No abstract available.
Diabetes Mellitus, Type 2* ; Diabetic Retinopathy* ; Humans

Artificial pancreas is a technique developed to automatically control blood glucose in people with diabetes by providing an endocrine function instead of a healthy pancreas. The technique was developed for the replacement of insulin secretion deficiencies among various exocrine and endocrine functions of the pancreas and is mainly used for people with type 1 diabetes or those who need intensive insulin treatment. This review briefly summarizes the working principles, components, recent clinical research, and future perspectives of artificial pancreas.
Blood Glucose ; Diabetes Mellitus ; Extracellular Fluid ; Glucose ; Insulin ; Pancreas ; Pancreas, Artificial*

OBJECTIVE: The authors demonstrate neuroprotective effects of antioxidant in reperfusion injury using ischemic rat model and evaluate the clinical eligibility of this agent to ischemic cerebrovascular diseases. METHODS: Rat model was made according to Longa method. Thirty-six Sprague-Dawley rats were used and were equally divided into three groups;A) treated subcutaneously with D,L-6,8-Thioctic acid 30 minutes before occlusion, B) within one hour after occlusion, and C) with vehicle only. Neurologic examination was performed immediately and 24 hours after reperfusion. Twenty-four hours after reperfusion, brains were extracted and stained with 2% 2,3,5-Triphenyltetrazolim chloride in 2mm-thickness section. Then, fixed sections were digitalized and used for infarct area calculation. RESULTS: There was no significant statistical difference in recorded hemodynamic and physiologic parameters between three groups. The neurologic status taken immediately following reperfusion were A) 2.67+/-0.492, B) 2.75+/-0.452, and C) 2.83+/-0.389, and were improved to A) 1.67+/-0.898, B) 1.92+/-0.900, and C) 2.08+/-0.793 just before sacrificing. However, there was no statistically significant difference between three groups. Mean volume of cerebral infarction was A) 9.5+/-1.67%, B) 10.4+/-1.58%, and C) 11.3+/-1.12% with no significant difference. Any specific correlation between the neurologic status and the mean infarction volume was not observed. CONCLUSION: Any single agent does not seem to reduce the infarction volume holistically, therefore, the incoming therapeutic target should be the development of versatile neuroprotective agents or the selection of preexisting synergistic compounds without compromising patients' safety.
Animals ; Brain ; Cerebral Infarction* ; Hemodynamics ; Infarction ; Models, Animal* ; Neurologic Examination ; Neuroprotective Agents ; Rats* ; Rats, Sprague-Dawley ; Reperfusion ; Reperfusion Injury

OBJECTIVES: To find differences in Framingham risk scores which predict the probable risk of future cardiovascular disease, among three different occupational categories. METHODS: Subjects were selected from respondents of the 3rd Korean National Health and Nutrition Examination Survey. A total of 2,059 employed people between 20 to 59 years old were selected. The occupational categories were professional and office workers, salespeople and service workers and technicians and elementary occupations. The Framingham risk score was calculated to find the risk of cardiovascular disease within the next 10 years. In addition socio-demographic characteristics, life-styles, the prevalence of chronic disease, and cardiovascular disease were compared among the occupational categories. RESULTS: The average Framingham risk score was 2.77+/-6.44 for professional and office workers (n=771), 5.95+/-6.10 for salespeople and service workers (n=603) and 7.07+/-5.87 for technician and elementary occupations (n=685) Statistically significant multiple regression equations were derived (p<0.001). CONCLUSIONS: Framingham risk scores of technicians and elementary occupations were highest which suggests that this occupational group has the highest risk of cardiovascular disease.
Cardiovascular Diseases ; Chronic Disease ; Data Collection ; Humans ; Nutrition Surveys ; Occupational Groups ; Occupations ; Prevalence

Hyperglycemia that does not satisfy the diagnostic criteria for diabetes mellitus (DM) is generally called prediabetes (preDM). The global prevalence of preDM has been increasing progressively in the past few decades, and it has been established that preDM status is a strong risk factor for DM and cardiovascular disease. Currently, preDM status is classified into two subtypes: impaired fasting glucose and impaired glucose tolerance. Currently, preDM is not regarded as an independent clinical entity, but only as a risk factor for others. In this article, we review various clinical aspects of preDM in terms of the working definition, changes in criteria over the years, epidemiology, and pathophysiological characteristics, and its clinical significance in current medicine.
Cardiovascular Diseases ; Diabetes Mellitus ; Diabetes Mellitus, Type 2 ; Fasting ; Glucose ; Hyperglycemia ; Insulin Resistance ; Korea ; Prediabetic State ; Prevalence ; Risk Factors

