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BACKGROUND: The aim of this study was to identify factors associated with mild cognitive impairment (MCI) in older Korean adults with type 2 diabetes mellitus. METHODS: A total of 226 older (age > or =65 years) adults without a history of cerebrovascular disease or dementia participated in this study. Cognitive function was assessed with the Montreal Cognitive Assessment-Korean version (MoCA-K). A MoCA-K score <23 was defined as MCI. RESULTS: The prevalence of MCI was 32.7%. In a logistic regression analysis, age (> or =74 years old vs. 65-68 years old; odds ratio [OR], 3.69; 95% confidence interval [CI], 1.55 to 8.82; P=0.003), educational background (college graduation vs. no school or elementary school graduation; OR, 0.16; 95% CI, 0.05 to 0.46; P=0.001), and systolic blood pressure (> or =135 mm Hg vs. < or =120 mm Hg; OR, 3.25; 95% CI, 1.29 to 8.17; P=0.012) were associated with MCI. CONCLUSION: More concentrated efforts focused on early detection and appropriate management of MCI may be required in older Korean adults with type 2 diabetes mellitus.
Adult* ; Blood Pressure ; Dementia ; Diabetes Mellitus, Type 2* ; Humans ; Logistic Models ; Mild Cognitive Impairment* ; Odds Ratio ; Prevalence

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Correlations between Glucagon Stimulated C-peptide Levels and Microvascular Complications in Type 2 Diabetes Patients.

Hye Jin YOON ; Youn Zoo CHO ; Ji Young KIM ; Byung Joon KIM ; Keun Young PARK ; Gwan Pyo KOH ; Dae Ho LEE ; Dong Mee LIM

Diabetes & Metabolism Journal.2012;36(5):379-387. doi:10.4093/dmj.2012.36.5.379

BACKGROUND: This study aimed to investigate whether stimulated C-peptide is associated with microvascular complications in type 2 diabetes mellitus (DM). METHODS: A cross-sectional study was conducted in 192 type 2 diabetic patients. Plasma basal C-peptide and stimulated C-peptide were measured before and 6 minutes after intravenous injection of 1 mg glucagon. The relationship between C-peptide and microvascular complications was statistically analyzed. RESULTS: In patients with retinopathy, basal C-peptide was 1.9+/-1.2 ng/mL, and stimulated C-peptide was 2.7+/-1.6 ng/mL; values were significantly lower compared with patients without retinopathy (P=0.031 and P=0.002, respectively). In patients with nephropathy, basal C-peptide was 1.6+/-0.9 ng/mL, and stimulated C-peptide was 2.8+/-1.6 ng/mL; values were significantly lower than those recorded in patients without nephropathy (P=0.020 and P=0.026, respectively). Stimulated C-peptide level was associated with increased prevalence of microvascular complications. Age-, DM duration-, and hemoglobin A1c-adjusted odds ratios for retinopathy in stimulated C-peptide value were 4.18 (95% confidence interval [CI], 1.40 to 12.51) and 3.35 (95% CI, 1.09 to 10.25), respectively. The multiple regression analysis between nephropathy and C-peptide showed that stimulated C-peptide was statistically correlated with nephropathy (P=0.03). CONCLUSION: In patients with type 2 diabetes, the glucagon stimulation test was a relatively simple method of short duration for stimulating C-peptide response. Stimulated C-peptide values were associated with microvascular complications to a greater extent than basal C-peptides.
C-Peptide ; Cross-Sectional Studies ; Diabetes Mellitus, Type 2 ; Glucagon ; Hemoglobins ; Humans ; Injections, Intravenous ; Odds Ratio ; Plasma ; Prevalence

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The Risk of Bladder Cancer in Korean Diabetic Subjects Treated with Pioglitazone.

Sun Ok SONG ; Kwang Joon KIM ; Byung Wan LEE ; Eun Seok KANG ; Bong Soo CHA ; Hyun Chul LEE

