Diabetes & Metabolism Journal

Original Article

Type 1 Diabetes
Differential Profile of Plasma Circular RNAs in Type 1 Diabetes Mellitus: Yangyang Li, Ying Zhou, Minghui Zhao, Jing Zou, Yuxiao Zhu, Xuewen Yuan, Qianqi Liu, Hanqing Cai, Cong-Qiu Chu, Yu Liu; Diabetes Metab J. 2020;44(6):854-865. Published online July 13, 2020; DOI: https://doi.org/10.4093/dmj.2019.0151

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Background

No currently available biomarkers or treatment regimens fully meet therapeutic needs of type 1 diabetes mellitus (T1DM). Circular RNA (circRNA) is a recently identified class of stable noncoding RNA that have been documented as potential biomarkers for various diseases. Our objective was to identify and analyze plasma circRNAs altered in T1DM.

Methods

We used microarray to screen differentially expressed plasma circRNAs in patients with new onset T1DM (n=3) and age-/gender-matched healthy controls (n=3). Then, we selected six candidates with highest fold-change and validated them by quantitative real-time polymerase chain reaction in independent human cohort samples (n=12). Bioinformatic tools were adopted to predict putative microRNAs (miRNAs) sponged by these validated circRNAs and their downstream messenger RNAs (mRNAs). Gene Ontology (GO) and Kyoto Encyclopedia of Genes and Genomes (KEGG) pathway analyses were performed to gain further insights into T1DM pathogenesis.

Results

We identified 68 differentially expressed circRNAs, with 61 and seven being up- and downregulated respectively. Four of the six selected candidates were successfully validated. Curations of their predicted interacting miRNAs revealed critical roles in inflammation and pathogenesis of autoimmune disorders. Functional relations were visualized by a circRNA-miRNA-mRNA network. GO and KEGG analyses identified multiple inflammation-related processes that could be potentially associated with T1DM pathogenesis, including cytokine-cytokine receptor interaction, inflammatory mediator regulation of transient receptor potential channels and leukocyte activation involved in immune response.

Conclusion

Our study report, for the first time, a profile of differentially expressed plasma circRNAs in new onset T1DM. Further in silico annotations and bioinformatics analyses supported future application of circRNAs as novel biomarkers of T1DM.

Citations

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Brief Report

Others
A Potential Issue with Screening Prediabetes or Diabetes Using Serum Glucose: A Delay in Diagnosis: Jun Goo Kang, Cheol-Young Park, Sung-Hee Ihm, Sung Woo Park; Diabetes Metab J. 2016;40(5):414-417. Published online September 1, 2016; DOI: https://doi.org/10.4093/dmj.2016.40.5.414

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The aim of this study was to compare the fasting serum glucose level with the fasting plasma glucose level for diagnosing hyperglycemic states in real-life clinical situations. Additionally, we investigated a usual delay in sample processing and how such delays can impact the diagnosis of hyperglycemic states. Among 1,254 participants who had normoglycemia or impaired fasting glucose (IFG) assessed by the fasting serum glucose level, 20.9% were newly diagnosed with diabetes based on the plasma fasting glucose level. Of the participants with normoglycemia, 62.1% and 14.2% were newly diagnosed with IFG and diabetes, respectively, according to the plasma fasting glucose level. In our clinical laboratory for performing health examinations, the time delay from blood sampling to glycemic testing averaged 78±52 minutes. These findings show that the ordinary time delay for sample processing of the serum glucose for screening hyperglycemic states may be an important reason for these diagnoses to be underestimated in Korea.

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Original Articles

Impact of HbA1c Criterion on the Detection of Subjects with Increased Risk for Diabetes among Health Check-Up Recipients in Korea: Hong-Kyu Kim, Sung-Jin Bae, Jaeone Choe; Diabetes Metab J. 2012;36(2):151-156. Published online April 17, 2012; DOI: https://doi.org/10.4093/dmj.2012.36.2.151

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Background

We performed the study to examine the impact of hemoglobin A1c (HbA1c) criterion on the screening of increased risk for diabetes among health check-up subjects in Korea.

Methods

We retrospectively analyzed clinical and laboratory data of 37,754 Korean adults (age, 20 to 89 years; 41% women) which were measured during regular health check-ups. After excluding subjects with previously diagnosed diabetes mellitus (n=1,812) and with overt anemia (n=318), 35,624 subjects (21,201 men and 14,423 women) were included in the analysis.

