• Clinical and Experimental Pediatrics
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• v.52 no.2
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• pp.220-226
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• 2009

Purpose : Macrovascular complications are the main cause of mortality in type 1 diabetes mellitus (T1DM). The purpose of this study was to clarify the presence of early vascular changes and to assess the risk factors of macrovascular complications in young adults with T1DM diagnosed in childhood and adolescence. Methods : Seventy-two patients ($23.9{\pm}2.4$ years) with T1DM diagnosed before 18 years of age and twenty normal controls were included. The incidence of hypertension, dyslipidemia, and other risk factors of macrovascular complication were reviewed. Flow-mediated vasodilation (FMD) and mean intima-media thickness (IMT) measured by ultrasound were compared between patients and control subjects, and their correlations with macrovascular risk factors were analyzed. Results : Of the 72 patients, 32 (44.4%) had hypertension. The proportions of maleness (P=0.03) and mean body mass index (P=0.04) were higher in the hypertensive patients than in normotensive patients. Thirty-one (N=69, 44.9%) patients had dyslipidemia and LDL-cholesterol was positively correlated with mean HbA1c (r=0.32, P=0.008) and total daily insulin dose (r=0.27, P=0.02). The mean IMT was significantly higher in patients than in control subjects ($0.43{\pm}0.06$ mm vs $0.39{\pm}0.06$ mm, P=0.03). There was no difference in the value of FMD between patients and controls, but the duration of the disease after pubertal onset was negatively correlated with FMD (r=-0.34, P=0.01). Conclusion : Hypertension, dyslipidemia and atherosclerotic vascular change were observed in young adults with T1DM diagnosed during childhood and adolescence; this strongly suggests that meticulous screening of macrovascular complications and control of their risk factors should be conducted.

• Journal of the Korean Society of Food Science and Nutrition
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• v.40 no.5
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• pp.689-695
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• 2011

Diabetic patients need nutritional education more than those suffering from other diseases because of the necessity of controlling blood glucose levels with dietary treatment. The purpose of this study was to find out the effectiveness of nutrition education on diabetes control and antioxidant status, both of which are related to diabetic complications. Thirty (15 males and 15 females) type 2 diabetes mellitus patients aged $66.7{\pm}8.8$ years participated in a 4-week nutrition education program. Nutrient intakes, blood glucose level, antioxidant status, and DNA damage were evaluated before, immediately after, and three months after the education program. Changes in those parameters over time were analyzed using repeated-measures analysis of covariance. Over time, HbA1c (p=0.000), plasma total cholesterol (p=0.002), plasma thiobarbituric acid related substances (TBARS; p=0.000), and leukocyte DNA damage (p=0.000) significantly decreased; plasma retinol (p=0.001), plasma tocopherol (p=0.000), erythrocyte catalase (CAT; p=0.000), and erythrocyte glutathione peroxidase (GPx; p=0.000) significantly increased. In an evaluation of nutrient intakes by Dietary Reference Intakes for Koreans (KDRI), energy (p=0.009), phosphorus (p=0.033), sodium (p=0.001), potassium (p=0.019), zinc (p=0.043), riboflavin (p=0.050), folic acid (p=0.048) and vitamin C (p=0.008) intakes had significant positive changes. In a correlation analysis of the biochemical and nutritional changes resulting from the education program, plasma TBARS were negatively correlated with potassium (r=-0.418, p<0.05), iron (r=-0.443, p<0.05), riboflavin (r=-0.432, p<0.05), and folic acid (r=-0.446, p<0.05) intakes, while plasma retinol was positively correlated with energy (r=0.543, p<0.01), protein (r=0.543, p<0.01), phosphorus (r=0.425, p<0.05), iron (r=0.485, p<0.05), zinc (r=0.570, p<0.01) and niacin (r=0.510, p<0.05) intakes. Erythrocyte CAT was positively correlated with folic acid intake (r=0.605, p<0.01). From these results, we suggest that an improvement in nutrition resulting from a diabetic education program for type 2 diabetes patients led to improvement in their antioxidant status, also possibly reducing complications resulting from diabetes.

