• Title/Summary/Keyword: 당뇨 치료약제

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특집 - 당뇨인의 다른 약제

  • 사단법인 한국당뇨협회
    • The Monthly Diabetes
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    • s.222
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    • pp.18-19
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    • 2008
  • 의학이 발달하고 식량이 풍부해짐에도 그만큼 현대인들은 많은 종류의 질병에 노출되어 있다. 특히, 당뇨병환자와 같이 면역력이 약한 환자의 경우에는 그 위험률이 더욱 증가되는 것이 사실이다. 이번 당뇨의 약물치료 특집코너에서 당뇨병 외에 나타날 수 있는 다른 질병에 대한 치료 약물은 어떤 것이 있는 지 알아보자.

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당뇨병의 유발요인으로서의 약물 및 화학물질의 남용

  • 변정란
    • The Monthly Diabetes
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    • s.148
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    • pp.13-15
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    • 2002
  • 1997년 미국당뇨병학회에서는 당뇨병을 그 원인과 병태생리에 따라 크게 세가지로 분류하였다. 그에 따르면 제 1형 당뇨병과 제 2형 당뇨병 그 외에 이 두 부류에 속하지 않는 기타 부류의 당뇨병으로 구분되는데, 약물에 의해서 유발되는 당뇨병이 이 세번째 부류에 속한다. 현대사회에는 여러 가지 약물들이 개발되어져서 더 많은 질병의 치료에 사용이 되어지고 있으며 그에 따르는 치료효과의 증대와 같은 많은 긍정적인 결과가 야기되었으나 이러한 약물의 사용에 필연적으로 동반될 수밖에 없는 문제 중의 하나가 약물에 의한 부작용이라 할 수 있다. 그러한 약물 부작용 중에서 당뇨병을 유발시키거나 악화시킬수 있는 약제들에 대해 간단히 살펴보기로 한다.

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$^{18}F$-FDG Colonic Uptake by Oral Anti-Diabetic Drugs Including Metfomin in PET/CT Scan (PET/CT 검사에서 Metformin 성분의 항 당뇨약제에 의한 대장에서의 $^{18}F$-FDG 섭취에 관한 연구)

  • Kim, Sang-Gyu;Park, Hoon-Hee;Kim, Jung-Yul;Bahn, Young-Kag;Lim, Han-Sang;Kim, Jae-Sam;Lee, Chang-Ho
    • The Korean Journal of Nuclear Medicine Technology
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    • v.14 no.2
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    • pp.50-54
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    • 2010
  • Purpose: The uptake of $^{18}F$-FDG is often observed in normal cell of colon to patients who have non-insulin-dependent diabetes mellitus and had taken anti-diabetic drugs including Metformin in PET/CT scan. In this study, the region of colon was compared between the patients who took anti-diabetic drugs including Metfomin and other patients who took the other anti-diabetic drugs through SUV measurements. Materials and Methods: A hundred eighty patients were studied. 120 patients who have non-insulin-dependent diabetes mellitus (Including Metformin: 60, Excluding Metformin: 60) and 60 patients as a control group were composed. The patient fasted at least 6 hours before receiving an intravenous injection of 370-592 MBq (10-16 mCi) of $^{18}F$-FDG. Scanning from the base of the skull though the mid thigh was performed using the Discovery STe PET/CT Equipment (GE Healthcare, Milwaukee, WI, USA). The highest uptake region was measured SUV among ascending, transverse and descending colon. Results: The values of patients who took the anti-diabetic drugs including Metformin were $6.16{\pm}3.64$ g/mL, $4.41{\pm}2.94$ g/mL, and $5.46{\pm}2.44$ g/mL. The patients who took the anti-diabetic drugs which does not have Metformin were $3.05{\pm}1.39$ g/mL, $2.08{\pm}0.97$ g/mL and $3.15{\pm}1.85$ g/mL. The control group were $2.02{\pm}0.88$ g/mL, $1.68{\pm}0.87$ g/mL and $2.19{\pm}1.88$ g/mL. Conclusion: The effect of the intake of Metformin was observed from the SUV on region of large bowel in this study. Thus, it could be helpful for the results by identifying the ingredient of anti-diabetic drug before the examination and the possibility of interpretation of false positive will be reduced.

