• Title/Summary/Keyword: type 1 diabetes

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Maturity-onset Diabetes of the Young: Update on Diagnosis and Treatment

  • Jang, Kyung Mi
    • Journal of Interdisciplinary Genomics
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    • v.3 no.1
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    • pp.1-6
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    • 2021
  • Maturity-onset diabetes of the young (MODY) is characterized by a heterogeneous group of monogenic diabetes. MODY has autosomal dominant inheritance, a primary defect in pancreatic β-cell, and an early onset. Discriminating MODY from type 1 or type 2 diabetes is often challenging at first. To date, 14 different disease causing mutations have been identified in MODY patients worldwide. Targeted DNA sequencing is the gold standard to diagnose MODY and their asymptomatic relatives. Next-generation sequencing may help successfully to diagnose MODY patients and identify new MODY genes. In this review, the current perspectives on diagnosis and treatment of MODY and discrepancy in the disease-causing mutations between the Asian and Caucasian patients with MODY are summarized.

Effects of Periodontal Treatment on Glycated Hemoglobin A Levels in Patients with Type 2 Diabetes: A Meta-Analysis of Randomized Clinical Trials

  • Son, So-Hyun;Lee, Eun-Sun
    • Journal of dental hygiene science
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    • v.18 no.3
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    • pp.137-146
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    • 2018
  • This systematic review aimed to investigate the effects of periodontal treatment on glycated hemoglobin A (HbA1c) levels in patients with type 2 diabetes who develop periodontal disease. The search of the MEDLINE, Embase, CINAHL, and Cochrane Library databases was completed on April 8, 2018. The study design was based on randomized clinical trials. Scaling and root planing was performed for the test group, whereas no periodontal treatment or simple oral training was performed for the control group. The main outcome variable was the change in HbA1c levels. We used the Review Manager statistical analysis software for the quantitative analysis of selected documents. Meta-analysis was performed using the inverse variance estimation method of the fixed-effect model to estimate the effects of periodontal treatment on HbA1c levels in patients with type 2 diabetes. A total of 1,011 documents were searched using search strategies, and 10 documents were included in the meta-analysis. The meta-analysis of the selected literature showed that periodontal treatment significantly reduced the HbA1c levels in patients with type 2 diabetes who develop periodontal disease (mean difference, -0.34; 95% confidence interval, -0.43 to -0.26; p<0.001). This study aimed to investigate the effects of periodontal treatment on HbA1c levels, which can be used as a basis for the increasing management of diabetic complications. To improve the quality of life and reduce the burden of medical expenses for patients with diabetes, periodontal disease management through nonsurgical periodontal treatment, such as scaling and root planing, is necessary.

The Association Between PM2.5 Exposure and Diabetes Mellitus Among Thai Army Personnel

  • Apisorn Laorattapong;Sarun Poobunjirdkul;Thanapoom Rattananupong;Wiroj Jiamjarasrangsi
    • Journal of Preventive Medicine and Public Health
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    • v.56 no.5
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    • pp.449-457
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    • 2023
  • Objectives: This study investigated the association between baseline exposures to particulate matter with a diameter <2.5 microns (PM2.5) and subsequent temporal changes in PM2.5 exposure with the incidence of type 2 diabetes among Royal Thai Army personnel. Methods: A retrospective cohort study was conducted using nationwide health check-up data from 21 325 Thai Army personnel between 2018 and 2021. Multilevel mixed-effects parametric survival statistics were utilized to analyze the relationship between baseline (i.e., PM2.5-baseline) and subsequent changes (i.e., PM2.5-change) in PM2.5 exposure and the occurrence of type 2 diabetes. Hazard ratios (HRs) and 95% confidence intervals (CIs) were employed to assess this association while considering covariates. Results: There was a significant association between both PM2.5 baseline and PM2.5-change and the incidence of type 2 diabetes in a dose-response manner. Compared to quartile 1, the HRs for quartiles 2 to 4 of PM2.5-baseline were 1.11 (95% CI, 0.74 to 1.65), 1.51 (95% CI, 1.00 to 2.28), and 1.77 (95% CI, 1.07 to 2.93), respectively. Similarly, the HRs for quartiles 2 to 4 of PM2.5-change were 1.41 (95% CI, 1.14 to 1.75), 1.43 (95% CI, 1.13 to 1.81) and 2.40 (95% CI, 1.84 to 3.14), respectively. Conclusions: Our findings contribute to existing evidence regarding the association between short-term and long-term exposure to PM2.5 and the incidence of diabetes among personnel in the Royal Thai Army.

