• 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.

• Clinical and Experimental Reproductive Medicine
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• v.47 no.1
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• pp.20-33
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• 2020

Objective: The differences between type 1 and type 2 diabetes mellitus (T1DM and T2DM) in terms of their adverse effects on male reproductive parameters have never been elucidated. This study aimed to distinguish between the effects of the DM types in mice treated with multiple low doses of streptozotocin (STZ) to mimic human T1DM and coadministered a high-fat diet (HFD) to mimic human T2DM. Methods: The T1DM mice were intraperitoneally injected with STZ (40 mg/kg body weight) for 5 days. The T2DM mice received an HFD for 14 days prior to STZ injection (85 mg/kg body weight), followed by continuous feeding of an HFD. Male reproductive parameters were evaluated. Results: The reproductive organs of the DM mice weighed significantly less than those of controls, and the seminal vesicles plus prostates of the T1DM mice weighed less than those of the T2DM mice. Increased sperm abnormalities and incomplete DNA packaging were observed in the DM groups. Sperm concentration and the proportion of normal sperm were significantly lower in the T1DM group. The seminiferous histopathology of DM mice was classified into seven types. The penises of the DM mice were smaller than those of the controls; however, tunica albuginea thickness and the amount of penile collagen fibers were increased in these mice. Round germ cells were abundant in the epididymal lumens of the mice with DM. Conclusion: T1DM adversely affected reproductive parameters to a greater extent than T2DM.

• Nutrition Research and Practice
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• v.16 no.4
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• pp.505-516
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• 2022

BACKGROUND/OBJECTIVES: The association between nutritional status and health-related quality of life (HRQoL) among patients with type 2 diabetes mellitus (T2DM) is not fully understood. This study was conducted to understand the role of nutritional status on HRQoL among people with and without T2DM. SUBJECTS/METHODS: Structured survey and direct measurement of anthropometric data were conducted among people with and without T2DM. Nutritional status was measured with Mini Nutritional Assessment tool and HRQoL was measured with a 36-item Short Form Healthy Survey. Data collection was conducted in Chuncheon, South Korea with 756 participants who are older than 40 yrs of age. RESULTS: This study found that overall HRQoL were significantly lower in people with T2DM than people without T2DM after controlling for key covariates. When stratified by nutritional status, a greater degree of negative impact of T2DM on overall physical HRQoL was observed among well-nourished or at risk of malnutrition, whereas significant and more evident negative impact of diabetes on overall psychological HRQoL was observed only among malnourished. CONCLUSIONS: The study results suggest the role of nutritional status among people with T2DM on overall, especially psychological aspects of HRQoL. Future longitudinal or intervention studies are warranted to test the impact of nutritional status on HRQoL among people with T2DM.

• Annals of Clinical Neurophysiology
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• v.25 no.1
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• pp.32-37
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• 2023

Background: Type 2 diabetic mellitus (T2DM) is an emerging global pandemic which is associated with lots of co-morbidities and reported vascular dysfunctions. T2DM associated vascular dysfunctions leads to vasculopathy in the form of altered peripheral vascular dynamics. Cold stress test (CST) is a reliable sympathetic reactivity test used for assessing vascular dysfunctions. In this study we are trying to quantify vascular dysfunctions in T2DM patients non invasively by various parameters of photoplethysmography (PPG) of cold stress test. Methods: Case control study had done in referral health center AIIMS, Raipur. Parameters are recorded by finger-PPG before, during and after CST (1 min) in 2 groups, control (n = 20 healthy volunteers) and case (n = 20 diagnosed T2DM patients). Results: Due to cold stress, PPG parameter peak amplitude was significantly decreased in both healthy and T2DM groups (p <0.001 and p <0.001, respectively). However, recovery trend of amplitude was significantly slow in T2DM compared to healthy subjects. Another PPG parameter peak to peak interval was significantly higher in healthy group compared to T2DM patients. Conclusions: This study showed that T2DM patients has significant deranged pulse volume parameters like amplitude and peak to peak interval can be used to objectively quantify the vasculopathy in T2DM patients by using sympathetic reactivity to cold stress.

