• 셀메드
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• 제11권3호
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• pp.12.1-12.5
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• 2021

Gestational diabetes mellitus (GDM) has become one of the major public health problems for both mothers and children globally. Internationally, the frequency of excess weight and obesity has risen dramatically in women of childbearing age. There seems to be a greater risk of having GDM in overweight or obese women, resulting in problems during pregnancy, birth and neonatal development. Hospital management is a problem for obese pregnant females with GDM and places extra burdens on the healthcare sector. GDM can result in possible risks to the wellbeing of the mother, fetus, and infant, as well as clinically significant negative effects on the mental health of the mother. For females and their developing babies, diabetes may cause problems during pregnancy. Unsatisfactory diabetes control enhances the risk of complications and other birth related issues during pregnancy. It may also cause a woman to suffer severe complications. Numerous maternal and fetal effects are associated with GDM and multiple detection and management methods are also pursued globally in order to reduce the burden of health. An overview of gestational diabetes treatment is given in this review.

• 대한한방내과학회지
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• 제25권2호
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• pp.277-287
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• 2004

Objective : Diabetes is a disease in which the body does not produce or properly use insulin. Etiological studies of diabetes and its complications showed that oxidative stress might playa major role. Therefore, many efforts have been made to regulate oxygen free radicals for treating diabetes and its complications. Because Jindangwon has been known to be effective in treatment of diabetes, the methanol extract of Jindangwon was tested for its effectiveness in reducing the oxidative stress induced by Streptozotocin. Methods : Jindangwon was washed, dried in the shade and crushed. The crushed Jindangwon was extracted 3 times, each time with 3 volumes of methyl alcohol at $60^{\circ}C$ for 24 hours. The extract was filtered and evaporated under reduced pressure using a rotary evaporator to yield 30.6 g. Jindangwon extract was oral-administered to the diabetic rats induced by streptozotocin 50 mg per 1 kg of body weight for 15 days. The efficacy of the Jindangwon extract was examined with regard to the enzymatic pathways involved in the oxygen free radical production and the glutathione balance. Results : he effects of the methanol extract of Jindangwon in streptozotocin-induced diabetics rats with regard to body weight, blood glucose level, hepatic lipid peroxide level, hepatic xanthine oxidase activity and type conversion rate, hepatic glutathione level, hepatic glutathione peroxidase activity, hepatic glutathione reductase activity, hepatic aldose reductase activity, and hepatic sorbitol dehydrogenase activity were favorable enough to suggest that it is a cure for diabetes and its complications. Conclusions :These results support Jindangwon as an effective reducing agent for oxidative stress in the tissues and organs by regulating the production of oxygen free radicals. Jindangwon, in particular, shows promising results for its use as a cure, or preventative medicine for diabetes and its complications by reducing oxidative stress in beta-cells of the pancreas.

• 대한한방내과학회지
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• 제27권4호
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• pp.811-821
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• 2006

Objectives : Diabetes is a disease in which the body does not produce or properly use insulin. Etiological studies of diabetes and its complications showed that oxidative stress might play a major role. Therefore, many methods have been tried to regulate oxygen free radicals for treating diabetes and its complications. Because Mori foliumhas been known to be effective for the treatment of diabetes, the methanol extract of Mori folium was tested for its effectiveness in reducing the oxidative stress induced by streptozotocin. Methods : The crushed Mori folium was extracted 3 times, each time with 3 volumes of methyl alcohol at $60^{\circ}C$ or 24 h. The extract was filtered and evaporated under reduced pressure using a rotary evaporator to yield 11.7 g. Mori folium extract was oral-administered to diabetic rats induced by streptozotocin at 100 mg per 1 kg of body weight for 20 days. The efficacy of the Mori foliumextract was examined with regard to the enzymatic pathways involved in oxygen free radical production and glutathione balance. Results : The effects of the Mori foliumin streptozotocin-induced diabetic rats with regards to body weight, blood glucose and insulin level, hepatic lipid peroxide level, hepatic glutathione level, hepatic glutathione S-transferase and glutathione peroxidase level, hepatic aldose reductase activity, and hepatic sorbitol dehydrogenase activity were shown to be good enough to cure and prevent diabetes and its complications. Conclusions : These results indicated that Mori folium might reduce oxidative stress in tissues and organs by regulating the production of oxygen free radicals. Especially Mori folium might prevent and cure diabetes and its complications by reducing oxidative stress in the ${\beta}-cells$ of the pancreas.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• 제45권4호
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• pp.207-214
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• 2019

