• The Journal of Internal Korean Medicine
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• v.28 no.2
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• pp.262-274
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• 2007

Objective : It has been reported that two-repeats ($IL1RN^{\ast}2$) of interleukin-1 receptor antagonist (IL-1Ra) gene is associated with ischemic stroke, and that Ala allele of the common Pro12Ala polymorphism in $PPAR-{\gamma}2$ isoform is associated with reduced risk for type 2 DM and its complications. The aim of the present study is to assess the association of IL-1Ra and $PPAR-{\gamma}2$ Pro12Ala polymorphism with the presence of ischemic stroke in the case of diabetic and non-diabetic patients. Methods : Genomic DNA was obtained from 373 healthy subjects, 157 DM subjects without ischemic stroke (known DM duration ${\ge}10$ years) and 302 ischemic stroke patients (including with DM). IL-1Ra polymorphism was analysed by polymerase chain reaction (PCR), and $PPAR-{\gamma}2$ polymorphism by restriction fragment length polymorphism after PCR. Results : $IL1RN^{\ast}1/IL1RN^{\ast}2$ genotype was associated with significantly increased risk for DM (OR=2.86, P = 0.0008) and ischemic stroke (OR=2.74, P = 0.0016). Pro/Ala genotype was associated with the reduced risk for DM (OR=0.53, P = 0.0491) and ischemic stroke (OR=0.38, P = 0.0039). They were also associated with the reduced risk for ischemic stroke in the DM patients compared with DM without ischemic stroke (OR=0.25, P = 0.0321). Conclusions : $IL1RN^{\ast}2$ allele could be an accelerating factor, not a predictive marker for ischemic stroke in type 2 DM. The Pro/Ala genotype of $PPAR-{\gamma}2$ Pro12Ala polymorphism may be associated with reduced risk for ischemic stroke with type 2 DM. Therefore it could be a useful predictive marker for ischemic stroke in Korean type 2 DM.

• Journal of the Korean Dietetic Association
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• v.10 no.2
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• pp.205-217
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• 2004

This study was carried out to provide information on the effect of nutrition education program for diabetic patients at the Guri City's Public Health Center. Subjects of this study were 31 persons(male 7, female 24) who attended all courses of "2002 Diabetes Education Class". They were indicated as the 'education group'(EG). Eating and living habits of EG were investigated before the education. EG's weight and blood glucose (post prandial 2 hours, PP2) were examined as well. EG's PP2 reduction was compared with a 'control group'(CG) who didn't join any course in that class. All of the subjects were non-insulin-dependent diabetes mellitus(NIDDM) patients. EG's average age was 62.4$\pm$8.8. Before taking the course, EG's PP2 was 251.5$\pm$29.6mg/dl, and body mass index(BMI) was 26.3$\pm$2.3 on average. Most of them were stressed out from their daily lives and usually had no exercise. Most people of EG ate meals rapidly and liked sweet and fatty foods. After the course of training, EG's weight and BMI before the training were not decreased significantly. However, all of the EG's PP2s, which were measured 4 times(before the meal at the special lunch session, after 2 hours at this meal, after 2 weeks and 4 weeks dietary assembly), were decreased in comparison with the PP2 which was checked prior to joining the training. EG's average PP2 was more reduced than CG's one. In addition, all groups' PP2s were decreased for 8 weeks. After all, this nutritional education at the public health center was effective in glycemic control for diabetes mellitus patients. Especially, when the dietary assembly as practical training was included in the educational process, the patient's dietary intake and PP2 was improved more effectively. Therefore, this study suggests that nutrition work at public health centers is necessary for the Health Promotion Policy.

• Korean Journal of Clinical Pharmacy
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• v.27 no.2
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• pp.99-104
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• 2017

