• 성인간호학회지
• /
• 제19권5호
• /
• pp.1-11
• /
• 2007

Purpose: The purpose of this study was to examine the effects of a cognitive behavioral stress management program on diabetic self-care and glycemic control with type 2 diabetic patients. Methods: Thirty three diabetic patients who were older than 40 were recruited from a public health center and conveniently assigned into both experimental(n=16) and control groups(n=17). Participants in the experimental group had attended the weekly cognitive behavioral program for 8 weeks. Data were collected from June 2005 to August 2006 and analyzed by independent t-test using the SPSS WIN program. Results: After an 8 week intervention, participants in the experimental group reported on increasement of diabetic self-care behaviors and an increasement of blood glucose levels, which were significantly different from those in the control group. Conclusion: On the basis of those findings, we concluded that the cognitive behavioral stress management program has positive effects on diabetic self-care and glycemic control for the patients with DM. Further research is needed to identify the long-term effects of the cognitive behavioral program.

• The Korean Journal of Physiology and Pharmacology
• /
• 제21권3호
• /
• pp.279-286
• /
• 2017

The root bark extract of Aralia taibaiensis is used traditionally for the treatment of diabetes mellitus in China. The total saponin extracted from Aralia Taibaiensis (sAT) has effective combined antihyperglycemic and hypolipidemic activities in experimental type 2 diabetic rats. However, the active compounds have not yet been fully investigated. In the present study, we examined effects of twelve triterpenoid saponins on AMP-activated protein kinase (AMPK) activation, and found that compound 28-O-${\beta}$-D-glucopyranosyl ester (AT12) significantly increased phosphorylation of AMPK and Acetyl-CoA carboxylase (ACC). AT12 effectively decreased blood glucose, triglyceride (TG), free fatty acid (FFA) and low density lipoprotein-cholesterol (LDL-C) levels in the rat model of type 2 diabetes mellitus (T2DM). The mechanism by which AT12 activated AMPK was subsequently investigated. Intracellular ATP level and oxygen consumption were significantly reduced by AT12 treatment. The findings suggested AT12 was a novel AMPK activator, and could be useful for the treatment of metabolic diseases.

• 한국산학기술학회논문지
• /
• 제19권10호
• /
• pp.243-253
• /
• 2018

본 연구 목적은 제2형 당뇨병 환자에서의 D-chiro-inositol(DCI)의 혈당강하 효과, 당뇨 자가관리(Summary of Diabetes Self-Care Activities, SDSCA) 및 삶의 질(SF-36 Version 2.0, Korean)에 미치는 요인을 파악하고자 하였다. 연구대상은 충남대학교병원 내분비대사내과에 내원한 제2형 당뇨병 환자 중에서 3제의 경구 혈당강하제를 12주 이상 투여 했음에도 불구하고 당화혈색소 7.0% 이상인 환자를 2015년 3월부터 2016년 5월까지 24주간 무작위 이중맹검 위약대조 임상시험으로 총 46명을 분석하였다. 연구결과, 실험군에서 DCI 투여 이후 당화혈색소 $8.75{\pm}0.79%$(베이스라인), $8.36{\pm}1.03%$(투여 12주), $8.65{\pm}0.81%$(투여 24주)으로 유의하게 감소하였으나(p<0.05), 대조군과의 변화량은 차이가 없었다. 흥미롭게도 실험군과 대조군에서 당뇨 자가관리 점수가 높아졌으며, 특히 실험군 변화량에서의 하부영역인 혈당검사 만이 유의한 차이를 보였고, 삶의 질은 투여 전 $73.05{\pm}16.85$점에서 투여후 $82.74{\pm}10.68$점으로 향상되었다. DCI 투여에 따른 실험군에서의 요인간 경로분석에서 공복 혈당 변화량은 당뇨 자가관리 변화량이 높을수록(${\beta}=-0.505$, t=-2.743) 높다고 확인되었다. 삶의 질 변화량에 가장 큰 영향을 준 변수는 공복 c-펩타이드 변화량이 높을수록(${\beta}=-0.445$, t=-2.668), 당뇨 자가관리 변화량이 높을수록(${\beta}=0.411$, t=2.024) 높은 것으로 확인되었다. 결론적으로 제2형 당뇨병 환자에게 DCI 투여는 투여 12주차에 혈당 강하 효과를 보이고, 24주차에는 없었지만, 혈당강하 효과는 환자의 당뇨 자가관리를 높이고 삶의 질을 향상시켰다. 본 연구에 기초하여 결과적인 지표와 제2형 당뇨병 환자의 주관적인 관점에서 평가될 수 있는 삶의 질에 대한 경로분석을 통하여 모형의 적합도에 관한 연구로써 그 의의가 있다고 본다.

