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대한당뇨병학회> Diabetes and Metabolism Journal (DMJ)

Diabetes and Metabolism Journal (DMJ) update

  • : 대한당뇨병학회
  • : 의약학분야  >  내과학
  • : KCI등재
  • : SCI,SCOPUS
  • : 연속간행물
  • : 격월
  • : 2233-6079
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  • : 당뇨병(~2007)→Korean Diabetes Journal(2008~)→Diabetes and Metabolism Journal (DMJ)(2011~)

수록정보
수록범위 : 1권1호(1972)~43권4호(2019) |수록논문 수 : 2,625
Diabetes and Metabolism Journal (DMJ)
43권4호(2019년 08월) 수록논문
최근 권호 논문
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KCI등재 SCI SCOPUS

1Continuous Glucose Monitoring Sensors for Diabetes Management: A Review of Technologies and Applications

저자 : Giacomo Cappon , Martina Vettoretti , Giovanni Sparacino , Andrea Facchinetti

발행기관 : 대한당뇨병학회 간행물 : Diabetes and Metabolism Journal (DMJ) 43권 4호 발행 연도 : 2019 페이지 : pp. 383-397 (15 pages)

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By providing blood glucose (BG) concentration measurements in an almost continuous-time fashion for several consecutive days, wearable minimally-invasive continuous glucose monitoring (CGM) sensors are revolutionizing diabetes management, and are becoming an increasingly adopted technology especially for diabetic individuals requiring insulin administrations. Indeed, by providing glucose real-time insights of BG dynamics and trend, and being equipped with visual and acoustic alarms for hypo-and hyperglycemia, CGM devices have been proved to improve safety and effectiveness of diabetes therapy, reduce hypoglycemia incidence and duration, and decrease glycemic variability. Furthermore, the real-time availability of BG values has been stimulating the realization of new tools to provide patients with decision support to improve insulin dosage tuning and infusion. The aim of this paper is to offer an overview of current literature and future possible developments regarding CGM technologies and applications. In particular, first, we outline the technological evolution of CGM devices through the last 20 years. Then, we discuss about the current use of CGM sensors from patients affected by diabetes, and, we report some works proving the beneficial impact provided by the adoption of CGM. Finally, we review some recent advanced applications for diabetes treatment based on CGM sensors.

KCI등재 SCI SCOPUS

22019 Clinical Practice Guidelines for Type 2 Diabetes Mellitus in Korea

저자 : Mee Kyoung Kim , Seung-hyun Ko , Bo-yeon Kim , Eun Seok Kang , Junghyun Noh , Soo-kyung Kim , Seok-o Park , Kyu Yeon Hur , Suk Chon , Min Kyong Moon , Nan-hee Kim , Sang Yong Kim , Sang Youl Rhee , Kang

발행기관 : 대한당뇨병학회 간행물 : Diabetes and Metabolism Journal (DMJ) 43권 4호 발행 연도 : 2019 페이지 : pp. 398-406 (9 pages)

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The Committee of Clinical Practice Guidelines of the Korean Diabetes Association revised and updated the 6th Clinical Practice Guidelines in 2019. Targets of glycemic, blood pressure, and lipid control in type 2 diabetes mellitus (T2DM) were updated. The obese and overweight population is increasing steadily in Korea, and half of the Koreans with diabetes are obese. Evidence-based recommendations for weight-loss therapy for obesity management as treatment for hyperglycemia in T2DM were provided. In addition, evidence from large clinical studies assessing cardiovascular outcomes following the use of sodium-glucose cotransporter-2 inhibitors and glucagon-like peptide 1 receptor agonists in patients with T2DM were incorporated into the recommendations.

KCI등재 SCI SCOPUS

3Changes in Metabolic Profile Over Time: Impact on the Risk of Diabetes

저자 : Yunjung Cho , Seung-hwan Lee

발행기관 : 대한당뇨병학회 간행물 : Diabetes and Metabolism Journal (DMJ) 43권 4호 발행 연도 : 2019 페이지 : pp. 407-409 (3 pages)

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4Asian Subpopulations May Exhibit Greater Cardiovascular Benefit from Long-Acting Glucagon-Like Peptide 1 Receptor Agonists: A Meta-Analysis of Cardiovascular Outcome Trials

저자 : Yu Mi Kang , Yun Kyung Cho , Jiwoo Lee , Seung Eun Lee , Woo Je Lee , Joong-yeol Park , Ye-jee Kim , Chang Hee Jung , Michael A. Nauck

발행기관 : 대한당뇨병학회 간행물 : Diabetes and Metabolism Journal (DMJ) 43권 4호 발행 연도 : 2019 페이지 : pp. 410-421 (12 pages)

