• Title/Summary/Keyword: hypoglycemia.

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Study on the Diurnal Variation of the Plasma Immunoreactive Glucagon (정상 한국인의 혈중 Glucagon의 동태에 관한 연구)

  • Lee, Hong-Kyu;Chung, June-Key;Kim, Eui-Chong;Hong, Kee-Suk;Kim, Byoung-Kook;Koh, Chang-Soon
    • The Korean Journal of Nuclear Medicine
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    • v.18 no.1
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    • pp.39-44
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    • 1984
  • It is well known that glucagon, like insulin, is very important in the moment-to-moment control of the homeostasis of glucose, and of amino acids. Glucagon has been shown to have potent glycogenolytic, gluconeogenic and lipolytic activities. Attention to its role in the pathogenesis of diabetes mellitus and hypoglycemia has been also advanced recently. To evaluate the diurnal variation of plasma glucagon concentration, we measured serum glucose, insulin, and plasma glucagon every 30 minutes or every hour in 7 normal Korean adults. Results were as follows: 1) Although plasma glucagon concentration showed wide individual variations, it had a tendency to decrease after meals. After lunch and dinner, plasma glucagon concentration had gradually declined and reached its nadir at postprandial 2-2.5 hours. The minimal level of plasma glucagon was at 4 A.M. 2) Serum insulin:plasma glucagon ratios were increased promptly after meals. Especially after lunch, its peak was prominent $(3.65{\pm}1.95)$. The minimal level of serum insulin:plasma glucagon ratio appeared at 6 A.M.

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Dapagliflozin's Effects on Glycemia and Cardiovascular Risk Factors and Incidence of Adverse Events in Patients with Type 2 Diabetes (제2형 당뇨병 환자에서 Dapagliflozin이 혈당과 심혈관계질환 위험인자에 미치는 영향 및 안전성)

  • Lee, Hye Jin;Geum, Min Jung;Kim, Jae Song;Kim, Soo Hyun;Son, Eun Sun
    • Korean Journal of Clinical Pharmacy
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    • v.27 no.4
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    • pp.214-220
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    • 2017
  • Background: Dapagliflozin is an oral selective inhibitor of sodium-glucose cotransporter 2(SGLT2), the kidney transporter chiefly responsible for glucose reabsorption from the glomerular filtrate. Because this mechanism does not require the action of insulin, dapagliflozin rarely causes hypoglycemia. Dapagliflozin may affect blood glucose control as well as blood pressure and the body weight which are one of the cardiovascular disease risk factors. However, dehydration and ketoacidosis are reported as the side effects of the dapagliflozin treatment and the safety issues have been occurred. The aim of this study is to analyze the effectiveness and adverse events of dapagliflozin in Korean patients. Methods: From December 2014 to August 2015, we retrospectively reviewed the electronic medical records of type 2 diabetes patients who were prescribed dapagliflozin at Severance Hospital. Results: A total of 202 Korean patients were enrolled in this study. The effectiveness in the reduction of blood glucose was statistically significant(p<0.001). Dapagliflozin decreased 0.74% of HbA1c after 24 weeks. Significantly more participants achieved the target HbA1c level(HbA1c<7%) after 24 weeks(n=42, 35.3%) than before taking dapagliflozin(n=21, 17.6%). Blood pressure decreased 5.7 mmHg systolic blood pressure(SBP), 1.9 mmHg diastolic blood pressure(DBP) after 24 weeks. More than one quarter of participants(n=35, 29.4%) experienced weight loss. Most common adverse event was genitourinary symptoms. Conclusion: In this study, the effectiveness of dapagliflozin in improving glycemic control, blood pressure control, and weight loss was statistically significant. However, elderly and female patients, who have higher incidence of adverse events, should use dapagliflozin cautiously.

One Case of Insulinoma (인슐린 분비성 췌장세포암 1례)

  • Ahn, Jae-Hee;Seo, Hye-Sang;Yoon, Sung-Chul;Yoon, Kyung-Woo;Choi, Soo-Bong;Lee, Hyun-Woo
    • Journal of Yeungnam Medical Science
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    • v.5 no.2
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    • pp.205-211
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    • 1988
  • Insulinoma is a rare tumor, occurring more often in women and in the older age range. Eighty percent of patients have a single benign tumor, usually 2cm in diameter, located with about equal frequency in body, head or tail of pancreas and amenable to surgical cure. About 10% have multiple tumors. The remaining 10% of patients have metastatic malignant insulinoma. The symptom of insulinoma is characterized by the periodic attack of hypoglycemia of blood sugar level below 50mg%, by fasting or exertion, and rapid relief of symptom by oral or intravenous administration of glucose. Symptom often lead to misdiagnosis as a neurologic or psychiatric disorder. A case described by authors was 44-year old female with the chief complaints of the loss of consciousness, epileptic seizure although she has been treated by anticonvulsants. Serum blood sugar and insulin level during fasting sugested insulinoma but abdominal computed tomography shows no definitive mass in pancreas. Celiac angiography revealed insulinoma. She transfered to the defartment of General Surgery and was performed enucleation. Microscopic findings shows the islet cell tumor of pancreas. A brief review of the literature was made.

