• Diabetes and Metabolism Journal
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• 제42권6호
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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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• 제47권1호
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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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• 제16권4호
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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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• 제25권1호
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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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• 제17권1호
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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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• 제2권2호
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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.

• 대한의생명과학회지
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• 제30권2호
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• pp.65-72
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• 2024

The national diabetes and prediabetes prevalence rate has risen among Korean adolescents and adults. Type 2 diabetes mellitus (T2DM) is commonly interrelated with genetic, metabolic, and environmental risk factors in clinical practice. In this study, we analyzed the association between genetic polymorphisms of the ABO gene with T2DM in the Korean population, we conducted an analysis of gene-phenotype correlation, based on an additive genetic model. A total of 8,840 subjects from the Korea Association REsource (KARE) were selected for this study. Using the genetic and epidemiologic data of 754 T2DM cases and 5721 normal controls from the KARE, single nucleotide polymorphisms (SNPs) in the ABO gene were analyzed for their genetic correlation. As a result, 8 SNPs out of the ABO gene demonstrated statistically significant association with T2DM. Among them, rs657152 in the ABO gene statistically showed the most significant correlation with T2DM (P-value=0.0084, OR=1.15, CI=1.04~1.28). The minor allele of A polymorphism within the intron genetic region of ABO directed increased risk of T2DM. This work reveals a significant association between genetic polymorphism in the ABO gene and T2DM. This finding suggested that ABO SNPs markers might be a genetic correlation to the etiology of T2DM.

• Journal of Nutrition and Health
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• 제57권3호
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• pp.282-291
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• 2024

Purpose: Korean patients with type 2 diabetes mellitus (T2DM) and obesity are at a high risk of developing severe non-alcoholic fatty liver disease (NAFLD). This study examined the dietary intakes and compared the risks of NAFLD-related complications in Korean patients with T2DM and obesity. Methods: Data from the Korean National Diabetes Program cohort were used to study patients with T2DM. Two hundred and sixty-five obese patients with T2DM (body mass index ≥ 25 kg/m²) were classified into NAFLD and non-NAFLD groups. The nutrient intake was analyzed using a 24-hour dietary recall questionnaire. Anthropometric and biochemical data were also obtained. Statistical analyses were performed to determine the significant differences between the 2 groups. Results: The serum gamma-glutamyl transpeptidase levels in obese patients with T2DM and NAFLD were significantly higher than in obese T2DM patients without NAFLD (p < 0.05). The serum glucose and lipid profiles showed no significant differences between the NAFLD and non-NAFLD groups. The carbohydrate, protein, and fat levels also did not differ significantly. The results showed that the fiber intake of the NAFLD and non-NAFLD groups was 14.11 ± 3.86 g/100 kcal and 15.70 ± 4.56 g/1,000 kcal, respectively, showing that the dietary fiber intake of the non-NAFLD group was significantly higher (p < 0.05). A correlation was observed between total fiber intake and γ-glutamyl transpeptidase in either patient group. In addition, the odds ratio of developing NAFLD was 0.29× lower when the fiber was consumed at 125% of adequate intake. Conclusions: A higher dietary fiber intake may reduce the risk of NAFLD in obese patients with T2DM. The dietary intake of Korean obese patients with T2DM should include and be enriched in dietary fiber to aid in preventing and treating NAFLD.

• Journal of Nutrition and Health
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• 제56권4호
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• pp.377-390
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• 2023

본 연구는 한국인을 대상으로 제2형 당뇨병 환자와 질병이 없는 정상대조군을 비교하여 성별에 따른 체액 불균형 정도와 영양소 섭취량을 평가하고자 하였다. 조사대상자는 총 57명으로, T2DM이 있는 T2DM군 (n = 36)과 T2DM이 없는 정상대조군 (n = 21)으로 나누어 분석하고, 성별에 따른 체액량의 차이를 고려하여 남성 T2DM군 (n = 24), 남성 정상대조군 (n = 9), 여성 T2DM군 (n = 12), 여성 정상대조군 (n = 12)으로 세분화하여 지표들의 특징을 분석하였다. BIA를 통하여 연구대상자의 체액 조성을 분석한 결과, ECW/ICW는 T2DM군이 정상대조군보다 유의적으로 높았고, 부종지수를 나타내는 ECW/TBW는 T2DM군이 정상대조군보다 유의적으로 높게 나타났다. 성별에 따른 체액 조성을 분석한 결과, 남성과 여성 모두 T2DM군은 정상대조군보다 높은 ECW/ICW, ECW/TBW를 보이며 동일한 체수분율 양상이 나타났다. 식사일기를 통해 연구대상자의 영양소 섭취량을 분석한 결과, 1,000 kcal 당 탄수화물, 식이섬유, 비타민 A, 비타민 C, 나트륨, 칼륨 섭취량은 T2DM군이 정상대조군보다 많았고, 1,000 kcal 당 지방, 콜레스테롤 섭취량은 T2DM군이 정상대조군보다 적었다. 본 연구를 통해 T2DM 환자에게서 체액 불균형이 나타날 가능성이 높음을 알 수 있었으며 추후 당뇨 합병증의 평가, 진단의 기초 자료로 널리 활용될 것으로 사료된다.

• 대한임상검사과학회지
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• 제53권1호
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• pp.81-87
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• 2021

제2형 당뇨병(T2DM)과 그 유병률은 전세계적으로 증가하고 있다. T2DM은 인슐린 저항성이 높아지고 인슐린 분비가 감소해 발생하는 당뇨병의 가장 흔한 유형 중 하나다. 과산화물 증식활성수용체 감마 공활성제 1 알파(PPARGC1A)는 미토콘드리아 생물 발생의 마스터 조절기와 간에서 포도당신합성에 관여한다. 본 연구에서는 T2DM이 있는 한국인 중년층의 PPARGC1A 유전자의 유전적 다형성을 분석하였다. 그 결과, PPARGC1A 유전자 중 15개의 SNP가 T2DM과 통계적으로 유의한 연관성을 보였으며, 그 중 PPARGC1A 유전자의 rs10212638은 T2DM (P=0.015, OR=1.29, CI=1.05~1.59)과 통계적으로 가장 큰 유의한 상관관계를 보였다. PPARGC1A의 마이너 유전자형(minor allele) G는 T2DM의 위험을 증가시켰다. 본 연구는 T2DM와 PPARGC1A의 유전적 다형성 사이에 유의한 연관성을 보여주고 있다. 이러한 결과는PPARGC1A의 SNP가 T2DM의 병의 원인이 되는 유전적 연관성이 있음을 시사한다.