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Plasma Glucose Regulation and Mortality in Korea: A Pooled Analysis of Three Community-Based Cohort Studies.

Nan Hee KIM ; Dong Jun KIM ; Seok Won PARK ; Jee Young OH ; Joong Yeol PARK ; Chol SHIN ; Hong Kyu LEE ; Yongsoo PARK

Diabetes & Metabolism Journal.2014;38(1):44-50. doi:10.4093/dmj.2014.38.1.44

BACKGROUND: Although diabetes is a well-known risk factor for death, its impact on cancer death is not clearly understood. Furthermore, it remains controversial whether impaired fasting glucose (IFG) and/or impaired glucose tolerance (IGT) are associated with increased risk of mortality. We investigated the impact of diabetes or glucose tolerance categories on all cause and cause-specific mortality. METHODS: Mortality analysis was conducted in three population-based cohort studies of 3,801 participants, divided according to fasting plasma glucose (FPG) (normal; stage 1 IFG [5.6< or =FPG<6.1 mmol/L]; stage 2 IFG [6.1< or =FPG<7.0 mmol/L]; diabetes mellitus [DM]-FPG); or 2-hour glucose after 75 g glucose loading (2hPG) (normal; IGT; DM-2hPG), or a combination of FPG and 2hPG criteria. RESULTS: During a median follow-up of 11.0 years, 474 subjects died from all causes. Hazard ratios (HRs) for all cause death were higher in those with diabetes as defined by either FPG or 2hPG criteria than their normal counterparts (HR, 2.2, 95% confidence interval [CI], 1.6 to 2.9 for DM-FPG; HR, 2.0, 95% CI, 1.5 to 2.7 for DM-2hPG). Similarly, diabetes defined by either FPG or 2hPG was associated with cancer death (HR, 2.9, 95% CI, 1.7 to 5.0; and HR, 2.1, 95% CI, 1.2 to 3.9, respectively). Although neither IFG nor IGT conferred higher risk for death, when combining stage 2 IFG and/or IGT, the risk of all cause death was higher than in subjects with normal glucose regulation (HR, 1.3; 95% CI, 1.0 to 1.6). CONCLUSION: Diabetes is associated with higher risk of death from all causes and cancer. In subjects without diabetes, stage 2 IFG and/or IGT confers increased risk for mortality.
Blood Glucose* ; Cohort Studies* ; Diabetes Mellitus ; Fasting ; Follow-Up Studies ; Glucose ; Glucose Intolerance ; Korea* ; Mortality* ; Plasma* ; Risk Factors

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Prevalence, Awareness, and Management of Obesity in Korea: Data from the Korea National Health and Nutrition Examination Survey (1998-2011).

Chul Sik KIM ; Seung Hyun KO ; Hyuk Sang KWON ; Nan Hee KIM ; Jae Hyeon KIM ; Soo LIM ; Sung Hee CHOI ; Kee Ho SONG ; Jong Chul WON ; Dae Jung KIM ; Bong Yun CHA

Diabetes & Metabolism Journal.2014;38(1):35-43. doi:10.4093/dmj.2014.38.1.35

BACKGROUND: Obesity is a risk factor for diabetes and several cardiovascular diseases. This study was to investigate the trends in the prevalence, awareness, and management status of obesity among the Korean population for recent 13 years. METHODS: The prevalence, subjective awareness, and management of obesity were investigated in adults aged > or =19 years by using the data from the Korea National Health and Nutrition Examination Surveys (KNHANES) 1998 to 2011. RESULTS: The number of participants was 8,117, 5,826, 5,500, 3,025, 6,756, 7,506, 6,255, and 6,155 in the KNHANES in years 1998, 2001, 2005, 2007, 2008, 2009, 2010, and 2011, respectively. The prevalence of obesity was 26.9%, 29.2%, 32.9%, 32.5%, 32.0%, 32.6%, 32.0%, and 32.0% in 1998, 2001, 2005, 2007, 2008, 2009, 2010, and 2011, respectively, while the overall prevalence of obesity and abdominal obesity increased by 1.19-fold and 1.24-fold respectively in 2011 compared against 2001. In general, a gradual increase in the prevalence of severe obesity has been observed as years go by. Furthermore, trends of improvements in obesity awareness and management rates were visible over the period of surveys. CONCLUSION: Although the management status of obesity has improved during the recent years, more effective strategy to control obesity is needed.
Adult ; Cardiovascular Diseases ; Diabetes Mellitus ; Humans ; Korea* ; Nutrition Surveys* ; Obesity* ; Obesity, Abdominal ; Obesity, Morbid ; Prevalence* ; Risk Factors

