• Clinical and Experimental Pediatrics
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• v.58 no.6
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• pp.234-237
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• 2015

Hepatic glycogenosis in type 1 diabetes mellitus (DM) can be caused by poor glycemic control due to insulin deficiency, excessive insulin treatment for diabetic ketoacidosis, or excessive glucose administration to control hypoglycemia. Mauriac syndrome, which is characterized by hepatomegaly due to hepatic glycogenosis, growth retardation, delayed puberty, and Cushingoid features, is a rare diabetic complication. We report a case of hepatic glycogenosis mimicking Mauriac syndrome. A 14-year-old girl with poorly controlled type 1 DM was admitted to The Catholic University of Korea, Seoul St. Mary's Hospital for abdominal pain and distension. Physical examination revealed hepatomegaly and a Cushingoid face. The growth rate of the patient had decreased, and she had not yet experienced menarche. Laboratory findings revealed elevated liver enzyme levels. A liver biopsy confirmed hepatic glycogenosis. Continuous glucose monitoring showed hyperglycemia after meals and frequent hypoglycemia before meals. To control hyperglycemia, we increased insulin dosage by using an insulin pump. In addition, we prescribed uncooked cornstarch to prevent hypoglycemia. After strict blood glucose control, the patient's liver functions and size normalized. The patient subsequently underwent menarche. Hepatic glycogenosis is a complication of type 1 DM that is reversible with appropriate glycemic control.

• Journal of Korean society of Dental Hygiene
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• v.20 no.1
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• pp.19-27
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• 2020

Objectives: This study aimed to analyze the association between self-assessed periodontal symptoms and glycated hemoglobin levels in patients with type 2 diabetes. Methods: This cross-sectional study involved 156 patients with type 2 diabetes who were aged 50 years or older. Structured questionnaires were used to investigate the self-assessed periodontal symptoms of the patients. The glycated hemoglobin test was performed to evaluate their long-term blood glycemic control. Chi-square test and logistic multiple regression were performed to analyze the factors associated with glycated hemoglobin levels. Results: Compared with patients aged 65 years and above, more patients aged 64 years and below showed poor glycemic control (p=0.020). Further, compared with patients without self-perceived gingival bleeding and halitosis, more patients with these two conditions showed poor glycemic control (p<0.05). Compared with the group of patients without any periodontal symptoms, the group of patients that had at least one periodontal symptom had a higher proportion of patients with poor glycemic control (p<0.001). In the logistic regression model, gingival bleeding and halitosis were the factors most associated with hyperglycemia (p<0.05). Conclusions: The results of our study suggest that gingival bleeding and halitosis can predict hyperglycemia in patients with type 2 diabetes.

• Journal of Korean Biological Nursing Science
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• v.24 no.4
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• pp.219-226
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• 2022

Purpose: This study aimed to investigate the status and factors associated with self-management behavior (SMB) of patients with type 2 diabetes (T2DM) in a border area of southwest China. Methods: A cross-sectional study was conducted with T2DM patients in Dali, China. The participants filled in the questionnaires including demographic and disease-related characteristics, psychosocial status, resources of DM knowledge, knowledge of DM care, competency in DM care skills, the Chinese Diabetes Management Self-Efficacy Scale (C-DMSES), and the Chinese Summary of Diabetes Self-Care Activities (C-SDSCA). All the data were analyzed with SPSS version 26. Multiple linear regression analysis examined associations between predictors and SMB. Results: A total of 470 valid questionnaires have been collected. The score for overall SMB was 50.71± 11.99; 19.6% of patients were at a good level, 48.3% were moderate, and 32.1% were poor. The significant factors that influenced SMB included self-efficacy (β= 0.37; p< .001), competency in DM care skills (β= 0.22; p< .001) and lacked in the treatment confidence (β= -0.09; p= .023). Conclusion: The level of self-management among T2DM patients in this area was medium-low state. For future studies, our findings suggest that self-efficacy, competency in DM care skills, and treatment confidence should be considered essential factors in improving the self-management behavior of T2DM patients in the border area of southwest China.

