• 약학회지
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• 제50권6호
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• pp.386-392
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• 2006

Pramlintide, a synthetic analogue of human hormone amylin, is the first of a new class of amylinomimetic compounds. Present study was undertaken to compile and analyze the clinical trials of pramlintide, and thereby to facilitate the design of the bridging study for the earlier introduction of the drug, which might be needed by diabetes patients in Korea. Sixty-two articles from Pubmed and MEDLINE search were used to analyze the trials of pramlintide along with prescribing information and New Drug Application packet obtained form the manufacturer. The efficacy of the new drug was attributed to three mechanisms: delay of gastric emptying time, inhibition of post-prandial glucagon secretion, and reduction of food intake by enhanced satiety. Clinical trials consistently identified the effectiveness of the drug for the treatment of type 1and type 2 diabetes who have failed to achieve glycemic control despite optimal therapy with insulin. However, the six pivotal Phase III clinical trials were peformed with mostly caucasian and some black and hispanic people. None of the trials documented the proportion of either Asian or Korean participants. Since Korean diabetes patients show different epidemiology and characteristics in their disease state, it appears that the bridging study of pramlintide should be designed in the level of full scale Phase III clinical trial along with pharmacokinetic and pbarmacodynamic studies.

• Nutrition Research and Practice
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• 제13권3호
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• pp.240-246
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• 2019

BACKGROUND/OBJECTIVES: Diabetes is diagnosed after an average of 10-12 years of diabetic development. Strict glycemic control in diabetic patients promotes the normalization of blood glucose and reduces cardiovascular diseases (CVDs) and diabetic complications. Therefore, early diagnosis in non-aware individuals is very important. SUBJECTS/METHODS: Clinical indices and nutrient intakes in Korean diabetic adults aged 19-64 years were examined according to the awareness of diabetes, using 2012 and 2013 Korea National Health and Nutrition Examination Survey (KNHANES) data. The aware group was defined as individuals who were aware of having diabetes from diagnosis by physician before the survey and the non-aware group as individuals who were not aware of having diabetes. RESULTS: The average age was higher in the aware group compared to the non-aware group in both men (P = 0.002) and women (P = 0.004). The prevalences of hypertension and dyslipidemia were not different between the two groups, but the diagnosis rate was significantly lower in the non-aware group. In the non-aware group, total and LDL-cholesterol were significantly higher (P < 0.001), the risk for total cholesterol over 240 mg/dL was 3.4 times (95% CI: 1.58-7.52) higher (P = 0.002) and the risk for LDL-cholesterol over 160 mg/dL was 4.59 times (95% CI: 2.07-10.17) higher (P < 0.001). The calorie intake of the female non-aware group was significantly higher compared to the female aware group (P = 0.033). CONCLUSION: The results suggested that the recommendation of screening test is necessary even for young adults. Studies on the methodology for early diagnosis of diabetes are also needed.

• 비만대사연구학술지
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• 제1권2호
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• pp.74-77
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• 2022

Treatment of obesity includes diet therapy, exercise therapy, cognitive behavioral therapy, drug therapy, and bariatric surgery. Most obese patients lose weight by combining diet, exercise, cognitive behavioral therapy or medication. But, in some cases, only one of these treatments is preferred. A 56-year-old male patient had a body mass index (BMI) of 33.1 kg/m² and a waist circumference of 108 cm. He had been treated for hypertension; diabetes and dyslipidemia were diagnosed but not treated. However, at the initial visit to treat obesity, he was diagnosed with type 2 diabetes mellitus and dyslipidemia again. So he decided to treat these two diseases with drugs first and modify his lifestyle. He started walking more than 20,000 steps every day and then he really walked about 15,000 steps every day during 5 months, although diet calorie or alcohol drinking amount was not significantly decreased. After about 6 months, the patient's weight decreased by 10.1 kg, the BMI decreased by 4.1 kg/m², the waist circumference decreased by 10 cm, the glycated hemoglobin (HbA1c) decreased by 4.59%, the visceral fat area decreased by 115 cm², and the subcutaneous fat decreased by 38 cm². As a result of body composition analysis, muscle mass increased by 1.2 kg, and the percentage of body fat decreased by 10.4%. The walking exercise does not have any space restrictions and has high accessibility by using a mobile phone app. Therefore, considering the patient's situation, it would be better to treat obese patients by first recommending walking exercises and increasing the number of steps to lose weight and improve the comorbidities.

