• Korea-Australia Rheology Journal
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• 제17권3호
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• pp.117-123
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• 2005

Background: Reduced deformability of red blood cells (RBCs) may play an important role on the pathogenesis of chronic vascular complications of diabetes mellitus. However, available techniques for measuring RBC deformability often require washing process after each measurement, which is not optimal for day­to-day clinical use at point of care. The objectives of the present study are to develop a device and to delineate the correlation of impaired RBC deformability with diabetic nephropathy. Methods: We developed a disposable ektacytometry to measure RBC deformability, which adopted a laser diffraction technique and slit rheometry. The essential features of this design are its simplicity (ease of operation and no moving parts) and a disposable element which is in contact with the blood sample. We studied adult diabetic patients divided into three groups according to diabetic complications. Group I comprised 57 diabetic patients with normal renal function. Group II comprised 26 diabetic patients with chronic renal failure (CRF). Group III consisted of 30 diabetic subjects with end-stage renal disease (ESRD) on hemo-dialysis. According to the renal function for the diabetic groups, matched non-diabetic groups were served as control. Results: We found substantially impaired red blood cell deformability in those with normal renal function (group I) compared to non-diabetic control (P = 0.0005). As renal function decreases, an increased impairment in RBC deformability was found. Diabetic patients with chronic renal failure (group II) when compared to non-diabetic controls (CRF) had an apparently greater impairment in RBC deformability (P = 0.07). The non-diabetic cohort (CRF), on the other hand, manifested significant impairment in red blood cell deformability compared to healthy: control (P = 0.0001). Conclusions: The newly developed slit ektacytometer can measure the RBC deformability with ease and accuracy. In addition, progressive impairment in cell deformability is associated with renal function loss in all patients regardless of the presence or absence of diabetes. In diabetic patients, early impairment in RBC deformability appears in patients with normal renal function.

• Journal of Yeungnam Medical Science
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• 제30권2호
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• pp.136-140
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• 2013

Diabetic nephropathy (DN) is a common complication and the leading cause of end-stage renal disease (ESRD) in diabetic patients. The occurrence of non-diabetic renal disease (NDRD) in diabetic patients has been increasingly recognized in recent years. Generally, renal injuries in DN are deemed difficult to reverse, whereas some NDRDs are often treatable and even remittable. Thus, the diagnosis of NDRD in patients with diabetes mellitus (DM) via a kidney biopsy would be significant for its prognosis and therapeutic strategy. According to recent studies, the most common NDRD is IgA nephropathy in type 2 diabetic patients, and some cases of minimal change disease and membranous glomerulonephritis have been reported in Korea. However, membranoproliferative glomerulonephritis (MPGN) is an uncommon condition in diabetic patients. To our knowledge, there has been no case yet of MPGN, except in a child with type 1 DM. We present an unusual case of a 27-year-old woman who had type 2 DM with MPGN, as confirmed via a kidney biopsy.

• Asian Pacific Journal of Cancer Prevention
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• 제15권9호
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• pp.3993-3996
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• 2014

Background: Diabetes is a chronic disease characterized by impaired fasting blood glucose that leads to disturbances in various organs. In this study, we evaluated relationships between tumor size and grade in a population of diabetic and non-diabetic patients with renal cell carcinoma. Materials and Methods: Between 2007-2013, in our clinic radical nephrectomy performed to 310 patients for renal tumors and pathology reported renal cell carcinoma cases were enrolled in the study. Patients with and without a history of diabetes regarding fasting glucose and HgA1c levels were evaluated during surgery for tumor size and Fuhrman grade. Results: Diabetes was found in 95 patients. The mean age of the patients with and without diabetes mellitus was 64.3 (40-79) and 58.4 (31-87) years, respectively. In the diabetes group 51% of patients had a tumor size over 7 cm and 54% a tumor grade over Fuhrman 3. The respective figures in the non-diabetes group were 35% and 30% (p<0.05 in both cases). Conclusions: Renal cancer appears more aggressive in patients with diabetes. In this study lifestyle and risk factors with diabetes regulation were observed to be important for renal cancer patients. Multicenter studies are needed in larger series for more accurate results.

