1.Health Effects of Sugar-Sweetened and Artificially Sweetened Beverages: Umbrella Review and Evidence-Based Consensus Statement of the Korean Diabetes Association and the Korean Nutrition Society
Jong Han CHOI ; SuJin SONG ; Soo Kyoung KIM ; Jae Won CHO ; Jae Hyun BAE ; Shinje MOON ; Jeong Hyun LIM ; YeonHee LEE ; Ji-Yun HWANG ; YoonJu SONG ; Sang Soo KIM
Diabetes & Metabolism Journal 2026;50(1):32-46
Background:
Excess intake of added sugars contributes to obesity, type 2 diabetes mellitus (T2DM), cardiovascular disease (CVD), and premature mortality. Sugar-sweetened beverages (SSBs), the main source of added sugars, are consistently linked to adverse outcomes. Artificially sweetened beverages (ASBs) have been suggested as short-term substitutes, but evidence regarding benefits and harms remains inconclusive, and guidance is lacking.
Methods:
This consensus statement draws on a structured evidence review combining two approaches: an updated meta-analysis of randomized controlled trials (RCTs) assessing short- to intermediate-term effects of replacing SSBs with ASBs on weight and metabolic outcomes; and an umbrella review of systematic reviews of cohort studies evaluating long-term associations of SSBs and ASBs with major outcomes, including mortality, CVD, and T2DM.
Results:
In 14 RCTs (3–76 weeks), replacing SSBs with ASBs produced modest reductions in body weight (–0.73 kg) and body fat (–0.72%), with inconsistent effects on glycemic and cardiometabolic markers. Evidence from 20 systematic reviews of cohorts (up to 34 years follow-up) showed that higher intake of both SSBs and ASBs was associated with increased risks of T2DM, CVD, and mortality, with relative risks for ASBs similar to those for SSBs.
Conclusion
ASBs may serve as a short-term substitution for individuals with high SSB intake, particularly those at elevated metabolic risk. However, regular or long-term use is not recommended due to uncertain safety and potential reinforcement of sweet preference. Public health strategies should emphasize reducing both SSBs and ASBs, prioritizing water and unsweetened beverages as the ultimate goal.
2.Ultrasonographic evaluation of gastrointestinal wall thickness in Korean raccoon dogs (Nyctereutes procyonoides koreensis)
Yoonju CHOI ; Myeongsu KIM ; Jae-Ik HAN ; Kichang LEE ; Hakyoung YOON
Journal of Veterinary Science 2025;26(6):e84-
Objective:
This study aimed to establish baseline ultrasonographic parameters for GI wall thickness and assess differences based on sex, gastric distension, body weight, and the presence of GI symptoms.
Methods:
A retrospective analysis was conducted on 42 Korean raccoon dogs (35 healthy, seven symptomatic). Total and individual layer thicknesses (mucosa, submucosa, muscularis, and serosa) were measured for the stomach, duodenum, jejunum, ileum (folded and interfolded regions), and colon. Statistical analyses were performed to assess the effects of sex, body weight, gastric distension, and GI symptoms on wall thickness.
Results:
All Korean raccoon dogs exhibited a five-layer GI wall and echogenicity similar to that of domestic dogs. Mean total wall thickness values were: stomach (2.77 ± 0.74 mm), duodenum (2.19 ± 0.31 mm), jejunum (2.06 ± 0.35 mm), ileum (folded, 1.75 ± 0.35 mm, interfolded, 2.31 ± 0.24 mm), and colon (1.06 ± 0.37 mm). Stomach wall thickness was greater in collapsed (3.31 ± 0.37 mm) than in distended (2.15 ± 0.52 mm) states.No statistically significant differences in GI wall thickness were observed based on sex or body weight. Symptomatic Korean raccoon dogs exhibited significant thickening of the duodenum, jejunum, and colon, along with increased mucosal echogenicity, loss of normal wall layering, and intestinal corrugation.
Conclusions
and Relevance: These findings provide essential reference values for GI ultrasonographic evaluation in Korean raccoon dogs, with implications for diagnostic accuracy.
