• Title/Summary/Keyword: Glycated Hemoglobin

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A Retrospective Study of the Safety and Effect of Co-administration of Glucose-lowering Medication and Bojungikgi-tang on Blood Glucose Level in Patients with Type 2 Diabetes Mellitus (제2형 당뇨병 환자에서 혈당강하제와 보중익기탕 병용 투여가 혈당 변화에 미치는 영향 및 안전성 연구)

  • Seung-hyun Oh;Woo-nyoung Jung;Mee-ryoung Song;Ji-won Noh;Young-min Ahn;Se-young Ahn;Byung-cheol Lee
    • The Journal of Internal Korean Medicine
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    • v.44 no.3
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    • pp.354-365
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    • 2023
  • Objective: This study aimed to assess the safety and effect on glucose level of Bojungikgi-tang in patients with type 2 diabetes mellitus. Methods: To review patients' clinical characteristics and laboratory tests retrospectively, we investigated 15 hospitalized patients with type 2 diabetes mellitus who took Bojungikgi-tang at Kyung Hee University Korean Medical Hospital for at least one day between January 2012 and December 2022. The blood glucose levels, including fasting blood sugar (FBS), 2-hour postprandial glucose (PP2) levels, and glycated hemoglobin level, were collected to determine the effect of the Bojungikgi-tang on blood sugar changes. Furthermore, to evaluate the safety of Bojungikgi-tang, hepatic function and renal function tests were implemented, including aspartate aminotransferase, alanine aminotransferase, alkaline phosphatase, γ-glutamyltransferase, blood urea nitrogen, creatinine, and Modification of Diet in Renal Disease estimated glomerular filtration rate. Results: When Bojungikgi-tang and a standard treatment for diabetes were administered for patients with type 2 diabetes, it was confirmed that there were no statistically significant changes in FBS and PP2 levels in the analysis of each medication taken. There was no significant difference in the safety profile after taking Bojungikgi-tang. Conclusions: The combined administration of Bojungikgi-tang with standard hypoglycemic medication for patients with type 2 diabetes may not affect blood glucose levels and safety.

The Cutoff Value of HbA1c in Predicting Diabetes and Impaired Fasting Glucose (당뇨병 및 공복혈당장애 예측을 위한 당화혈색소 값)

  • Kwon, Seyoung;Na, Youngak
    • Korean Journal of Clinical Laboratory Science
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    • v.49 no.2
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    • pp.114-120
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    • 2017
  • There have been many studies to develop methods for predicting diabetes and to prevent diabetes. The validity of glycated hemoglobin (HbA1c), one of the commonly known tools in predicting diabetes, has been verified by many previous studies. In this study, we examined the cutoff value of HbA1c for diabetes and impaired fasting glucose (IFG). Based on this study, we proposed a proper clinical guideline and evaluated the validation of the guideline. Excluding those without blood glucose and HbA1c data, we used the data of 5,161 subjects (2,281 men and 2,880 women) over the age of 20 years from the 2015 Korean National Health and Nutrition Examination Survey. The correlation efficient of fasting plasma glucose (FPG) and HbA1c was 0.79, indicating a strong relationship. Howeve, the correlation efficient of FPG and HbA1c was low, showing 0.27 in non-diabetes, 0.39 in IFG, and 0.66 in diabetes, showing a strong relationship. The cutoff value of HbA1c for predicting diabetes using ROC curve was 6.05% (sensitivity 84.6%, and specificity 92.0%), and AUC was 0.941 (0.937 in men, and 0.946 in women). The cutoff value of HbA1c for predicting IFG using ROC curve was 5.55% (sensitivity 64.5%, and specificity 70.0%), and AUC was 0.733 (0.708 in men, and 0.764 in women). Therefore, it may not be appropriate to apply the guidelines for diagnosing IFG since sensitivity and specificity were below 70%. For future studies retarding the cutoff value of HbA1c in predicting IFG, high sensitivity and specificity are expected if we segment the reference range of IFG.

