• Asian Pacific Journal of Cancer Prevention
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• v.15 no.16
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• pp.6863-6869
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• 2014

Objectives: Several preclinical and observational studies have shown that anti-diabetic medications (ADMs) may modify the risk of lung cancer. We performed a systematic review and meta-analysis evaluating the effect of metformin, sulfonylureas (SUs), thiazolidinediones (TZDs), and insulin on the risk of lung cancer in patients with diabetes mellitus (DM). Materials and Methods: We conducted a systematic search of Pubmed and Web of Science, up to August 20, 2013. We also searched the Conference Proceedings Citation Index (CPCI) and China National Knowledge Infrastructure (CNKI) for abstracts from major meetings. Fixed or random effect pooled measures were selected based on heterogeneity among studies, which was evaluated using Q test and the I2 of Higgins and Thompson. Meta-regression was used to explore the sources of between-study heterogeneity. Publication bias was analyzed by Begg's funnel plot and Egger's regression test. Associations were assessed by odds ratios (ORs) with 95% confidence intervals (CIs). Results: A total of 15 studies (11 cohort, 4 case-control) were included in this meta-analysis. In observational studies no significant association between metformin (n=11 studies; adjusted OR=0.99, 95%CI: 0.87-1.12), SUs (n=5 studies; adjusted OR=0.98, 95%CI: 0.79-1.22), or TZDs (n=7 studies; adjusted OR=0.92, 95%CI: 0.75-1.13), insulin (n=6 studies; adjusted OR=1.13, 95%CI: 0.79-1.62) use and risk of developing lung cancer was noted. There was considerable inherent heterogeneity between studies not explained by study design, setting, or location. Conclusions: Meta-analysis of existing studies does not support a protective or harmful association between ADMs use and risk of lung cancer in patients with DM. There was considerable heterogeneity across studies, and future, well-designed, prospective studies would be required for better understanding of any association.

• The Journal of Internal Korean Medicine
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• v.33 no.3
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• pp.317-326
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• 2012

Objectives : To investigate the prevalence and utilization pattern of complementary and alternative medicine (CAM) in individuals with type 2 diabetes. Methods : We conducted a nationwide survey and a total of 535 individuals with type 2 diabetes were asked about their demographic, diabetes-related characteristics and CAM use. We used multiple logistic regression modeling to determine independent predictors of CAM use. Results : Of the 535 subjects, 417 (77.9%) used CAM in last 12 months. The most commonly used modality was red ginseng (17.9%). CAM use was independently associated with being married, northern area residence, higher education and diabetes duration of 3-5 years. More than half(58.3%) of the CAM users used it expecting a better outcome in addition to conventional therapy. Information sources about CAM were mostly friends (36.0%) and family (31.9%), only 28.1% of diabetic patients seek counsel from medical doctors or oriental medical doctors about CAM. Many people perceived CAM as effective (62.7%) and reported side effects only rarely (1.2%). Conclusions : Many diabetic patients used CAM and found it effective, which urges clinicians to pay attention to CAM use of their diabetic patients. Also, further studies are required regarding efficacy and safety about CAM.

• Journal of Korean Foot and Ankle Society
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• v.20 no.2
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• pp.78-83
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• 2016

Purpose: This study examined the factors affecting the treatment of diabetes mellitus foot patients who had undergone a Syme amputation. Materials and Methods: This study included 17 patients diagnosed with a diabetes mellitus foot and who had undergone a Syme amputation from January 2010 to January 2014. Some of the risk factors (age, body mass index [BMI], disease duration, smoking, ankle brachial index [ABI], HbA1c, serum albumin, total lymphocyte, C-reactive protein [CRP], and serum creatine) that affect the successful Syme amputation were analyzed. Results: The healing rate of a Syme amputation was significantly higher when the lymphocyte count was above $1,500mm^3$ (p=0.029). The factors affecting the surgical outcome according to multivariate analysis were HbA1c and the BMI (p=0.014, p=0.013). Regarding reamputation, there was a significant difference with HbA1c, lymphocyte, and BMI (p=0.01, p=0.03, and p=0.01). No significant differences were observed with age, disease duration of diabetes mellitus, smoking, ABI, serum albumin, CRP, and serum creatine. Conclusion: The HbA1c level, BMI and total lymphocyte count are risk factors that must be considered for successful Syme amputation in patients with diabetic foot disease.