• Journal of Dairy Science and Biotechnology
• /
• 제29권1호
• /
• pp.17-22
• /
• 2011

Milk intake is widely recommended for healthy diet, not only for bone growth and maintenance, but also as a protein, calcium and magnesium sources as part of an adequate diet. Many research suggest that milk and dairy products are associated with a lower risk of type 2 diabetes mellitus (T2DM). Milk and dairy products are low Glycemic index (GI) and Glycemic load (GL) foods. The GI and GL are useful tools to choose foods to help control blood glucose levels in people with diabetes. The GI and GL of milk are 32~42 and 4~5, respectively, and which are about 1/2 and 1/5 of boiled rice. The mechanisms underlying the effects of dairy on T2DM development includes the calcium and vitamin D content in dairy foods and the possible positive effect of high milk and calcium intake on weight control. The role of dairy products on reducing the risk of diabetes can be inferred from the reports that lower serum IGF-1 levels were positively associated with diabetes and the girls with low milk intake had significantly lower IGF-1. Accumulating data from both patients and animal models suggest that microbial ecosystems associated with the human body, especially the gut microbiota, may be associated with several important diseases, such as inflammatory bowel disease, obesity, diabetes and cardiovascular disease. It was thought that fermented milk containing lots of probiotics can be useful for controling blood glucose levels and preventing complication of diabetes, but sucrose in commercial yogurt should be substituted. There are some reports of oligosaccharide, xylitol, and stevia as a potentially useful sweetener in the diabetic diet.

• 문화기술의 융합
• /
• 제4권1호
• /
• pp.315-323
• /
• 2018

당뇨 환자의 급격한 증가는 한국의 주요 건강문제중 하나이다. 당뇨 예방 또는 치료용 식품개발에 대한 노력의 일환으로 본 연구에서는 고지방식이급여로 유도한 제2형 당뇨동물모델에서 커큐민의 항당뇨효능을 연구하였다. C57BL/6 마우스를 정상식이, 고지방식이, 그리고 고지방식이에 0.02% 커큐민을 급여한 군으로 나누고 각 식이를 총 16주간 급여하였다. 그 결과, 커큐민 급여군이 고지방식이급여군에 비해 체중 증가량, 혈당, 혈중 인슐린, 총콜레스테롤, LDL-콜레스테롤 농도가 유의적으로 감소하였고 반면에 HDL-콜레스테롤 수준은 증가하였다. 또한 커큐민의 급여는 인슐린 신호전달체계를 활성화시켰다. 이러한 결과는 커큐민이 인슐린 저항성을 일부 극복시킴으로써 비만과 연관된 제2형 당뇨병을 개선시킬 수 있음을 제시한다.

