• The Journal of Internal Korean Medicine
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• v.42 no.1
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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.

• Annals of Pediatric Endocrinology and Metabolism
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• v.23 no.4
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• pp.196-203
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• 2018

Purpose: The hemoglobin glycation index (HGI) represents the degree of nonenzymatic glycation and has been positively associated with cardiometabolic risk factors (CMRFs) and cardiovascular disease in adults. This study aimed to investigate the association between HGI, components of metabolic syndrome (MS), and alanine aminotransferase (ALT) in a pediatric nondiabetic population. Methods: Data from 3,885 subjects aged 10-18 years from the Korea National Health and Nutrition Examination Survey (2011-2016) were included. HGI was defined as subtraction of predicted glycated hemoglobin ($HbA1_c$) from measured $HbA1_c$. Participants were divided into 3 groups according to HGI tertile. Components of MS (abdominal obesity, fasting glucose, triglycerides, high-density lipoprotein cholesterol, and blood pressure), and proportion of MS, CMRF clustering (${\geq}2$ of MS components), and elevated ALT were compared among the groups. Results: Body mass index (BMI) z-score, obesity, total cholesterol, ALT, abdominal obesity, elevated triglycerides, and CMRF clustering showed increasing HGI trends from lower-to-higher tertiles. Multiple logistic regression analysis showed the upper HGI tertile was associated with elevated triglycerides (odds ratio, 1.65; 95% confidence interval, 1.18-2.30). Multiple linear regression analysis showed HGI level was significantly associated with BMI z-score, $HbA1_c$, triglycerides, and ALT. When stratified by sex, age group, and BMI category, overweight/obese subjects showed linear HGI trends for presence of CMRF clustering and ALT elevation. Conclusion: HGI was associated with CMRFs in a Korean pediatric population. High HGI might be an independent risk factor for CMRF clustering and ALT elevation in overweight/obese youth. Further studies are required to establish the clinical relevance of HGI for cardiometabolic health in youth.

• Journal of Periodontal and Implant Science
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• v.51 no.2
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• pp.114-123
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• 2021

Purpose: This retrospective cohort study aimed to assess the effect of nonsurgical periodontal therapy on glycated hemoglobin (HbA1c) levels in patients with both type 2 diabetes and chronic periodontitis. Methods: The intervention cohort (IC) comprised 133 patients with type 2 diabetes who received nonsurgical periodontal treatment, while the matching cohort (MC) included 4787 patients with type 2 diabetes who visited the Department of Endocrinology and Metabolism of Asan Medical Center. The patients in each cohort were divided into 3 groups according to their baseline HbA1c level: subgroup 1, HbA1c <7%; subgroup 2, 7%≤ HbA1c <9%; and subgroup 3, HbA1c ≥9%. Changes in HbA1c levels from baseline to 6 and 12 months were analyzed. In addition, the association between changes in HbA1c levels and the number of periodontal maintenance visits was investigated. Results: There were no statistically significant changes in HbA1c levels in the IC and MC or their subgroups when evaluated with repeated-measures analysis of variance. However, the IC showed maintenance of baseline HbA1c levels, while the MC had a trend for HbA1c levels to steadily increase as shown by pairwise comparisons (baseline to 6 months and baseline to 12 months). IC subgroup 1 also maintained steady HbA1c levels from 6 months to 12 months, whereas MC subgroup 1 presented a steady increase during the same period. The number of periodontal maintenance visits had no association with changes in HbA1c levels during the 1-year study duration. Conclusions: For patients with both type 2 diabetes and periodontitis, nonsurgical periodontal treatment and periodontal maintenance may help to control HbA1c levels.

• Journal of Korean Biological Nursing Science
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• v.23 no.2
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• pp.119-126
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• 2021

Purpose: This study confirmed the effects of body mass index (BMI) and waist circumference (WC) on fasting blood glucose (FBS) and hemoglobin A1c (HbA1c) in adults without diabetes mellitus (DM). Methods: The subjects were 4,659 adults (≥ 20 years), and data were extracted from the 6th National Health and Nutrition Survey 2015 (KNHANES VI-3). The subject's data were analyzed using a complex sample t-test, χ²-test, and multiple logistic regression analysis (SPSS 24.0). Results: The incidence of the high FBS group was increased 1.60 times in males with a WC ≥ 90 cm and 1.78 times in females with a WC ≥ 85 cm. The incidence of the high HbA1c group was increased 1.54 times in those who were overweight and 2.22 times in those who were obese. The incidence of the high HbA1c group was increased 1.99 times in males with a WC ≥ 90 cm and 1.87 times in females with a WC ≥ 85 cm. Conclusion: This study presented evidence that interventions for BMI and WC should be included in DM prevention programs. It also suggested that these findings can be utilized for early detection of DM.

• The Journal of Internal Korean Medicine
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• v.40 no.6
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• pp.1318-1324
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• 2019

Objectives: The purpose of this study was to evaluate the effectiveness of the management of blood glucose in diabetes mellitus using modified Jawonjihwang-tang in a Korean medical clinic, retrospectively. Methods: From 2006 to 2018, 150 patients diagnosed with diabetes who visited a Korean medical clinic were treated with Korean medicine. Then, 81 of them were prescribed Jawonjihwang-tang. Five cases who changed the formula during the procedure were excluded; therefore, 76 cases were finally selected. Their therapeutic effects were evaluated by the variance in glycated hemoglobin (HbA1c). Results: After administration of Jawonjihwang-tang, most patients exhibited a decreased level of HbA1c, and 24 patients had normalized the level of HbA1c. The HbA1c level of all patients decreased from 9.1±2.2 to 7.8±2.2 significantly (p<0.001). Conclusions: It is concluded that Jawonjihwang-tang may control blood glucose in diabetes patients. However, more prospective randomized clinical trials are warranted to verify this conclusion.