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Background: Based on reported results of three large cardiovascular outcome trials (CVOTs) of glucagon-like peptide 1 receptor agonists (GLP-1 RAs), we aimed to investigate the overall effect of GLP-1 RAs on major adverse cardiovascular events (MACEs) and to identify subpopulations exhibiting the greatest cardiovascular (CV) benefit.
Methods: Three CVOTs reporting effects of long-acting GLP-1 RAs were included: LEADER (liraglutide), SUSTAIN-6 (semaglutide), and EXSCEL (exenatide once weekly). In all studies, the primary endpoint was three-point MACE, comprising CV death, non-fatal myocardial infarction, and non-fatal stroke. Overall effect estimates were calculated as hazard ratios and 95% confidence intervals (CIs) using the random-effects model; subgroup analyses reported in the original studies were similarly analyzed.
Results: Overall, statistically significant risk reductions in MACE and CV death were observed. Subgroup analysis indicated a significant racial difference with respect to CV benefit (P for interaction <0.001), and more substantial risk reductions were observed in subjects of African origin (relative risk [RR], 0.78; 95% CI, 0.60 to 0.99) and in Asians (RR, 0.35; 95% CI, 0.09 to 1.32). However, post hoc analysis (Bonferroni method) revealed that only Asians exhibited a significantly greater CV benefit from treatment, compared with white subjects (P<0.0001).
Conclusion: Long-acting GLP-1 RAs reduced risks of MACE and CV deaths in high-risk patients with type 2 diabetes mellitus. Our findings of a particularly effective reduction in CV events with GLP-1 RA in Asian populations merits further exploration and dedicated trials in specific populations.

KCI등재 SCI SCOPUS

5Additional Effect of Dietary Fiber in Patients with Type 2 Diabetes Mellitus Using Metformin and Sulfonylurea: An Open-Label, Pilot Trial

저자 : Seung-eun Lee , Yongbin Choi , Ji Eun Jun , You-bin Lee , Sang-man Jin , Kyu Yeon Hur , Gwang Pyo Ko , Moon-kyu Lee

발행기관 : 대한당뇨병학회 간행물 : Diabetes and Metabolism Journal (DMJ) 43권 4호 발행 연도 : 2019 페이지 : pp. 422-431 (10 pages)

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Background: Metformin, sulfonylurea, and dietary fiber are known to affect gut microbiota in patients with type 2 diabetes mellitus (T2DM). This open and single-arm pilot trial investigated the effects of the additional use of fiber on glycemic parameters, insulin, incretins, and microbiota in patients with T2DM who had been treated with metformin and sulfonylurea.
Methods: Participants took fiber for 4 weeks and stopped for the next 4 weeks. Glycemic parameters, insulin, incretins during mixed-meal tolerance test (MMTT), lipopolysaccharide (LPS) level, and fecal microbiota were analyzed at weeks 0, 4, and 8. The first tertile of difference in glucose area under the curve during MMTT between weeks 0 and 4 was defined as 'responders' and the third as 'nonresponders,' respectively.
Results: In all 10 participants, the peak incretin levels during MMTT were higher and LPS were lower at week 4 as compared with at baseline. While the insulin sensitivity of the 'responders' increased at week 4, that of the 'nonresponders' showed opposite results. However, the results were not statistically significant. In all participants, metabolically unfavorable microbiota decreased at week 4 and were restored at week 8. At baseline, metabolically hostile bacteria were more abundant in the 'nonresponders.' In 'responders,' Roseburia intestinalis increased at week 4.
Conclusion: While dietary fiber did not induce additional changes in glycemic parameters, it showed a trend of improvement in insulin sensitivity in 'responders.' Even if patients are already receiving diabetes treatment, the additional administration of fiber can lead to additional benefits in the treatment of diabetes.

KCI등재 SCI SCOPUS

6Effectiveness and Safety of Adding Basal Insulin Glargine in Patients with Type 2 Diabetes Mellitus Exhibiting Inadequate Response to Metformin and DPP-4 Inhibitors with or without Sulfonylurea

저자 : Yu Mi Kang , Chang Hee Jung , Seung-hwan Lee , Sang-wook Kim , Kee-ho Song , Sin Gon Kim , Jae Hyeon Kim , Young Min Cho , Tae Sun Park , Bon Jeong Ku , Gwanpyo Koh , Dol Mi Kim , Byung-wan Lee , Joong-

발행기관 : 대한당뇨병학회 간행물 : Diabetes and Metabolism Journal (DMJ) 43권 4호 발행 연도 : 2019 페이지 : pp. 432-446 (15 pages)

