoni, Valerio Blini, Stefano Buda, Rosella D’avella, Gina Gasperini, Fabio Lena, Francesca Fanelli, Luca Gazzi, Francesco Giorgino
    Journal of Diabetes Research.2019; 2019: 1.     CrossRef
  • Self-Monitoring of Blood Glucose in Patients with Insulin-Treated Type 2 Diabetes Mellitus
    Kyung-Soo Kim
    Diabetes & Metabolism Journal.2018; 42(1): 26.     CrossRef
Clinical Care/Education
Comparison of Glucose Area Under the Curve Measured Using Minimally Invasive Interstitial Fluid Extraction Technology with Continuous Glucose Monitoring System in Diabetic Patients
Mei Uemura, Yutaka Yano, Toshinari Suzuki, Taro Yasuma, Toshiyuki Sato, Aya Morimoto, Samiko Hosoya, Chihiro Suminaka, Hiromu Nakajima, Esteban C. Gabazza, Yoshiyuki Takei
Diabetes Metab J. 2017;41(4):265-274.   Published online July 31, 2017
DOI: https://doi.org/10.4093/dmj.2017.41.4.265
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AbstractAbstract PDFPubReader   ePub   
Background

Continuous glucose monitoring (CGM) is reported to be a useful technique, but difficult or inconvenient for some patients and institutions. We are developing a glucose area under the curve (AUC) monitoring system without blood sampling using a minimally invasive interstitial fluid extraction technology (MIET). Here we evaluated the accuracy of interstitial fluid glucose (IG) AUC measured by MIET in patients with diabetes for an extended time interval and the potency of detecting hyperglycemia using CGM data as a reference.

Methods

Thirty-eight inpatients with diabetes undergoing CGM were enrolled. MIET comprised a pretreatment step using a plastic microneedle array and glucose accumulation step with a hydrogel patch, which was placed on two sites from 9:00 AM to 5:00 PM or from 10:00 PM to 6:00 AM. IG AUC was calculated by accumulated glucose extracted by hydrogel patches using sodium ion as standard.

Results

A significant correlation was observed between the predicted AUC by MIET and CGM in daytime (r=0.76) and nighttime (r=0.82). The optimal cutoff for the IG AUC value of MIET to predict hyperglycemia over 200 mg/dL measured by CGM for 8 hours was 1,067.3 mg·hr/dL with 88.2% sensitivity and 81.5% specificity.

Conclusion

We showed that 8-hour IG AUC levels using MIET were valuable in estimating the blood glucose AUC without blood sampling. The results also supported the concept of using this technique for evaluating glucose excursion and for screening hyperglycemia during 8 hours in patients with diabetes at any time of day.

Citations

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  • LLM-Powered Prediction of Hyperglycemia and Discovery of Behavioral Treatment Pathways from Wearables and Diet
    Abdullah Mamun, Asiful Arefeen, Susan B. Racette, Dorothy D. Sears, Corrie M. Whisner, Matthew P. Buman, Hassan Ghasemzadeh
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    Matthew Zapf, C. Patrick Henson, Eunice Y. Huang, Jonathan P. Wanderer, Leslie C. Fowler, Karen Y. McCarthy, Robert E. Freundlich, Matthew S. Shotwell, Ronald Bell, Svetlana Eden, Miklos D. Kertai
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    Yongseok Joseph Hong, Hyunjae Lee, Jaemin Kim, Minha Lee, Hyung Jin Choi, Taeghwan Hyeon, Dae‐Hyeong Kim
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Clinical Care/Education
Physician-Directed Diabetes Education without a Medication Change and Associated Patient Outcomes
Hun-Sung Kim, Hyunah Kim, Hae-Kyung Yang, Eun Young Lee, Yoo Jin Jeong, Tong Min Kim, So Jung Yang, Seo Yeon Baik, Seung-Hwan Lee, Jae Hyoung Cho, In Young Choi, Hyeon Woo Yim, Bong-Yun Cha
Diabetes Metab J. 2017;41(3):187-194.   Published online May 12, 2017
DOI: https://doi.org/10.4093/dmj.2017.41.3.187
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AbstractAbstract PDFPubReader   ePub   
Background

When patients with diabetes mellitus (DM) are first referred to a hospital from primary health care clinics, physicians have to decide whether to administer an oral hypoglycemic agent (OHA) immediately or postpone a medication change in favor of diabetes education regarding diet or exercise. The aim of this study was to determine the effect of diabetes education alone (without alterations in diabetes medication) on blood glucose levels.

Methods

The study was conducted between January 2009 and December 2013 and included patients with DM. The glycosylated hemoglobin (HbA1c) levels were evaluated at the first visit and after 3 months. During the first medical examination, a designated doctor also conducted a diabetes education session that mainly covered dietary management.

