• Title/Summary/Keyword: Type 1 diabetes.

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Lithium and exercise ameliorate insulin-deficient hyperglycemia by independently attenuating pancreatic α-cell mass and hepatic gluconeogenesis

  • Su-Ryun Jung;Ji-Hye Lee;Hanguk Ryu;Yurong Gao;Jaemin Lee
    • The Korean Journal of Physiology and Pharmacology
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    • v.28 no.1
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    • pp.31-38
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    • 2024
  • As in type 1 diabetes, the loss of pancreatic β-cells leads to insulin deficiency and the subsequent development of hyperglycemia. Exercise has been proposed as a viable remedy for hyperglycemia. Lithium, which has been used as a treatment for bipolar disorder, has also been shown to improve glucose homeostasis under the conditions of obesity and type 2 diabetes by enhancing the effects of exercise on the skeletal muscles. In this study, we demonstrated that unlike in obesity and type 2 diabetic conditions, under the condition of insulin-deficient type 1 diabetes, lithium administration attenuated pancreatic a-cell mass without altering insulin-secreting β-cell mass, implying a selective impact on glucagon production. Additionally, we also documented that lithium downregulated the hepatic gluconeogenic program by decreasing G6Pase protein levels and upregulating AMPK activity. These findings suggest that lithium's effect on glucose metabolism in type 1 diabetes is mediated through a different mechanism than those associated with exercise-induced metabolic changes in the muscle. Therefore, our research presents the novel therapeutic potential of lithium in the treatment of type 1 diabetes, which can be utilized along with insulin and independently of exercise.

Role of Innate Immunity in Diabetes and Metabolism: Recent Progress in the Study of Inflammasomes

  • Lee, Myung-Shik
    • IMMUNE NETWORK
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    • v.11 no.2
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    • pp.95-99
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    • 2011
  • Type 1 diabetes is one of the classical examples of organ-specific autoimmune diseases characterized by lymphocytic infiltration or inflammation in pancreatic islets called 'insulitis'. In contrast, type 2 diabetes has been traditionally regarded as a metabolic disorder with a pathogenesis that is totally different from that of type 1 diabetes. However, recent investigation has revealed contribution of chronic inflammation in the pathogenesis of type 2 diabetes. In addition to type 2 diabetes, the role of chronic inflammation is being appreciated in a wide variety of metabolic disorders such as obesity, metabolic syndrome, and atherosclerosis. In this review, we will cover the role of innate immunity in the pathogenesis of metabolic disorders with an emphasis on NLRP3.

Egg consumption is associated with a lower risk of type 2 diabetes in middle-aged and older men

  • Lee, Jieul;Kim, Jihye
    • Nutrition Research and Practice
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    • v.12 no.5
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    • pp.396-405
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    • 2018
  • BACKGROUND/OBJECTIVES: This prospective study examined gender-specific associations between egg intake and the risk of developing type 2 diabetes using data from a large-scale cohort study. SUBJECTS/METHODS: A total of 7,002 Korean adults (40-69 years) without type 2 diabetes at baseline were analyzed. Dietary intake was evaluated by a food frequency questionnaire administered at baseline (2001-2002) and the second follow-up examination (2005-2006). Type 2 diabetes was diagnosed as a fasting glucose concentration ${\geq}126mg/dL$ or current use of glucose-lowering medications or insulin injection. Multivariate Cox proportional hazard models were used to calculate hazard ratios (HRs) with 95% confidence intervals (CIs) for incident type 2 diabetes according to egg consumption or cholesterol intake. RESULTS: During a 14-year follow up period, 857 subjects developed type 2 diabetes. In men, frequent egg intake (2- < 4 servings/week) was associated with a 40% lower risk of developing type 2 diabetes than infrequent egg intake (0- < 1 serving/week) (HR = 0.60, 95% CI: 0.37-0.97), whereas no association between egg intake and incidence of type 2 diabetes was observed in women (HR = 0.61, 95% CI: 0.27-1.37). There was no association between cholesterol intake and risk of incident type 2 diabetes in either men or women. CONCLUSIONS: Egg consumption was inversely related to the risk of incident type 2 diabetes in men, but not in women, suggesting gender differences in the relationship between diet and disease risk.

Healthcare coaching program for youth with type 1 diabetes in South Korea: a pilot study

