• Childhood Kidney Diseases
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• v.13 no.2
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• pp.242-247
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• 2009

Type 1 diabetes mellitus (T1DM) commonly occurs in childhood and adolescence and diabetic nephropathy is a serious metabolic complication of T1DM that leads to serious morbidity. With poor glycemic control prepubertal diabetes duration contributes to the risk of long-term microvascular complications, however, the younger age at onset or longer prepubertal diabetes duration seems to prolong the time to development of microalbuminuria or later end-stage renal disease (ESRD). Therefore, there have been a few cases of diabetic nephropathy in prepubertal patients and therefore the ESRD cases developed during adolescence in T1DM children were very rare. Here we report an adolescent with T1DM who had poor glycemic control and was diagnosed as diabetic nephropathy in a prepubertal period and leading to end-stage renal disease during adolescence.

• 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.

• Clinical and Experimental Pediatrics
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• v.51 no.6
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• pp.569-575
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• 2008

Type 1 diabetes mellitus (T1 DM) develops in genetically susceptible individuals as a result of progressive autoimmune destruction of beta cells. There is larger global variation in incidence among children aged 0-14 years. The incidence of T1 DM in Korea is very low. The latest survey in Korea was conducted in 2001 by Korean Society of Pediatrics to analyse the childhood (0-14 years) national-wide incidence during 1 995-2000. The average childhood incidence (/100,000 and year) was 1.36 (95% CI: 1.23-1.48), higher than 1.06 of Korea in 1 994. This survey reported that higher mean annual incidence was observed in female (girls, 1.67 vs boy 1.07), older age group (10-14 years, 1.98; 5-9 years, 1.43; 0-4 years, 0.73), Kangwondo (2.09) and Seoul (1.99), and more new patients developed in spring (spring, 27.1%; winter, 26.6%; summer, 24.8%; autumn, 21.5%). The increase of childhood T1 DM incidence has occurred in every region (4.0% in Asia, 3.2% in Europe during 1990-1999). Also, steady increase in incidence was observed during 1985-2000 in Korea. This trends may be maintained or accelerated by environmental factors, known as triggers, modifiers and promoters of the T1 DM occurrence. The rising incidence of T1 DM suggests the need for continuous monitoring of incidence by using standardized methods in order to plan or assess prevention strategies.

• Journal of Korean Biological Nursing Science
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• v.24 no.4
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• pp.219-226
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• 2022

Purpose: This study aimed to investigate the status and factors associated with self-management behavior (SMB) of patients with type 2 diabetes (T2DM) in a border area of southwest China. Methods: A cross-sectional study was conducted with T2DM patients in Dali, China. The participants filled in the questionnaires including demographic and disease-related characteristics, psychosocial status, resources of DM knowledge, knowledge of DM care, competency in DM care skills, the Chinese Diabetes Management Self-Efficacy Scale (C-DMSES), and the Chinese Summary of Diabetes Self-Care Activities (C-SDSCA). All the data were analyzed with SPSS version 26. Multiple linear regression analysis examined associations between predictors and SMB. Results: A total of 470 valid questionnaires have been collected. The score for overall SMB was 50.71± 11.99; 19.6% of patients were at a good level, 48.3% were moderate, and 32.1% were poor. The significant factors that influenced SMB included self-efficacy (β= 0.37; p< .001), competency in DM care skills (β= 0.22; p< .001) and lacked in the treatment confidence (β= -0.09; p= .023). Conclusion: The level of self-management among T2DM patients in this area was medium-low state. For future studies, our findings suggest that self-efficacy, competency in DM care skills, and treatment confidence should be considered essential factors in improving the self-management behavior of T2DM patients in the border area of southwest China.

