• Journal of Korean Biological Nursing Science
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• v.5 no.1
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• pp.5-12
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• 2003

The purpose of this study to compare of clinical profile between obese and nonobese type 2 diabetic patients. The subjects were consist of 111 obese (50 male, 61 female) and 159 non obese (79 male, 80 female) type 2 diabetic patients underwent fasting blood glucose, 2-hour postprandial blood glucose, $HbA_1c$, total cholesterol, triglyceride, high density lipoprotein, microalbuminuria, fasting C-peptide and 2-hour postprandial C-peptide were measured. Diabetes was diagnosed according to the American Diabetes Association (ADA) criteria. Obesity was defined as body mass index (BMI, kilograms per meters squared) ${\geq}23$. Data analyses were t-test, chisquare test in SAS program. The results were as follows : 1) Triglycerides and 2-hour postprandial C-peptide were significant higher in obese than non-obese patients. 2) Systolic blood pressure, Diastolic blood pressure, fasting blood sugar, 2-hour postprandial blood glucose, $HbA_1c$, total cholesterol, high-density lipoprotein, microalbuminuria and fasting C-peptide were no difference between obese and non-obese groups. These data indicate that obesity is a risk factor for the development of coronary heart disease (CHD) in diabetic patients. Therefore, weight reductions have beneficial effects on insulin action and glycemic control in obese type 2 diabetic patients.

• Journal of Korean Academy of Nursing
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• v.31 no.6
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• pp.1034-1043
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• 2001

To determine the frequency of past and present obesity among patients with NIDDM and to identify the differences of body fat, blood pressure and C-peptide/glucose ratio according to obese diabetic patients (BMI$\geq$25 kg/$m^2$) and nonobese (BMI<25 kg/$m^2$). Also the final factor is to observe the anthrometric change patterns in the study. Method: The weight at 20 years-old, previous maximal body weight, and acute weight loss were queried. Current height, body weight, BMI, waist & hip circumferences, waist-hip ratio, skinfold thicknesses, blood pressure, fasting blood glucose, and fasting C-peptide were measured in one hundred sixty-seven NIDDM patients. The differences of the parameters ccording to obese and nonobese, and three anthropometric change patterns were analyzed. Result: Results were as follows: 1. 66.5 % of the NIDDM patients had a history of past obesity as assessed by their maximum weight, while only 33.2% of them were currently obese (p's < 0.001). 2. The waist & hip circumferences, skinfold thicknesses, systolic, diastolic & mean arterial blood pressure in obese patients were greater than those of nonobese patients (all p's < 0.001). 3. The waist and the hip circumferences, and skinfold thicknesses (subscapula & triceps) were highest among the obese-obese group. WHR and abdominal skinfold thickness in the obese-obese and obese-nonobese groups were higher than those in the nonobese- nonobese group. Systolic & diastolic and mean arterial blood pressures in the obese-obese group were higher than those of obese-nonobese and nonobese-nonobese groups(all p's < 0.005). 4. The abdominal and subscapular skinfold thicknesses in female diabetic patients were greater than those of male patients (all p's <0.0001). Conclusion: Although most Korean NIDDM patients were previously obese, many of them were not obese during the course of the study. Greater central and upper body adiposicity and higher blood pressure was shown in obese diabetic patients. Also, greater central and upper body adiposicity was demonstrated in female diabetic patients.

• Journal of Korean Academy of Fundamentals of Nursing
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• v.11 no.3
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• pp.275-280
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• 2004

Purpose: The purpose of this study was to evaluate the effects on obesity of nurse education using the short message service (SMS) of cellular phones and wire Internet. Method: Forty patients in an experimental group, which was assessed pre- and post intervention, completed this study. The patients were divided into two groups according to degree of obesity. The goal of the intervention was to keep blood glucose concentrations close to the normal range. The intervention was applied weekly for 3 months. Participants were requested to input the blood glucose level everyday at http://www.biodang.com by cellular phone or wire internet. The researcher sent optimal recommendations to each patient using SMS of cellular phones and wire Internet. The plasma glucose levels and serum lipids were measured before and after the intervention. Results: After 3 months of education, Glycosylated hemoglobin (HbAlc) decreased by 1.4% in non-obese patients and 0.7% in obese patients. Fasting plasma glucose (FPG) decreased 22.6mg/dl in non-obese patients and 22.3mg/dl in obese patients. Two-hour plasma glucose (2HPG) decreased 97.0mg/dl in non-obese patients and 67.8mg/dl in obese patients. Conclusion: These results indicate that a nurse SMS intervention would improve HbAlc, FPG, and 2HPG in both non-obese and obese patients.