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Background: We aimed to investigate the effectiveness and safety of adding basal insulin to initiating dipeptidyl peptidase-4 (DPP-4) inhibitor and metformin and/or sulfonylurea (SU) in achieving the target glycosylated hemoglobin (HbA1c) in patients with type 2 diabetes mellitus (T2DM).
Methods: This was a single-arm, multicenter, 24-week, open-label, phase 4 study in patients with inadequately controlled (HbA1c ≥7.5%) T2DM despite the use of DPP-4 inhibitor and metformin. A total of 108 patients received insulin glargine while continuing oral antidiabetic drugs (OADs). The primary efficacy endpoint was the percentage of subjects achieving HbA1c ≤7.0%. Other glycemic profiles were also evaluated, and the safety endpoints were adverse events (AEs) and hypoglycemia.
Results: The median HbA1c at baseline (8.9%; range, 7.5% to 11.1%) decreased to 7.6% (5.5% to 11.7%) at 24 weeks. Overall, 31.7% subjects (n=33) achieved the target HbA1c level of ≤7.0%. The mean differences in body weight and fasting plasma glucose were 1.2±3.4 kg and 56.0±49.8 mg/dL, respectively. Hypoglycemia was reported in 36 subjects (33.3%, 112 episodes), all of which were fully recovered. There was no serious AE attributed to insulin glargine. Body weight change was significantly different between SU users and nonusers (1.5±2.5 kg vs. -0.9±6.0 kg, P=0.011).
Conclusion: The combination add-on therapy of insulin glargine, on metformin and DPP-4 inhibitors with or without SU was safe and efficient in reducing HbA1c levels and thus, is a preferable option in managing T2DM patients exhibiting dysglycemia despite the use of OADs.

KCI등재 SCI SCOPUS

7Association between Serum Selenium Level and the Presence of Diabetes Mellitus: A Meta-Analysis of Observational Studies

저자 : Juno Kim , Hye Soo Chung , Min-kyu Choi , Yong Kyun Roh , Hyung Joon Yoo , Jung Hwan Park , Dong Sun Kim , Jae Myung Yu , Shinje Moon

발행기관 : 대한당뇨병학회 간행물 : Diabetes and Metabolism Journal (DMJ) 43권 4호 발행 연도 : 2019 페이지 : pp. 447-460 (14 pages)

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Background: Epidemiological studies have suggested an association between selenium (Se) and diabetes mellitus (DM). However, different studies have reported conflicting results. Therefore, we performed a comprehensive meta-analysis to clarify the impact of Se on DM.
Methods: We searched the PubMed database for studies on the association between Se and DM from inception to June 2018.
Results: Twenty articles evaluating 47,930 participants were included in the analysis. The meta-analysis found that high levels of Se were significantly associated with the presence of DM (pooled odds ratios [ORs], 1.88; 95% confidence interval [CI], 1.44 to 2.45). However, significant heterogeneity was found (I2=82%). Subgroup analyses were performed based on the Se measurement methods used in each study. A significant association was found between high Se levels and the presence of DM in the studies that used blood (OR, 2.17; 95% CI, 1.60 to 2.93; I2=77%), diet (OR, 1.61; 95% CI, 1.10 to 2.36; I2=0%), and urine (OR, 1.49; 95% CI, 1.02 to 2.17; I2=0%) as samples to estimate Se levels, but not in studies on nails (OR, 1.24; 95% CI, 0.52 to 2.98; I2=91%). Because of significant heterogeneity in the studies with blood, we conducted a sensitivity analysis and tested the publication bias. The results were consistent after adjustment based on the sensitivity analysis as well as the trim and fill analysis for publication bias.
Conclusion: This meta-analysis demonstrates that high levels of Se are associated with the presence of DM. Further prospective and randomized controlled trials are warranted to elucidate the link better.

KCI등재 SCI SCOPUS

8Lower Leg Fat Depots Are Associated with Albuminuria Independently of Obesity, Insulin Resistance, and Metabolic Syndrome (Korea National Health and Nutrition Examination Surveys 2008 to 2011)

저자 : Eugene Han , Nan Hee Cho , Mi Kyung Kim , Hye Soon Kim

발행기관 : 대한당뇨병학회 간행물 : Diabetes and Metabolism Journal (DMJ) 43권 4호 발행 연도 : 2019 페이지 : pp. 461-473 (13 pages)