BACKGROUND/AIMS: This study was conducted to examine the relationship between family history of type 2 diabetes (T2DM) and risk of developing gestational diabetes mellitus (GDM) in Korean women. METHODS: We performed a 100-g oral glucose tolerance test in 858 pregnant women who had abnormal glucose tolerance in 50-g oral glucose challenge. In addition, we reviewed the incidence of T2DM in the parents and siblings and analyzed the association between the familial history of T2DM and the risk of GDM. RESULTS: Of the 858 subjects, 427 were normal, and 431 were diagnosed with GDM. Compared with women with no family history of T2DM, women with first degree family history of T2DM displayed higher risk of T2DM (odd ratio: parent only 1.91, sibling only 6.24, any 2.27). CONCLUSIONS: The risk of developing GDM was significantly increased in Korean women with a family history of T2DM in first-degree relatives.
Adult ; Cluster Analysis ; Diabetes Mellitus, Type 2/*genetics ; Diabetes, Gestational/diagnosis/*genetics ; Female ; Genetic Predisposition to Disease ; Glucose Tolerance Test ; Humans ; Korea ; Male ; Parents ; Pregnancy ; Risk Factors ; Siblings

BACKGROUND: The prevalence of diabetes mellitus (DM) continues to increase, and the disease burden is the highest of any medical condition in Korea. However, large-scale clinical studies have not yet conducted to establish the basis for diabetes prevention in Korea. METHODS: The hospital-based Korean Diabetes Prevention Study (H-KDPS) is a prospective, multi-center, randomized, open-label controlled study conducted at university hospitals for the purpose of gathering data to help in efforts to prevent type 2 DM. Ten university hospitals are participating, and 744 subjects will be recruited. The subjects are randomly assigned to the standard care group, lifestyle modification group, or metformin group, and their clinical course will be observed for 36 months. RESULTS: All intervention methodologies were developed, validated, and approved by Korean Diabetes Association (KDA) multi-disciplinary team members. The standard control group will engage in individual education based on the current KDA guidelines, and the lifestyle modification group will participate in a professionally guided healthcare intervention aiming for ≥5% weight loss. The metformin group will begin dosing at 250 mg/day, increasing to a maximum of 1,000 mg/day. The primary endpoint of this study is the cumulative incidence of DM during the 3 years after randomization. CONCLUSION: The H-KDPS study is the first large-scale clinical study to establish evidence-based interventions for the prevention of type 2 DM in Koreans. The evidence gathered by this study will be useful for enhancing the health of Koreans and improving the stability of the Korean healthcare system (Trial registration: CRIS KCT0002260, NCT02981121).
Clinical Study ; Delivery of Health Care ; Diabetes Mellitus ; Diabetes Mellitus, Type 2 ; Early Intervention (Education) ; Education ; Hospitals, University ; Incidence ; Korea ; Life Style ; Metformin ; Prediabetic State ; Prevalence ; Primary Prevention ; Prospective Studies ; Random Allocation ; Risk Reduction Behavior ; Weight Loss

BACKGROUND/AIMS: Due to recent increases in the disease burden of diabetes mellitus, the Health Insurance Review and Assessment Service (HIRA) of Korea implemented a quality assessment of the treatment of diabetes to improve patient care. The present study was conducted to identify any changes after the implementation of the diabetes quality assessment (DQA). METHODS: The present study evaluated eight quality assessment indicators that were proposed by the HIRA in all patients with diabetes who visited a university hospital in Korea between 2009 and 2014. The indicators were statistically compared according to the characteristics of the subjects. RESULTS: There were several significant differences in the indicators among the subjects according to their demographic characteristics. Female patients had a higher continuity of treatment (COT) than that of male patients, and the insulin-treated group had a higher COT than that of the non-treated group, as well as a higher rate of undergoing the diabetes complication tests (DCTs). Patients between 40 and 80 years of age had the highest COT, while patients under 40 years of age had the lowest COT but the highest rate of taking the DCTs. Patients receiving treatment from an endocrinologist exhibited higher numbers of DCTs performed but displayed lower proportions for the prescription indicators. CONCLUSIONS: The present analysis of the DQA findings revealed that endocrinologists combine prevention and management of diabetes complications with measures for glycemic control. Thus, the effective management of diabetes likely entails systematic joint treatment regimens that involve an endocrinologist.
Diabetes Complications ; Diabetes Mellitus ; Endocrinology ; Female ; Humans ; Insurance, Health ; Joints ; Korea* ; Male ; Patient Care ; Prescriptions ; Quality Improvement ; Quality of Health Care

