• Genomics & Informatics
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• 제10권4호
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• pp.239-243
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• 2012

Gestational diabetes mellitus (GDM) is a complex metabolic disorder of pregnancy that is suspected to have a strong genetic predisposition. It is associated with poor perinatal outcome, and both GDM women and their offspring are at increased risk of future development of type 2 diabetes mellitus (T2DM). During the past several years, there has been progress in finding the genetic risk factors of GDM in relation to T2DM. Some of the genetic variants that were proven to be significantly associated with T2DM are also genetic risk factors of GDM. Recently, a genome-wide association study of GDM was performed and reported that genetic variants in CDKAL1 and MTNR1B were associated with GDM at a genome-wide significance level. Current investigations using next-generation sequencing will improve our insight into the pathophysiology of GDM. It would be important to know whether genetic information revealed from these studies could improve our prediction of GDM and the future development of T2DM. We hope further research on the genetics of GDM would ultimately lead us to personalized genomic medicine and improved patient care.

• 동서간호학연구지
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• 제22권2호
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• pp.170-177
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• 2016

Purpose: The purpose of this study was to examine the mediating effect of regimen distress in the relationship between medication adherence and glycemic control in men with type 2 diabetes. Methods: A total of 116 patients with type 2 diabetes was recruited for the cross-sectional survey design. Data were analyzed using descriptive statistics, independent t-test, ANOVA, Pearson's correlation coefficient, and multiple regression using Baron and Kenny steps for mediation. Results: The mean score for medication adherence was 6.32, and the mean glycemic control level (HbA1c) was 7.47%. The mean score was 2.37 for regimen distress. There were significant correlations among medication adherence, regimen distress, and HbA1c. Regimen distress had a partial mediating effect (${\beta}$=.22, p=.005) in the relationship between medication adherence and HbA1c (Sobel test: Z=2.47, p=.013). Conclusion: Regimen distress was found to be associated with glycemic control in men with type 2 diabetes. Based on the findings of this study, nursing intervention programs focusing on decreasing regimen distress are highly recommended to improve level of glycemic control in patients with type 2 diabetes.

• Journal of Interdisciplinary Genomics
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• 제4권1호
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• pp.7-10
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• 2022

Purpose:Maturity onset diabetes of the young (MODY) is the most common hereditary form of diabetes mellitus (DM), with similar clinical manifestations to type 1 or type 2 DM, leading to diagnostic ambiguity. Despite increased genetic research on monogenic DM, studies with Asian populations are limited. Therefore, we investigated mutation in possible monogenic DM and MODY in Korean children and aldolescents. Methods: Targeted panel exome sequencing including 32 targets genes was performed for 41 patients with suspected monogenic DM at Kyungpook National University Children's Hospital. Results: Variants were detected in 19 patients, including those in known MODY-associated genes (HNF4A, GCK, HNF1A, CEL, PAX4, INS, and BLK) and monogenic DM-associated genes (WFS1, FRX6, and GLIS3). Conclusion: MODY variants were detected more than expected. Targeted exon sequencing is helpful in diagnosing MODY or possible monogenic DM patients.

• Diabetes and Metabolism Journal
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• 제42권6호
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• pp.480-487
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• 2018

Background: This study aimed to evaluate the relationship between the frequency of self-monitoring of blood glucose (SMBG) and glycosylated hemoglobin (HbA1c) levels among Korean adolescents with type 1 diabetes mellitus (T1DM). Factors affecting the SMBG frequency were analyzed in order to improve their glycemic control. Methods: Sixty-one adolescents aged 13 to 18 years with T1DM were included from one tertiary center. Clinical and biochemical variables were recorded. Factors associated with SMBG frequency were assessed using structured self-reported questionnaires. Results: Average total daily SMBG frequency was $3.8{\pm}2.1$ and frequency during the school day was $1.3{\pm}1.2$. The mean HbA1c level was $8.6%{\pm}1.4%$. As the daily SMBG frequency increased, HbA1c levels declined (P=0.001). The adjusted odds of achieving the target HbA1c in participants who performed daily SMBG ${\geq}5$ significantly increased 9.87 folds (95% confidence interval [CI], 1.58 to 61.70) compared with those performed SMBG four times a day. In the subjects whose SMBG frequency <1/day during the school day, an 80% reduction in the adjusted odds ratio 0.2 (95% CI, 0.05 to 0.86) showed compared to the group with performing two SMBG measurements in the school setting. The number of SMBG testing performed at school was significantly high for individuals assisted by their friends (P=0.031) and for those who did SMBG in the classrooms (P=0.039). Conclusion: Higher SMBG frequency was significantly associated with lower HbA1c in Korean adolescents with T1DM. It would be necessary to establish the school environments that can facilitate adequate glycemic control, including frequent SMBG.