Diabetes & Metabolism Journal.2012;36(5):371-378. doi:10.4093/dmj.2012.36.5.371

BACKGROUND: There is growing concern regarding the increased incidence of bladder cancer in diabetic patients using pioglitazone. This study aimed to investigate the association between bladder cancer and the use of pioglitazone in Korean diabetics. METHODS: This retrospective, matched case-control study included a case group (n=329) of diabetic patients with bladder cancer who presented at the Severance Hospital from November 2005 to June 2011. The control group consisted of patients without bladder cancer (1:2 ratio matching for sex and age, n=658) who were listed on the Severance Hospital diabetes registry. RESULTS: The percentage of subjects who had ever used pioglitazone was significantly lower in the case group than in the control group (6.4% vs. 15.0%, P<0.001). Multivariate conditional logistic analysis revealed that independent factors affecting bladder cancer were smoking (odds ratio [OR], 11.64; 95% confidence interval [CI], 6.56 to 20.66; P<0.001), coexisting cancer (OR, 6.11; 95% CI, 2.25 to 16.63; P<0.001), and hemoglobin levels (OR, 0.78; 95% CI, 0.69 to 0.88; P<0.001). The OR of the history of pioglitazone use was 2.09 and was not significantly different between the two groups (95% CI, 0.26 to 16.81; P=0.488). CONCLUSION: A relationship between pioglitazone use and incidence of bladder cancer was not observed in Korean diabetic patients. This suggests that the risk for bladder cancer in Korean diabetic subjects treated with pioglitazone might be different from that of Caucasian populations. Large-scale, well-designed and multi-center studies are needed to further evaluate this relationship.
Case-Control Studies ; Diabetes Mellitus, Type 2 ; Hemoglobins ; Humans ; Incidence ; Korea ; Retrospective Studies ; Smoke ; Smoking ; Thiazolidinediones ; Urinary Bladder ; Urinary Bladder Neoplasms

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Effects of a 6-Month Exenatide Therapy on HbA1c and Weight in Korean Patients with Type 2 Diabetes: A Retrospective Cohort Study.

Juyoung SHIN ; Jin Sun CHANG ; Hun Sung KIM ; Sun Hee KO ; Bong Yun CHA ; Ho Young SON ; Kun Ho YOON ; Jae Hyoung CHO

Diabetes & Metabolism Journal.2012;36(5):364-370. doi:10.4093/dmj.2012.36.5.364

BACKGROUND: While many studies have shown the good efficacy and safety of exenatide in patients with diabetes, limited information is available about exenatide in clinical practice in Korean populations. Therefore, this retrospective cohort study was designed to analyze the effects of exenatide on blood glucose level and body weight in Korean patients with type 2 diabetes mellitus. METHODS: We reviewed the records of the patients with diabetes who visited Seoul St. Mary's Hospital and for whom exenatide was prescribed from June 2009 to October 2011. After excluding subjects based on their race/ethnicity, medical history, whether or not they changed more than 2 kinds of oral hypoglycemic agents with exenatide treatment, loss to follow-up, or whether they stopped exenatide therapy within 6 months, a total of 52 subjects were included in the final analysis. RESULTS: The mean glycated hemoglobin (HbA1c) level and weight remarkably decreased from 8.5+/-1.7% to 6.7+/-1.0% (P<0.001) and from 82.3+/-15.8 kg to 78.6+/-16.3 kg (P<0.001), respectively. The multiple regression analysis indicated that the reduction in HbA1c level was significantly associated with a shorter duration of diabetes, a higher baseline HbA1c level, and greater weight reduction, whereas weight loss had no significant correlation with other factors. No severe adverse events were observed. CONCLUSION: These results suggest that a 6-month exenatide injection therapy significantly improved patients' HbA1c levels and body weights without causing serious adverse effects in Korean patients with type 2 diabetes.
Blood Glucose ; Body Weight ; Cohort Studies ; Diabetes Mellitus, Type 2 ; Follow-Up Studies ; Glucagon-Like Peptide 1 ; Hemoglobins ; Humans ; Hypoglycemic Agents ; Peptides ; Retrospective Studies ; Treatment Outcome ; Venoms ; Weight Loss

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Cardio-Metabolic Features of Type 2 Diabetes Subjects Discordant in the Diagnosis of Metabolic Syndrome.

Sa Rah LEE ; Ying HAN ; Ja Won KIM ; Ja Young PARK ; Ji Min KIM ; Sunghwan SUH ; Mi Kyoung PARK ; Hye Jeong LEE ; Duk Kyu KIM

