• 대한한방내과학회지
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• 제43권1호
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• pp.22-40
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• 2022

Objectives: The purpose of this study is to assess the antidiabetic effect and safety of Galgunhwangryunhwanggum-tang for type 2 diabetes without complications by analyzing related research. Methods: For a systematic review and meta-analysis, we searched for the antidiabetic effect and safety of Galgunhwangryunhwanggum-tang for type 2 diabetes without complications in 10 databases up to September 2021. Only randomized controlled trials were chosen. Results: In the treatment effectiveness analysis and meta-analysis, Galgunhwangryunhwanggum-tang had significant improvement effects on fasting plasma glucose level, 2-hour postprandial glucose level, glycated hemoglobin, fasting insulin, and homeostasis model assessment for insulin resistance compared to the control group when treated in parallel with oral glycemic drugs. Conclusion: Galgunhwangryunhwanggum-tang is effective in improving blood sugar and insulin resistance in type 2 diabetes patients without complications and can especially be considered in parallel treatment with oral hypoglycemic drugs. A large-scale randomized controlled clinical trial is required to complement the limitations presented in this study in the future.

• Diabetes and Metabolism Journal
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• 제42권6호
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• pp.513-518
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• 2018

Background: Recent studies have correlated serum cystatin C (CysC) with vascular complications, but few studies have investigated this correlation in diabetes patients without nephropathy. This study aimed to evaluate if higher serum CysC levels increase the risk for vascular complications in type 2 diabetes mellitus patients with normal renal function or mild renal impairment. Methods: A total of 806 consecutive patients with type 2 diabetes mellitus who were admitted to the diabetes center of Soonchunhyang University Hospital for blood glucose control were retrospectively reviewed. Patients with nephropathy were excluded. Subjects were categorized into quartiles of serum CysC levels (Q1, ${\leq}0.65mg/L$; Q2, 0.66 to 0.79 mg/L; Q3, 0.80 to 0.94 mg/L; and Q4, ${\geq}0.95mg/L$). Results: The proportion of patients with diabetic retinopathy (DR) (P for trend <0.001), coronary heart disease (CHD) (P for trend <0.001), and stroke (P for trend <0.001) increased across the serum CysC quartiles. After adjustment for confounding factors, the highest serum CysC level remained a significant risk factor for DR (odds ratio [OR], 1.929; 95% confidence interval [CI], 1.007 to 4.144; P=0.040). Compared with Q1, a significant positive association was observed between serum CysC and CHD in Q2 (OR, 7.321; 95% CI, 1.114 to 48.114; P=0.012), Q3 (OR, 6.027; 95% CI, 0.952 to 38.161; P=0.020), and Q4 (OR, 8.122; 95% CI, 1.258 to 52.453; P=0.007). No associations were observed between CysC and stroke after additional adjustment for confounding variables. Conclusion: Serum CysC levels are independently associated with DR and CHD, suggesting that CysC may be useful for identifying type 2 diabetes mellitus patients without nephropathy who are at high risk for vascular complications.

• 대한한방내과학회지
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• 제42권4호
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• pp.605-621
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• 2021

Objectives: The purpose of this review is to assess the efficacy and safety of Hwangryunhaedok-tang for type 2 diabetes without complications by systemic review and meta-analysis of randomized controlled trials (RCTs). Methods: We searched the following up to March 31. 2021: PubMed, EMBASE, The Cochrane Library, CNKI, CiNii, KISS, KMBASE, OASIS, ScienceON. Data extraction and assessment of Cochrane's risk of bias (RoB) tool were performed by two independent authors, and if there was disagreement between two researchers, it was resolved through the intervention of a third researcher. Results: A total of seven trials are included in this systemic review. The treatment group (Hwangryunhaedok-tang plus conventional treatment) showed more statistically significant effects than did the control group (conventional treatment only) in fasting plasma glucose level, 2-hour postprandial plasma glucose level, glycated hemoglobin A1c, fasting insulin level, and HOMA-IR. There was no significant difference between the treatment group (Hwangryunhaedok-tang alone) and the control group (metformin alone). Conclusion: Hwangryunhaedok-tang might have efficacy and safety in controlling blood sugar level and improving insulin-resistance. However, the number of studies included in the meta-analysis was insufficient, and the Hwangryunhaedok-tang used in the included studies was not standardized. Also, the quality of the involved studies was generally low. Therefore, further studies are needed to determine the efficacy and safety of Hwangryunhaedok-tang treatment for type 2 diabetes mellitus.

