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Clinical Experience of the Reverse Iontophoresis Based Glucose Measuring System: Glucall(TM).

Sang Youl RHEE ; Suk CHON ; Gwanpyo KOH ; Seungjoon OH ; Jeong taek WOO ; Sung Woon KIM ; Jin Woo KIM ; Young Seol KIM

Korean Diabetes Journal.2009;33(2):167-167. doi:10.4093/kdj.2009.33.2.167

To the editor, My original paper that published in Journal of Korean Diabetes Association 2005;29:167-172, entitled, Clinical Experience of the Reverse Iontophoresis Based Glucose Measuring System: Glucall(TM) was submitted to other international journals by me and the coauthor at the same time independently. I hereby retract the paper.
Glucose ; Iontophoresis

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Cause-of-Death Trends for Diabetes Mellitus over 10 Years (Korean Diabetes J 33(1):65-72, 2009).

Su Kyung PARK ; Duk Kyu KIM

Korean Diabetes Journal.2009;33(2):166-166. doi:10.4093/kdj.2009.33.2.166

No abstract available.
Diabetes Mellitus

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Cause-of-Death Trends for Diabetes Mellitus over 10 Years (Korean Diabetes J 33(1):65-72, 2009).

Hae Jin KIM

Korean Diabetes Journal.2009;33(2):164-165. doi:10.4093/kdj.2009.33.2.164

No abstract available.
Diabetes Mellitus

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Bowl-Based Meal Plan versus Food Exchange-Based Meal Plan for Dietary Intake Control in Korean Type 2 Diabetic Patients.

Hee Jung AHN ; Boo Kyung KOO ; Ji Yeon JUNG ; Hwi Ryun KWON ; Hyun Jin KIM ; Kang Seo PARK ; Kyung Ah HAN ; Kyung Wan MIN

Korean Diabetes Journal.2009;33(2):155-163. doi:10.4093/kdj.2009.33.2.155

BACKGROUND: The food exchange-based meal plan is effective in controlling dietary energy intake with a macronutrient balance. However, it is difficult to practice for relatively low-literacy patients. As an alternative, we developed a system employing a standardized-sized bowl and investigated its effectiveness on achieving proper energy intake and macronutrient composition and patient compliance, compared to the conventional food exchange system in Korean type 2 diabetes patients. METHODS: Eighty subjects with type 2 diabetes were assigned to both the novel bowl-based meal plan group (BG) and the food exchange-based meal plan group (ExG). BG received limited simple instructions for the plan. Time spent for plan instruction was 10 min for BG and 40 min for ExG. Dietary energy and macronutrient intake were estimated with 3-day dietary records and patient comprehension of the plan was estimated with a 5-point Likert scale. RESULTS: After 12 weeks, dietary energy compliance showed no difference between the groups (BG: 103 +/- 10%, ExG: 101 +/- 17%). Both groups showed significant reduction in carbohydrate and protein intake and there was no difference in the proportion of carbohydrate, protein and fat in energy intake between the groups despite the shorter instruction time for BG. Following the instruction period, there was no difference in the understanding score between the groups. CONCLUSION: This bowl-based plan was equally effective as the food exchange-based plan in controlling dietary energy intake and macronutrient composition, as well as patient comprehension and compliance. Our novel plan may allow for more cost-effective methods in terms of time needed for plan instruction.
Compliance ; Comprehension ; Diabetes Mellitus, Type 2 ; Diet, Diabetic ; Diet Records ; Energy Intake ; Humans ; Meals ; Patient Compliance

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Associations between ApoB/ApoA-I Ratios and Metabolic Syndrome and its Components in Patients with Type 2 Diabetes.

Jung Eun KIM ; Wha Young KIM ; Yoon Jung LEE ; Ji Eun PARK ; Young Ju CHOI ; Kap Bum HUH ; Ji Yun HWANG