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Clinical Manifestations of Persistent Smear Positive and Culture Negative Sputum Tests 5 Months after First-Line Anti-Tuberculous Chemotherapy (일차 항결핵제 치료 5개월 후 도말 양성 및 배양 음성을 보이는 폐결핵 환자의 임상 양상)

  • Kim, Do Hyung;Hwang, Su Hee;Cheon, Du Su;Min, Jin Hong;Kang, Hyung Seok;Park, Seung Gyu
    • Tuberculosis and Respiratory Diseases
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    • v.63 no.5
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    • pp.417-422
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    • 2007
  • Background: It is not known with certainty whether patients with persistently positive sputum smear results who have also had negative sputum culture results require prolongation of treatment for tuberculosis in order to avoid an increased risk of eventual relapse. The purpose of the present study was to retrospectively describe the treatment characteristics and evaluate the appropriate duration of treatment in these patients. Methods: Sixty of 69 patients with sputum smear positive and culture negative tests at 5 months after first line anti-tuberculous chemotherapy from 2002 to 2003 were retrospectively analyzed. Exclusion criteria included incomplete treatment or resistance to rifampicin or two additional antibiotics, as determined by a drug susceptibility test (DST). Results: Smear conversion of the study subjects was observed after $8.3{\pm}2.3$ months treatment, and the patients were culture negative after $2.0{\pm}0.8$ months. The relapse rates of the study subjects were 3.8, 10.0, and 25.8% after 1, 2, and 5 years of anti-tuberculosis chemotherapy, respectively. The relapse rates were not significantly affected by a series of risk factors such as age, sex, presence of diabetes, a sputum culture examination after 2 months treatment, previous treatment history, chest radiograph, and duration of the treatment (P>0.05). Conclusion: Regimen change is not required for patients with persistent smear positive but culture negative tests in the fifth month for first line antituberculous treatment. However, a further study will be needed to clarify the high relapse rate in this specific group of patients.

The Mechanism of Hematoxylin on Glucose Metabolism Improvement in Sciatic Nerves from Streptozotocin-induced Diabetic Rats (Streptozotocin으로 유도한 당뇨쥐의 대퇴신경에서 Hematoxylin의 당대사 개선 메커니즘)

  • Chung, Myung-Kiu;Kang, Soon-Kook
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.12 no.7
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    • pp.3310-3316
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    • 2011
  • Hematoxylin is the main component of Hematoxylon campechianum which has been utilized in the southern provinces of Korea as a folk remedy for diabetic complications. In the present study, to investigate the hypoglycemic mechanism of hematoxylin, the 2-deoxyglucose uptake and phospholipid metabolism were examined in sciatic nerves from three groups of rats : normal control, diabetic control, diabetic hematoxylin-treated group. Hematoxylin significantly reduced blood glucose levels in diabetic control rats. On a wet weight basis, the nerves from diabetic rats showed a 20% decrease in total phospholipid from that of controls and a relative decrease in phosphatidylinositide. Hematoxylin treatment increased the incorporation rate of 2-[3H] myo-inositol into total phosphoinositids in diabetic rat. The effectiveness were more potent in higher dose hematoxylin-treated rats than lower dose hematoxylin-treated rats. These results suggest that hematoxylin increases glucose transport and lipid metabolism by partially normalizing concerned with myo-inositol metabolism in diabetic rat. Therefore we propose that hematoxylin can be a promising candidate for diabetes medication.

조경수에 발생되는 병해 - 두릅나무에 문제가 되는 토양 병해 역병 -

  • Lee, Sang-Hyeon
    • Landscaping Tree
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    • s.109
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    • pp.23-24
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    • 2009
  • 두릅나무는 낙엽활엽수로 맛과 향이 독특하여 어린순은 나물, 찜, 튀김 등 식용으로 뿌리는 관절염, 위암, 당뇨병, 감기, 두통 등의 약용으로 쓰이는 봄철 대표적인 생물자원이며, 재배하기도 비교적 수월하고 재배를 통해 높은 소득을 올릴 수 있는 유망한 특용수종이다. 하지만 야생상태에서는 크게 문제가 되지 않았으나, 재배면적이 늘어나고 집단적으로 재배하면서 역병 피해가 발생되어 두릅나무에 큰 장애 요인으로 발생되고 있는 실정이다. 역병은 토양전염성 병해로 약제 방제가 어렵고, 병이 발병되면 치료가 거의 불가능한 병해로 특히, 병이 발생되지 않도록 관리에 신경을 써야한다.