• Journal of Genetic Medicine
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• v.11 no.1
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• pp.1-10
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• 2014

Type 1 diabetes (T1D) is a chronic autoimmune disease characterized by selective destruction of pancreatic ${\beta}$-cells resulting in insulin deficiency. The genetic determinants of T1D susceptibility have been linked to several loci, in particular to the human leukocyte antigen (HLA) region, which accounts for 50% of the genetic risk of developing T1D. Multiple genes in the HLA region, which are in strong linkage disequilibrium, are thought to be involved. Another important locus, with a smaller effect on genetic predisposition to T1D, is the insulin gene. The advent of numerous single nucleotide polymorphism markers and genome screening has enabled the identification of dozens of new T1D susceptibility loci. Some of them appear to predispose to T1D independently of the HLA and may be important in families with T1D who lack strong HLA susceptibility. Other loci may interact with each other to cause susceptibility. The autoimmune response against ${\beta}$-cells can also be triggered by environmental factors in the presence of a predisposing genetic background. Deciphering the environmental and genetic factors involved should help to understand the origin of T1D and aid in the design of individualized prevention programs.

• The Korean Journal of Physiology and Pharmacology
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• v.10 no.1
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• pp.39-44
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• 2006

Type I diabetes (T1D) is an organ-specific autoimmune disease caused by the T cell-mediated destruction of the insulin-producing ${\beta}$ cells in the pancreatic islets. The onset of T1D is the consequence of a progressive destruction of islet ${\beta}$ cells mediated by an imbalance between effector $CD4^+$ T helper (Th)1 and regulatory $CD4^+$ Th2 cell function. Since interferon-alpha (IFN-${\alpha}$) has been known to modulate immune function and autoimmunity, we investigated whether administration of adenoviralmediated IFN-${\alpha}$ gene would inhibit the diabetic process in NOD mice. The development of diabetes was significantly inhibited by a single injection of adenoviral-mediated IFN-${\alpha}$ gene before 8 weeks of age. Next, we examined the hypothesis that Th2-type cytokines are associated with host protection against autoimmune diabetes, whereas Th1-type cytokines are associated with pathogenesis of T1D. The expression of IFN-${\alpha}$ induced increase of serum IL-4 and IL-6 (Th2 cytokines) levels and decrease of serum IL-12 and IFN-${\gamma}$ (Th1 cytokines) levels. Therefore, overexpression of IFN-${\alpha}$ by adenoviralmediated delivery provides modulation of pathogenic progression and protection of NOD mice from T1D.

• Journal of Korean Biological Nursing Science
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• v.5 no.1
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• pp.5-12
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• 2003

The purpose of this study to compare of clinical profile between obese and nonobese type 2 diabetic patients. The subjects were consist of 111 obese (50 male, 61 female) and 159 non obese (79 male, 80 female) type 2 diabetic patients underwent fasting blood glucose, 2-hour postprandial blood glucose, $HbA_1c$, total cholesterol, triglyceride, high density lipoprotein, microalbuminuria, fasting C-peptide and 2-hour postprandial C-peptide were measured. Diabetes was diagnosed according to the American Diabetes Association (ADA) criteria. Obesity was defined as body mass index (BMI, kilograms per meters squared) ${\geq}23$. Data analyses were t-test, chisquare test in SAS program. The results were as follows : 1) Triglycerides and 2-hour postprandial C-peptide were significant higher in obese than non-obese patients. 2) Systolic blood pressure, Diastolic blood pressure, fasting blood sugar, 2-hour postprandial blood glucose, $HbA_1c$, total cholesterol, high-density lipoprotein, microalbuminuria and fasting C-peptide were no difference between obese and non-obese groups. These data indicate that obesity is a risk factor for the development of coronary heart disease (CHD) in diabetic patients. Therefore, weight reductions have beneficial effects on insulin action and glycemic control in obese type 2 diabetic patients.