Diabetes & Metabolism Journal.2012;36(5):357-363. doi:10.4093/dmj.2012.36.5.357

BACKGROUND: The aim of this study is to investigate the cardio-metabolic parameters and surrogate markers of insulin resistance in a discordant group of type 2 diabetes (T2DM) subjects who satisfy the Adults Treatment Panel (ATP) III criteria, but not the International Diabetes Federation (IDF) criteria, for metabolic syndrome (MetS). METHODS: We assessed the prevalence of MetS in T2DM subjects (n=167) who were selected from subjects registered at the diabetes center of Dong-A University Medical Center. We used the ATP III criteria and the IDF criteria for the diagnosis of MetS and sorted the subjects into 2 MetS groups: one group diagnosed per ATP III criteria (MetSa) and one diagnosed per IDF criteria (MetSi). We then compared the clinical characteristics, metabolic parameters (homeostasis model assessment of insulin resistance, aspartate aminotransferase, alanine aminotransferase, and uric acid values) and co-morbidities (prevalence of microalbuminuria, fatty liver, and cardiovascular disease) between the MetSa, MetSi, and discordant MetS groups. RESULTS: The prevalence of MetS in the MetSa group (73.6%) was higher than in the MetSi group (62.2%). The MetS prevalence in the discordant group was 11.4%. The discordant group showed no significant differences in clinical characteristics (except waist circumference and body mass index), metabolic parameters, or prevalence of co-morbidities, as compared with subjects with MetS by both criteria. CONCLUSION: In this study, cardio-metabolic features of the subjects diagnosed with MetS using ATP III criteria, but not IDF criteria, are not significantly different from those of subjects diagnosed with MetS using both criteria.
Academic Medical Centers ; Adenosine Triphosphate ; Adult ; Alanine Transaminase ; Aspartate Aminotransferases ; Biomarkers ; Diabetes Mellitus ; Enkephalin, Methionine ; Fatty Liver ; Humans ; Insulin Resistance ; Prevalence ; Uric Acid ; Waist Circumference

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The Association of Self-Reported Coronary Heart Disease with Diabetes Duration in Korea.

Hye Mi KANG ; Yun Jeong LEE ; Dong Jun KIM

Diabetes & Metabolism Journal.2012;36(5):350-356. doi:10.4093/dmj.2012.36.5.350

BACKGROUND: This study aimed to investigate the association of diabetes duration with self-reported coronary heart disease (CHD) in Korea. METHODS: Among data from 34,145 persons compiled in the third Korean National Health and Nutrition Examination Survey in 2005, laboratory test and nutritional survey data from 5,531 persons were examined. The participants were asked to recall a physician's diagnosis of CHD (angina or myocardial infarction). RESULTS: Age- and sex-adjusted relative risk for CHD was 1.51 (95% confidence interval [CI], 0.64 to 3.59; not significant) for diabetes with duration of <1 year, 2.27 (95% CI, 1.14 to 4.54; P=0.020) for diabetes with a duration of 1 to 5 years, and 3.29 (95% CI, 1.78 to 6.08; P<0.001) for diabetes with a duration >5 years, compared with non-diabetes as a control. Even after adjusting for age, sex, current smoking status, waist circumference, hypertension, triglycerides, high density lipoprotein cholesterol, and fasting plasma glucose, relative risk for CHD was 2.87 (95% CI, 1.01 to 8.11; P=0.047) in diabetes with a duration of 6 to 10 years and 4.07 (95% CI, 1.73 to 9.63; P=0.001) in diabetes with duration of >10 years with non-diabetes as a control. CONCLUSION: CHD prevalence increased with an increase in diabetes duration in Korean men and women. Recently detected diabetes (duration <1 year) was not significantly associated with CHD prevalence compared to non-diabetes. However, diabetes of a duration of >5 years was associated with an increase in CHD compared to non-diabetics after adjusting for several CHD risk factors.
Cholesterol ; Cholesterol, HDL ; Coronary Disease ; Diabetes Mellitus ; Fasting ; Female ; Glucose ; Humans ; Hypertension ; Korea ; Lipoproteins ; Male ; Nutrition Surveys ; Plasma ; Prevalence ; Risk Factors ; Smoke ; Smoking ; Triglycerides ; Waist Circumference

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C-Peptide and Vascular Complications in Type 2 Diabetic Subjects.

Seok Man SON

Diabetes & Metabolism Journal.2012;36(5):345-349. doi:10.4093/dmj.2012.36.5.345

No abstract available.
C-Peptide

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Management of Type 2 Diabetes Mellitus in Older Adults.

Kyung Soo KIM ; Soo Kyung KIM ; Kyung Mi SUNG ; Yong Wook CHO ; Seok Won PARK

Diabetes & Metabolism Journal.2012;36(5):336-344. doi:10.4093/dmj.2012.36.5.336

In the near future, the majority of patients with diabetes will be adults aged 65 or older. Unlike young adults with diabetes, elderly diabetic people may be affected by a variety of comorbid conditions such as depression, cognitive impairment, muscle weakness (sarcopenia), falls and fractures, and physical frailty. These geriatric syndromes should be considered in the establishment of treatment goals in older adults with diabetes. Although there are several guidelines for the management of diabetes, only a few are specifically designed for the elderly with diabetes. In this review, we present specific conditions of elderly diabetes which should be taken into account in the management of diabetes in older adults. We also present advantages and disadvantages of various glucose-lowering agents that should be considered when choosing a proper regimen for older adults with diabetes.
Adult ; Aged ; Depression ; Diabetes Mellitus, Type 2 ; Humans ; Muscle Weakness ; Sarcopenia ; Young Adult

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