Results

Patients were divided into those who received no diabetic medications (n=66) and those who received an OHA (n=124). Education resulted in a marked decrease in HbA1c levels in the OHA group among patients who had DM for <1 year (from 7.0%±1.3% to 6.6%±0.9%, P=0.0092) and for 1 to 5 years (from 7.5%±1.8% to 6.9%±1.1%, P=0.0091). Those with DM >10 years showed a slightly lower HbA1c target achievement rate of <6.5% (odds ratio, 0.089; P=0.0024).

Conclusion

For patients who had DM for more than 5 years, higher doses or changes in medication were more effective than intensive active education. Therefore, individualized and customized education are needed for these patients. For patients with a shorter duration of DM, it may be more effective to provide initial intensive education for diabetes before prescribing medicines, such as OHAs.

Citations

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The Effects of Propofol and Isoflurane on Blood Glucose during Abdominal Hysterectomy in Diabetic Patients
Shekoufeh Behdad, Abulghasem Mortazavizadeh, Vida Ayatollahi, Zahra Khadiv, Saidhossein Khalilzadeh
Diabetes Metab J. 2014;38(4):311-316.   Published online August 20, 2014
DOI: https://doi.org/10.4093/dmj.2014.38.4.311
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  • 30 Crossref
AbstractAbstract PDFPubReader   ePub   
Background

Acute hyperglycemia in the perioperative period is associated with significantly increased complications. In few human studies the effects of propofol and inhalational anesthetic on the glucose metabolism were compared. In this study we evaluated the effect of propofol and isoflurane on blood glucose during abdominal hysterectomy in diabetic patients.

Methods

After approval by the Ethical Committee and written informed consent, thirty 35 to 65 years old diabetic women underwent for elective abdominal hysterectomy under general anesthesia were studied in this randomized single blind clinical trial study. The plasma glucose was maintained at 100 to 180 mg/dL during the operation. Anesthesia protocol was similar in two groups except maintenance of anesthesia that was with infusion of propofol in the propofol group and with isoflurane in the isoflurane group. Blood glucose level and the rate of insulin intake during surgery compared between two groups.

Results

Mean blood glucose before induction of anesthesia did not have significant difference between two groups, but 60 and 90 minutes after starting the operation blood glucose in the propofol group was significantly lower than isoflurane group. Also with using Repeated Measure test, two groups was significantly different according to blood glucose (P=0.045). Mean of administration of insulin during the surgery did not have significant difference between two groups by using repeated measure test and P=0.271. Also mean of bispectral index in different times during the surgery between two groups didn't have significant difference (P=0.35 repeated measure test).

Conclusion

Blood glucose increased during maintenance of anesthesia with isoflurane compared to propofol during the surgery.

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Predicting Mortality of Critically Ill Patients by Blood Glucose Levels
Byung Sam Park, Ji Sung Yoon, Jun Sung Moon, Kyu Chang Won, Hyoung Woo Lee
Diabetes Metab J. 2013;37(5):385-390.   Published online October 17, 2013
DOI: https://doi.org/10.4093/dmj.2013.37.5.385
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AbstractAbstract PDFPubReader   ePub   
Background

The aim of this study is to observe the outcome of critically ill patients in relation to blood glucose level at admission and to determine the optimal range of blood glucose at admission predicting lower hospital mortality among critically ill patients.

Methods

We conducted a retrospective cohort study of a total 1,224 subjects (males, 798; females, 426) admitted to intensive care unit (ICU) from 1 January 2009 to 31 December 2010. Blood glucose levels at admission were categorized into four groups (group 1, <100 mg/dL; group 2, 100 to 199 mg/dL; group 3, 200 to 299 mg/dL; and group 4, ≥300 mg/dL).

Results

Among 1,224 patients, 319 patients were already known diabetics, and 296 patients died in ICU. Five hundred fifty-seven subjects received insulin therapy, and 118 received oral hypoglycemic agents. The overall mortality rate was 24.2% (296 patients). The causes of death and mortality rates of diabetic patients were not different from nondiabetic subjects. The mortality curve showed J shape, and there were significant differences in mortality between the groups of blood glucose levels at admission. Group 2 had the lowest mortality rate (P<0.05).

Conclusion

These results suggest that serum glucose levels upon admission into ICU is associated with clinical outcomes in ICU patients. Blood glucose level between 100 and 199 mg/dL at the time of ICU admission could predict lower hospital mortality among critically ill patients.

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    Byung Sam Park, Ji Sung Yoon
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    Hyeong Kyu Park
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Influence of the Duration of Diabetes on the Outcome of a Diabetes Self-Management Education Program
Seung-Hyun Ko, Sin-Ae Park, Jae-Hyoung Cho, Sun-Hye Ko, Kyung-Mi Shin, Seung-Hwan Lee, Ki-Ho Song, Yong-Moon Park, Yu-Bae Ahn
Diabetes Metab J. 2012;36(3):222-229.   Published online June 14, 2012
DOI: https://doi.org/10.4093/dmj.2012.36.3.222
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AbstractAbstract PDFPubReader   ePub   
Background

Diabetes education and lifestyle modification are critical components in controlling blood glucose levels of people with type 2 diabetes. Until now, available data on the effectiveness of education with respect to the duration of diabetes are limited. We investigated whether adherence to lifestyle behavior modification prompted by diabetes education was influenced by the duration of diabetes.