Results

Among the 35,624 subjects, 11,316 (31.8%) subjects were categorized as increased risk for diabetes (IRD) by fasting plasma glucose (FPG) criteria, 6,531 (18.1%) subjects by HbA1c criteria, and 13,556 (38.1%) subjects by combined criteria. Therefore, although HbA1c criteria alone identifies 42% [(11,316-6,531)/11,316] fewer subjects with IRD than does FPG criteria, about 20% [(13,556-11,316)/11,316] more subjects could be detected by including new HbA1c criteria in addition to FPG criteria. Among the 13,556 subjects with IRD, 7,025 (51.8%) met FPG criteria only, 2,240 (16.5%) met HbA1c criteria only, and 4,291 (31.7%) met both criteria. Among subjects with impaired fasting glucose, 65% were normal, 32% were IRD, and 3% were diabetes by HbA1c criterion. In receiver operating characteristic curve analysis, cutoff point of HbA1c with optimal sensitivity and specificity for identifying IRD was 5.4%.

Conclusion

Although HbA1c criteria alone identifies fewer subjects with IRD than does FPG criteria, about 20% more could be detected by addition of HbA1c criteria. Further studies are needed to define optimal cutoff point of HbA1c and to establish screening and management guidelines for IRD.

Citations

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Saebom Kim, Sehee Kim, Youngmin Kim, Seonmi Seo, Yu Jin Chung, Sam Cheol Kim
Korean Journal of Family Practice.2023; 13(3): 179. CrossRef
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Wichaporn Intharachuti, Jiruth Sriratanaban
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Bernd Richter, Bianca Hemmingsen, Maria-Inti Metzendorf, Yemisi Takwoingi
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Seyoung Kwon, Youngak Na
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Sangmo Hong, Jun Goo Kang, Chul Sik Kim, Seong Jin Lee, Chang Beom Lee, Sung-Hee Ihm
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Impact of hemoglobin A1c‐based criterion on diagnosis of prediabetes: The Korea National Health and Nutrition Examination Survey 2011
Chul‐Hee Kim, Hong‐Kyu Kim, Bo‐Yeon Kim, Chan‐Hee Jung, Ji‐Oh Mok, Sung‐Koo Kang
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Letter: Impact of HbA1c Criterion on the Detection of Subjects with Increased Risk for Diabetes among Health Check-Up Recipients in Korea (Diabetes Metab J 2012;36:151-6)
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Efficacy of Sitagliptin When Added to Ongoing Therapy in Korean Subjects with Type 2 Diabetes Mellitus: Hye Soo Chung, Moon-Kyu Lee; Diabetes Metab J. 2011;35(4):411-417. Published online August 31, 2011; DOI: https://doi.org/10.4093/dmj.2011.35.4.411

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Background

To evaluate the clinical efficacy of sitagliptin for reducing plasma glucose levels in Korean subjects with type 2 diabetes mellitus during a 14-week treatment period.

Methods

Our study design involved the addition of 100 mg sitagliptin once-daily to three ongoing combination therapy regimens and changing from glimepiride and metformin to sitagliptin and metformin.

Results

The addition of sitagliptin 100 mg/day produced a statistically significant reduction in mean HbA1c level (mean HbA1c reduction of 0.99±0.85%, P<0.01). In the group taking a combination of sitagliptin and metformin (n=143, initial mean HbA1c level=7.48%), the reductions in HbA1c, 2-hour postprandial glucose, and fasting glucose levels were 0.72±0.76% (P<0.01), 47±65 mg/dL (P<0.01), and 15±44 mg/dL (P<0.01), respectively. In the group taking a combination of sitagliptin, glimepiride, and metformin (n=125, initial mean HbA1c level=8.42%), the reductions in HbA1c, 2-hour postprandial glucose, and fasting glucose levels were 1.09±0.86% (P<0.01), 62±64 mg/dL (P<0.01), and 31±45 mg/dL (P<0.01), respectively. In the group taking a combination of sitagliptin, glimepiride, metformin, and α-glucosidase inhibitor (n=63, initial mean HbA1c level=9.19%), the reductions in HbA1c, 2-hour postprandial glucose, and fasting glucose levels were 1.27±0.70% (P<0.01), 72±65 mg/dL (P<0.01), and 35±51 mg/dL (P<0.01), respectively. In the group that had previous hypoglycemic events and that changed from glimepiride to sitagliptin, HbA1c level did not change but fasting glucose increased significantly (14±29 mg/dL, P<0.01).

