• Korean Journal of Exercise Nutrition
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• v.24 no.4
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• pp.34-43
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• 2020

[Purpose] The purpose of this study was to assess changes in blood glucose level, blood pressure, and arterial stiffness after a 75 g oral glucose tolerance test (OGTT) in elderly women aged over 65 years with hypertension and either normal glycemic control, impaired fasting glucose tolerance, or diabetes mellitus. We also wished to investigate the relationship between stages of diabetes and physical fitness. [Methods] A total of 24 elderly women with hypertension were assigned to a control group (CON; n=7), impaired fasting glucose group (IFG; n=9), and diabetes mellitus group (DM; n=8). In each group, blood glucose level, brachial ankle pulse wave velocity (PWV), and blood pressure were measured at baseline as well as 60 and 120 minutes after a 75 g OGTT. Physical fitness factors such as hand grip strength, balance test, 4 m gait speed test, chair stand test, short physical performance battery, and 6-minute walking test were subsequently assessed. [Results] In all three groups, blood glucose levels were significantly increased at 60 and 120 minutes after a 75 g OGTT. In the DM group, blood glucose levels were significantly higher before and after a 75 g OGTT than in the CON group. In the CON group, PWV was significantly increased at 60 minutes after a 75 g OGTT; however, there were no changes in other groups after glucose ingestion. In the CON group, systolic and diastolic blood pressures were significantly decreased at 60 and 120 minutes after a 75 g OGTT compared to baseline. However, there was no change in blood pressure after ingestion in the DM group. The IFG group had greater grip strength than the CON group; however, there were no differences in other variables between the groups. [Conclusion] After a 75 g OGTT, elderly women with hypertension and diabetes maintain higher blood glucose levels compared to those with hypertension alone. Unlike elderly women with hypertension alone, those with hypertension and diabetes did not show changes in arterial stiffness and blood pressure after a 75 g OGTT. Therefore, elderly women with hypertension and diabetes may not be able to control their blood vessels following a 75 g OGTT due to impaired vascular endothelial function. Moreover, there was no association between diabetes stage and physical fitness in elderly women with hypertension.

• Nutrition Research and Practice
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• v.3 no.4
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• pp.315-322
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• 2009

This study was designed to evaluate the effect of individualized diabetes nutrition education. The nutrition education program was open to all type 2 diabetes patients visiting the clinic center and finally 67 patients agreed to join the program. To compare with 67 education group subjects, 34 subjects were selected by medical record review. The education program consisted of one class session for 1-2 hours long in a small group of 4~5 patients. A meal planning using the food exchange system was provided according to the diet prescription and food habits of each subject. Measurements of clinical outcomes and dietary intakes were performed at baseline and 3 months after the education session. After 3 months, subjects in education group showed improvement in dietary behavior and food exchange knowledge. In education group, intakes of protein, calcium, phosphorus, vitamin $B_2$, and folate per 1,000 kcal/day were significantly increased and cholesterol intake was significantly decreased. They also showed significant reductions in body weight, body mass index (BMI), and fasting blood concentrations of glucose (FBS), HbA1c, total cholesterol, and triglyceride. However, no such improvements were observed in control group. To evaluate telephone consultation effect, after the nutrition education session, 34 subjects of the 67 education group received telephone follow-up consultation once a month for 3 months. The others (33 subjects) had no further contact after the nutrition education session. Subjects in the telephone follow-up group showed a decrease in BMI, FBS, and HbA1c. Moreover, the subjects who did not receive telephone follow-up also showed significant decreases in BMI and FBS. These results indicated that our individually planned education program for one session was effective in rectifying dietary behavior problems and improving food exchange knowledge, and quality of diet, leading to an improvement in the clinical outcomes. In conclusion, our individualized nutrition education was effective in adherence to diet recommendation and in improving glycemic control and lipid concentrations, while follow-up by telephone helped to encourage the adherence to diet prescription.

• Health Policy and Management
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• v.29 no.4
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• pp.431-444
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• 2019

Background: This study aimed to properly manage diseases such as blood sugar control so that patients with diabetes can benefit from both medication and health activities. Also, these health practices are greatly influenced by self-rated health, a subjective assessment of health status. Because self-rated health does not necessarily match the objective health status, it is important to identify which factors affect self-rated health. Methods: For the study, the data was gathered from the 4th-6th National Health Nutrition Survey (2007-2015). Out of the total 73,353 participants in the survey, 2,303 patients with uncontrolled blood sugar with an HbA1c level of more than 7% were selected for the final study. Dependent variables fell into two categories depending on how the participant reported whether he or she was in good health or not. Independent variables included socio-demographics, health behavioral, and health status factors. This study performed logistic regression analysis. Results: Out of 2,303 participants, 18.1% reported that their heath was 'good,' despite the fact that their blood sugar level was not controlled. After running a logistic regression model, the odds ratio of groups that perceive subjective health awareness as good was higher in the groups of people as below: in the people over 60 years old; in the people who graduated from a junior college or higher than those who had a level of education of primary school completion or less; in the people living in Chungnam than those living in Seoul; and in the group with hypertriglyceridemia. Conclusion: The study identified factors associated with those failed to perceive the blood sugar level as a severe health problem despite of the fact that blood sugar was not controlled. To improve public health, diabetes management policies need to be addressed to population groups with these problems above.