• The Korean Journal of Physiology and Pharmacology
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• 제28권1호
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• pp.31-38
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• 2024

As in type 1 diabetes, the loss of pancreatic β-cells leads to insulin deficiency and the subsequent development of hyperglycemia. Exercise has been proposed as a viable remedy for hyperglycemia. Lithium, which has been used as a treatment for bipolar disorder, has also been shown to improve glucose homeostasis under the conditions of obesity and type 2 diabetes by enhancing the effects of exercise on the skeletal muscles. In this study, we demonstrated that unlike in obesity and type 2 diabetic conditions, under the condition of insulin-deficient type 1 diabetes, lithium administration attenuated pancreatic a-cell mass without altering insulin-secreting β-cell mass, implying a selective impact on glucagon production. Additionally, we also documented that lithium downregulated the hepatic gluconeogenic program by decreasing G6Pase protein levels and upregulating AMPK activity. These findings suggest that lithium's effect on glucose metabolism in type 1 diabetes is mediated through a different mechanism than those associated with exercise-induced metabolic changes in the muscle. Therefore, our research presents the novel therapeutic potential of lithium in the treatment of type 1 diabetes, which can be utilized along with insulin and independently of exercise.

• Child Health Nursing Research
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• 제30권1호
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• pp.17-30
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• 2024

Purpose: This pilot study aimed to assess the feasibility, preliminary efficacy, and effects of a mobile app healthcare coaching program developed based on self-regulation theory among youths with type 1 diabetes. Methods: A mixed-method design was utilized. Participants were randomly assigned into intervention (n=23, 12-week coaching program) or control groups (n=16, usual care). Pre- and post-intervention assessments included self-efficacy, diabetes management behavior, and health outcomes (quality of life, depression, and HbA1c). Quantitative data were analyzed with SPSS/WIN ver. 26.0. The narrative information from the participants in the healthcare coaching program underwent content analyzed. Results: The intervention group had significantly lower depression scores (t=2.57, p=.014) than the control group. No significant differences were observed in self-efficacy, diabetes management behavior, and health outcomes between the two groups. The average frequency of health behavior monitoring per week among the participants was 1.86±1.60. The qualitative findings indicated that participants perceived improved diabetes self-management with the intervention; however, challenges during vacations, dietary control difficulties, and a lack of disease awareness were identified. Conclusion: The healthcare coaching program improved psychological aspects for youth with type 1 diabetes. Further research is needed to develop and implement mobile app interventions aimed at enhancing compliance with diabetes management in pediatric and adolescent populations.

• Journal of Korean Biological Nursing Science
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• 제23권1호
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• pp.31-42
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• 2021

Purpose: This study was performed to assess the level of blood glucose and to identify poor glycemic control groups among patients with type 2 diabetes mellitus (DM). Methods: Data of 1,022 Korean type 2 DM patients aged 30-64 years were extracted from the Korea National Health and Nutrition Examination Survey VII. Complex samples analysis and a decision-tree analysis were performed using the SPSS WIN 26.0 program. Results: The mean level of hemoglobin A1c (HbA1c) was 7.22±0.25%, and 69.0% of the participants showed abnormal glycemic control (HbA1c≥6.5%). The characteristics of participants associated with poor glycemic control groups were presented with six different pathways by the decision-tree analysis. Poor glycemic control groups were classified according to the patients' characteristics such as period after DM diagnosis, awareness of DM, sleep duration, gender, alcohol drinking, occupation, income status, low density lipoprotein-cholesterol, abdominal obesity, and number of walking days per week. Period of DM diagnosis with a cut-off point of 6 years was the most significant predictor of the poor glycemic control group. Conclusion: The findings showed the predictable characteristics of the poor glycemic control groups, and they can be used to screen the poor glycemic control groups among adults with type 2 DM.