Conclusion

Sitagliptin combination therapy for 14 weeks significantly improved glycemic control and was well-tolerated in Korean subjects with type 2 diabetes mellitus.

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Glimepiride Strongly Enhances the Glucose-Lowering Effect in Triple Oral Antidiabetes Therapy with Sitagliptin and Metformin for Japanese Patients with Type 2 Diabetes Mellitus
Keiko Arai, Hajime Maeda, Sin-ichiro Sirabe, Ritsuko Yamamoto, Mikio Yamauchi, Tetsuyuki Hirao, Setsuko Hirao, Koichi Hirao
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The Correlation and Accuracy of Glucose Levels between Interstitial Fluid and Venous Plasma by Continuous Glucose Monitoring System: Young Ha Baek, Heung Yong Jin, Kyung Ae Lee, Seon Mee Kang, Woong Ji Kim, Min Gul Kim, Ji Hyun Park, Soo Wan Chae, Hong Sun Baek, Tae Sun Park; Korean Diabetes J. 2010;34(6):350-358. Published online December 31, 2010; DOI: https://doi.org/10.4093/kdj.2010.34.6.350

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Abstract PDF PubReader

Background

Clinical experience with the continuous glucose monitoring systems (CGMS) is limited in Korea. The objective of this study is to evaluate the accuracy of the CGMS and the correlation between interstitial fluid and venous plasma glucose level in Korean healthy male subjects.

Methods

Thirty-two subjects were served with glucose solution contained same amount of test food's carbohydrate and test foods after separate overnight fasts. CGMS was performed over 3 days during hopitalization for each subjects. Venous plasma glucose measurements were carried out during 4 hours (0, 0.25, 0.5, 0.75, 1, 2, 4 hours) just before and after glucose solution and test food load. The performance of the CGMS was evaluated by comparing its readings to those obtained at the same time by the hexokinase method using the auto biochemistry machine (Hitachi 7600-110). Also, correlations between glucose recorded with CGMS and venous plasma glucose value were examined.

Results

CGMS slightly underestimated the glucose value as compared with the venous plasma glucose level (16.3 ± 22.2 mg/dL). Correlation between CGMS and venous plasma glucose values throughout sensor lifetime is 0.73 (regression analysis: slope = 1.08, intercept = 8.38 mg/dL). Sensor sensitivity can deteriorate over time, with correlations between venous blood glucose and CGMS values dropping from 0.77 during 1st day to 0.65 during 2nd and 3rd day.

Conclusion

The accuracy of data provided by CGMS may be less than expected. CGMS sensor sensitivity is decreased with the passage of time. But, from this study, CGMS can be used for glucose variability tendency monitoring conveniently to the Korean.

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Evaluation of Fasting Plasma Glucose as a Screening for Diabetes Mellitus in Middle-aged Adults of Naju Country.: Jin Hwa Kim, Mi Ah Han, Chol Jin Park, Il Goo Park, Ji Hye Shin, Sang Yong Kim, So Yeon Ryu, Hak Yeon Bae; Korean Diabetes J. 2008;32(4):328-337. Published online August 1, 2008; DOI: https://doi.org/10.4093/kdj.2008.32.4.328