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Statin for the Primary Prevention of Cardiovascular Disease in Patients with Diabetes Mellitus.

Bo Kyung KOO

Diabetes & Metabolism Journal.2014;38(1):32-34. doi:10.4093/dmj.2014.38.1.32

No abstract available.
Cardiovascular Diseases* ; Diabetes Mellitus* ; Humans ; Hydroxymethylglutaryl-CoA Reductase Inhibitors* ; Primary Prevention*

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Current Status of Diabetic Peripheral Neuropathy in Korea: Report of a Hospital-Based Study of Type 2 Diabetic Patients in Korea by the Diabetic Neuropathy Study Group of the Korean Diabetes Association.

Jong Chul WON ; Sang Soo KIM ; Kyung Soo KO ; Bong Yun CHA

Diabetes & Metabolism Journal.2014;38(1):25-31. doi:10.4093/dmj.2014.38.1.25

Diabetic peripheral neuropathy (DPN) is the most common complication associated with diabetes. DPN can present as a loss of sensation, may lead to neuropathic ulcers, and is a leading cause of amputation. Reported estimates of the prevalence of DPN vary due to differences in study populations and diagnostic criteria. Furthermore, the epidemiology and clinical characteristics of DPN in Korean patients with type 2 diabetes mellitus (T2DM) are not as well understood as those of other complications of diabetes such as retinal and renal disease. Recently, the Diabetic Neuropathy Study Group of the Korean Diabetes Association (KDA) conducted a study investigating the impact of DPN on disease burden and quality of life in patients with T2DM and has published some data that are representative of the nation. This review investigated the prevalence and associated clinical implications of DPN in Korean patients with diabetes based on the KDA study.
Amputation ; Diabetes Mellitus, Type 2 ; Diabetic Neuropathies* ; Epidemiology ; Humans ; Korea* ; Peripheral Nervous System Diseases* ; Prevalence ; Quality of Life ; Retinaldehyde ; Sensation ; Ulcer

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The Hijacking of Cellular Signaling and the Diabetes Epidemic: Mechanisms of Environmental Disruption of Insulin Action and Glucose Homeostasis.

Robert M SARGIS

Diabetes & Metabolism Journal.2014;38(1):13-24. doi:10.4093/dmj.2014.38.1.13

The burgeoning epidemic of metabolic disease causes significant societal and individual morbidity and threatens the stability of health care systems around the globe. Efforts to understand the factors that contribute to metabolic derangements are critical for reversing these troubling trends. While excess caloric consumption and physical inactivity superimposed on a susceptible genetic background are central drivers of this crisis, these factors alone fail to fully account for the magnitude and rapidity with which metabolic diseases have increased in prevalence worldwide. Recent epidemiological evidence implicates endocrine disrupting chemicals in the pathogenesis of metabolic diseases. These compounds represent a diverse array of chemicals to which humans are exposed via multiple routes in adulthood and during development. Furthermore, a growing ensemble of animal- and cell-based studies provides preclinical evidence supporting the hypothesis that environmental contaminants contribute to the development of metabolic diseases, including diabetes. Herein are reviewed studies linking specific endocrine disruptors to impairments in glucose homeostasis as well as tying these compounds to disturbances in insulin secretion and impairments in insulin signal transduction. While the data remains somewhat incomplete, the current body of evidence supports the hypothesis that our chemically polluted environment may play a contributing role in the current metabolic crisis.
Delivery of Health Care ; Diabetes Mellitus ; Endocrine Disruptors ; Glucose* ; Homeostasis* ; Humans ; Insulin Resistance ; Insulin* ; Metabolic Diseases ; Prevalence ; Signal Transduction

