Compared to that in the Caucasian population, type 1 diabetes mellitus (T1DM) incidence rates are very low in Koreans. Therefore, compared to the recent development of pharmacological therapy applicable to Korean children with T1DM, interest in nonpharmacological therapy and psychosocial support systems remains low, as is the development of Korean-style T1DM education programs for therapeutic application. Children who have been newly diagnosed with diabetes are placed in completely new environments for treatment. For appropriate control of diabetes, patients have to self-monitor blood glucose levels and inject insulin several times a day and must use extreme self-control when they eat foods to avoid increases in blood glucose levels. Blood glucose excursions resulting from impaired pancreatic ${\beta}$ cell functions cause mental stress due to vague fears of chronic complications of diabetes. In addition, children with diabetes cannot be excluded from the substantial amount of studies required of Korean adolescents, and the absolute shortage of time for ideal control of diabetes adds to their mental stress. Many of these patients are psychologically isolated in school where they spend most of their time, and they are not appropriately considered or supported with respect to blood glucose control in many cases. In this respect, this author will introduce some of the newest views on nonpharmacological therapy and psychosocial support systems that account for important parts of T1DM management and seek measures to apply them in conformity with the social characteristics of Korea.
Purpose: The purpose of this study was to identify relationships between HbA1c (Glycosylated Hemoglobin), WHR (Waist hip ratio), WTR (Waist thigh ratio) and compliance in elderly diabetes mellitus patients aged 65 years or over. Method: We conducted a survey and measured HbA1c, WHR, WTR in a total of 180 elderly patients with diabetes from 5 May 2014 to 30 May 2014. The data were analyzed by t-test, ANOVA, and Pearson's Correlation Coefficient using the SPSS program. Results: There were no significant differences in diabetes-related characteristics for HbA1c, WHR and WTR. However, patients with a family history had low compliance scores (p=.004). Furthermore, patients who visited the hospital regularly had higher compliance scores than patients who visited hospital when they were sick (p<.001). Patients with diabetic complications had low treatment compliance scores (p=.001). In addition, WHR and WTR (r=0.47, p<.001). and WHR and compliance (r=0.15, p=.045) showed positive correlation. Conclusion: For elderly diabetes mellitus patients, diabetes-related characteristics and compliance were highly related, so it is necessary to improve compliance for managing diabetes mellitus.
Purpose: To evaluate the possible risk factors of lower extremity amputations in diabetic foot patients. Materials and Methods: The study is based on 37 patients who received lower extremity amputations from April, 1997 to February 2005 due to diabetic foot complications with at least 1 year follow up. As for the control group, 49 diabetes patients who had been treated at the endocrinology department for at least 1 year without any diabetic foot complication were evaluated. As for the possible risk factors, age, gender, duration of diabetes mellitus, body mass index, Hb A1c, blood glucose level, total cholesterol, s-creatinine, C-peptide, smoking, alcohol, hypertension, cardiovascular disease, CVA, retinopathy and neuropathy were investigated. Results: Among the possible risk factors evaluated, age, Hb A1c, smoking, neuropathy and blood glucose level factors showed statistically significant difference between the diabetic amputation and the control group. Conclusion: In reducing the risk of the lower extremity amputations in the diabetic patients due to diabetic foot complications, strict control of blood glucose level and cessation of smoking were found to be utmost important.
Journal of the Korean Association of Oral and Maxillofacial Surgeons
/
v.39
no.4
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pp.175-181
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2013
Objectives: This retrospective study was performed to evaluate the clinical impact of diabetes mellitus on the prognosis in secondary space infection. Materials and Methods: Medical records, radiographic images, computed tomography, and microbial studies of 51 patients (25 diabetic patients and 26 non-diabetic patients) were reviewed. Patients were diagnosed as secondary fascial space infections with odontogenic origin and underwent treatment at Chonnam National University Hospital, in Department of Oral and Maxillofacial Surgery, from January 2007 to February 2009. Results: Compared to patients without diabetes, patients with diabetes were presented with the following characteristics: older age (diabetic patients: 62.9 years, non-diabetic patients, 47.8 years), more spaces involved (diabetic patients, 60%; non-diabetic patients, 27.3%), more intense treatment, longer hospitalization (diabetic patients, 28.9 days; non-diabetic patients, 15.4 days), higher white blood cell and C-reactive protein values, higher incidence of complication (diabetic patients, 40%; non-diabetic patients, 7.7%), and distinctive main causative microorganisms. Conclusion: These results suggest that the prognosis of diabetic patients is poorer than that of non-diabetic patients in secondary space infections since they had greater incidence rates of involved spaces, abnormal hematologic findings, more complications, and additional procedures, such as tracheostomy.