Methods

Two hundred and twenty-five people with type 2 diabetes were recruited for an intensive, collaborative, group-based diabetes education program with annual reinforcement. We divided the patients into two groups based on the duration of their diabetes prior to the education program (≤1 year [≤1Y] vs. ≥3 years [≥3Y]). Dietary habits, physical activity, and the frequency of blood glucose self-monitoring were evaluated with a questionnaire prior to education and at the follow-up endpoint.

Results

The mean follow-up period was 32.2 months. The mean hemoglobin A1c (A1C) value was significantly lower in the ≤1Y group. Self-care behaviors, measured by scores for dietary habits (P=0.004) and physical activity (P<0.001), were higher at the endpoint in the ≤1Y group than in the ≥3Y group. Logistic regression analysis revealed that a longer diabetes duration before education was significantly associated with mean A1C levels greater than or equal to 7.0% (53 mmol/mol).

Conclusion

Diabetes duration influenced the effectiveness of diabetes education on lifestyle behavior modification and glycemic control. More-intense, regular, and sustained reinforcement with encouragement may be required for individuals with longstanding type 2 diabetes.

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A Survey on Ubiquitous Healthcare Service Demand among Diabetic Patients
Soo Lim, So-Youn Kim, Jung Im Kim, Min Kyung Kwon, Sei Jin Min, Soo Young Yoo, Seon Mee Kang, Hong Il Kim, Hye Seung Jung, Kyong Soo Park, Jun Oh Ryu, Hayley Shin, Hak Chul Jang
Diabetes Metab J. 2011;35(1):50-57.   Published online February 28, 2011
DOI: https://doi.org/10.4093/dmj.2011.35.1.50
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AbstractAbstract PDFPubReader   ePub   
Background

Advanced information technology can be used when developing diagnostic and treatment strategies to provide better care for diabetic patients. However, the levels of need and demand for the use of technological advances have not been investigated in diabetic patients. We proposed and developed an individualized, ubiquitous (U)-healthcare service using advanced information technology for more effective glucose control. Prior to our service initiation, we surveyed patient needs and other pertinent information.

Methods

During August 2009, we conducted a 34-item questionnaire survey among patients with diabetes who were older than 40 years in two certain hospitals in Korea.

Results

The mean age of the 228 participants was 61.2±9 years, and males made up 49.1% of the sample. Seventy-one percent replied that they wanted individualized healthcare service, and they also wanted their health information to be delivered through mobile devices such as a cellular phone or a personal digital assistant (40.4%). Most patients had never heard of U-healthcare services (81.1%); however, after explaining the concept, 71.1% of participants responded that they would use the service if it was provided. Despite their willingness, participants were concerned about technical difficulty in using the service (26.3%) as well as the cost of the service (29.8%).

Conclusion

The current study suggests that more than 70% of diabetic patients are interested in using U-healthcare services. To encourage widespread use, the application program or device of U-healthcare services should be simple, easy to use and affordable while also including a policy for the protection of private information.

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The Changes in Early Phase Insulin Secretion in Newly Diagnosed, Drug Naive Korean Prediabetes Subjects
Sang Youl Rhee, Joo Young Kim, Suk Chon, You Cheol Hwang, In Kyung Jeong, Seungjoon Oh, Kyu Jeung Ahn, Ho Yeon Chung, Jeong-taek Woo, Sung Woon Kim, Jin-Woo Kim, Young Seol Kim
Korean Diabetes J. 2010;34(3):157-165.   Published online June 30, 2010
DOI: https://doi.org/10.4093/kdj.2010.34.3.157
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AbstractAbstract PDFPubReader   ePub   
Background

There have been no systematic observations regarding changes in early phase insulin secretion among Korean prediabetes and early stage type 2 diabetes mellitus (T2DM) patients.

Methods

We conducted 75-g oral glucose tolerance tests (OGTT) in 873 subjects with suspected abnormal glucose tolerance. All subjects were diagnosed as having normal glucose tolerance (NGT), prediabetes (preDM), or T2DM according to the OGTT results and the insulin secretory and insulin resistance indices of each subject were calculated. Additionally, we analyzed the changes in early phase insulin secretion according to changes in fasting (Glc0), post-prandial (Glc120) glucose and HbA1c (A1c) levels.

Results

As compared to subjects with NGT, the insulin secretory indices of the preDM and T2DM subjects progressively declined, and the insulin resistance indices were progressively aggravated. Early phase insulin secretion decreased rapidly according to the increments of Glc0, Glc120 and A1c, and these changes were most prominent in the NGT stage. Compared to the control group, the early phase insulin secretion levels of the preDM or T2DM subjects were less than 50% when Glc0 was over 100 mg/dL, Glc120 was over 145 mg/dL, and A1c was over 5.8%.