• Physical Therapy Rehabilitation Science
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• 제7권3호
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• pp.139-145
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• 2018

Objective: Older persons with diabetes mellitus (DM) are particularly more likely to have fallen in the previous year than those without DM. The purpose of this study was to investigate the relationship between the risk of falls and type 2 DM in older adults who are 65 years of age or above. Design: A systematic review. Methods: PubMed and other two databases were searched up to August 2, 2018. Observational and cohort studies evaluating fall risk in people who are 65 years of age or above with DM were included. This review extracted the following information from each study selected: first author's surname, year of publication, country, average follow-up period, sex, age at enrollment, study population, measurement variables, relative risk, 95% confidence intervals and controlled variables. Results: This review involved nine cohort studies with 3,765 older adults with DM and 12,989 older adults without DM. Six studies compared with or without DM and two studies compared fallers with non-fallers with DM. Risk factors for falls included impaired cognitive function, diabetes-related complications (peripheral nerve dysfunction, visual impairment), and physical function (balance, gait velocity, muscle strength, and severity of physical activities). Conclusions: People who are 65 years of age or above with DM have increased risk of falling caused by impaired cognitive function, peripheral nerve dysfunction, visual impairment, and physical function in community-dwellers. For adults who are 65 years of age or older with DM, research fields and clinical settings should consider therapeutic approaches to improve these risk factors for falls.

• 대한한방내과학회지
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• 제42권4호
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• pp.672-686
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• 2021

Objectives: The purpose of this study is to assess the efficacy and safety of Baekhogainsam-tang for type 2 diabetes without complications by systemic review and meta-analysis of randomized controlled trials (RCTs). Methods: For a systematic review and meta-analysis, we set a key question in accordance with PICOT-SD. We searched the following up to March 31. 2021: PubMed, EMBASE, The Cochrane Library, CNKI, CiNii, KISS, KMBASE, OASIS, and ScienceON. A meta-analysis was conducted by synthesizing the results, including fasting plasma glucose level, postprandial 2-hour plasma glucose level, and Glycated Hemoglobin (HbA1c). Results: A total of five trials are included in this systemic review. The treatment group (Baekhogainsam-tang plus conventional treatment) showed more statistically significant effect than did the control group (conventional treatment only) in fasting plasma glucose level, postprandial 2-hour plasma glucose level, and glycated hemoglobin (HbA1c). Conclusions: Baekhogainsam-tang showed statistically significant effects in hypoglycemic effect and in improving insulin resistance. However, the number of studies included in the meta-analysis was insufficient, and the BIT used in the included studies was not standardized. This topic requires further attention and more clinical research.

• 보건행정학회지
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• 제26권2호
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• pp.125-134
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• 2016

Background: Glycemic control is an effective way to reduce the cardiovascular complications of diabetes, but more than half of the adults with diabetes in Korea are improperly controlling their glycemic levels. The purpose of this study is to identify the factors associated with poor glycemic control in type 2 diabetes patients. Methods: This study analyzed 1,261 subjects ${\geq}30years$ old diagnosed with type 2 diabetes who participated in the fifth Korean National Health and Nutrition Examination Survey (2010-2012). Poor glycemic control rates were defined as hemoglobin A1c (HbA1c) level ${\geq}7%$. To shed light on the causes of poor glycemic control, socio-demographics, diabetes severity, health status, and health behavior factors were adjusted and logistic regression was done. Results: Of the total 1,261 patients, 53.0% of patients with type 2 diabetes had HbA1c ${\geq}7%$. After running a logistic regression model, the odds ratio of poor glycemic control was higher in high school graduates than elementary school graduates; in people living in Chungcheong and Jeolla/Jeju than those living in Seoul; in the group with diabetes for over 5 years had diabetes less than 5 years; in a group with insulin and oral hypoglycemic agent treatment than non-treatment; in a group with hypertriglyceridemia than without hypertriglyceridemia; and in the group with slept less than 6 hours slept 7-8 hours. Conclusion: We need a comprehensive public health policy to reduce the poor glycemic control rates in type 2 diabetes patients. We should recognize the education levels, duration of diabetes, diabetes treatment, hypertriglyceridemia, and sleep duration were associated with poor glycemic control.

