• Korean System Dynamics Review
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• v.17 no.1
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• pp.25-40
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• 2016

This research aims to identify important variables and their effects on diabetes prevention or progression from prediabetes to diabetic complication using system thinking. Based on the existing studies, we have constructed a causal loop diagram explaining dynamics of diabetes and have found 7 important reinforcing loops and 3 balancing loops in the causal loop diagram. The CLD displays an effect of increasing prediabetes early detection and awareness on diabetes prevention. The findings indicate that the projects in Korea for reducing incidence of diabetes and potential risk of complication have focused on variables which are related only on diabetes even though prediabetes has been a critical point on diabetes prevention and management. Thus, it also concludes that the effect of projects focusing only on diabetes have faced limitation to manage diabetes accordingly.

• Nutrition Research and Practice
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• v.12 no.3
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• pp.233-242
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• 2018

BACKGROUND/OBJECTIVES: The effects of fish consumption by subjects with prediabetes on the metabolic risk factors were examined based on the data from the $6^{th}$ Korea National Health and Nutrition Examination Surveys in 2015. SUBJECTS/METHODS: A total of 1,520 subjects who agreed to participate in a blood test and dietary intake survey were divided into a prediabetes group and normal blood glucose group, and the level of the subjects' fish consumption was divided into ${\leq}17.0g/day$, 18.0-93.0 g/day, and ${\geq}94g/day$. The correlation between the level of fish intake and the metabolic risk factors was evaluated by multinomial logistic regression analysis. RESULTS: A significant difference in the gender distribution was observed in the prediabetes group, which is a group with a high risk of non-communicable diseases, according to the fish intake, and there were significant differences in the total energy intake, protein intake, n-3 fatty acids intake, and the intakes of sodium and micro-nutrients according to the intake group (P < 0.05). In addition, the blood total cholesterol (TC) decreased 0.422 fold in model 1 (unadjusted) [95% confidence interval (CI): 0.211-0.845] and 0.422 fold in model 2 (adjusted for sex) (95% CI: 0.210-0.846) in those with a fish intake of 18.0-93.0 g/day (P < 0.05) compared to those with a fish intake of ${\leq}17.0g/day$. The blood TC decreased 0.555 fold (95% CI: 0.311-0.989) in model 1 and 0.549 fold (95% CI: 0.302-0.997) in model 2 in those with a fish intake of ${\geq}94g/day$ compared to those with a fish intake of ${\leq}17.0g/day$ (P < 0.05). CONCLUSION: Subjects with prediabetes or the metabolic risk factors can maintain their blood low density lipoprotein cholesterol (LDL-C) and blood TC concentrations at the optimal level by consuming fish (18.0-93.0 g/day).

• YAKHAK HOEJI
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• v.41 no.2
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• pp.260-267
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• 1997

To establish prediabetes in vitro model concerning the etiology of IDDM(Insulin Dependent Diabetes Mellitus) in cellular level we have designed prediabetes in vitro models in pa ncreatic beta cells. HIT-T15, RINm5F and isolated rat islets were chosen as pancreatic beta cells, and streptozotocin (STZ) used as diabetogenic agent. Degree of beta cell destruction to establish prediabetic in vitro model was determined by cell proliferation and insulin release using thymidine uptake and radio immuno assay. When HIT-T15 and RINm5F cells were treated with STZ, the degree of cell deterioration was dependent upon the origin and passage number of beta cells, and in the case of isolated islets STZ showed the more sensitivity than above two beta cell lines. The concentration and exposure time of STZ treatment to establish prediabetes in vitro model in beta cell lines and isolated rat islets were 2 ~ 10mM, 30 min. and 1 ~ 5mM, 30 min., respectively.

• The Journal of Korean Diabetes
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• v.16 no.3
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• pp.161-167
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• 2015

In Korea, diabetes mellitus, which causes micro and macrovascular complications, has been rapidly increasing during recent decades and has become a leading cause of disability-adjusted life years. The prevalence of diabetes mellitus was 12.4% in 2011 and that of prediabetes, a condition of high risk for developing diabetes mellitus, is 1.5- to 3-fold greater than that of diabetes. The diabetes prevention programs in other countries were shown to reduce or delay progression from prediabetes to diabetes mellitus. However, these results are not applicable to Korean people because of genetic and environmental differences. Therefore, we need to plan and perform a diabetes prevention study in Korean. Based on these results, we should design intervention tools for a Korean diabetes prevention program. We can consider several preventive interventions with lifestyle modification suitable for Korean people and pharmacologic treatments such as metformin or alpha-glucosidase inhibitor.