Effects of Laminaria Japonica Extract Supplement on Blood Glucose, Serum Lipids and Antioxidant Systems in Type ll Diabetic Patients (다시마추출물이 제2형 당뇨병 환자의 혈당, 지질 및 항산화 체계에 미치는 영향)

  • Park, Min-Jung;Ryu, Ho-Kyung;Han, Ji-Sook
    • Journal of the Korean Society of Food Science and Nutrition
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    • v.36 no.11
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    • pp.1391-1398
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    • 2007
  • We performed a randomized double-blind placebo-controlled trial to determine whether Laminaria japonica extract (LJE) supplement modulates blood glucose, serum lipids and antioxidant systems in type II diabetic patients. We also measured critical parameters assessing safety in liver and kidney functions after LJE supplement. A total of 37 patients (18 males and 19 females) were randomized to either LJE group or placebo group. The treatment group received four 350 mg of LJE capsules (1.4 g, total) per day for 12 weeks. The placebo group received the same dose of cellulose capsules. Baseline characteristics regarding general life style and dietary intake pattern were similar between the two groups. There were no significant influences of LJE supplement except for waist circumference on anthropometric parameters. As the whole, 12 weeks of LJE supplement resulted in a little decrease in fasting blood glucose (FBG) and glycated hemoglobin (HbA1c), but a significant decrease was not observed. Total cholesterol, LDL-cholesterol and triglyceride concentrations were significantly (p<0.05) lowered in LJE group. The antioxidant enzymes, glutathion peroxidase (GSH-px) and superoxide dismutase (SOD) levels were elevated in the LJE group (p<0.05) compared to the placebo. The increase of these enzymes was associated significantly with the decrease of MDA concentration (p<0.05). Furthermore, LJE supplement showed no adverse effects on the functions of liver and kidney. Findings from this study suggest that LJE supplement can help improve serum lipid status in type II diabetic subjects without adverse effects.

Early assessment of atherosclerosis in children with type 1 diabetes (제1형 당뇨병 소아 환자에서 동맥경화증의 조기 평가)

  • Park, So-Yoon;Kang, Seok Jeong;Choi, Kwang Hae;Park, Yong Hoon;Lee, Young Hwan
    • Clinical and Experimental Pediatrics
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    • v.51 no.7
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    • pp.747-753
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    • 2008
  • Purpose : Diabetes mellitus is a major risk factor for the development of cardiovascular disease. Early atherosclerotic changes in the arterial walls begin in adolescence and the risk factors are associated with its development. To assess the usefulness of carotid artery intima-media thickness (IMT), as a marker of early atherosclerosis, we evaluated the structural and functional characteristics of the carotid artery and investigated their relationshop with the metabolic and anthropometric parameters in children and adolescents with type 1 diabetes. Methods : For this study, we enrolled 23 children with type 1 diabet and 19 age and sex-equivalent healthy children as the control group. Metabolic and anthropometric parameters such as serum lipid levels, plasma glycated hemoglobin (HbA1c), and body mass index were measured after a 12-h fasting period. The carotid artery IMT was measured by a high-quality ultrasound system, and compliance, and distensibility were calculated by an equation. Results : There were no significant differences between the 2 groups with regard to the sex ratio, age, blood pressure and serum cholesterol levels' however, HbA1c levels were significantly higher in the diabetic children ($8.5{\pm}1.8$ vs. $5.0{\pm}0.2$, P=0.001). Ultrasonographic findings showed that compared with the control group, the diabetic group had higher IMT ($0.45{\pm}0.06mm$ vs. $0.41{\pm}0.04mm$, P=0.04), but there were no significant differences in compliance and distensibility. The HbA1c (P=0.002) and high-density lipoprotein cholesterol (P=0.026) levels were independent IMT predictors in the diabetic group. Conclusion : Here, the carotid artery IMT was higher in the diabetic group, and it is correlated with atherosclerotic risk factor. Thus, carotid IMT could be evaluated as a marker of early atherosclerosis in diabetic children.

