• Journal of the Korean Magnetic Resonance Society
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• v.22 no.4
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• pp.149-157
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• 2018

Diabetes is known to be one of common causes for several types of peripheral nerve damage. Diabetic neuropathy (DN) is a significant complication lowering the quality of life that can be frequently found in diabetes patients. In this study, the metabolomic characteristic of DN and Diabetes was investigated with NMR spectroscopy. The sera samples were collected from DN patients, Diabetes patients, and healthy volunteers. Based on the pair-wise comparison, three metabolites were found to be noticeable: glucose, obviously, was upregulated both in DN patients (DNP) and Diabetes. Citrate is also increased in both diseases. However, the dietary nutrient and biosynthesized metabolite from glucose, ascorbate, was elevated only in DNP, compared to healthy control. The multivariate model of OPLS-DA clearly showed the group separation between healthy control-DNP and healthy control-Diabetes. The most significant metabolites that contributed the group separation included glucose, citrate, ascorbate, and lactate. Lactate did not show the statistical significance of change in t-test while it tends to down-regulated both in DNP and Diabetes. We also conducted the ROC curve analysis to make a multivariate model for discrimination of healthy control and diseases with the identified three metabolites. As a result, the discrimination model between healthy control and DNP (or Diabetes) was successful while the model between DNP and Diabetes was not satisfactory for discrimination. In addition, multiple combinations of lactate and citrate in the OPLS-DA model of healthy control and diabetes group (DNP + Diabetes patients) gave good ROC value of 0.952, which imply these two metabolites could be used for diagnosis of Diabetes without glucose information.

• Korean Journal of Pharmacognosy
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• v.45 no.4
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• pp.354-358
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• 2014

Aldose reductase (AR) has been demonstrated to play important role in the development of the diabetic complications such as diabetic retinopathy, diabetic neuropathy and diabetic nephropathy. To discover novel treatments for diabetic complications from natural sources, 69 Korean herbal medicines have been investigated for inhibitory activities on AR. Among them, 7 herbal medicines, Eleutherococcus sessiliflorus (stems), Artemisia japonica (whole plants), Wisteria floribunda (leaves), Eurya japonica (stems, twigs and leaves, leaves), Ampelopsis brevipedunculata (stems) exhibited a significant inhibitory activity compared with 3,3-tetramethyleneglutaric acid as positive control.

• Annals of Clinical Neurophysiology
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• v.21 no.1
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• pp.36-43
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• 2019

Background: Diabetic peripheral polyneuropathy (DPN) is associated with a variety of symptoms. Nerve conduction studies (NCSs) are considered to be the gold standard of nerve damage assessments, but these studies are often dissociated from the subjective symptoms observed in DPN patients. Thus, the aim of the present study was to investigate the correlations between NCS parameters and neuropathic symptoms quantified using the Michigan Neuropathy Screening Instrument (MNSI). Methods: Patients with type 2 diabetes mellitus (T2DM) with or without symptoms of neuropathy were retrospectively enrolled. Demographic data, clinical laboratory data, MNSI score, and NCS results were collected for analysis; DPN was diagnosed based on the MNSI score (${\geq}3.0$) and abnormal NCS results. Pearson's correlation coefficients were used to evaluate the relationships between MNSI score and NCS variables. Results: The final analyses included 198 patients (115 men and 83 women) with a mean age of $62.6{\pm}12.7$ years and a mean duration of diabetes of $12.7{\pm}8.4$ years. The mean MNSI score was 2.8 (range, 0.0-9.0), and 69 patients (34.8%) were diagnosed with DPN. The MNSI score was positively correlated with the median motor nerve latency and negatively correlated with the median motor, ulnar sensory, peroneal, tibial, and sural nerve conduction velocities (NCVs). When the patients were categorized into quartiles according to MNSI score, peroneal nerve conduction velocity was significantly lower in the second MNSI quartile than in the first MNSI quartile (p = 0.001). A multivariate analysis revealed that the peroneal NCV was independently associated with MNSI score after adjusting for age, sex, and glycosylated hemoglobin A1c (HbA1c) levels. Conclusions: The present results indicate that a decrease in peroneal NCV was responsible for early sensory deficits in T2DM patients.