• BMB Reports
• /
• 제42권8호
• /
• pp.475-481
• /
• 2009

Emerging data demonstrate pivotal roles for brain insulin resistance and insulin deficiency as mediators of cognitive impairment and neurodegeneration, particularly Alzheimer's disease (AD). Insulin and insulin-like growth factors (IGFs) regulate neuronal survival, energy metabolism, and plasticity, which are required for learning and memory. Hence, endogenous brain-specific impairments in insulin and IGF signaling account for the majority of AD-associated abnormalities. However, a second major mechanism of cognitive impairment has been linked to obesity and Type 2 diabetes (T2DM). Human and experimental animal studies revealed that neurodegeneration associated with peripheral insulin resistance is likely effectuated via a liver-brain axis whereby toxic lipids, including ceramides, cross the blood brain barrier and cause brain insulin resistance, oxidative stress, neuro-inflammation, and cell death. In essence, there are dual mechanisms of brain insulin resistance leading to AD-type neurodegeneration: one mediated by endogenous, CNS factors; and the other, peripheral insulin resistance with excess cytotoxic ceramide production.

• 보건행정학회지
• /
• 제19권3호
• /
• pp.92-108
• /
• 2009

This study suggests a model for continuing and comprehensive management of hypertension or Type 2 diabetes mellitus (T2DM) in Korea. Moreover, this paper computed the contribution cost of hypertension or T2DM management using the healthcare medical cost, which could have occurred from stroke, myocardial infarction (MI), and end-stage renal disease (ESRD) that were successfully prevented from the effective hypertension or T2DM management. Additionally, these costs were compared with the cost of implementing the hypertension or T2DM management model suggested in this study. This study used the medical fee summary of the health insurance claims submitted to National Health Insurance Corporation by medical facilities for services provided during the period from January 1st 1999 to December 31st 2006. The prevalence rate with treatment referred to cases in which patients submitted their medical claims at least once during the period, along with an accordant diagnosis. The incidence rate with treatment referred to cases in which patients who never submitted claims for the accordant disease during the five years from 1999 to 2003 submitted claims for the accordant disease in 2004 and 2005. The relative risk of the occurrence of stroke, MI and ESRD was 11.0, 13.6, and 30.3, respectively. The attributable risk of hypertension or T2DM for stroke was 0.730, and that for MI and ESRD were 0.773 and 0.888, respectively. Based on these, the contribution cost of hypertension or T2DM is estimated to be 986.3 billion Korean Won(KRW) for stroke patients, 330.5 billion KRW for MI patients, and 561.7 billion KRW for ESRD patients as in 2005. Hence, the total contribution cost of hypertension or T2DM to stroke, MI, and ESRD is 1.878 trillion KRW. The estimate for operational costs included an annual expenditure of 50,000 KRW per each recipient and an annual subsidy of 0.22 million KRW per person for the 1.6 million low.income individuals with hypertension or T2DM to cover their out.of.pocket medical expenses. Under this assumption, it took approximately 0.6 trillion KRW to manage 5 million high.risk patients in the low. and mid.income range, coverings up to 50% of costs. In conclusion, considering the potential benefits of preventing stroke, MI, and ESRD, the costs seems to be reasonable.

• 생약학회지
• /
• 제53권3호
• /
• pp.145-152
• /
• 2022

Type II diabetes mellitus (T2DM) is a chronic metabolic disease caused by insulin resistance, and abnormally elevated hepatic gluconeogenesis is characterized. Phillyrin, one of the major active constituents of Forsythia suspense, is known to possess the anti-inflammatory and anti-oxidant effects. However, the anti-diabetes mellitus effect of phillyrin and its molecular mechanisms are unclear. The aim of the current study was to investigate the role of phillyrin on gluconeogenesis in insulin resistant HepG2 cells. Phillyrin suppressed high glucose (HG)-induced glucose production. In addition, phillyrin reduced HG-induced the expression of phosphoenolpyruvate carboxykinase (PEPCK) and glucose 6-phosphatase (G6Pase), major genes in hepatic gluconeogenesis. Phillyrin treatment attenuated HG-induced nucleus protein levels of FOXO1 and HDAC5 and increased the phosphorylation of Akt, AMPK, HDAC5, and FOXO1. The block of AMPK and Akt activity did not exert the inhibitory effect of phillyrin on gluconeogenesis in insulin resistant HepG2. Taken together, these results suggest that phillyrin inhibits gluconeogenesis of hepatocytes to improve glucose metabolism, through the regulation of LKB1/AMPK/HDAC5 and PI3K/AKT/FOXO1 pathway. These results indicate that phillyrin may be useful in improving hepatic gluconeogenesis associated with insulin resistant and T2DM.