• The Journal of Korean Medicine
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• v.25 no.4
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• pp.200-208
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• 2004

Objective: Non-insulin Dependent Diabetes Mellitus (NIDDM) is characterized by insulin resistance, which affects the glucose transportation inside the cell. The purpose of this study was to find out how Palmijihwangtang (PMT) and exercise influence the glucose transport metabolism in the organ muscles of ZDF (zucker diabetic fatty) rat with insulin resistance. Methods: Using three male normal zucker rats and twelve male obese rats, they were divided into a normal lean group (N=3), obese control group (N=3), obese exercises group (N=3), obese medication group (N=3), obese exercise and medication group (N=3). Treadmill exercise were repeated with 27m/min speed for an hour a day, five days a week, for 8 weeks. And 20β/sub ￠/ of PMT was orally administered twice a day for 8 weeks, after that a period blood sample was exsanguinated by heart perforation and was analyzed. Results: The body weight of the OM and OEM group showed a significant decrease among all the obese groups. The blood insulin level increased significantly of all groups in comparison with the N group. All of the OE, OM and the OEM groups showed a significant decrease of insulin level compared with the OC group; especially the OEM group demonstrated the most among obese groups. Regarding GLUT-4 level, OEM was the unique group showed a significant increase among all the obese groups. The VAMP-2 level in myocardium cell membrane was increased significantly at OC group in comparison with the N group, whereas the OEM group only showed significant decrease of it. In addition, the VAMP-2 level in pancreas β-cell was significantly decreased at all the obese groups in comparison with the N group. Only the OEM group showed significant increase among all the obese groups. Conclusion: Palmijihwangtang (PMT) and exercise could effectively promote the insulin metabolism in pancreas β-cells and activate the glucose transport process in myocardium cell membrane by lowering the insulin resistance of ZDF rats.

• Journal of Nutrition and Health
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• v.26 no.2
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• pp.164-173
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• 1993

This study was aimed to investigate whether abdominal obesity is associated with non-insulin dependednt diabetes. The distribution of body fat patterns was observed in 181 female patients with diabetes, aged 33 to 83 years, living in the Taegu area, Korea. The following anthropometric measuremetns were made on all participants from October 1 to November 25, 1991 : weight, height ; waist and hip circumferences in standing position. The waist hip circumference ratio was used as an index of abdominal obesity. The results were as follows; 1) The mean fasting blood glucose of diabetic subjects was 145$\pm$50.3mg/dl and the mean duration of diabetes was 4.7$\pm$7.5 years. 2) Obese subjects above the ideal body weight body weight of 120% in the investigation are presently 52%, but 63% of subjects were reported to be obese in the past. The mean BMI of the subjects is 24.57$\pm$3.15 and the past mean BMI was 27.13$\pm$3.26. One year after reaching their highest body weight, 47% of the subjects developed diabetes. Two years after reaching their peak body weight, 74% of diabetic subjects developed diabetes. 3) Using the waist-hip circumference ratio, subjects beloing to the upper body obesity(WHR>0.84) were 65.5%. 4) The average daily energy intake did not differ between the obese and non-obese diabetic subjects, whether they were assessed with BMI or with RBW. 5) The average daily energy intake was higher in the upper body obesity subjects than in the lower body obesity subjects. 6) Diabetics withing the regular exercise group had lower fasting blood glucose levels than the non-regular exercise group. Exercise did not effect the RBW, BMI, and WHR. 7) The waist-to-hip circumference ratio correlated significantly in positive with waist-circumference, but did not correlated with hip-circumference. Therefore, WHR may depended on the increased accumulation of abdominal fat in female diabetics. In conclusion, these findings suggest that caloric intake is more associated with abdominal fat accumulation in diabetic women. Blood glucose concentration is independently effected by exercise, and exercise does not affect the WHR. Therefore, control of caloric intake and development of specific exercises to change the WHR seems important for controling diabetes in female subjects.