• Journal of Korean Academy of Nursing
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• v.51 no.3
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• pp.280-293
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• 2021

Purpose: This study aimed to identify the risk factors for diabetic foot ulceration (DFU) to develop and evaluate the performance of a DFU prediction model and nomogram among people with diabetes mellitus (DM). Methods: This unmatched case-control study was conducted with 379 adult patients (118 patients with DM and 261 controls) from four general hospitals in South Korea. Data were collected through a structured questionnaire, foot examination, and review of patients' electronic health records. Multiple logistic regression analysis was performed to build the DFU prediction model and nomogram. Further, their performance was analyzed using the Lemeshow-Hosmer test, concordance statistic (C-statistic), and sensitivity/specificity analyses in training and test samples. Results: The prediction model was based on risk factors including previous foot ulcer or amputation, peripheral vascular disease, peripheral neuropathy, current smoking, and chronic kidney disease. The calibration of the DFU nomogram was appropriate (χ² = 5.85, p = .321). The C-statistic of the DFU nomogram was .95 (95% confidence interval .93~.97) for both the training and test samples. For clinical usefulness, the sensitivity and specificity obtained were 88.5% and 85.7%, respectively at 110 points in the training sample. The performance of the nomogram was better in male patients or those having DM for more than 10 years. Conclusion: The nomogram of the DFU prediction model shows good performance, and is thereby recommended for monitoring the risk of DFU and preventing the occurrence of DFU in people with DM.

• Archives of Plastic Surgery
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• v.41 no.3
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• pp.248-252
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• 2014

Background Patients with diabetes mellitus often have a difficult life, suffering from foot ulceration or amputation. Diabetes is characterized by chronic inflammation, and one of the features of inflammation is hypoxia. Recently, it has been reported that KAI1 is a hypoxia target gene. There is no published research on hypoxia-related KAI1 protein levels in human diabetic skin. Therefore, we have investigated the expression of KAI1 protein in diabetic skin tissue in vivo. Methods The expression of KAI1 protein was evaluated by western blotting in 6 diabetic skin tissue samples and 6 normal skin samples. Immunohistochemical staining was carried out to identify KAI1 expression. Results The western blotting revealed significantly increased expression of the KAI1 protein in diabetic skin tissues as compared to normal skin tissues. Immunohistochemical examination demonstrated that KAI1 was expressed in all diabetic skin tissues with moderate-to-strong positivity and weakly expressed in normal skin tissues. Conclusions Our data suggest that a high expression of the KAI1 protein can be observed in diabetic skin tissue. To the best of our knowledge, this is the first report suggesting that KAI1 protein expression in diabetic skin tissues may be associated with chronic inflammatory states and hypoxia.

• The Journal of Korean Physical Therapy
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• v.18 no.4
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• pp.11-17
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• 2006

Purpose: This study aims to suggest clinical basis of physical therapy to skeletal system complication in type II diabetic patients through a variety of analysis methods. Methods: 75 subjects(type II diabetic patients; age from 40 to 80) of this study were participated in BMD(Bone Mineral Density) and Dual energy X-ray absorptiometry, blood test to their skeletal system. Results: Incidence of osteopenea was higher than normal group as women(91.2%) and men(53.5%) in diabetes group. However, women were showed no significantly difference in comparison group. Above age 60(in diabetes group; men and women) showed to highly incidence of osteopenea as well as significantly difference in osteopenea(peripheral neuropathy). As a result of analyzing blood through presence and absence of osteopenea in diabetes group, men were showed significantly difference in DPD/creatinine ratio and women were showed significantly difference in Alkaline phosphatase, Corrected Calcium. Conclusion: This study shows that decreased BMD and increased osteopenea through type II diabetes. Women were particularly lower BMD and higher incidence of osteopenea than men and men influence of type II diabetes on change of BMD was greater than women.

• BMB Reports
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• v.40 no.1
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• pp.29-35
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• 2007

During the past decade, many salivary parameters have been used to characterize disease states. Ghrelin (GAH) is recently-discovered peptide hormone secreted mainly from the stomach but also produced in a number of other tissues including salivary glands. The aim of this work was to examine the relationship between active (aGAH) and inactive (dGAH) ghrelin in the saliva and other salivary parameters in type II diabetic patients and healthy controls. Salivary parameters were assessed in a single measurement of unstimulated whole saliva from 20 obese and 20 non-obese type II diabetes patients, and in 22 healthy controls. Total protein and alpha-amylase were determined by colorimetric methods, and glucose by the glucose-oxidase method. Saliva aGAH and dGAH levels were measured using a commercial radioimmunoassay (RIA) kit. Salivary concentrations of aGAH and dGAH ghrelin were more markedly decreased in obese diabetic subjects than in the two other groups. Glucose and alpha-amylase levels were higher in diabetic subjects than in controls. Furthermore, there were correlations between GAH levels and BMI, and between GAH and blood pressure. However, there was no marked variability in saliva flow rates among the groups. These results indicate that measurement of salivary GAH and its relationship to other salivary parameters might help to provide insight into the role of ghrelin in diabetes.