Korean Diabetes Journal.2009;33(2):143-154. doi:10.4093/kdj.2009.33.2.143

BACKGROUND: The Apolipoprotein B/apolipoprotein A-I ratio (apoB/apoA-I) is a powerful clinical indicator of metabolic syndrome. However, few studies have searched for an association between ApoB/ApoA-I and metabolic syndrome in Korean patients with type 2 diabetes. We investigated the relation between ApoB/ApoA-I and the risk of metabolic syndrome and its components. METHODS: Subjects were 812 (424 males and 388 females) Korean patients who were being treated for type 2 diabetes at Huh's Diabetes Center in Seoul. The patients were classified into quartiles (lowest:Q1-highest:Q4) of ApoB/ApoA-I by gender. Anthropometric and hematological characteristics and dietary intake using a food frequency questionnaire were assessed. RESULTS: The prevalence of metabolic syndrome in our sample was 47.9% in males and 66.5% in females. The odds ratios (OR) for metabolic syndrome and for having its components were significantly increased from Q2 to Q4 quartiles of ApoB/ApoA-I in males (OR = 5.37; 95% CI = 2.98-9.65 and OR = 7.41; 95% CI = 4.04-13.6) and females (OR = 2.57; 95% CI = 1.28-5.15 and OR = 8.49; 95% CI = 4.28-16.8). These trends withstood adjustment for age, duration of type 2 diabetes, fasting blood glucose levels, and macronutrient intake both in males (OR = 5.24; 95% CI = 2.80-9.24 and OR = 7.98; 95% CI = 4.09-15.6) and in females (OR=4.41; 95% CI = 2.26-8.61 and OR = 8.29; 95% CI = 3.85-17.8). CONCLUSION: ApoB/ApoA-I appeared to be independently associated with risk of having metabolic syndrome and its components in Korean patients with type 2 diabetes after adjustment for putative risk factors including macronutrient intake, a particularly important lifestyle factor for patients with type 2 diabetes. A follow-up study of this population should evaluate the mechanisms underlying the relation between ApoB/ApoA-I and metabolic syndrome and its components.
Apolipoprotein A-I ; Apolipoproteins ; Blood Glucose ; Diabetes Mellitus, Type 2 ; Fasting ; Female ; Humans ; Life Style ; Male ; Metabolic Syndrome X ; Odds Ratio ; Prevalence ; Risk Factors ; Surveys and Questionnaires

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Risk Factors for Early Development of Macrovascular Complications in Korean Type 2 Diabetes.

Hae Ri LEE ; Jae Myung YU ; Moon Gi CHOI ; Hyung Joon YOO ; Eun Gyoung HONG

Korean Diabetes Journal.2009;33(2):134-142. doi:10.4093/kdj.2009.33.2.134

BACKGROUND: The average duration of diabetes and predictive factors of macrovascular complications in Korean diabetic patients remain to be elucidated. This study examines the average duration of diabetes up to the onset of macrovascular complications and clinically important factors of early development of these complications in Korean type 2 diabetic patients. METHODS: Clinical characteristics in type 2 diabetics with (n = 121) and without macrovascular complications (n = 115) were analyzed. In addition, early onset (< or = 5 years, n = 54) and late onset groups (> 5 years, n = 67) were compared, as were the clinical characteristics between male and female patients in the macrovascular complications group. RESULTS: The average duration of diabetes was 8.7 +/- 7.8 years in the macrovascular complications group. Average age, systolic and diastolic blood pressures and smoking history were all higher in the macrovascular complications group than the control group. However, HbA1c levels and prevalence of microvascular complications were higher in the controls. Average age was lower in the early onset group and many more patients of that group had a smoking history. In the analysis based on sex, marcrovascular complications developed earlier in male patients. In addition, the prevalence of family history of diabetes was higher in males and 77.8% of male patients had a smoking history (female: 3.4%). CONCLUSION: Our study confirms that older age, high blood pressure and smoking history are major risk factors for the development of macrovascular complications. Moreover, a smoking history in males can be both risk and predictive factors for earlier development of macrovascular complications in Korean type 2 diabetic patients. We also found that several clinical characteristics including age, family history of diabetes, hypertension and smoking history, vary between the sexes, and these findings can provide useful indices for the prevention of macrovascular complications.
Diabetes Complications ; Diabetes Mellitus, Type 2 ; Female ; Humans ; Hypertension ; Male ; Prevalence ; Risk Factors ; Smoke ; Smoking

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Chronic Complications in Adult Diabetic Patients with and without GAD Antibody.