3.Clinical Practice Guidelines for Diagnosis and Non-Surgical Treatment of Primary Frozen Shoulder
Byung Chan LEE ; Gi-Wook KIM ; Keewon KIM ; Nackhwan KIM ; Dong Hwan KIM ; Doo Young KIM ; Du Hwan KIM ; Beom Suk KIM ; Seong Hun KIM ; In Jong KIM ; Hyun Jung KIM ; Yoonju NA ; Kyung Eun NAM ; Sung Gyu MOON ; Chang-Won MOON ; Kyunghoon MIN ; Donghwi PARK ; Myung Woo PARK ; Yong Bok PARK ; Jae Hyeon PARK ; Chul-Hyun PARK ; Hyeng-Kyu PARK ; Yunsoo SOH ; Jaeki AHN ; Seoyon YANG ; Kyeong Eun UHM ; Sun Jae WON ; Yu Hui WON ; Dong Hwan YUN ; Yu Sung YOON ; Jin A YOON ; Byeong-Ju LEE ; Woo Hyung LEE ; Yun Jung LEE ; Jae-Hyun LEE ; Jong Hwa LEE ; Yu Jin IM ; Jae-Young LIM ; Min Cheol CHANG ; Sung Joon CHUNG ; Il Young JUNG ; Sungju JEE ; Kyoung Hyo CHOI ; Jong-Moon HWANG ; Jae-Young HAN
Clinical Pain 2025;24(1):1-26
Objective:
Primary frozen shoulder causes significant pain and progressively restricts shoulder movements. Diagnosis is made clinically based on patient history and physical examination. Management is mainly non-invasive owing to its self-limiting clinical course. However, clinical practice guidelines for frozen shoulder have not yet been developed in Korea. The developed guidelines aim to provide evidence-based recommendations for the diagnosis and treatment of frozen shoulder.
Methods:
A guideline development committee reviewed the literature from four databases (PubMed, Embase, Cochrane Library, and KMbase). Using the Population, Intervention, Comparator, and Outcome (PICO) framework, the committee formulated two backgrounds and 16 key questions to address common clinical concerns. Recommendations were made using the Grading of Recommendations, Assessment, Development, and Evaluation framework.
Results:
Diabetes, thyroid disease, and dyslipidemia significantly increase the risk of developing a frozen shoulder. Although frozen shoulder is often self-limiting, some patients may experience long-term functional disabilities. Ultrasound and magnetic resonance imaging should be used as adjunctive tools alongside clinical diagnosis, and rather than as independent diagnostic methods. Noninvasive approaches, such as medications, physical modalities, exercises, electrical stimulation, and manual therapy, may reduce pain and improve shoulder function. Other noninvasive interventions have limited evidence, and their application should be based on clinical judgment. Intra-articular steroid injections are recommended for treatment, and physiotherapy or hydrodilation with steroid injections can also be beneficial.
Conclusion
These guidelines provide evidence-based recommendations for diagnosing and treating primary frozen shoulder.
4.The Impact of Non-Sugar Sweetener on Health Outcomes in the General Population and Patients with Diabetes
Shinje MOON ; Soo Kyoung KIM ; Jong Han CHOI ; Yoonju SONG ; Jeong Hyun LIM ; Jae Won CHO ; Sang Soo KIM
Journal of Korean Diabetes 2024;25(4):211-216
Non-sugar sweeteners (NSS) are low in calories and can be used in very small amounts. Both the U.S. Food and Drug Administration and Korea Ministry of Food and Drug Safety have stated that consuming NSS within the recommended dosage is not harmful to human health. Nonetheless, the World Health Organization in its 2023 guidelines on NSS use advised the general population against the consumption of NSS as a means of controlling weight and reducing the risk of chronic diseases, including diabetes. However, there is insufficient evidence regarding the health benefits and potential risks of NSS for patients with diabetes. Given the ongoing debate about the efficacy of NSS, the 2023 clinical guidelines of the Korean Diabetes Association recommend minimizing beverages containing sugar or NSS, although NSS may help reduce sugar intake in the short term. This review aims to explore the latest research on the benefits and risks of NSS for the general population and patients with diabetes.