Conclusion

This study suggests that progressive beta cell dysfunction in Koreans may be initiated and rapidly aggravated during the period generally designated as 'normal.'

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The Combination of Fasting Plasma Glucose and Glycosylated Hemoglobin as a Predictor for Type 2 Diabetes in Korean Adults.
Chan Hee Lee, Woo Jin Chang, Hyun Hee Chung, Hyun Jung Kim, Sang Hyun Park, Jun Sung Moon, Ji Eun Lee, Ji Sung Yoon, Kyung Ah Chun, Kyu Chang Won, Ihn Ho Cho, Hyoung Woo Lee
Korean Diabetes J. 2009;33(4):306-314.   Published online August 1, 2009
DOI: https://doi.org/10.4093/kdj.2009.33.4.306
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AbstractAbstract PDF
BACKGROUND
The oral glucose tolerance test (OGTT) for detection of diabetes is difficult to perform in clinical settings. The aim of this study is to evaluate the performance of a more practical detection test, combined fasting plasma glucose (FPG) and glycosylated hemoglobin (HbA1c), as a predictor of diabetes mellitus (DM) in a Korean sample. METHODS: We examined 2,045 (M = 1,276, mean age = 47.8 +/- 9.0 yrs) medical check-up program participants between January 2002 to December 2003. FPG, HbA1c and a number of other biochemical tests were performed at baseline and four after years after initial screening. Patients who originally presented with diabetes were excluded. The characteristics of newly-diagnosed DM patients and non-diabetic patients were compared. RESULTS: The incidence of newly diagnosed diabetes was 1.6% (32/2,045) after four years of follow up. The subjects in the DM group were older, had higher levels of SBP, DBP, FPG, HbA1c, triglyceride, HDL cholesterol, GGT and LDH (P < 0.05). In multivariate logistic regression analysis, FPG (odds ratio [OR] 1.124) and HbA1c (OR 4.794) were significantly correlated with onset of diabetes (P < 0.05). The interaction parameter between FPG and HbA1c was more than 1.0, indicating that the two effects are synergistic. The predictive cut-off values of HbA1c and FPG were 5.35% (area under curve [AUC] = 0.944) and 102.5 mg/dL (AUC = 0.930), respectively. CONCLUSION: The combination of HbA1c above 5.35% and FPG above 102.5 mg/dL predicted the onset of diabetes in a Korean sample. These results suggest that the combination of FPG and HbA1c may be useful for predicting progression to type 2 diabetes in east Asians.

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    Soo Lim
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Effects of 'Ubiquitous Healthcare' on the Ability of Self-Management in Elderly Diabetic Patients.
Sung Hoon Yu, Sun Hee Kim, So Yeon Kim, Sung Hee Choi, Soo Lim, Yoon Seok Chang, Hak Jong Lee, Young Joo Park, Hak Chul Jang
Korean Diabetes J. 2009;33(1):58-64.   Published online February 1, 2009
DOI: https://doi.org/10.4093/kdj.2009.33.1.58
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AbstractAbstract PDF
BACKGROUND
The need for a new healthcare system is growing due to the paradigm shift from health supervision to health maintenance. Previously, we performed a pilot study that examined the effectiveness of a ubiquitous healthcare (U-healthcare) diabetes management program which consists of self-monitoring of blood glucose (SMBG) and mobile phone services for elderly patients with type 2 diabetes mellitus. In this study, we investigated the effect of a diabetes management program using U-healthcare based on the self-care skills of elderly patients with diabetes mellitus. METHODS: From July to October 2005, 17 patients were recruited and provided with a blood glucometer with the ZigBee module and a mobile phone. In addition, the patients' understanding of diabetes self-care skills was examined at the beginning and end of the study. At the end of the study, we determined the level of patient satisfaction regarding U-healthcare services. RESULTS: The patients' test scores on their understanding of diabetes mellitus improved from 57.2 +/- 20.7 to 72.7 +/- 13.4%. Specifically, patient knowledge of the basic principles for a proper diabetic diet (52.9% vs. 82.4%, P = 0.046), foods that influence blood sugar level (41.2% vs. 76.5%, P = 0.007) and the influence of beverage choice (41.2% vs. 64.7%, P = 0.007), all increased. In addition, a significant increase in knowledge of living standards regarding diabetes mellitus was observed (64.7% vs. 88.2%, P = 0.0032). CONCLUSION: We conclude that the U-healthcare incorporating SMBG could be promising, as it improves self-management skills of diabetes mellitus patients, as well as their understanding of the disease.