• Journal of Korea Association of Health Promotion
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• v.4 no.1
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• pp.12-27
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• 2006

"본 논문은 대한내과학회지 2006년 제70권 제3호에 실렸던 논문으로 대한내과학회 편집위원회의 승인을 득하고 본 협회지에 게재함. Background : Diabetes mellitus is a major independent risk factor for atherosclerosis. In recent years non-invasive high resolution B-mode ultrasound methods have been developed to measure the intima-media thickness(IMT) of the carotid artery as an indicator for early atherosclerosis. Itis known that obesity plays a role in the development of type 2 diabetes and cardiovascular disease, and it has also been reported that not only the amount but also the distribution of body fat is important. This study investigated the relationship between obesity and the development of carotid atherosclerosis in type 2 diabetic patients. Methods: Carotid IMT was measured by ultrasound B-mode imaging in 144 patients with type 2diabetes mellitus. All subjects underwent assessment for the degree and distribution of obesity, the presence of coronary artery disease risk factors, and the presence of diabetic complications. Resuts: Carotid IMT was increased in the abdominal obese group defined by waist circurference. However, there was no significant difference in carotid TMT between the non-obese group and obese group as defined by body mass index, waist to hip ratio, and total body fat percent measured by bio electrical impedance analysis. There were positive correlations between carotid IMT and age, duration of diabetes, systolic blood pressure, and waist circumference. Multiple linear regression analysis revealed the variable that interacted independently with carotid IMT was age in type 2 diabetic patients. Carotid IMT was significantly increased in type 2 diabetic patients with macrovascular complications and microvascvlar complications .Conclusion: This study suggested that abdominal obesity rather than general obesity was associated with carotid atherosclerosis reflected by increment of carotid IMT in type 2 diabetic subjects.

• BMB Reports
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• v.40 no.1
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• pp.29-35
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• 2007

During the past decade, many salivary parameters have been used to characterize disease states. Ghrelin (GAH) is recently-discovered peptide hormone secreted mainly from the stomach but also produced in a number of other tissues including salivary glands. The aim of this work was to examine the relationship between active (aGAH) and inactive (dGAH) ghrelin in the saliva and other salivary parameters in type II diabetic patients and healthy controls. Salivary parameters were assessed in a single measurement of unstimulated whole saliva from 20 obese and 20 non-obese type II diabetes patients, and in 22 healthy controls. Total protein and alpha-amylase were determined by colorimetric methods, and glucose by the glucose-oxidase method. Saliva aGAH and dGAH levels were measured using a commercial radioimmunoassay (RIA) kit. Salivary concentrations of aGAH and dGAH ghrelin were more markedly decreased in obese diabetic subjects than in the two other groups. Glucose and alpha-amylase levels were higher in diabetic subjects than in controls. Furthermore, there were correlations between GAH levels and BMI, and between GAH and blood pressure. However, there was no marked variability in saliva flow rates among the groups. These results indicate that measurement of salivary GAH and its relationship to other salivary parameters might help to provide insight into the role of ghrelin in diabetes.

• Journal of Life Science
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• v.10 no.4
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• pp.388-396
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• 2000

The effect of the traditional herbal medicine Yukmijihwangtang-Jahage(YJ) on the improvement of insulin resistance and lipid profile was studied using a model for non-insulin dependent diabetes mellitus, lean (Fa/-) and obese (fa/fa) Zucker rats. Yukmijihwangtang-Jahage feeding for 4 weeks resulted in a significant decrease in the concentration of plasma triglyceride in both lean and obese Zucker rats. Furthermore, Yukmijihwangtang-Jahage markedly decreased both plasma cholesterol and fasting plasma insulin, and significantly decreased the postprandial glucose level at 30 min during oral glucose tolerance test in obese Zucker rats. Although there was no statistical significance, the crude glucose transporter 4 protein level of Yukmijihwangtang-Jahage dieted obese rats tended to increase when compared to that of obese control rats. Therefore, the present results suggested that Yukmijihwangtang-Jahage may be useful in prevention and improvement of metabolic disorders characterized by hyperinsulinemia states such as non-insulin dependent diabetes mellitus, syndrome X and coronary artery disease.

