• Perspectives in Nursing Science
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• v.13 no.1
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• pp.17-28
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• 2016

Purpose: This study aimed to identify patterns of diagnosis and to explore risk factors for type 2 diabetes beyond the postpartum period in women with a previous history of gestational diabetes, and to identify differences in such risk factors between early and late-onset (aged <45 and ${\geq}45$). Methods: Using epidemiological data from the Korean Genome and Epidemiology Study, a retrospective analysis of 175 women with various timings of type 2 diabetes diagnosis was performed. Results: The average age ($42.6{\pm}10.6$) at type 2 diabetes diagnosis was earlier than the general population, and obesity was prevalent with marked weight gains around 35 years old. Longer duration of breastfeeding was observed in women with late-onset of type 2 diabetes. Conclusion: For prevention of type 2 diabetes, early intervention is required, and modifiable factors such as weight control and breastfeeding should be taken into consideration for intervention strategies.

• Clinical and Experimental Pediatrics
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• v.45 no.5
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• pp.646-653
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• 2002

Purpose : The incidence of type 2 diabetes mellitus in children has been increasing worldwide recently, which is thought to be related to the increasing prevalence of obesity. We investigated to evaluate the incidence and the characteristics of type 2 diabetes mellitus in children and also analysed the relationship between intrauterine growth retardation and type 2 diabetes mellitus. Methods : We investigated 25 children diagnosed as type 2 diabetes mellitus between March 1990 and December 2000. The analysis was performed retrospectively with medical records based on the clinical characteristics and laborotory findings. Results : Incidence of type 1 and type 2 diabetes mellitus in children has been increasing since 1990. We demonstrated an increase in the percentage of type 2 diabetes mellitus children from 5.3% in 1990 to 21.0% in 2000. Sixty eight percent of patients(17/25) were classified as obese group. Initial symptoms at first visit were polyuria, polydipsia and polyphagia 48%(12/25), asymptomatic glycosuria 40% (10/25), weight loss 8%(2/25) and obesity 4%(1/25). The mean age at diagnosis was $12.9{\pm}1.8$ years. 64%(16/25) of patients had positive family history of type 2 diabetes mellitus. Autoanti-bodies were positive in 18.1%(4/22) of patients. Twenty eight percent (7/25) of patients had an associated disease and two patients had fatty liver in association with obesity. Treatment consisted of diet, exercise, education and oral hypoglycemic agents. Three patients were treated with insulin as well as oral hypoglycemic agents because of poor blood glucose control. Long-term diabetic complications occurred in 4 patients. Intrauterine growth retardtion was found in 34.6%(9/25); 88.9% (8/9) of these patients were non-obese group. Conclusion : The increase in the incidence of type 2 diabetes mellitus in children is thought to be related to the increasing prevalence of obesity. The non-obese group of patients might be associated with intrauterine growth retardation.

• Journal of Korean Academic Society of Home Health Care Nursing
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• v.23 no.2
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• pp.139-146
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• 2016

Purpose: This research seeks to identify differences between general characteristics, disease-related characteristics, glycated hemoglobin (HbAlc) levels, and aspects of chronic complications of diabetes mellitus in type 2 diabetes. Methods: This research was conducted from the 1st to the 15th of February in 2016, on 263 in patients. Patients' electronic medical records were used to identify their general characteristics, disease-related characteristics, HbAlc, and chronic diabetic complications. Chi-square test, ANOVA, ANCOVA, and the Cochran-Mantel-Haenszel test were used for data analysis. Results: Statistical significance was observed for general characteristics, based on smoking status, such as age, and education level; disease-related characteristics differed according to the duration of diabetes. Smoking status did not differ according to HbAlc level. In term of chronic diabetic complications, statistically significance was observed for diabetic nephropathy, based on smoking status. Conclusion: Patients who had a history of smoking, but were not currently smoking, were likely to display higher HbAlc levels and diabetic nephropathy. Therefore, there is need for regular checkups for diabetic complications among patients with a history of smoking and it is important to emphasize smoking cessation.