Pattern and Management of Dyslipidemia in Type 2 Diabetes Patients in Korea (제 2형 당뇨환자에서 지질이상 유형 및 관리)

  • Jeong, Kyong-Ju;Cho, Seung-Ki
    • Korean Journal of Clinical Pharmacy
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    • v.16 no.1
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    • pp.46-51
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    • 2006
  • Dyslipidemia is an important CHD risk factor in diabetic patients. We conducted this study to assess the pattern of dyslipidemia in type 2 diabetes patients, to examine the demographic and clinical factors associated with dyslipidemia and to evaluate attaining within the lipid target goals and treatment strategies. A retrospective analysis was conducted among patents diagnosed type 2 diabetes at outpatient clinic in endocrinology between January 2003 and December 2004. Clinical history and physical examination were reviewed and laboratory data including blood glucose, HbAlc, lipid levels were recorded sequentially at least 1 year. In 882 patients with type 2 diabetes, 437 patients (49.6%) have dyslipidemia and 73% of them (319 patients) received lipid-lowering agents. 244 patients (94 males, 150 females, mean age 60 years old) were susceptible to analyses. The most frequent pattern of dyslipidemia is high LDL level and high TG levels (28%). Metabolic syndrome and macrovascular complication were significant negative independent association with lipid levels within the target goals (p<0.05). Only 15.2% (19 males, 18 females) attained within the lipid tar- get goals. Patients with diabetic dyslipidemia need maximization of lipid-lowering agents, increasing the fibric acid derivatives prescription and the effort to correction of low HDL and/or high TG.

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The Relationship between Depression, Self-Care Activity and $HbA_1c$ in Clients with Type-2 Diabetes Mellitus (제 2형 당뇨환자의 우울, 자가간호 이행과 당화혈색소와의 관계)

  • Kim, Sun-Hyang;Kang, Hee-Sun
    • Journal of Korean Academy of Fundamentals of Nursing
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    • v.15 no.2
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    • pp.178-185
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    • 2008
  • Purpose: This study was done to investigate the relationship between depression, self-care activity and $HbA_1c$ in clients with type-2 diabetes mellitus (DM) clients. Method: This was a cross sectional descriptive study and data were collected between October 4 and 27, 2006 using a questionnaire. The participants were inpatients and outpatients with type-2 diabetes being seen in one of two hospitals. The questionnaire included general as well as disease related characteristics, a depression scale (CES-D), and the self-care activity scale developed by Kim (1996). $HbA_1c$ was obtained from medical records. Results: There were 50 men (41.7%) and 70 women (58.3%). The mean scores for depression and self-care activity were $18.22{\pm}10.03$ and 3.51, respectively. Almost half of the Participants (46.7%) had an $HbA_1c$ greater than 7%. Self-care activity was negatively correlated with depression (r=-.436, p=0.00) and $HbA_1c$ (r=-.269, p=0.03). Depression was positively correlated with $HbA_1c$ (r=-.325, p=0.00). Participants who had diabetes education showed a significantly lower level of $HbA_1c$ than the group who had never had diabetes education. Conclusions: It is Important to make ensure that patients with diabetes have education on diabetes mellitus and to screen and manage depression as part of the care for these patients.

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Transformational Experience of a Student Nurse with Diabetes: A Case Study

  • Choi, Hye-Jung;Hong, Young-Sang
    • Journal of Korean Academy of Nursing
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    • v.37 no.2
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    • pp.192-200
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    • 2007
  • Purpose. The current study was aimed to investigate the transformational experience of a female student nurse living with type 1 diabetes. Methods. A case study of a 24-year-old diabetes patient was conducted, with interviews concerning the evolving process she had lived through during the period from her later high school years to her graduation from nursing college. Results. Followings were identified as 5-transformation process: With her diabetes-related limitation, the participant experienced 'conflict involving choosing a college and major'. The participant tried to be in charge of managing her diabetes and stepped forward to 'adaptation to college life as a new environment', and she learned more about the process of 'evolving awareness of caring' and developed herself further through the process of 'integration of the nurse identity into self-identity', and finally through the process of 'progression and preparation for getting a job' she achieved her goals, being positive about the future. Conclusions. The results of the study can provide individuals with diabetes a way of self-management and help the patients and their families in diabetes education. Further research will be needed to refine the results of this study and to learn more about the experiences of patients with type I diabetes in college years.