Jin Ook CHUNG ; Dong Hyeok CHO ; Dong Jin CHUNG ; Min Young CHUNG

Korean Diabetes Journal.2009;33(2):124-133. doi:10.4093/kdj.2009.33.2.124

BACKGROUND: Although the majority of diabetes mellitus (DM) patients diagnosed as adults have non-autoimmune forms of the disease, islet autoimmunity is encountered in some patients initially thought to have type 2 DM. The phenotype of DM patients with glutamic acid decarboxylase (GAD) antibodies is different from that of patients with GAD antibody-negative type 2 DM, with features such as relative leanness and hyperglycemia which may influence the development of complications. We sought to compare the prevalence of chronic complications in patients with and without the GAD antibody. METHODS: We recruited 427 patients (M: 218, F: 209) that were clinically diagnosed with type 2 DM after the age of 35 years. We measured GAD antibody and assessed the factors associated with chronic microvascular and macrovascular complications. RESULTS: Of these patients, 26 were GAD antibody-positive. The patients with GAD antibody had lower systolic blood pressure, higher high-density lipoprotein cholesterol value, and lower level of fasting and stimulated C-peptide than patients without GAD antibody (P < 0.05). Also, the patients with GAD antibody had lower prevalence of retinopathy compared with the patients without GAD antibody (19.2 vs. 47.9%; P < 0.05). The prevalence of nephropathy, peripheral neuropathy and cardiovascular autonomic neuropathy did not differ between the groups. In addition, the prevalence of coronary heart disease, cerebrovascular disease and peripheral arterial disease did not differ between the two groups. CONCLUSION: This study suggests that diabetic patients with GAD antibody have a lower risk for the development of retinopathy compared with patients without GAD antibody.
Adult ; Antibodies ; Autoimmunity ; C-Peptide ; Cholesterol ; Coronary Disease ; Diabetes Complications ; Diabetes Mellitus ; Fasting ; Glutamate Decarboxylase ; Humans ; Hyperglycemia ; Hypertension ; Lipoproteins ; Peripheral Arterial Disease ; Peripheral Nervous System Diseases ; Phenotype ; Prevalence ; Thinness

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Matrix Metalloproteinase-3 Gene Polymorphism is Associated with Coronary Artery Calcification Scores in Patients with Type 2 Diabetes Mellitus.

Sang Wook KIM ; Eun Hee CHO

Korean Diabetes Journal.2009;33(2):113-123. doi:10.4093/kdj.2009.33.2.113

BACKGROUND: Matrix metalloproteinase-3 (MMP-3) is expressed in human coronary atherosclerotic lesions and is known to be involved in the degradation of plaque. This study examines the association of MMP-3 gene promoter 5A/6A and -709A>G polymorphisms with coronary artery calcium scores in type 2 diabetes patients. METHODS: The study comprises 140 type 2 diabetes patients aged 34~85 years, who showed no evidence of clinical cardiovascular disease before recruitment. Recruitment was based on patient's coronary artery calcium (CAC) scores and polymorphisms were identified. RESULTS: Multiple regression analysis showed that the CAC scores were significantly associated with age (P = 0.008), waist circumference (P = 0.03), duration of diabetes (P = 0.003) and the serum creatinine level (P = 0.012). MMP-3 5A/6A and -709A>G polymorphisms were not associated with CAC across all subjects. However, in the subgroup with a duration of diabetes over 10 years, MMP-3 -709A>G were significantly associated with CAC (P = 0.037) adjusted for age, body mass index, waist circumference and duration of diabetes. CONCLUSION: Our data suggest that the CAC scores in patients with type 2 diabetes were related with age, waist circumference, duration of diabetes and higher serum creatinine levels. MMP-3 polymorphisms with -709A>G are associated with high CAC in patients with a duration of diabetes over 10 years.
Aged ; Body Mass Index ; Calcinosis ; Calcium ; Cardiovascular Diseases ; Coronary Vessels ; Creatinine ; Diabetes Mellitus, Type 2 ; Humans ; Matrix Metalloproteinase 3 ; Polymorphism, Genetic ; Waist Circumference

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The Relationship between Serum Retinol-Binding Protein 4 Levels and Coronary Artery Disease in Korean Adults.

Ji Hoon KIM ; Eun Jung RHEE ; Eun Suk CHOI ; Jong Chul WON ; Cheol Young PARK ; Won Young LEE ; Ki Won OH ; Byung Jin KIM ; Ki Chul SUNG ; Bum Soo KIM ; Jin Ho KANG ; Sung Woo PARK ; Sun Woo KIM ; Man Ho LEE ; Jung Roe PARK