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Abstract PDF

BACKGROUND
The criteria for the diagnosis of diabetes mellitus have been modified by the American Diabetes Association (ADA) in 1997. The ADA proposed that the diagnosis of diabetes be defined by a fasting plasma glucose (FPG) of 7.0 mmol/L. Disagreement has been reported between criteria based on FPG and postchallenge 2-h plasma glucose (2-h PG). The aim of the present study is to assess the FPG criteria as the diagnostic screening test for diabetes in Korean middle-aged adults in comparison to the 2-h PG criteria. METHODS: Randomly selected 1,731 subjects (679 men and 1,052 women) aged 40~70 years (mean age: 58.4 +/- 7.89 years) without previously diagnosed diabetes completed 75 g oral glucose tolerance test (OGTT). We assessed the prevalence of diabetes mellitus and the level of agreement (kappa statistics) according to the different diagnostic glucose categories. RESULTS: The frequency of newly diagnosed diabetes was 2.7% (n = 51) using the FPG criteria only; 6.4% (n = 120) using the 2-h PG criteria only; and 6.9% (n = 130) using concentrations of > or = 7.0 mmol/L for FPG or > or = 11.1 mmol/L for 2-h PG. Of the 120 subjects with diabetes by the 2-h PG criteria, 65.8% (n = 79) were not diagnosed with diabetes according to FPG concentration. The level of agreement between two diagnostic criteria was low (kappa = 0.268). The receiver operating characterstic (ROC) curve analysis determined FPG of 5.6 mmol/L to yield optimal sensitivity and specificity corresponding to 2-h PG 11.1 mmol/L. CONCLUSION: The findings in this study demonstrate that the discordance between the FPG and 2-h PG criteria in the diagnosis of diabetes in Korean middle-aged adults is large. We suggest that IFG group (FPG 5.6~6.9 mmol/L) were performed 75 g OGTT for diagnosing diabetes mellitus in Korean middle-aged adults.

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Increased Plasma Dipeptidyl Peptidase IV Activities in ob/ob Mice.: Sang Dal Rhee, Young Sil Lee, Hye Sung Lee, Won Hoon Jung, Hyae Gyeong Cheon, Jin Hee Ahn, Sung Su Kim, Sang Gi Paik, Sung Don Yang; Korean Diabetes J. 2005;29(1):22-29. Published online January 1, 2005

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Abstract PDF: BACKGROUND
Dipeptidyl peptidase IV (DPP IV/CD26), a multi-functional glycoprotein, cleaves and inactivates major insulinotropic hormones, such as glucagon-like protein (GLP)-1 and glucose dependent insulinotrophic polypeptide (GIP). METHODS: The plasma DPP IV activities in ob/ob mice were measured at 4, 8 and 13 weeks of age and the correlation between the plasma glucose concentration and DPP IV activity analyzed at 7~9 weeks of age. The glucose lowering effects of P32/98, a DPP IV inhibitor, was assessed with the oral glucose tolerance test. RESULTS: The plasma DPP IV activities in ob/ob mice were higher than those in lean mice. The plasma DPP IV activity was correlated with the plasma glucose concentration both in male and female ob/ob mice. The glucose lowering effect of DPP IV inhibitor was more prominent in ob/ob than in lean mice. CONCLUSION: The plasma DPP IV activities in ob/ob mice were higher than in lean control mice, which may contribute to the higher glucose lowering effect of the DPP IV inhibitor in ob/ob mice

Common Genetic Polymorphisms in the Promoter of Resistin Gene are Major Determinants of Plasma Resistin Concentrations in Humans.: Young Min Cho, Byung Soo Youn, Sung Soo Chung, Ki Woo Kim, Bo Kyeong Koo, Kang Yeol Yu, Hong Je Park, Hyoung Doo Shin, Hak Chul Jang, Kyong Soo Park, Seong Yeon Kim, Hong Kyu Lee; Korean Diabetes J. 2004;28(1):9-19. Published online February 1, 2004

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Abstract PDF: BACKGROUND
Resistin has been postulated to be an important link between obesity and insulin resistance. Genetic polymorphisms in the resistin gene promotor have been suggested as a determinant of the expression of resistin mRNA, which is possibly associated with obesity and insulin resistance. In this study, the association between the genotype of the resistin promoter, and its plasma concentrations, were investigated. METHODS: The g.-537A>C and g.-420C>G polymorphisms in the resistin promoter were examined, and the levels of plasma resistin measured in the Korean subjects, both with and without type 2 diabetes. Haplotype-based promoter activity and the gel electrophoretic mobility-shift assays(EMSA) were also performed. RESULTS: The -420G and the -537A alleles, which were in linkage disequilibrium, were associated with higher plasma resistin concentrations. Individuals with the A-G(-537 A and -420G) haplotypes showed significantly higher plasma resistin levels than those that did not. The haplotypes A-G had modestly increased promoter activities compared to the other haplotypes. The EMSA revealed the -420 G allele to be specific for binding of the nuclear proteins from adipocytes and monocytes. However, neither polymorphism was associated with type 2 diabetes or obesity in our study subjects. CONCLUSION: Polymorphisms in the promoter of the resistin gene are major determinants of plasma resistin concentrations in humans