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Clinical Study of Pulmonary Tuberculosis for Admitted Patients at National Masan Tuberculosis Hospital (국립마산결핵병원에 입원한 환자에 대한 폐결핵의 임상적 동태에 관한 연구)

  • Park, Seung-Kyu;Choi, In-Hwan;Kim, Chul-Min;Kim, Cheon-Tae;Song, Sun-Dae
    • Tuberculosis and Respiratory Diseases
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    • v.44 no.2
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    • pp.241-250
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    • 1997
  • Objective : Although the prevalence of pulmonary tuberculosis has decreased progressively after the national control program for tuberculosis began, nowadays the number of MDRTB is increasing seriously. MDRTB tends to be poor responsive to current antituberculosis regimens. It is mainly due to poor compliance, high rate of side reaction of secondary drugs, and limitation in number of available drugs. The purpose of present study is to evaluate the clinical features of pulmonary tuberculosis patients admitted in one national tuberculosis hospital and to expose the problems pertaining to current remedies, to increase the treatment efficacy for pulmonary tuberculosis including MDRTB in the end. Method : Retrospective analysis of 336 pulmonary tuberculosis patients admitted in National Masan Tuberculosis Hospital was done. Contents of analysis were patients profile, the first diagnosed time and medical institutes, family history, residence, previous treatment history, chief complaints at the time of admission, lesion site on chest X -ray film, combined deseases, side reaction to antibuberculosis drugs, used drugs before admission and the results of drug sensitivity test. Results : The ratio between male and female was 4 : 1. Age showed relatively even distribution from 3rd to 6 th decades. 64.6% of the patients was diagnosed at public health center. Weight loss was the most common complaint at admission. Bilateral lesions on chest X-ray films were 59.8%. 130patients had combined desease, of which DM was the most common(37.7%). 95patients had family history, of which parents were the most common(41.7%). According to the time of first diagnosis, 31 patients were diagnosed before 1980, and after then the number of patients was increased by degrees. Residence overwhelmed in pusan and gyung-nam province. 258 patients got previous treatment history, of which 112 patients(43.4%) had more than 3 times and only 133 patients(51.6%)got regular medication. 97 patients used more than other 3 drugs in addition to INH, EMB, RFP and PZA before admission. 154 patients were informed with the results of drug sensitivity test. of which 77 patients had resistance to more than 5 drugs. Gastrointestinal problem was the most common in side reaction to drugs. Conclusion : In the case of weight loss of unknown cause, tuberculosis should be suspected. In first treatment, sufficient and satisfactory explanation for tuberculosis is necessary and treatment period should not be stict to 6 month-short term therapy. In retreatment, new drugs should not be added to used drugs even though drug sensitivity results show sensitivity to some of them. Proper time for surgical intervention should not be delayed.

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당말녕(糖末寧)을 위주(爲主)로 당뇨병(糖尿病)의 주위신경병변(周圍神經病變)을 치료(治療)하는 임상연구(臨床硏究)

