• 제목/요약/키워드: Diabetes mellitus, Type 2

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항정신병 약물과 혈당조절이상 (Antipsychotics and Abnormality in Glucose Regulation)

  • 황재승;김현;권영준;정희연
    • 생물정신의학
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    • 제10권2호
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    • pp.107-115
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    • 2003
  • Objective:The purpose of this study was to know about the mechanism of pathogenesis of type 2 diabetes mellitus by using of blood glucose, glucoregulatory factor, insulin resistance in schizophrenic patients receiving antipsychotics. Method:Modified oral glucose tolerance tests were performed in 20 schizophrenic patients receiving haloperidol, risperidone and olanzapine. Insulin, glucagon, C-peptide and cortisol were measured in 0, 15, 45, 75 minutes after glucose loading, and insulin resistance was calculated by HOMA(homeostasis model assessment) method. Result:Olanzapine-treated patients had significant glucose elevation 45 minutes after glucose challenge. Also modest increases in HOMA IR values were detected in patients treated with olanzapine. Conclusion:Olanzapine treatment of non-diabetic patients with schizophrenia can be associated with type 2 diabetes mellitus through the elevation of glucose and insulin resistance. Elevated insulin resistance may be a causative mechanism of type 2 diabetes mellitus in patients receiving olanzapine.

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Risk of falls in community-dwelling older adults aged 65 or over with type 2 diabetes mellitus: a systematic review

  • Hwang, Sujin
    • Physical Therapy Rehabilitation Science
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    • 제7권3호
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    • pp.139-145
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    • 2018
  • Objective: Older persons with diabetes mellitus (DM) are particularly more likely to have fallen in the previous year than those without DM. The purpose of this study was to investigate the relationship between the risk of falls and type 2 DM in older adults who are 65 years of age or above. Design: A systematic review. Methods: PubMed and other two databases were searched up to August 2, 2018. Observational and cohort studies evaluating fall risk in people who are 65 years of age or above with DM were included. This review extracted the following information from each study selected: first author's surname, year of publication, country, average follow-up period, sex, age at enrollment, study population, measurement variables, relative risk, 95% confidence intervals and controlled variables. Results: This review involved nine cohort studies with 3,765 older adults with DM and 12,989 older adults without DM. Six studies compared with or without DM and two studies compared fallers with non-fallers with DM. Risk factors for falls included impaired cognitive function, diabetes-related complications (peripheral nerve dysfunction, visual impairment), and physical function (balance, gait velocity, muscle strength, and severity of physical activities). Conclusions: People who are 65 years of age or above with DM have increased risk of falling caused by impaired cognitive function, peripheral nerve dysfunction, visual impairment, and physical function in community-dwellers. For adults who are 65 years of age or older with DM, research fields and clinical settings should consider therapeutic approaches to improve these risk factors for falls.

Fall prevention strategies in community-dwelling older adults aged 65 or over with type 2 diabetes mellitus: a systematic review and meta-analysis

  • Hwang, Sujin;Woo, Youngkeun
    • Physical Therapy Rehabilitation Science
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    • 제7권4호
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    • pp.197-203
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    • 2018
  • Objective: Independent walking is the most essential prerequisite to maintain quality of life in older persons. The purpose of this review was to investigate the effect of fall prevention strategies on fall risk for type 2 diabetes mellitus (T2DM) within community-dwelling older adults aged 65 and over. Design: A systematic review and meta-analysis. Methods: PubMed and three other databases were searched up to October 31st, 2018 and randomized controlled trials (RCTs) evaluating fall prevention strategies for fall risk in persons who were 65 years of age or above with T2DM were included. The review extracted the following information from each study selected: first author's surname, published year, country, study population, type of intervention, intensity of intervention, comparison, measurement variables, additional therapy, summary of results, and mean and standard deviation from selected studies. Results: This review selected fourteen RCTs with 460 older adults with diabetes mellitus. Of the 14 studies, the types of intervention used to improve the risk of falls were strengthening (5), aerobic exercises (2), multimodal exercises (4), one virtual reality exercise (1), whole body vibration with balance exercise (1), and Tai Chi exercise (1). Seven RCTs were eligible for the meta-analysis. Therapeutic interventions were more effective than the control group for the Timed Up-and-Go test (-1.11; 95% CI, -1.82 to -0.41) and the 6-minute Walk Test (-1.89; 95% CI, -8.33 to 4.54). Conclusions: The results of the review suggest that interventions to prevent fall risk in older adults with T2DM should focus on strengthening, balance, aerobic, and multimodal exercises.

