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Original Article
Complications
Risk Factors for the Development and Progression of Diabetic Kidney Disease in Patients with Type 2 Diabetes Mellitus and Advanced Diabetic Retinopathy
Kyung-Jin Yun, Hye Ji Kim, Mee Kyoung Kim, Hyuk-Sang Kwon, Ki-Hyun Baek, Young Jung Roh, Ki-Ho Song
Diabetes Metab J. 2016;40(6):473-481.   Published online September 20, 2016
DOI: https://doi.org/10.4093/dmj.2016.40.6.473
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AbstractAbstract PDFPubReader   
Background

Some patients with type 2 diabetes mellitus (T2DM) do not develop diabetic kidney disease (DKD) despite the presence of advanced diabetic retinopathy (DR). We aimed to investigate the presence of DKD and its risk factors in patients with T2DM and advanced DR.

Methods

We conducted a cross-sectional study in 317 patients with T2DM and advanced DR. The phenotypes of DKD were divided into three groups according to the urine albumin/creatinine ratio (uACR, mg/g) and estimated glomerular filtration rate (eGFR, mL/min/1.73 m2): no DKD (uACR <30 and eGFR ≥60), non-severe DKD (uACR ≥30 or eGFR <60), and severe DKD (uACR ≥30 and eGFR <60). Mean systolic and diastolic blood pressure, mean glycosylated hemoglobin (HbA1c) level, and HbA1c variability (standard deviation [SD] of serial HbA1c values or HbA1c-SD) were calculated for the preceding 2 years.

Results

The prevalence of no DKD, non-severe DKD, and severe DKD was 37.2% (n=118), 37.0% (n=117), and 25.8% (n=82), respectively. HbA1c-SD and the triglyceride/high density lipoprotein cholesterol (TG/HDL-C) ratio correlated positively with uACR and negatively with eGFR. Multiple linear regression analyses showed that the HbA1c-SD and TG/HDL-C ratio were significantly related with eGFR. Multiple logistic regression analyses after adjusting for several risk factors showed that HbA1c-SD and the TG/HDL-C ratio were significant risk factors for severe DKD.

Conclusion

The prevalence of DKD was about 60% in patients with T2DM and advanced DR. HbA1c variability and TG/HDL-C ratio may affect the development and progression of DKD in these patients.

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Review
The Roles of Glycated Albumin as Intermediate Glycation Index and Pathogenic Protein
Kwang Joon Kim, Byung-Wan Lee
Diabetes Metab J. 2012;36(2):98-107.   Published online April 17, 2012
DOI: https://doi.org/10.4093/dmj.2012.36.2.98
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  • 63 Download
  • 72 Crossref
AbstractAbstract PDFPubReader   

The conventional glycemic indices used in management of diabetic patients includes A1c, fructosamine, 1,5-anhydroglucitol, and glycated albumin (GA). Among these indices, A1c is currently used as the gold standard. However, A1c cannot reflect the glycemic change over a relatively short period of time, and its accuracy is known to decrease when abnormalities in hemoglobin metabolism, such as anemia, coexist. When considering these weaknesses, there have been needs for finding a novel glycemic index for diagnosing and managing diabetes, as well as for predicting diabetic complications properly. Recently, several studies have suggested the potential of GA as an intermediate-term glycation index in covering the short-term effect of treatment. Furthermore, its role as a pathogenic protein affecting the worsening of diabetes and occurrence of diabetic complications is receiving attention as well. Therefore, in this article, we wanted to review the recent status of GA as a glycemic index and as a pathogenic protein.

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Original Articles
Serum Visfatin and Fetuin-A Levels and Glycemic Control in Patients with Obese Type 2 Diabetes Mellitus
Fethiye Oztop Gunduz, Sembol Turkmen Yildirmak, Mustafa Temizel, Yilmaz Faki, Mustafa Cakmak, Mustafa Durmuscan, Funda Sezgin
Diabetes Metab J. 2011;35(5):523-528.   Published online October 31, 2011
DOI: https://doi.org/10.4093/dmj.2011.35.5.523
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AbstractAbstract PDFPubReader   
Background

Visfatin is an adipokine produced by visceral adipose tissue and has insulin-mimicking effects. Fetuin-A is a hepatic secretory protein that binds the insulin receptor and inhibits insulin action both in vivo and in vitro. The authors of the present study aimed to investigate the levels of serum visfatin and fetuin-A and their correlation with hemoglobin A1c (HbA1c) and urine albumin levels in patients with type 2 diabetes mellitus (T2DM).