• Diabetes and Metabolism Journal
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• v.42 no.6
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• pp.488-495
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• 2018

Background: Skeletal muscle plays a major role in glucose metabolism. We investigated the association between thigh muscle mass, insulin resistance, and incident type 2 diabetes mellitus (T2DM) risk. In addition, we examined the role of body mass index (BMI) as a potential effect modifier in this association. Methods: This prospective study included 399 Japanese Americans without diabetes (mean age 51.6 years) who at baseline had an estimation of thigh muscle mass by computed tomography and at baseline and after 10 years of follow-up a 75-g oral glucose tolerance test and determination of homeostasis model assessment of insulin resistance (HOMA-IR). We fit regression models to examine the association between thigh muscle area and incidence of T2DM and change in HOMA-IR, both measured over 10 years. Results: Thigh muscle area was inversely associated with future HOMA-IR after adjustment for age, sex, BMI, HOMA-IR, fasting plasma glucose, total abdominal fat area, and thigh subcutaneous fat area at baseline (P=0.033). The 10-year cumulative incidence of T2DM was 22.1%. A statistically significant interaction between thigh muscle area and BMI was observed, i.e., greater thigh muscle area was associated with lower risk of incident T2DM for subjects at lower levels of BMI, but this association diminished at higher BMI levels. Conclusion: Thigh muscle mass area was inversely associated with future insulin resistance. Greater thigh muscle area predicts a lower risk of incident T2DM for leaner Japanese Americans.

• Nutrition Research and Practice
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• v.10 no.1
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• pp.67-73
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• 2016

BACKGROUND/OBJECTIVES: This study was aimed at examining the association between dietary flavanones intake and lipid profiles according to the presence of metabolic syndrome (MetS) in Korean women with type 2 diabetes mellitus (T2DM). SUBJECTS/METHODS: A cross-sectional analysis was performed among 502 female T2DM patients (non-MetS group; n = 129, MetS group; n = 373) who were recruited from the Huh's Diabetes Clinic in Seoul, Korea between 2005 and 2011. The dietary intake was assessed by a validated semi-quantitative food frequency questionnaire (FFQ) and the data was analyzed using the Computer Aided Nutritional Analysis program (CAN-Pro) version 4.0 software. The intake of flavanones was estimated on the basis of the flavonoid database. RESULTS: In the multiple linear regression analysis after adjustment for confounding factors, daily flavanones intake was negatively associated with CVD risk factors such as total cholesterol, LDL-cholesterol, and apoB and apoB/apoA1 ratio only in the MetS group but not in the non-MetS group. Multiple logistic regression analysis revealed that the odds ratio for a higher apoB/apoA1 ratio above the median (${\geq}0.74$) was significantly low in the $4^{th}$ quartile compared to that in the $1^{st}$ quartile of dietary flavanones intake [OR: 0.477, 95% CI: 0.255-0.894, P for trend = 0.0377] in the MetS group. CONCLUSIONS: Dietary flavanones intake was inversely associated with the apoB/apoA1 ratio, suggesting a potential protective effect of flavanones against CVD in T2DM women with MetS.

• 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.

• Journal of Life Science
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• v.19 no.1
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• pp.81-86
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• 2009

The purpose of the present study was to examine effect of 12 week regular aerobic exercise on ST-segment and QTc interval in middle age type 2 diabetes mellitus (T2DM) patients. The subjects consist of 13 type 2 diabetes mellitus (T2DM) patients in middle age men and all of them had no other complications. Subjects participated in aerobic exercise training for 12 weeks. They started to exercise for $20{\sim}60$ min at $60{\sim}80%$ of $HR_{max}$, (exercise intensity has been increased gradually) per day, $3{\sim}5$ times a week. The results were compared before and after. Weight and BMI, % body fat, fasting glucose, HOMA-IR, $_{peak}DBP$ were significantly decreased and $_{peak}HR$, $_{peak}VO_2$, exercisre time were significantly increased after 12 week aerobic exercise. Also, QTc interval and ST-segment were significantly decreased during at rest, peak exercise after 12 week aerobic exercise. Conclusionally, 12 week aerobic exercise may be improvement in decreased cardiovascular mortality factors (ST-segment) and abnormal autonomic dysfunction (QTc interval) and potentially increased exercise capacity.

