• 제목/요약/키워드: non insulin-treated type 2diabetes

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제 2형 당뇨 환자에서 자가혈당측정의 임상적 유용성 : 체계적문헌고찰 및 메타분석 (Clinical Benefits of Self-monitoring of Blood Glucose in Non-insulin Treated Patients with Type 2 Diabetes : A systematic Review and Meta-analysis)

  • 최윤영;손현순;신현택
    • 한국임상약학회지
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    • 제20권3호
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    • pp.183-192
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    • 2010
  • While Self-monitoring of blood glucose (SMBG) has been recommended in some diabetes mellitus (DM) patients population according to the 2010 American Diabetes Association (ADA), 2007 Korean Diabetes Association (KDA), 2005 International Diabetes Federation guideline, it is excluded from a routine insurance coverage for outpatients in Korea. The objective of this study is to meta-analyze the impact of SMBG on HbA1c in non insulin-treated diabetes mellitus (NIT) DM patients. Published clinical literatures were identified through electronic database searches from inception and until May 2010. Studies were selected if they met the following inclusion criteria: 1) randomized controlled trials (RCTs), 2) comparing SMBG with non-SMBG in NIT type 2 diabetes, 3) measuring HbA1c as an outcome. Literature qualities were assessed by the Scottish Intercollegiate Guidelines Network Checklist. The mean difference of HbA1c between the 2 groups was pooled from non-heterogeneous 6 RCTs by meta-analysis using Review Manger (RevMan) Version 5.0 program. Pooled results demonstrated that SMBG is associated with a statistically significant improvement in glycemic control (mean HbA1c difference -0.23, 95%CI -0.32, -0.13). Sensitivity analysis showed that glycemic controls were significantly improved in patients with shorter study duration, more frequent self-monitoring, higher baseline HbA1c value, and without prior SMBG experiences. Conclusively SMBG is effective in improving glycemic control in NIT DM patients, but additional evidences from further researches in Korean patients and cost-effectiveness analysis would be necessary to make a suggestion for coverage expansion.

항정신병 약물과 혈당조절이상 (Antipsychotics and Abnormality in Glucose Regulation)

  • 황재승;김현;권영준;정희연
    • 생물정신의학
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    • 제10권2호
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    • pp.107-115
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    • 2003
  • Objective:The purpose of this study was to know about the mechanism of pathogenesis of type 2 diabetes mellitus by using of blood glucose, glucoregulatory factor, insulin resistance in schizophrenic patients receiving antipsychotics. Method:Modified oral glucose tolerance tests were performed in 20 schizophrenic patients receiving haloperidol, risperidone and olanzapine. Insulin, glucagon, C-peptide and cortisol were measured in 0, 15, 45, 75 minutes after glucose loading, and insulin resistance was calculated by HOMA(homeostasis model assessment) method. Result:Olanzapine-treated patients had significant glucose elevation 45 minutes after glucose challenge. Also modest increases in HOMA IR values were detected in patients treated with olanzapine. Conclusion:Olanzapine treatment of non-diabetic patients with schizophrenia can be associated with type 2 diabetes mellitus through the elevation of glucose and insulin resistance. Elevated insulin resistance may be a causative mechanism of type 2 diabetes mellitus in patients receiving olanzapine.

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오디의 항당뇨 효능에 관한 연구 (A Study on the Antidiabetic Effect of Mulberry Fruits)

  • 김태완;권영배
    • 한국잠사곤충학회지
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    • 제38권2호
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    • pp.100-107
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    • 1996
  • 인슐린 의존형 당뇨병 및 인슐린 비의존형 당뇨명 모델동물을 이용하여 오디의 항당뇨 효과를 검정해 보았다. 오디의 투여에 의해 정상 ICR 마우스 및 STZ 투여로 제1형 당뇨병을 유발한 ICR 마우스에서 체중과 혈당치의 유의성 있는 변화를 관찰할 수 없었다. 뿐만 아니라 STZ-유도성 당뇨병 유발억제 효과에 대한 실험에서도 역시 유의성 있는 억제 효과를 나타내지 않았으나 STZ로 유발한 당뇨병에서 용량의존적으로 혈당이 강하되는 경향을 관찰할 수 있었다. 2일령의 랫트에 STZ를 투여하여 제2형 당뇨병을 유발한 실험에서 오디 투여군은 혈당을 유의성 있는 감소를 나타내었으며, 간장의 무게 역시 대조군에 대해 유의성 있게 감소되었다. 그리고 자연발생 제2형 당뇨병 모델동물인 KK 마우스에서 오디 투여군은 대조군에 비해 내당능이 유의성 있게 회복되는 경향을 관찰 할 수 있었다. 오디는 제1형당뇨병에 대해서는 유의한 영향을 미치지 못하는 반면, 제2형당뇨병에 대해서는 유의성 있는 향당뇨 효능을 나타내었다. 이러한 사실은 오디를 이용하여 인슐린 비의존성 당뇨병에 대하여 항당뇨효과를 가진 기능성 식품을 개발 할 수 있는 가능성을 시사하고 있다.