The Effects of Several Halophytes on Insulin Resistance in Otsuka Long-evans Tokushima Fatty Rats (OLETF 쥐에서 칠면초와 세발나물의 인슐린 저항성 개선 효과)

  • Cho, Jeong-Yong;Huang, Zhangjun;Park, Sun-Young;Park, Kyung-Hee;Pai, Tong-Kun;Kim, So-Young;Kim, Haeng-Ran;Ham, Kyung-Sik
    • Korean Journal of Food Science and Technology
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    • v.46 no.1
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    • pp.100-107
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    • 2014
  • We evaluated preventive effects of Suaeda japonica (SJ) and Spergularia marina Griseb (SMG) on the insulin resistance in Otsuka Long-Evans Tokushima Fatty (OLETF) rats. The 10-week old OLETF rats were fed diets containing 3% (w/w) SJ and SMG for 18 weeks. Fasting blood glucose levels in SJ and SMG groups, measured using the oral glucose tolerance test, were lower than that of the control rats. The SMG group showed significantly lower levels of insulin, glycated hemoglobin, triglyceride, and total cholesterol than the control group. In addition, these levels were relatively lower in the SJ group than those in the control rats. The SJ and SMG groups had relatively lower protein levels of nuclear factor-kappa B (NF-${\kappa}B$) p65 in adipose tissue and serine phosphorylated insulin receptor substrate 1 (IRS-1) in skeletal muscle than the control group. These results suggest that SJ and SMG prevent insulin resistance and SMG in particular reduces blood triglyceride and total cholesterol levels.

Autonomic Neuropathy in Adolescents with Diabetes Mellitus (청소년기 당뇨병 환자의 자율신경계 합병증에 관한 연구)

  • Yoo, Eun-Gyong;Ahn, Sun-Young;Kim, Duk Hee
    • Clinical and Experimental Pediatrics
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    • v.46 no.6
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    • pp.585-590
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    • 2003
  • Purpose : This study is designed to determine the prevalence of cardiovascular autonomic neuropathy and its relationship to risk factors in adolescents with diabetes mellitus(DM). Methods : Ninety-two diabetic patients(80 with type 1 DM and 12 with type 2 DM), ranging from eight to 26 years of age, were studied for cardiovascular autonomic function, and the relationship to age, duration of diabetes, glycated hemoglobin(HbA1c), urinary albumin excretion, and the presence of diabetic retinopathy and abnormal nerve conduction velocities(NCV) were analysed. Autonomic function was assessed by measuring heart rate variation during valsalva manoeuvre, deep breathing and standing from a lying position(30 : 15 ratio), and postural hypotension. Results : Among patients with type 1 DM, 22.5% had early, 8.7% had definite, and 1.3% had severe autonomic dysfunction, and among patients with type 2 DM, 16.7% had early, 8.3% had definite, and 8.3% had severe autonomic dysfunction. On logistic regression analysis including both type 1 and type 2 diabetic patients, the age of the patient(OR=1.133(1.003-1.279), P<0.05) and duration of diabetes(OR=1.148(1.009-1.307), P<0.05) significantly predicted cardiovascular autonomic dysfunction while HbA1c, blood pressure, urinary albumin excretion, and presence of diabetic retinopathy and abnormal NCV did not. The valsalva ratio was borderline or abnormal in 31.5% of patients, the heart rate variation on deep breathing in 41.3%, the 30 : 15 ratio in 14.1%, and postural hypotension in 9.8% of patients. The valsalva ratio and the heart rate variation on deep breathing significantly predicted cardiovascular autonomic dysfunction, but the 30 : 15 ratio and postural hypotension did not. Conclusion : Cardiovascular autonomic dysfunction was found in 32.6% of diabetic patients and 10.8 % of patients had definite or severe involvement. The risk of cardiovascular autonomic dysfunction increased with the patient's age and the duration of DM. This study suggests that the valsalva ratio and the heart rate variation on deep breathing are the most useful tests in evaluating the cardiovascular autonomic function in children and adolescents with DM.

