• The Journal of Internal Korean Medicine
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• v.45 no.2
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• pp.303-313
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• 2024

Introduction: We describe the effects of Sosiho-tang decoction and insulin combination therapy, as well as the effect of integrated traditional Korean medicine therapy, using continuous glucose monitoring (CGM) in a diabetic patient complaining of a range of diabetic symptoms. Case report: A 24-year-old female presented with symptoms of diabetes, including weight loss, thirst, and polyuria, and was diagnosed with type 2 diabetes through blood tests, endocrine tests, and autoantibody tests. During hospitalization, the patient received insulin therapy and Sosiho-tang decoction concurrently, achieving normal blood glucose levels. After discharge, adhering to the Sosiho-tang decoction and CGM enabled the insulin dosage to be gradually reduced while maintaining normal blood glucose levels. Conclusion: Combination therapy with insulin and Sosiho-tang rapidly reduced hyperglycemia in the short term. CGM post-discharge allowed for observation of the patient's blood glucose levels. Ultimately, Sosiho-tang medication lowered blood glucose levels, reduced insulin requirements, and facilitated a reduction in the insulin dosage.

• Journal of Nutrition and Health
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• v.31 no.2
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• pp.117-125
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• 1998

Mulberry leaves(Mori folium) and silkworm(Bombyx mori) are potnet inhibiters of intestinal $\alpha$-glycosidase, and inhibit the digestion of starch and sucrose in the small intestine. They are able to prevent postprandial hyperglycemia and decrease blood insulin levels. In this study , a high-carbohydrate diet(CHO ; 67.5%, protein ; 20.8%, fat : 11.7%) was received by the control group. In contrast, the experimental groups received a high-carbohydrate diet with extracts of mulberry leaves and silkwork(50mg.100g diet), and acarbose(6.7mg/100g diet). after a 10 week study period , the experimental groups had lower blood glucose and triglyceride levels. The experimental groups tended to have lwer Hb Alc levels. Also, blood insulin levels were lower than the control groups in accordance with blood glucose levels. The activities of intestinal $\alpha$-glucosidase in the middle and distal parts of small intestine were induced by the extracts of mulberry leaves and silkworm in the experimental groups. However, the activities of liver lysosomal glucosidase and the contents of glycogen in the liver were not affected by the mulberry leave and silkworm extracts nor by acarbose. Mulberry leaves and silkworm were able to prevent sudden postprandial peaks in blood glucose as a result of $\alpha$-glycosidase, inhibition, there by decreasing unnecessary insulin secretion.

• Journal of the Korean Society of Physical Medicine
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• v.13 no.1
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• pp.11-26
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• 2018

PURPOSE: The aim of this study was to review the effects of exercise intervention on blood glucose control in obese type 2 diabetic patients. METHODS: The PubMed and KERISS search engines were used and 61 papers that met the key questions were selected. RESULTS: Exercise is an effective intervention for the control of blood glucose in type 2 diabetic patients because it does not impair glucose transport in the skeletal muscle induced by muscle contractions. Insulin resistance, which is characteristic of type 2 diabetes, is caused by decreased insulin sensitivity or insulin responsiveness. Acute exercise improves the glucose metabolism by increasing the insulin-independent signaling pathways and insulin sensitivity in the skeletal muscle, and regular long-term exercise improves the skeletal muscle insulin responsiveness and systemic glucose metabolism by increasing the mitochondrial and GLUT4 protein expression in the skeletal muscle. CONCLUSION: The improvement of the glucose metabolism through exercise shows a dose-response pattern, and if exercise consumes the same number of calories, high intensity exercise will be more effective for the glucose metabolism. On the other hand, it is practically difficult for a patient with obese type 2 diabetes to control their blood glucose with high intensity or long-term exercise. Therefore, it will be necessary to study safe adjuvants (cinnamic acid, lithium) that can produce similar effects to high-intensity and high-volume exercises in low-intensity and low-volume exercises.