Alterations of Plasma Atrial Natriuretic Peptide and its mRNA in Non-insulin Dependent Diabetic Model of Rats.: Byeong Dae Yoo, Won Kyun Park, Young Su Hong, Dae Kyu Song, Jae Hoon Bae; Korean Diabetes J. 2000;24(4):421-430. Published online January 1, 2001

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Abstract PDF: BACKGROUND
Diabetes mellitus has led to change in fluid and electrolyte balance and consequently affected blood volume and blood pressure. These changes can trigger the secretion and synthesis of atrial natriuretic peptide (ANP) from both atrial and extra-atrial tissues. ANP plays an important role in the regulations of body fluid balance and blood pressure. Therefore, this study was carried out to elucidate whether or not atrial and extra-atrial synthesis of ANP is influenced in experimental non-insulin dependent diabetes mellitus (NIDDM) rats. METHODS: Neonatal rats were induced into NIDDM rats by single injection of streptozotocin (80 mg/kg). Plasma ANP level was measured by the use of radioimmunoassay method and the ANP mRNA expressions from the right atrium, left ventricle, hypothalamus and kidney were analyzed by reverse transcription- polymerase chain reaction with [32P]-dCTP at 8 weeks after injection of streptozotocin or citrate buffer. RESULTS: Blood glucose was more significantly increased at 2 hours after glucose loading in NIDDM rats than control rats. Plasma concentration of ANP tended to significantly increase in NIDDM rats compared with control rats. The expressions of ANP mRNA from each tissue were observed in different patterns. Right atrial ANP mRNA expression revealed non-significant increasing trend in NIDDM rats, whereas left ventricular ANP mRNA did not have difference. However, both hypothalamic and renal ANP mRNA expressions in NIDDM rats were significantly increased. CONCLUSION: These results indicate that the enhanced expressions of hypothalamic and renal ANP mRNA act as an important regulator of electrolytes and body fluid volume in neonatally streptozotocin-induced NIDDM rats.

The Appropriteness of New ADA Diagnostin Criteria for Diabetes Mellitus in Korean Population.: Moon kyu Lee, Myung Shik Lee, Young Ki Min, Sung Hoon Kim, Byoung Joon Kim, Dong Jun Kim, Jong Ryeal Hahm, Eun Young Oh, Yun Jae Chung, Kyoung Ah Kim, Jae Hoon Chung, Kwang Won Kim; Korean Diabetes J. 1999;23(3):336-351. Published online January 1, 2001

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Abstract PDF: BACKGROUND
The ADA has proposed a new diagnostic criteria for diabetes based on fasting plasma glucose, redefining diabetes as fasting plasma glucose 7.0 mmol/L. Since only a few studies for the appropriateness of tbis new ADA criteria were undertaken in the Korean population, we examined the appropriateness of the new ADA criteria by analyzing the results of oral glucose tolerance tests done in our hospital. METHODS: 507 oral glucose tolerance tests were conducted. Cases with diabetes and diseases that could affect the glucose tolerance were excluded. Plasma glucose was measured by the hexokinase method. Three groups of NGT, IGT, and DM by the WHO criteria of 2 hour-plasma glucose were redivided at each level of fasting plasma glucose. We calculated the sensitivity and specificity of each level of fasting plasma glucose (FPG), and the FPG value of maximum accuracy to diagnose diabetes with reference to the WHO criteria of 2 hour-plasma glucose. RESULTS: Correlation between the levels of fasting plasma glucose and 2 hour-plasma glucose was relatively low (r=0.676). FPG of 7.0 mmol/L for diagnosing diabetes was relatively specific (specificity=0.934), but not sensitive (sensitivity= 0.552). FPG value of maximum accuracy for diagnosing diabetes was 6.8 mmol/L. 39 % of IFG (> 6.1mmol/L and < 7.0mmol/L) was reclassified as diabetes by the criteria of 2 hour plasma glucose 11.1 mmol/L and 34 % of NFG (<6.1mmol/L) was reclassified as impaired glucose tolerance by the criteria of 2 hour plasma glucose > 7.8 mmol/L. CONCLUSION: The fasting plasma glucose of 7.0 mmol/L was relatively specific for diagnosing diabetes. However, the new ADA criteria tended to underestimate the prevalence of diabetes and impaired glucose tolerance in the Korean population. Therefore, oral glucose tolerance test may be needed to diagnose diabetes in high risk subjects. Large-scale cross-sectional and prospective studies will be needed to clarify these points.

