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당뇨병(JKD) update

The Journal of Korean Diabetes

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수록범위 : 1권1호(2000)~19권1호(2018) |수록논문 수 : 857
당뇨병(JKD)
19권1호(2018년 03월) 수록논문
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1시론 : 한국적 선샤인 액트(K-Sunshine Act): 경제적 이익 제공 내역에 관한 지출보고서 제출

저자 : 이일권 ( Ilkweon Lee )

발행기관 : 대한당뇨병학회 간행물 : 당뇨병(JKD) 19권 1호 발행 연도 : 2018 페이지 : pp. 1-6 (6 pages)

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(1) A drug provider shall prepare an expense report on economic interests, etc. to be provided to pharmacists, oriental medicine pharmacists, medical personnel, medical institution founders, or persons working for a medical institution, within three months after the termination of each fiscal year, as prescribed by Ordinance of the Ministry of Health and Wealth, and shall retain the relevant expense report, books related thereto, and base data for five years. (2) Where deemed necessary, the Minister of Health and Wealth may request the submission of the expense report, books related thereto, and base data under paragraph (1). In such cases, a drug provider shall comply therewith without justifiable grounds.

2Statement : 당뇨병 환자에게 적절한 목표 혈압

저자 : 강태수 ( Tae Soo Kang ) , 박성하 ( Sungha Park )

발행기관 : 대한당뇨병학회 간행물 : 당뇨병(JKD) 19권 1호 발행 연도 : 2018 페이지 : pp. 7-14 (8 pages)

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The recently published 2017 American College of Cardiology (ACC)/American Heart Association (AHA)/ American Academy of Physician Assistants/Association of Black Cardiologists/American College of Preventive Medicine/American Geriatrics Society/American Pharmacists Association/American Society of Hypertension (ASH)/American Society for Preventive Cardiology/National Medical Association/ Preventive Cardiovascular Nurses Association (2017 ACC/AHA/ASH guideline for short) lowered the threshold for diagnosis of hypertension from 140/90 mm Hg to 130/80 mm Hg. Also, the revised guideline recommends pharmacological treatment for all hypertensive patients with either previous cardiovascular disease or 10-year atherosclerotic cardiovascular disease (ASCVD) risk greater than 10%. Since most diabetic hypertensive patients have ASCVD risk greater than 10%, the guideline recommends that all diabetics with blood pressure (BP) above 130/80 mm Hg be treated both pharmacologically and with active lifestyle modification. Although the evidence suggests that intensive lowering of BP may be beneficial in diabetic patients, there is lack of evidence that pharmacologic treatment in subjects with baseline BP below 140 mm Hg is beneficial, with some studies suggesting actual potential for harm. Also, there are data to suggest a potential risk of increased risk of cardiovascular events and mortality in subjects whose diastolic BP (DBP) was lowered to below 60 mm Hg. As such, strict BP lowering may be beneficial if the target BP could be achieved without side effects such as orthostatic hypotension and decreased renal function. Also, lowering of DBP below 60 mm Hg should be avoided. Lastly, treatment should be started in subjects with baseline BP above 140/90 mm Hg until further evidence suggests otherwise.

3특집 : 제2형 당뇨병 환자의 약제치료 개정안 2017: 경구혈당강하제 단일요법

저자 : 이상열 ( Sang Youl Rhee )

발행기관 : 대한당뇨병학회 간행물 : 당뇨병(JKD) 19권 1호 발행 연도 : 2018 페이지 : pp. 15-22 (8 pages)

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When starting initial medication in people with type 2 diabetes mellitus (T2DM), the appropriate drug should be selected considering characteristics of the patient, efficacy, side effects, and cost. It is generally recommended to use metformin as the first-line treatment oral hypoglycemic agent in T2DM patients. Metformin is recommended as the first treatment because of its excellent glucose lowering effect, relatively mild side effects, long-term safety, low risk of hypoglycemia, and small weight gain. If it is difficult to use metformin as a first-line treatment, appropriate drugs can be selected based on the clinical situation.

4특집 : 제2형 당뇨병의 경구혈당강하제 병합요법

저자 : 문민경 ( Min Kyong Moon )

발행기관 : 대한당뇨병학회 간행물 : 당뇨병(JKD) 19권 1호 발행 연도 : 2018 페이지 : pp. 23-30 (8 pages)

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The Korean Diabetes Association (KDA) recently updated the Clinical Practice Guidelines on antihyperglycemic agent therapy for adult patients with type 2 diabetes mellitus (T2DM). In combination therapy of oral hypoglycemic agents (OHAs), general recommendations were not changed compared to those of 2015 KDA guidelines. The committee of Clinical Practice Guideline of KDA has extensively reviewed and discussed the results of meta-analyses and systematic reviews of the effectiveness and safety of OHAs and many clinical trials on Korean patients with T2DM for the update of guidelines. All OHAs were effective when added to metformin or metformin and sulfonylurea, although the effects of each agent on body weight and hypoglycemia were different. Therefore, selection of a second agent as a metformin add-on therapy or a third agent as a metformin and sulfonylurea add-on therapy should be based on the patient's clinical characteristics and the efficacy, side effects, cardiovascular benefit, risk of hypoglycemia, effect on body weight, patient preference, and combined comorbidity.