Objectives: This study aimed to compare effects on glycemic control and weight loss between the metformin/dapagliflozin combination and the metformin/sitagliptin combination in type 2 diabetic patients. Methods: This study retrospectively reviewed the medical records, from January $1^{st}$ 2015 to March $31^{st}$ 2016, of type 2 diabetic patients who were older than 18 and were prescribed with dapagliflozin or sitagliptin in combination with metformin. Hemoglobin $A_{1c}$ ($HbA_{1c}$) levels and weights were measured every 3 months. Results: The dapagliflozin group showed a greater decrease in $HbA_{1c}$ levels after 3 months (-0.75% vs. 0.01%, P<0.001), 6 months (-0.36% vs. 0.08%, P=0.029), and 9 months (-0.53% vs. 0.08%, P=0.046) compared to the sitagliptin group. Also, the dapagliflozin group showed a greater significant decrease in the rate of change in $HbA_{1c}$ levels after 3 months (-0.09 vs. 0.01, P<0.001), 6 months (-0.04 vs. 0.01, P=0.031), 9 months (-0.07 vs. 0.02, P=0.029), and 12 months (-0.05 vs. 0.05, P=0.047). Furthermore, the dapagliflozin group showed a greater decrease in amount of weight change after 3 months (-2.46 kg vs. 0.37 kg, P<0.001), 6 months (-3.02 kg vs. 0.13 kg, P<0.001), and 9 months (-2.27 kg vs. 0.50 kg, P=0.002). Finally, the dapagliflozin group showed a greater decrease in the rate of change in weight after 3 months (-3.10% vs. 0.52%, P<0.001), 6 months (-3.83% vs. 0.21%, P<0.001), 9 months (-2.84% vs. 0.79%, P=0.002), and 12 months (-4.91% vs. 0.44%, P<0.001). Conclusions: It was concluded that dapagliflozin is more effective than sitagliptin for type 2 diabetic patients.

• Journal of the Korean Dietetic Association
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• v.12 no.3
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• pp.254-263
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• 2006

Background: Type 2 diabetes is occuring in epidemic proportions worldwide and aging has been defined as one of the risk factors for the progression to diabetes. High carbohydrates intake increases blood sugar level and obesity in type 2 diabetes. The purpose of this study was to examine the relationship between carbohydrate intake and obesity in type 2 diabetes. Methods: The study subjects were 72 patients (male 27, female 45), who had been diagnosed as type 2 diabetes at Seoul National University of Bundang Hospital. Their anthropometric(height, weight, waist and hip circumference), biochemical(fasting blood sugar, postprandial -2hour blood sugar, HbA1C, C-peptide, insulin, total cholesterol, triglyceride, HDL-cholesterol, LDL-cholesterol) and body composition were measured. Dietary data were collected by trained interviewers using three non-consecutive food records. Results: The mean age of the subjects was 55.86$\pm$9.30 years, and the mean duration of disease was 1.9$\pm$1.72 years. The mean fasting blood sugar, postprandial-2hour blood sugar and HbA1C of the subjects were 151.91$\pm$34.65mg/dl, 235.23$\pm$70.74mg/dl and 7.45$\pm$1.13%, respectively. There was significant positive correlation of the percent body fat and hip to carbohydrate intake/kg of body weight in obese males (p<0.05). However, the correlation of biochemical factors to carbohydrate intake was not significantly different in obese and non-obese male. The correlation of anthropometry to carbohydrate intake/kg of body weight was not significantly different in obese and non-obese females (p<0.05), and other nutrients. We found significant association between carbohydrate intake and obesity in obese males among type 2 diabetes. The females in type 2 diabetes were affected by several factors rather than energy nutrient intake. Conclusion: In conclusion, the correlation of carbohydrate intake with obesity factor was different in males and females. Therefore, diabetic educators should individualize diabetes nutrition therapy considering the gender.

• The Journal of Internal Korean Medicine
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• v.42 no.1
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• pp.40-52
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• 2021

Objective: This study was conducted to investigate the hypoglycemic effect and safety of Ojeok-san in patients with type 2 Diabetes Mellitus. Methods: We investigated type 2 diabetes mellitus patients at Kyung-Hee University Korean Medical Hospital who were administered Ojeok-san for at least one day between January 2012 and September 2020, basal characteristics and laboratory tests were reviewed retrospectively. The hypoglycemic effect of Ojeok-san was assessed by comparing fasting blood sugar (FBS) and two hours post-prandial plasma glucose (PP2) levels from before and after taking Ojeok-san. Subgroup analyses were conducted according to baseline hypoglycemic treatments and glycated hemoglobin levels (< or ≥6.5%). The safety of Ojeok-san was assessed by comparing levels of aspartate aminotransferase, alanine aminotransferase, γ-glutamyl transferase, blood urea nitrogen, and creatinine. Results: After Ojeok-san administration, FBS and PP2 were significantly reduced to an average of 14.33 mg/dL and 27.67 mg/dL respectively. In the subgroup analysis, PP2 in patients receiving metformin mono therapy was significantly reduced to 28.67 mg/dL, and those receiving a dual therapy of metformin and DPP-4 inhibitor, it was significantly reduced to 32.33 mg/dL. In patients with glycated hemoglobin of lower than 6.5%, FBS was significantly reduced to 12.20 mg/dL, and both FBS and PP2 were significantly reduced, to 15.50 mg/dL and 40.00 mg/dL, respectively, in those with glycated hemoglobin levels of more than 6.5%. The safety profile showed no significant difference after Ojeok-san administration. Conclusions: Ojeok-san has significant hypoglycemic effects in patients with type 2 diabetes mellitus who are also taking hypoglycemic agents.