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Ameliorating Effects of Sulfonylurea Drugs on Insulin Resistance in Otsuka Long-Evans Tokushima Fatty Rats

  • Park, Jeong-Kwon;Kim, Sang-Pyo;Song, Dae-Kyu
    • The Korean Journal of Physiology and Pharmacology
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    • 제12권1호
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    • pp.7-12
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    • 2008
  • OLETF (Otsuka Long-Evans Tokushima Fatty) rats are characterized by obesity-related insulin resistance, which is a phenotype of type 2 diabetes. Sulfonylurea drugs or benzoic acid derivatives as inhibitors of the ATP-sensitive potassium $(K_{ATP})$ channel are commercially available to treat diabetes. The present study compared sulfonylurea drugs (glimepiride and gliclazide) with one of benzoic acid derivatives (repaglinide) in regard to their long-term effect on ameliorating insulin sensitivity in OLETF rats. Each drug was dissolved and fed with drinking water from 29 weeks of age. On high glucose loading at 45 weeks of age, response of blood glucose recovery was the greatest in the group treated with glimepiride. On immunohistochemistry analysis for the Kir6.2 subunit of $K_{ATP}$ channels, insulin receptor ${\beta}$-subunits, and glucose transporters (GLUT) type 2 and 4 in liver, fat and skeletal muscle tissues, the sulfonylurea drugs (glimepiride and gliclazide) were more effective than repaglinide in recovery from their decreased expressions in OLETF rats. From these results, it seems to be plausible that $K_{ATP}$-channel inhibitors containing sulfonylurea moiety may be much more effective in reducing insulin resistance than those with benzoic acid moiety. In contrast to gliclazide, non-tissue selectivity of glimepiride on $K_{ATP}$ channel inhibition may further strengthen an amelioration of insulin sensitivity unless considering other side effects.

Effects of Purslane Extract on Obesity and Diabetes in High-Fat Diet-Induced Obese Mice

  • Kang, Kwang-Soon
    • 한국컴퓨터정보학회논문지
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    • 제21권7호
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    • pp.61-66
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    • 2016
  • The frequency of obesity has risen dramatically in recent years but only few safe and effective drugs are currently available. In addition, obesity can induce type 2 diabetes (T2DM), hyperlipidemia and fatty liver disease. Recently, protective effect of purslane extract (PE) on obesity has been reported, but little is known about the role and mechanism of PE in obesity. This study aimed to evaluate the effect of PE on obesity and diabetes in obese mice. In addition, the effect of PE was compared with anti-obesity and diabetes drugs. High-fat diet (HFD)-induced obese mice were treated for 8 weeks with drugs as follows: PE, orlistat, metformin, voglibose or pioglitazone. While PE mixed with normal diet did not have any effects on BW in non-obese mice, PE mixed with HFD significantly reduced BW gain, insulin resistance, and glucose intolerance, without affecting food intake and appetite in obese mice. The effect was comparable to the effects of anti-obesity and diabetes drugs. Furthermore, PE significantly increased the activity of hepatocellular anti-oxidant enzymes, leading to protection of liver from oxidative stress in obese mice. These results suggest that PE treatment may be a useful tool for preventing obesity and complication of obesity.

