• 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.

• Journal of the Korean Dietetic Association
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• v.11 no.2
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• pp.223-232
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• 2005

The purpose of this study was to investigate the dietary behavior of people with type 2 diabetes mellitus and to improve their quality of life through medical nutrition therapy. The subjects were 38 persons with type 2 diabetes mellitus visiting a public health center to participate in a dietary education program from Jun, 2003 to Nov. 2003 in Daegu, Korea. The interviews were tape-recorded and analyzed attitude, knowledge, and awareness of patients by focus group interview. Most of the patients were mainly dependent on drug therapy and had little experience of diet education. Barriers to dietary practice adherences were limitations in food selection, lack of will and feel of burden. Barriers to follow guidelines were lack of self-control, confliction with food habits of their family, accessibility, economical problems, fear for the change after dietary practice, food difficulties in meal distribution and difficulties for eating out. After 4 weeks of intensive nutrition education, fasting blood sugar levels were decreased and postprandial and waist circumference were significantly decreased in all patients and 26.9% of patients were under decreased oral hypoglycemic agent dosage due to improved blood sugar level. dietary knowledge of subjects were greatly improved in such items as dietary intake, saturated fat, HbA1C, ideal body weight, and waist circumference.

• Journal of Acupuncture Research
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• v.27 no.5
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• pp.1-12
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• 2010

Objectives : This study was designed to evaluate the antidiabetes effects of Cinnamomum cassia and Aconitum carmichaeli in type II diabetes mellitus model mice. Methods : The experimental animals were divided into 3 groups and treated for 50 days as follows:control group, pharmacopuncture group and extract administration group. The effects of Cinnamomum cassia and Aconitum carmichaeli were observed by measuring body weight, blood glucose, insulin, insulin immunoreactivity of the pancreas and subpopulation of splenocytes. Results : Cinnamomum cassia sample groups were reduced a little body weight than control group. Glucose level of extract administration group lowered than control and pharmacopuncture group. Insulin immunoreactivity of Aconitum carmichaeli extract group appeared more effective than control and pharmacopuncture group. Conclusions : This study shows that Cinnamomum cassia and Aconitum carmichaeli have a distinct antidiabetes effect in type II diabetes mellitus model.

• Korean Journal of Schizophrenia Research
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• v.22 no.1
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• pp.8-13
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• 2019

Objectives: The aim of this study was to explore the prevalence of type 1 diabetes in patients with schizophrenia and their total medical costs and risk of hospitalization. Methods: This study used Health Insurance Review and Assessment Service data in Korea. To examine total medical costs and risk of hospitalization, we selected 1,510 subjects with schizophrenia (half with and half without type 1 diabetes) that were 1:1 matched via propensity score matching. In health care system perspective, total medical costs included out-of-pocket and insurer's costs. Logistic regression models were used to examine the risk of hospitalization. Results: The prevalence of type 1 diabetes in patients with schizophrenia was 3.87 per 1,000 person year. Among patients with schizophrenia, the amount of total average medical costs and hospitalization costs in patients with type 1 diabetes was 1.49 and 1.59 times higher than those in patients without it, respectively. The odds of hospitalization were higher among patients with type 1 diabetes compared with those without it (odds ratio, OR=1.97 ; 95% CI 1.60-2.43). Conclusion: This study showed that medical costs and risk of hospitalization were higher in schizophrenia patients with type 1 diabetes. Therefore, these individuals may require specific care programs.

• 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.

• Nutrition Research and Practice
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• v.9 no.6
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• pp.658-666
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• 2015

BACKGROUND/OBJECTIVES: The current study examined trends in adherence to dietary recommendations and compared the levels of adherence between diagnosed and undiagnosed subjects with type 2 diabetes mellitus (T2DM) in Korea over the past 14 years. SUBJECTS/METHODS: Data were collected from the 1998-2012 Korea National Health and Nutrition Examination Surveys (KNHANES). Diagnosed diabetes was defined as giving a positive response to questions about awareness of the disease, a physician's diagnosis of diabetes, or medical treatment for diabetes, whereas undiagnosed diabetes was defined as having a fasting glucose level ${\geq}126mg/dl$. Assessment of adherence level was based on 6 components of dietary guidelines, considering meal patterns and intake levels of calories, carbohydrates, vegetable/seaweed, sodium, and alcohol. The participants received 1 point if they met the criteria for each of the 6 components, and the total possible score ranged from 0 to 6 points. Multivariate generalized linear regression was performed, taking into account the complex survey design. RESULTS: Among all diabetic patients aged 30 years or older, the proportion of diagnosed diabetes increased dramatically, from 40.9% in 1998 to 75.9% in 2012 (P for trend < 0.001). The overall adherence levels to dietary recommendations were low and did not significantly differ between diagnosed and undiagnosed subjects with T2DM for all survey years. Several improvements were observed, including increased adherence to maintaining sufficient vegetable/seaweed consumption (increased from 0.12 to 0.16 points) and limiting sodium intake (increased from 0.12-0.13 points to 0.19-0.24 points; P for trend < 0.001), while adherence to maintaining moderate alcohol consumption decreased. CONCLUSIONS: Analysis of data collected by the KNHANES indicates that Korean T2DM patients have poor adherence to dietary recommendations and maintenance of a healthy lifestyle, regardless of disease awareness. This finding suggests that development of practical, evidence-based guidelines is necessary and that provision and expansion of educational programs for T2DM patients is critical after diagnosis.