5.The Impact of Non-Sugar Sweetener on Health Outcomes in the General Population and Patients with Diabetes
Shinje MOON ; Soo Kyoung KIM ; Jong Han CHOI ; Yoonju SONG ; Jeong Hyun LIM ; Jae Won CHO ; Sang Soo KIM
Journal of Korean Diabetes 2024;25(4):211-216
Non-sugar sweeteners (NSS) are low in calories and can be used in very small amounts. Both the U.S. Food and Drug Administration and Korea Ministry of Food and Drug Safety have stated that consuming NSS within the recommended dosage is not harmful to human health. Nonetheless, the World Health Organization in its 2023 guidelines on NSS use advised the general population against the consumption of NSS as a means of controlling weight and reducing the risk of chronic diseases, including diabetes. However, there is insufficient evidence regarding the health benefits and potential risks of NSS for patients with diabetes. Given the ongoing debate about the efficacy of NSS, the 2023 clinical guidelines of the Korean Diabetes Association recommend minimizing beverages containing sugar or NSS, although NSS may help reduce sugar intake in the short term. This review aims to explore the latest research on the benefits and risks of NSS for the general population and patients with diabetes.
6.The Impact of Non-Sugar Sweetener on Health Outcomes in the General Population and Patients with Diabetes
Shinje MOON ; Soo Kyoung KIM ; Jong Han CHOI ; Yoonju SONG ; Jeong Hyun LIM ; Jae Won CHO ; Sang Soo KIM
Journal of Korean Diabetes 2024;25(4):211-216
Non-sugar sweeteners (NSS) are low in calories and can be used in very small amounts. Both the U.S. Food and Drug Administration and Korea Ministry of Food and Drug Safety have stated that consuming NSS within the recommended dosage is not harmful to human health. Nonetheless, the World Health Organization in its 2023 guidelines on NSS use advised the general population against the consumption of NSS as a means of controlling weight and reducing the risk of chronic diseases, including diabetes. However, there is insufficient evidence regarding the health benefits and potential risks of NSS for patients with diabetes. Given the ongoing debate about the efficacy of NSS, the 2023 clinical guidelines of the Korean Diabetes Association recommend minimizing beverages containing sugar or NSS, although NSS may help reduce sugar intake in the short term. This review aims to explore the latest research on the benefits and risks of NSS for the general population and patients with diabetes.
7.The Impact of Non-Sugar Sweetener on Health Outcomes in the General Population and Patients with Diabetes
Shinje MOON ; Soo Kyoung KIM ; Jong Han CHOI ; Yoonju SONG ; Jeong Hyun LIM ; Jae Won CHO ; Sang Soo KIM
Journal of Korean Diabetes 2024;25(4):211-216
Non-sugar sweeteners (NSS) are low in calories and can be used in very small amounts. Both the U.S. Food and Drug Administration and Korea Ministry of Food and Drug Safety have stated that consuming NSS within the recommended dosage is not harmful to human health. Nonetheless, the World Health Organization in its 2023 guidelines on NSS use advised the general population against the consumption of NSS as a means of controlling weight and reducing the risk of chronic diseases, including diabetes. However, there is insufficient evidence regarding the health benefits and potential risks of NSS for patients with diabetes. Given the ongoing debate about the efficacy of NSS, the 2023 clinical guidelines of the Korean Diabetes Association recommend minimizing beverages containing sugar or NSS, although NSS may help reduce sugar intake in the short term. This review aims to explore the latest research on the benefits and risks of NSS for the general population and patients with diabetes.