• 대한지역사회영양학회지
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• 제10권5호
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• pp.693-699
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• 2005

Protein-calorie malnutrition is common in maintenance dialysis patients. Indeed, diabetic patients with chronic renal failure are considered to be at increased risk of malnutrition. The aim of this study was to compare the nutritional status and markers of inflammation of hemodialysis patients with and without type 2 diabetes. We compared nutritional parameters and C-reactive protein (CRP) as a marker of inflammation in 30 type 2 diabetic patients and age-matched 30 non-diabetic patients with hemodialysis. Serum albumin was significantly lower in patients with type 2 diabetes $(3.45\pm0.43g/dL)$ than in non-diabetic patients $(3.64\pm0.36 g/dL)$ (p<0.05). In contrast, the concentration of serum CRP was significantly higher in type 2 diabetes $(1.42\pm1.8mg/dL)$ (p<0.05). There were significant negative-relationships between serum albumin and CRP level in both diabetic (r=-0.553, p<0.01) and non-diabetic (r=-0.579, p<0.01) patients. In diabetic patients, serum albumin level was significantly correlated with hemoglobin (r = 0.488, p < 0.01) and hematocrit (r=0.386, p < 0.01). Diabetic patients as compared to non-diabetic patients showed a significant (p < 0.01) increased serum triglyceride (TG) $(153.1\pm80.1mg/dL\;vs\;101.6\pm62.4mg/dL)$ and decreased serum HDL cholesterol $(36.89\pm13.48mg/dL\;vs\;47.00\pm14.02mg/dL,\;P<0.05)$. There were significant correlations in the intake of calorie and serum albumin levels in both diabetic (r=0.438, p< 0.05) and non-diabetic (r=0.527, p<0.05) patients. Serum CRP level was negatively correlated with calorie (r= -0.468, p < 0.05), protein (r=-0.520, p < 0.01) and fat intakes (r=-0.403, p < 0.05) in diabetic patients and calorie (r=-0.534, p<0.05) and protein intakes (r=-0.559, p<0.05) in non-diabetic patients. The prevalence of protein malnutrition and the risk factors of cardiovascular disease were significantly higher in type 2 diabetic patients than in non-diabetic hemodialysis patients. Thus, we can suggest that the higher comorbidity and mortality rate in diabetic hemodialysis patients are partially explained by malnutrition and inflammation.

• 대한약리학회지
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• 제31권1호
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• pp.95-102
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• 1995

당뇨병성 신증은 만성 당뇨병에서 흔히 동반되는 심각한 합병증이나 그 발생기전은 확실히 밝혀져 있지 않다. 본 연구에서는 암, 노화, 염증등 여러 가지 질환의 발생에 관여한다고 알려진 산화성 스트레스의 증가가 당뇨병성 신증의 발생에 관여하는지를 알아 보았다. 쥐에서 신증의 유발을 용이하게 하기 위해 먼저 한쪽 신장을 적출한후 스트렙토조토신을 주사하여 당뇨병을 유발하였다(NEPH-STZ). 당뇨병 유발 8주후, NEPH-STZ쥐들은 심한 고혈당증, 단백뇨, 고혈압의 증상을 보였으며 신장조직은 보상성 비대와 함께 혈관간기질(mesangial matrix) 증대의 형태학적 변화를 보였다. 그러나 스트렙토조토신만을 주사한 쥐(STZ)에서는 단백뇨가 나타나지 않았고, 신장적출만을 한 쥐에서는(NEPH) 단백뇨의 증상은 나타났으나 신장조직의 형태학적 관찰에서 혈관간 기질의 증대는 보이지 않았다. 이화같이 그 증상이나 신장조직 병변의 정도는 모두 달랐음에도 불구하고, 신피질 조직 단백질의 산화는 NEPH, STZ, NEPH-STZ의 세 실험군 쥐에서 대조군(CONT)에 비해 유의하게 증가 되어 있었다. 이 실험결과는 세 실험군 모두에서 조직의 산화성 스트레스가 증가되어 있음을 나타내는 것으로, 산화성 스트레스의 증가가 당뇨병성 신증을 일으키는 유일한 발병기전은 아닐 가능성을 시사한다. 그러나 조직의 산화성 스트레스의 증가가 여러 질환에서 조직의 손상을 유발하는 공통된 최종 경로라는 것을 고려해 볼 때, 혈행학적(hemodynamic) 혹은 대사성 인자 등에 의해 증가된 산화성 스트레스가 당뇨병성 신증의 발생에 있어서도 기여할 가능성은 크다.id deptide의 양이 변해서가 아니라 다른 기전에 의하여 조절되어지고 있음을 시사한다.