• Journal of Periodontal and Implant Science
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• v.38 no.3
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• pp.511-520
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• 2008

Purpose: Diabetes mellitus is a clinically and genetically heterogeneous group of metabolic disorders manifested by abnormally high levels of glucose in the blood. Mounting evidence demonstrates that diabetes is a risk factor for gingivitis and periodontitis. The circulating mononuclear phagocytes in diabetic patients with hyperglycemia are chronically exposed to high level of serum glucose. Thus, this study attempted to determine the effect of pre-exposure of monocytes and macrophages to high concentration of glucose on lipopolysaccharide (LPS)-induced production of pro-inflammatory mediators. Material and Methods: For this purpose, cells were cultured in medium containing normal (5 mM) or high glucose (25 mM) for 4-5 weeks before treatment for 24 h with LPS. LPS was highly purified from Porphyromonas gingivalis or Prevotella intermedia by phenol extraction. Result: Results showed that prolonged pre-exposure of cells to high glucose markedly increased LPS-stimulated NO secretion when compared to normal glucose. In addition to NO, high glucose also augmented LPS-stimulated IL-6, IL-8, and TNF-$\alpha$ secretion after cells were exposed to high glucose for 4 weeks. Conclusion: The present study demonstrates that pre-exposure of mononuclear phagocytes with high glucose augments LPS-stimulated production of pro-inflammatory mediators. These findings may explain why periodontal tissue destruction in diabetic patients is more severe than that in non-diabetic individuals.

• Proceedings of the KOSOMBE Conference
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• v.1996 no.11
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• pp.363-367
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• 1996

In general, the physiological systems have shown nonlinear complex phenomena. This study analyzes nonlinear characteristics of the flow of peripheral blood vessel dynamics in physiological systems using chaos theory. We performed this study by means of several quantity methods and power spectrum. The quantity methods are a phase space reconstruction and a poincare's map. And the power spectrum method is a conventional linear analysis. Experimental data have been acquired from examining 10 diabetic patients, and 10 control subjects in initial stable state. In acquisition experminetal data, we anlysized the differences of nonlinear characteristics between diabetic group and control group. The results of quality analysis methods showed the flow of peripheral blood vessel had the nonlinear and chaotic characteristics, screening a strange attractor on reconstructed phase space. In conclusion, the flow dynamics of peripheral blood vessel had a chaotic behavior of nonlinear dynamic systems, dynamic system, and differences of characteristic of nonlinear dynamic system.

• Journal of Nutrition and Health
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• v.27 no.2
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• pp.172-180
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• 1994

This study showed the psychological symptoms, nutritional status and eating behaviors of diabetic patients. General informations on subjects nutritional status were collected by questionnaire, whereas Symptom Check List-90-Revision(SCL-90R) was used for gathering the data related to psychological problem. 34 diabetics in the hospital, aged 49$\pm$10.5 years old, were chosen as the subjects of this study. Their average height was 162.3$\pm$9.4cm and weight was 57.0$\pm$9.5kg. The average period of their suffering from DM was 54.1 weeks. Among, the subjects, 71.0% adapted diet therapy for their disease, whereas 36.7% and 40.7% did diabetic drugs and daily exercise like walking and jogging, respectively, Among 9 psychological symptoms observed, the scores of somatization, depression, anxiety, phobic anxiety and psychoticism were higher than the standard score, however they were not statistically significant. The score of paranoid ideation was lower than standard score. It was statistically significant. As the measure of their clinical status, BMI(body mass index), PIBW(percent ideal body weight) and fasting blood sugar(FBS) were selected 21.6$\pm$2.8, 102.4$\pm$14.8% and 207.8$\pm$19.9mg/이 respectively. The somatization was significantly correlated with subjects duration of DM. Subjects with psychological problems showed wrong eating behaviors. The fasting blood sugar was significantly correlated with the level of depression.