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Clinical Implications of Serum Biomarkers in Diabetic Cardiovascular Complications.

Korean Diabetes Journal.2009;33(5):363-372. doi:10.4093/kdj.2009.33.5.363

Diabetes is associated with increased risk of cardiovascular disease, with atherosclerosis responsible for most associated morbidity and mortality. Atherosclerosis often causes acute thrombotic events through plaque rupture and formation of platelet-rich thrombi. The principal clinical manifestations of atherosclerosis are coronary artery disease, ischemic stroke, and peripheral arterial disease. Endothelial dysfunction, oxidative stress, and low-grade inflammation are key features in the pathophysiology of atherosclerosis.
Atherosclerosis ; Biomarkers ; Cardiovascular Diseases ; Coronary Artery Disease ; Diabetes Mellitus ; Inflammation ; Oxidative Stress ; Peripheral Arterial Disease ; Rupture ; Stroke

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Epidemiologic Characteristics of Diabetes Mellitus in Korea: Current Status of Diabetic Patients Using Korean Health Insurance Database.

Ie Byung PARK ; Sei Hyun BAIK

Korean Diabetes Journal.2009;33(5):357-362. doi:10.4093/kdj.2009.33.5.357

The aim of article is to introduce the current status of diabetes care and characteristics in diabetic patients in Korea, which is a joint report by Korean Diabetes Association (KDA) and Health Insurance Review Agency (HIRA) ("Diabetes in Korea 2007") and to review the recent published data about the current status of diabetes mellitus in Korea.
Diabetes Mellitus ; Humans ; Insurance, Health ; Joints ; Korea ; National Health Programs

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Protective Effects of Glucagon Like Peptide-1 on HIT-T15 beta Cell Apoptosis via ER Stress Induced by 2-deoxy-D-glucose.

Ju Young KIM ; Seong Kyu LEE ; Haing Woon BAIK ; Ki Ho LEE ; Hyun Jin KIM ; Kang Seo PARK ; Byung Joon KIM

Korean Diabetes Journal.2008;32(6):477-487. doi:10.4093/kdj.2008.32.6.477

BACKGROUND: The characteristic feature of pancreatic beta cells is highly developed endoplasmic reticulum (ER) due to a heavy engagement in insulin secretion. The ER serves several important function, including post-translational modification, folding, and assembly of newly synthesized secretory proteins, and its proper function is essential to cell survival. Various stress conditions can interfere with ER function. Pancreatic beta cells may be particularly vulnerable to ER stress that causes to impair insulin biosynthesis and beta cell survival through apoptosis. Glucagon like peptide-1 (GLP-1) is a new drug for treatment of type 2 diabetes and has effects on stimulation of insulin secretion and beta cell preservation. Also, it may have an antiapoptotic effect on beta cells, but detailed mechanisms are not proven. Therefore, we investigated the protective mechanism of GLP-1 in beta cells through ER stress response induced by 2-deoxy-D-glucose (2DG). METHODS: For induction of the ER stress, HIT-T15 cells (hamster beta cell line) were treated with 2DG (10 mM). Apoptosis was evaluated with MTT assay, hoechst 33342 staining and Annexin/PI flow cytometry. Expression of ER stress-related molecules was determined by real-time PCR or western blot. For blocking ER stress, we pretreated HIT-T15 cells with exendin-4 (Ex-4; GLP-1 receptor agonist) for 1 hour before stress induction. RESULTS: After induction with ER stress (2DG), beta cells were lost by apoptosis. We found that Ex-4 had a protective effect through ER stress related molecules (GRP78, GRP94, XBP-1, eIF2alpha, CHOP) modulation. Also, Ex-4 recovered the expression of insulin2 mRNA in beta cells. CONCLUSION: These results suggest that GLP-1 may protect beta cells apoptosis through ER stress modulation.
Apoptosis ; Benzimidazoles ; Blotting, Western ; Cell Survival ; Deoxyglucose ; Endoplasmic Reticulum ; Flow Cytometry ; Glucagon ; Glucagon-Like Peptide 1 ; Glucagon-Like Peptide-1 Receptor ; HSP70 Heat-Shock Proteins ; Insulin ; Insulin-Secreting Cells ; Membrane Proteins ; Peptides ; Protein Processing, Post-Translational ; Proteins ; Real-Time Polymerase Chain Reaction ; Receptors, Glucagon ; RNA, Messenger ; Venoms

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Cystatin C is a Valuable Marker for Predicting Future Cardiovascular Diseases in Type 2 Diabetic Patients.

Ki Won OH

Korean Diabetes Journal.2008;32(6):474-476. doi:10.4093/kdj.2008.32.6.474

No abstract available.
Cardiovascular Diseases ; Cystatin C ; Humans

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Mitochondrial Dysfunction in Diabetic Cardiomyopathy.