• 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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• 제16권4호
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• pp.450-463
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• 2022

BACKGROUND/OBJECTIVES: Adolescents who skip breakfast have an increased prevalence of chronic diseases. Thus, we aimed to evaluate whether the intake of rice-based breakfast had positive effects on blood glucose indices and to determine the possibility of diabetes prevalence in Korean youths who habitually skip breakfast. SUBJECTS/METHODS: In this randomized parallel-group controlled trial, 81 subjects who were suitable for compliance among 105 middle-and high-school students aged 12-18 years who usually skipped breakfast were included in this study (rice-meal group [RMG], n = 26; wheat-meal group [WMG], n = 29; general-meal group [GMG], n = 26). The RMG and WMG received a rice-based breakfast and a wheat-based breakfast for 12 weeks, respectively. The anthropometric indices, blood glucose indices, and metabolites were measured at baseline and the endpoint, respectively. RESULTS: The mean body weights in the RMG, WMG, and GMG groups at the endpoint were 62.44 kg, 61.80 kg, and 60.28 kg, respectively, and the mean body weights of the WMG and GMG groups at the endpoint were significantly higher than that at baseline (P < 0.05). The levels of fasting insulin and homeostasis model assessment of insulin resistance (HOMA-IR) values were significantly decreased in the RMG group at the endpoint compared to baseline (P < 0.05, P < 0.05, respectively). The levels of tryptophan and tyrosine in the WMG group at the endpoint were significantly higher than that those at baseline (P < 0.01, P < 0.05, respectively). CONCLUSIONS: Rice-based breakfast has positive effects on fasting insulin levels and HOMA-IR in Korean adolescents who skip breakfast. Additionally, it was found that a skipping breakfast could increase the prevalence of diabetes in adolescents who skip breakfast. Therefore, in addition to reducing breakfast skipping, it is vital to develop a rice-based menu that fits teenage preferences to prevent chronic diseases such as diabetes.

• 여성건강간호학회지
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• 제28권2호
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• pp.112-122
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• 2022

Purpose: The prevalence of osteoporosis in postmenopausal women is increasing, and diabetes patients have decreased bone density. Their health-related quality of life (HRQoL) is diminished by the resultant physical dysfunction and depression. The purpose of this study was to identify factors influencing HRQoL in postmenopausal women with diabetes and osteoporosis. Methods: This was a secondary data analysis of the Seventh Korea Health and Nutrition Examination Survey (2016-2018), which utilized a complex, multistage probability sample design. The participants in the study were 237 women with diabetes and osteoporosis. To evaluate the factors that influenced HRQoL, a complex-samples general linear model was constructed, and the Bonferroni correction was performed. Results: In this sample of women aged 45 to 80 years (mean±standard deviation, 71.12±7.21 years), the average HRQoL score was 0.83±0.18 out of 1.0. Factors influencing HRQoL were age (70s: t=-3.74, p<.001; 80s: t=-3.42, p=.001), walking for exercise more than 5 days a week (t=-2.83, p=.005), cerebrovascular disease (t=-8.33, p<.001), osteoarthritis (t=-2.04, p=.014), hypertension (t=2.03, p=.044), higher perceived stress (t=-2.17, p=.032), poor glycemic control (t=3.40, p=.001), waist circumference (t=-2.76, p=.007), sitting time per day (t=-2.10, p=.038), and a longer postmenopausal period (t=3.09, p=.002). Conclusion: In order to improve the HRQoL of postmenopausal women with osteoporosis and diabetes, it is necessary to implement intervention strategies that enable the effective management of chronic diseases, while preventing the complications of diabetes and minimizing stress through physical activity.

• Nutrition Research and Practice
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• 제17권2호
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• pp.297-306
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• 2023

BACKGROUND/OBJECTIVES: The prevalence of diabetes has continued to increase globally. Changes in eating habits, lack of exercise, increased stress, and aging are major contributors. Glycemic control is the key strategy of diabetes management. The purpose of this study was to analyze the utilization of nutrition labels and related factors among patients with diabetes. MATERIALS/METHODS: Data from the 7th Korea National Health and Nutrition Examination Survey were used. General, health-related, diabetes-related characteristics from 1,587 adults with diabetes history were included. Nutrition label utilization was assessed with awareness and use of nutrition labels and effects on food choice. For statistical analyses, chi-square test and multiple logistic regression analysis were performed. RESULTS: The prevalence of awareness, use, and effects of nutrition labels on food choice among diabetic patients were 48.8%, 11.4%, and 9.6%, respectively. High monthly income, walking frequency, family history of diabetes, younger age at diagnosis, and shorter duration of diabetes were associated with higher nutrition label awareness. Nutrition label use and effect on food choice were higher in women, those with high monthly income, those diagnosed at younger than 45 yrs, those with diabetes for less than 10 yrs, those with meal therapy, or patients who had undergone a fundus examination. CONCLUSIONS: Nutrition label utilization status was low in Korean patients with diabetes. Strategies are needed to promote nutrition label use as a diet management tool for patients with diabetes.