• Health Policy and Management
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• v.26 no.2
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• pp.125-134
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• 2016

Background: Glycemic control is an effective way to reduce the cardiovascular complications of diabetes, but more than half of the adults with diabetes in Korea are improperly controlling their glycemic levels. The purpose of this study is to identify the factors associated with poor glycemic control in type 2 diabetes patients. Methods: This study analyzed 1,261 subjects ${\geq}30years$ old diagnosed with type 2 diabetes who participated in the fifth Korean National Health and Nutrition Examination Survey (2010-2012). Poor glycemic control rates were defined as hemoglobin A1c (HbA1c) level ${\geq}7%$. To shed light on the causes of poor glycemic control, socio-demographics, diabetes severity, health status, and health behavior factors were adjusted and logistic regression was done. Results: Of the total 1,261 patients, 53.0% of patients with type 2 diabetes had HbA1c ${\geq}7%$. After running a logistic regression model, the odds ratio of poor glycemic control was higher in high school graduates than elementary school graduates; in people living in Chungcheong and Jeolla/Jeju than those living in Seoul; in the group with diabetes for over 5 years had diabetes less than 5 years; in a group with insulin and oral hypoglycemic agent treatment than non-treatment; in a group with hypertriglyceridemia than without hypertriglyceridemia; and in the group with slept less than 6 hours slept 7-8 hours. Conclusion: We need a comprehensive public health policy to reduce the poor glycemic control rates in type 2 diabetes patients. We should recognize the education levels, duration of diabetes, diabetes treatment, hypertriglyceridemia, and sleep duration were associated with poor glycemic control.

• Journal of Korean Biological Nursing Science
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• v.2 no.1
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• pp.64-75
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• 2000

This study was conducted to identify the effects of exercise therapy applied in an efficacy expectation promoting program that was based on Bandura's self efficacy model on self-efficacy, cardiopulmonary function and metabolism in type 2 diabetes mellitus patients. The study design was nonequivalent pre-test post-test control design. 34 type 2 diabetes mellitus patients who received follow-up care regularly through the diabetic out-patient clinic were randomly sampled for this study. Twenty patients were assigned to the experimental group and fourteen patients were assigned to the control group. To the experimental group, exercise therapy applied in an efficacy expectation promoting program that is composed of individualized exercise prescription for 12 weeks was provided. In case of the control group, they were instructed to continue their usual lives. Data collection period was from March 1998 to June 2000 Data were analyzed using SPSS/WINDOW 10.0 program. The results were as follows. In experimental group, The score of self efficacy has increased from 64.20 to 66.65 after exercise therapy applied in an efficacy expectation promoting program and it was statistically significant(t=2.07, p=.04). The anaerobic threshold has increased from $18.20\;m{\ell}$/kg/min to $19.07\;m{\ell}$/kg/min and it was statistically significant(t=2.05, p=.04). Level of fasting blood sugar has decreased from $188.20\;mg/d{\ell}$ to $155.55\;mg/d{\ell}$ after exercise therapy applied in an efficacy expectation promoting program and it was statistically significant.(t=-2.69, p=.01). For the lipid metabolism, percent body fat has decreased from 27.16% to 26.57% after exercise therapy applied in an efficacy expectation promoting program. In conclusion, the exercise therapy applied in an efficacy expectation promoting program showed positive effect of self-efficacy, cardiopulmonary function and glucose and lipid metabolism.

• The Journal of Internal Korean Medicine
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• v.43 no.3
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• pp.363-374
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• 2022

Objective: This study was conducted to evaluate the hypoglycemic effect and safety of herbal extracts in patients with type 2 diabetes mellitus. Methods: We investigated 19 hospitalized patients with type 2 diabetes mellitus who were administered Banhasasim-tang (BST), Gumiganghwal-tang (GGT), or Pyeongwee-san (PWS) at Kyung Hee University Korean Medical Hospital for at least three days between January 2012 and December 2021. Their clinical characteristics and laboratory tests were reviewed retrospectively. The glucose-lowering effect of the herbal extracts was assessed by comparing blood glucose levels, including fasting blood sugar (FBS), two-hour postprandial glucose (PP2) levels, and glycated hemoglobin levels. To evaluate the safety of the herbal extract, liver function test and kidney function test results were compared, including aspartate aminotransferase (AST), alanine aminotransferase (ALT), blood urea nitrogen (BUN), and creatinine (Cr). Results: After taking herbal extracts, PP2 and HbA1c levels significantly decreased from 205.82 mg/dL to 171.41 mg/dL and 7.58% to 6.62%, respectively. The safety profile reported no significant difference after taking herbal extracts. Conclusions: BST, GGT, and PWS may have hypoglycemic effects in patients with type 2 diabetes mellitus taking hypoglycemic medication.