• Nutrition Research and Practice
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• v.9 no.6
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• pp.658-666
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• 2015

BACKGROUND/OBJECTIVES: The current study examined trends in adherence to dietary recommendations and compared the levels of adherence between diagnosed and undiagnosed subjects with type 2 diabetes mellitus (T2DM) in Korea over the past 14 years. SUBJECTS/METHODS: Data were collected from the 1998-2012 Korea National Health and Nutrition Examination Surveys (KNHANES). Diagnosed diabetes was defined as giving a positive response to questions about awareness of the disease, a physician's diagnosis of diabetes, or medical treatment for diabetes, whereas undiagnosed diabetes was defined as having a fasting glucose level ${\geq}126mg/dl$. Assessment of adherence level was based on 6 components of dietary guidelines, considering meal patterns and intake levels of calories, carbohydrates, vegetable/seaweed, sodium, and alcohol. The participants received 1 point if they met the criteria for each of the 6 components, and the total possible score ranged from 0 to 6 points. Multivariate generalized linear regression was performed, taking into account the complex survey design. RESULTS: Among all diabetic patients aged 30 years or older, the proportion of diagnosed diabetes increased dramatically, from 40.9% in 1998 to 75.9% in 2012 (P for trend < 0.001). The overall adherence levels to dietary recommendations were low and did not significantly differ between diagnosed and undiagnosed subjects with T2DM for all survey years. Several improvements were observed, including increased adherence to maintaining sufficient vegetable/seaweed consumption (increased from 0.12 to 0.16 points) and limiting sodium intake (increased from 0.12-0.13 points to 0.19-0.24 points; P for trend < 0.001), while adherence to maintaining moderate alcohol consumption decreased. CONCLUSIONS: Analysis of data collected by the KNHANES indicates that Korean T2DM patients have poor adherence to dietary recommendations and maintenance of a healthy lifestyle, regardless of disease awareness. This finding suggests that development of practical, evidence-based guidelines is necessary and that provision and expansion of educational programs for T2DM patients is critical after diagnosis.

• 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.

• Korean System Dynamics Review
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• v.9 no.1
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• pp.155-170
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• 2008

The purpose of this study was to develop a system dynamics model for management of glucose metabolism disorders that demonstrated dynamic relationships between insulin and plasma glucose levels over the time. The model was developed to 1) represent the physiology of glucose metabolism for an normal adult subject, 2) to draw causal loop diagram that demonstrate feedback systems of glucose regulation in normal condition and pathologic condition of the type 2 diabetes, 3) to develop an interactive computer simulation model for management of glucose metabolism disorders. The simulation results showed the plasma glucose level for normal persons varied from 75 to 140 which was consistent with clinical findings. As an example for patients we selected a case which varied from 110 to 310. Two types of interventions were chosen to review the model; meal control and insulin administration. The simulation results for those cases also matched well with clinical findings. The developed model can be used as an effective educational tool for patients to develop healthy lifestyle choices. The results also provide a blueprint for health providers to maintain normal blood glucose levels in diabetes patients.

• Korean Journal of Pharmacognosy
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• v.35 no.1 s.136
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• pp.16-21
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• 2004

Protein tyrosine phosphatase 1B(PTP1B) is thought to be a negative regulator in insulin signal-transduction pathway. Insulin-resistance by the activation of PTP1B is a hallmark of both type 2 diabetes and obesity. Thus, the compounds inhibiting PTP1B can improve insulin resistance and can be effective in treating type 2 diabetes and obesity. The methanol extracts of 160 herbal medicines were screened for the inhibitory activity against PTP1B. Among the tested extracts, methanol extracts of Amsonia elliptica, Areca catechu, Benincasa hispida, Morus alba, Salvia miltiorrhiza, Siegesbeckia orientalis, and Trichosanthes kirilowii showed relatively strong inhibitory activity against PTP1B.