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Gestational Diabetes Mellitus in Korean Women: Similarities and Differences from Other Racial/Ethnic Groups.

Catherine KIM

Diabetes & Metabolism Journal.2014;38(1):1-12. doi:10.4093/dmj.2014.38.1.1

Gestational diabetes mellitus (GDM) reflects defects in insulin secretion in response to the metabolic demands of pregnancy. While GDM is increasingly common worldwide due in large part to the obesity epidemic, its frequency is relatively low in Korean women. In this report, the prevalence and risk factors for GDM, perinatal outcomes, and postpartum course are compared in non-Korean and Korean women. While Koreans and non-Koreans with GDM share pathophysiology and complications, there may be differences in the role of obesity and thus the effectiveness of interventions targeting obesity in GDM women. Further investigations of the effectiveness of weight loss interventions and pharmacotherapy specifically among Korean women are needed. Dietary and other lifestyle data from Korean populations could inform prevention and treatment strategies in other countries which suffer from significantly higher prevalences of GDM.
Diabetes, Gestational* ; Drug Therapy ; Epidemiology ; Female ; Humans ; Insulin ; Life Style ; Obesity ; Postpartum Period ; Pregnancy ; Prevalence ; Risk Factors ; Weight Loss

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Response: Prevalence of Depression and Glucose Abnormality in an Urbanizing Rural Population of Bangladesh (Diabetes Metab J 2015;39:218-29).

Khurshid NATASHA ; Akhtar HUSSAIN ; A K AZAD KHAN ; Bishwajit BHOWMIK

Diabetes & Metabolism Journal.2015;39(6):530-530. doi:10.4093/dmj.2015.39.6.530

No abstract available.
Bangladesh* ; Depression* ; Glucose* ; Prevalence* ; Rural Population*

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Letter: Prevalence of Depression and Glucose Abnormality in an Urbanizing Rural Population of Bangladesh (Diabetes Metab J 2015;39:218-29).

Tomoyuki KAWADA

Diabetes & Metabolism Journal.2015;39(6):528-529. doi:10.4093/dmj.2015.39.6.528

No abstract available.
Bangladesh* ; Depression* ; Glucose* ; Prevalence* ; Rural Population*

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Metformin Promotes Apoptosis but Suppresses Autophagy in Glucose-Deprived H4IIE Hepatocellular Carcinoma Cells.