Prediction of Type 2 Diabetes Remission after Bariatric or Metabolic Surgery

  • Park, Ji Yeon
    • Journal of Obesity & Metabolic Syndrome
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    • 제27권4호
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    • pp.213-222
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    • 2018
  • Bariatric surgery has evolved from a surgical measure for treating morbid obesity to an epochal remedy for treating metabolic syndrome as a whole, which is represented by type 2 diabetes mellitus. Numerous clinical trials have advocated bariatric or metabolic surgery over nonsurgical interventions because of markedly superior metabolic outcomes in morbidly obese patients who satisfy traditional criteria for bariatric surgery (body mass index [BMI] >$35kg/m^2$) and in less obese or simply overweight patients. Nevertheless, not all diabetes patients achieve the most desirable outcomes; i.e., diabetes remission after metabolic surgery. Thus, candidates for metabolic surgery should be carefully selected based on comprehensive preoperative assessments of the risk-benefit ratio. Predictors for diabetes remission after metabolic surgery may be classified into two groups based on mechanism of action. The first is indices for preserved pancreatic beta-cell function, including younger age, shorter duration of diabetes, and higher C-peptide level. The second is the potential for an insulin resistance reduction, including higher baseline BMI and visceral fat area. Several prediction models for diabetes remission have been suggested by merging these two to guide the joint decision-making process between clinicians and patients. Three such models, DiaRem, ABCD, and individualized metabolic surgery scores, provide an intuitive scoring system and have been validated in an independent external cohort and can be utilized in routine clinical practice. These prediction models need further validation in various ethnicities to ensure universal applicability.

Case of hyperosmolar hyperglycemic state by a sodium-glucose cotransporter 2 inhibitor

  • Nho, In-Young;Kim, Hae-Sung;Kang, Nam-Kyu;Lee, Myung-Won;Kim, Soo-Kyung;Park, Seok-O
    • 고신대학교 의과대학 학술지
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    • 제33권3호
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    • pp.402-408
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    • 2018
  • Inhibitors of sodium-glucose cotransporters type 2 (SGLT2) are proposed as a novel approach for the management of type 2 diabetes mellitus. SGLT2 cotransporters are responsible for reabsorption of 90 % of the glucose filtered by the kidney. The glucuretic effect resulting from SGLT2 inhibition contributes to reduce hyperglycaemia and also assists weight loss and blood pressure reduction. In this study, we presented the case of a 59-year-old male who developed hyperosmolar hyperglycemic state (HHS), possibly caused by a sodium-glucose cotransporter 2 (SGLT2) inhibitor, a novel class of antihyperglycemic agents. This case highlights that HHS can develop in patients with diabetes treated with SGLT2 inhibitors.

오적산 병용투여가 혈당강하 치료를 받고 있는 제2형 당뇨병 환자의 혈당에 미치는 영향 (A Retrospective Study on the Effect of the Co-Administration of Ojeok-san and Hypoglycemic Agents on Blood Glucose Levels in Type 2 Diabetes Mellitus)

  • 이민승;정수민;오승현;이한영;임형근;안영민;안세영;이병철
    • 대한한방내과학회지
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    • 제42권1호
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    • pp.40-52
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    • 2021
  • Objective: This study was conducted to investigate the hypoglycemic effect and safety of Ojeok-san in patients with type 2 Diabetes Mellitus. Methods: We investigated type 2 diabetes mellitus patients at Kyung-Hee University Korean Medical Hospital who were administered Ojeok-san for at least one day between January 2012 and September 2020, basal characteristics and laboratory tests were reviewed retrospectively. The hypoglycemic effect of Ojeok-san was assessed by comparing fasting blood sugar (FBS) and two hours post-prandial plasma glucose (PP2) levels from before and after taking Ojeok-san. Subgroup analyses were conducted according to baseline hypoglycemic treatments and glycated hemoglobin levels (< or ≥6.5%). The safety of Ojeok-san was assessed by comparing levels of aspartate aminotransferase, alanine aminotransferase, γ-glutamyl transferase, blood urea nitrogen, and creatinine. Results: After Ojeok-san administration, FBS and PP2 were significantly reduced to an average of 14.33 mg/dL and 27.67 mg/dL respectively. In the subgroup analysis, PP2 in patients receiving metformin mono therapy was significantly reduced to 28.67 mg/dL, and those receiving a dual therapy of metformin and DPP-4 inhibitor, it was significantly reduced to 32.33 mg/dL. In patients with glycated hemoglobin of lower than 6.5%, FBS was significantly reduced to 12.20 mg/dL, and both FBS and PP2 were significantly reduced, to 15.50 mg/dL and 40.00 mg/dL, respectively, in those with glycated hemoglobin levels of more than 6.5%. The safety profile showed no significant difference after Ojeok-san administration. Conclusions: Ojeok-san has significant hypoglycemic effects in patients with type 2 diabetes mellitus who are also taking hypoglycemic agents.