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    Diabetes & Metabolism Journal.2011; 35(1): 50.     CrossRef
Average Daily Risk Range-Index of Glycemic Variability-Related Factor in Type 2 Diabetic Inpatients.
Shin Ae Park, Seung Hyun Ko, Seung Hwan Lee, Jae Hyung Cho, Sung Dae Moon, Sang A Jang, Ki Ho Song, Hyun Shik Son, Kun Ho Yoon, Bong Yun Cha, Ho Young Son, Yu Bae Ahn
Korean Diabetes J. 2009;33(1):31-39.   Published online February 1, 2009
DOI: https://doi.org/10.4093/kdj.2009.33.1.31
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AbstractAbstract PDF
BACKGROUND
It is known that chronic sustained hyperglycemia and its consequent oxidative stress causes diabetic complication in type 2 diabetes. It has been further proven that glycemic variability causes oxidative stress. The aim of this study is to measure the average daily risk range (ADDR)-index of glycemic variability, and to evaluate relevant variables. METHODS: We measured the blood glucose level of type 2 diabetic patients who were treated with multiple daily injections from January to July, 2008. The blood glucose levels were checked four times a day for 14 days and were conversed according to the ADRR formula. The degree of glycemic variability was categorized into non-fluctuation and fluctuation groups. We collected patient data on age, sex, duration of diabetes, body mass index, HOMA(IR), HOMA(betacell) and HbA1c. RESULTS: A total of 97 patients were enrolled in this study. The mean age, duration of diabetes, HbA1c and mean ADRR were 57.6 +/- 13.4, 11.5 +/- 8.5 years, 10.7 +/- 2.5%, and 26.6 +/- 9.8, respectively. We classified 18.5% of the patients to the non-fluctuation group, and 81.5% to the fluctuation group. ADRR was significantly correlated with duration of diabetes, fasting and postprandial glucose, fructosamine, HbA1c and BMI and HOMAbetacell. In addition, this study confirmed that BMI, HOMAbetacell and HbA1c were ADRR-related independent variables. CONCLUSION: ADRR can be used as an index for blood glucose fluctuation in type 2 diabetic patients. Measuring ADRR in patients with low BMI and a long duration of diabetes is helpful to improve the effectiveness of their care.

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  • Relationships between Thigh and Waist Circumference, Hemoglobin Glycation Index, and Carotid Plaque in Patients with Type 2 Diabetes
    Myung Ki Yoon, Jun Goo Kang, Seong Jin Lee, Sung-Hee Ihm, Kap Bum Huh, Chul Sik Kim
    Endocrinology and Metabolism.2020; 35(2): 319.     CrossRef
  • Reversal of Hypoglycemia Unawareness with a Single-donor, Marginal Dose Allogeneic Islet Transplantation in Korea: A Case Report
    Hae Kyung Yang, Dong-Sik Ham, Heon-Seok Park, Marie Rhee, Young Hye You, Min Jung Kim, Ji-Won Kim, Seung-Hwan Lee, Tae Ho Hong, Byung Gil Choi, Jae Hyoung Cho, Kun-Ho Yoon
    Journal of Korean Medical Science.2015; 30(7): 991.     CrossRef
An Association between 609 C --> T Polymorphism in NAD(P)H: Quinone Oxidoreductase 1 (NQO1) Gene and Blood Glucose Levels in Korean Population.
Dohee Kim
Korean Diabetes J. 2009;33(1):24-30.   Published online February 1, 2009
DOI: https://doi.org/10.4093/kdj.2009.33.1.24
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  • 1 Crossref
AbstractAbstract PDF
BACKGROUND
NAD(P)H: quinone oxidoreductase 1 (NQO1), which is an obligate two-electron reductase that utilizes NAD(P)H as an electron donor and is involved in the protection against oxidative stress, is likely involved in beta-cell destruction. We evaluated the frequency of the NQO1 polymorphism and its association with blood glucose levels. METHODS: Genotypes were determined using a polymerase chain reaction restriction fragment length polymorphism-based assay in 56 patients and 48 healthy subjects. Fasting blood glucose, insulin, and lipid profiles were measured and homeostasis model assessment (HOMA)-insulin resistance (IR) was calculated from fasting glucose and insulin levels in the healthy subjects. RESULTS: The genotype frequencies of NQO1 polymorphism were C/C (56.7%), C/T (42.3%), and T/T (1.0%). There were no associations between the NQO1 polymorphism and body mass index, blood pressure, lipid profile, HbA1c, postprandial glucose, and HOMA-IR. However, NQO1 mutants (C/T and T/T) showed weak but significantly higher fasting blood glucose levels compared with wild type (C/C). CONCLUSION: Our data suggest that NQO1 609 C --> T polymorphism may be associated with glucose metabolism.