Deok Bae PARK

Diabetes & Metabolism Journal.2015;39(6):518-527. doi:10.4093/dmj.2015.39.6.518

BACKGROUND: Metformin, a well-known anti-diabetic drug, has gained interest due to its association with the reduction of the prevalence of cancer in patients with type 2 diabetes and the anti-proliferative effect of metformin in several cancer cells. Here, we investigated the anti-proliferative effect of metformin with respect to apoptosis and autophagy in H4IIE hepatocellular carcinoma cells. METHODS: H4IIE rat cells were treated with metformin in glucose-free medium for 24 hours and were then subjected to experiments examining the onset of apoptosis and/or autophagy as well as the related signaling pathways. RESULTS: When H4IIE cells were incubated in glucose-free media for 24 hours, metformin and 5-aminoimidazole-4-carboxamide ribonucleotide (AICAR) reduced the viability of cells. Inhibition of AMP-activated protein kinase (AMPK) by compound C significantly blocked cell death induced by metformin or AICAR. Pro-apoptotic events (nuclear condensation, hydrolysis of intact poly ADP ribose polymerase and caspase-3) were stimulated by metformin and then suppressed by compound C. Interestingly, the formation of acidic intracellular vesicles, a marker of autophagy, was stimulated by compound C. Although the deprivation of amino acids in culture media also induced apoptosis, neither metformin nor compound C affected cell viability. The expression levels of all of the autophagy-related proteins examined decreased with metformin, and two proteins (light chain 3 and beclin-1) were sensitive to compound C. Among the tested inhibitors against MAP kinases and phosphatidylinositol-3-kinase/mammalian target of rapamycin, SB202190 (against p38MAP kinase) significantly interrupted the effects of metformin. CONCLUSION: Our data suggest that metformin induces apoptosis, but suppresses autophagy, in hepatocellular carcinoma cells via signaling pathways, including AMPK and p38 mitogen-activated protein kinase.
Amino Acids ; AMP-Activated Protein Kinases ; Animals ; Apoptosis* ; Autophagy* ; Carcinoma, Hepatocellular* ; Cell Death ; Cell Survival ; Culture Media ; Humans ; Hydrolysis ; Metformin* ; Phosphotransferases ; Poly(ADP-ribose) Polymerases ; Prevalence ; Protein Kinases ; Rats ; Sirolimus

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Non-Association between rs7903146 and rs12255372 Polymorphisms in Transcription Factor 7-Like 2 Gene and Type 2 Diabetes Mellitus in Jahrom City, Iran.

Mohammad POURAHMADI ; Saiedeh ERFANIAN ; Malihe MORADZADEH ; Abdolreza Sotoodeh JAHROMI

Diabetes & Metabolism Journal.2015;39(6):512-517. doi:10.4093/dmj.2015.39.6.512

BACKGROUND: Transcription factor 7-like 2 (TCF7L2) is a transcription factor in the Wnt signaling pathway. High levels of TCF7L2 have been reported in most human tissues, including the heart, lung, brain, liver, kidney, placenta, adipose tissues, and pancreatic beta-cells. The purpose of this study was to assess the association between TCF7L2 polymorphisms (rs12255372 and rs7903146) and type 2 diabetes mellitus in the city of Jahrom, Iran. METHODS: This case-control study was conducted with 200 patients referred to Diabetes Clinics and 200 healthy subjects in Jahrom City. Biochemical characteristics were first determined. TCF7L2 rs1255372 and rs7903146 polymorphisms were then genotyped using the polymerase chain reaction-restriction fragment length polymorphism method. RESULTS: T-allele frequencies of both single nucleotide polymorphisms (SNPs) were significantly higher in diabetic patients than in normal glucose-tolerant subjects (rs12255372: 20.3% vs. 14.5%; rs7903146: 28.5% vs. 22.25%). The rs12255372 (G/T) polymorphism analysis showed an odds ratio of 0.473 (95% confidence interval [CI], 0.170 to 1.314; P=0.151) for the TT genotype and 0.646 (95% CI, 0.410 to 1.019; P=0.060) for the TG genotype, compared with the GG genotype. The rs7903146 (C/T) polymorphism odds ratios for TT and TC genotypes were 0.564 (95% CI, 0.280 to 1.135; P=0.109) and 0.751 (95% CI, 0.487 to 1.157; P=0.194) compared with the CC genotype, respectively. CONCLUSION: The rs12255372 and rs7903146 SNPs of the TCF7L2 gene were not associated with insulin resistance in the evaluated population.
Brain ; Case-Control Studies ; Diabetes Mellitus, Type 2* ; Genotype ; Heart ; Humans ; Insulin Resistance ; Iran* ; Kidney ; Liver ; Lung ; Odds Ratio ; Placenta ; Polymorphism, Single Nucleotide ; Transcription Factors* ; Wnt Signaling Pathway

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