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Evaluation of three glucometers for whole blood glucose measurements at the point of care in preterm or low-birth-weight infants

  • Hwang, Joon Ho;Sohn, Yong-Hak;Chang, Seong-Sil;Kim, Seung Yeon
    • Clinical and Experimental Pediatrics
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    • v.58 no.8
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    • pp.301-308
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    • 2015
  • Purpose: We evaluated three blood glucose self-monitoring for measuring whole blood glucose levels in preterm and low-birth-weight infants. Methods: Between December 1, 2012 and March 31, 2013, 230 blood samples were collected from 50 newborns, who weighed, ${\leq}2,300g$ or were ${\leq}36$ weeks old, in the the neonatal intensive care unit of Eulji University Hospital. Three blood glucose self-monitoring (A: Precision Pcx, Abbott; B: One-Touch Verio, Johnson & Johnson; C: LifeScan SureStep Flexx, Johnson & Johnson) were used for the blood glucose measurements. The results were compared to those obtained using laboratory equipment (D: Advia chemical analyzer, Siemens Healthcare Diagnostics Inc.). Results: The correlation coefficients between laboratory equipment and the three blood glucose self-monitoring (A, B, and C) were found to be 0.888, 0.884, and 0.900, respectively. For glucose levels ${\leq}60mg/dL$, the correlation coefficients were 0.674, 0.687, and 0.679, respectively. For glucose levels>60 mg/dL, the correlation coefficients were 0.822, 0.819, and 0.839, respectively. All correlation coefficients were statistically significant. And the values from the blood glucose self-monitoring were not significantly different from the value of the laboratory equipment, after correcting for each device's average value (P>0.05). When using laboratory equipment (blood glucose ${\leq}60mg/dL$), each device had a sensitivity of 0.458, 0.604, and 0.688 and a specificity of 0.995, 0.989, and 0.989, respectively. Conclusion: Significant difference is not found between three blood glucose self-monitoring and laboratory equipment. But correlation between the measured values from blood glucose self-monitoring and laboratory equipment is lower in preterm or low-birth-weight infants than adults.

Effect of High Dose Insulin/Euglycemia Therapy for Acute Calcium Channel Blocker Intoxication: A Systematic Review (급성 칼슘통로차단제 중독에서 고용량 인슐린/정상혈당치료의 효과: 체계적 고찰)

  • Yang, Jinmo;Ko, Dong Ryul;Kong, Taeyoung;Joo, Young Seon;You, Je Sung;Chung, Sung Phil
    • Journal of The Korean Society of Clinical Toxicology
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    • v.13 no.2
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    • pp.103-110
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    • 2015
  • Purpose: The purpose of this study is to evaluate the effectiveness and the adverse events of high dose insulin/euglycemia therapy in acute calcium channel blocker (CCB) poisoning. Methods: We developed a systematic search strategy and applied it to 4 electronic reference databases. We searched medical journals as well as the bibliographies of relevant articles. All forms of literature relevant to human use of high dose insulin for acute CCB poisoning were included. The literature search was conducted by two investigators in August, 2015 with publication language restricted to English and Korean. Case reports were divided between CCB overdose alone and multi-drug overdose including CCB. The effect and adverse event of high dose insulin and clinical outcome of each case were analyzed. Results: Among 55 searched studies, 20 studies were included. A prospective study, a retrospective study, a systematic review study, and 17 case reports were identified. Case reports consisted of 11 CCB alone and 12 multidrug overdose cases including CCB. Although most cases described significant clinical improvements, one of them showed no beneficial effect. Several adverse events including hypoglycemia and hypokalemia were reported. No significant sequalae from adverse events was reported. Conclusion: Although there were many case reports demonstrating successful use of high dose insulin for CCB poisoning, the effect cannot be estimated due to a possibility of publication bias. Therefore, high dose insulin/euglycemia therapy might be considered adjunctive therapy in cases of CCB intoxication refractory for standard therapy.