Estimation of Cut-off Point of Fasting Blood Glucose Predicting Pancreaticbeta-cell Decompensation During Oral Glucose Tolerance Test.: Mi Deok Lee, Hong Seung Kim, Young Uk Kim, Young Goo Shin, Chang Ho Song, Young Jun Won, Choon Hee Chung; Korean Diabetes J. 1998;22(4):513-521. Published online January 1, 2001

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Abstract PDF: BACKGROUND
The secretory dysfunction of pancreatic B-cell is one of the important in the pathogenesis of NIDDM. And the conversion from IGT to DM is developed by the exhaustion and decompensation of 0-cell. So our purp was estimating the cut-off point of fasting blood sugar predicting B-cell decompensation during OGTT. METHOD: The clinical characteristics and anthropometric parameters were determined in all subjects. 75 g ora] glucose tolerance tests were performed with serial blood sampling to measure plasma glucose levels, insulin and C-peptide levels. And we calcolated insulin response areas and C-peptide response areas. RESULTS: l) The basal C-peptide levels were elevated in IG1' and DM group. however, post-load 30min C-peptide and 30min insulin levels were significantly decreased in DM group compared with normal and IGl. 2) IGT group showed the highest C-peptide response areas among three groups. 3) The relationships between fasting plasma glucose, C-peptide & insulin levels showed that basal C-peptide level had turning point at 6.7 mmol/L of fastiing glucose, basal insulin level at 6.5 mmol/L, 30 min C-peptide at 6.2 mmol/1, 30 min insulin at 5.8 mmol/L and C-peptide response area at 7.0 mmol/L. Conclusion : Above result suggest that the fasting plasma glucose of 7.0 mmol/L may be the cut-off point of pancreatic B-cell decompensation.

Evaluation of Fasting Plasma Glucose to Diagnose Diabetes in Yonchon County.: Young Joo Park, In Kyoung Chung, Chan Soo Shin, Kyong Soo Park, Seong Yeon Kim, Hong Kyu Lee, Sun Ja Kwon; Korean Diabetes J. 1998;22(3):372-380. Published online January 1, 2001

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Abstract PDF: BACKGROUND
Recently, many studies were performed to evaluate the diagnostic value of fasting plasma glucose to diagnose diabetes, and the diagnostic criteria were revised by ADA in 1997 to avoid discrepancy between the fasting plasma glucose (FPG) and 2 hour post-load plasma glucose(2hPG) cutpoint values after 75g oral glucose loading and to alsc facilitate and encourage the use of test for diagnosing diabetes. This study was performed to assess the performance of different cutpoint of fasting plasma glucose in the diagnosis of diabetes and to compare the prevalence and incidence of diabetes using revised 1997 ADA FPG criterion with those using 1985 WHO criteria in Yonchon County of Korea. METHODS: Two thousand three hundred fifty-six subjects who participated in population based cross-sectional study in Yonchon County in 1993. We have also analysed the data from 1141 subjects who were non-diabetic in 1993 and participated in the follow-up survey in 1995. The relationship between FPG and 2hPG were determined using sensitivity, specificity and the prevalence of diabetes according to FPG and/or 2hPG values. We have determined the prevalence and the incidence of diabetes using the ADA criterion. RESULTS: Based on WHO criteria, a FPG of 6.1 mmol/L(110mg/dL) was determined to yield optimal sensitivity(83.6%) and specificity(82.4%), but it showed low positive predictive value(27.2%) and high prevalence(24.5%). The FPG cutpoint which showed same prevalence with the criterion ot the 2hPG >11.1mmol/L(87 in 2251) was 7.4mmol/L (133mg/dL, 87 in 2251), The crude prevalence of diabetes and impaired fasting glucose by ADA criterion were 9.6% and 14.9%, respectively, where as the crude prevalence of diabetes and IGT were 9.4% and 11.5% by WHO criteria. The crude incidence of diabetes was 5.1% as defined by ADA criterion and 34.4% of subjects who showed impaired fasting glucose in 1993 converted to diabetes in 1995, whereas the incidence was 2.5% by WHO criteria and 13% of IGT subjeets converted to diabetes in 2 years. Conclusions: The adequate cutpoint for FPG seems to lie between 6.1mmol/L and 7.4mmol/L. The 1997 ADA criterion of the FPG > 7.0mmol/L produced similar prevalence and higher incidence than those obtained from 1985 WHO criteria and the former seems to be better to detect the risk group who may progress to diabetes.