Objectives: Medically compromised patients often fear required dental surgical procedures that can increase the risk of medical emergency when combined with reduced tolerance for stress. A stress reduction protocol (SRP) helps doctors minimize treatment-related stress and improves patient management with minimum complications. Diabetes and co-morbid hypertension carry 4-fold risk of aggravation of cardiovascular emergencies and 7.2-fold risk of mortality. Diabetic neuropathy can result in difficult diagnosis of myocardial infarction and reduces chances of surviving a myocardial infarction compared with a non-diabetic person. The aim of the study was to assess the feasibility of a protocol for management of patients having both diabetes and hypertension who required minor oral surgery to minimize the rate of cardiovascular emergencies. Materials and Methods: A prospective study was conducted in 140 patients having both diabetes and hypertension who required minor oral surgical procedures. A systematic approachable protocol was designed for management of such patients. Results: Among 140 patients, 6 patients (4.3%) had cardiovascular complications, while 3 patients (1 with syncope and 2 with hypertension) did not require any intervention other than observation. Two patients were managed with aspirin and nitroglycerin, and 1 patient had possible myocardial infarction (overall incidence 0.7%) with chest pain, S-T segment elevation on electrocardiogram, and troponin level of 0.60 ng/mL. Conclusion: The proposed protocol helps to improve management of patients having both diabetes and hypertension. We recommend that patients with uncontrolled diabetes and uncontrolled hypertension and/or patients having history of cardiovascular complication should be treated in a medical facility with a readily available cardiology unit. This facilitates prompt response to emergency and instant implementation of treatment, helping to reduce morbidity and mortality.

• Diabetes and Metabolism Journal
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• 제42권6호
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• pp.513-518
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• 2018

Background: Recent studies have correlated serum cystatin C (CysC) with vascular complications, but few studies have investigated this correlation in diabetes patients without nephropathy. This study aimed to evaluate if higher serum CysC levels increase the risk for vascular complications in type 2 diabetes mellitus patients with normal renal function or mild renal impairment. Methods: A total of 806 consecutive patients with type 2 diabetes mellitus who were admitted to the diabetes center of Soonchunhyang University Hospital for blood glucose control were retrospectively reviewed. Patients with nephropathy were excluded. Subjects were categorized into quartiles of serum CysC levels (Q1, ${\leq}0.65mg/L$; Q2, 0.66 to 0.79 mg/L; Q3, 0.80 to 0.94 mg/L; and Q4, ${\geq}0.95mg/L$). Results: The proportion of patients with diabetic retinopathy (DR) (P for trend <0.001), coronary heart disease (CHD) (P for trend <0.001), and stroke (P for trend <0.001) increased across the serum CysC quartiles. After adjustment for confounding factors, the highest serum CysC level remained a significant risk factor for DR (odds ratio [OR], 1.929; 95% confidence interval [CI], 1.007 to 4.144; P=0.040). Compared with Q1, a significant positive association was observed between serum CysC and CHD in Q2 (OR, 7.321; 95% CI, 1.114 to 48.114; P=0.012), Q3 (OR, 6.027; 95% CI, 0.952 to 38.161; P=0.020), and Q4 (OR, 8.122; 95% CI, 1.258 to 52.453; P=0.007). No associations were observed between CysC and stroke after additional adjustment for confounding variables. Conclusion: Serum CysC levels are independently associated with DR and CHD, suggesting that CysC may be useful for identifying type 2 diabetes mellitus patients without nephropathy who are at high risk for vascular complications.

• 대한한방내과학회지
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• 제43권1호
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• pp.22-40
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• 2022

Objectives: The purpose of this study is to assess the antidiabetic effect and safety of Galgunhwangryunhwanggum-tang for type 2 diabetes without complications by analyzing related research. Methods: For a systematic review and meta-analysis, we searched for the antidiabetic effect and safety of Galgunhwangryunhwanggum-tang for type 2 diabetes without complications in 10 databases up to September 2021. Only randomized controlled trials were chosen. Results: In the treatment effectiveness analysis and meta-analysis, Galgunhwangryunhwanggum-tang had significant improvement effects on fasting plasma glucose level, 2-hour postprandial glucose level, glycated hemoglobin, fasting insulin, and homeostasis model assessment for insulin resistance compared to the control group when treated in parallel with oral glycemic drugs. Conclusion: Galgunhwangryunhwanggum-tang is effective in improving blood sugar and insulin resistance in type 2 diabetes patients without complications and can especially be considered in parallel treatment with oral hypoglycemic drugs. A large-scale randomized controlled clinical trial is required to complement the limitations presented in this study in the future.

• Nutrition Research and Practice
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• 제11권4호
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• pp.327-333
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• 2017

BACKGROUND/OBJECTIVES: Complications of diabetes, such as cardiovascular disease, are associated with increased mortality among type 2 diabetes mellitus patients. Homocysteine has been recently identified as a predictor of cardiovascular disease-related complications in diabetes. We investigated whether or not supplementation with folic acid tablets can lower homocysteine levels and improve parameters related with vascular complications. SUBJECTS/METHODS: We conducted a non-randomized 8-week trial involving postmenopausal diabetic women (n = 25) supplemented with $800{\mu}g$ of folic acid ($400{\mu}g$ twice a day) daily. Subjects' serum levels of folate, homocysteine, and vitamin $B_{12}$ were measured, along with vascular function and brachial-ankle pulse wave velocity. RESULTS: Folic acid supplementation significantly increased serum folate levels (P < 0.0001), reduced homocysteine levels (P < 0.0001), and increased vitamin $B_{12}$ levels (P = 0.0063). There were significant decreases in low-density lipoprotein cholesterol levels as well as the ratios of low-density lipoprotein cholesterol to high-density lipoprotein cholesterol and total cholesterol to high-density lipoprotein cholesterol. Brachial-ankle pulse wave velocities were not altered by supplementation. Changes in serum vitamin $B_{12}$ after folic acid supplementation were negatively correlated with changes in brachial-ankle pulse wave velocity. CONCLUSIONS: In this study on postmenopausal Korean women with type 2 diabetes mellitus, folic acid supplementation reduced serum homocysteine levels, increased serum folate and vitamin $B_{12}$ levels, and lowered lipid parameters.

