• Title/Summary/Keyword: Complications of Diabetes Mellitus

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Diabetes affects Peripheral Nerve and Heart Function

  • Ku, Jeong-Min;Choi, Hwa-Sik;Hyun, Kyung-Yae;Moon, Seong-Min;Kim, Dae-Sik;Choi, Seok-Cheol
    • Biomedical Science Letters
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    • v.17 no.4
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    • pp.313-319
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    • 2011
  • Diabetes mellitus (DM) leads to a variety of complications and thus we have retrospectively studied to investigate problems of nerve conduction velocity (NCV) study and the heart in the patients with type-II DM. Blood glucose and blood pressure levels were higher in DM group than in Non-DM group. We found that several latencies were delayed in motor conduction study of upper (median and ulnar nerve) and lower extremities (peroneal and tibial nerve), whereas amplitudes and NCVs were decreased in DM group compared with Non-DM group. Latencies of sensory conduction study in upper and lower extremities (sural nerve) were delayed, while amplitudes and NCVs were lower in DM group than in Non-DM group. Abnormal percent of the electrocardiogram was higher in DM group than in Non-DM group. This retrospective study suggests that type-II DM can cause a damage effect on the peripheral nerve and the heart function.

Cognitive dysfunctions in individuals with diabetes mellitus

  • Kim, Hye-Geum
    • Journal of Yeungnam Medical Science
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    • v.36 no.3
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    • pp.183-191
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    • 2019
  • Some patients with type 1 and type 2 diabetes mellitus (DM) present with cognitive dysfunctions. The pathophysiology underlying this complication is not well understood. Type 1 DM has been associated with a decrease in the speed of information processing, psychomotor efficiency, attention, mental flexibility, and visual perception. Longitudinal epidemiological studies of type 1 DM have indicated that chronic hyperglycemia and microvascular disease, rather than repeated severe hypoglycemia, are associated with the pathogenesis of DM-related cognitive dysfunction. However, severe hypoglycemic episodes may contribute to cognitive dysfunction in high-risk patients with DM. Type 2 DM has been associated with memory deficits, decreased psychomotor speed, and reduced frontal lobe/executive function. In type 2 DM, chronic hyperglycemia, long duration of DM, presence of vascular risk factors (e.g., hypertension and obesity), and microvascular and macrovascular complications are associated with the increased risk of developing cognitive dysfunction. The pathophysiology of cognitive dysfunction in individuals with DM include the following: (1) role of hyperglycemia, (2) role of vascular disease, (3) role of hypoglycemia, and (4) role of insulin resistance and amyloid. Recently, some investigators have proposed that type 3 DM is correlated to sporadic Alzheimer's disease. The molecular and biochemical consequences of insulin and insulin-like growth factor resistance in the brain compromise neuronal survival, energy production, gene expression, plasticity, and white matter integrity. If patients claim that their performance is worsening or if they ask about the effects of DM on functioning, screening and assessment are recommended.

Hepatic glycogenosis in type 1 diabetes mellitus mimicking Mauriac syndrome

  • Jung, In Ah;Cho, Won Kyoung;Jeon, Yeon Jin;Kim, Shin Hee;Cho, Kyoung Soon;Park, So Hyun;Jung, Min Ho;Suh, Byung-Kyu
    • Clinical and Experimental Pediatrics
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    • v.58 no.6
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    • pp.234-237
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    • 2015
  • Hepatic glycogenosis in type 1 diabetes mellitus (DM) can be caused by poor glycemic control due to insulin deficiency, excessive insulin treatment for diabetic ketoacidosis, or excessive glucose administration to control hypoglycemia. Mauriac syndrome, which is characterized by hepatomegaly due to hepatic glycogenosis, growth retardation, delayed puberty, and Cushingoid features, is a rare diabetic complication. We report a case of hepatic glycogenosis mimicking Mauriac syndrome. A 14-year-old girl with poorly controlled type 1 DM was admitted to The Catholic University of Korea, Seoul St. Mary's Hospital for abdominal pain and distension. Physical examination revealed hepatomegaly and a Cushingoid face. The growth rate of the patient had decreased, and she had not yet experienced menarche. Laboratory findings revealed elevated liver enzyme levels. A liver biopsy confirmed hepatic glycogenosis. Continuous glucose monitoring showed hyperglycemia after meals and frequent hypoglycemia before meals. To control hyperglycemia, we increased insulin dosage by using an insulin pump. In addition, we prescribed uncooked cornstarch to prevent hypoglycemia. After strict blood glucose control, the patient's liver functions and size normalized. The patient subsequently underwent menarche. Hepatic glycogenosis is a complication of type 1 DM that is reversible with appropriate glycemic control.