8.Three Diverse, Nearly Misdiagnosed Inflammatory, and Infectious Diseases at Atlantoaxial Joint
Jihong CHOI ; Sungwon KIM ; Duk Hyun SUNG ; Yoonju NA
Clinical Pain 2024;23(1):33-38
Severe neck pain, worsened by head rotation, may signal atlantoaxial joint involvement, prompting differentiation between inflammatory and mechanical causes. This study challenges conventions by presenting three cases where inflammatory diseases, typically associated with extremities, affect the atlantoaxial joint. Cases involve a 64-year-old woman with crowned dens syndrome (CDS) due to calcium pyrophosphate crystals, a 69-year-old male with septic arthritis at the C1-2 level and an 82-year-old female with rheumatoid arthritis (RA). Despite shared severe neck pain, patients with CDS and septic arthritis show notable neck rotation limitations, while the RA patient experiences joint pain without such constraints. Diagnostic methods include cervical computed tomography (CT) for CDS, and various imaging and blood tests for septic arthritis, and American College of Rheumatology/European League Against Rheumatism criteria (ACR/EULAR) for RA. These cases highlight atypical inflammatory manifestations at the atlantoaxial joint, urging consideration in severe neck pain scenarios.
9.The Impact of Non-Sugar Sweetener on Health Outcomes in the General Population and Patients with Diabetes
Shinje MOON ; Soo Kyoung KIM ; Jong Han CHOI ; Yoonju SONG ; Jeong Hyun LIM ; Jae Won CHO ; Sang Soo KIM
Journal of Korean Diabetes 2024;25(4):211-216
Non-sugar sweeteners (NSS) are low in calories and can be used in very small amounts. Both the U.S. Food and Drug Administration and Korea Ministry of Food and Drug Safety have stated that consuming NSS within the recommended dosage is not harmful to human health. Nonetheless, the World Health Organization in its 2023 guidelines on NSS use advised the general population against the consumption of NSS as a means of controlling weight and reducing the risk of chronic diseases, including diabetes. However, there is insufficient evidence regarding the health benefits and potential risks of NSS for patients with diabetes. Given the ongoing debate about the efficacy of NSS, the 2023 clinical guidelines of the Korean Diabetes Association recommend minimizing beverages containing sugar or NSS, although NSS may help reduce sugar intake in the short term. This review aims to explore the latest research on the benefits and risks of NSS for the general population and patients with diabetes.
10.2023 Clinical Practice Guidelines for Diabetes Mellitus of the Korean Diabetes Association
Jong Han CHOI ; Kyung Ae LEE ; Joon Ho MOON ; Suk CHON ; Dae Jung KIM ; Hyun Jin KIM ; Nan Hee KIM ; Ji A SEO ; Mee Kyoung KIM ; Jeong Hyun LIM ; YoonJu SONG ; Ye Seul YANG ; Jae Hyeon KIM ; You-Bin LEE ; Junghyun NOH ; Kyu Yeon HUR ; Jong Suk PARK ; Sang Youl RHEE ; Hae Jin KIM ; Hyun Min KIM ; Jung Hae KO ; Nam Hoon KIM ; Chong Hwa KIM ; Jeeyun AHN ; Tae Jung OH ; Soo-Kyung KIM ; Jaehyun KIM ; Eugene HAN ; Sang-Man JIN ; Won Suk CHOI ; Min Kyong MOON ; ;
Diabetes & Metabolism Journal 2023;47(5):575-594
In May 2023, the Committee of Clinical Practice Guidelines of the Korean Diabetes Association published the revised clinical practice guidelines for Korean adults with diabetes and prediabetes. We incorporated the latest clinical research findings through a comprehensive systematic literature review and applied them in a manner suitable for the Korean population. These guidelines are designed for all healthcare providers nationwide, including physicians, diabetes experts, and certified diabetes educators who manage patients with diabetes or individuals at risk of developing diabetes. Based on recent changes in international guidelines and the results of a Korean epidemiological study, the recommended age for diabetes screening has been lowered. In collaboration with the relevant Korean medical societies, recently revised guidelines for managing hypertension and dyslipidemia in patients with diabetes have been incorporated into this guideline. An abridgment containing practical information on patient education and systematic management in the clinic was published separately.

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