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  • Association of Nuclear Factor‐Erythroid 2‐Related Factor 2, Thioredoxin Interacting Protein, and Heme Oxygenase‐1 Gene Polymorphisms with Diabetes and Obesity in Mexican Patients
    Angélica Saraí Jiménez-Osorio, Susana González-Reyes, Wylly Ramsés García-Niño, Hortensia Moreno-Macías, Martha Eunice Rodríguez-Arellano, Gilberto Vargas-Alarcón, Joaquín Zúñiga, Rodrigo Barquera, José Pedraza-Chaverri, Silvana Hrelia
    Oxidative Medicine and Cellular Longevity.2016;[Epub]     CrossRef
Randomized Controlled Trial
Short-term Therapeutic Efficacy of Different Oral Hypoglycemic Agents Combined with Once Daily Insulin Glargine in Type 2 Diabetic Subjects with Failure of Sulfonylurea and Metformin Combination.
Seong Il Hong, Hyeong Jin Kim, Jong Myon Bae, Sun Ok Song, Kyung Suk Park, Byung Soo Jeon, Seun Duk Hwang, Jin Yi Choi, Jeong Hun Kim, Hyuk Jin Kwon, Ja Sung Choi, Myoung Lyeol Woo, Ji Hoon Cho, Young Jun Won
Korean Diabetes J. 2007;31(4):336-342.   Published online July 1, 2007
DOI: https://doi.org/10.4093/jkda.2007.31.4.336
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AbstractAbstract PDF
Backgroud: Although the extended duration of action of insulin glargine supports a convenient once daily injection, the combination with other short acting insulins or oral hypoglycemic agents is required to control postprandial hyperglycemia in type 2 diabetes. The present study was designed to compare the short-term therapeutic efficacy of oral hypoglycemic agents with once daily insulin glargine, switching from a multiple daily injection regimen. METHODS: After control with the intensive regimen (daily lispro insulin and glargine) during 5~7 days, 80 in-patients with type 2 diabetes were randomized and treated with four oral hypoglycemic agents (glimepiride 4 mg qd, metformin 500 mg bid, nateglinide 90 mg tid, or acarbose 100 mg tid) plus once daily insulin glargine during 5 days. Blood glucose concentration was recorded by seven daily estimations (before each meal, 2 hours after each meal, and bedtime). Blood glucose concentrations and area under the curves (AUCs) of blood glucose were compared among four groups. RESULTS: The area under the curve of blood glucose of metformin, glimepiride, nateglinide, and acarbose groups were 165.5 +/- 46.0, 178.5 +/- 36.5, 209.9 +/- 55.1, and 224.9 +/- 55.8 mmol/L/hr respectively. Blood glucose concentrations and area under the curves of blood glucose of glimepiride and metformin groups were significantly lower than those of acarbose group. Also, those of metformin group were significantly lower than those of nateglinide group. Conclusions: Metformin or glimepiride are more effective oral hypoglycemic agent than nateglinide or acarbose in the combination with insulin glargine in type 2 diabetic subjects with failure of sulfonylurea and metformin combination.
Original Articles
Glycemic Control and Health Behaviors through Diabetes Mellitus Education in a Clinic.
Kyeong Soon Chang, Kwan Lee, Hyun Sul Lim
Korean Diabetes J. 2006;30(1):73-81.   Published online January 1, 2006
DOI: https://doi.org/10.4093/jkda.2006.30.1.73
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AbstractAbstract PDF
BACKGROUND
This study was carried out to examine the changes in the health behaviors and glycemic control before and after administering a Diabetes Mellitus (DM) education program in a clinic. METHODS: The author conducted a questionnaire and analyzed the blood chemistry with the fasting plasma blood sugar (FBS) and hemoglobin A1c (HbA1c) level of 80 patients in a clinic for 6 months from February to July 2004. The study group was divided into a poorly controlled (PC) group and well-controlled (WC) group according to the FBS or HbA1c level. The author then educated the subjects about general knowledges for DM over a 6-month period. The changes in the results before and after the DM education were measured as the changes in the health behaviors along with the changes in the FBS, and HbA1c levels. RESULTS: The study subjects contained 20 males and 20 females in each groups, and the major age group was the fifth decade (22 cases, 27.5%). The mean values for the total health behavior scores after the DM education program in the PC and WC group were 16.2 +/- 1.9, and 16.2 +/- 1.7 respectively, and were significantly higher than that before the education program (11.4 +/- 2.1, 15.3 +/- 1.9, P < 0.05). The mean FBS levels after the DM education program in the PC and WC groups were 130.2 +/- 22.8 mg/dL, and 116.2 +/- 16.6 mg/dL respectively, and was significantly lower than that before the education program (186.3 +/- 33.5 mg/dL, 135.3 +/- 16.3 mg/dL, P < 0.05). The mean HbA1c levels after the DM education program in the PC and WC groups were 7.0 +/- 0.8%, and 6.2 +/- 0.4% respectively, which were significantly lower than that before the education program (9.2 +/- 1.4%, 6.5 +/- 0.4%, P < 0.05). CONCLUSION: This study suggests that a DM education program in a clinic is effective in improving the health behaviors and laboratory findings in DM patients.