• The Journal of Internal Korean Medicine
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• v.38 no.1
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• pp.10-19
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• 2017

Objective: This study reviewed experimental studies on the effects of Korean medical treatment for diabetes mellitus (DM). Method: We reviewed 24 studies about DM that had been published since 2013. We searched the Korean Institute of Oriental Medicine (KIOM) database with the keyword '당뇨', '消渴', 'Diabetes'. Results: 1. The studies used various Korean medicine treatments; 15 used single medicinal herbs, 6 used herbal complexes, and 2 used acupuncture. 2. The measurement parameters used in the studies included blood glucose, body weight, histochemical change, lipid parameters, and food/water intake. Anti-diabetic effects were demonstrated in most of the studies. 3. The experimental animals used were rats or mice. There were 15 type 1 diabetes models, 7 type 2 diabetes models, and one normal model. Among them, 13 cases of chemical diabetes induced by Streptozotosin (STZ, type 1 diabetes inducer) were the most common. Conclusion: Further articles on Korean medical treatment of DM should be studied.

• Diabetes and Metabolism Journal
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• v.42 no.6
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• pp.465-471
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• 2018

My professional journey to understand the glucose homeostasis began in the 1990s, starting from cloning of the promoter region of glucose transporter type 2 (GLUT2) gene that led us to establish research foundation of my group. When I was a graduate student, I simply thought that hyperglycemia, a typical clinical manifestation of type 2 diabetes mellitus (T2DM), could be caused by a defect in the glucose transport system in the body. Thus, if a molecular mechanism controlling glucose transport system could be understood, treatment of T2DM could be possible. In the early 70s, hyperglycemia was thought to develop primarily due to a defect in the muscle and adipose tissue; thus, muscle/adipose tissue type glucose transporter (GLUT4) became a major research interest in the diabetology. However, glucose utilization occurs not only in muscle/adipose tissue but also in liver and brain. Thus, I was interested in the hepatic glucose transport system, where glucose storage and release are the most actively occurring.

• Childhood Kidney Diseases
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• v.13 no.1
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• pp.1-13
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• 2009

Type 1 diabetes mellitus commonly occurs in childhood and adolescence, although the prevalence of type 2 diabetes mellitus in these age groups is now being increased in the western world and Korea. Diabetic nephropathy developing in 15-25% of subjects with type 1 diabetes mellitus and in similar or higher percentage of type 2 diabetes mellitus patients is the leading cause of end-stage renal disease worldwide. Although prepubertal diabetic duration may contribute less to the development of microvascular complications than pubertal and postpubertal duration, diabetic nephropathy in susceptible patients almost certainly begins soon after disease onset and may accelerate during adolescence, leading to microalbuminuria or incipient DN. Type 1 diabetes is commonly associated with a period of hyperfiltration followed by the development of persistent microalbuminuria after as little as 7-10 years of type 1 diabetes. Microalbuminuria is associated with pathologic lesions that are so advanced as to overlap with those seen in patients with overt proteinuria and declining kidney function, therefore, microalbuminuria currently considered the best clinical indicator of overt diabetic nephropathy risk. This review covers the natural history and renal manifestations of diabetic nephropathy in children and adolescents.

• Journal of Korean Biological Nursing Science
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• v.24 no.1
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• pp.58-66
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• 2022

Purpose: The purpose of this study was to identify the level of psychological insulin resistance and self-care activities and to evaluate the factors affecting self-care activities in patients with type 2 diabetes mellitus undergoing insulin therapy to provide basic data for the development of educational programs. Methods: Data were collected through the interviews using a structured questionnaire from August 29 to October 20, 2017, from the patients with type 2 diabetes mellitus visiting the Diabetes Mellitus Center at H-General Hospital in J-city. The subjects were 168 patients who had been being treated via self-injection for at least three months after the start of insulin therapy. Data analyses were conducted using t-test, ANOVA, Pearson's correlation coefficients, and stepwise multiple regression using the SAS WIN 9.2 program. Results: The mean score of psychological insulin resistance was 61.25 (range 19-95) and the mean score of self-care activities was 53.19 (range 18-90). Self-care activities were significantly different by gender (t = -2.94, p= .004), perceived health status (F= 7.00, p< .001), and hypoglycemia during the last three months (t= -2.47, p= .015). Negative correlation was observed between psychological insulin resistance and self-care activities (r= -.33, p< .001). Self-care activities were significantly predicted by psychological insulin resistance, perceived health status, gender, and hypoglycemia during the last three months, and 19.0% of the variance in self-care activities was explained (F= 9.01, p< .001). Conclusion: Psychological insulin resistance in patients undergoing insulin therapy and its effects on self-care activities identified in this study will be useful in starting and maintaining insulin therapy in the future.