• Journal of Life Science
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• v.17 no.6 s.86
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• pp.859-866
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• 2007

The main objective of this study was to investigate the effects of exercise on serum insulin and leptin levels and GLUT-4 and VAMP-2 in skeletal muscles from the pregnant rats. F344 rats were randomly divided into four groups (n = 15 in each group): control group (CG), pregnant group (PG), pregnant running group (PR), and pregnant swimming group (PS). From the 15th day of pregnancy, animals in the running group were forced to run on treadmill for 30 min with a light intensity, while those in the swimming group were forced to swim in swimming pool for 10 min once a day for 6 consecutive days. The present result demonstrated that in pregnant rat group, serum insulin levels significantly in-creased and leptin levels significantly decreased. Skeletal GLUT-4 and VAMP-2 protein expression was significantly decreased in pregnant rats compared to non-pregnant rats. However, matenal running during gestational period alleviated pregnancy-induced changes in plasma insulin and leptin levels, and it significantly enhanced skeletal GLUT-4 and VAMP-2 protein expression. From those results, it can be suggested that running exercise during gestational period may improve glycemic control by up-regulating GLUT-4 and VAMP-2 protein expression.

• Journal of Nutrition and Health
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• v.47 no.3
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• pp.157-166
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• 2014

Purpose: Rice bran is a byproduct of the hulling of rice and contains a variety of bioactive components. Various studies have reported on the antioxidative, anticancer, immune-enhancing, and hypocholesterolemic effects of rice bran. However, few studies about the physiological activity of stabilized rice bran supplement on dietary intake of sugars is limited. The aim of this study was to investigate the effect of stabilized rice bran supplement on blood glucose in C57BL/6 mice fed a high sucrose diet. Methods: Animals were randomly divided into three groups respectively, and were fed a normal diet (ND group), a high sucrose diet (HSD group) or a high sucrose diet containing 20% stabilized rice bran (HSD-SRB group) for 12 weeks. Results: In the oral glucose tolerance test (OGTT), after seven weeks of feeding on the experimental diets, a significantly lower result was observed for HSD-SRB than for HSD at 30 and 60 minutes after oral administration in glucose solution (2 g/kg body weight). The incremental area under the curve (IAUC) of HSD-SRB was significantly lower than that of HSD. After 12 weeks, fasting blood glucose level of HSD-SRB was significantly lower than that of HSD. No significant difference in the serum insulin level was observed between HSD and HSD-SRB. However, HOMA-IR was significantly decreased in HSD-SRB compared to HSD. In addition, HOMA ${\beta}$-cell was significantly increased in HSD-SRB compared to HSD. Triglyceride in liver of HSD-SRB was significantly lower than that of HSD. Conclusion: Feeding diets containing 20% rice bran improved insulin resistance and insulin secretion by decreasing triglyceride in liver. Thus, rice bran has a positive effect on glycemic control. In addition, the results are expected to be utilized as a basis for human study and development of food products with added rice bran.

• Korean Journal of Clinical Pharmacy
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• v.25 no.2
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• pp.74-79
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• 2015

Objective: Treatment with sulfonylureas in combination with metformin improves glycemic control in type 2 diabetes mellitus (T2DM), but is associated with hypoglycemia and weight gain. This retrospective study aims to compare the effectiveness of dipeptidylpeptidase-4 (DPP-4) inhibitors and sulfonylureas as an add-on therapy to metformin in patients with T2DM. Methods: Data from medical records of 355 T2DM patients received therapy either DPP-4 inhibitors (DPP-4 inhibitor group) or sulfonylurea (SU group) in combination with metformin from 1 March 2009 to 30 September 2011 were retrospectively reviewed. Of total 355 patients, 231 patients were in DPP-4 inhibitor group and 124 patients were in SU group. Baseline Hemoglobin $A_{1c}$ ($HbA_{1c}$) level in SU group was higher than DPP-4 inhibitor group with a statistically significant difference (8.6% vs. 7.8%). Comparative analysis between DPP-4 inhibitor group and SU group was performed for $HbA_{1c}$ values, amounts of $HbA_{1c}$ changes, and rates of $HbA_{1c}$ changes from baseline at 6-month intervals and incidence rates of major cardiocerebral events. Results: SU group showed larger $HbA_{1c}$ changes in both amounts and rates compared to DPP-4 inhibitor group, although statistical significance was not found in all study periods. Proportions of patients with stable $HbA_{1c}$ <6.5% or 7% were significantly higher in DPP-4 inhibitor group than SU group (<6.5%: 30.4% vs. 13.4%, <7%: 72.3% vs. 41.2%). Time to achieve stable $HbA_{1c}$ <6.5% was not significantly different, but time to achieve stable $HbA_{1c}$ <7% was shorter in DPP4 inhibitor group than SU group with a significant difference. The incidence rate of cardiocerebral events in group of patients with or without previous events was 1.7%, not significantly lower than that in DPP-4 inhibitor group (4.0%). For newly encountered cardiocerebral events during the treatment, incidence rates of two groups did not differ significantly. Conclusion: DPP-4 inhibitors were as effective as sulfonylureas in achieving the $HbA_{1c}$ goal of less than 6.5% or 7% and cardiocerebral event rates did not differ between the two drugs.