  • Dae Eun Lee;Haejung Lee;Chong Kun Cheon;Ju Young Yoon
    • Child Health Nursing Research
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    • v.30 no.1
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    • pp.17-30
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    • 2024
  • Purpose: This pilot study aimed to assess the feasibility, preliminary efficacy, and effects of a mobile app healthcare coaching program developed based on self-regulation theory among youths with type 1 diabetes. Methods: A mixed-method design was utilized. Participants were randomly assigned into intervention (n=23, 12-week coaching program) or control groups (n=16, usual care). Pre- and post-intervention assessments included self-efficacy, diabetes management behavior, and health outcomes (quality of life, depression, and HbA1c). Quantitative data were analyzed with SPSS/WIN ver. 26.0. The narrative information from the participants in the healthcare coaching program underwent content analyzed. Results: The intervention group had significantly lower depression scores (t=2.57, p=.014) than the control group. No significant differences were observed in self-efficacy, diabetes management behavior, and health outcomes between the two groups. The average frequency of health behavior monitoring per week among the participants was 1.86±1.60. The qualitative findings indicated that participants perceived improved diabetes self-management with the intervention; however, challenges during vacations, dietary control difficulties, and a lack of disease awareness were identified. Conclusion: The healthcare coaching program improved psychological aspects for youth with type 1 diabetes. Further research is needed to develop and implement mobile app interventions aimed at enhancing compliance with diabetes management in pediatric and adolescent populations.

Diabetes and depression

  • Jeon, Eon-Ju
    • Journal of Yeungnam Medical Science
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    • v.35 no.1
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    • pp.27-35
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    • 2018
  • Diabetes and depression are serious chronic conditions. As a result of their increasing prevalence, diabetes and depression, together with population growth and aging, are public health issues. The rate of depression in adults with either type 1 diabetes or type 2 diabetes is high relative to the general population. The coexistence of diabetes and depression has attracted much interest. Although it is unclear whether diabetes and depression are causally linked, most studies have shown that the association between diabetes and depression might be bidirectional. Currently, emotional well-being is becoming an increasingly important aspect of diabetes care and self-management. Psychiatric disorders and diabetic distress among people with diabetes may increase the risk of diabetes complication and mortality. Thus, assessment and appropriate management of depression in people with diabetes should be considered to achieve psychological well-being and optimize medical outcomes.

A Study on Self Management, Hemoglobin A1c (HbA1c), and Perceived Health Status for the Type II Diabetes Patients (제2형 당뇨병 환자의 자가관리, 당화혈색소 및 주관적 건강상태)

  • Park, Ju-Young
    • Journal of Korean Biological Nursing Science
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    • v.12 no.2
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    • pp.106-113
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    • 2010
  • Purpose: This study is conducted to examine the relationship among self management, HbA1c, and perceived health status of type II diabetes patients in community health department. Methods: Data were collected from 93 type II diabetes patients who are registered at five community health center using comprehensive survey, modified self care behavior, blood glucose and HbA1c were assessed by nurses. The data was analyzed by the SPSS (14.0) computer program, and it included descriptive statistics, t-test, ANOVA, and pearson's correlation coefficient. Results: There was significant relationship between perceived health status and HbA1c (r=-.252, p=.015). There was significant relationship between self management and HbA1c (r=-.279, p=.007). Conclusion: In order to control blood glucose in the type II diabetes patients, it is necessary to develop supportive self management programs by considering perceived health status.

Latent Autoimmune Diabetes in Adults: A Review on Clinical Implications and Management

  • Pieralice, Silvia;Pozzilli, Paolo
    • Diabetes and Metabolism Journal
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    • v.42 no.6
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    • pp.451-464
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    • 2018
  • Latent autoimmune diabetes in adults (LADA) is a heterogeneous disease characterized by a less intensive autoimmune process and a broad clinical phenotype compared to classical type 1 diabetes mellitus (T1DM), sharing features with both type 2 diabetes mellitus (T2DM) and T1DM. Since patients affected by LADA are initially insulin independent and recognizable only by testing for islet-cell autoantibodies, it could be difficult to identify LADA in clinical setting and a high misdiagnosis rate still remains among patients with T2DM. Ideally, islet-cell autoantibodies screening should be performed in subjects with newly diagnosed T2DM, ensuring a closer monitoring of those resulted positive and avoiding treatment of hyperglycaemia which might increase the rate of ${\beta}-cells$ loss. Thus, since the autoimmune process in LADA seems to be slower than in classical T1DM, there is a wider window for new therapeutic interventions that may slow down ${\beta}-cell$ failure. This review summarizes the current understanding of LADA, by evaluating data from most recent studies, the actual gaps in diagnosis and management. Finally, we critically highlight and discuss novel findings and future perspectives on the therapeutic approach in LADA.

Interaction Effects between Individual Socioeconomic Status and Regional Deprivation on Onset of Diabetes Complication and Diabetes-Related Hospitalization among Type 2 Diabetes Patients: National Health Insurance Cohort Sample Data from 2002 to 2013 (개인의 사회경제적 수준과 지역의 사회경제적 수준의 상호작용이 제2형 당뇨 환자에서 당뇨합병증 발생 및 당뇨와 관련된 입원에 미치는 영향: 2002-2013년 국민건강보험공단 표본 코호트 자료를 활용하여)