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  • Economic Evaluation of Diabetes Education
    Jin-Won Noh, Young Dae Kwon, Jin-Hee Jung, Kang Hee Sim, Hee-Sook Kim, Minjae Choi, Jumin Park
    The Journal of Korean Diabetes.2015; 16(4): 293.     CrossRef
  • Group Classification on Management Behavior of Diabetic Mellitus
    Sung-Hong Kang, Soon-Ho Choi
    Journal of the Korea Academia-Industrial cooperation Society.2011; 12(2): 765.     CrossRef
  • Effect on Glycemic, Blood Pressure, and Lipid Control according to Education Types
    Mi-Ju Choi, Seung-Hyun Yoo, Kum-Rae Kim, Yoo-Mi Bae, Sun-Hee Ahn, Seong-Shin Kim, Seong-Ah Min, Jin-Sun Choi, Seung-Eun Lee, Yeo-Jin Moon, Eun Jung Rhee, Cheol-Young Park, Won Young Lee, Ki Won Oh, Sung Woo Park, Sun Woo Kim
    Diabetes & Metabolism Journal.2011; 35(6): 580.     CrossRef
  • The Effects of Regular Walking Exercise on Metabolic Syndrome, Cardiovascular Risk Factors, and Depressive Symptoms in the Elderly with Diabetic Mellitus
    Ki-Wol Sung, Ji-Hyun Lee
    Journal of Korean Academy of Community Health Nursing.2010; 21(4): 409.     CrossRef
Clinical Experience of the Reverse Iontopheresis Based Glucose Measuring System: GlucallTM.
Sang Youl Rhee, Suk Chon, Gwanpyo Koh, Seungjoon Oh, Jeong Taek Woo, Sung Woon Kim, Jin Woo Kim, Young Seol Kim
Korean Diabetes J. 2005;29(2):167-172.   Published online March 1, 2005
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AbstractAbstract PDF
BACKGROUND
Finger pricking is currently the common method of blood glucose measurement in patients with diabetes mellitus. However, diabetes patients have proven reluctant to regularly check their glucose profiles because of the small amount of blood that is required. Recently, a non-invasive and continuous glucose monitoring device that is based on reverse iontophoresis(GlucallTM) has been developed. In this study we wanted to evaluate the accuracy and the clinical acceptability of this new device. METHODS: The study was conducted during the period from November 2003 to January 2004 on 19 in-patients who had been admitted to Kyung Hee University Hospital. Glucose measurements using GlucallTM were performed between 10am and 4pm. The concurrent plasma glucose levels were checked hourly and they were subsequently compared with the GlucallTM data. RESULTS: The mean error(ME) of the GlucallTM measurements was -3.45+/-52.99mg/dL with a mean absolute relative error(MARE) of 20+/-15.16%. Measurements obtained by GlucallTM had a correlation coefficient of 0.784(P<0.05) with the plasma glucose levels, as was determined by linear regression analysis. This correlation was consistent regardless of the time of data collection. However, after excluding such confounding variables as age and gender, the correlation coefficient exhibited a tendency to increase. 98.9% of the results were clinically acceptable according to Clarke error grid analysis. CONCLUSION: GlucallTM does not yet have the reliability and accuracy to wholly replace the conventional methods. However, further technical advancements to reduce its shortcomings will make this device useful for the management of diabetes patients
The Long-term Effect of a Structured Diabetes Education Program for Uncontrolled Type 2 Diabetes Mellitus Patients-a 4-Year Follow-up.
Min Sun Song, Ki Ho Song, Seung Hyun Ko, Yu Bai Ahn, Joon Sung Kim, Jin Hee Shin, Yang Kyung Cho, Kun Ho Yoon, Bong Youn Cha, Ho Young Son, Dong Han Lee
Korean Diabetes J. 2005;29(2):140-150.   Published online March 1, 2005
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AbstractAbstract PDF
BACKGROUND
Diabetes mellitus is a chronic illness with many metabolic complications. The prevalence of diabetes mellitus has markedly increased. Until now, however, little data have been presented for the long-term evaluation of a structured diabetes education program (SDEP) for patients with type 2 diabetes mellitus. The aim of this study was to examine the effects of the SDEP on glycemic control, lipid profiles, and self-care behavior over a four-year follow-up period. METHODS: A total of 248 diabetic patients completed the SDEP from December 1999 to September 2000. Ninety-eight patients were followed-up for more than four years and 75 of them were selected for the study, after those subjects having a baseline glycated hemoglobin(HbA1c) levels below 7.9% were excluded. The laboratory data included the glycemic control status(fasting blood sugar and HbA1c), serum creatinine, and lipid profiles. Compliance with their diet, self monitoring of blood glucose, and their exercise frequency were monitored with a questionnaire that was completed by the patients when they visited the hospital. The data were analyzed by using repeated ANOVA measures and chi2 testing for detecting trends. RESULTS: There were no significant decreases in the fasting blood glucose, creatinine, total cholesterol, triglycerides or low density lipoprotein cholesterol for the SDEP group compared with the control group. The self-care behavior of the SDEP group was much better than that of the control group and it was well