Korean Diabetes Journal.2009;33(2):105-112. doi:10.4093/kdj.2009.33.2.105

BACKGROUND: A recently discovered adipokine, retinol-binding protein-4 (RBP-4), is reportedly associated with insulin resistance and metabolic syndrome. This study was performed to analyze the relationship between serum RBP-4 levels and coronary artery disease (CAD) in Korean adults. METHODS: In 235 subjects (mean age 58 years) in whom coronary artery angiograms were performed due to complaints of chest pain, serum RBP-4 levels were measured by enzyme-linked immunosorbent assay. Coronary artery angiograms were performed in all subjects and the severity of CAD was assessed by the number of stenotic vessels. The presence of metabolic syndrome was defined by AHA/NHLBI criteria with body mass index substituted for waist circumference. RESULTS: Coronary angiogram showed that 101 subjects (43%) had normal coronary vessel, 82 subjects (34.9%) had 1-vessel disease, 31 subjects (13.2%) had 2-vessel disease and 21 subjects (8.9%) had 3-vessel disease. Subjects with coronary artery stenosis showed a higher mean age (60.5 +/- 10.0 years), fasting glucose (123.3 mg +/- 45.0 mg/dL) and lower mean value for high-density lipoprotein cholesterol (HDL-C) level (49.0 +/- 13.2 mg/dL), although serum RBP-4 levels were not significantly different between those with and without CAD. Mean age and fasting glucose level increased significantly as the number of stenotic vessels increased, although serum RBP4 level showed no significant differences among the different groups. Among the metabolic parameters, only serum triglyceride levels showed a significant correlation with serum RBP-4 levels. CONCLUSION: There was no difference in mean serum RBP-4 levels between subjects with or without coronary artery disease in Korean adults. Further studies are warranted to draw a clear conclusion on the effect of RBP-4 on atherosclerosis.
Adipokines ; Adult ; Atherosclerosis ; Body Mass Index ; Chest Pain ; Cholesterol ; Coronary Artery Disease ; Coronary Stenosis ; Coronary Vessels ; Enzyme-Linked Immunosorbent Assay ; Fasting ; Glucose ; Glycosaminoglycans ; Humans ; Insulin Resistance ; Lipoproteins ; Waist Circumference

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High Glucose and/or Free Fatty Acid Damage Vascular Endothelial Cells via Stimulating of NAD(P)H Oxidase-induced Superoxide Production from Neutrophils.

Sang Soo KIM ; Sun Young KIM ; Soo Hyung LEE ; Yang Ho KANG ; In Ju KIM ; Yong Ki KIM ; Seok Man SON

Korean Diabetes Journal.2009;33(2):94-104. doi:10.4093/kdj.2009.33.2.94

BACKGROUND: Oxidative stress and inflammation are important factors in the pathogenesis of diabetes and contribute to the development of diabetic complications. To understand the mechanisms that cause vascular complications in diabetes, we examined the effects of high glucose and/or free fatty acids on the production of superoxide from neutrophils and their role in endothelial cell damage. METHODS: Human neutrophils were incubated in the media containing 5.5 mM D-glucose, 30 mM D-glucose, 3 nM oleic acid, or 30 microM oleic acid for 1 hour to evaluate superoxide production through NAD(P)H oxidase activation. Human aortic endothelial cells were co-cultured with neutrophils exposed to high glucose and oleic acid. We then measured neutrophil adhesion to endothelial cells, neutrophil activation and superoxide production, neutrophil-mediated endothelial cell cytotoxicity and subunits of neutrophil NAD(P)H oxidase. RESULTS: After 1 hour of incubation with various concentrations of glucose and oleic acid, neutrophil adherence to high glucose and oleic acid-treated endothelial cells was significantly increased compared with adhesion to low glucose and oleic acid-treated endothelial cells. Incubation of neutrophils with glucose and free fatty acids increased superoxide production in a dose-dependent manner. High glucose and oleic acid treatment significantly increased expression of the membrane components of NAD(P)H oxidase of neutrophil (gp91(phox)). Endothelial cells co-cultured with neutrophils exposed to high glucose and oleic acid showed increased cytolysis, which could be prevented by an antioxidant, N-acetylcysteine. CONCLUSION: These results suggest that high glucose and/orfree fatty acidsincrease injury of endothelial cells via stimulating NAD(P)H oxidase-induced superoxide production from neutrophils.
Acetylcysteine ; Diabetes Complications ; Endothelial Cells ; Fatty Acids, Nonesterified ; Glucose ; Humans ; Inflammation ; Membranes ; NADPH Oxidase ; Neutrophil Activation ; Neutrophils ; Oleic Acid ; Oxidative Stress ; Superoxides

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