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당뇨병(JKD) update

The Journal of Korean Diabetes

  • : 대한당뇨병학회
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  • : 임상 당뇨병(~2010)→ 당뇨병(JKD)(2011~)

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수록범위 : 1권1호(2000)~20권1호(2019) |수록논문 수 : 894
당뇨병(JKD)
20권1호(2019년 03월) 수록논문
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1Opinion : 심부전: 2형 당뇨병의 합병증

저자 : 설상훈 ( Sang-hoon Seol )

발행기관 : 대한당뇨병학회 간행물 : 당뇨병(JKD) 20권 1호 발행 연도 : 2019 페이지 : pp. 1-5 (5 pages)

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There is a close relationship between diabetes mellitus and heart failure, both of which are known to increase morbidity and mortality. Diabetes can cause or aggravate heart failure, and heart failure can precipitate diabetes. Diabetes mellitus causes structural and functional changes in the heart, such as fibrosis of the myocardium and left ventricular dysfunction. The mechanisms of diabetic cardiomyopathy are metabolic disturbance, myocardial fibrosis, microvascular disease, and autonomic dysfunction. Improper blood glucose control leads to deterioration of heart failure, but the role of strict glycemic control in reducing heart failure is unclear. The role of SGLT2 inhibitors in reducing the incidence of heart failure is of great importance in the treatment of diabetic patients. However, further long-term follow-up and safety studies are needed.

2Statement : 제2형 당뇨병 환자의 혈당 관리: 2018년 미국/유럽 당뇨병학회 합의안 요약

저자 : 김정미 ( Jeong Mi Kim ) , 김상수 ( Sang Soo Kim )

발행기관 : 대한당뇨병학회 간행물 : 당뇨병(JKD) 20권 1호 발행 연도 : 2019 페이지 : pp. 6-9 (4 pages)

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In 2018, the American Diabetes Association (ADA) and the European Association for the Study of Diabetes (EASD) published a consensus recommendation on management of hyperglycemia. This consensus report emphasized the need for patient-centered management considering multimorbidity and individual patient preferences and barriers. Patients with type 2 diabetes with established atherosclerotic cardiovascular disease who fail to control blood glucose with the initial glucose-lowering medication are recommended a sodium-glucose cotransporter 2 (SGLT2) inhibitor or a glucagon-like peptide 1 (GLP-1) receptor agonist. For patients with chronic kidney disease and heart failure, SGLT2 inhibitors are recommended. In patients who need an injectable medication, GLP-1 receptor agonists are the preferred choice over insulin. In this section, we summarize “Management of Hyperglycemia in Type 2 Diabetes, 2018. A Consensus Report by the American Diabetes Association (ADA) and the European Association for the Study of Diabetes (EASD).”

3Focused Issue : 당뇨병 환자에서 말초혈관질환의 병태생리와 역학

저자 : 구보경 ( Bo Kyung Koo )

발행기관 : 대한당뇨병학회 간행물 : 당뇨병(JKD) 20권 1호 발행 연도 : 2019 페이지 : pp. 10-16 (7 pages)

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Epidemiologic studies have revealed diabetes mellitus is an important determining factor not only for the presence of peripheral arterial disease (PAD) but also for the severity of PAD. As PAD is closely related to mortality and morbidity in individuals with diabetes as well as the general population, the primary prevention for PAD is very important. Age, disease duration, the level of hyperglycemia, blood pressure, and smoking status are independent risk factors for development of PAD in diabetic patients, and management of those risk factors might be an effective tool for reducing PAD burden.

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Peripheral artery disease (PAD) is the most frequent cause of reduced perfusion in peripheral arteries. Patients with PAD often have manifestations of atherosclerosis of the lower limb, although both symptomatic and asymptomatic disease is common. The clinical signs of PAD can differ in diabetic and non-diabetic patients. Diabetic patients are at high risk for PAD characterized by symptoms of intermittent claudication or critical limb ischemia. However, the majority of PAD patients are clinically asymptomatic. In addition to history taking, physical examinations including inspection of the skin, palpation of leg and foot pulses, and determination of the ankle-brachial index (ABI) are considered for diagnosis of PAD. The ABI measurement is the easiest and most common investigative technique for PAD. For hemodynamic assessment, additional diagnostic modalities could be considered.

5Focused Issue : 당뇨병 환자에서 말초동맥질환의 약물적 치료: 심혈관질환 위험요소 관리

저자 : 전숙 ( Suk Chon )

발행기관 : 대한당뇨병학회 간행물 : 당뇨병(JKD) 20권 1호 발행 연도 : 2019 페이지 : pp. 24-32 (9 pages)

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Peripheral arterial disease is an arteriosclerotic disease that can affect the arteries of the whole body except the coronary arteries and the aorta. In general, disease of the descending aorta, iliac artery, and lower limb arteries below the renal artery is referred to as peripheral artery disease (PAD) or lower extremity artery disease. PAD is highly associated with ischemic heart disease, cerebrovascular disease, and mortality. Diabetes mellitus (DM) is a major risk factor for a variety of cardiovascular diseases, especially PAD. Recent studies have shown that PAD patients with DM have a significantly higher rate of major adverse cardiovascular events, all-cause mortality, and limb amputation compared with patients with PAD alone. To prevent and manage various complications of patients with DM, aggressive diagnosis and management and treatment of PAD play an important role in prevention of complications threatening quality of life such as cardiovascular disease and limb amputation.