  • 우세가
    • Journal of Haehwa Medicine
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    • v.5 no.2
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    • pp.501-501
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    • 1997
  • 당뇨병성(糖尿病性) 주위신경병변(周圍神經病變)은 당뇨병(糖尿病)에서 가장 많이 볼 수 있는 삼대합병증(三大合倂症) 중(中)의 하나이다. 환자(患者)의 임상표현(臨床表現)은 사고(四股) 및 구간부(軀幹部)가 마목(麻木)하고,동통(疼痛)이 칼로 베는 듯하거나 침(鍼)으로 찌르는 듯하여 참기 힘들며, 환자(患者)로 하여금 작업능력(作業能力)을 상실(喪失)하게 하고 휴식(休息)과 수안(睡眼)에 엄중(嚴重)한 영향(影響)을 준다. 지금까지 국내외(國內外)에서는 아직 효과적(效果的)인 치료방법(治療方法)이 없다. 우리는 임상(臨床)에서 관찰(觀察)해 본 결과(結果), 이 병(病)의 임상표현(臨床表現)인 "사고마목(四股麻木), 자통(刺痛), 야간가중(夜間加重), 통처고정(痛處固定)"의 특징(特徵)이 중의임상(中醫臨床)에서 표현(表現)되는 "혈어형(血瘀型)" 동통(疼痛)과 완전(完全)히 상동(上同)하였다. 우리는 "활혈화어(活血化瘀), 통락지통(通絡止痛), 거어생신(祛瘀生新)"을 치료원칙(治療原則)으로 중약복방(中藥復方) 제제(制劑) "당말녕(糖末寧)"을 제조(製造)하여 이 병(病)을 치료(治療)하는데 만족(滿足)스러운 임상치료효과(臨床治療效果)를 거두었다. 전체(全體)의 병례(病例)는 모두 우리 과(科)의 입원환자(入院患者)로써 모두 45례(例)인데, 병기(病機)에 따라 양조(兩組)로 나누었다. 관찰조(觀察組) 30례(例) 중(中)에는 남성(男性)이 19례(例)이고 여성(女性)이 12례(例)이며, 年齡(연령)은 25세(歲)에서 68세(歲)까지로 평균연령(平均年齡)이 49.8세(歲)이다. I형(型) 당뇨병(糖尿病)이 10례(例)이고 II형(型) 당뇨병(糖尿病)이 20례(例)이며, 당뇨병(糖尿病)의 병정(病程)은 6개월(個月)에서 17년(年)사이로 평균(平均) 7.1 년(年)이다. 주위신경병변(周圍神經病變)의 병정(病程)은 2주(周)에서 3년(年)까지로 평균(平均) 1년(年)이다. 대조조(對照組)는 15례(例)로 남성(男性)이 8례(例)이고 여성(女性)이 7례(例)이며, 연령(年齡)은 20세(歲)에서 65세(歲)까지로 평균(平均) 49세(歲)이다. I형(型) 당뇨병(糖尿病)이 7례(例)이고 II형(型) 당뇨병(糖尿病)이 8례(例)이며, 橋民病의 병정(病程)은 3개월(個月)에서 12년(年)까지로 평균(平均) 7.5년(年)이다. 주위신경병변(周圍神經病變)의 병정(病程)은 1개월(個月)에서 3년(年)까지로 평균병정(平均病程)은 11.6개월(個月)이다. 양조(兩組)사이의 병정(病程)은 현저(顯著)한 차이는 없으나 서로 비교(比較)해 볼만하다. 당말녕(糖末寧)은 주(主)로 삼궁(三芎),원호(元胡), 당귀(當歸), 계혈승 등(等)의 약물(藥物)로 조성(組成)되었고, 약제실(藥劑室)에서 濃縮液(농축액)(매(每) ml당(當) 생약량(生藥量) 2.5g 함유(含有))으로 제조(製造)하였다. 관찰조(觀察組)는 매차례(每次例) 당말녕(糖末寧) 50ml를 하루 세번씩 복용(服用)하였고; 대조조(對照組)는 비타민 $B_1$, 비타민 $B_6$을 각각(各各) 20mg씩 하루 세차례 복용(服用)하였다. 양조(兩組) 모두 사주(四周)를 한번의 치료료정(治療療程)으로 하였다. 우리는 모두 45례(例)의 환자(患者)를 관찰(觀察)하였는데, 그 중(中) 관찰조(觀察組)가 30례(例)이고 대조조(對照組)가 15례(例)이다. 임상표현(臨床表現) 분급(分級)과 신경근전도(神經筋電圖)(운동신경(運動神經)과 감각신경(感覺神經)의 전도(電圖) 속도(速度))를 치료(治療) 전(前)과 후(後)의 대조지표(對照指標)로 하였고. 매(每) 4주(周)를 한개의 료정(療程)으로 총(總) 1-2개(個)의 료정(療程)을 진행(進行)하여 比較硏究(비교연구)하였다. 총유효율(總有效率)은 96.7%이고 총현효율(總顯效率)은 50%로써 대조조(對照組)보다 뚜렷하게 높았다. 치료전(治療前) MNCV와 SNCV를 측정(測定)한 것은 당말녕(糖末寧)이 당뇨병(糖尿病) 주위신경병변(周圍神經病變) 환자(患者)의 신경전도속도(神經電圖速度)를 명확(明確)하게 개선(改善)하였음을 표현(表現)하고 있다. 신경근전도(神經筋電圖)에서 자발전위(自發電位)는 눈에 띄게 감소(減少)되고 소력수축(小力收縮)의 평균시한(平均時限)은 명확(明確)히 연장(延長)되었으며 다상전위(多相電位)는 명확(明確)하게 증가(增加)되었는데, 이는 신경지측(神經支測)이 재생(再生)되고 회복(恢復)하였음을 설명(說明)하고 있다. 중약복방제제(中藥復方制劑) "당말녕(糖末寧)"이 본병(本病)을 치료(治療)하는 기전(機轉)은 여러 방면(方面)일 것이다. 그 중(中) 微循環(미순환)을 개선(改善)하고 적혈구(赤血球)의 변형성(變形性)을 향상(向上)하여 신경세포(神經細胞)에 혈액(血液)과 산소공급(酸素供給) 및 영양공급(營養供給)을 향상(向上)함으로써 神經損傷(신경손상)의 수정(修整)과 회복(恢復)을 촉진(促進)하는 것이 주요(主要)한 일환(一環)이 될 것이다.