제2형 당뇨병 환자에게 한방의료보험용 혼합엑기스산제와 경구혈당강하제 병용요법이 혈당 변화에 미치는 영향 (A Retrospective Study on the Effect of Herbal Extracts Combined with Conventional Therapy on Blood Glucose in Type 2 Diabetes Mellitus)

  • 정수민;노지원;이민승;양희권;안영민;안세영;이병철
    • 대한한방내과학회지
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    • 제41권6호
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    • pp.1231-1244
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    • 2020
  • Objective: This study was conducted to report the glucose-lowering effect and safety of herbal extracts in patients with type 2 diabetes mellitus. Methods: We investigated 21 patients with type 2 diabetes mellitus who were administered Daeshiho-tang, Bojungikgi-tang, Jowiseunggi-tang, and Hoechunyanggyeok-san at Kyung-Hee University Korean Medical Hospital from 2014 to 2019. The hypoglycemic effect of the herbal extracts was assessed by comparing blood glucose levels, including fasting blood sugar (FBS) and 2-hour postprandial glucose (PP2) levels. For safety assessment, the effects of herbal extracts on liver and kidney function were analyzed by liver function tests, including aspartate aminotransferase (AST), alanine aminotransferase (ALT), and γ-glutamyltransferase (GGT), and kidney function tests, including blood urea nitrogen (BUN) and creatinine (Cr). Patients were stratified according to their glycated hemoglobin (<6.5 or >6.5) levels and the kind of herbal extract used for treatment. Results: After administration of herbal extracts, FBS and PP2 significantly decreased to 20.24 mg/dL and 35.0 mg/dL respectively. Subgroup analysis revealed that, regardless of the glycated hemoglobin level, FBS and PP2 were significantly reduced in both groups. The safety profile showed no significant difference before and after taking herbal extracts. Conclusions: Daeshigo-tang, Bojungikgi-tang, Jowiseunggi-tang, and Hoechunyanggyeok-san may show the further glucose-lowering effects on patients with type 2 diabetes mellitus who have already treated with anti-hyperglycemic agents.

고지방식이와 STZ 유도 제2형 당뇨병 마우스에서 상엽 추출물의 항당뇨 효과 (Anti-Diabetic Effects of Mori Folium Extract on High-Fat Diet and Streptozotocin-Induced Type II Diabetes Mellitus in Mice)

  • 권태오;최지원;이현서;조병옥;윤홍화;장선일
    • 대한본초학회지
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    • 제30권1호
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    • pp.1-9
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    • 2015
  • Objectives : The present study was designed to investigate the anti-diabetic effects of Mori Folium (Morus alba L. of Moraceae) extract (MFE) on high fat diet (HFD) and streptozotocin (STZ)-induced type II diabetes mellitus in mice. Methods : The mice (C57BL/6J) were fed HFD for 8 weeks and then was induced with a single injection of STZ (75 mg/kg). The diabetic mice were divided into four groups [(STD, HFD, HFD + MFE and HFD + quercetin (QUR)] and administered with MFE or OUR for 4 weeks. Fasting blood glucose, lipid profile (triglycerides and cholesterol etc.), glutamic oxaloacetic transaminase (GOT), glutamic pyruvic transaminase (GPT), insulin and leptin were measured every 2 weeks. Results : Body weight gain was lower in the MFE and QUR groups than HFD group. The fasting blood glucose was lower in the MFE and QUR groups. Oral glucose and insulin tolerance were decreased in the MFE and QUR groups. The levels of serum total cholesterol, triglycerides, and LDL cholesterol were reduced in the MFE and QUR groups. The HDL cholesterol was much higher in the MFE and QUR groups than HFD group. The levels of GOT, GPT and atherogenic index were decreased in the MFE and QUR groups. The serum insulin and leptin concentrations were reduced in the MFE and QUR groups. Conclusions : These results showed that MFE could decrease blood glucose level and lead to an amelioration in dyslipidemia states on HFD/STZ-induced type II diabetes mellitus in mice.