Ji Hyun AHN ; Jae Taek KIM

Korean Diabetes Journal.2008;32(6):467-473. doi:10.4093/kdj.2008.32.6.467

Metabolic syndrome and diabetes are associated with increased risk of cardiac dysfunction independently of underlying coronary artery disease. The underlying pathogenesis is partially understood but accumulating evidence suggests that alterations of cardiac energy metabolism might contribute to the development of contractile dysfunction. Recent findings suggest that myocardial mitochondrial dysfunction may play an important role in the pathogenesis of cardiac contractile dysfunction in type 2 diabetes. This review is focused on evaluating mechanisms for the mitochondrial abnormalities that may be involved in the development and progression of cardiac dysfunction in diabetes.
Coronary Artery Disease ; Diabetic Cardiomyopathies ; Energy Metabolism ; Mitochondria

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Bone Mineral Density in Prediabetic Men.

Ju Hee LEE ; Yun Hyeong LEE ; Kyoung Hye JUNG ; Min Kyeong KIM ; Hye Won JANG ; Tae Kyun KIM ; Hyun Jin KIM ; Young Suk JO ; Minho SHONG ; Tae Yong LEE ; Bon Jeong KU

Korean Diabetes Journal.2010;34(5):294-302. doi:10.4093/kdj.2010.34.5.294

BACKGROUND: There are many studies regarding the effects of insulin on bone metabolism and changes in bone mineral density (BMD) in the setting of diabetes. The effect of prediabetes on BMD is not known. METHODS: A total of 802 men participated in the Korea Rural Genomic Cohort Study (in Geumsan County). According to the results of an oral glucose tolerance test, subjects were classified into normal, prediabetic, and diabetic categories. One hundred twenty-four subjects diagnosed with type 2 diabetes were excluded, leaving 678 subjects for the study inclusion. BMD was estimated with a quantitative ultrasonometer. RESULTS: The average BMD T scores of normal and prediabetic subjects were -1.34 +/- 1.42 and -1.33 +/- 1.30, respectively; there was no significant difference in the BMD T scores between these groups. The BMD T score was inversely associated with age and positively correlated with body weight, body mass index, total cholesterol, low density lipoprotein cholesterol, and HbA1c. On multiple linear regression analysis, low density lipoprotein cholesterol was the only statistically significant variable for prediabetes (beta = 0.007, P = 0.005). On the stepwise regression analysis, age (beta = -0.026, P < 0.001), the body mass index (beta = 0.079, P < 0.001), and low density lipoprotein cholesterol (beta = 0.004, P = 0.016) were significant variables for prediabetes. CONCLUSIONS: There was no significant difference in the BMD T score between the normal and prediabetic subjects. Further studies are needed regarding the association of fracture risk and changes in BMD with the development of overt diabetes.
Body Mass Index ; Body Weight ; Bone Density ; Cholesterol ; Cholesterol, LDL ; Cohort Studies ; Glucose Tolerance Test ; Humans ; Insulin ; Korea ; Linear Models ; Lipoproteins ; Male ; Prediabetic State

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The Association of Brachial-Ankle Pulse Wave Velocity with 30-Minute Post-Challenge Plasma Glucose Levels in Korean Adults with No History of Type 2 Diabetes.

Eun Suk CHOI ; Eun Jung RHEE ; Ji Hoon CHOI ; Ji Cheol BAE ; Seung Hyun YOO ; Won Jun KIM ; Se Eun PARK ; Cheol Young PARK ; Won Young LEE ; Yong Kyun CHO ; Ki Won OH ; Sung Woo PARK ; Sun Woo KIM

Korean Diabetes Journal.2010;34(5):287-293. doi:10.4093/kdj.2010.34.5.287

BACKGROUND: Acute postprandial hyperglycemia is an important affector for atherosclerosis in subjects with glucose intolerance. We analyzed the relationship of brachial-ankle pulse wave velocity (baPWV) with fasting and post-challenge plasma glucose levels according to different time points during oral glucose tolerance test (OGTT). METHODS: In 663 subjects with fasting hyperglycemia, 75 g OGTT were performed to confirm the glucose tolerant status, and fasting, post-challenge 30-minute and 120-minute glucose levels were measured. Anthropometric measurements were done, and fasting lipid profiles were measured. baPWV were measured in all subjects and the relationship between fasting, 30- and 120-minute post-challenge glucose levels and baPWV were analyzed. RESULTS: Among the participants, 62.9% were prediabetes and 31.7% were diabetes. Mean baPWV value was significantly higher in subjects with diabetes compared with prediabetes group. In bivariate correlation analyses, age, blood pressure, total cholesterol, low density lipoprotein cholesterol, 30-minute and 120-minute post-challenge glucose levels showed significant positive correlation with baPWV value. In multiple regression analysis, 30-minute post-challenge glucose level was a weak but significant determinant for mean baPWV value even after adjustment for other confounding variables. CONCLUSIONS: Postprandial hyperglycemia, especially 30-minute glucose levels showed significant correlation with baPWV in subjects with fasting hyperglycemia. These results can imply the deleterious effect of acute hyperglycemic excursion on arterial stiffness in subjects with glucose intolerance.
Adult ; Atherosclerosis ; Blood Pressure ; Cholesterol ; Cholesterol, LDL ; Confounding Factors (Epidemiology) ; Fasting ; Glucose ; Glucose Intolerance ; Glucose Tolerance Test ; Humans ; Hyperglycemia ; Lipoproteins ; Plasma ; Prediabetic State ; Pulse Wave Analysis ; Vascular Stiffness