BACKGROUND: Air pollution causes many diseases and deaths. It is important to see how air pollution affects obesity, which is common worldwide. Therefore, we analyzed data from a smartphone application for intentional weight loss, and then we validated them. METHODS: Our analysis was structured in two parts. We analyzed data from a cohort registered to a smartphone application in 10 large cities of the world and matched it with the annual pollution values. We validated these results using daily pollution data in United States and matching them with user information. Body mass index (BMI) variation between final and initial login time was considered as outcome in the first part, and daily BMI in the validation. We analyzed: daily calories intake, daily weight, daily physical activity, geographical coordinates, seasons, age, gender. Weather Underground application programming interface provided daily climatic values. Annual and daily values of particulate matter PM10 and PM2.5 were extracted. In the first part of the analysis, we used 2,608 users and then 995 users located in United States. RESULTS: Air pollution was highest in Seoul and lowest in Detroit. Users decreased BMI by 2.14 kg/m2 in average (95% confidence interval, −2.26 to −2.04). From a multilevel model, PM10 (β=0.04, P=0.002) and PM2.5 (β=0.08, P < 0.001) had a significant negative effect on weight loss when collected per year. The results were confirmed with the validation (βAQI*time=1.5×10–5; P < 0.001) by mixed effects model. CONCLUSION: This is the first study that shows how air pollution affects intentional weight loss applied on wider area of the world.
Air Pollution* ; Body Mass Index ; Cohort Studies ; Mobile Applications ; Motor Activity ; Obesity ; Particulate Matter ; Seasons ; Seoul ; Smartphone ; United States ; Weather ; Weight Loss

BACKGROUND: There have been equivocal results in studies of the effects of dipeptidyl peptidase-4 inhibitors (DPP-4i) on fractures. In this study, we analyzed the effect of DPP-4i on bone fracture risk in a Korean population. METHODS: We extracted subjects (n = 11,164) aged 50 years or older from the National Health Insurance Service–National Sample Cohort 2.0 from 2009 to 2014. Our control group included subjects without diabetes (n = 5,582), and our treatment groups with diabetes included DPP-4i users (n = 1,410) and DPP-4i non-users (n = 4,172). The primary endpoint was the incidence of a composite outcome consisting of osteoporosis diagnosis, osteoporotic fractures, vertebral fractures, non-vertebral fractures, and femoral fractures. The secondary endpoint was the incidence of each individual component of the composite outcome. Survival analysis was performed with adjustment for age, gender, diabetes complications severity index, Charlson comorbidity index, hypertension medication, and dyslipidemia treatment. RESULTS: The incidence of the composite outcome per 1,000 person-years was 0.089 in DPP-4i users, 0.099 in DPP-4i non-users, and 0.095 in controls. There was no significant difference in fracture risk between DPP-4i users and DPP-4i non-users or controls after the adjustments (P > 0.05). The incidences of osteoporosis diagnosis, osteoporotic fractures, vertebral fractures, non-vertebral fractures, and femoral fractures were not significantly different between DPP-4i users and non-users. The results of subgroup analyses by gender and age were consistent. CONCLUSION: DPP-4i had no significant effect on the risk of fractures in a Korean population.
Cohort Studies ; Comorbidity ; Diabetes Complications ; Diabetes Mellitus, Type 2 ; Diagnosis ; Dipeptidyl-Peptidase IV Inhibitors ; Dyslipidemias ; Femoral Fractures ; Fractures, Bone ; Hypertension ; Incidence ; National Health Programs ; Osteoporosis ; Osteoporotic Fractures