• Nutrition Research and Practice
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• 제10권1호
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• pp.33-41
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• 2016

BACKGROUND/OBJECTIVES: Diabetes mellitus (DM) is a major chronic disease which increases global health problems. Diabetes-induced renal damage is associated with inflammation and fibrosis. Alpha (AT) and gamma-tocopherols (GT) have shown antioxidant and anti-inflammatory effects in inflammation-mediated injuries. The primary aim of this study was to investigate effects of AT and GT supplementations on hyperglycemia induced acute kidney inflammation in alloxan induced diabetic mice with different levels of fasting blood glucose (FBG). MATERIALS/METHODS: Diabetes was induced by injection of alloxan monohydrate (150 mg/kg, i.p) in ICR mice (5.5-week-old, male) and mice were subdivided according to their FBG levels and treated with different diets for 2 weeks; CON: non-diabetic mice, m-DMC: diabetic control mice with mild FBG levels (250 mg/dl ${\leq}$ FBG ${\leq}$ 450 mg/dl), m-AT: m-DM mice fed AT supplementation (35 mg/kg diet), m-GT: m-DM mice with GT supplementation (35 mg/kg diet), s-DMC: diabetic control mice with severe FBG levels (450 mg/dl < FBG), s-AT: s-DM mice with AT supplementation, s-GT: s-DM mice with GT supplementation. RESULTS: Both AT and GT supplementations showed similar beneficial effects on $NF{\kappa}B$ associated inflammatory response (phosphorylated inhibitory kappa B-${\alpha}$, interleukin-$1{\beta}$, C-reactive protein, monocyte chemotactic protein-1) and pre-fibrosis (tumor growth factor ${\beta}$-1 and protein kinase C-II) as well as an antioxidant emzyme, heme oxygenase-1 (HO-1) in diabetic mice. On the other hands, AT and GT showed different beneficial effects on kidney weight, FBG, and oxidative stress associated makers (malondialdehyde, glutathione peroxidase, and catalase) except HO-1. In particular, GT significantly preserved kidney weight in m-DM and improved FBG levels in s-DM and malondialdehyde and catalase in m- and s-DM, while AT significantly attenuated FBG levels in m-DM and improved glutathione peroxidase in m- and s-DM. CONCLUSIONS: the results suggest that AT and GT with similarities and differences would be considered as beneficial nutrients to modulate hyperglycemia induced acute renal inflammation. Further research with careful approach is needed to confirm beneficial effects of tocopherols in diabetes with different FBG levels for clinical applications.