• Journal of Nutrition and Health
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• v.44 no.6
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• pp.577-591
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• 2011

A food exchange system for diabetes is a useful tool for meal planning and nutritional education. The first edition of the Korean food exchange lists was developed in 1988 and the second edition was revised in 1995. With recent changes in the food marketplace and eating patterns of Koreans, the third edition of food exchange lists was revised in 2010 by the Korean Diabetes Association, the Korean Nutrition Society, the Korean Society of Community Nutrition, the Korean Dietetic Association and the Korean Association of Diabetes Dietetic Educators through a joint research effort. The third edition is based on nutritional recommendations for people with diabetes and focuses on adding foods to implement personalized nutrition therapy considering individual preferences in diverse dietary environment. Foods were selected based on scientific evidence including the 2007 Korea National Health and Nutrition Examination Survey data analysis and survey responses from 53 diabetes dietetic educators. While a few foods were deleted, a number of foods were added, with 313 food items in food group lists and 339 food items in the appendix. Consistent with previous editions, the third edition of the food exchange lists included six food categories (grains, meat, vegetables, fats and oils, milk, and fruits). The milk group was subdivided into whole milk group and low fat milk. The standard nutrient content in one exchange from each food group was almost the same as the previous edition. Korea Food & Drug Administration's FANTASY (Food And Nutrient daTA SYstem) database was used to obtain nutrient values for each individual food and to determine the serving size most appropriate for matching reference nutrients values by each food group. The revised food exchange lists were subjected to a public hearing by experts. The third edition of the food exchange lists will be a helpful tool for educating people with diabetes to select the kinds and amounts of foods for glycemic control, which will eventually lead to preventing complications while maintaining the pleasure of eating.

• Journal of Nutrition and Health
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• v.53 no.3
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• pp.244-254
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• 2020

Purpose: Ixeris strigosa (IS) is a perennial plant that commonly grows in meadows. The leaves and roots of IS have been used in medicine as a sedative. This study evaluated the antioxidant and carbohydrate-digestive-enzyme inhibitory effects of IS to determine its potential as an essential antioxidant and glycemic inhibitor for type 2 diabetics. Methods: The antioxidative and α-amylase and α-glucosidase inhibitory activities were examined using the water extracts (ISW), ethanol extracts (ISE), and solvent fractions from IS. The antioxidative activities were measured using in vitro methods by measuring the 1,1-diphenyl-2-picrylhydrazyl and 2,2'-azino-bis-3-ethylbenzothiazoline-6-sulfonic acid radical scavenging activity. Results: Investigations of the total polyphenol, flavonoid content, in vitro antioxidant activity, and α-amylase and α-glucosidase inhibitory activities of the IS extract showed that the ISE had higher total phenolic and flavonoid contents than the ISW, as well as high antioxidant activity. The ethanolic extracts of IS (70%) had an α-amylase inhibitory activity of 78.55%. The ethyl acetate fraction (90.56%) showed higher α-glucosidase inhibitory activity than the positive control, acarbose (83.01%). Conclusion: Among the ISE fractions, the ethyl acetate and butanol fractions showed the best digestive enzyme inhibitory activity. Moreover, the antioxidant activity of the extract and the carbohydrate, α-amylase, and α-glucosidase inhibitory effects showed a stronger correlation with the total phenol and flavonoid contents compared to the ISW. As a result, the antioxidant and digestive enzyme inhibitory activities of high ISE are due to the phenolic compounds, particularly the flavonoid compounds. Therefore, ethyl acetate and butanol fractions of the 70% ethanol extract are excellent anti-diabetic functional materials.