The incidence of diabetes is continuously increasing worldwide, resulting in a considerable socioeconomic burden. Glycemic control using traditional diabetes medications prevents microvascular complications; however, there is no objective evidence that it prevents macrovascular complications. In the 21st century, concerns have arisen that strict glycemic control and the diabetes drug rosiglitazone might increase mortality. This led the United States Food and Drug Administration to establish guidelines that require that cardiovascular outcome trials (CVOTs) with 3-point major adverse cardiovascular events (3-P MACE) as the primary endpoints be performed for new diabetes drugs. Since then, 20 CVOTs have been reported. Dipeptidyl peptidase 4 inhibitors do not increase the incidence of cardiovascular disease; however, saxagliptin increases the risk of heart failure. Sodium-glucose cotransporter inhibitors (SGLT2is) and glucagon-like peptide 1 receptor agonists (GLP-1RAs) not only have proven cardiovascular safety but also have shown results beyond expectations by reducing the incidence of cardiovascular diseases. Additionally, SGLT2is have been reported to markedly prevent heart failure and kidney disease. The reduction in 3-P MACE by GLP-1RAs was observed only with long-acting agents; long-acting GLP-1RAs also markedly reduced renal endpoints. However, no preventive effect against heart failure was observed with GLP-1RAs. The preventive effects of both drug types against cardiovascular and kidney diseases appear to be independent of glycemic control. In conclusion, based on CVOT results, it is necessary to actively prescribe SGLT2is and GLP-1RAs to prevent cardiovascular disease in patients with diabetes, regardless of glycemic control.
Jung, Se Ho;Sung, Hee Jin;Lim, Su Ji;Lee, Cham Kyul;Jo, Na Young;Roh, Jeong Du;Lee, Eun Yong
Journal of Acupuncture Research
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v.32
no.4
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pp.17-27
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2015
Objectives : The purpose of this study is to evaluate the correlation between HbA1c and pain intensity in diabetic peripheral neuropathy patients, and to compare the difference between two groups divided by the risk of complications. Methods : The participants were 46 men and women suffering from neuropathic pain diagnosed with diabetes mellitus who visited the Hospital of Traditional Korean Medicine, Semyung University from June, 2014 to August, 2015. Age, duration of diabetes mellitus, numeric rating scale(NRS), and Michigan neuropathy screening instrument(MNSI) were used as evaluation tools. Results : 1. In all 46 cases, there were no significant correlations between HbA1c and age, duration of diabetes mellitus, NRS, MNSIQ, or MNSIE. 2. Among 23 cases with a high risk of complications (more than 7.0 % of HbA1c, group A), there were no significant correlations between HbA1c and age, duration of diabetes mellitus, NRS, MNSIQ, or MNSIE. 3. Among 23 cases with a low risk of complications(less than 7.0 % of HbA1c, group B), there were no significant correlations between HbA1c and age, duration of diabetes mellitus, NRS, MNSIQ, or MNSIE. 4. Means of duration of diabetes mellitus, NRS, MNSIQ, and MNSIE were higher in group A than group B, but there were no significant correlations in statistics. Conclusions : This study could not find statistically significant correlations between pain intensity and HbA1c in diabetic peripheral neuropathy patients, so more studies are required in the future.
Journal of Physiology & Pathology in Korean Medicine
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v.21
no.3
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pp.671-678
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2007
Diabetes is a disease in which the body does not produce or properly use insulin. Etiological studies of diabetes and its complications showed that oxidative stress might play a major role. Therefore, many efforts have been tried to regulate free oxygen radicals for treating diabetes and its complications. Gamigukihwandong-hwan has been known to be effective for the treatment of diabetes. The present study was carried out to investigate the effect of Gamigukihwandong-hwan on renal function, peroxynitrite (ONOO$^-$) scavenging activity and polyol pathway in streptozotocin-induced diabetic rats. The crushed Gamigukihwandong-hwan was extracted 3 times, each time with 3 volumes of methyl alcohol at 60$^{\circ}C$ for 24 h. The extract was filtered and evaporated under a reduced pressure using a rotary evaporator to yield 74.95 g. Gamigukihwandong-hwan extract was oral-administered 100 mg per 1 kg of body weight for 20 days to the diabetic rats induced by streptozotocin (60 mg/kg). The effects of Gamigukihwandong-hwan extract on the streptozotocin-induced diabetic rats were observed by measuring the serum level of glucose, insulin, lipid components, creatinine and BUN, and also the kidney levels of superoxide anion radical (${\cdot}O_2^-$), nitric oxide (NO) and ONOO$^-$, and also the enzyme activities involved in polyol pathway. The Effects of Gamigukihwandong-hwan on the streptozotocin-induced diabetic rats with regards to body weight, blood glucose and insulin levels, creatinine and BUN levels, total cholesterol and triglyceride levels, and HDL-cholesterol levels were all shown to be good enough to cure and prevent the diabetes and its complications. Gamigukihwandong-hwan inhibited the generation of ${\cdot}O_2^-$, NO and ONOO$^-$ in the kidney of streptozotocin-induced diabetic rats. Renal aldose reductase and sorbitol dehydrogenase activities were increased in the streptozotocin-induced diabetic rats, whereas the ones in the Gamigukihwandong-hwan administered group among the streptozotocin-induced diabetic rats were reversed toward the natural activities. Gamigukihwandong-hwan might inhibit the development of diabetic nephropathy by scavenging reactive oxygen and nitrogen species, thereby by reducing oxidative stresses and also by regulating the activities of polyol pathway enzymes, all of which could help to recover the function of kidney.