• Journal of Korean Academy of Nursing Administration
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• v.16 no.3
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• pp.295-305
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• 2010

Purpose: This study was conducted to evaluate the economic efficiency of a community-based nursing care center to help policy makers determine whether or not to invest in similar facilities. Methods: The subjects were 101 elderly people over 65 years who participated in a health management program from February 1 to July 31, 2007. Direct cost was estimated with center operations cost, medical cost for out-patients and pharmacy cost. Indirect cost was measured by transportation cost. Direct benefit was calculated by saved medical cost for out-patients, saved pharmacy cost, saved transportation cost, and reducing hospital charges. Indirect benefit was estimated with prevention of severe complications. Economic efficiency was evaluated by cost-benefit ratio and net benefit. Results: Operating a community-based nursing care center was found to be cost-effective. Specifically, the cost of operating the center evaluated here was estimated at 135 million won while the benefit was estimated at 187 million won. Benefit-cost ratio was 1.38. Conclusion: The Community-based nursing care center that was described here could be a useful health care delivery system for reducing medical expenditures.

• Journal of Pharmacopuncture
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• v.16 no.3
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• pp.23-29
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• 2013

Objectives: Dyslipidemia in diabetes mellitus is a significant risk factor for the development of cardiovascular complications. The aim of this study was to evaluate the effect of the ethyl-acetate fraction of an ethanolic extract from Streospermum suaveolens on lipid metabolism in streptozotocin (STZ)-induced diabetic rats. Methods: Diabetes was induced by intraperitonial injection of STZ (50 mg/kg). Diabetic rats were treated with an ethyl-acetate fraction orally at doses of 200 and 400 mg/kg daily for 14 days. On the $15^{th}$ day, serum lipid profiles, such as total cholesterol (TC), triglycerides (TG), low-density lipoprotein (LDL), and high-density lipoprotein (HDL), were estimated in experimental rats. The atherogenic (AI) and the coronary risk (CRI) indices were also evaluated. Results: The ethyl-acetate fraction at doses of 200 and 400 mg/kg significantly (P < 0.001) and dose-dependently reduced serum cholesterol, triglycerides and LDL, but increased HDL towards near normal levels as compared to diabetic control rats. The fraction also significantly (P < 0.001) lowered the atherogenic index (AI) and coronary risk index (CAI) in a dose-dependent manner. Conclusion: The present study demonstrated that the ethyl-acetate fraction of Stereospermum suaveolens exhibits a potent antihyperlipidemic activity in hyperglycemic rats and suggests that the plant may have therapeutic value in treating the diabetic complication of hyperlipidemia.

• The Journal of Korean Medicine
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• v.27 no.2 s.66
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• pp.155-170
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• 2006

Objectives : This study aimed to evaluate the hypoglycemic, hepatoprotective, and nephroprotective effects of 'Saengjinyanghyul-tang($Sh\={e}ngj\={i}ny\v{a}ngxu\`{e}-t\={a}ng$ : SJYHT)' in streptozotocin (STZ)-induced diabetic SD rat model. Methods : SJYHT extracts were once a day dosed for 28 days at a dosage 1000, 500, and 250mg/kg/5ml from 25 days after STZ-dosing, and the changes on blood glucose levels, liver and kidney weight, serum AST, ALT, BUN and creatinine levels were observed with histological changes on the liver and kidney. Results : Increased blood glucose levels, and diabetic hepatopathy & nephropathy including increased serum AST, ALT, BUN and creatinine levels, histological changes after STZ-dosing were dose-dependently reduced by SJYHT extract-dosing. Conclusions : 'SJYHT' water extracts have favorable hypoglycemic, hepatoprotective, and nephroprotective effects on the STZ-induced diabetic SD rats. Therefore, it is expected that 'SJYHT' has potential for use in the management of diabetes and diabetic complications.

• Journal of Nutrition and Health
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• v.32 no.7
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• pp.767-774
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• 1999

This study was carrid out to examine a part of the mechanism for the etiology of diabetic complications. Thirty normal and forty streptozotocin(STZ)-induced diabetic rats were used as the animal models. Animals were sacrificed at the time points of 3 days, 1, 2, 4 and 6 weeks after STZ-injection and time course in body weight and organ weight, the levels of blood glucose, plasma lipid patterns, and atherogenic index were measured during 6 weeks. The STZ-diabetic animals showed 63% survival rate and fsting blood glucose levels of the diabetic animals measured in the range of 230-410mg/dL during the experimental period. The body weigh of diabetic animals decreased significantly throughout the experimental period and the relative weights of organs to body weight were significantly higher than the normal control ones. The enlargement of the kidney in the diabetic animals was especially remarkable. Plasma triglyceride concentration in diabetic rats substancially increased from the first week of onset of diabetes mellitus and maintained higher levels than the control ones throughout the whole experimental period. The plasma total cholesterol level and atherogenic index in the diabetic rats were significantly higher than the normal ones from the third day after STZ injection and showed a gradual increase with the duration of the disease. Throughout the experiment, the diabetic rats consistently showed a slightly lower HDL-cholesterol level compared to the normal animals. From the results of this study, it appears that the significant changes in blood lipid pattern in STZ-diabetic animals start from the first week after STZ injection.