• Korean Journal of Pharmacognosy
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• v.33 no.1 s.128
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• pp.21-28
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• 2002

Antidiabetic effects of the acid hydrolysate of silk fibroin were investigated by oral administration to animal models for diabetes mellitus, Fibroin protein was extracted from cocoon and digested to peptides of low-molecular weight range (mainly below 3,000) and amino acids by acid hydrolysis, Feeding of the fibroin hydrolysate resulted in a significant recovering effect on reduction of body weight gain and a lowering effect on blood glucose gain in streptozotocin-induced diabetic Sprague Dawley rats (STZ rats) which were used as an insulin-dependent diabetic animal model. But the body weight and blood glucose level in C57BL/KsJ-db/db mice (db/db mice), an non-insulin-dependent diabetic animal model, were not changed significantly by the feeding, On the other hand, plasma leptin levels increased according to increased feeding amount of the hydrolysate in STZ rats and db/db mice in common, It was concluded from the results that the fibroin hydrolysate might stimulate the insulin secretion by recovering or activating pancreatic ${\beta}$ cells and result in the increased plasma leptin level. It was also deduced that the antidiabetic improvements in body weight and blood glucose gain in STZ were thought to be due to the increased insulin secretion, but in db/db mice of which the diabetic symptoms were caused by insulin resistance, the stimulated secretion of insulin was unlikely to be able to change body weight and blood glucose level significantly.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• v.21 no.1
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• pp.59-67
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• 2018

Purpose: to compare cut off points corrected for age and gender (COOP) with fixed cut off points (FCOP) for fasting plasma insulin and Homeostatic model assessment-insulin resistance (HOMA-IR) for the diagnosis of IR in obese children and adolescents and their correlation with dyslipidemia. Methods: A multicenter, cross-sectional study including 383 subjects aged 7 to 18 years, evaluating fasting blood glucose, plasma insulin, and lipid profile. Subjects with high insulin levels and/or HOMA-IR were considered as having IR, based on two defining criteria: FCOP or CCOP. The frequency of metabolic abnormalities, the presence of IR, and the presence of dyslipidemia in relation to FCOP or CCOP were analyzed using Fisher and Mann-Whitney exact tests. Results: Using HOMA-IR, IR was diagnosed in 155 (40.5%) and 215 (56.1%) patients and, using fasting insulin, 150 (39.2%) and 221 (57.7%), respectively applying FCOP and CCOP. The use of CCOP resulted in lower insulin and HOMA-IR values than FCOP. Dyslipidemia was not related to FCOP or CCOP. Blood glucose remained within normal limits in all patients with IR. There was no difference in the frequency of IR identified by plasma insulin or HOMA-IR, both for FCOP and CCOP. Conclusion: The CCOP of plasma insulin or of HOMA-IR detected more cases of IR as compared to the FCOP, but were not associated with the frequency of dyslipidemia. As blood glucose has almost no fluctuation in this age group, even in the presence of IR, fasting plasma insulin detected the same cases of IR that would be detected by HOMA-IR.

• Nutrition Research and Practice
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• v.15 no.1
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• pp.54-65
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• 2021

BACKGROUND/OBJECTIVES: This study aimed to develop healthy, appetizing high-protein snacks with enhanced isolated soy protein for diabetic patients and determine the blood glucose and insulin response after being consumed by these patients. MATERIALS/METHODS: Thirty adult patients aged between 30 and 75 years, with a ≤ 10-year history of type 2 diabetes and hemoglobin A1c of < 7.5%, were enrolled in this study. They made 3 clinical visits at one-week intervals. The control group consumed 50 g carbohydrates (white bread), whereas the test groups consumed high-protein grain (HP_G) or high-protein chocolate (HP_C) after an 8-hrs fast. Blood (2 ㎤) was drawn at 15, 30, 45, 60, 90, and 120 min before and after consumption to analyze the blood glucose and insulin concentrations. RESULTS: Compared to the commercial snacks, the developed high-protein snacks had below-average calorie, carbohydrate, and fat content and a 2.5-fold higher protein content. In diabetic patients who consumed these snacks, the postprandial blood glucose increased between 15 min and 2 h after consumption, which was significantly slower than the time taken for the blood glucose to increase in the patients who consumed the control food product (P < 0.001). Insulin secretion was significantly lower at 45 min after consumption (P < 0.05), showing that the high-protein snacks did not increase the blood glucose levels rapidly. The incremental area under the curve (iAUC), which indicated the degree of blood sugar and insulin elevation after food intake, was higher in the control group than the groups given the 2 developed snacks (P < 0.001), and there was no significant difference in insulin secretion. CONCLUSIONS: The results of the postprandial blood glucose and insulin response suggest that high-protein snacks are potential convenient sources of high-quality protein and serve as a healthier alternative for patients with type 2 diabetes, who may have limited snack product choices. Such snacks may also provide balanced nutrition to pre-diabetic and obese individuals.