Background: There have been an increasing number of reports about infection-related complications after epidural block, and the analysis of these previous reports may offer valuable information for the prevention and treatment of such complications. Methods: We searched for complications about infection that was related to epidural blockade procedures by using the Medline Search program. We analyzed the types of infection-related complications as well as the potential risk factors, the time course from symptom development to treatment, the causative organisms and the treatment outcomes. Results: Seventeen cases were identified. The types of complications were epidural abscess, subdural abscess, spinal arachnoiditis, bacterial meningitis and aseptic meningitis. Five patients received a single block and twelve patients received a continuous block with catheterization. The most common site of epidural catheterization was the lumbar area and eight patients had indwelling catheters for less than fifteen days. Eight patients had a diabetes mellitus as a risk factor and fourteen patients showed less than seven days from the development of symptoms to treatment. Eleven patients received laminectomy and intravenous antibiotics as a treatment and eight patients had full recovery without neurological deficit. Conclusions: Early diagnosis and treatment is essential for the favorable outcome of infection-related complication after epidural block. In addition, absolute sterile technique should always be performed and patient education concerning these potential complications must be accompanied.
Objectives : In present study, therefore, possible beneficial pharmacological activities of standard potato protein extracts (SPE) were observed on the mild diabetic obese mice. Methods : After end of 12 weeks of continuous oral administrations of three different dosages of SPE 400, 200 and 100 mg/kg, or metformin 250 mg/kg, analyzed the hepatoprotective, hypolipidemic, hypoglycemic, nephroprotective and anti-obesity effects, separately. In addition, liver antioxidant defense systems were additionally measured with lipid metabolism-related genes expressions and hepatic glucose-regulating enzyme activities for action mechanism. Results : All of diabetes and related complications including obesity were significantly inhibited by treatment of SPE 400, 200 and 100 mg/kg, dose-dependently, and they also dramatically normalized the hepatic lipid peroxidation and depletion of liver endogenous antioxidant defense system, the changes of the hepatic glucose-regulating enzyme activities, also changes of the lipid metabolism-related genes expressions including hepatic $AMPK{\alpha}1$ and $AMPK{\alpha}2$ mRNA expressions, dose-dependently. Especially, SPE 200 mg/kg constantly showed favorable inhibitory activities against type II diabetes and related complications as comparable to those of metformin 250 mg/kg in HFD mice, respectively. Conclusions : The present work demonstrated that SPE 400, 200 and 100 mg/kg showed favorable anti-diabetic and related complications including obesity refinement activities in HFD mice, through AMPK upregulation mediated hepatic glucose enzyme activity and lipid metabolism-related genes expression, antioxidant defense system and pancreatic lipid digestion enzyme modulatory activities.
Kim, Sang-Woo;Hwang, Hye-Jin;Baek, Yu-Mi;Hwang, Hee-Sun;Yun, Jong-Won
Journal of Microbiology and Biotechnology
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v.19
no.10
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pp.1109-1121
/
2009
In an attempt to discover novel biomarker proteins in type 2 diabetes prognosis, we investigated the influence of hypoglycemic extracellular polysaccharides (EPS) obtained from the macrofungus Tremella fuciformis on the differential levels of plasma proteins in ob/ob mice using two-dimensional gel electrophoresis (2-DE). The 2-DE analysis demonstrated that 92 spots from about 900 visualized spots were differentially regulated, of which 40 spots were identified as principal diabetes-associated proteins. By comparing control with EPS-fed mice, we found that at least six proteins were significantly altered in ob/ob mice, including Apo A-I, IV, C-III, E, retinol-binding protein 4, and transferrin, and their levels were interestingly normalized after EPS treatment. Western blot analysis revealed that the altered levels of the two regulatory molecules highlighted in diabetes and obesity (e.g., resistin and adiponectin) were also normalized in response to EPS. The Mouse Diabetes PCR Array profiles showed that the expression of 84 genes related to the onset, development, and progression of diabetes were significantly downregulated in liver, adipocyte, and muscle of ob/ob mice. EPS might act as a potent regulator of gene expression for a wide variety of genes in ob/ob mice, particularly in obesity, insulin resistance, and complications from diabetes mellitus.
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