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Effects of Diabetic Education Fortified with Individual Practice on Plasma Glucose, Self-care, and Self Reported Physical Symptom in Type 2 Diabetic Patients (개별실습을 강화한 당뇨교육이 제2형 당뇨병 환자의 혈당, 자가 관리 및 자각증상에 미치는 효과)

  • Kim, Hyeon Jeong;Kim, Hee Seung;Ahn, Sung Hee
    • Korean Journal of Adult Nursing
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    • v.18 no.2
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    • pp.194-201
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    • 2006
  • Purpose: This study was attempted to estimate the effects of diabetic education fortified with individual practice on plasma glucose, self-care, and self reported physical symptoms in type 2 diabetes patients Method: The subjects consisted of 46 patients with type 2 diabetes patients, who took the hospitalization diabetes education program from July 2003 until February 2004 at Seoul C university hospital. The experimental group was assessed at preand post intervention. The diabetes education was provided for one week. The education consisted of diabetes education videos for the diabetic introduction, group education for medication therapy, dietetic treatment and diabetes complication education. Also individual education for nurses examination of glycemia and insulin injection practice. Results: The HbA1c values significantly decreased from 9.6% on the time of hospitalization to 7.4% 3 months after discharge. In respect to the number of days of self-care, medication, diet, exercise, cleansing feet, and carrying sweets to prepare for hypoglycemia all significantly increased 3 months after discharge compared to the values at the time of hospitalization. Self reported physical symptoms were also significantly increased 3 months after discharge compared to the time of hospitalization. Conclusion: The diabetic education fortified with individual practice can be practically used as a plan for managing glycemia, self-care, and self reported physical symptom of diabetes patients.

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고려 인삼의 효능과 우수성 확인

  • Jeong Seong Hyeon
    • 한국인삼전략화협의회:학술대회논문집
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    • v.2003 no.09
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    • pp.77-88
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    • 2003
  • "Ginseng (Panax ginseng C.A. Meyer) has been a popular herbal remedy used in eastern Asian cultures for thousands of years, and a number of health claims are made for it. Modern therapeutic claims for ginseng refer to vitality, immune function, cancer, cardiovascular diseases, diabetes and sexual function. These claims are mostly based on uncontrolled or non-randomized studies. Among modern therapeutic claims, however, therapeutic effects for diabetes can reasonably be accepted. Following experiment was done recently in our lab: this study was designed to compare the antidiabetic activities between Ginseng Radix Alba (GRA), Ginseng Radix Rubra (GRR) and Panax Quinquefoli Radix (PQR) in multiple low dose (MLD) streptozotocin (STZ) (20mg/kg i.p injection for 5 days) induced diabetic rats. In the glucose tolerance test, 500mg/kg of each ginseng ethanol extract was admoinistered intraperitoneally 30min before glucose challenge. While GRA failed to lower blood glucose level, GRR and PQR both significantly prevented the hyperglycemia when compared with the control group. In the MLD STZ-induced diabetic rats, 300 mg/kg of each ginseng ethanol extract was administered intraperitoneally for 2 weeks. Plasma glucose and insulin levels were markedly improved in all treatment groups. While GRR showed the highest antidiabetic activity, and GRA and PQR revealed somewhat equipotent antidiabetic activities, but less than that in GRR-treated group as for as blood parameters and diabetic symptoms such as polydipsia are concerned. Blood glucose levels were closely associated with plasma insulin levels, and this result may suggest that ginseng ethanol extracts showed the activity to enhance insulin secretion as well as preventing destruction of pancreatic islet cells. To elucidate the relationship between antidiabetic activity and ginsenoside profiles, seven major ginsenoside were quantified by HPLC. We figured out the fact that protopanaxatriol (PPT) : proptopanaxadiol (PPD) ratio might play an important role in its hypoglycemia effects."

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Effect of Saryuktangkamibang on Streptozotocin-induced Diabetic Rat (사육탕가미방(四六湯加味方)이 streptozotocin으로 유발(誘發)된 백서(白鼠)의 실험적(實驗的) 탕뇨(糖尿)에 미치는 영향)