• 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.

• Journal of Korean Society of Occupational and Environmental Hygiene
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• v.30 no.3
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• pp.313-320
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• 2020

Objectives: The aim of this study is to evaluate the association between vibration exposure and skeletal muscle mass index through a single university health check-up. Methods: We used data from 134,067 male subjects who received a general health check-up or vibration exposure health check-up out of the 1,515,322 people who underwent medical check-up at a local university hospital from 2002 to 2018. Pearson correlation analysis was conducted for comparing the association between skeletal muscle mass index and demographic and hematological variables in both groups. Mixed linear model analysis after controlling demographic and hematological variables was used to analyze the differences in skeletal muscle mass index between groups at every visit over 10 years. Results: In the Pearson correlation test, the variables that showed different results when comparing the two groups were C-reactive protein (p=0.001) and glycated hemoglobin (p=0.002) in the vibration exposure group and erythrocyte sedimentation rate (p<0.001) and vitamin D (p<0.001) in the general group. After the adjustment of demographic and hematologic variables, the skeletal muscle mass index at every visit was markedly decreased in the vibration exposure group (p<0.001). Conclusions: In the vibration exposure group, the skeletal muscle mass index showed a tendency to decrease markedly over time compared to the general health check-up group, which showed that C-reactive protein and glycated hemoglobin would have an influence on skeletal muscle index in male workers exposed to vibration.

• Journal of Convergence for Information Technology
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• v.8 no.6
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• pp.75-84
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• 2018

Objects: This study is a descriptive study to identify the factors influencing the glycated hemoglobin control in type 2 diabetes patients. Methods: This study used raw data from the third year of the National Health and Nutrition Examination Survey performed from 2015. The subjects were 285 people who were classified as type 2 diabetes patients among the 7,380 participants of the National Health and Nutrition Examination Survey. Findings: The factors influencing the glycated hemoglobin control in type 2 diabetes patients were found to be age, education level, prevalence period and sleeping time. Improvements: In type 2 diabetes patients, it is very important to have appropriate education on diabetes when they discovered the disease morbidity in the middle age rather than in the aged period and to have enough sleeping time. A practical program to help this education and training should be developed.

• Nutrition Research and Practice
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• v.7 no.3
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• pp.166-171
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• 2013

The purpose of this study was to investigate the effects of lotus leaf on hyperglycemia and dyslipidemia in animal model of diabetes. Inhibitory activity of ethanol extract of lotus leaf against yeast ${\alpha}$-glucosidase was measured in vitro. The effect of lotus leaf on the postprandial increase in blood glucose levels was assessed in streptozotocin-induced diabetic rats. A starch solution (1 g/kg) with and without lotus leaf extract (500 mg/kg) was administered to the rats after an overnight fast, and postprandial plasma glucose levels were monitored. Four-week-old db/db mice were fed a basal diet or a diet containing 1% lotus leaf extract for 7 weeks after 1 week of acclimation to study the chronic effect of lotus leaf. After sacrifice, plasma glucose, insulin, triglycerides (TG), total cholesterol (CHOL), high-density lipoprotein (HDL)-CHOL, and blood glycated hemoglobin levels were measured. Lotus leaf extract inhibited ${\alpha}$-glucosidase activity by 37.9%, which was 1.3 times stronger than inhibition by acarbose at a concentration of 0.5 mg/mL in vitro. Oral administration of lotus leaf extract significantly decreased the area under the glucose response curve by 35.1% compared with that in the control group (P < 0.01). Chronic feeding of lotus leaf extract significantly lowered plasma glucose and blood glycated hemoglobin compared with those in the control group. Lotus leaf extract significantly reduced plasma TG and total CHOL and elevated HDL-CHOL levels compared with those in the control group. Therefore, we conclude that lotus leaf is effective for controlling hyperglycemia and dyslipidemia in an animal model of diabetes mellitus.

• Korean Journal of Exercise Nutrition
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• v.25 no.3
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• pp.36-43
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• 2021

[Purpose] Exercise is a key factor in preventing obesity and metabolic syndrome. Sumo wrestlers increase their body size from childhood for athletic advantage; however, the risk of metabolic syndrome in junior sumo wrestlers is undetermined. Preventive measures against pediatric obesity should be initiated during childhood to prevent obesity in adulthood, considering its high global incidence. We comparatively evaluated the risk factors for metabolic syndrome in junior sumo wrestlers and children with obesity. [Methods] We enrolled 70 male children (age 9-17 years [sumo group, n = 14] and 9-14 years [other sports and non-exercise groups, n = 28 each]) and evaluated their anthropometric parameters (height, weight, body mass index z-score, obesity rate, waist circumference, waist to height ratio) and hematological parameters (total, low-density, high-density, and non-high-density lipoprotein-cholesterol; triglycerides; plasma glucose, and glycated hemoglobin levels). [Results] The BMI z-score, obesity rate, waist circumference (p < 0.05, along with the non-exercise group), and systolic blood pressure were significantly higher and the high-density cholesterol level was lower in the sumo group than in the other sports group (p < 0.05). The waist to height ratio was significantly higher in the non-exercise group than in the other sports group (p < 0.05). No significant difference was found in other blood lipid, plasma glucose (significantly lower level than the reference range in the sumo group, p < 0.05), and glycated hemoglobin (within the reference range in all groups) levels among the three groups. [Conclusion] Junior sumo wrestlers had a larger body size and higher blood pressure than children with obesity who exercised regularly. This provides direction for future research into targeted preventive interventions against metabolic syndrome for junior sumo wrestlers with large body size.