Methods

A total of 40 obese patients with T2DM (11 males and 29 females; age, 54.47±10.83 years and 23 obese nondiabetic controls (8 males and 15 females; age, 53.04±11.33 years) were included in the study. Age, sex, and body mass index were similar in the 2 groups. Serum visfatin and fetuin-A levels were measured by enzyme-linked immunosorbent assay. HbA1c and urine albumin levels were measured by high performance liquid chromatography and nephelometric method, respectively.

Results

Serum levels of visfatin in patients with T2DM (4.03±2.44 ng/mL) were similar to the control group (3.65±3.02 ng/mL). Serum fetuin-A levels were significantly lower in patients with T2DM than the controls (298.75±78.86 and 430.73±94.46 µg/mL, respectively). HbA1c levels were significantly higher in the T2DM group compared with controls (7.33±1.32 and 5.44±0.84%, respectively). Correlations between visfatin, fetuin-A and HbA1c levels were not observed.

Conclusion

The present study suggests fetuin-A may play a role in the pathogenesis of T2DM.

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Association between Obesity and Physical Fitness, and Hemoglobin A1c Level and Metabolic Syndrome in Korean Adults
Yoonsuk Jekal, Mi-Kyung Lee, Sukyung Park, Seung-Hwan Lee, Jun-Young Kim, Jung-Ui Kang, Masayo Naruse, Sang-Hwan Kim, Sun-Hyeon Kim, Sang Hui Chu, Sang-Hoon Suh, Justin Y Jeon
Korean Diabetes J. 2010;34(3):182-190.   Published online June 30, 2010
DOI: https://doi.org/10.4093/kdj.2010.34.3.182
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AbstractAbstract PDFPubReader   
Background

The purpose of the current study was to investigate the association of obesity level, physical fitness level, hemoglobin A1c (HbA1c) level and metabolic syndrome (MetS) risk factors among Korean adults.

Methods

A total of 557 adults (272 males and 285 females) who underwent medical check-up at local hospital were recruited. In addition to regular health check-up, cardiopulmonary fitness, muscular endurance were measured and their association were analyzed.

Results

The prevalence of MetS was 31.7% for males and 23.7% for females. Females with the higher muscular endurance had lower waist circumference, triglyceride level, and HbA1c level than those with the lower muscular endurance. Males with the higher level of cardiopulmonary fitness had lower diastolic blood pressure, lower high-sensitivity C-reactive protein level and higher high density lipoprotein cholesterol level than males with the lower level of cardiopulmonary fitness. Females with the higher level of cardiopulmonary fitness had lower body weight, body mass index, systolic blood pressure, and fasting blood glucose level than females with the lower level of cardiopulmonary fitness. Participants with the higher level of adiposity and the lower level of physical fitness were 5.26 times (95% confidence interval [CI], 2.19 to 12.62), 5.71 times (95% CI, 2.23 to 14.60) more likely to have MetS, respectively, in male and female compared to participants who were neither obese nor have the lower level of fitness.

Conclusion

This study suggests that maintaining a healthy body weight as well as a certain level of fitness is important for the prevention of MetS.

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The Cutoff Value of HbA1c in Predicting Diabetes in Korean Adults in a University Hospital in Seoul.
Ji Cheol Bae, Eun Jung Rhee, Eun Suk Choi, Ji Hoon Kim, Won Jun Kim, Seung Hyun Yoo, Se Eun Park, Cheol Young Park, Won Young Lee, Ki Won Oh, Sung Woo Park, Sun Woo Kim
Korean Diabetes J. 2009;33(6):503-510.   Published online December 1, 2009
DOI: https://doi.org/10.4093/kdj.2009.33.6.503
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AbstractAbstract PDF
BACKGROUND
Glycated hemoglobin (HbA1c) levels represent a 2~3 month average of blood glucose concentration. The use of HbA1c as a diagnostic tool for diabetes is gaining interest. Therefore, we determined the cutoff point of HbA1c for predicting abnormal glucose tolerance status in non-diabetic Korean subjects. METHODS: We analyzed the data from 1,482 subjects without diabetes mellitus in whom a 75-g oral glucose tolerance test (OGTT) was performed due to suspected abnormal glucose tolerance. We obtained an HbA1c cutoff point for predicting diabetes using Receiver Operating Characteristic (ROC) curve analysis. RESULTS: A cut-off point of 5.95% HbA1c yielded sensitivity of 60.8% and specificity of 85.6%, respectively, for predicting diabetes. There was a difference in HbA1c cut-off value between men and women, 5.85% and 6.05%, respectively. CONCLUSION: To use the cut-off point of 5.95% HbA1c for predicting undiagnosed diabetes in Koreans may be reliable. However, studies of different ethnic groups have reported disparate HbA1c cut-off points. Thus, ethnicity, age, gender, and population prevalence of diabetes are important factors to consider in using elevated HbA1c value as a tool to diagnose diabetes.