• Journal of Korean Academy of Nursing
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• v.50 no.2
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• pp.298-312
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• 2020

Purpose: This study had two objectives: 1) to develop a scale for the process of exercise engagement (SPEE) for prediabetic individuals (PDIs); 2) to validate a structural model for the process of exercise engagement for PDIs. Methods: A cross-sectional survey with simple random sampling was conducted from September 2013 to December 2015 (in Taiwan). A total of 310 PDIs were enrolled for scale development and model validation via item analysis, factor analyses, and structural equation modeling. The Kuo model was used as the basis for developing the Chinese version of the SPEE for PDIs. Results: The SPEE contains five subscales with a total of twenty-one items that account for 54.9% to 65.9% of the total variance explained for assessing participants' process of engagement during exercise. For Kuo model validation, the model measures indicated goodness of fit between the Kuo model and sample data. Analysis further revealed a direct effect between the creating health blueprints (CHB) stage and the spontaneous regular exercise (SRE) stage (β=.60). Conclusion: The SPEE includes five subscales for assessing the psychological transition and behavioral expression at each stage of the process of exercise engagement for PDIs. The SPEE for people with prediabetes provides deeper insights into the factors of behavioral change stages that are required to initiate long-term health care outcomes and avoid developing diabetes. These insights are significant as they allow for patient-specific mapping and behavior modification to effect exercise.

• Journal of East-West Nursing Research
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• v.29 no.2
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• pp.106-116
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• 2023

Purpose: The purpose of this study was to identify the impact of obesity on the incidence of diabetes mellitus in adults with pre-diabetes. Methods: This study employed a longitudinal study design and utilized secondary data drawn from the Korean Genome and Epidemiology Study. This study used data from a sample of 3,693 adults with prediabetes who were followed every two years from 2001 to 2018. Statistical data analysis for frequency, number of cases per 1,000 person-years, log-rank test, Kaplan-Meier curve, and Cox's proportional hazards regression analysis was performed using IBM SPSS statistics version 26. Results: During the observation period, there were 1,309 (35.4%) patients with diabetes, and the total number of person-years was 35,342. The incidence of diabetes was higher in the obese group compared to the normal weight group (body mass index [BMI]: hazard ratio=1.57, 95% confidence interval [CI]=1.40~1.77, waist: hazard ratio=1.55, 95% CI=1.38~1.76, waist to hip ratio [WHR]: hazard ratio=1.53, 95% CI=1.24~1.89, body fat [BF] (%): hazard ratio=1.42, 95% CI=1.27~1.61). Conclusion: An increase in BMI, waist circumference, and WHR, which are indicators of obesity, can exacerbate the risk factors for diabetes. Thus, a decrease in BMI, waist circumference, and WHR is necessary to prevent pre-diabetes. In particular, health care professionals should provide individualized weight management program interventions, including adult obesity programs and obesity counseling in partnership with local health departments, to reduce BMI and waist circumference in people at high risk for diabetes.

• The Korean Journal of Physiology and Pharmacology
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• v.19 no.4
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• pp.309-318
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• 2015

Alcohol consumption increases the risk of type 2 diabetes. However, its effects on prediabetes or early diabetes have not been studied. We investigated endoplasmic reticulum (ER) stress in the pancreas and liver resulting from chronic alcohol consumption in the prediabetes and early stages of diabetes. We separated Otsuka Long-Evans Tokushima Fatty (OLETF) rats, a type-2 diabetic animal model, into two groups based on diabetic stage: prediabetes and early diabetes were defined as occurrence between the ages of 11 to 16 weeks and 17 to 22 weeks, respectively. The experimental group received an ethanol-containing liquid diet for 6 weeks. An intraperitoneal glucose tolerance test was conducted after 16 and 22 weeks for the prediabetic and early diabetes groups, respectively. There were no significant differences in body weight between the control and ethanol groups. Fasting and 120-min glucose levels were lower and higher, respectively, in the ethanol group than in the control group. In prediabetes rats, alcohol induced significant expression of ER stress markers in the pancreas; however, alcohol did not affect the liver. In early diabetes rats, alcohol significantly increased most ER stress-marker levels in both the pancreas and liver. These results indicate that chronic alcohol consumption increased the risk of diabetes in prediabetic and early diabetic OLETF rats; the pancreas was more susceptible to damage than was the liver in the early diabetic stages, and the adaptive and proapoptotic pathway of ER stress may play key roles in the development and progression of diabetes affected by chronic alcohol ingestion.