• Journal of Microbiology and Biotechnology
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• v.20 no.4
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• pp.817-820
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• 2010

Type 1 diabetes mellitus (T1DM) is an autoimmune disease characterized by extreme insulin deficiency due to an overall reduction in the mass of functional pancreatic ${\beta}$-cells. Several animal models have been used to study T1DM. Amongst these, the mini-pig seems to be the most ideal model for diabetes research, owing to similarities with humans in anatomy and physiology. The purpose of this study was to analyze differentially expressed pancreatic proteins in a streptozotocin (STZ)-induced mini-pig T1DM model. Pancreas proteins from mini-pigs treated with STZ were separated by two-dimensional gel electrophoresis, and 11 protein spots were found to be altered significantly when compared with control mini-pigs. The data in this study utilizing proteomic analysis provide a valuable resource for the further understanding of the T1DM pathomechanism.

• The Journal of Internal Korean Medicine
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• v.42 no.4
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• pp.718-726
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• 2021

This study presents a case of add-on traditional Korean medical treatments in a 77-year-old male patient with uncontrolled type 2 diabetes mellitus with conventional oral hypoglycemic agents. Chief complaints were uncontrolled glucose level and weight loss. The patient was treated with electroacupuncture (on ST36, CV4, and CV12), herbal medication, and lifestyle advice. The conventional oral hypoglycemic medications were maintained. After 12 weeks, the glycated hemoglobin A1c (HbA1c) decreased from 11.0% to 8.4%. There were significant abnormalities in the liver function and renal function tests, but no adverse event was reported. Further studies are needed to confirm the findings of this case.

• Child Health Nursing Research
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• v.29 no.1
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• pp.7-23
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• 2023

Purpose: The purpose of this study was to investigate the effect of family-centered interventions on improving health outcomes in children and adolescents with type 1 diabetes mellitus (T1DM). Methods: A literature search was conducted according to the PRISMA guidelines, using six electronic databases: EMBASE, CINAHL, Medline, CENTRAL, Scopus, and Web of Science. The inclusion criteria encompassed studies with populations of children and adolescents (age <18 years) and at least one parent/caregiver, or only parents/caregivers if the children were very young, and studies that investigated the health outcomes of children and parents/caregivers diagnosed with T1DM. Results: From 2,746 published studies, only nine studies met the inclusion criteria. The key interventions were non-technology-based interventions (n=4), technology-based interventions (n=2), and combined technology- and non-technology-based interventions (n=3). The interventions had effects on glycated hemoglobin, adherence to diabetes management, diabetes self-management behaviors, and parent-child teamwork in diabetes management. Other essential effects were children's quality of life, children's problem-solving skills, parents' quality of life, and parents' coping and depression. Conclusion: Family-centered interventions can effectively improve health outcomes in children and adolescents with T1DM. In the future, family-centered interventions integrated with other approaches, theories, and models should be developed to achieve the best possible outcomes.

• Clinical and Experimental Pediatrics
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• v.52 no.11
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• pp.1279-1282
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• 2009

Hepatomegaly and liver dysfunction might develop in patients with diabetes mellitus due to glycogen deposition or nonalcoholic steatohepatitis. We experienced a case of hepatic glycogenosis in a patient with type 1 diabetes mellitus who presented with recurrent hypoglycemia, suggesting impairment of glycogenolysis and gluconeogenesis. A 10-year-old girl with a 4-year history of type 1 diabetes mellitus was admitted because of recurrent hypoglycemia and abdominal pain in the right upper quadrant. She had Cushingoid features and hepatomegaly that extended 6 cm below the right costal margin. Laboratory data and radiologic examination revealed elevated liver enzyme levels due to fatty liver. Periodic acid-Schiff (PAS) staining revealed intense glycogen deposition in the cytoplasm of the hepatocytes and PAS reactivity was lost with diastase treatment. At 2 months after administration of glucagon injection and uncooked cornstarch between meals and at bedtime, the hypoglycemic episodes and liver dysfunction improved. It is important to distinguish hepatic glycogenosis from steatohepatitis, because it is possible to prevent excessive hepatic glycogen storage in hepatic glycogenosis cases by strictly controlling blood glucose level and by glucagon administration. To prevent severe hypoglycemic symptoms accompanied by hepatic glycogenosis, we suggest that uncooked cornstarch, which is effective in maintaining blood glucose level, can also be administered.