• 대한한방내과학회지
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• 제43권3호
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• pp.363-374
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• 2022

Objective: This study was conducted to evaluate the hypoglycemic effect and safety of herbal extracts in patients with type 2 diabetes mellitus. Methods: We investigated 19 hospitalized patients with type 2 diabetes mellitus who were administered Banhasasim-tang (BST), Gumiganghwal-tang (GGT), or Pyeongwee-san (PWS) at Kyung Hee University Korean Medical Hospital for at least three days between January 2012 and December 2021. Their clinical characteristics and laboratory tests were reviewed retrospectively. The glucose-lowering effect of the herbal extracts was assessed by comparing blood glucose levels, including fasting blood sugar (FBS), two-hour postprandial glucose (PP2) levels, and glycated hemoglobin levels. To evaluate the safety of the herbal extract, liver function test and kidney function test results were compared, including aspartate aminotransferase (AST), alanine aminotransferase (ALT), blood urea nitrogen (BUN), and creatinine (Cr). Results: After taking herbal extracts, PP2 and HbA1c levels significantly decreased from 205.82 mg/dL to 171.41 mg/dL and 7.58% to 6.62%, respectively. The safety profile reported no significant difference after taking herbal extracts. Conclusions: BST, GGT, and PWS may have hypoglycemic effects in patients with type 2 diabetes mellitus taking hypoglycemic medication.

• Journal of Periodontal and Implant Science
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• 제44권4호
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• pp.158-168
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• 2014

Purpose: The present study was conducted to evaluate the impact of scaling and root planing (SRP) on the C-reactive protein (CRP) levels of gingival crevicular fluid (GCF) and serum in chronic periodontitis patients with type 2 diabetes mellitus (T2DM-CP) or without type 2 diabetes mellitus (NDM-CP). Methods: Forty-eight human participants were divided into two groups: an experimental (T2DM-CP) group (group I, n=24) comprising chronic periodontitis patients with random blood sugar ${\geq}200mg/dL$ and type 2 diabetes mellitus, and control (NDM-CP) group (group II, n=24) of those with chronic periodontitis and random blood sugar <200 without T2DM for the study. All subjects underwent nonsurgical periodontal therapy (NSPT) including complete SRP and subgingival debridement. Periodontal health parameters, plaque index (PI), gingival index (GI), probing pocket depth (PPD), clinical attachment level (CAL), GCF volume (GCF vol), GCF-CRP, random blood glucose (RBS), glycated hemoglobin, and systemic inflammatory markers, serum CRP, total leukocyte count (TLC), neutrophil count (Neutr) and lymphocyte count (Lymph), were evaluated at baseline, 1 month, and 3 months after SRP. Results: NSPT resulted in statistically significant improvement in periodontal health parameters (PI, GI, PPD, CAL, GCF vol), CRP levels in serum as well as GCF of both groups I and II. The mean improvement in periodontal health parameters (PI, GI, PPD, CAL, GCF vol), CRP levels in serum and GCF was greater in group I than group II after NSPT. There was nonsignificant increase in GCF-CRP, TLC, Lymph, and RBS, and a significant increase in Neutr and Serum CRP in group II at 1 month. The Serum CRP level of 20 out of 24 group II patients had also increased at 1 month. Conclusions: The CRP levels in both GCF and serum were higher in T2DM-CP patients than in NDM-CP patients. Although there was a significant improvement in both the groups, greater improvement was observed in both GCF and serum samples of T2DM-CP patients.

• 동의생리병리학회지
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• 제27권5호
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• pp.677-682
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• 2013

Impaired glucose tolerance(IGT) & Impaired fasting glucose(IFG) were standardized in 1979 by the National Diabetes Data Group and the World Health Organization as a risk factor for type 2 diabetes. The main clinical significance of IGT & IFG shows some risk factors on type 2 diabetes, cardiovascular disease and component of the metabolic syndrome. In 1997, the American Diabetes Association(ADA) proposed the new classification and diagnostic criteria for diabetes, which wss striction on the diagnostic baseline of Diabetes from 140 mg/dl to 126 mg/dl. This is because that the early diagnosis and treatments can prevent chronic complications. In the oriental medicine, Gamiyookmigihwang-tang has been using for the treatments of Diabetes including IGT & IFG; however, there have not been enough studies about the effect of the glycemic control objectively. So clinical studies have been performed on a mild DM(Diabetes Mellitus) patient with IGT and IFG in order to investigate whether there is hypoglycemic effect of Gamiyookmigihwang-tang. Prior to the study, for two weeks fasting blood sugar(FBS) and postprandial 2hrs(PP2hrs) glucose were checked. in addition ECG, T-cholesterol, TG, HbA1c levels were measured; then, Gamiyookmigihwang-tang has administrated for 4 weeks. and FBS, PP2hrs, T-cholesterol, TG, HbA1c were measured again after the herb medicine treatment. FBS, PP2hrs glucose levels and other measuring levels (T-cholesterol, TG, HbA1c) were decreased by the administration of Gamiyookmigihwang-tang. Gamiyookmigihwang-tang has hypoglycemic effects on a mild DM patient with IGT and IFG.