• Journal of Korean Foot and Ankle Society
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• v.10 no.1
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• pp.1-6
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• 2006

Purpose: To evaluate the clinical manifestations, the patterns and the functional outcome of the amputations due to the diabetic foot complications. Materials and Methods: Fifty patients (50 feet) of diabetic foot amputations were followed for more than 1 year. The mean age was 62.5 years, and the mean follow-up period was 46 months. Retrospective analysis was performed using chart review and interview with the patients. The outcome was assessed with modified AOFAS scale. Results: The diabetic foot lesions were infection in 45 feet, gangrene in 35 feet and ulcer in 15 feet. Toe amputation was most commonly performed procedure (23 cases) followed by below knee and ray amputation. Postoperative modified AOFAS score was average 51.5 points, and 94% were satisfied with outcome. Minor amputations showed better outcome than the major amputations. Conclusion: Overall postoperative functional outcome was encouraging with high patient satisfaction rate (94%). Better outcome was obtained with the minor amputations.

• Journal of Home Health Care Nursing
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• v.23 no.2
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• pp.139-146
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• 2016

Purpose: This research seeks to identify differences between general characteristics, disease-related characteristics, glycated hemoglobin (HbAlc) levels, and aspects of chronic complications of diabetes mellitus in type 2 diabetes. Methods: This research was conducted from the 1st to the 15th of February in 2016, on 263 in patients. Patients' electronic medical records were used to identify their general characteristics, disease-related characteristics, HbAlc, and chronic diabetic complications. Chi-square test, ANOVA, ANCOVA, and the Cochran-Mantel-Haenszel test were used for data analysis. Results: Statistical significance was observed for general characteristics, based on smoking status, such as age, and education level; disease-related characteristics differed according to the duration of diabetes. Smoking status did not differ according to HbAlc level. In term of chronic diabetic complications, statistically significance was observed for diabetic nephropathy, based on smoking status. Conclusion: Patients who had a history of smoking, but were not currently smoking, were likely to display higher HbAlc levels and diabetic nephropathy. Therefore, there is need for regular checkups for diabetic complications among patients with a history of smoking and it is important to emphasize smoking cessation.

• Archives of Plastic Surgery
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• v.49 no.6
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• pp.782-784
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• 2022

Diabetic foot ulcers are a severe complication of diabetes, and their management requires a multidisciplinary approach for optimal management. When treating these ulcers, limb salvage remains the ultimate goal. In this article, we present the "hanging" free flap for the reconstruction of chronic lower extremity diabetic ulcers. This two-staged approach involves standard free flap harvest and inset; however, following inset the "hanging" pedicle is covered within a skin graft instead of making extraneous incisions within the undisturbed soft tissues or tunnels that can compress the vessels. After incorporation, a second-stage surgery is performed in 4 to 6 weeks which entails pedicle division, flap inset revision, and end-to-end reconstruction of the recipient vessel. Besides decreasing the number of incisions on diabetic patients, our novel technique utilizing the "hanging" pedicle simplifies flap monitoring and inset and allows reconstruction of recipient vessels to reestablish distal blood flow.

• Journal of Chest Surgery
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• v.36 no.5
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• pp.303-308
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• 2003

Background: It has been known that internal thoracic artery grafting has a better patency rate compare to other graft conduits in coronary revascularization. Better patency rates can be expected in more coronary arteries with the use of bilateral internal thoracic artery. However, there were some debates on the complications after the use of bilateral internal thoracic artery. The purpose of our study was to reveal the results of bilateral internal thoracic artery. Material and Method: The 26 coronary artery bypass operations with bilateral internal thoracic artery were performed from July 2001 to May 2002. We compared the results of 8 diabetic patients to those of 18 non-diabetic patients. We compared the results of BITA (bilateral internal thoracic artery) group to those of SITA (single internal thoracic artery) group that were 20 patients and performed during same period. Result: There was no mortality. There was one wound complication in the diabetic group and one in the non-diabetic group. There were no significant differences in operation time, duration of mechanical ventilation, amount of bleeding, infusing duration of cardiotonics, and complication between two groups. There were no significant differences in results between the BITA group and the SITA group. Conclusion: There were no significant differences in early results between the BITA group and the SITA group, and there were no significant differences in results between the diabetic group and the non-diabetic group. We think coronary artery bypass grafting with the use of bilateral internal thoracic artery is considered in diabetic patients.