• Journal of Korean Biological Nursing Science
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• v.24 no.3
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• pp.171-180
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• 2022

Purpose: The purpose of this study was to investigate the nutritional intake status, according to the risk of diabetic complications in Type 2 diabetes patients. Methods: This was a secondary data analysis study that included 83 patients. The nutritional intake was assessed, using 24-hour dietary recall. The risk of diabetic complications was measured, using the Framingham Risk Score (FRS) and Michigan Neuropathy Screening Instrument Questionnaire (MNSIQ). The nutritional intake was analyzed using the CAN-pro 4.0 program. Data were analyzed using descriptive statistics, Chi-square test, and Independent t-test, using the SPSS WIN 26.0 program. Results: The mean FRS and MNSIQ scores for the participants was 14.46± 4.09 and 2.30± 2.22, respectively. Thirty two participants (38.6%) were in the high-risk groups for cardiovascular disease and peripheral neuropathy. The participants consumed high amounts of grain and low amounts of vegetables, fruits, and dairy products when compared to the recommended intake. However, the nutritional intake did not differ according to FRS or MNSIQ levels. Consumption of vegetables and fruits were significantly different between high and low risk groups of MNSIQ. Conclusion: It is necessary to consider the composition of dietary intake to improve the imbalanced diet in Type 2 diabetes patients and prevent diabetic complications. Type 2 diabetes patients should reduce the intake of grains and sodium, and increase vegetable intake. More deliberate future studies are needed, to investigate the relationship between food intake and the risk status for diabetic complication.

• Journal of the Korean Burn Society
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• v.23 no.1
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• pp.20-24
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• 2020

Diabetic patients have an increased risk of burn injuries on foot. Because of their diabetic neuropathy, they could contact with hot water or warming device without being aware of it. Split-thickness skin graft (STSG) is successful in treatment of various wound types; however, donor site wounds are sometimes problematic, and complications such as pain and impaired healing often occur. Although, donor site wounds in healthy young individuals can rapidly heal without complications, the wound-healing capacity of elderly patients or those with a comorbidity has been reported to be low. The dermatome is the most commonly used tool because it can harvest a large skin graft in one attempt. However, it is difficult to harvest tissues if the area is not flat. Furthermore, because the harvested skin is usually rectangular, additional skin usually remains after skin grafting. Therefore, use of razor blade and fragmented STSG on a large defect area is advantageous for harvesting a graft with a desired size, shape, and thickness. From January 2018 to July 2018, fragmented STSG was used in 9 patients who suffered from burn induced open wound on foot with diabetic neuropathy. With this approach, healing process was relatively rapid. The mean age of patients was 70 (57~86 years) and all of 9 patients had diabetes mellitus type 2. In all patients, the skin graft on the defect site healed well and did not result in complications such as hematoma or seroma.

• Proceedings of the Korean Society of Applied Pharmacology
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• 2000.04a
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• pp.3-5
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• 2000

Of 16 million diabetic patients in the USA, 2.4 millions have experienced diabetic foot ulcer and 67,000 have amputations every year. For treatment of diabetic foot ulcer, Americans spend more than $1 billion each year, including $36,000 per patient for complete treatment and $60,000 for each amputation. Neuropathy and ischemia, two common complications of diabetes mellitus, are the primary underlying risk factors for development of diabetic foot ulcers. Ischemic ulcers develop as a result of low perfusion pressure in the foot with inadequate blood supply, whereas neuropathic ulcers develop from loss of protective sensation. In addition, diabetes also increases the risk of infection by impairing the body's ability to eliminate bacteria. From these circumstances, results are chronic wounds with impaired healing ability.

• Asian-Australasian Journal of Animal Sciences
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• v.23 no.5
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• pp.672-679
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• 2010

Diabetes mellitus is a worldwide epidemic with high mortality. As concern over this disease rises, the number and value of research grants awarded by the National Research Foundation of Korea (NRF) have increased. Diabetes mellitus is classified into two groups. Type 1 diabetes requires insulin treatment, whereas type 2 diabetes, which is characterized by insulin resistance, can be treated using a variety of therapeutic approaches. Hyperglycemia is thought to be a primary factor in the onset of diabetes, although hyperlipidemia also plays a role. The major organs active in the regulation of blood glucose are the pancreas, liver, skeletal muscle, adipose tissue, intestine, and kidney. Diabetic complications are generally classified as macrovascular (e.g., stroke and heart disease) or microvascular (i.e., diabetic neuropathy, nephropathy, and retinopathy). Several animal models of diabetes have been used to develop oral therapeutic agents, including sulfonylureas, biguanides, thiazolidinediones, acarbose, and miglitol, for both type 1 and type 2 diseases. This review provides an overview of diabetes mellitus, describes oral therapeutic agents for diabetes and their targets, and discusses new developments in diabetic drug research.