• The Journal of Internal Korean Medicine
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• v.37 no.4
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• pp.609-623
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• 2016

Objective: This study was undertaken to investigate the effects of Mori folium on insulin resistance and adipose tissue inflammation in an experimental mouse model of obesity.Methods: Obesity was induced in C57BL/6 mice by feeding them a high-fat diet. The mice were divided into four groups (n=6): a normal diet, high-fat diet, high-fat diet with 40 mg of Mori folium, and high-fat diet with 800 mg of Mori folium groups. After 13 wk, the body weights, fasting blood glucose and fasting serum insulin levels, insulin resistance (homeostatic model assessment) levels, oral glucose tolerance test levels, epididymal fat and liver weights, and gene expression of tumor necrosis factor-α, interleukin-6, and interferon-γ were measured. In addition, adipose tissue macrophages were analyzed by fluorescence-activated cell sorting.Results: Mori folium significantly reduced blood glucose levels, oral glucose tolerance levels, and liver weights. It also reduced adipose tissue macrophage numbers and tumor necrosis factor receptor-α gene expression.Conclusions: These results show that Mori folium has insulin resistance reduction and anti-inflammatory effects in an experimental mouse model of obesity.

• Journal of Korean Society of Occupational and Environmental Hygiene
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• v.19 no.1
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• pp.30-38
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• 2009

The objective of this study was to evaluate the effects of occupational exposure to styrene on the components of metabolic syndrome. We surveyed 263 employees, among whom 117workers we ere chronically exposed to styrene in glass-reinforced plastic boat manufacturing factories and 146 controls had never been occupationally exposed to styrene as will as hazardous chemicals. The general and job characteristics such as age, smoking and drinking habit, working hours and duration were not significant different except sleeping hours(p<0.05). Among the components of metabolic syndrome, the systolic blood pressure, total cholesterol, HDL-cholesterol and fasting glucose were significantly higher in exposed workers. On multiple logistic regression analysis for the components of metabolic syndrome, waist circumference was insulin (OR=1.129), blood pressure was MA(OR=14.724), fasting glucose(OR=1.191) and metabolic syndrome(OR=1.110) were significantly associated with insulin. The mean concentration of airborne styrene was $ 38.1{\pm}40.1$ ppm, blood concentrations of glucose and insulin and levels of HOMA-IR in over 50 ppm exposed group were higher than in blow 50 ppm exposed group. These results suggested that the exposure of styrene affects blood pressure, fasting glucose and insulin levels and that dysfunction and/or declination in glucose and insulin metabolism might induced ultimately insulin resistance and metabolic syndrome.

• The Korean Journal of Pharmacology
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• v.7 no.1
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• pp.53-65
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• 1971