Comparison of the New Diagnostic Criteria for Diabetes Mellitus Recommended by the Expert Committee of the American Diabetes Association with the Criteria by the NDDG or WHO in Koreans with Fasting Plasma Glucose between 110 and 139 mg / dL.: Yeo Joo Kim, Moon Suk Nam, Mi Rim Kim, Yong Seong Kim, Kwan Woo Lee, Hyeon Man Kim, Choon Hee Chung, Su Youn Nam, Bong Soo Cha, Kyung Rae Kim, Hyun Chul Lee, Sam Kweon, Yong Wook Cho, Kap Bum Huh; Korean Diabetes J. 1998;22(2):209-217. Published online January 1, 2001

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Abstract PDF: BACKGROUND
The current diagnostic criteria for diabetes mellitus announced by National Diabetes Data Group(NDDG) in 1979 were revised by Expert Committee of World Health Organization(WHO) in both 1980 and 1985. However, according to advancement in the knowledge of the etiology and pathogenesis of diabetes mellitus, the International Expert Committee working under the sponsorship of the American Diabetes Association(ADA) decided to adopt the resolution proposing that the criteria of fasting glucose level applied to diagnosis of diabetes mellitus should be lowered at the 57 ADA conference held in Boston, USA in June 1997(97 ADA). Hereupon, by comparing the diagnostic criteria of the former (NDDG/WHO) with the later, the authors have examined the usefulness of new diaignostic criteria, 97 ADA. METHOD: We collected the data from 13 university hospitals in Korea which contain the results of 75 gram oral glucose tolerance test(OGTT) for 532 Kareans between 110 and 139 mg/dL in fasting plasma glucose. We have then evaluated the results by classifying and comparing them in accordance with the criteria of NDDG/WHO and 97 ADA, respectively. RESULTS: 1. The number which tested for oral glucose tolerance was 532 and the majority of tests have been carried out between 110 and 119 mg/dL in fasting plasma glucose. 2. When we have classified the same results of OGTT by respective diagnostic criteria of NDDG/ WHO and 97 ADA, the NDDG/WHO have diagnosed 50.4%(268/532) of the total number of people as diabetes mellitus, while the '97 ADA has shown that only 33.1%(176/532) of it corresponded to the same diagnosis. On the other hand, the diagnosis rate of impaired fasting glucose(IFG) or impaired glucose tolerance(IGT) has shown 28.8~ 31.8%(NDDG/ WHO) and 66.9%(97 ADA), respectively. 3. Following the diagnostic criteria of the 97 ADA, we have separated the results into two groups which were above and below 126 mg/dL in fasting glucose. In addition, when we have again classified two groups by the criteria of the NDDG/WHO, the group above 126mg/dL in fasting glucose, which was all diagnosed as diabetes mellitus in 97 ADA has represented a ratio of 72.2%(127/176) in same diagnosis. However, within the group below 126mg/ dL, in fasting glucose being classitied as IFG in the 97 ADA, its diagnosis rate of diabetes mellitus has also shown 39.7%(141/356) applying to the criteria of the NDDG/WHO. CONCLUSION: The criteria of the 97 ADA can simply make a diagnosis of diabetes mellitus with fasting plasma glucose and additionally fmd out the IFG whose rate is 17.9 20% regarded as a normal condition by NDDG/WHO, whereas the existing criteria of the NDDG/WHO have to carry out the OGTT which is difficult in clinics. However, since among the patients ot 50.4% diagnosed as diabetes mellitus by NDDG/WHO, the 97 ADA classifies 17.3% of them as IFG, it is regarded that the need of OGTT for the diagnosis of diabetes mellitus can not be passed over in the future.

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