The Study on the Effect of Nutritional Counseling in Diabetes Mellitus Patients with Microalbuminuria (미세단백뇨를 동반한 인슐린비의존형 당뇨병 환자를 대상으로 한 영양 상담의 효과 연구)

  • Son, Jeong-Min;Kim, Suk-Gyeong;Park, Hyeong-Gyu;Sin, Chan-Su;Kim, Seong-Yeon;Lee, Hong-Gyu
    • Journal of the Korean Dietetic Association
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    • v.7 no.2
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    • pp.138-143
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    • 2001
  • Microalbuminuria is a strong predictor of diabetic nephropathy and is also associated with increased mortality in people with non-insulin-dependent diabetes mellitus(NIDDM) patients. Improved glycemic control and dietary protein restriction are recommended to retard and avoid developing microalbuminuria. The purpose of this study was to measure the dietary counseling effects for diabetes mellitus patients with microalbuminuria. To investigate the effects of the dietary counseling effect, thirty NIDDM patients with microalbuminuria were selected from outpatient diabetic clinic of Seoul National University Hospital for this study. None of them had evidence of renal and heart complications. For 24 weeks, they received individualized dietary counseling 3 times. The results of this study can be summarized as follows 1) Dietary protein and calorie intake decreased significantly from 79.8$\pm$29.9g/d to 66.6$\pm$16.5g/d, from 1845.4$\pm$631.9kcal to 1515.7$\pm$392.7kcal after dietary counseling, respectively (p<0.05). 2)The glycosylate hemoglobin level showed significantly decreased after dietary counseling(p<0.05). However there were no change in lipid profiles and blood pressure after counseling. 3) There was a significant correlation between the duration of disease and the amount of microalbuminuria. Any other cardiovascular risk factors, such as duration of diabetes, total cholesterol level and systolic blood pressure were not correlated with microalbuminuria. These results shown that dietary counseling can be used as an effective therapy to control blood sugar levels for NIDDM patients who are poorly controlled with microalbuminuria.

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Fatal Facial Mucormycosis on a Diabetic Patient: A Case Report (당뇨 환자에서 발생한 안면부 털곰팡이증에 대한 증례)

  • Choi, Jung-Hun;Kim, Young-Joon;Kwon, Ji-Eun;Kim, Hoon;Nam, Sang-Hyun;Choi, Young-Woong
    • Archives of Plastic Surgery
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    • v.38 no.1
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    • pp.93-95
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    • 2011
  • Purpose: Mucormycosis generally occurs in patients with uncontrolled diabetes mellitus and immunocompromised conditions. It is rare, but once a patient is infected with it, it can occur as a rapidly extending, aggressive, and life-threatening rhinocerebral infection with a high mortality rate. Methods: A 70-year-old female patient had a 40 years of history of adult onset diabetes mellitus. She presented herself with severe right hemifacial pain, swelling, and weakness for 3 days and was admitted to ENT. On a facial computed tomography (CT) scan, it was found that her infection extended from her inferior temporal scalp to her submental area and involved her submandibular, masseter, prevertebral, parapharyngeal, retropharyngeal, and pharyngeal mucosal space and pansinusitis. Through endoscopic sinus surgery, mucormycosis was confirmed via histologic examination. Results: Despite empiric antibiotics and amphotericin B administration, the patient was in a septic condition and in a coma. The patient's family wanted to withdraw her life support, and the patient expired. Conclusion: Mucormycosis is very rare, but is one of the disastrous complications of uncontrolled diabetes mellitus. Suspicion of its occurrence, based on identified risk factors, and its rapid diagnosis can enhance the chance of its cure.