• Nutrition Research and Practice
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• 제17권4호
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• pp.789-802
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• 2023

BACKGROUND/OBJECTIVES: Habitual coffee consumption was inversely associated with type 2 diabetes (T2D) and hyperglycemia in observational studies, but the causality of the association remains uncertain. This study tested a causal association of genetically predicted coffee consumption with T2D using the Mendelian randomization (MR) method. SUBJECTS/METHODS: We used five single-nucleotide polymorphisms (SNPs) as instrumental variables (IVs) associated with habitual coffee consumption in a previous genome-wide association study among Koreans. We analyzed the associations between IVs and T2D, fasting blood glucose (FBG), 2h-postprandial glucose (2h-PG), and glycated haemoglobin (HbA1C) levels. The MR results were further evaluated by standard sensitivity tests for possible pleiotropism. RESULTS: MR analysis revealed that increased genetically predicted coffee consumption was associated with a reduced prevalence of T2D; ORs per one-unit increment of log-transformed cup per day of coffee consumption ranged from 0.75 (0.62-0.90) for the weighted mode-based method to 0.79 (0.62-0.99) for Wald ratio estimator. We also used the inverse-variance-weighted method, weighted median-based method, MR-Egger method, and MR-PRESSO method. Similarly, genetically predicted coffee consumption was inversely associated with FBG and 2h-PG levels but not with HbA1c. Sensitivity measures gave similar results without evidence of pleiotropy. CONCLUSIONS: A genetic predisposition to habitual coffee consumption was inversely associated with T2D prevalence and lower levels of FBG and 2h-PG profiles. Our study warrants further exploration.

• Journal of Veterinary Science
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• 제24권6호
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• pp.86.1-86.14
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• 2023

Background: Long-term comparisons of phacoemulsification with topical medication are limited in canine diabetic cataracts. Objectives: To compare outcomes of eyes submitted to phacoemulsification with those of topical medication for canine diabetic cataracts and identify risk factors for complications. Methods: Through medical records review, 150 eyes (76 dogs) with diabetic cataracts were included; 58 eyes (31 dogs) underwent phacoemulsification (phaco-group) and 92 eyes (48 dogs) received ophthalmic solution alone (medication-group). The medication-group was divided into owner-led and vet-led groups depending on who elected not to perform surgery. Comparisons involved time-to-complications, vision, and the number and type of ophthalmic solutions administered. The association between complications and pretreatment clinical findings was investigated. Results: No difference was found in complication risk between the phaco and owner-led medication groups. Conversely, the vet-led medication-group had a higher complication risk than the other groups. At the last follow-up, 94.8% of the phaco-group had vision, whereas 7.6% of the medication-group restored some visual axis. Poor glycemic control in the medication-group and younger age in the phaco-group increased complication risk. At 1-year post-treatment, the average number of ophthalmic solutions administered was 1.7 and 2.6 in the phaco and medication groups, respectively. The medication-group used anti-inflammatories the most throughout the follow-up, whereas the phaco-group used anti-inflammatories the most until 1-year post-treatment and lacrimostimulants at 1.5-year post-treatment. Conclusions: For canine diabetic cataracts, phacoemulsification is recommended because it is superior to topical management alone in terms of maintaining vision and reducing the number of ophthalmic solutions required in the long term.

• 디지털정책학회지
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• 제2권4호
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• pp.25-32
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• 2023

논문은 PPG 기반 센서에서 측정한 심박수(HR), 심박변이도(HRV) 데이터를 기반으로 DNN(Deep Neural Network) 혈당예측 모델을 개발하는 연구이다. 혈당 예측은 다층퍼셉트론(MLP) 신경망을 이용하였다. DNN 심층학습은 11의 독립변수가 있는 입력층, 은닉층, 출력층으로 구성된다. 혈당 예측모델의 학습결과는 MAE=0.3781, MSE=0.8518, 및 RMSE=0.9229이며, 결정계수(R²)는 0.9994이다. PPG기반의 디지털기기를 이용한 비채혈적 생체신호를 이용하여 혈당관리의 가능성을 확인하였다. PPG기반의 표준화된 활력신호 획득 및 해석법, 다량의 데이터기반 심층학습(Deep Learning)의 데이터셋, 정확성를 실증하는 연구가 이어진다면 개의 혈당관리에 편이성과 대안적인 방법을 제공할 수 있을 것이다.