• Journal of Nutrition and Health
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• v.50 no.5
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• pp.447-459
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• 2017

Purpose: Metabolic Syndrome (MetS) is defined as a cluster of inter-connected metabolic disorders involving the glucose metabolism, dyslipidaemia, high blood pressure, and abdominal obesity. The worldwide prevalence has been rapidly increasing to approximately 20~25%, and the prevalence in Korea as of 2012 was reported to be 31.3%. The association of MetS with various diseases needs to be analyzed by conducting an investigation of frequently consumed foods, such as dairy products, fish, and shellfish in prediabetic subjects. Methods: The dietary intake of subjects who met the criteria of the study from January to December 2015 was assessed using the 24-hour recall method. After adjusting the age, sex, BMI, and total energy intake, which are confounding factors that may affect the dietary intake of the subjects, the associations of dairy products, fish, and shellfish intake with the MetS risk factors was analyzed. Results: In prediabetes, the intake of subjects who consumed more than the dairy products median (187.0 g) and the elevation risk of TC [OR, 2.369; 95% CI, 1.057 to 5.312] showed a significant positive association. In prediabetes, the intake of subjects who consumed more than the fish and shellfish median (44.0 g) and the elevation risk of BP showed a significantly weak negative association [OR, 0.073; 95% CI, 0.010 to 0.520]. The probability that the blood LDL cholesterol was ${\geq}100mg/dL$ decreased 0.397 times [95% CI, 0.189 to 0.832]. Conclusion: To control the metabolic risk factors of pre-diabetic and vascular disease subjects, proper dairy, fish and shellfish intake will be important.

• Experimental and Molecular Medicine
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• v.50 no.12
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• pp.13.1-13.12
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• 2018

We aimed to explore whether changes in circulating levels of miRNAs according to type 2 diabetes mellitus (T2DM) or prediabetes status could be used as biomarkers to evaluate the risk of developing the disease. The study included 462 patients without T2DM at baseline from the CORDIOPREV trial. After a median follow-up of 60 months, 107 of the subjects developed T2DM, 30 developed prediabetes, 223 maintained prediabetes and 78 remained disease-free. Plasma levels of four miRNAs related to insulin signaling and beta-cell function were measured by RT-PCR. We analyzed the relationship between miRNAs levels and insulin signaling and release indexes at baseline and after the follow-up period. The risk of developing disease based on tertiles (T1-T2-T3) of baseline miRNAs levels was evaluated by COX analysis. Thus, we observed higher miR-150 and miR-30a-5p and lower miR-15a and miR-375 baseline levels in subjects with T2DM than in disease-free subjects. Patients with high miR-150 and miR-30a-5p baseline levels had lower disposition index (p = 0.047 and p = 0.007, respectively). The higher risk of disease was associated with high levels (T3) of miR-150 and miR-30a-5p ($HR_{T3-T1}=4.218$ and $HR_{T3-T1}=2.527$, respectively) and low levels (T1) of miR-15a and miR-375 ($HR_{T1-T3}=3.269$ and $HR_{T1-T3}=1.604$, respectively). In conclusion, our study showed that deregulated plasma levels of miR-150, miR-30a-5p, miR-15a, and miR-375 were observed years before the onset of T2DM and pre-DM and could be used to evaluate the risk of developing the disease, which may improve prediction and prevention among individuals at high risk for T2DM.

• Journal of the Korea Academia-Industrial cooperation Society
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• v.16 no.1
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• pp.389-396
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• 2015

This study examined the relationships among impaired fasting glucose (IFG), diabetes and periodontal disease. The data from 10,856 adults (aged over 19 years) was derived from the Fifth Korean National Health and Nutrition Examination Survey, which was conducted in 2010 and 2012. Adjusting the related confounders, multiple logistic regression analysis showed that periodontitis were related to gender, age, education level, smoking and diabetic status (p<0.001). These findings suggest that abnormal fasting glucose, which is a predisposing factor for diabetes mellitus, does not appear to be a risk indicator for periodontal disease. On the other hand, if patients do not take steps to prevent or delay diabetes, prediabetes is likely to develop into type 2 diabetes within 10 years. Therefore, patients with prediabetes need to undergo continuous examinations and management of periodontal disease.