• Journal of Periodontal and Implant Science
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• v.52 no.6
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• pp.455-465
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• 2022

Purpose: Periodontal diseases are inflammatory conditions that alter the host's response to microbial pathogens. Type 2 diabetes mellitus (T2DM) is a complex disease that affects the incidence and severity of periodontal diseases. This study investigated the gingival crevicular fluid (GCF) levels of colony-stimulating factor-1 (CSF-1) and interleukin-34 (IL-34) in patients with stage III grade C periodontitis (SIII-GC-P) and stage III grade C periodontitis with uncontrolled type 2 diabetes (SIII-GC-PD). Methods: In total, 72 individuals, including 24 periodontally healthy (PH), 24 SIII-GC-P, and 24 SIII-GC-PD patients, were recruited for this study. Periodontitis patients (stage III) had interdental attachment loss (AL) of 5 mm or more, probing depth (PD) of 6 mm or more, radiographic bone loss advancing to the middle or apical part of the root, and tooth loss (<5) due to periodontal disease. Radiographic bone loss in the teeth was also evaluated; grade C periodontitis was defined as a ratio of the percentage of root bone loss to age greater than 1.0. The plaque index (PI), gingival index (GI), presence of bleeding on probing (BOP), PD, and clinical AL were used for clinical periodontal assessments. GCF samples were obtained and analyzed using an enzyme-linked immunosorbent assay. Results: All clinical parameters-PD, AL, GI, BOP, and PI-were significantly higher in the SIII-GC-PD group than in the PH and SIII-GC-P groups for both the full mouth and each sampling site (P<0.05). The total IL-34 and CSF-1 levels were significantly higher in the SIII-GC-PD group than in the PH and SIII-GC-P groups (P<0.05), and there were significant differences between the periodontitis groups (P<0.05). Conclusions: These findings suggest that IL-34 and CSF-1 expression increases in patients with SIII-GC-PD. CSF-1 was associated with the inflammatory status of periodontal tissues and T2DM, while IL-34 was associated only with T2DM.

• Diabetes and Metabolism Journal
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• v.42 no.6
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• pp.480-487
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• 2018

Background: This study aimed to evaluate the relationship between the frequency of self-monitoring of blood glucose (SMBG) and glycosylated hemoglobin (HbA1c) levels among Korean adolescents with type 1 diabetes mellitus (T1DM). Factors affecting the SMBG frequency were analyzed in order to improve their glycemic control. Methods: Sixty-one adolescents aged 13 to 18 years with T1DM were included from one tertiary center. Clinical and biochemical variables were recorded. Factors associated with SMBG frequency were assessed using structured self-reported questionnaires. Results: Average total daily SMBG frequency was $3.8{\pm}2.1$ and frequency during the school day was $1.3{\pm}1.2$. The mean HbA1c level was $8.6%{\pm}1.4%$. As the daily SMBG frequency increased, HbA1c levels declined (P=0.001). The adjusted odds of achieving the target HbA1c in participants who performed daily SMBG ${\geq}5$ significantly increased 9.87 folds (95% confidence interval [CI], 1.58 to 61.70) compared with those performed SMBG four times a day. In the subjects whose SMBG frequency <1/day during the school day, an 80% reduction in the adjusted odds ratio 0.2 (95% CI, 0.05 to 0.86) showed compared to the group with performing two SMBG measurements in the school setting. The number of SMBG testing performed at school was significantly high for individuals assisted by their friends (P=0.031) and for those who did SMBG in the classrooms (P=0.039). Conclusion: Higher SMBG frequency was significantly associated with lower HbA1c in Korean adolescents with T1DM. It would be necessary to establish the school environments that can facilitate adequate glycemic control, including frequent SMBG.