Pectinase-Processed Ginseng Radix (GINST) Ameliorates Hyperglycemia and Hyperlipidemia in High Fat Diet-Fed ICR Mice

  • Yuan, Hai-Dan;Kim, Jung-Tae;Chung, Sung-Hyun
    • Biomolecules & Therapeutics
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    • 제20권2호
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    • pp.220-225
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    • 2012
  • To develop a ginseng product possessing an efficacy for diabetes, ginseng radix ethanol extract was treated with pectinase and obtained the GINST. In the present study, we evaluate the beneficial effect of GINST on high fat diet (HFD)-induced hyperglycemia and hyperlipidemia and action mechanism(s) in ICR mice. The mice were randomly divided into five groups: regular diet group (RD), high fat diet group (HFD), HFD plus GINST at 75 mg/kg (GINST75), 150 mg/kg (GINST150), and 300 mg/kg (GINST300). Oral glucose tolerance test reveals that GINST improves the glucose tolerance after glucose challenge. Fasting plasma glucose and insulin levels were decreased by 4.3% and 4.2% in GINST75, 10.9% and 20.0% in GINST150, and 19.6% and 20.9% in GINST300 compared to those in HFD control group. Insulin resistance indices were also markedly decreased by 8.2% in GINST75, 28.7% in GINST150, and 36.4% in GINST300, compared to the HFD control group. Plasma triglyceride, total cholesterol and non-esterified fatty acid levels in the GINST300 group were decreased by 13.5%, 22.7% and 24.1%, respectively, compared to those in HFD control group. Enlarged adipocytes of HFD control group were markedly decreased in GINST-treated groups, and shrunken islets of HFD control mice were brought back to near normal shape in GINST300 group. Furthermore, GINST enhanced phosphorylation of AMP-activated protein kinase (AMPK) and glucose transporter 4 (GLUT4). In summary, GINST prevents HFD-induced hyperglycemia and hyperlipidemia through reducing insulin resistance via activating AMPK-GLUT4 pathways, and could be a potential therapeutic agent for type 2 diabetes.

Leptin 결핍 ob/ob 마우스에서 소맥엽 추출물의 혈당 강하 및 혈중 콜레스테롤에 미치는 효과 (Administration of Triticum aestivum Sprout Water Extracts Reduce the Level of Blood Glucose and Cholesterol in Leptin Deficient ob/ob Mice)

  • 이선희;임성원;응웬반민;허정무;송봉준;이영미;이회선;김대기
    • 한국식품영양과학회지
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    • 제40권3호
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    • pp.401-408
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    • 2011
  • 본 연구에서는 소맥엽 물추출물을 제2형 당뇨동물모델 ob/ob 마우스에게 6주간 경구투여 하여 혈중 포도당 및 혈중 지질에 미치는 영향에 대하여 연구하였다. TAWE를 투여한 결과, lean 마우스 대조군 및 실험군들의 혈중 포도당 농도와 체중은 유의적인 변화가 없었다. 반면, ob/ob 마우스에서 대조군은 실험기간 내내 혈중 포도당 농도 및 체중이 높은 증가율을 보였으나, TAWE를 투여한 ob/ob 마우스에서는 혈중 포도당 및 체중 증가가 TAWE 투여용량 의존적으로 감소되었으며, 특히 TAWE-100 투여군에서 대조군에 비하여 체중 약 11.9%, 혈중 포도당 약 78.4% 감소되는 효과를 보였다. 또한 TAWE 투여가 실험동물의 장기무게에 미치는 영향을 알아보기 위해 비장, 신장, 심장 및 폐의 무게를 측정한 결과, lean 마우스 및 ob/ob 마우스 실험군 사이에 각각의 장기에 대한 유의적인 무게 차이는 나타나지 않았다. 혈중 인슐린 농도는 lean 마우스 대조군 및 실험군의 평균 농도(3.93 ng/mL)에 비하여 ob/ob 마우스 대조군(15.60 ng/mL), TAWE-100 투여군(20.19 ng/mL) 및 TAWE-25 투여군(19.66 ng/mL)에서 모두 높게 나타나는 경향을 보였지만 ob/ob 마우스 TAWE-100 투여군에서는 보다 증가된 인슐린 수치를 확인하였으며, 면역조직화학염색 시험법에서도 췌장 $\beta$세포의 인슐린 발현정도가 TAWE-100 투여군에서 가장 높게 나타났다. TAWE는 lean 마우스의 총콜레스테롤, 중성지방 및 HDL에 유의적인 영향을 미치지 않았지만, ob/ob 마우스 TAWE-100 투여군에서 대조군에 비해 총콜레스테롤 24.35%, 중성지방 23.97%가 감소하였고, HDL은 29.80% 증가하였다. 포도당 내당능에 대한 평가를 위해 당부하 검사를 실시한 결과 ob/ob 마우스 TAWE-100 투여군에서 60분부터 당부하가 유의적으로 개선되는 효과를 보였다. 결과적으로, TAWE의 인슐린 저항성 제2형 당뇨병 동물모델 ob/ob 마우스에 6주간의 장기투여는 혈당 및 혈중 지질대사를 개선할 수 있음을 의미하며, 임상학적 당뇨 증상완화 및 당뇨 합병증 예방 및 치료제로 음용할 수 있을 것으로 사료된다.