• Journal of Nutrition and Health
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• 제57권3호
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• pp.282-291
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• 2024

Purpose: Korean patients with type 2 diabetes mellitus (T2DM) and obesity are at a high risk of developing severe non-alcoholic fatty liver disease (NAFLD). This study examined the dietary intakes and compared the risks of NAFLD-related complications in Korean patients with T2DM and obesity. Methods: Data from the Korean National Diabetes Program cohort were used to study patients with T2DM. Two hundred and sixty-five obese patients with T2DM (body mass index ≥ 25 kg/m²) were classified into NAFLD and non-NAFLD groups. The nutrient intake was analyzed using a 24-hour dietary recall questionnaire. Anthropometric and biochemical data were also obtained. Statistical analyses were performed to determine the significant differences between the 2 groups. Results: The serum gamma-glutamyl transpeptidase levels in obese patients with T2DM and NAFLD were significantly higher than in obese T2DM patients without NAFLD (p < 0.05). The serum glucose and lipid profiles showed no significant differences between the NAFLD and non-NAFLD groups. The carbohydrate, protein, and fat levels also did not differ significantly. The results showed that the fiber intake of the NAFLD and non-NAFLD groups was 14.11 ± 3.86 g/100 kcal and 15.70 ± 4.56 g/1,000 kcal, respectively, showing that the dietary fiber intake of the non-NAFLD group was significantly higher (p < 0.05). A correlation was observed between total fiber intake and γ-glutamyl transpeptidase in either patient group. In addition, the odds ratio of developing NAFLD was 0.29× lower when the fiber was consumed at 125% of adequate intake. Conclusions: A higher dietary fiber intake may reduce the risk of NAFLD in obese patients with T2DM. The dietary intake of Korean obese patients with T2DM should include and be enriched in dietary fiber to aid in preventing and treating NAFLD.

• Journal of Nutrition and Health
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• 제56권4호
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• pp.377-390
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• 2023

본 연구는 한국인을 대상으로 제2형 당뇨병 환자와 질병이 없는 정상대조군을 비교하여 성별에 따른 체액 불균형 정도와 영양소 섭취량을 평가하고자 하였다. 조사대상자는 총 57명으로, T2DM이 있는 T2DM군 (n = 36)과 T2DM이 없는 정상대조군 (n = 21)으로 나누어 분석하고, 성별에 따른 체액량의 차이를 고려하여 남성 T2DM군 (n = 24), 남성 정상대조군 (n = 9), 여성 T2DM군 (n = 12), 여성 정상대조군 (n = 12)으로 세분화하여 지표들의 특징을 분석하였다. BIA를 통하여 연구대상자의 체액 조성을 분석한 결과, ECW/ICW는 T2DM군이 정상대조군보다 유의적으로 높았고, 부종지수를 나타내는 ECW/TBW는 T2DM군이 정상대조군보다 유의적으로 높게 나타났다. 성별에 따른 체액 조성을 분석한 결과, 남성과 여성 모두 T2DM군은 정상대조군보다 높은 ECW/ICW, ECW/TBW를 보이며 동일한 체수분율 양상이 나타났다. 식사일기를 통해 연구대상자의 영양소 섭취량을 분석한 결과, 1,000 kcal 당 탄수화물, 식이섬유, 비타민 A, 비타민 C, 나트륨, 칼륨 섭취량은 T2DM군이 정상대조군보다 많았고, 1,000 kcal 당 지방, 콜레스테롤 섭취량은 T2DM군이 정상대조군보다 적었다. 본 연구를 통해 T2DM 환자에게서 체액 불균형이 나타날 가능성이 높음을 알 수 있었으며 추후 당뇨 합병증의 평가, 진단의 기초 자료로 널리 활용될 것으로 사료된다.