• Journal of Korean Biological Nursing Science
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• v.17 no.1
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• pp.71-77
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• 2015

Purpose: This study was performed to identify lower urinary tract symptoms (LUTS), and to evaluate the factors affecting LUTS in patients with type 2 diabetes mellitus (T2DM). Methods: The cross sectional study was used with a structured questionnaire to collect data through interviews with 181 T2DM patients and their clinical data from a university hospital diabetes clinic from October 2010 to April 2012. LUTS were measured using the International Prostate Symptom Score (IPSS), depression using the Center for Epidemiologic Studies Depression Scale (CES-D), and glycosylated hemoglobin (HbA1c) from the clinical data. Results: Of all patients with T2DM, the mean IPSS of LUTS was $9.34{\pm}6.86$. Concerning the reported severity of LUTS, 53.6% of the subjects were in the moderate and severe group. In each symptom score of LUTS (range 0-5), nocturia was the highest 2.04, weak stream 1.62, and frequency 1.45. LUTS was significantly predicted by HbA1c and depression, and 14.3% of the variance in LUTS was explained. Conclusion: HbA1c and depression were found to be very important factors associated with LUTS in T2DM patients.

• Journal of mucopolysaccharidosis and rare diseases
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• v.2 no.2
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• pp.35-37
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• 2016

Prader-Willi syndrome (PWS) often develops type 2 diabetes mellitus (T2DM) related to severe obesity. The prevalence of T2DM in adults with PWS (7-20%) exceeds greatly the prevalence in the general population (5-7%). It is uncommon for pre-pubertal children with PWS to develop overt diabetes or glucose intolerance. GH therapy and genotype did not influence the development of altered glucose metabolism. It has been assumed that T2DM in PWS develops as a consequence of morbid obesity and concomitant insulin resistance. However recent studies suggest the relationship between morbid obesity and T2DM development is more complex and appears to differ in PWS subjects compared to non-PWS subjects. PWS patients had relatively lower fasting insulin levels and increased adiponectin levels compared with BMI-matched obese control despite of similar levels of leptin. So PWS children may be protected to some extent form of obesity-associated insulin resistance. Although there's no data, it seems logical to approach diabetes management including weight loss and increased exercise, using similar pharmacological agents as with non-PWS obesity-related diabetes such as metformin or thiazolidinedione, with the introduction of insulin as required. On the other hand, several recent T2DM in PWS case reports suggest favorable outcomes using Glucagon-like peptide 1 (GLP-1) analog with regard to ghrelin reduction, control of glucose and appetite, weight loss and pre-prandial insulin secretion. The role of GLP-1 agonist therapy is promising, but has not yet been fully elucidated.

• Journal of Nutrition and Health
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• v.56 no.4
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• pp.377-390
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• 2023

Purpose: Diabetes mellitus (DM) causes body fluid imbalance because of hyperglycemia, but there is a lack of research on the relationship between DM and body fluid imbalance in the Korean population. This study compared the differences in body fluid composition and dietary intake between individuals with type 2 DM (T2DM) and a normal control (NC) group without the disease. Methods: In this study, 36 subjects with T2DM and 21 without diabetes were divided into the T2DM and NC groups. The subjects were divided into four subgroups to assess differences in body fluid volume according to sex: men T2DM group (n = 24), men NC group (n = 9), women T2DM group (n = 12), and women NC group (n = 12). The body fluid composition was measured using bioelectrical impedance analysis, including intracellular water (ICW), extracellular water (ECW), total body water (TBW), ECW/ICW, and ECW/TBW. Nutrient intake was evaluated using their dietary records. Results: The results showed that the ECW/ICW and the ECW/TBW were significantly higher in the T2DM group compared to the NC group. Both men and women in the T2DM group showed significantly higher ECW/ICW and ECW/TBW than the respective NC group. The T2DM group had a higher carbohydrate, dietary fiber, vitamin A, vitamin C, sodium, and potassium intake per 1,000 kcal and lower total daily energy, fat, and cholesterol intake per 1,000 kcal than the NC group. Conclusion: These results suggest a positive association between T2DM and body fluid imbalance. This study can be used widely as basic data for the evaluation and diagnosis of diabetic complications in the future.