  • Jang, Jieun;Ju, Yeong Jun;Lee, Doo Woong;Lee, Sang Ah;Oh, Sarah Soyeon;Choi, Dong-Woo;Lee, Hyeon Ji;Shin, Jaeyong
    • Health Policy and Management
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    • v.31 no.1
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    • pp.114-124
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    • 2021
  • Background: In this study, we aimed to investigate the interaction effects of individual socioeconomic status and regional deprivation on the onset of diabetes complications and diabetes-related hospitalization among type 2 diabetes patients. Methods: Korean National Health Insurance Service National Sample Cohort data from 2002 to 2013 were used. A total of 50,954 patients newly diagnosed with type 2 diabetes from 2004 to 2012 and aged 30 years or above were included. We classified patients into six groups according to individual income level and neighborhood deprivation: 'high in advantaged,' 'high in disadvantaged,' 'middle in advantaged,' 'middle in disadvantaged,' 'low in advantaged,' and 'low in disadvantaged.' We calculated hazard ratios (HR) of onset of diabetes complication and diabetes-related hospitalization using the Cox proportional hazard model, with the reference group as diabetes patients with high income in advantaged regions. Results: In terms of the interaction effects of individual income level and regional socioeconomic level, even with the same low individual income level, the group with a high regional socioeconomic level (low in advantaged) showed low HRs for the onset of diabetes complication (HR, 1.04; 95% confidence interval [CI], 1.00-1.08) compared to the 'low in disadvantaged' group (HR, 1.10; 95% CI, 1.05-1.16). In addition, the 'high in advantaged' group showed slightly higher HRs for the onset of diabetes complication (HR, 1.06; 95% CI, 1.00-1.11) compared to the 'low in advantaged' and it appeared to be associated with slight mitigation of the risk of diabetes complication. For the low-income level, the patients in disadvantaged regions showed the highest HRs for diabetes-related hospitalization (HR, 1.29; 95% CI, 1.19-1.41) compared to the other groups. Conclusion: Although we need to perform further investigations to reveal the mechanisms that led to our results, interaction effects individual socioeconomic status and regional deprivation might be associated with on onset of diabetes complications and diabetes-related hospitalization among type 2 diabetes patients.

Factors Affecting the Self-Management of Adolescents with Type 1 Diabetes Mellitus based on the Information-Motivation-Behavioral Skills Model (제1형 당뇨병 청소년의 자기관리 영향요인: 정보-동기-행동기술 모델을 기반으로)

  • Lee, Hooyun;Choi, Eun Kyoung;Kim, Heejung;Kim, Ho-Seong;Kim, Hee-Soon
    • Child Health Nursing Research
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    • v.25 no.2
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    • pp.234-243
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    • 2019
  • Purpose: The purpose of this study was to investigate associations between self-management and diabetes knowledge, diabetes-related attitudes, family support, and self-efficacy in adolescents with type 1 diabetes mellitus based on the information-motivation-behavior skills model. Methods: Data collection was conducted between March 18 and September 30, 2018. Patients (N=87) aged 12 to 19 years were recruited from the outpatient clinic of S children's hospital and an online community for patient with type 1 diabetes mellitus. Data were analyzed using descriptive statistics, the independent t-test, one-way ANOVA, Pearsons correlation, and hierarchical multiple linear regression with SPSS IBM 23.0, with the two-tailed level of significance set at 0.05. Results: The mean score of self-management in adolescents with type 1 diabetes mellitus was $61.23{\pm}10.00$ out of 80. The regression analysis showed that self-efficacy and family support significantly explained 56.9% of the variance in self-management (F=21.38, p<.001). Self-efficacy (${\beta}=.504$, p<.001) and family support (${\beta}=.188$, p<.001) were significant predictors of self-management. Conclusion: It is necessary to develop individual interventions to improve self-efficacy and family support for adolescents with type 1 diabetes mellitus to help them enhance their self-management.

Effect of a Self Lead Camp for Type 1 Diabetes on Depression, Anxiety, Self-respect and Self-efficacy with Type 1 Diabetes (1형 당뇨인 자기주도 캠프가 1형 당뇨병 대상자의 우울, 불안, 자아존중감 및 당뇨관리 자아효능감에 미치는 영향)

  • Jean, Cheol;Kim, Mi Young
    • Journal of Korean Public Health Nursing
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    • v.31 no.1
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    • pp.71-83
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    • 2017
  • Purpose: It is thought to be crucial to guide diabetic children and adolescents through their adolescent period psychologically and emotionally. Therefore, we investigated what positive roles a type 1 diabetic camp program would play on subjects in terms of depression, anxiety, self-esteem and self-efficacy. Methods: This study evaluated 38 diabetic children and adolescents with type 1 diabetes who attended summer camp. Subjects were analyzed using a one-group pretest-posttest quasi-experimental research design. Results: There was a significant decrease in depression (t=3.55, p=.001) and anxiety (t=3.09, p=.004) after attending camp, as well as a significant improvement in self-efficacy (t=-3.64, p=.001). However, there was no significant change in self-esteem (t=0.14, p=.891). Conclusion: The results of this study indicate that type 1 diabetic camps are an effective intervention program to promote psychological and emotional stability among diabetic children; therefore, it is recommended that various diabetes programs related to camps be developed.