• Journal of Veterinary Clinics
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• v.28 no.1
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• pp.139-143
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• 2011

A Spitz (5-years old, castrated male) and a Maltese (9-years old, castrated male) were presented with weight loss, polyuria/polydipsia (PU/PD) and depression. Diabetic ketosis was diagnosed based on clinical signs, physical examinations and screening tests (CBC, serum chemistry and urinalysis). The dogs were treated with NPH initially. However, NPH was inadequate to control blood glucose level due to the short duration of the action (< 5 hours). Because of the poor glycemic control with NPH, the dogs showed diabetic complications including weight loss and cataract. After change to glargine, the duration of insulin action was extended up to 11 hours. As a result, there was significant improvement in clinical signs and serum fructosamine concentrations. This study suggests that glargine is useful as a long-acting insulin in dogs which have poor glycemic control due to the short duration of NPH.

• Proceedings of the KIEE Conference
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• 2007.04a
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• pp.67-69
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• 2007

Recently, the prevalence rate of diabetes in Korea has been increasing rapidly due to high growth of economy and changes in dietary lifestyle. Vascular complication is one of diabetic complications which have frequently occurred by obesity, hyperglycemia and impaired glucose metabolism. Photoplethysmogram(PPG) measured from finger and toe is very useful for evaluation of vascular aging and sclerosis level since the PPG signal represents characteristics of peripheral vascular. Several researchers have reported that second derivative of the finger PPG waveform was useful to evaluate vascular compliance and developed various analysis methods for vascular compliance. However, peripheral vascular compliance study for diabetic patient was never evaluated by using second derivative of PPG. Therefore, we aimed to objectively compare and to assess normal and diabetic group vascular compliance using the second derivative of PPG waveform in this study. The evaluated factors of second derivative of PPG are 'a', 'b', 'c', 'd', 'e' and b/a represents vascular compliance. Study found out that when vascular compliance is decreased, b/a is increased, the absolute value of b/a is decreased. The average vascular compliance of 50 diabetic patients with neuropathy is statistically lower than the normal group(p<0.05). We suggest an objective evaluation of peripheral vascular compliance for diabetic patients and prevention of vascular complication.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.37
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• pp.39.1-39.6
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• 2015

Skull-base osteomyelitis is a rare disease affecting the medulla of the temporal, sphenoid, and occipital bones. In general, it occurs due to external ear canal infections caused by malignant external otitis. Skull-base osteomyelitis usually affects elderly diabetic patients. The patient, a 58-year-old man, was referred for evaluation and management of the left jaw. Clinical examination of the patient revealed pain in the left jaw and mouth-opening deflection to the left. The maximum active mouth opening was measured to about 27 mm. Panoramic, CT, and CBCT revealed bone resorption patterns in the left condyle. Through control of diabetes, continued pharmacological treatment, arthrocentesis, and occlusal stabilization appliance therapy were carried out. The extent of active mouth opening was increased to 45 mm, and pain in the left jaw joint was alleviated. This was a case wherein complications caused by failure to control diabetes induced skull-base osteomyelitis. There is a need for continued discussion about the advantages and disadvantages of arthrocentesis with lavage for patients with skull-base osteomyelitis and other treatment options.

• The Journal of Internal Korean Medicine
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• v.23 no.1
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• pp.141-145
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• 2002

Diabetic Ketoacidosis(DKA), one of acute complications of diabetes mellitus(DM) occurs mostly in insulin dependent diabetes mellitus (IDDM) patients. Its clinical symptoms are hyperglycemia, ketonemia or ketonuria, metabolic acidosis, etc. The interaction of lack of insulin, excessive secretion of insulin antagonic hormone and dehydration cause body fluid loss and electrolyte, typical symptom of DKA as polyuria, polydipsia, nausea, vomiting, abdominal pain occur. As a result, prompt supply of fluid and insulin by intravenous injection should be conducted for treatment. It is still an emergent disorder whose mortality is still 10 to 15%, though is has decreased compared to the past. We treated a female patient who has DKA, had withdrawn insulin pump therapy. We report a case of DKA with a brief review of related literatures.