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A Nationwide Survey about the Current Status of Glycemic Control and Complications in Diabetic Patients in 2006: The Committee of the Korean Diabetes Association on the Epidemiology of Diabetes Mellitus.
Soo Lim, Dae Jung Kim, In Kyung Jeong, Hyun Shik Son, Choon Hee Chung, Gwanpyo Koh, Dae Ho Lee, Kyu Chang Won, Jeong Hyun Park, Tae Sun Park, Jihyun Ahn, Jaetaek Kim, Keun Gyu Park, Seung Hyun Ko, Yu Bae Ahn, Inkyu Lee
Korean Diabetes J. 2009;33(1):48-57.   Published online February 1, 2009
DOI: https://doi.org/10.4093/kdj.2009.33.1.48
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AbstractAbstract PDF
BACKGROUND
The Committee of the Korean Diabetes Association on the Epidemiology of Diabetes Mellitus performed a nationwide survey about the current status of glycemic control and diabetic complications in 2006. METHODS: The current study included 5,652 diabetic patients recruited from the rosters of endocrinology clinics of 13 tertiary hospitals in Korea. Age, gender, height, weight, waist circumference and blood pressure were investigated by standard method. Fasting and postprandial 2 hour glucose, glycosylated hemoglobin (HbA1c), lipid profiles, fasting insulin and c-peptide levels were measured. Microvascular (microalbuminuria, retinopathy and neuropathy) and macrovascular (coronary artery disease [CAD], cerebrovascular disease [CVD] and peripheral artery disease [PAD]) complications were reviewed in their medical records. RESULTS: Mean age of total subjects was 58.7 (+/- 11.6) years and duration of diabetes was 8.8 (0~50) years. Mean fasting and postprandial 2 hour glucose levels were 145.9 +/- 55.0 and 208.0 +/- 84.4 mg/dL, respectively. Their mean HbA1c was 7.9 +/- 1.9%: the percentage of patients within target goal of glycemic control (< 7% of HbA1c) was 36.7%. In this study, 30.3%, 38.3% and 44.6% of patients was found to have microalbuminuria, retinopathy and nephropathy, respectively. Prevalence of CAD, CVD and PAD was 8.7%, 6.7% and 3.0%, respectively. Diabetic complications were closely related with age, duration of diabetes and glycemic control, and this relationship was stronger in microvascular complications than macrovascular ones. CONCLUSION: Only about one third of patients with diabetes was found to reach target glycemic control in tertiary hospitals of Korea. More tight control is needed to reduce deleterious complications of diabetes in Korea.