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The Association of Brachial-Ankle Pulse Wave Velocity with Acute Postprandial Hyperglycemia in Korean Prediabetic and Diabetic Subjects.

Chul Woo AHN

Korean Diabetes Journal.2010;34(5):284-286. doi:10.4093/kdj.2010.34.5.284

No abstract available.
Hyperglycemia ; Pulse Wave Analysis

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Role of Pyruvate Dehydrogenase Kinase 4 in Regulation of Blood Glucose Levels.

Nam Ho JEOUNG ; Robert A HARRIS

Korean Diabetes Journal.2010;34(5):274-283. doi:10.4093/kdj.2010.34.5.274

In the well-fed state a relatively high activity of the pyruvate dehydrogenase complex (PDC) reduces blood glucose levels by directing the carbon of pyruvate into the citric acid cycle. In the fasted state a relatively low activity of the PDC helps maintain blood glucose levels by conserving pyruvate and other three carbon compounds for gluconeogenesis. The relative activities of the pyruvate dehydrogenase kinases (PDKs) and the opposing pyruvate dehydrogenase phosphatases determine the activity of PDC in the fed and fasted states. Up regulation of PDK4 is largely responsible for inactivation of PDC in the fasted state. PDK4 knockout mice have lower fasting blood glucose levels than wild type mice, proving that up regulation of PDK4 is important for normal glucose homeostasis. In type 2 diabetes, up regulation of PDK4 also inactivates PDC, which promotes gluconeogenesis and thereby contributes to the hyperglycemia characteristic of this disease. When fed a high fat diet, wild type mice develop fasting hyperglycemia but PDK4 knockout mice remain euglycemic, proving that up regulation of PDK4 contributes to hyperglycemia in diabetes. These finding suggest PDK4 inhibitors might prove useful in the treatment of type 2 diabetes.
Animals ; Blood Glucose ; Carbon ; Citric Acid Cycle ; Diet, High-Fat ; Fasting ; Gluconeogenesis ; Glucose ; Homeostasis ; Hyperglycemia ; Ketone Bodies ; Mice ; Mice, Knockout ; Oxidoreductases ; Phosphoric Monoester Hydrolases ; Phosphotransferases ; Protein Kinases ; Protein-Serine-Threonine Kinases ; Pyruvate Dehydrogenase Complex ; Pyruvic Acid ; Up-Regulation

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Ubiquitous Diabetes Management System via Interactive Communication Based on Information Technologies: Clinical Effects and Perspectives.

Jae Hyoung CHO ; Hun Sung KIM ; Jae Hoon HAN ; Jin Hee LEE ; Jeong Ah OH ; Yoon Hee CHOI ; Kun Ho YOON

Korean Diabetes Journal.2010;34(5):267-273. doi:10.4093/kdj.2010.34.5.267

New diabetes management systems based on interactive communication have been introduced recently, accompanying rapid advances in information technology; these systems are referred to as "ubiquitous diabetes management systems." In such ubiquitous systems, patients and medical teams can communicate via Internet or telecommunications, with patients uploading their glucose data and personal information, and medical teams sending optimal feedback. Clinical evidence from both long-term and short-term trials has been reported by some researchers. Such systems appear to be effective not only in reducing the levels of HbA1c but also in stabilizing glucose control. However, most notably, evidence for the cost-effectiveness of such a system should be demonstrated before it can be propagated out to the general population in actual clinical practice. To establish a cost-effective model, various types of clinical decision supporting software designed to reduce the labor time of physicians must first be developed. A number of sensors and devices for monitoring patients' data are expected to be available in the near future; thus, methods for automatic interconnections between devices and web charts were also developed. Further investigations to demonstrate the clinical outcomes of such a system should be conducted, hopefully leading to a new paradigm of diabetes management.
Delivery of Health Care ; Diabetes Mellitus ; Glucose ; Humans ; Internet ; Software Design ; Telecommunications

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