  • Oh, Young-Taek;Kim, Dong-Woo
    • Herbal Formula Science
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    • v.14 no.2
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    • pp.57-66
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    • 2006
  • Objectives : The objective of this study is to observe the effect of Saryuktangkamibang, Saryuktang with Liriopis Tuber, Lycii Fructus, Schizandrae Fructus, and Bombyx Batryticatus, on the experimental diabetes. Methods : In order to induce diabetes experimentally, injected streptozotocin to the vein in the tail of rats and then treated oral administration of Saryuktangkamibang water extracts. In the measurement of the variation levels of glucose, ALP, creatinine, and BUN concentration for each concentration levels for serum (0.2g/100g, 0.4g/l00g, 0.6g/100g), concentration level of glucose significantly decreased in 0.4g/l00g concentration level of Saryuktangkamibang. With this 0.4g/l00g concentration level of Saryuktangkamibang, the following conclusion was derived from the measurement of the serum levels of glucose. ALP, AST, ALT, creatinine, and BUN concentration for the injection of each 4th, 11th, and 18th day. Results : 1. In the measurement for each concentrations, the glucose concentration level in the serum significantly decreased on the 9th day in the Saryuktangkamibang-dosed group. 2. The creatinine and BUN concentration level in the serum significantly decreased on the 9th day in the Saryuktangkamibang-dosed group to which 0.6g/100g injected. 3. In the measurement for each dosage dates, the glucose concentration level in the serum significantly decreased on the 11th day in the Saryuktangkamibang-dosed group to which 0.6g/100g injected. 4. The AST concentration level in the serum significantly decreased on the 11th day in the Saryuktangkamibang-dosed group. Conclusion : Saryuktangkamibang, Saruktang with Liriopis Tuber, Lycii Fructus, Schizandrae Fructus, and Bombyx Batryticatus, has an effect of hypoglycemia, with no hepato-renal dysfunction. For the experimental results above, in that nephrotoxicity significantly decreased on the 0.6g/100g concentration, another research such as study for effect in other ranges and study for effect of dosage term except the concentration range of this study is necessary. Also dosage of appropriate concentration of Saryuktangkamibang is thought to provide valuable aid to cure on diabetes.

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Effects of Carbohydrates on Change in Blood Glucose Levels (당류유형이 혈당변화에 미치는 효과)

  • Lee, Mi Sun;Lee, Kyung Sook;Kim, Eun Joo
    • Journal of muscle and joint health
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    • v.26 no.3
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    • pp.205-213
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    • 2019
  • Purpose: This study was to investigate the effects of Carbohydrates on blood glucose levels in healthy adults after taking the monosaccharide glucose and disaccharide candies. Methods: This study was experimental research using a randomized controlled trial. Participants were college students who could agree the purpose of the study and participated voluntarily and met the selection criteria. Considering the dropout rate, 25 subjects in each group were included. The assignments of the experimental group and the control group were randomly assigned, and this study used the allocation concealment. Glucose tablets of 15g in the experimental group, and 15g sugar of candies in the control group were orally ingested. Blood glucose was measured before ingestion, 10 minutes, 15 minutes, and 30 minutes after ingestion. Results: There were no statistically significant differences in blood glucose of 10 minutes (U=406.00, p=.069), 15 minutes (U=370.00, p=.264), and 30 minutes after ingestion (U=337.00, p=.634) between experimental (glucose tablet oral ingestion) and control groups (mint candy oral ingestion). Conclusion: There was no difference in the blood glucose level up to 30 minutes after ingestion of monosaccharide glucose and disaccharide candy. Through this study, the decision to use either candy or glucose tablets in the event of hypoglycemia can be chosen according to the patient's preference.

KOREAN RED GINSENG IN EXHAUSTION EXERCISE

  • Prieto J.G.;Fernandez E.;Redondo P.A.;Ferrando A.;Vila L.;Voces J.;Estal del J.;Alvarez A.I.
    • Proceedings of the Ginseng society Conference
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    • 1993.09a
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    • pp.171-178
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    • 1993
  • The effects of Korean Red Ginseng (KRG) in rats submitted to exhaustion exercise have been studied, by measuring different enzymatic and hematological parameters in plasma and muscle. KRG powder was daily administered to 15 male Wistar rats for a period of two weeks. Another group of 15 rats with the same characteristics were administered physiological saline. Both groups were divided as follows: 5 control. 5 exercised till exhaustion and 5 recovered for 48 h after exhaustion. The following results were obtained for the groups treated with KRG in rapport to those treated with saline: - Higher endurance to running, - Increase of the osmotic resistence of red blood cells and higher presence of reticulocytes. - Lower triglyceride levels in plasma. - Increase non statistically significant of urea levels in plasma, - Lower non statistically significant hypoglycemia after exhaustion exercise. - Decrease of liver glycogen after exercise and faster recovery of the resting - level. - Protective effect on tissular damage produced by exhaustion exercise - Lower LDH activity in all studied muscles. only statistically significant in the WG.

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