• Journal of Nutrition and Health
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• v.32 no.1
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• pp.17-23
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• 1999

The purpose of this study was to determine the extent of oxidative stress in NIDDM patients with diabetic complications and to determine the relationship between oxidative stress and diabetic complications. For this study, 139 NIDDM patients were recruited, 85 with diabetic complications and 54 without complications were recruited. The concentration of malondialdehyde(MDA) and the activities of antioxidant enzymes including catalase, superoxide dismutase(SOD), gluthatione peroxidase(GSH-Px)were determined. The daily intakes and plasma concentrations of beta-carotene, lycopene, lutein nd alpha-tocopherol were determined by food frequency questionnaire and by high performance liquid chromatography(HPLC), respectively. Among the antioxidant enzymes studied, only GSH-Px activity was lower in NIDDM patient, with diabetic complications than in those without complications(2.91$\pm$0.80 vs 3.54$\pm$0.44 U/mgHb, p<0.05). Those NIDDM patients with diabetic complications had higher MDA concentrations than those without diabetic complications(1.40$\pm$0.25 vs 1.25$\pm$0.11 nmol/ml, p<0.05). There were no significant differences in the dietary intakes of total carotenoids(2854 vs 2824ug/day)or vitamin E (9.5$\pm$3.2 vs 9.5$\pm$2.0mg/day)between NIDDA patients with and without complications. However, the plasma concentrations of beta-carotene and lycopene were significantly lower in NIDDM patients with complications than in NIDDM patients without complications (Beta-carotene : 24.2$\pm$12.5 vs 33.1$\pm$16.2(ug/dl), lycopene : 2.8$\pm$2.1 vs 4.3$\pm$2.8(ug/dl)). This study showed that in NIDDM patients with complications, the lipid peroxidation of erythrocytes was higher increased and the antioxidant reserves were significantly dipleted, compared with NIDDM patients without complications. The lower plasma concentrations of beta-carotene and lycopene in NIDDM patients may be due to the presence of diabetic complication, not due to the lower dietary intakes of antioxidant vitamins. To define the role of carotenoids in diabetes, more experimental and clinical studies are needed.

• Biomolecules & Therapeutics
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• v.26 no.2
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• pp.130-138
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• 2018

Quercetin and resveratrol are known to have beneficial effects on the diabetes and diabetic complication, however, the effects of combined treatment of these compounds on diabetes are not fully revealed. Therefore, the present study was designed to investigate the combined antidiabetic action of quercetin (QE) and resveratrol (RS) in streptozotocin (STZ)-induced diabetic rats. To test the effects of co-treated with these compounds on diabetes, serum glucose, insulin, lipid profiles, oxidative stress biomarkers, and ions were determined. Additionally, the activities of hepatic glucose metabolic enzymes and histological analyses of pancreatic tissues were evaluated. 50 male Sprague-Dawley rats were divided into five groups; normal control, 50 mg/kg STZ-induced diabetic, and three (30 mg/kg QE, 10 mg/kg RS, and combined) compound-treated diabetic groups. The elevated serum blood glucose levels, insulin levels, and dyslipidemia in diabetic rats were significantly improved by QE, RS, and combined treatments. Oxidative stress and tissue injury biomarkers were dramatically inhibited by these compounds. They also shown to improve the hematological parameters which were shown to the hyperlactatemia and ketoacidosis as main causes of diabetic complications. The compounds treatment maintained the activities of hepatic glucose metabolic enzymes and structure of pancreatic ${\beta}-cells$ from the diabetes, and it is noteworthy that cotreatment with QE and RS showed the most preventive effect on the diabetic rats. Therefore, our study suggests that cotreatment with QE and RS has beneficial effects against diabetes. We further suggest that cotreatment with QE and RS has the potential for use as an alternative therapeutic strategy for diabetes.

• Korean Journal of Food Science and Technology
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• v.53 no.5
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• pp.561-569
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• 2021

Diabetic nephropathy is a major and representative complication of type 2 diabetes. Hyperglycemia increases the incidence of diabetic nephropathy, and induces kidney inflammation, thereby causing renal fibrosis, which is an important factor in the pathogenesis of diabetic nephropathy. This study investigated the effects of blackcurrant extract (BLC), which has been implicated in diabetic nephropathy in db/db mice, on glomerular fibrosis and renal dysfunction. The results showed that BLC consumption in type 2 diabetic db/db mice ameliorated diabetes-related metabolic disorders, such as insulin resistance and renal dysfunction, and significantly attenuated renal inflammation and renal fibrosis in diabetic nephropathy. In conclusion, these findings suggest that BLC consumption may help prevent renal fibrosis, inflammation, and consequent diabetic nephropathy.