• 농촌의학ㆍ지역보건
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• 제49권3호
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• pp.179-193
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• 2024

Objectives: This study aimed to determine the time-series changes in provincial diabetes management indices using by results of the 2008-2022 Korea Community Health Survey. Methods: We collected diabetes diagnosis experience rate, treatment rate for people diagnosed with diabetes, annual screening rate for diabetic eye disease complications, and annual screening rate for diabetic kidney disease complications with age-standardized rates from the Regional Health Statistics. The unit of analysis was the nation and 17 provinces and the time-series trend analysis was performed by joinpoint regression using the Joinpoint Regression Program, and the annual percent change (APC) and average APC (AAPC) were estimated, and statistical significance was tested using 95% confidence interval (CI). Results: From 2008-2022, the national AAPC (95% CI) for diabetes diagnosis experience rate steadily increased to 2.77 (2.25-3.27), increasing in all regions, excluding Sejong. The national AAPC for treatment rate for people diagnosed with diabetes was 0.75 (0.47-1.04), with a slight but steady trend toward improvement, excluding Daejeon, Sejong, and Jeonbuk, which showed significant improvement. The national AAPCs for annual screening rates for diabetic eye disease and kidney disease complications were 1.82 (0.99-2.66) and 1.95 (0.60-3. 41), respectively, and the area with the largest change was Sejong. Conclusions: In Korea, the diabetes management indices tended to increase and improve, but the trends among provinces varied. Therefore, efforts are needed to address regional disparities in diabetes management.

• 대한한의학회지
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• 제27권1호
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• pp.91-103
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• 2006

Objectives : Etiological studies of diabetes and its complications showed that oxidative stress might play a major role. Therefore, many effects have been fried to regulate oxygen free radicals for treating diabetes and its complications. Because Holotrichia has been known to be effective for the treatment of diabetes, the methanol extract of Holotrichia was tested for its effectiveness in reducing the oxidative stress induced by streptozotocin. Methods : Holotrichia was washed, dried in the shade and crushed. The crushed Holotrichia was extracted 3 times, each time with 3 volumes of methyl alcohol at $60^{\circ}C$ for 24h. The extract was filtered and evaporated under a reduced pressure using a rotary evaporator to yield 17 g. Holotrichia extract was oral-administed to the diabetic rats induced by streptozotocin 50 mg per 1 kg of body weight for 20 days. The efficacy of the Holotrichia extract was examined with regard to the enzymatic pathways involved in the oxygen free radical production and the glutathione balance. Results : The Effects of the methanol extract of Holotrichia in streptozotocin-induced diabolic rats with regards to body weight, blood glucose level, hepatic lipid peroxide level, hepatic superoxide anion radical content. hepatic xanthine oxidase activity and type conversion rate, hepatic glutathione level, hepatic aldose reductase activity, and hepatic sorbitol dehydrogenase activity were shown to be good enough to cure and prevent the diabetes and its complications. Conclusions : These results indicated that Holotrichia might reduce the oxidative stress in the tissues and organs by regulating the production of oxygen free radicals. Especially, Holotrichia might prevent and cure the diabetes and its complications by reducing the oxidative stress in the ${\beta}$-cells of pancreas. Some suggestions on biophoton experiments were made.

• 대한기관식도과학회지
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• 제17권2호
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• pp.98-103
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• 2011

Purpose Pulmonary complications continue to be the major cause of morbidity and mortality after esophageal resection. The aim of this study was to compare and analyze retrospectively the factors which effect for postoperative pulmonary complications in patients who underwent curative resection for esophageal cancer. Material and Method A total of 118 patients were enrolled in the study from January 1994 to March 2009, and patients with previous neoadjuvant chemotherapy or radiotherapy were excluded. Of the total 118 patients, 27 patients developed pulmonary complications within 30 days of their operation. the factors which effect for postoperative pulmonary complications were compared and analyzed. Results There were 7 patients in-hospital deaths. 51 patients (43.2%) developed complications, and of them, the most common complication was pulmonary complication and occurred in 27 patients (22.9%). In univariate analysis, diabetes mellitus, cervical anastomosis through the retrosternal route, old age and poor lung function were risk factors contributing to postoperative pulmonary complications (p<0.05). In multivariate analysis, statistically significant factor was old age (65 years or older). Conclusion Clinical factor for the pulmonary complications after esophagectomy of esophageal cancer was significantly associated with diabetes mellitus, cervical anastomosis through the retrosternal route, old age (65 years or older) and poor lung function (FEV1<80%). Of these, old age was the most significant factor.