Beneficial Effects of Acanthopanax senticosus Extract in Type II Diabetes Animal Model via Down-Regulation of Advanced Glycated Hemoglobin and Glycosylation End Products (제2형 당뇨 동물모델에서 가시오가피 추출물의 당화혈색소 및 최종당화산물 억제를 통한 혈당조절 효과)

  • Kwon, Han Ol;Lee, Minhee;Kim, Yong Jae;Kim, Eun;Kim, Ok-Kyung
    • Journal of the Korean Society of Food Science and Nutrition
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    • v.45 no.7
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    • pp.929-937
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    • 2016
  • The purpose of this study was to investigate the effect of Acanthopanax senticosus extract (ASE) (ethanol : DW=1:1, v/v) on inhibition of type 2 diabetes using an OLETF rat model via regulation of HbA1c and AGEs levels. Supplementation with ASE 0.1% and 0.5% effectively lowered levels of glucose, insulin, oral glucose tolerance test, and Homa-insulin resistance, suggesting reduced insulin resistance. Blood levels of HbA1c and AGEs were significantly reduced in a dose-dependent manner. As oxidative stress plays a key role in accelerating production of HbA1c and AGEs, which worsen symptoms of type 2 diabetes, levels of malonaldehyde and pro-inflammatory cytokines were measured. Lipid peroxidation in both blood and liver tissues was significantly reduced, and induction of pro-inflammatory cytokines interleukin-${\beta}$ and tumor necrosis factor-${\alpha}$, which elevate production of HbA1c and AGEs, was inhibited (P<0.05). To evaluate the possible cellular events after AGEs receptor activation, genetic expression of protein kinase C (PKC)-${\delta}$ and transforming growth factor (TGF)-${\beta}$ was measured by real-time polymerase chain reaction. Supplementation with both ASE 0.1% and 0.5% significantly inhibited mRNA expression of PKC-${\delta}$ and TGF-${\beta}$, indicating that ASE may have beneficial effects on preventing insulin-resistant cells or tissues from progressing to diabetic complications. Taken together, ASE has potential to improve type 2 diabetes by inhibiting insulin resistance and protein glycosylation, including production of HbA1c and AGEs. Anti-oxidative activities of ASE are a main requisite for reducing production of HbA1c and AGEs and are also related to regulation of the PKC signaling pathway, resulting in suppression of TGF-${\beta}$, which increases synthesis of collagen, prostaglandin, and disease-related proteins.

Amelioration of Plasma Glucose and Cholesterol levels in Db/db Mice by a Mixture of Chinese Herbs (Db/db 마우스 모델에 있어서 한약재조성물의 혈당 및 혈장 콜레스테롤 개선효과)