• Nutrition Research and Practice
• /
• 제12권1호
• /
• pp.20-28
• /
• 2018

BACKGROUND/OBJECTIVES: Perilla frutescens (L.) Britton var. (PF) sprout is a plant of the labiate family. We have previously reported the protective effects of PF sprout extract on cytokine-induced ${\beta}-cell$ damage. However, the mechanism of action of the PF sprout extract in type 2 diabetes (T2DM) has not been investigated. The present study was designed to study the effects of PF sprout extract and signaling mechanisms in the T2DM mice model using C57BL/KsJ-db/db (db/db) mice. MATERIALS/METHODS: Male db/db mice were orally administered PF sprout extract (100, 300, and 1,000 mg/kg of body weight) or rosiglitazone (RGZ, positive drug, 1 mg/kg of body weight) for 4 weeks. Signaling mechanisms were analyzed using liver tissues and HepG2 cells. RESULTS: The PF sprout extract (300 and 1,000 mg/kg) significantly reduced the fasting blood glucose, serum insulin, triglyceride and total cholesterol levels in db/db mice. PF sprout extract also significantly improved glucose intolerance and insulin sensitivity, decreased hepatic gluconeogenic protein expression, and ameliorated histological alterations of the pancreas and liver. Levels of phosphorylated AMP-activated protein kinase (AMPK) protein expression also increased in the liver after treatment with the extract. In addition, an increase in the phosphorylation of AMPK and decrease in the phosphoenolpyruvate carboxykinase and glucose 6-phosphatase proteins in HepG2 cells were also observed. CONCLUSIONS: Our results sugges that PF sprout displays beneficial effects in the prevention and treatment of type 2 diabetes via modulation of the AMPK pathway and inhibition of gluconeogenesis in the liver.

• Annals of Clinical Neurophysiology
• /
• 제21권1호
• /
• pp.36-43
• /
• 2019

Background: Diabetic peripheral polyneuropathy (DPN) is associated with a variety of symptoms. Nerve conduction studies (NCSs) are considered to be the gold standard of nerve damage assessments, but these studies are often dissociated from the subjective symptoms observed in DPN patients. Thus, the aim of the present study was to investigate the correlations between NCS parameters and neuropathic symptoms quantified using the Michigan Neuropathy Screening Instrument (MNSI). Methods: Patients with type 2 diabetes mellitus (T2DM) with or without symptoms of neuropathy were retrospectively enrolled. Demographic data, clinical laboratory data, MNSI score, and NCS results were collected for analysis; DPN was diagnosed based on the MNSI score (${\geq}3.0$) and abnormal NCS results. Pearson's correlation coefficients were used to evaluate the relationships between MNSI score and NCS variables. Results: The final analyses included 198 patients (115 men and 83 women) with a mean age of $62.6{\pm}12.7$ years and a mean duration of diabetes of $12.7{\pm}8.4$ years. The mean MNSI score was 2.8 (range, 0.0-9.0), and 69 patients (34.8%) were diagnosed with DPN. The MNSI score was positively correlated with the median motor nerve latency and negatively correlated with the median motor, ulnar sensory, peroneal, tibial, and sural nerve conduction velocities (NCVs). When the patients were categorized into quartiles according to MNSI score, peroneal nerve conduction velocity was significantly lower in the second MNSI quartile than in the first MNSI quartile (p = 0.001). A multivariate analysis revealed that the peroneal NCV was independently associated with MNSI score after adjusting for age, sex, and glycosylated hemoglobin A1c (HbA1c) levels. Conclusions: The present results indicate that a decrease in peroneal NCV was responsible for early sensory deficits in T2DM patients.