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Background: Although the involvement of obesity in metabolic disorders is well known, leg fat depot influences on albuminuria have not been determined.
Methods: This population-based, cross-sectional study used a nationally representative sample of 2,076 subjects aged ≥20 years from the Korea National Health and Nutrition Examination Surveys of 2008 to 2011. The ratio of leg fat to total fat (LF/TF ratio) was assessed by dual X-ray absorptiometry, and albuminuria was defined as more than one positive dipstick test or an albumin-to-creatinine ratio of ≥30 mg/g.
Results: Individuals whose LF/TF ratio was in the lowest tertile showed a higher proportion of albuminuria than those in the highest tertile (odds ratio [OR], 2.82; 95% confidence interval [CI], 2.01 to 3.96; P<0.001). This association was observed in both sexes, all age groups, and all subgroups stratified by body mass index, waist circumference, homeostasis model assessments of insulin resistance, and the presence of metabolic syndrome (all, P<0.05). Multiple logistic regression analyses also demonstrated that the lowest LF/TF ratio was independently associated with albuminuria risk (OR, 1.55 to 2.16; all, P<0.05). In addition, the risk of albuminuria was higher in sarcopenic individuals with lower LF/TF ratios than in the highest LF/TF ratio subjects without sarcopenia (OR, 3.73; 95% CI, 2.26 to 6.13).
Conclusion: A lower LF/TF ratio was associated with an increased risk of albuminuria independent of obesity, insulin resistance, and metabolic syndrome, and when combined with sarcopenia, the albuminuria risk synergistically increased. Hence, our findings may have implications to improve risk stratification and recommendations on body fat distribution in the general population.

KCI등재 SCI SCOPUS

9Plasma Fetuin-A Levels and Risk of Type 2 Diabetes Mellitus in A Chinese Population: A Nested Case-Control Study

저자 : Yeli Wang , Woon-puay Koh , Majken K. Jensen , Jian-min Yuan , An Pan

발행기관 : 대한당뇨병학회 간행물 : Diabetes and Metabolism Journal (DMJ) 43권 4호 발행 연도 : 2019 페이지 : pp. 474-486 (13 pages)

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Background: Fetuin-A is a hepatokine that involved in the pathogenesis of insulin resistance. Previous epidemiological studies have found a positive association between blood fetuin-A and type 2 diabetes mellitus (T2DM) risk among Caucasians and African Americans. We aimed to investigate the prospective relationship between fetuin-A and T2DM in an Asian population for the first time.
Methods: A nested case-control study was established within a prospective cohort of Chinese living in Singapore. At blood collection (1999 to 2004), all participants were free of diagnosed T2DM and aged 50 to 79 years. At subsequent follow-up (2006 to 2010), 558 people reported to have T2DM and were classified as incident cases, and 558 controls were randomly chosen from the participants who did not develop T2DM to match with cases on age, sex, dialect group, and date of blood collection. Plasma fetuin-A levels were measured retrospectively in cases and controls using samples collected at baseline. Conditional logistic regression models were used to compute the odds ratio (OR) and 95% confidence interval (CI). Restricted cubic spline analysis was used to examine a potential non-linear association between fetuin-A levels and T2DM risk.
Results: Compared with those in the lowest fetuin-A quintile, participants in the highest quintile had a two-fold increased risk of developing T2DM (OR, 2.06; 95% CI, 1.21 to 3.51). A non-linear association was observed (P nonlinearity=0.005), where the association between fetuin-A levels and T2DM risk plateaued at plasma concentrations around 830 μg/mL.
Conclusion: There is a positive association between plasma fetuin-A levels and risk of developing T2DM in this Chinese population.

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10Diabetes Fact Sheets in Korea, 2018: An Appraisal of Current Status

저자 : Bo-yeon Kim , Jong Chul Won , Jae Hyuk Lee , Hun-sung Kim , Jung Hwan Park , Kyoung Hwa Ha , Kyu Chang Won , Dae Jung Kim , Kyong Soo Park

발행기관 : 대한당뇨병학회 간행물 : Diabetes and Metabolism Journal (DMJ) 43권 4호 발행 연도 : 2019 페이지 : pp. 487-494 (8 pages)

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Background: The objective of this study was to investigate the prevalence, management, and comorbidities of diabetes among Korean adults aged 30 years and older.
Methods: This study used 2013 to 2016 data from the Korea National Health and Nutrition Examination Survey, a nationally-representative survey of the Korean population. Diabetes was defined as fasting glucose ≥126 mg/dL, current use of antidiabetic medication, a previous history of diabetes, or glycosylated hemoglobin (HbA1c) ≥6.5%.
Results: In 2016, 14.4% (approximately 5.02 million) of Korean adults had diabetes. The prevalence of impaired fasting glucose was 25.3% (8.71 million). From 2013 to 2016, the awareness, control, and treatment rates for diabetes were 62.6%, 56.7%, and 25.1%, respectively. People with diabetes had the following comorbidities: obesity (50.4%), abdominal obesity (47.8%), hypertension (55.3%), and hypercholesterolemia (34.9%). The 25.1%, 68.4%, and 44.2% of people with diabetes achieved HbA1c <6.5%, blood pressure <140/85 mm Hg, and low density lipoprotein cholesterol <100 mg/dL. Only 8.4% of people with diabetes had good control of all three targets.
Conclusion: This study confirms that diabetes is as an important public health problem. Efforts should be made to increase awareness, detection, and comprehensive management of diabetes to reduce diabetes-related morbidity and mortality.

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