• Annals of Clinical Neurophysiology
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• v.24 no.1
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• pp.7-16
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• 2022

Background: There is inadequate information on the validation of diabetic microvascular complications in the Korean National Health Insurance Service data set. We aimed to validate the diagnostic algorithms regarding the nephropathy, neuropathy, and retinopathy of diabetes. Methods: From various secondary and tertiary medical centers, we selected 6,493 patients aged ≥ 40 years who were diagnosed with diabetic microvascular complications more than once based on codes in the 10th version of the International Classification of Diseases (ICD-10). During 2019 and 2020, we randomly selected the diagnoses of 200 patients, 100 from each of two hospitals. The positive predictive value (PPV), negative predictive value, error rate, sensitivity, and specificity were determined for each diabetic microvascular complication according to the ICD-10 codes, laboratory findings, diagnostic studies, and treatment procedure codes. Results: Among the 200 patients who visited the hospital more than once and had the diagnostic codes of diabetic microvascular complications, 142, 110, and 154 patients were confirmed to have the gold standard of diabetic nephropathy (PPV, 71.0%), diabetic neuropathy (PPV, 55.0%), and diabetic retinopathy (PPV, 77.0%), respectively. The PPV and specificity of diabetic nephropathy (PPV, 71.0-81.4%; specificity, 10.3-53.4%), diabetic neuropathy (PPV, 55.0-81.3%; specificity, 66.7-76.7%) and diabetic retinopathy (PPV, 77.0-96.6%; specificity, 2.2-89.1%) increased after combining them with the laboratory findings, diagnostic studies, and treatment procedures codes. These change trends were observed similarly for both hospitals. Conclusions: Defining diabetic microvascular complications using ICD-10 codes and their related examination codes may be a feasible method for studying diabetic complications.

• Asian Pacific Journal of Cancer Prevention
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• v.17 no.1
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• pp.105-108
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• 2016

Background: Epidemiological evidence indicates that individuals with diabetes mellitus (DM) may have a modestly increased risk of bladder cancer. In the present study, we aimed to show any association between DM and risk of metastasis in patients with non-muscle-invasive bladder cancer (NMIBC). Materials and Methods: We retrospectively analyzed 698 patients between January 2007 and December 2014 who were diagnosed with and underwent transurethral resection of bladder tumors (TUR-BT). Comparisons of means was conducted by independent samples t test, and relations between categorical variables were investigated by non-parametric chi-square test. A p value of 0.05 was accepted as statistically significant in comparisons. Results: We analyzed 418 patients with non muscle invasive bladder cancer. 123 of whom were diabetic and 295 non-diabetic. In diabetic patients, 13 were N1 stage and 11 M1 stage. When compared with non diabetic patients that was statistically significant (p<0.001). TNM stages were more advanced in diabetic patients (p<0.001), but concurrent CIS (p=0.1) and squamous metaplasia did not significantly differ between diabetic and non-diabetic cases (p=1). Conclusions: Diabetic patients with non-muscle-invasive bladder cancer may suffer metastases earlier than expected although they are non invasive. Therefore such patients must be followed-up carefully and early cystectomy decision may be necessary. Further prospective studies with more patients are needed to confirm these findings.

• Journal of Korean Academy of Fundamentals of Nursing
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• v.23 no.3
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• pp.300-309
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• 2016

Purpose: This study was a descriptive survey research to identify whether characteristics of patients with type 2 diabetes mellitus, their knowledge about diabetes, and self-care behavior impacted on the level of diabetic retinopathy. Methods: Participants were 133 patients who had type 2 diabetes mellitus and were being seen at a hospital in Korea. The scale for knowledge about diabetes had 24 items, the scale for self-care behavior, 20 items, and the level of diabetic retinopathy was classified according to the international clinical diabetic retinopathy severity measurement standards. Results: The influence of the independent variables on the level of diabetic retinopathy showed that age, job, time since onset of Diabetes Mellitus, regular ophthalmologic examinations, and systolic blood pressure were identified as factors affecting the level of diabetic retinopathy. The explanation power of this regression model was 23.0% and it was statistically significant (F=5.42, p<.001). Conclusion: Early education about occurrence of diabetes related diseases, specifically diabetic retinopathy should be provided for patients from younger ages. Moreover, for disease management, social support is needed from co-workers and friends. Efforts to encouraged prevention and delay of diabetic retinopathy should include control of blood sugar and blood pressure.