It is well known that diabetes mellitus is associated with metabolic derangements, such as hyper-glycemia, ketosis, glycosuria, and also widespread alterations in the blood vessels, kidneys, eyes, peripheral nerves and heart. It is also recognized that healing of skin wound is delayed in diabetics. In bone, according to Aegerter, osteopenia develops in diabetes mellitus and it is chiefly ascribed to overutilization of protein. Shim claims that total blood flow to the entire skeletal system is approximately 4 to 8 percent of resting cardiac output and blood supply to the skeletal system would be decreased on account of secondary arteriosclerotic changes in the diabetics. An adequate blood supply is an essential factor in the healing process of fracture, and disturbed blood flow, either local or systemic, will invariably delay union of the fragments or the fragments from being fused. As the author has encountered several cases of diabetics in whom healing of fracture was delayed or incomplete, this experimental study was undertaken to elucidate the effects of hyperglycemia and diabetes mellitus on the healing process of fracture. In this experiment adult albino rabbits, weighing about 2 kg. were used and divided into 6 groups. The femur of each animal was fractured surgically, and then the healing process of fracture was periodically checked by radiography at an interval of one week for a period of 6 weeks. Thereafter, all the rabbits were killed to obtain tissue preparation of the femur. The experimental groups were as follows; 1) Control group: Six rabbits sustained a surgical fracture to the femur, without being given any other treatment or drug. 2) Alloxan-treated group: For inducing diabetes, alloxan was given intravenously to 17 rabbits in various dose as follows; to 7 of them 40 mg/kg, to 6 rabbits 80 mg/kg and to 4 rabbits 120 mg/kg of body weight, respectively. 3) Insulin-treated group: Protamine-zinc insulin was injected subcutaneously to each of 6 rabbits in a daily dose of 1 unit per kilogram of body weight. 4) Group treated with insulin after alloxan: Four rabbits were given 80 mg of alloxan once and than 1 unit of insulin per kilogram of body weight daily. Another 5 rabbits were injected 1 unit of insulin per kg of body weight daily following administration of alloxan in a dose of 120 mg/kg. 5) Homotransplantation group: Following intravenous injection of alloxan in a dose of 120 mg/kg, 10 rabbits underwent homotransplantation of a short bone segment to the femur. Five of them were subsequently given 1 unit/kg of insulin daily. 6) Sugar-treated group: six rabbits were fed $15{\sim}20$ gm of sugar daily throughout the period of experiment. The results obtained are summarized as follows; 1. Blood sugar level and damage to the pancreatic islet increased proportionately when alloxan was given to the rabbits in various doses. No appreciable change could be observed in the islets when the blood sugar level was altered by either oral administration of sugar or subcutaneous injection of insulin. 2. Comparing with the control group, healing of fracture was delayed in the alloxan-treated group, while callus formation and periosteal reaction were shown to be more prominent in this group and subsequently, the ultimate osseous tissue formed at the fracture site was significantly smaller in amount and less compact. These findings were more marked as the amount of alloxan increased. 3. Administration of insulin prevented the delay in healing process of fracture in the rabbits with alloxan-induced hyperglycemia. In this case, the course and progression of fracture healing were almost similar to those of control group. 4. Union between the host bone and the fragment transplanted from other rabbit of the same species was more delayed in the group treated with alloxan alone than in the group to which insulin was administered after development of alloxan-induced diabetes. In both groups periosteal new bone developed from the ends of the host bone, above and below the transplanted fragment, and directly fused with failure of periosteal callus to bridge the adjacent ends of the host bone and the transplanted fragment. 5. The healing process of fracture was not inhibited by alteration in blood sugar level when the blood sugar was abnormally increased by excessive sugar intake or lowered by administration of insulin alone. The healing of fracture in these groups progressed similarly as in the control group. In brief summary, it appears that the healing process of fracture would be definitely disturbed in diabetic state brought about by damage to the pancreatic islet. As such an inhibition could be overcome with insulin, it seems that insulin plays an important role in healing of fracture, but alteration in blood sugar level alone does not modify healing process of fracture to significant degree.

• Biomedical Science Letters
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• v.15 no.4
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• pp.281-286
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• 2009

We found previously that Undaria pinnatifida extract has an effect of lowering blood glucose levels in diabetic rats. Therefore, an effect of Undaria pinnatifida extract on the insulin secretion directly from the pancreas was examined in this study. Neonatal diabetes were induced by intraperitoneal injection of Streptozotocin (100 mg/kg body weight) at age of day 1. Rats were fed a rodent pellet diet until they were grown to adults (age of 7 weeks). Rats having a fasting serum glucose level over 250 mg/dL were used in this feeding study and they were divided into two diet groups as follows; a diet with Undaria pinnatifida extract (5%) and a diet without this extract (control group). Fasting (12 hr) blood glucose and serum insulin levels were measured before and after feeding a diet with Undaria pinnatifida extract for 4 weeks. At the last day of feeding, in vitro pancreas perfusion was performed. Pancreas was stimulated with a perfusate without glucose during a period of 0~10 minutes and with a perfusate containing 200 mg/dL glucose during a period of 11~40 minutes. Insulin amount was measured using a radioimmuno assay. In results, amount of the insulin secreted from the pancreas in the diabetic rats fed Undaria pinnatifida extract was significantly greater than that in the diabetic control group during the periods of the equilibration period (0~10 min) and the first phase (11~20 min) of the insulin secretion (P<0.05). It is concluded that Undaria pinnatifida extract increases insulin secretion from the pancreas in the neonatal diabetic rats. Therefore, the blood glucose lowering effect of the Undaria pinnatifida extract may be elucidated by mechanisms with promoted insulin secretion from the pancreas in diabetic rats.