Plasma Concentrations of Lipid Profiles and Lipoprotein(a) In Type 2 Diabetes Mellitus Patients with Macrovascular Complications (제2형 당뇨병 환자의 대혈관 합병증 유무별 혈중 지질농도와 Lipoprotein(a) 비교)

  • Song Min Sun;Yoo Yang Sook;Kim Hee Seung
    • Journal of Korean Public Health Nursing
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    • v.16 no.1
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    • pp.115-122
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    • 2002
  • The purpose of this study to examine lipid profiles and lipoprotein (a) concentrations and identify the risk factors of type 2 diabetes mellitus patients with macrovascular complications. The subjects were consisted of 618 out patients with type 2 diabetes mellitus from beginning of March through the end of April in 2001, who visited at the endocrinology department at Kangnam St. Mary's Hospital of Catholic University in Seoul. The patient's clinical laboratory data and the occurrence of chronic complications of diabetes were assessed at medical record review. The data were analyzed using for t-test. chi-square test and logistic regression. The results were as follows : 1. There were no significant differences in age. duration of diabetes. body mass index, sex, fasting blood glucose, 2-hour postprandial blood glucose and $HbA_{1}c$ level between macrovascular complication group and non macrovascular complication group. 2. There were significant differences in the level of total cholesterol. triglyceride. HDL(High density lipoprotein) cholesterol, LDL(Low density lipoprotein) cholesterol and lipoprotein(a) between macrovascular complication group and non macrovascular complication group. 3. Significant factor associated with macrovascular complication in the logistic regression best gut model was HDL cholesterol.

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Cardiovascular Autonomic Neuropathy Predicts Higher HbA1c Variability in Subjects with Type 2 Diabetes Mellitus

  • Yang, Yeoree;Lee, Eun-Young;Cho, Jae-Hyoung;Park, Yong-Moon;Ko, Seung-Hyun;Yoon, Kun-Ho;Kang, Moo-Il;Cha, Bong-Yun;Lee, Seung-Hwan
    • Diabetes and Metabolism Journal
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    • v.42 no.6
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    • pp.496-512
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    • 2018
  • Background: This study aimed to investigate the association between the presence and severity of cardiovascular autonomic neuropathy (CAN) and development of long-term glucose fluctuation in subjects with type 2 diabetes mellitus. Methods: In this retrospective cohort study, subjects with type 2 diabetes mellitus who received cardiovascular autonomic reflex tests (CARTs) at baseline and at least 4-year of follow-up with ${\geq}6$ measures of glycosylated hemoglobin (HbA1c) were included. The severity of CAN was categorized as normal, early, or severe CAN according to the CARTs score. HbA1c variability was measured as the standard deviation (SD), coefficient of variation, and adjusted SD of serial HbA1c measurements. Results: A total of 681 subjects were analyzed (294 normal, 318 early, and 69 severe CAN). The HbA1c variability index values showed a positive relationship with the severity of CAN. Multivariable logistic regression analysis showed that CAN was significantly associated with the risk of developing higher HbA1c variability (SD) after adjusting for age, sex, body mass index, diabetes duration, mean HbA1c, heart rate, glomerular filtration rate, diabetic retinopathy, coronary artery disease, insulin use, and anti-hypertensive medication (early CAN: odds ratio [OR], 1.65; 95% confidence interval [CI], 1.12 to 2.43) (severe CAN: OR, 2.86; 95% CI, 1.47 to 5.56). This association was more prominent in subjects who had a longer duration of diabetes (>10 years) and lower mean HbA1c (<7%). Conclusion: CAN is an independent risk factor for future higher HbA1c variability in subjects with type 2 diabetes mellitus. Tailored therapy for stabilizing glucose fluctuation should be emphasized in subjects with CAN.

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

  • Choi, Yoon-Young;Sohn, Hyun-Soon;Shin, Hyun-Taek
    • Korean Journal of Clinical Pharmacy
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    • v.20 no.3
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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.

Structural Equation Analysis of Social Support, Impaired Fasting Glucose, and Type 2 Diabetes

  • Kang, Yun-Jung;Park, Sang-Nam;Yoon, Ki Nam
    • Biomedical Science Letters
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    • v.25 no.4
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    • pp.357-366
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    • 2019
  • This study is to identify how the social support influences the impaired fasting glucose and type 2 diabetes as structural equation analysis reflects the health behavior and psychological path. It investigates participants who give consents to participate in the Korean Health Examine Cohort (KOEX), which collects surveys and biological samples at eight university hospitals nationwide. Of the 53,767 adults over 30 years of age enrolled in the 2nd to 7th KOEX study from 2004 to 2010 (1st to 7th), 18,618 participants with a history of chronic diseases related to type 2 diabetes, the main variable, were excluded. The number of participants were 34,316 with enough data on social support and diabetes, which are the main variables. The results show that social support affects health behaviors and lowers fasting blood sugar. Therefore, not only the management of risk factors of individuals, but also the practice of healthy behavior with the attention of social relations such as social support, etc., can prevent type 2 diabetes.