• Journal of Korean Academy of Rural Health Nursing
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• v.8 no.1
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• pp.13-24
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• 2013

Purpose: The purpose of this study was to examine the knowledge of diabetes and self-care behavior of patients with diabetes mellitus living in rural area. Methods: Participants in this study were 94 patients with type 2 diabetes mellitus. Data were collected from July 13 to September 14, 2012. The instruments were the knowledge of diabetes measurement developed by Park Oh Jang and the measurement of self-care behavior for patients with diabetes developed by Kim Young Ok. Data were analyzed using the SPSSWIN 18.0 program for t-test, one-way ANOVA and Scheffe test. Results: There were significant differences in knowledge of diabetes according to education level (p=.011), alcohol use (p=.010), regular exercise (p=.046), and duration of illness (p=.045). There were significant differences in self-care behavior of patients with diabetes according to satisfaction with income (p=.031), regular exercise (p<.001), experience with diabetes education (p=.001), number of diabetes education sessions (p<0.001), and complications (p=.001). Conclusion: Based on the result of this study, there is a need to develop and confirm the efficacy of education programs by examining their fit to characteristics of patients with diabetes mellitus living in rural areas.

• Korean Journal of Clinical Pharmacy
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• v.21 no.2
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• pp.57-65
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• 2011

Incretin hormones such as glucagon-like peptide-1 (GLP-1) and glucose-dependent insulinotropic polypeptide delay gastric emptying, increasing satiety, and enhance insulin secretion. Two new classes of treatments related to incretin hormones for the management of type 2 diabetes mellitus have emerged: GLP-1 receptor agonists (e.g., exenatide, liraglutide) and the dipeptidyl peptidase-4 (DPP-4) inhibitors (e.g., sitagliptin, saxagliptin, vildagliptin, alogliptin), which prevent the degradation of GLP-1. A MEDLINE search was conducted in order to evaluate the efficacy and safety of incretin-based therapies and publications were reviewed. Data from clinical trials indicated incretin-based treatment showed clinically significant reductions in hemoglobin A1c with low risk of hypoglycemia. Weight reductions were observed with GLP-1 receptor agonists where as DPP-4 inhibitors are weight neutral.

• Annals of Clinical Neurophysiology
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• v.16 no.1
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• pp.8-14
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• 2014

Background: Early detection of neuropathy may prevent further progression of this complication in the diabetic patients. The purpose of this study was to evaluate the prevalence of early neuropathic complication in patients with newly diagnosed type 1 and type 2 diabetes. Methods: Nerve conduction studies (median, ulnar, posterior tibial, peroneal, and sural nerves) were performed for 49 type 1 (27 males, mean $14.1{\pm}7.5$ years) and 40 type 2 (27 males, $42.0{\pm}14.1$ years) diabetic patients at onset of diabetes. Children with age at onset under 4 years and adults over 55 years were excluded to eliminate the aging effect and the influence of obstructive arteriosclerosis. Neuropathy was defined as abnormal nerve conduction findings in two or more nerves including the sural nerve. Results: Mean HbA1c level was $12.6{\pm}3.3%$ for type 1 and $10.5{\pm}2.9%$ for type 2 diabetes. The prevalence of neuropathy was 12.2% for type 1, and 35.0% for type 2 diabetes, respectively. There were significant trends in the prevalence of neuropathy with increasing age (p<0.05). The effect of the mean level of glycosylated hemoglobin on the prevalence of polyneuropathy at onset of diabetes was borderline (p=0.0532). Neither sex of the patients nor the type of diabetes affected the neurophysiologic abnormalities at the diagnosis. Conclusions: Even in a population with diabetes at the diagnosis, the prevalence of subclinical neuropathy was not low. Neuropathy has been significantly associated with increasing age indicating the possibility of longer duration of undetected diabetes among them, especially in type 2 diabetes.