Impact of dietary fiber intake on non-alcoholic fatty liver disease risk in Korean patients with obesity and type 2 diabetes mellitus

  • Ji-Sook Park;Hina Akbar;Young-Seol Kim;Jung-Eun Yim
    • Journal of Nutrition and Health
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    • v.57 no.3
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    • pp.282-291
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    • 2024
  • Purpose: Korean patients with type 2 diabetes mellitus (T2DM) and obesity are at a high risk of developing severe non-alcoholic fatty liver disease (NAFLD). This study examined the dietary intakes and compared the risks of NAFLD-related complications in Korean patients with T2DM and obesity. Methods: Data from the Korean National Diabetes Program cohort were used to study patients with T2DM. Two hundred and sixty-five obese patients with T2DM (body mass index ≥ 25 kg/m2) were classified into NAFLD and non-NAFLD groups. The nutrient intake was analyzed using a 24-hour dietary recall questionnaire. Anthropometric and biochemical data were also obtained. Statistical analyses were performed to determine the significant differences between the 2 groups. Results: The serum gamma-glutamyl transpeptidase levels in obese patients with T2DM and NAFLD were significantly higher than in obese T2DM patients without NAFLD (p < 0.05). The serum glucose and lipid profiles showed no significant differences between the NAFLD and non-NAFLD groups. The carbohydrate, protein, and fat levels also did not differ significantly. The results showed that the fiber intake of the NAFLD and non-NAFLD groups was 14.11 ± 3.86 g/100 kcal and 15.70 ± 4.56 g/1,000 kcal, respectively, showing that the dietary fiber intake of the non-NAFLD group was significantly higher (p < 0.05). A correlation was observed between total fiber intake and γ-glutamyl transpeptidase in either patient group. In addition, the odds ratio of developing NAFLD was 0.29× lower when the fiber was consumed at 125% of adequate intake. Conclusions: A higher dietary fiber intake may reduce the risk of NAFLD in obese patients with T2DM. The dietary intake of Korean obese patients with T2DM should include and be enriched in dietary fiber to aid in preventing and treating NAFLD.

Ginsenosides for the treatment of insulin resistance and diabetes: Therapeutic perspectives and mechanistic insights

  • Tae Hyun Kim
    • Journal of Ginseng Research
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    • v.48 no.3
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    • pp.276-285
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    • 2024
  • Diabetes mellitus (DM) is a systemic disorder of energy metabolism characterized by a sustained elevation of blood glucose in conjunction with impaired insulin action in multiple peripheral tissues (i.e., insulin resistance). Although extensive research has been conducted to identify therapeutic targets for the treatment of DM, its global prevalence and associated mortailty rates are still increasing, possibly because of challenges related to long-term adherence, limited efficacy, and undesirable side effects of currently available medications, implying an urgent need to develop effective and safe pharmacotherapies for DM. Phytochemicals have recently drawn attention as novel pharmacotherapies for DM based on their clinical relevance, therapeutic efficacy, and safety. Ginsenosides, pharmacologically active ingredients primarily found in ginseng, have long been used as adjuvants to traditional medications in Asian countries and have been reported to exert promising therapeutic efficacy in various metabolic diseases, including hyperglycemia and diabetes. This review summarizes the current pharmacological effects of ginsenosides and their mechanistic insights for the treatment of insulin resistance and DM, providing comprehensive perspectives for the development of novel strategies to treat DM and related metabolic complications.

DNA Microarrays Analysis of Gene Expression Profiles in Diabetes-related genes using Immunosuppressant (면역억제제에 의한 당뇨 관련 유전자의 DNA microarray 분석)

  • Kim, Kyoung-Shin;Kim, Byoung-Soo
    • Journal of Haehwa Medicine
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    • v.21 no.1
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    • pp.11-21
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    • 2012
  • New onset diabetes is a major complication after kidney transplantation. However, the natural course of posttransplantation diabetes mellitus (PTDM) remains unclear. The aim of this study was to demonstrate the detailed natural courses of PTDM according to the onset and persistency of hyperglycemia, and to investigate risk factors for development of different courses of PTDM in renal allograft recipients. The purpose of this study is to develop novel immune suppressants for PTDM using of action mechanism of them. The use of immunosuppressive drugs in transplanted patients is associated with the development of diabetes, possibly due to ${\beta}$-cell toxicity. To better understand the mechanisms leading to post-transplant diabetes, we investigated the actions of prolonged exposure of ${\beta}$-cells to therapeutical levels of tacrolimus (FK506) or cyclosporin A(CsA). The immunosuppressive drug cyclosporine(CsA) is a potent agent widely used after organ transplantations and various autoimmune disorders. After using CsA, some patients suffer severe complications including renal and vascular toxicity. The renal or vascular toxicity is influenced by the degree of the endothelial damage. FK506(tacrolimus) is a widely used immunosuppressive agent in the treatment of various medical conditions, including autoimmune disease, bone marrow and organ transplantations. We found some interesting clusters and confirmed the feasibility of cDNA microarray in the study of Immunosuppressant. In this study, we investigated gene expression patterns induced by Immunosuppressant in RIN-m5F of rat insulinoma cell line. Gene expressions evaluated using cDNA microarry in two clusters were increased or decreased. this study provides comprehensive comparison of the patterns of gene expression changes induced by CsA and FK506 in ${\beta}$-cells. This study could establish that the mode of action mechanism by which currently used insulin inhibitors inducing PTDM could be elucidated at least in part, which raises the possibility that novel immune suppressive PTDM can be developed. The molecular biological study on PTDM will also contribute the progress in diabetes research field as well as in that of PTDM.