• Journal of Nutrition and Health
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• v.43 no.1
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• pp.46-56
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• 2010

This study was intended to assess the effects of low glycemic index (LGI) nutrition education on dietary management and glycemic control of patients with type 2 diabetes mellitus. The subjects were 48 sex-matched patients with type 2 diabetes mellitus, aged $66.5\;{\pm}\;6.2$ years, visiting a public health center. They were divided into two groups: the control group (males 10, females 14) and the educated group (males 10, females 14). The educated group was provided with a LGI nutrition education program for 7 weeks. The control group was educated only one time for general diabetic education. Anthropometric indices, knowledge and perception of efficacy of low glycemic index carbohydrates, dietary glycemic index (DGI) and glycemic load (DGL), fasting blood glucose, and HbA1c were assessed. In the educated group body weight, body mass index and systolic blood pressure (from $138.0\;{\pm}\;18.9\;mmHg$ to $130.6\;{\pm}\;15.0\;mmHg$) were significantly reduced after the nutrition education (p < 0.05). The scores of knowledge and perception of efficacy of low glycemic index carbohydrates increased significantly in the educated group. Dietary glycemic index and glycemic load of the educated group decreased significantly from $103.4\;{\pm}\;67.6$ to $45.4\;{\pm}\;27.1$ (p < 0.001), and from $173.3\;{\pm}\;135.9$ to $66.8\;{\pm}\;50.4$ (p < 0.001), respectively. Also fasting blood glucose and HbA1c levels of the educated group significantly decreased from $124.5\;{\pm}\;28.8\;mg/dL$ to $96.7\;{\pm}\;21.6\;mg/dL$ (p < 0.001) and from $7.1\;{\pm}\;1.3%$ to $6.4\;{\pm}\;1.2%$ (p < 0.05), respectively. The score of knowledge and perception of efficacy of low glycemic index significantly correlated with fasting blood glucose and HbA1c levels negatively. DGI, DGL and duration of diabetes significantly correlated with HbA1c level positively. From stepwise multiple linear regression analysis, DGI, DGL and the duration of diabetes were extracted as factors influencing HbA1c level of the subjects. The results of this study suggest that low glycemic index nutrition education programs is an effective intervention measure for the glycemic control in type 2 diabetic patients.

• Korean journal of food and cookery science
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• v.21 no.1 s.85
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• pp.64-74
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• 2005

To develop the diet for Korean type 2 diabetic patients, a consumer survey was conducted (N=35) and was analyzed statistically. The survey compared the results of a questionnaire, somatometry, and blood parameters before and 8 weeks after the experiment. It was divided into Diabetic diet enforcement group (DDE) vs. Non diabetic diet enforcement group (NDDE). There was no significant difference in body weight, body mass index (BMI), body fat, triglyceride (TG) and low density lipoprotein cholesterol (LDL-C) of the subjects before and 8 weeks after the experiment. DDE's average fasting glucose (FBG) and post prandial 2 hours blood glucose (PP2) were significantly decreased before and after the experiment (p<0.05). NDDE's average FBG and PP2 showed no significant difference. In terms of Hemoglobin $A_lC\;(HbA_1C)$ content, DDE's had significantly decreased level both before and after the experiment (p<0.05), while there was no significant difference in the NDDE group. Cholesterol and High density lipoprotein cholesterol (HDL-C) were significantly different in DDE (p<0.05) both before and after the experiment. Whereas in the case of NDDE, there was no significant difference on the cholesterol and HDL-C, while DDE's showed a significant difference before and after the experiment. In terms of patients distribution depending on their treatment (p<0.05), NDDE had no significant difference before and after the experiment. For an item asking blood glucose control, DDE had significant difference before and after the experiment (p<0.01), while NDDE had no significant difference. For program satisfaction (p<0.05) and health (p<0.001), both the groups changed significantly after the experiment. But there was no significant difference in applying it to their real life after the experiment. Based on these results, DDE had the decreased blood glucose levels, $HbA_1C$, and cholesterol and increased HDL-C, with decreased rate of the patients taking oral hypoglycemic agents. In addition, many of the patients who participated in the experiment were found to be satisfied with the program, in terms of having less trouble in glucose control and exhibited improvement in health. Hence, based on the above results it was concluded that program was a very successful one for the treatment of diabetes.