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  • The Effect of the Experience of Diabetes Education on Knowledge, Self-Care Behavior and Glycosylated Hemoglobin in Type 2 Diabetic Patients
    Seung Hei Moon, Young Whee Lee, Ok-Kyung Ham, Soo-Hyun Kim
    The Journal of Korean Academic Society of Nursing Education.2014; 20(1): 81.     CrossRef
  • Clinical Characteristics of Diabetic Patients Transferred to Korean Referral Hospitals
    Min Young Oh, Sang Soo Kim, In Joo Kim, In Kyu Lee, Hong Sun Baek, Hyoung Woo Lee, Min Young Chung
    Diabetes & Metabolism Journal.2014; 38(5): 388.     CrossRef
  • Current Status of Prescription in Type 2 Diabetic Patients from General Hospitals in Busan
    Ji Hye Suk, Chang Won Lee, Sung Pyo Son, Min Cheol Kim, Jun Hyeob Ahn, Kwang Jae Lee, Ja Young Park, Sun Hye Shin, Min Jeong Kwon, Sang Soo Kim, Bo Hyun Kim, Soon Hee Lee, Jeong Hyun Park, In Joo Kim
    Diabetes & Metabolism Journal.2014; 38(3): 230.     CrossRef
  • The Influence of Admission Hypoglycemia on Clinical Outcomes in Acute Myocardial Infarction Patients with Diabetes Mellitus
    Eun Jung Kim, Myung Ho Jeong, In Seok Jeong, Sang Gi Oh, Sang Hyung Kim, Young keun Ahn, Ju Han Kim, Young Jo Kim, Shung Chull Chae, Taek Jong Hong, In Whan Seong, Jei Keon Chae, Chong Jin Kim, Myeong Chan Cho, Ki Bae Seung, Hyo Soo Kim
    Korean Journal of Medicine.2014; 87(5): 565.     CrossRef
  • Duration of diabetes and effectiveness of insulin in the management of insulin-naïve Korean patients uncontrolled on oral antidiabetic drugs: a sub-analysis of the MOdaliTy of Insulin treatment eValuation (MOTIV) registry results
    Sang Soo Kim, In Joo Kim, Yong Ki Kim, Kun Ho Yoon, Ho Young Son, Sung Woo Park, Yeon Ah Sung, Hong Sun Baek, Kyoung Soo Ha
    Acta Diabetologica.2014; 51(4): 655.     CrossRef
  • Is the Indicator Magnifying Window for Insulin Pens Helpful for Elderly Diabetic Patients?
    Ju Hee Lee, Eun Shil Hong, Jung Hun Ohn, Young Min Cho
    Diabetes & Metabolism Journal.2013; 37(2): 149.     CrossRef
  • Prevalence of and Factors Associated with Albuminuria in the Korean Adult Population: The 2011 Korea National Health and Nutrition Examination Survey
    Jong Chul Won, Yun Jeong Lee, Jung Min Kim, Sang Youb Han, Jung Hyun Noh, Kyung Soo Ko, Byoung Doo Rhee, Dong-Jun Kim, Harald Mischak
    PLoS ONE.2013; 8(12): e83273.     CrossRef
  • The Epidemiology of Diabetic Nephropathy
    Jin Hwa Kim
    The Journal of Korean Diabetes.2013; 14(1): 11.     CrossRef
  • The Relationship between Neuropathic Pain and Glycemic Control, Self Management in Type II Diabetes Mellitus Patients
    Yeong-Mi Seo, Won-Hee Choi
    Journal of the Korea Academia-Industrial cooperation Society.2013; 14(4): 1774.     CrossRef
  • Efficacy and Safety of Biphasic Insulin Aspart 30/70 in Type 2 Diabetes Suboptimally Controlled on Oral Antidiabetic Therapy in Korea: A Multicenter, Open-Label, Single-Arm Study
    Kee-Ho Song, Jung Min Kim, Jung-Hyun Noh, Yongsoo Park, Hyun-Shik Son, Kyong Wan Min, Kyung Soo Ko
    Diabetes & Metabolism Journal.2013; 37(2): 117.     CrossRef
  • Comorbidity Study on Type 2 Diabetes Mellitus Using Data Mining
    Hye Soon Kim, A Mi Shin, Mi Kyung Kim, Yoon Nyun Kim
    The Korean Journal of Internal Medicine.2012; 27(2): 197.     CrossRef
  • Low ankle-brachial index is an independent predictor of poor functional outcome in acute cerebral infarction
    Jinkwon Kim, Dong Hyun Lee, Myoung-Jin Cha, Tae-Jin Song, Ji Hye Park, Hye Sun Lee, Chung Mo Nam, Hyo Suk Nam, Young Dae Kim, Ji Hoe Heo
    Atherosclerosis.2012; 224(1): 113.     CrossRef
  • Glucose, Blood Pressure, and Lipid Control in Korean Adults with Diagnosed Diabetes
    Sun-Joo Boo
    Korean Journal of Adult Nursing.2012; 24(4): 406.     CrossRef
  • Diabetic Peripheral Neuropathy in Type 2 Diabetes Mellitus in Korea
    Seung-Hyun Ko, Bong-Yun Cha
    Diabetes & Metabolism Journal.2012; 36(1): 6.     CrossRef
  • The Association of Self-Reported Coronary Heart Disease with Diabetes Duration in Korea
    Hye Mi Kang, Yun Jeong Lee, Dong-Jun Kim
    Diabetes & Metabolism Journal.2012; 36(5): 350.     CrossRef