• Clinical and Experimental Pediatrics
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• 제50권2호
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• pp.190-197
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• 2007

목 적: 1형 당뇨병 소아, 청소년에서 혈당 조절이 불량하면 성장 장애와 미세혈관 합병증이 발생할 수 있다. 1형 당뇨병이 성장에 미치는 영향과 미세혈관 합병증(당뇨병성 신병증 또는 망막병증) 발생과 관련된 요인을 파악하고자 하였다. 방 법: 서울대병원에서 추적 중인 16세 이상의 154명 환자들의 의무기록을 후향적으로 분석하였다. 성인키 SDS(standard deviation score)에 영향을 미치는 요인을 분석하였고 합병증 유무, 미세알부민뇨의 경과에 따라 군을 나누어 특징을 비교하였다. 결 과: 성인키 SDS는 $-0.11{\pm}1.15$(여 $-0.26{\pm}1.33$, 남 $0.04{\pm}0.91$)였다. 성인키 SDS는 중간부모키 SDS에 비해 작았고(여 P=0.001, 남 P=0.002), 진단시 키 SDS에 비해서도 유의하게 감소하였다(여 P<0.001, 남 P=0.013). 진단시 사춘기 유무, 합병증 유무, 혈당 조절 정도, 이환 기간은 성인키 SDS에 영향을 미치지 않았다. 사춘기 시작시 키 SDS, 중간부모키 SDS, 사춘기 성장이 성인키 SDS에 영향을 미치는 요인이었다. 합병증이 발생한 37명(24%) 중에서 신병증은 29명, 망막병증은 19명, 동반된 경우는 11명이었다. 사춘기 전에 발병한 환자들은 사춘기에 발병한 환자들에 비해 첫 합병증이 발생한 연령은 더 낮았으나 첫 합병증 발생까지의 유병 기간은 더 길었다. 합병증이 발생한 그룹은 합병증이 없는 그룹보다 평균당화혈색소가 더 높았다. 미세알부민뇨가 소실된 환자들은 미세알부민뇨가 지속되거나 현성 신병증으로 진행한 환자들에 비해 평균당화혈색소, 수축기 혈압, 두 번째 측정한 24시간 소변 미세알부민 수치가 더 낮았다. 결 론: 1형 당뇨병 환자의 성인키는 혈당 조절 정도의 영향을 받지 않았지만, 중간부모키, 진단시 키에 비해 감소하여 당뇨병의 여러 요인에 의해 성장소실이 가능함을 알 수 있었다. 미세혈관 합병증 발생을 예방하기 위해서는 철저한 혈당 조절이 필요하다. 혈당 조절이 불량하거나 사춘기가 시작되면 미세혈관 합병증에 대한 선별검사를 시행해야 한다.

• Nutrition Research and Practice
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• 제1권2호
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• pp.79-83
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• 2007

The present study was conducted to document the association between plasma homocysteine levels and the presence of macrovascular angiopathy with food and nutrient intake patterns among patients with Type II diabetes mellitus in Korea. Plasma total homocysteine concentration was analyzed by HPLC-fluorescence detector method in 127 patients with non-insulin dependent diabetes mellitus. Logistic regression analyses were performed respectively to study the association of plasma homocysteine levels with clinical and dietary characteristics and macroangiopathy (MA). The average plasma homocysteine level of patients with MA was $14.2{\mu}mol/l$, which was significantly higher than that of patients without MA ($11.4{\mu}mol/l$). The proportions of patients with MA showed a significant difference, being 32.3% in hyperhomocysteinemic ($>14.0{\mu}mol/l$) patients and 13.5% in others with homocysteine levels lower than $14.0{\mu}mol/l$. Odds ratios for macroangiopathy by tertile increase of plasma homocysteine concentration were 1.633 ($Q_2$) and 4.831 ($Q_3$), when adjusted for age, sex, and cigarette smoking. Patients with MA consumed reduced amounts of vitamin $B_1,\;B_2$, and folate. The results indicate that the plasma homocysteine levels are significantly increased in NIDDM patients who have macroangiopathy. Dietary management such as increased fruits and vegetables and decreased potatoes and starches might be beneficial for the prevention of macroangiopathy in diabetic patients.