• Genomics & Informatics
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• v.20 no.3
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• pp.26.1-26.19
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• 2022

Diabetes and its related complications are associated with long term damage and failure of various organ systems. The microvascular complications of diabetes considered in this study are diabetic retinopathy, diabetic neuropathy, and diabetic nephropathy. The aim is to identify the weighted co-expressed and differentially expressed genes (DEGs), major pathways, and their miRNA, transcription factors (TFs) and drugs interacting in all the three conditions. The primary goal is to identify vital DEGs in all the three conditions. The overlapped five genes (AKT1, NFKB1, MAPK3, PDPK1, and TNF) from the DEGs and the co-expressed genes were defined as key genes, which differentially expressed in all the three cases. Then the protein-protein interaction network and gene set linkage analysis (GSLA) of key genes was performed. GSLA, gene ontology, and pathway enrichment analysis of the key genes elucidates nine major pathways in diabetes. Subsequently, we constructed the miRNA-gene and transcription factor-gene regulatory network of the five gene of interest in the nine major pathways were studied. hsa-mir-34a-5p, a major miRNA that interacted with all the five genes. RELA, FOXO3, PDX1, and SREBF1 were the TFs interacting with the major five gene of interest. Finally, drug-gene interaction network elucidates five potential drugs to treat the genes of interest. This research reveals biomarker genes, miRNA, TFs, and therapeutic drugs in the key signaling pathways, which may help us, understand the processes of all three secondary microvascular problems and aid in disease detection and management.

• Physical Therapy Korea
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• v.12 no.4
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• pp.12-19
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• 2005

The purpose of this study was to investigate the possibility of virtual moving surround (VMS) on static balance in the patients with balance dysfunction. Eighty three subjects who were admitted or treated as an outpatient, or a family member, at the department of rehabilitation unit of university hospital were recruited to participate. Subjects were three groups based on their overall medical status: healthy, diabetic neuropathy and stroke. Each group was tested for static balance with a forceplate during static standing with VMS. The virtual movement was simulated with a head mounted display. The parameters for static balance were total sway path. In this study, the parameters of postural control for patients with diabetic neuropathy and stroke subjects were significantly increased in conditions elicited with the VMS. In the healthy elderly participants, the total sway path was not significantly different under virtual movement conditions. Therefore, VMS could be used in the evaluation and treatment of the patients with balance dysfunction.

• Journal of Korean Foot and Ankle Society
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• v.15 no.4
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• pp.232-239
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• 2011

Purpose: Diabetic foot ulcer is one of the most important diabetic complications because it increases the risk of amputations. Moreover, it lowers the quality of patients' life and increases the social medical expenses. Authors analyzed risk factors of intractable diabetic foot ulcer using retrospective study. Materials and Methods: From January 2007 to December 2010, 40 patients who could not achieve complete healing despite more than 12 weeks of proper management among who had been diagnosed and treated as diabetic foot ulcer at our hospital were included and evaluated retrospectively. We compared the risk factors between two groups who were finally treated by amputation and non-amputation. Results: The sample was composed of 31 male patients (77.5%) and 9 female patients (22.5%). Comorbidity including hypertension and hyperlipidemia were 77.5% and 80% each. By Wagner classification, 30 patients (80%) had ulcerative lesion over the grade 3. From bacteriology results, 29 patients (72.5%) had polybacteria infection. 35 patients (87.5%) had neuropathy and 26 patients (65%) had vascular stenosis at least one level. The mean initial ankle-brachial index and toe-brachial index were 0.982 and 0.439. In comparison between amputation group and non-amputation group, ulcer severity, number of stenotic vessel and initial ankle-brachial index/toe-brachial index had statistical significance. Conclusion: The most commonly risk factor of intractable diabetic foot ulcer was peripheral neuropathy reaching 87.5% of cases. In comparison with non-amputation group, ulcer severity according to Wagner classification, number of stenotic vessel and initial ankle-brachial index/toe-brachial index were demonstrated as a risk factor of amputation in intractable diabetic foot ulcer.