  • Response: The Prevalence of Peripheral Arterial Disease in Korean Patients with Type 2 Diabetes Mellitus Attending a University Hospital (Diabetes Metab J 2011;35:543-50)
    Ji Hee Yu, Ki-Up Lee
    Diabetes & Metabolism Journal.2012; 36(1): 77.     CrossRef
  • Reduction in glycated albumin can predict change in HbA1c: comparison of oral hypoglycaemic agent and insulin treatments
    H. K. Won, K. J. Kim, B.‐W. Lee, E. S. Kang, B. S. Cha, H. C. Lee
    Diabetic Medicine.2012; 29(1): 74.     CrossRef
  • Management of Blood Pressure in Patients with Type 2 Diabetes Mellitus: A Nationwide Survey in Korean
    Mi Hae Seo, Woo Je Lee, Cheol Young Park, Sung Rae Kim, Joong Yeol Park, Kun-Ho Yoon, Moon Kyu Lee, Sung Woo Park
    Diabetes & Metabolism Journal.2011; 35(4): 348.     CrossRef
  • Accuracy Evaluation of the Alternative Site Blood Glucose Test Using Error Grid
    Kyung-Soon Park, Eun-Jong Cha
    Journal of Biomedical Engineering Research.2011; 32(1): 25.     CrossRef
  • Glycated albumin is a useful glycation index for monitoring fluctuating and poorly controlled type 2 diabetic patients
    Eun Young Lee, Byung-Wan Lee, Daham Kim, Yong-ho Lee, Kwang Joon Kim, Eun Seok Kang, Bong-Soo Cha, Eun Jig Lee, Hyun Chul Lee
    Acta Diabetologica.2011; 48(2): 167.     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
  • Predictive Clinical Parameters for the Therapeutic Efficacy of Sitagliptin in Korean Type 2 Diabetes Mellitus
    Soon Ae Kim, Woo Ho Shim, Eun Hae Lee, Young Mi Lee, Sun Hee Beom, Eun Sook Kim, Jeong Seon Yoo, Ji Sun Nam, Min Ho Cho, Jong Suk Park, Chul Woo Ahn, Kyung Rae Kim
    Diabetes & Metabolism Journal.2011; 35(2): 159.     CrossRef
  • Epidemiology of Micro- and Macrovascular Complications of Type 2 Diabetes in Korea
    Jung Hee Kim, Dae Jung Kim, Hak Chul Jang, Sung Hee Choi
    Diabetes & Metabolism Journal.2011; 35(6): 571.     CrossRef
  • Increasing Trend in the Number of Severe Hypoglycemia Patients in Korea
    Jin Taek Kim, Tae Jung Oh, Ye An Lee, Jun Ho Bae, Hyo Jeong Kim, Hye Seung Jung, Young Min Cho, Kyong Soo Park, Soo Lim, Hak Chul Jang, Hong Kyu Lee
    Diabetes & Metabolism Journal.2011; 35(2): 166.     CrossRef
  • Prevalence and Associated Factors of Diabetic Retinopathy in Rural Korea: The Chungju Metabolic Disease Cohort Study
    Ji-Hyun Kim, Hyuk-Sang Kwon, Yong-Moon Park, Jin-Hee Lee, Man-Soo Kim, Kun-Ho Yoon, Won Chul Lee, Bong-Yun Cha, Ho-Young Son
    Journal of Korean Medical Science.2011; 26(8): 1068.     CrossRef
  • The Prevalence of Peripheral Arterial Disease in Korean Patients with Type 2 Diabetes Mellitus Attending a University Hospital
    Ji Hee Yu, Jenie Yoonoo Hwang, Mi-Seon Shin, Chang Hee Jung, Eun Hee Kim, Sang Ah Lee, Eun Hee Koh, Woo Je Lee, Min-Seon Kim, Joong-Yeol Park, Ki-Up Lee
    Diabetes & Metabolism Journal.2011; 35(5): 543.     CrossRef
  • Prevalence, Awareness, and Control of Hypertension among Diabetic Koreans
    Hyun Hee Chung, Kyu Chang Won
    Diabetes & Metabolism Journal.2011; 35(4): 337.     CrossRef
  • Factors Influencing Physical Activity Behavior among Iranian Women with Type 2 Diabetes Using the Extended Theory of Reasoned Action
    Alireza Didarloo, Davoud Shojaeizadeh, Hassan Eftekhar Ardebili, Shamsaddin Niknami, Ebrahim Hajizadeh, Mohammad Alizadeh
    Diabetes & Metabolism Journal.2011; 35(5): 513.     CrossRef
  • Factors that Affect Medication Adherence in Elderly Patients with Diabetes Mellitus
    Kyung-Ae Park, Jung-Guk Kim, Bo-Wan Kim, Sin Kam, Keon-Yeop Kim, Sung-Woo Ha, Sung-Taek Hyun
    Korean Diabetes Journal.2010; 34(1): 55.     CrossRef
  • The Effects of Tailored Diabetes Education on Blood Glucose Control and Self-Care
    Kyung Sun Hyun, Kwang Mi Kim, Sook Hee Jang
    Journal of Korean Academy of Nursing.2009; 39(5): 720.     CrossRef
  • Epidemiologic Characteristics of Diabetes Mellitus in Korea: Current Status of Diabetic Patients Using Korean Health Insurance Database
    Ie Byung Park, Sei Hyun Baik
    Korean Diabetes Journal.2009; 33(5): 357.     CrossRef

Diabetes Metab J : Diabetes & Metabolism Journal