maintained. Although the self-care behavior tended to deteriorate with time in the SDEP group, the exercise frequency did not change. The HbA1c level was much improved in the SDEP group(HbA1c: SDEP, 7.9+/-1.2% vs. 8.9+/-1.6% for the control; P =0.009). High density lipoprotein(HDL) cholesterol was also relatively improved in the SDEP group(HDL cholesterol: SDEP, 1.1+/-0.2 mmol/L vs. 1.0+/-0.3mmol/L for the control; P=0.006). CONCLUSIONS: The glycemic control status of diabetic patients who undertook the SDEP was satisfactory for one year after the program, although all the habitual compliance measures decreased gradually with time over the total four years. These results demonstrate that the SDEP for patients with diabetes is useful in improving their long-term glycemic control and self-care behavior. Regular and sustained reinforcement with encouragement will be required for the diabetic patients to maintain their self-care
Effect of Various Snacks and Meal woth Different Kinds of Staples on Bloos Glucose, Insulin, and C- Peptide Levels in Healthy and Type 2 Diabetic Patients.
Youn Sang Oh, Hye Ok Lee, Ryo Won Cho
Korean Diabetes J. 1999;23(4):601-612.   Published online January 1, 2001
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AbstractAbstract PDF
BACKGROUND
There are large differences in the glycemic response among different foods. These differences complicate the glycemic response of foods in diabetic patients. Studies have found that the diet with low glycemic index foods had positive effects on the clinical management of diabetic and hyperlipidemia patients. The concept of glycemic index of foods and the values of glycemic index of meals were measured in this study to suggest the dietary recommendation for type 2 diabetic patients. METHODS: The blood levels of glucose, insulin, C-peptide were measured for healthy subjects and Type 2 diabetic patients after taking various foods and meals. The isocaloric glycemic index of each food and meal was calculated in comparison with standard foods and meals. RESULTS: For the normal subjects, serum glucose, insulin, and C-peptide reached peaks 30 minutes after the meals. The glycemic indices of red bean bread (122.2%),orange juice (106.8%), ice cream (106.3%), and yoghurt (101.6%) were the highest among the respective groups. For the Type 2 diabetic patients, serum glucose reached peaks 60 minutes after the ingestion of meals. The isocaloric glycemic indices were red bean (93.7%), barley (94.6%), mixed cereal (97.9%), Brown rice (98.8%), rice (100%), and milled foxtail (106.9%) in increasing order. CONCLUSION: It is expected that isocaloric glycemic index of Korean foods and meals that are most frequent]y and preferentially eaten by diabetic patients can be used as a guide for menu selection and also to educate the dietary guideline for diabetic patients.
Fasting Serum Insulin Levels in Relation to Age and Body Mass Index and Serum Glucose Level in Healthy Subjects in Korea.
Sang Ah Chang, Ho Young Son, Bong Yun Cha, Sung Dae Moon, Ki Ho Song, Soon Jib Yoo, Kun Ho Yoon, Moo Il Kang, Kwang Woo Lee, Sung Ku Kang
Korean Diabetes J. 1997;21(4):433-443.   Published online January 1, 2001
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AbstractAbstract PDF
BACKGROUND
Ethnic variability in the relationship between glucose tolerance and insulin secretion has been reported. Clinical characteristics of Korean diabetic patients are different from that of diabetic patients in Western countries. It is generally assumed that typical IDDM or obese diabetic patients are relatively rare among Korean subjects. This study attempted to define the characteristics of fasting serum insulin levels of healthy Korean adult subjects. Futhermore, we tried to evaluate the relationship between fasting serum insulin level and age, body mass index, serum glucose. METHODS: We examined 1917 Korean subjects who had fasting blood glucose within normal range (3.6~6.4mmol/L). The fasting insulin levels, total choiesterol, triglyceride concentrations and anthropometric characteristics(body weight, height and body mass index(BMI)) of these subjects were measured. RESULTS: 1) Mean fasting insulin levels were 33.9+0.5pmol/ L, the fasting insulin levels in men and women were 34.9+0.6 and 31.8+0.6pmol/L, respectively. 2) The fasting insulin levels of obese(BMI>25) subjects were significantly higher than those of non-obese subjects(43.2+ 1.2 pmol/L vs. 30.6+0.6 pmol/L, p<0.001). 3) There were significant differences in the basal insulin levels among the age groups, and fasting blood glucose levels were increased with aging. 4) In a multiple stepwise regression analysis, insulin levels were positively correlated with serum triglycerides, fasting blood glucose, body mass index and negatively correlated with age. Conclusion : The fasting insulin levels of healthy subjects in Korea were relatively lower than the previously measured value of Caucasians. The insulin levels were decreased with aging and increased with the elevation of BMI, fasting blood glucose and triglyceride.

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