• Korean Circulation Journal
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• v.53 no.12
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• pp.843-854
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• 2023

Background and Objectives: We evaluated the effect of diabetes on the relationship between body mass index (BMI) and clinical outcomes in patients following percutaneous coronary intervention (PCI) with drug-eluting stent implantation. Methods: A total of 6,688 patients who underwent PCI were selected from five different registries led by Korean Multicenter Angioplasty Team. They were categorized according to their BMI into the following groups: underweight (<18.5 kg/m²), normal weight (18.5-24.9 kg/m²), overweight to obese (≥25.0 kg/m²). Major adverse cardiac and cerebrovascular events (MACCE), defined as a composite of death, nonfatal myocardial infarction, stroke, and target-vessel revascularization, were compared according to the BMI categories (underweight, normal and overweight to obese group) and diabetic status. All subjects completed 1-year follow-up. Results: Among the 6,688 patients, 2,561 (38%) had diabetes. The underweight group compared to normal weight group had higher 1-year MACCE rate in both non-diabetic (adjusted hazard ratio [HR], 2.24; 95% confidence interval [CI], 1.04-4.84; p=0.039) and diabetic patients (adjusted HR, 2.86; 95% CI, 1.61-5.07; p<0.001). The overweight to obese group had a lower MACCE rate than the normal weight group in diabetic patients (adjusted HR, 0.67 [0.49-0.93]) but not in non-diabetic patients (adjusted HR, 1.06 [0.77-1.46]), with a significant interaction (p-interaction=0.025). Conclusions: Between the underweight and normal weight groups, the association between the BMI and clinical outcomes was consistent regardless of the presence of diabetes. However, better outcomes in overweight to obese over normal weight were observed only in diabetic patients. These results suggest that the association between BMI and clinical outcomes may differ according to the diabetic status.

• The Journal of Internal Korean Medicine
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• v.43 no.4
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• pp.606-624
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• 2022

Objective: The aim of this study was to compare the effects of different doses of Geumnyeonyijin-tang (GNYJT) water extracts with those of metformin (250 mg/kg) in mild diabetic-obese mice. Methods and Results: The 48 mice were divided into 1 normal pellet diet (NFD) group and 5 high-fat diet (HFD) groups. At the end of 12 weeks of oral administration of metformin (250 mg/kg) or GNYJT water extracts (400, 200, or100 mg/kg), the effects were evaluated. The HFD control mice showed noticeable increases in body weight, adipose tissue density, fat pad weight of the periovarian and abdominal wall, and insulin, blood glucose, and HbA1c levels, with decreases in serum HDL levels. Increases in the periovarian and dorsal abdominal fat pad, regions of steatohepatitis, adipocyte hypertrophy, and hepatocyte hypertrophy were also discovered. The HFD group showed a decline in glucose levels and elevation of hepatic gluconeogenesis, suggesting an HFD-induced AMPK downregulation related to glucose dysregulation, as well as lipid metabolism related to obese insulin-resistant type II diabetes, dyslipidemia, and oxidative stress related diabetic hepatopathy (non-alcoholic fatty liver disease, NAFLD). Conclusion: Assessment of the key parameters for inhibition of diabetes and related complications in HFD-fed diabetic-obese mice demonstrated that GNYJT water extracts have favorable ameliorating effects. The effect of GNYJT was manifested through the stimulation of AMPK upregulation of related hepatic glucose enzyme activities and expression of lipid metabolism-related genes. Therefore, appropriate oral dosages of GNYJT could be promising as a new preventive candidate for controlling diabetes and related complications. Further screening of biologically active compounds, elucidation of detailed mechanisms, and more animal studies are warranted.