제2형 당뇨모델 db/db 마우스에서 밀순 물추출물의 항당뇨 효과 (Anti-diabetic Effects of Triticum aestivum L. Water Extracts in db/db Mice as an Animal Model of Diabetes Mellitus Type II)

  • 이선희;임성원;이영미;허정무;이회선;김대기
    • 생약학회지
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    • 제41권4호
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    • pp.282-288
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    • 2010
  • We evaluated the anti-diabetic effects of Triticum aestivum sprout water extract (TA) in diabetes mellitus type 2. For the experiments, the diabetic animal model db/db mice were divided to 3 groups: diabetic control (db/db) and two experimental groups orally treated with 25 and 100 mg/kg single dose of TA (TA-25 and TA-100, respectively). The lean mice were used as the non-diabetic normal control. All mice have free access to water and AIN-93 diet. TA was administrated to diabetic mice for 5 weeks and the diabetic clinical markers, including blood glucose level, body weight, food intake and insulin level, were measured at a time. After administration for 5 weeks, the blood glucose level was decreased 1.10 and 1.98 folds in TA-25 and TA-100 groups, respectively, compared with db/db group. The body weight and diet consumption were significantly reduced by TA treatment in dose-dependent manner. The treatments of TA-100 also significantly decreased remarkedly liver weight and slightly serum insulin levels when compared with them of the diabetic control group. However the immunohistochemical staining for insulin clearly showed high expression of insulin in the pancreatic islet cells derived from all db/db mice, even if TA was administrated. Moreover, TA-100 treatment significantly improved impaired glucose tolerance in diabetic db/db mice. The results suggest that TA has anti-hyperglycemic effect attenuating blood glucose in the animal model of type 2 diabetes and might be useful as a functional diet for human diabetic diseases.

인슐린 비의존형(Type II) 당뇨환자에서 누에분말 섭취가 혈당 및 혈중지질농도에 미치는 영향 (Effects of Silkworm Powder on Blood Glucose and Lipid Levels in NIDDM(Type II) Patients)