• The Journal of Internal Korean Medicine
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• v.27 no.4
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• pp.845-854
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• 2006

Objectives : This study aimed at investigating whether aqueous extract of Radix et Rhizoma Rhei (AR) ameliorates renal and vascular complications in diabetic rats. Methods : The experiment operated for 6 weeks. The rats were divided into 4 groups: normal group, diabetic group (control group), diabetic group treated with AR (100 mg/kg/day) for the last 3 weeks, and diabetic group treated with AR (200 mg/kg/day) for the last 3 weeks. Results : There were no significant changes in the renal functional parameters by treatment of AR in the diabetic rats. Aorta segment in the diabetic rats revealed a thickening of intima and media, which was ameliorated by treatment with AR. The aortic expression level of endothelin-1 was also significantly attenuated by treatment with AR. Conclusions : Treatment with AR could not ameliorate renal functional defects, but improved vascular complication in diabetic rats.

• Journal of Preventive Medicine and Public Health
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• v.51 no.6
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• pp.265-274
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• 2018

Objectives: A positive association between air pollution and both the incidence and prevalence of diabetes mellitus (DM) has been reported in some epidemiologic and animal studies, but little research has evaluated the relationship between air pollution and diabetic coma. Diabetic coma is an acute complication of DM caused by diabetic ketoacidosis or hyperosmolar hyperglycemic state, which is characterized by extreme hyperglycemia accompanied by coma. We conducted a time-series study with a generalized additive model using a distributed-lag non-linear model to assess the association between ambient air pollution (particulate matter less than $10{\mu}m$ in aerodynamic diameter, nitrogen dioxide [$NO_2$], sulfur dioxide, carbon monoxide, and ozone) and emergency department (ED) visits for DM with coma in Seoul, Korea from 2005 to 2009. Methods: The ED data and medical records from the 3 years previous to each diabetic coma event were obtained from the Health Insurance Review and Assessment Service to examine the relationship with air pollutants. Results: Overall, the adjusted relative risks (RRs) for an interquartile range (IQR) increment of $NO_2$ was statistically significant at lag 1 (RR, 1.125; 95% confidence interval [CI], 1.039 to 1.219) in a single-lag model and both lag 0-1 (RR, 1.120; 95% CI, 1.028 to 1.219) and lag 0-3 (RR, 1.092; 95% CI, 1.005 to 1.186) in a cumulative-lag model. In a subgroup analysis, significant positive RRs were found for females for per-IQR increments of $NO_2$ at cumulative lag 0-3 (RR, 1.149; 95% CI, 1.022 to 1.291). Conclusions: The results of our study suggest that ambient air pollution, specifically $NO_2$, is associated with ED visits for diabetic coma.

• Korean Journal of Clinical Pharmacy
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• v.24 no.1
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• pp.33-38
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• 2014

Background: Diabetes is accompanied by complications. One of the chronic complications, diabetic retinopathy is the most common cause of the loss of eyesight and thus has enormous impacts on the quality of life to the patients. It has been reported that thorough glucose regulation can prevent or postpone the outset of diabetic retinopathy in diabetic patients and that the patients who received anti-diabetic manage & care education would be capable of more thorough glucose-level regulation than those who did not. Method: This study set out to investigate the current state of education on anti-diabetic manage & care in South Korea and connections between anti-diabetic manage & care education and occurrence of diabetic retinopathy in diabetic patients based on the Korea National Health and Nutrition Examination Survey of 2011. Results: Of the 410 diabetes patients, 74 received anti-diabetic manage & care education, which means that only 15% of diabetic patients benefited from the education in the nation. The occurrence rate of diabetic retinopathy was 28% in the education group and 24% in the non-education group with no significant differences between them. The anti-diabetic manage & care education group recorded a higher occurrence rate of diabetic retinopathy, one of the chronic diabetic complications, than the non-education group contrary to the hypothesis. One of the reasons was that the educated group had a significantly longer duration of diabetes and significantly higher HbA1c than the noneducated group, which indicates that anti-diabetic manage & care education is provided to those who have progressed farther along the course of diabetes instead of the early stage and cannot regulate their glucose-level well in the nation. Conclusion: Those findings raise a need for active educational policies in order to provide anti-diabetic manage & care education under the goals of preventing complications through anti-diabetic education for many patients in early stages of diabetes.