Comparison of sevoflurane and propofol anesthesia on the incidence of hyperglycemia in patients with type 2 diabetes undergoing lung surgery

  • Kim, Hyuckgoo;Han, Jisoo;Jung, Sung Mee;Park, Sang-Jin;Kwon, Nyeong Keon
    • Journal of Yeungnam Medical Science
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    • v.35 no.1
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    • pp.54-62
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    • 2018
  • Background: The type and regimen of anesthesia may affect perioperative hyperglycemia following major surgical stress. This study compared the effects of sevoflurane and propofol on the incidence of hyperglycemia and clinical outcomes in diabetic patients undergoing lung surgery. Methods: This retrospective study included 176 patients with type 2 diabetes mellitus who had undergone lung surgery. Blood glucose levels and clinical outcomes from the preoperative period to the first 2 postoperative days (PODs) were retrospectively examined in patients who received sevoflurane (group S, n= 87) and propofol (group P, n=89) for maintenance of general anesthesia. The primary endpoint was the incidence of persistent hyperglycemia (2 consecutive blood glucose levels >180 mg/dL [10.0 mmol/L]) during the perioperative period. The secondary composite endpoint was the incidence of major postoperative complications and 30-day mortality rate after surgery. Results: Blood glucose levels similarly increased from the preoperative period to the second POD in both groups (p=0.857). Although blood glucose levels at 2 hours after surgery were significantly lower in group P than in group S (p=0.022; 95% confidence interval for mean difference, -27.154 to -2.090), there was no difference in the incidence of persistent hyperglycemia during the perioperative period (group S, 70%; group P, 69%; p=0.816). The composite of major postoperative complications and all-cause in-hospital and 30-day mortality rates were also comparable between the two groups. Conclusion: Sevoflurane and propofol were associated with a comparable incidence of perioperative hyperglycemia and clinical outcomes in diabetic patients undergoing lung surgery.

A Study on the Hypoglycemic Effect and Safety of Combined-Therapy of Baekhogainsam-tang and Hypoglycemic Agent for Type 2 Diabetes Mellitus Patients without Complications: A Systematic Review and Meta-Analysis (합병증을 동반하지 않은 2형 당뇨병 환자에 대한 백호가인삼탕과 혈당강하제 병행치료의 혈당 강하 효과 및 안전성 연구 : 체계적 문헌 고찰과 메타분석)

  • Shin, Jae-ik;Baek, Ji-soo;Shin, Seon-mi;Cho, Chung-sik
    • The Journal of Internal Korean Medicine
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    • v.42 no.4
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    • pp.672-686
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    • 2021
  • Objectives: The purpose of this study is to assess the efficacy and safety of Baekhogainsam-tang for type 2 diabetes without complications by systemic review and meta-analysis of randomized controlled trials (RCTs). Methods: For a systematic review and meta-analysis, we set a key question in accordance with PICOT-SD. We searched the following up to March 31. 2021: PubMed, EMBASE, The Cochrane Library, CNKI, CiNii, KISS, KMBASE, OASIS, and ScienceON. A meta-analysis was conducted by synthesizing the results, including fasting plasma glucose level, postprandial 2-hour plasma glucose level, and Glycated Hemoglobin (HbA1c). Results: A total of five trials are included in this systemic review. The treatment group (Baekhogainsam-tang plus conventional treatment) showed more statistically significant effect than did the control group (conventional treatment only) in fasting plasma glucose level, postprandial 2-hour plasma glucose level, and glycated hemoglobin (HbA1c). Conclusions: Baekhogainsam-tang showed statistically significant effects in hypoglycemic effect and in improving insulin resistance. However, the number of studies included in the meta-analysis was insufficient, and the BIT used in the included studies was not standardized. This topic requires further attention and more clinical research.