표준 치료를 받고 있는 제2형 당뇨병 환자에서 혈당강하제와 평위산 및 향사평위산 병용 투여가 혈당에 미치는 영향 및 안정성 연구 (Assessment of Combined Administration of Hypoglycemic Agents and Herbal Extracts (Pyeongwi-san or HyangsaPyongwi-san) on Blood Glucose Levels in Type 2 Diabetes Mellitus: A Retrospective Study)

  • 정우녕;오승현;송미령;노지원;안영민;안세영;이병철
    • 대한한방내과학회지
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    • 제44권4호
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    • pp.661-674
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    • 2023
  • Abstract: This retrospective study delved into the effects and safety considerations associated with the concomitant usage of hypoglycemic agents and herbal extracts, specifically Pyeongwi-san (PWS) or HyangsaPyongwi-san (HSPWS) in the context of type 2 diabetes mellitus management. Methods: The investigation involved 38 inpatients with type 2 diabetes mellitus who received PWS or HSPWS treatment at Kyung Hee University Korean Medical Hospital from January 2012 to December 2022. By investigating clinical attributes and conducting laboratory assessments, this study aimed to discern the impact of these herbal extracts on blood glucose levels, encompassing fasting blood sugar (FBS) and mean 2-hour postprandial glucose (PP2) levels. Furthermore, the safety profile of the herbal extracts was assessed by comparing liver function indicators, including aspartate aminotransferase (AST), alanine aminotransferase (ALT), and γ-glutamyl transferase (GGT), alongside kidney function markers, such as blood urea nitrogen (BUN) and creatinine (Cr). Results: Following the administration of the herbal extracts, no statistically significant alterations in FBS and mean PP2 levels emerged compared to the baseline levels. Notably, the safety evaluation revealed no significant differences in liver and kidney function parameters following herbal extract administration. Conclusion: The results of this research indicate that using PWS or HSPWS alongside hypoglycemic medications could be a beneficial additional method for addressing digestive symptoms in individuals with type 2 diabetes mellitus. Notably, this combination seems to have no negative interactions with other drugs.

비타민 C 보충이 제 2형 당뇨병 환자의 혈당 및 항산화상태에 미치는 효과 (Effect of Vitamin C Supplementation on Blood Sugar and Antioxidative Status in Types II Diabetes Mellitus Patients)

  • 박형숙;이윤미
    • 대한간호학회지
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    • 제33권2호
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    • pp.170-178
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    • 2003
  • Purpose: This study was to determine the effect of oral vitamin C supplements on blood sugar and antioxidative status in Types II diabetes mellitus patients. Method: Data for the study were collected from June 24 to August 31, 2001. Participants(31) took 1g/day vitamin C for 4 weeks, after a 1 - week taking no Vitamin C, followed by Vitamin C 3g/day for 4 weeks. A baseline blood sample was obtained following a 12hour overnight fast and at the end of each 4week Vitamin C administration. Blood samples were taken for plasma vitamin C concentration, fasting blood sugar, HbA1c, superoxide scavenging activity and hydrogen peroxide scavenging activity. The data were analyzed by SPSS for repeated measures ANOVA. Result: Plasma vitamin C concentration was significantly increased over dose(F=3.316, p=.043). Fasting blood sugar and HbA1c was significantly decreased over dose(F=13.192, p=.000; F=11.995, p=.000). Superoxide scavenging activity and hydrogen peroxide scavenging activity was significantly increased over dose(F=486.138, p=.000; F=177.704, p= .000). Conclusion: The results suggest that megadose vitamin C supplementation may have a beneficial effect in diabetes mellitus patients on both glycemic control and antioxidant status. Thus dietary measures to increase plasma vitamin C may be an important health strategy for reducing the compliance of diabetic patients