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Topical Steroid Therapy using Stent on Chronic Ulcerative Gingival Lesions (스텐트를 이용한 만성 궤양성 치은 병소의 국소 스테로이드 치료)

  • Park, Hyung-Uk;Ahn, Hyung-Joon;Choi, Jong-Hoon;Kwon, Jeong-Seung
    • Journal of Oral Medicine and Pain
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    • v.35 no.4
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    • pp.259-264
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    • 2010
  • The majority of chronic gingival ulcerative lesions are known to be due to autoimmune disease such as oral lichen planus, benign mucous membrane pemphigoid or pemphigus vulgaris. Topical or systemic corticosteroids are mainly used and adjuvant drugs like immunosuppressant, anti-inflammatory drugs, antimalarials or antimetabolites can also be prescribed. Because systemic corticosteroids causes various side effects, such as gastrointestinal disturbance, osteoporosis, diabetes or adrenal suppression. So, topical steroid therapy is main treatment for chronic gingival ulcerative lesion confined to small area. However, there's also limitation of topical corticosteroids. The effect of the corticosteroids decreases due to salivary flow and the movement of the tongue, lips, or buccal mucosa. When the lesions are widely distributed or positioned deeply in oral cavity, it is hard to apply the medication on patients' own. Moreover, it can be applied to unaffected mucosa. Although occlusive steroid therapy using stent was reported to minimize taking steroid and overcome the faults of applying topical steroids, it has been used less frequently in the clinical field. Therefore, this report is going to find out the usefulness and the way to utilize clinically through the case which acted satisfactorily by performing topical steroid therapy using stent on chronic ulcerative gingival lesions.

Short-Term Efficacy of Steroid and Immunosuppressive Drugs in Patients with Idiopathic Pulmonary Fibrosis and Pre-treatment Factors Associated with Favorable Response (특발성폐섬유화증에서 스테로이드와 면역억제제의 단기 치료효과 및 치료반응 예측인자)

  • Kang, Kyeong-Woo;Park, Sang-Joon;Koh, Young-Min;Lee, Sang-Pyo;Suh, Gee-Young;Chung, Man-Pyo;Han, Jung-Ho;Kim, Ho-Joong;Kwon, O-Jung;Lee, Kyung-Soo;Rhee, Chong-H.
    • Tuberculosis and Respiratory Diseases
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    • v.46 no.5
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    • pp.685-696
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    • 1999
  • Background : Idiopathic pulmonary fibrosis (IPF) is a diffuse inflammatory and fibrosing process that occurs within the interstitium and alveolus of the lung with invariably poor prognosis. The major problem in management of IPF results from the variable rate of disease progression and the difficulties in predicting the response to therapy. The purpose of this retrospective study was to evaluate the short-term efficacy of steroid and immunosuppressive therapy for IPF and to identify the pre-treatment determinants of favorable response. Method : Twenty patients of IPF were included. Diagnosis of IPF was proven by thoracoscopic lung biopsy and they were presumed to have active progressive disease. The baseline evaluation in these patients included clinical history, pulmonary function test, bronchoalveolar lavage (BAL), and chest high resolution computed tomography (HRCT). Fourteen patients received oral prednisolone treatment with initial dose of 1mg/kg/day for 8 to 12 weeks and then tapering to low-dose prednisolone (0.25mg/kg/day). Six patients who previously had experienced significant side effects to steroid received 2mg/kg/day of oral cyclophosphamide with or without low-dose prednisolone. Follow-up evaluation was performed after 6 months of therapy. If patients met more than one of followings, they were considered to be responders : (1) improvement of more than one grade in dyspnea index, (2) improvement in FVC or TLC more than 10% or improvement in DLco more than 20% (3) decreased extent of disease in chest HRCT findings. Result : One patient died of extrapulmonary cause after 3 month of therapy, and another patient gave up any further medical therapy due to side effect of steroid. Eventually medical records of 18 patients were analyzed. Nine of 18 patients were classified into responders and the other nine patients into nonresponders. The histopathologic diagnosis of the responders were all nonspecific interstitial pneumonia (NSIP) and that of nonresponders were all usual interstitial pneumonia (UIP) (p<0.001). The other significant differences between the two groups were female predominance (p<0.01), smoking history (p<0.001), severe grade of dyspnea (p<0.05), lymphocytosis in BAL fluid ($23.8{\pm}16.3%$ vs $7.8{\pm}3.6%$, p<0.05), and less honeycombing in chest HRCT findings (0% vs $9.2{\pm}2.3%$, p<0.001). Conclusion : Our results suggest that patients with histopathologic diagnosis of NSIP or lymphocytosis in BAL fluid are more likely to respond to steroid or immunosuppressive therapy. Clinical results in large numbers of IPF patients will be required to identify the independent variables.

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