  • Lee, Jai-Heon;Cho, Chang-Woo;Han, Xiang-Fu;Hwang, Ji-Yeon;Kang, Min-Jung;Joo, Hee-Jeong;Kim, Mi-Eun;Seo, Yeong-Ju;Kim, Jung-In
    • Korean Journal of Medicinal Crop Science
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    • v.16 no.4
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    • pp.225-230
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    • 2008
  • Diabetes mellitus is the fifth leading cause of death among Koreans. Control of hyperglycemia and dyslipidemia is strongly correlated with decrease in risks for cardiovascular diseases, the most common and fatal diabetic complication. The effects of chronic feeding of a mixture of Chinese herbs on blood lipid profile were measured in an animal model of type 2 diabetes mellitus, db/db mice (C57BL/Ks). The Chinese herb mixture was composed of Panax ginseng C. A. Meyer,Astragalus membranaceus, Glycyrrhiza uralensis, Lycium chinense, Morus, Pueraria thunbergiana, Prunella vulgaris var. lilacina, Acanthopanax sessiliflorus, Schizandra chinensis, Scutellaria baicalensis, Dioscorea batatas, Polygonatum doratumvar. pluriflorum, Paeonia lactiflora, and Rehmannia glutinosa in a ratio of 1 : 0.7 : 0.4 : 0.7 :0.4 : 0.7 : 1.1 : 0.9 : 0.4 : 0.4 : 0.7 :0.7 : 0.9 : 0.9. Methanol extract of the Chinese herb mixture was tested for the inhibitory activity against yeast ${\alpha}$-glucosidase in vitro. The Chinese herb mixture extract inhibited ${\alpha}$-glucosidase by 25.2% at the concentration of 0.5mg/mL. Four weekold male db/db mice (n = 14) were fed AIN-93G semipurified diet or diet containing 10% powder of the Chinese herb mixture for 6 weeks after 1 week of adaptation period. Body weight (39.5 ${\pm}$ 1.6 g) and food intake (4.3 ${\pm}$ 0.6 g/day) of the Chinese herb group were not significantly different from those of the control group (40.4 ${\pm}$ 2.6 g and 4.5 ${\pm}$ 0.6 g/day). Consumption of Chinese herb mixture significantly decreased plasma glucose level (442.5 ${\pm}$ 36.0mg/dL) compared with the control group (489.8 ${\pm}$ 34.6 mg/dL, p < 0.05). Plasma cholesterol level (159.2 ${\pm}$ 18.4 mg/dL) of the Chinese herb group was significantly lower than that of the control group (185.4 ${\pm}$ 13.7 mg/dL, p < 0.05). Blood glycated hemoglobin (6.3 ${\pm}$ 0.8%) and plasma triglyceride levels (99.4 ${\pm}$ 15.0mg/dL) of the Chinese herb group were not significantly different from those of the control group (6.7 ${\pm}$ 0.7% and 108.8 ${\pm}$ 11.0mg/dL). Thus, the Chinese herb mixture could be useful in the treatment of diabetes and cardiovascular complications of diabetes.

Changes in body composition, body balance, metabolic parameters and eating behavior among overweight and obese women due to adherence to the Pilates exercise program (과체중·비만인에서 필라테스 운동 순응도에 따른 식생활 변화, 체구성, 신체 균형도 및 대사지표 개선효과)

  • Hyun Ju Kim;Jihyun Park;Mi Ri Ha;Ye Jin Kim;Chaerin Kim;Oh Yoen Kim
    • Journal of Nutrition and Health
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    • v.55 no.6
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    • pp.642-655
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    • 2022
  • Purpose: We examined the effects of the 8-week moderate-intensity Pilates exercise program on body composition, balance ability, metabolic parameters, arterial condition, and eating habits among overweight and obese women. Methods: From the general sample of overweight or obese Korean women (body mass index ≥ 23 kg/m2 ), those who had not been diagnosed with any chronic degenerative diseases were enrolled in the study (n = 39). After 8 weeks of the Pilates exercise program, the participants were subdivided into adherence and non-adherence groups. Among the study participants, 24 women were matched for age and menopausal status to reduce the bias, and then finally included for the comparison (Pilates-adherence, n = 12; Pilates-non-adherence, n = 12). Results: The body balance measured by the Y-balance test, body mass index, and subcutaneous fat areas were significantly improved in both groups. However, the Pilate-sadherence group showed more positive changes in body balance and had significant improvement in body composition parameters such as waist size, visceral fat area, systolic blood pressure, arterial aging index, fasting blood glucose, and glycated hemoglobin than the Pilates-non-adherence group. In addition, the nutrition quotient for Korean adults (balance, moderation, and behavior except diversity) were significantly improved in both groups after dietary education. However, the participants did not show dramatic improvement in the metabolic parameters, because all the study subjects were in relatively good health and did not have any diagnosed diseases. Conclusion: This study demonstrated that higher adherence to the Pilates exercise program together with a modification of eating habits may effectively improve body balance, body composition, and obesity-related parameters among overweight and obese women.