  • 조미란;조여원;정성현;류재환
    • Journal of Nutrition and Health
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    • 제31권7호
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    • pp.1139-1150
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    • 1998
  • 본 연구에서는, 무분별하게 사용되고 있는 민간요법의 과학적인 접근의 일환으로 인슐린 비의존형 당뇨환자를 대상으로 당뇨치료약물을 복용하는 당뇨군과 당뇨치료약물을 복용하지 않는 당뇨군 그리고 정상군으로 나누어 각군 모두에게 누에분말을 복용시켜 혈당 및 혈중 당화헤모글로빈, 인슐린, 그리고 혈중 지질농도에 미치는 영향을 관찰하여 요약하면 다음과 같다. 1) 신장, 체중, BMI, 둔부둘레는 세군간에 차이가 없었다. 허리둘레는 기존의 당뇨치료약물과 누에분말을 동시에 투여받는 당뇨군에서 다른 두 군에 비해 유의적으로 높아 WHR은 당뇨치료 약물을 동시에 복용한 당뇨군>누에분말만 복용한 당뇨군>정상군의 순으로 나타났다. 누에분말을 투여받는 동안 체중의 변화는 관찰되지 않았다. 2) 당뇨군과 정상군 사이에 열량 및 열량구성비에는차이가 없었으며, 연구 진행동안의 유의적인 변화도 관찰되지 않았다. 실험기간동안 총열량 섭취량은 남자의 경우, 권장량의 87.7%, 여자의 경우, 권장량의 86.2% 를 섭취하고 있었다. 하루동안 누에분말로 공급된 단백질 함량은 0.279이었으며 식이로의 단백질섭취는 남녀 각각 권장량의 97.5%. 108.3%를 섭취하고 있었다. 총 열량구성비는 남자의 경우 탄수화물 단백질. 지방이 68 : 15 : 17, 여자의 경우 69 : 16 : 15이었다. 3) 당뇨치료 약물을 누에분말과 동시에 복용한 당뇨군에서 누에분말 복용후 공복시 혈당이 7.4%, 식사후 2시간의 혈당이 19.4% 감소하는 경향이었고, 누에분말만 섭취한 당뇨군은 누에분말 복용후 혈당이 공복시 9.7%, 식사후 2시간시 23.4%의 감소경향을 나타냈다. 공복시와 식사후 2시간의 혈당 모두 누에분말 섭취후에도 정상범위보다 다소 높았으나, 혈당감소율(%)은 당뇨치료약물을 동시에 복용한 당뇨군에 비해 누에분말만 섭취한 당뇨군에서 큰 경향이었다. 정상군의 혈당에 는 큰 변화가 없었다. 4) 당뇨치료 약물을 동시에 복용한 당뇨군이 누에분말만 복용한 당뇨군에 비해 당화 헤모글로빈이 낮았고 정상군은 더 낮았다. 4주동안 누에분말 복용 후 당화헤모글로빈의 변화는 관찰되지 않았다. 5) 본 연구 대상자들의 공복시 인슐린 농도는 당뇨치료 약물을 동시에 복용한 당뇨군에서 누에분말만 복용한 당뇨군과 정상군에 비해 높았다. 누에분말 복용에 따른 공복시 인슐린 농도의 유의적인 변화는 관찰되지 않았다. 6) 누에분말 복용에 따른 각 군간의 혈중 지질 농도의 유의적인 변화가 관찰되지 않았다. 혈중 중성지방의 농도는 당뇨치료 약물을 동시에 복용한 당뇨군의 경우 8.5%, 누에분말만 섭취한 당뇨군의 경우 9.0% 그리고 정상군은 3.4%가 감소되는 경향을 나타내었다.

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Robinetin Alleviates Metabolic Failure in Liver through Suppression of p300-CD38 Axis

  • Ji-Hye Song;Hyo-Jin Kim;Jangho Lee;Seung-Pyo Hong;Min-Yu Chung;Yu-Geun Lee;Jae Ho Park;Hyo-Kyoung Choi;Jin-Taek Hwang
    • Biomolecules & Therapeutics
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    • 제32권2호
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    • pp.214-223
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    • 2024
  • Metabolic abnormalities in the liver are closely associated with diverse metabolic diseases such as non-alcoholic fatty liver disease, type 2 diabetes, and obesity. The aim of this study was to evaluate the ameliorating effect of robinetin (RBN) on the significant pathogenic features of metabolic failure in the liver and to identify the underlying molecular mechanism. RBN significantly decreased triglyceride (TG) accumulation by downregulating lipogenesis-related transcription factors in AML-12 murine hepatocyte cell line. In addition, mice fed with Western diet (WD) containing 0.025% or 0.05% RBN showed reduced liver mass and lipid droplet size, as well as improved plasma insulin levels and homeostatic model assessment of insulin resistance (HOMA-IR) values. CD38 was identified as a target of RBN using the BioAssay database, and its expression was increased in OPA-treated AML-12 cells and liver tissues of WD-fed mice. Furthermore, RBN elicited these effects through its anti-histone acetyltransferase (HAT) activity. Computational simulation revealed that RBN can dock into the HAT domain pocket of p300, a histone acetyltransferase, which leads to the abrogation of its catalytic activity. Additionally, knock-down of p300 using siRNA reduced CD38 expression. The chromatin immunoprecipitation (ChIP) assay showed that p300 occupancy on the promoter region of CD38 was significantly decreased, and H3K9 acetylation levels were diminished in lipid-accumulated AML-12 cells treated with RBN. RBN improves the pathogenic features of metabolic failure by suppressing the p300-CD38 axis through its anti-HAT activity, which suggests that RBN can be used as a new phytoceutical candidate for preventing or improving this condition.