• Korean Journal of Clinical Pharmacy
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• v.20 no.2
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• pp.107-113
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• 2010

서 론: 중환자실에서 집중적 인슐린 요법에 의한 평균혈당강하는 사망률을 감소시키는 것으로 나타났으나 이로 인한 저혈당 및 혈당변동은 새로운 문제로 대두되고 있다. 본 연구에서는 혈당과 관련한 여러 요인들이 사망에 미치는 영향을 규명하고 적정 혈당치를 확인하고자 하였다. 연구방법: 2008년 2월부터 7월 사이인 6개월 동안 서울아산병원 외과계 중환자실에서 4일 이상 재실한 18세 이상의 성인 환자를 대상으로 전자 의무기록 조사를 통해 후향적으로 연구가 진행되었다. 연구를 위해 환자의 인구학적 특성, 수술의 종류, 중환자실에서의 재실기간, 사망여부, 스테로이드 사용 유무, 기계적 인공호흡기의 사용유무, 신대체요법의 사용유무, 혈당치, 재실기간 중 스테로이드 사용유무와 인슐린 양, 입원 후 첫 24시간 동안의 포도당 주입속도, 입원 후 2일 이내와 그 이후에 발생한 균혈증 감염, APACH II와 SOFA 점수를 조사하였다. 혈당수치는 각각의 환자에서 중환자실 입실 후 가장 처음 측정된 혈당, 재실기간 중 가장 높은 혈당과 가장 낮은 혈당수치를 조사하였고 중환자실 전체 재실기간 동안 혈당수치의 평균과 변동계수를 계산하였다. 이상의 혈당관련지표를 포함한 인자들이 일차 종속변수인 사망에 어떠한 영향을 주는지를 환자를 생존군과 사망군으로 나누어 분석하였고 ROC (receiver operator characteristic) 곡선을 사용하여 혈당지표와 APACH 및 SOFA 점수의 cut-off치를 구하여 이로부터 단변량 및 다변량 분석을 시행하였다. 결 과: 연구에 포함된 환자는 170명 이었고 그 중 23명이 연구 기간 중 중환자실에서 사망하였다. 생존자에 비해 사망자의 최대혈당은 유의적으로 높았고 최소혈당치는 유의적으로 낮아 높은 변동계수를 보였다. ROC곡선으로부터 산출된 혈당치들의 cut-off 수치는 최소혈당치 70 mg/dL, 변동계수 25%, 최대혈당치 250 mg/dL, 평균혈당치 150 mg/dL이었다. 다변량분석에서 최소혈당이 70 mg/dL 보다 큰 경우가 낮은 경우에 비해 오즈비가 0.922(95% 신뢰구간 0.881-0.965)로 유의성 있게 낮았으며 변동계수가 25% 보다 높은 집단의 경우 그보다 낮은 집단에 비해 오즈비가 1.121(95% 신뢰구간 1.017-1.236)로 유의성 있게 높았다. Kaplan-Meier 생존분석 결과 최소혈당치 70 mg/dL와 변동계수 25%에 따라 생존기간에 유의성 있는 차이가 나타났다.(각각 P < 0.001, P < 0.05) 결 론: 고혈당 발생의 감소뿐 아니라 최소혈당치를 70 mg/dL 이상으로 유지하면서 변동을 최소화하는 것이 외과계 중환자실에서의 사망률감소를 위한 중요한 요인임을 알 수 있었다.

• Journal of the Korean Society of Food Science and Nutrition
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• v.32 no.6
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• pp.921-925
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• 2003

To control blood glucose level as close to normal is the major goal of treatment of diabetes mellitus. $\alpha$-glucosidase is the enzyme to digest dietary carbohydrate and inhibition of $\alpha$-glucosidase could suppress postprandial hyperglycemia. The methanol extract of soybean sprout was tested for the inhibitory activities against $\alpha$-glucosidase in vitro. Soybean sprout extract inhibited yeast $\alpha$-glucosidase activity by 24.5% at the concentration of 5 mg/mL. The methanol extract of soybean sprout was subsequently subjected to sequential fractionation with hexane, ethyl acetate, butanol and water. Among the fractions tested ethyl acetate-soluble fraction showed relatively strong inhibition against $\alpha$-glucosidase by 36.3% at the concentration of 5 mg/mL. Acarbose, standard $\alpha$-glucosidase inhibitor, inhibited $\alpha$-glucosidase activity by 40.1%. The ability of soybean sprout extract to lower postprandial glucose was studied in streptozotocin-induced diabetic rats. Starch solution (1 g/kg) with and without the methanol extract of soybean sprout (500 mg/kg) was administered to diabetic rats after an overnight-fast by gastric intubation. A single oral dose of soybean sprout extract inhibited the increase in blood glucose levels significantly at 60, 90, 120, 180 min (p<0.05) and decreased incremental response areas under the glycemic response curve significantly (p<0.05). These results suggest that soybean sprout might exert hypoglycemic effect by inhibiting $\alpha$-glucosidase activity.