• 대한영양사협회학술지
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• 제7권2호
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• pp.138-143
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• 2001

Microalbuminuria is a strong predictor of diabetic nephropathy and is also associated with increased mortality in people with non-insulin-dependent diabetes mellitus(NIDDM) patients. Improved glycemic control and dietary protein restriction are recommended to retard and avoid developing microalbuminuria. The purpose of this study was to measure the dietary counseling effects for diabetes mellitus patients with microalbuminuria. To investigate the effects of the dietary counseling effect, thirty NIDDM patients with microalbuminuria were selected from outpatient diabetic clinic of Seoul National University Hospital for this study. None of them had evidence of renal and heart complications. For 24 weeks, they received individualized dietary counseling 3 times. The results of this study can be summarized as follows 1) Dietary protein and calorie intake decreased significantly from 79.8$\pm$29.9g/d to 66.6$\pm$16.5g/d, from 1845.4$\pm$631.9kcal to 1515.7$\pm$392.7kcal after dietary counseling, respectively (p<0.05). 2)The glycosylate hemoglobin level showed significantly decreased after dietary counseling(p<0.05). However there were no change in lipid profiles and blood pressure after counseling. 3) There was a significant correlation between the duration of disease and the amount of microalbuminuria. Any other cardiovascular risk factors, such as duration of diabetes, total cholesterol level and systolic blood pressure were not correlated with microalbuminuria. These results shown that dietary counseling can be used as an effective therapy to control blood sugar levels for NIDDM patients who are poorly controlled with microalbuminuria.

• Journal of Preventive Medicine and Public Health
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• 제54권3호
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• pp.190-198
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• 2021

Objectives: Insufficient evidence exists regarding factors that affect screening adherence among people with a family history of diabetes, who comprise roughly half of all patients with diabetes. Therefore, we aimed to identify the determinants of diabetes screening adherence in adults with a family history of diabetes who had not yet been diagnosed with diabetes. Methods: This cross-sectional study was conducted at selected urban primary healthcare facilities in Tehran, Iran. The study population was clinically non-diabetic adults above 20 years of age with a family history of diabetes in at least 1 first-degree relative. All eligible people identified on randomly-selected days of the month were invited to join the study. Results: Among 408 participants, 128 (31.4%) had received a fasting blood glucose check during the last year. Using binary logistic regression, the independent predictors of screening adherence were knowledge of adverse effects of diabetes such as sexual disorders (odds ratio [OR], 3.05) and renal failure (OR, 2.73), the impact of family members' advice on receiving diabetes screening (OR, 2.03), recommendation from a healthcare provider to have a fasting blood glucose check (OR, 2.61), and intention to have a fasting blood glucose check within the next 6 months (OR, 2.85). Other variables that predicted screening adherence were age (OR, 1.05), job (being a housekeeper; OR, 3.39), and having a college degree (OR, 3.55). Conclusions: Knowledge of the adverse effects of diabetes, physicians' and healthcare providers' advice about the benefits of early disease detection, and family members' advice were independent predictors of screening adherence.

• 대한이식학회지
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• 제32권4호
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• pp.104-107
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• 2018

Mucormycosis is an extremely rare but potentially life-threatening fungal infection. Gastrointestinal (GI) mucormycosis is very rare and occurs primarily in highly malnourished patients, especially in infants and children. A 55-year-old man with end-stage renal disease due to diabetic nephropathy, who had undergone deceased donor kidney transplantation 2 years prior, complained of abdominal pain and distension with a 3-day duration. Computed tomography revealed diffuse gastric wall thickening, and a huge amount of grey colored necrotic debris surrounded by erythematous erosive mucosa was observed at the antrum to upper body by GI endoscopy. The microscopic examination obtained from a GI endoscopic specimen demonstrated peptic detritus with numerous non-septate mucor hyphae in the mucosa and submucosa. Mucormycosis was diagnosed based on the clinical findings and morphological features. A total gastrectomy was performed and an antifungal agent was administered. A microscopic examination of the surgical specimen demonstrated invasive mucormycosis with numerous fungal hyphae with invasion into the mucosa to subserosa. The patient and graft were treated successfully by total gastrectomy and antifungal therapy.