• Korean Journal of Clinical Laboratory Science
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• v.53 no.1
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• pp.81-87
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• 2021

The prevalence of type 2 diabetes mellitus (T2DM) is increasing worldwide. T2DM is one of the most common types of diabetes and is caused by increased insulin resistance and reduced insulin secretion. Peroxisome proliferator-activated receptor γ coactivator 1 alpha (PPARGC1A) is a master modulator of mitochondrial biogenesis and of gluconeogenesis in liver. In this study, we analyzed genetic polymorphisms of PPARGC1A gene in a middle-aged Korean population with T2DM. Using the genotype data of 736 T2DM cases and 4544 healthy controls obtained from the Korean Association Resource (KARE), we analyzed genetic correlations between single nucleotide polymorphisms (SNPs) of PPARGC1A and T2DM. Fifteen SNPs of PPARGC1A demonstrated a statistically significant association with T2DM. Of these, rs10212638 exhibited the strongest correlation with T2DM (P-value=0.015, OR=1.29, CI=1.05~1.59), and the minor G allele of PPARGC1A increased the risk of T2DM. This is the first study to report a significant association between genetic polymorphisms in PPARGC1A and T2DM and suggests that SNPs of PPARGC1A display genetic correlations to the etiology of T2DM.

• Clinical and Experimental Pediatrics
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• v.54 no.2
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• pp.45-50
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• 2011

Compared to that in the Caucasian population, type 1 diabetes mellitus (T1DM) incidence rates are very low in Koreans. Therefore, compared to the recent development of pharmacological therapy applicable to Korean children with T1DM, interest in nonpharmacological therapy and psychosocial support systems remains low, as is the development of Korean-style T1DM education programs for therapeutic application. Children who have been newly diagnosed with diabetes are placed in completely new environments for treatment. For appropriate control of diabetes, patients have to self-monitor blood glucose levels and inject insulin several times a day and must use extreme self-control when they eat foods to avoid increases in blood glucose levels. Blood glucose excursions resulting from impaired pancreatic ${\beta}$ cell functions cause mental stress due to vague fears of chronic complications of diabetes. In addition, children with diabetes cannot be excluded from the substantial amount of studies required of Korean adolescents, and the absolute shortage of time for ideal control of diabetes adds to their mental stress. Many of these patients are psychologically isolated in school where they spend most of their time, and they are not appropriately considered or supported with respect to blood glucose control in many cases. In this respect, this author will introduce some of the newest views on nonpharmacological therapy and psychosocial support systems that account for important parts of T1DM management and seek measures to apply them in conformity with the social characteristics of Korea.

• Diabetes and Metabolism Journal
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• v.42 no.6
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• pp.465-471
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• 2018

My professional journey to understand the glucose homeostasis began in the 1990s, starting from cloning of the promoter region of glucose transporter type 2 (GLUT2) gene that led us to establish research foundation of my group. When I was a graduate student, I simply thought that hyperglycemia, a typical clinical manifestation of type 2 diabetes mellitus (T2DM), could be caused by a defect in the glucose transport system in the body. Thus, if a molecular mechanism controlling glucose transport system could be understood, treatment of T2DM could be possible. In the early 70s, hyperglycemia was thought to develop primarily due to a defect in the muscle and adipose tissue; thus, muscle/adipose tissue type glucose transporter (GLUT4) became a major research interest in the diabetology. However, glucose utilization occurs not only in muscle/adipose tissue but also in liver and brain. Thus, I was interested in the hepatic glucose transport system, where glucose storage and release are the most actively occurring.