• Journal of Audiology & Otology
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• v.25 no.1
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• pp.27-35
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• 2021

Background and Objectives: This study aimed to evaluate the clinical features and the clinical factors associated with prognosis of sudden sensorineural hearing loss (SSNHL) in diabetic patients. Subjects and Methods: Forty-nine diabetic with unilateral SSNHL were retrospectively included. All patients received systemic high dose steroid therapy within one month after onset and had more than one month of follow-up audiogram. The basic characteristics of the patients, initial and follow-up audiograms, laboratory data, and methods of steroid treatment were collected. Results: Compared to reference values in healthy subjects, 79%, 55%, and 45% of the patients had higher values of mean neutrophil-lymphocyte ratio (NLR), platelet-lymphocyte ratio (PLR), and lymphocyte-monocyte ratio (LMR), respectively. Older patients had significantly less degree of hearing loss, but they also had significantly worse hearing thresholds in the unaffected ear. After steroid treatment, less than half patients (47%) showed hearing recovery. Simultaneous intratympanic dexamethasone (ITD) injections with systemic steroid did not confer an additional hearing gain or an earlier recovery rate in diabetic patients with SSNHL. In the multivariate analysis, initial hearing thresholds of affected ear and timing of steroid treatment were significantly associated with hearing prognosis in diabetic patients with SSNHL. Conclusions: Diabetic patients with SSNHL tended to have increased NLR, LMR, and PLR, which are reported to be associated with microvascular angiopathy. Simultaneous ITD injections to improve hearing recovery in diabetic patients with SSNHL seems unnecessary.

• Korean Journal of Audiology
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• v.25 no.1
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• pp.27-35
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• 2021

Background and Objectives: This study aimed to evaluate the clinical features and the clinical factors associated with prognosis of sudden sensorineural hearing loss (SSNHL) in diabetic patients. Subjects and Methods: Forty-nine diabetic with unilateral SSNHL were retrospectively included. All patients received systemic high dose steroid therapy within one month after onset and had more than one month of follow-up audiogram. The basic characteristics of the patients, initial and follow-up audiograms, laboratory data, and methods of steroid treatment were collected. Results: Compared to reference values in healthy subjects, 79%, 55%, and 45% of the patients had higher values of mean neutrophil-lymphocyte ratio (NLR), platelet-lymphocyte ratio (PLR), and lymphocyte-monocyte ratio (LMR), respectively. Older patients had significantly less degree of hearing loss, but they also had significantly worse hearing thresholds in the unaffected ear. After steroid treatment, less than half patients (47%) showed hearing recovery. Simultaneous intratympanic dexamethasone (ITD) injections with systemic steroid did not confer an additional hearing gain or an earlier recovery rate in diabetic patients with SSNHL. In the multivariate analysis, initial hearing thresholds of affected ear and timing of steroid treatment were significantly associated with hearing prognosis in diabetic patients with SSNHL. Conclusions: Diabetic patients with SSNHL tended to have increased NLR, LMR, and PLR, which are reported to be associated with microvascular angiopathy. Simultaneous ITD injections to improve hearing recovery in diabetic patients with SSNHL seems unnecessary.

• Journal of Oral Medicine and Pain
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• v.6 no.1
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• pp.83-90
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• 1981

This study was undertaken to study the changes of epithelium of oral mucosa caused by diabetic disease in terms of keratinization and morphology of epithelial cells of oral mucasa, and to diagnose the oral diseases caused by systemic origns in terms of oral exfoliative cytology as a diagnostic tool. The author has studied the changes of epithelial cells on the cheek mucosa and upper antirior gingiva of 20 adult diabetic patients by Oral Exfoliative Cytology. And 50 healthy adults were selected as control group. The cytologic smears were stained by Papanicolaou method. The results were as follows : 1. In diabetic patient's cheek mucosa, Yellow staining cells were reveald as 11.8%, which was higher than the control group(4.2%). 2. In diabetic patients' upper anterior gingiva, Yellow staining cells were reaveale as 12.4%, which was lower than the control group(68.2%) 3. The changes of nucleus and cytoplasmic changes were not significantly different in diabetic patients and control group.

• The Journal of the Korean dental association
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• v.47 no.2
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• pp.90-101
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• 2009

The aim of this study was to appraise the influence of conventional periodontal treatment on metabolic control in Korean type 2 diabetic patients. In addition, their periodontal change was compared with non-diabetic patients. Before and after treatment, it was performed to measure periodontal and metabolic indices in thirteen type 2 diabetic patients. Periodontal indices included plaque index, gingival index, bleeding on probing, probing pocket depth, gingival recession, and clinical attachment level. Metabolic indices included glycated hemoglobin(HbA1c), fasting plasma glucose, fasting plasma insulin, total cholesterol, triglyceride, and HDL-cholesterol. Plaque index, gingival index, bleeding on probing, probing pocket depth, and gingival recession showed significant improvements in the statistics. Diabetic patients showed no statistically significant differences in the changes of periodontal indices compared with non-diabetic patients. HbA1c values decreased in five of the thirteen subjects and fasting plasma glucose levels were reduced in four of the seven subjects after periodontal treatment. All five subjects whom HOMA values were calculated in showed the increases of insulin secretions. The results of this study ascertained the possibility of the better glycemic contol after conventional periodontal treatment in Korean type 2 diabetic patients and diabetes were well healed of their periodontal diseases after the treatment.