6Focused Issue : 당뇨병 환자에서 말초혈관질환의 중재시술 및 수술적 치료

저자 : 김상훈 ( Sang Hoon Kim )

발행기관 : 대한당뇨병학회 간행물 : 당뇨병(JKD) 20권 1호 발행 연도 : 2019 페이지 : pp. 33-41 (9 pages)

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After diagnosis of peripheral artery disease in diabetic patients, revascularization can be considered in those who are not improved after guideline-directed medical therapy. Recently, more aggressive approaches with interventional treatment have been recommended. Before revascularization therapy, it is important to differentiate patients with claudication or critical limb ischemia, and the final goal and treatment modality of interventional treatments should be based on clinical diagnosis. For patients with claudication, the goal of revascularization is improvement of functional capacity or quality of life; however, in more severe forms of critical limb ischemia, the purpose of revascularization is limb salvage and ultimately saving patient's life. With improvement of vascular interventions, interventional treatment for peripheral artery disease is preferred, although surgical treatment might show better results than intervention in some cases.

7Information Desk : 연속혈당모니터를 활용한 혈당 관리

저자 : 강양교 ( Yanggyo Kang )

발행기관 : 대한당뇨병학회 간행물 : 당뇨병(JKD) 20권 1호 발행 연도 : 2019 페이지 : pp. 42-46 (5 pages)

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In the Diabetes Care Guidelines of the Korean Diabetes Association in 2015, the use of continuous glucose monitoring in patients with type 1 diabetes who undergo multiple insulin therapy or insulin pump therapy is helpful in controlling blood sugar and monitoring blood glucose level when fluctuation is high or hypoglycemia is frequent. Recently, the American Diabetes Association published in the 2019 Standard of Care in Diabetes in the new diabetes technology part the criteria for use and methods of the continuous blood glucose meter. Continuous and real-time blood glucose meters emphasize the importance of education prior to use. In particular, the real-time blood glucose meter is a useful device for prevention of hypoglycemia in type 1 diabetes in children and adults. The purpose of this study is to summarize the contents of the continuous blood glucose measurement part of the 2019 Standard of Care in Diabetes.

8Information Desk : 당뇨병 환자의 음료 섭취

저자 : 심지선 ( Jee-seon Shim )

발행기관 : 대한당뇨병학회 간행물 : 당뇨병(JKD) 20권 1호 발행 연도 : 2019 페이지 : pp. 47-52 (6 pages)

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Beverage consumption is one of the most habitual dietary behaviors. Beverages such as coffee, tea, and juice are among the most widely and commonly consumed food. Recently, consumption of sugarsweetened beverages has been steadily increasing across the globe. Beverages, particularly sugarsweetened beverages, are the primary source of added sugars and contribute to energy overconsumption. A number of studies have shown positive associations of sugar-sweetened beverage consumption with weight gain, obesity, diabetes, hypertension, and cardiovascular diseases. This review presents consumption of diabetic patients, impact of beverage consumption on metabolic and cardiovascular health, and much healthier beverage choices for diabetic patients.

9Information Desk : 생애주기와 당뇨병

저자 : 김준영 ( Jun Young Kim )

발행기관 : 대한당뇨병학회 간행물 : 당뇨병(JKD) 20권 1호 발행 연도 : 2019 페이지 : pp. 53-56 (4 pages)

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Diabetes educators need to understand and intervene in various patient situations to help provide education about effective blood glucose management. Diagnosis of diabetes can be traumatic and challenging. Therefore, diabetes educators should educate patients according to their life cycle characteristics.

10Case Report : 첫 증상으로 흔하지 않은 원인에 의한 양하지 부종을 나타낸 당뇨병 환자 1예

저자 : 백초옥 ( Cho-ok Baek ) , 김기회 ( Ki Hoi Kim ) , 송선경 ( Sun Kyung Song ) , 김지혜 ( Ji Hye Kim )

발행기관 : 대한당뇨병학회 간행물 : 당뇨병(JKD) 20권 1호 발행 연도 : 2019 페이지 : pp. 57-61 (5 pages)

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The present article demonstrates an unusual case of bilateral lower extremity edema caused by neurogenic areflexic bladder as the first physical symptom of diabetes. A 52-year-old man presented to the emergency department because of massive edema of his lower limbs. The edema had been present for 2 weeks, was symmetrical, and was progressively covering the lower limbs up to the inguinal area, scrotal bag, and penis and was accompanied by dysuria and an interrupted urine stream. Laboratory findings revealed a serum glucose level of 657 mg/dL and glycated hemoglobin (HbA1c) level of 15.6%. Computed tomography (CT) of the abdomen and pelvis revealed marked enlargement of the bladder with bilateral hydronephrosis and hydroureter. In addition, CT demonstrated bilateral compression of the iliac veins caused by the enlarged bladder. This case highlights the importance of a broad differential diagnosis for patients with diabetes and extensive peripheral edema. Neurogenic bladder should be considered in the differential diagnosis, even in newly diagnosed diabetic patients.

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