• Journal of Nutrition and Health
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• v.17 no.4
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• pp.273-280
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• 1984

The blood components of diabetic patients who visited S- hospital in seoul from January 1982 to June 1983 were compared with the reference levels. Hemoglobin and hematocrit levels of diabetic patients were significantly lower than the reference. The diabetic patients showed 2-3 times higher levels of fasting blood glucose and postprandial -2 hours blood sugar. Levels of blood urine nitrogen and creatine were also significantly higher in the diabetes mellitus and the levels of potassium sodium and chlorine showed no differences although these were decreased gradually in older patients. Lower serum calcium levels were seen in the diabetic patients and this change was more significant at the ages higher than 40. The effect of an active vitamin D on serum-Ca level in diabetic patients was studied in comparison to that of non- diabetic persons. The serum calcium levels were slightly increased in control and insulin- dependent diabetic patients after a week- intake of 1,000mg calcium a day, while the intake of 1,25-dihydroxycholecalciferol ( 1,000 IU per day ) did not increase the serum calcium levels of these groups. Insulin - independent diabetic patients showed the rather lower serum calcium levels after a week- intake of 1,000mg calcium per day. However, the levels were increased after 2-weeks intake of the calcium and a week-in-take of the active vitamin D(1,000 IU/day ). This effect of vitamin D was seen in the groups with lower intake of calcium(500mg/day ) but not in the groups with 1,000mg calcium intake a day.

• Journal of Nutrition and Health
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• v.33 no.3
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• pp.250-256
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• 2000

Hyperhomocysteinemia has been shown to be associated with increased risks for macrovascular angiopathy. The present study was conducted to document the relationship between plasma homocysteine levels and the presence of macrovascular angiopath in patients with Type II diabetes mellitus. Plasma total homocysteine was determined by a HPLC-fluorescence detection method in a total of 238 subjects, 127 diabetic patients and 111 control. Dietary information including folate intake was assessed by a 24-hour recall in a total 113 subjects, 70 diabetic patients and 43 control. Folate intake was significantly lower inn patients with diabetes mellitus than that in the control. The lowered folate intake in the diabetic patients was mainly due to reduced intakes of fruits and vegetables. The average plasma homocysteine level of patients with MA was 14.2$\mu$㏖/L, which was significantly higher than that of either the patients without MA(11.4$\mu$㏖/L) or the control(11.5$\mu$㏖/L). Twenty five percent of the diabetic patients were positively correlated with age (r=0.20), body weight (r=0.28), body mass index (r=0.28), body mass index (r=0.18), diastolic blood pressure (r=0.20), and total cholesterol (r=0.14). cigarette smokers had significantly higher levels of plasma homocysteine than the non-smokers. Further prospective studies are needed to investigate whether folate or other B vitamin supplementation could be beneficial for the prevention of hyperhomocysteinemia or macrovascular angiopathy in the diabetic patients.

• International journal of advanced smart convergence
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• v.9 no.1
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• pp.37-46
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• 2020

Cerebral vascular surgery can damage patients' motor and sensory nerves; therefore, neuromonitoring is performed intraoperatively. Patients with diabetes often have peripheral neuropathy and may be prone to nerve damage during surgery. This study aimed to identify factors that should be considered when diabetic patients undergo intraoperative neuromonitoring during brain vascular surgery and to present new criteria. Methods: In patients with and without diabetes who underwent cerebrovascular surgery (n = 30/group), we compared the intraoperative stimulation intensity, postoperative motor power and sensory, glycated hemoglobin (HbA1c) and glucose levels, and imaging findings. Results: Fasting glucose, blood glucose, and HbA1c levels were 10%, 12.1%, and 9.7%, respectively; they were higher in patients with than in patients without diabetes. Two patients with diabetes had weakness, and 10 required increased Somato sensory evoked potential (SSEP) stimulation, while in 16, motor power recovered over time rather than immediately. The non-diabetic group had no weakness after surgery, but 10 patients required more increased SSEP stimulation. The diabetic group showed significantly more abnormal test results than the non-diabetic group. Conclusion: For patients with diabetes undergoing surgery with intraoperative neuromonitoring, whether diabetic peripheral neuropathy is present, their blood glucose level and the anesthetic used should be considered.