5특집 : 2017년 대한당뇨병학회 권고안: 인슐린

저자 : 이병완 ( Byung-wan Lee )

발행기관 : 대한당뇨병학회 간행물 : 당뇨병(JKD) 19권 1호 발행 연도 : 2018 페이지 : pp. 31-34 (4 pages)

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Since 1990, the Korean Diabetes Association has published Clinical Practice Recommendations, which include the “Standards of Medical Care in Diabetes.” The position statement of the Korean Diabetes Association on diabetes care and management has been recognized as one of the primary references for medical care in diabetes. This English version published in 2017 will be a good reference for daily clinical practice of diabetes care. In this paper, I provide an executive summary of insulin therapy for adult patients with type 2 diabetes in Korea.

6특집 : 제2형 당뇨병 약제치료 지침 2017 개정안: Glucagon-Like Peptide-1 수용체작용제

저자 : 김현진 ( Hyun Jin Kim )

발행기관 : 대한당뇨병학회 간행물 : 당뇨병(JKD) 19권 1호 발행 연도 : 2018 페이지 : pp. 35-40 (6 pages)

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Glucagon-like peptide-1 receptor agonists (GLP-1RAs) were recommended as a monotherapy or combination therapy with oral hypoglycemic agents or basal insulin in the position statement of the Korean Diabetes Association 2017 for pharmacological therapy, which was a change from the previous guideline that recommended them only as a combination therapy. Many randomized clinical trials and systematic reviews report that GLP-1RAs have considerable glucose-lowering effect and lead to weight reduction and low risk of hypoglycemia when used as a monotherapy or combination therapy. The results of cardiovascular outcome trials of long-acting GLP-1RAs (liraglutide, semaglutide) have demonstrated cardiovascular benefits in subjects with type 2 diabetes mellitus and a high risk of cardiovascular disease. The GLP-1RAs may be a choice of therapy when weight control and avoidance of hypoglycemia are important, and patients with high risk of cardiovascular disease might also favor choosing GLP-1RA.

7당뇨병 교육을 위한 정보광장 : 당뇨병 환자를 위한 발 관리

저자 : 차혜정 ( Hye Jung Cha )

발행기관 : 대한당뇨병학회 간행물 : 당뇨병(JKD) 19권 1호 발행 연도 : 2018 페이지 : pp. 41-45 (5 pages)

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The incidence of diabetes is increasing not only in Korea, but also globally. Diabetes mellitus is a disease with problematic complications. Diabetic foot is a typical complication that reduces the quality of life and is a burden on the economy. Active foot examination and foot care education are methods to prevent diabetic foot at a minimum cost. Early detection, treatment, and education are the primary responsibilities of healthcare providers.

8당뇨병 교육을 위한 정보광장 : 당뇨병 교육자를 위한 올바른 건강기능식품에 대한 이해

저자 : 이혜옥 ( Hye Ok Lee )

발행기관 : 대한당뇨병학회 간행물 : 당뇨병(JKD) 19권 1호 발행 연도 : 2018 페이지 : pp. 46-52 (7 pages)

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Recently, increasing interest in health care is boosting demand for products such as immuno-enhanced products and vitamins. There is a large selection of health functional foods for use by diabetics. Diabetic patients may learn about health functional foods from people around them, internet, and TV. Therefore, diabetic educators need to impart a good understanding of health functional foods so patients do not use them indiscriminately. It is important for diabetic educators to specifically ask patients about the use of healthy functional foods in their consultations. In addition, diabetic educators should provide knowledge on the efficacy of health functional foods and the desirable information.

9당뇨병 교육을 위한 정보광장 : 당뇨병, 직업복귀 그리고 건강증진행동의 권리

저자 : 박유정 ( Yu Jeong Park )

발행기관 : 대한당뇨병학회 간행물 : 당뇨병(JKD) 19권 1호 발행 연도 : 2018 페이지 : pp. 53-57 (5 pages)

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Diabetes sufferers in their 30s to 50s are at an age must maintain their income-producing activities while also managing their health; however, maintaining this balance is not always easy due to their disease. Patients in their 30s to 50s who are actively engaged in work life may not experience workplace difficulties when their diagnosis is known and can be addressed with health-promoting behaviors or passive management. Patients have limitations in implementing the active self-management required by the educational scene in-house. The reason is because the working environment in Korea has not yet established a proper perception of diabetes and feels that allowing diabetes to manage diseases against fairness. The educators proudly reveal themselves as diabetes and cannot take into consideration or take responsibility the disadvantages they can experience when returning to work, we must consider what the patient “has to do to get back to work.” In addition, patients should think about how to manage their disease effectively through more than just a passive response. Moreover the Korean Diabetes Association should establish guidelines for the areas that need to be protected legally and on the defensive aspects that need to be better perceived.

10원저 : 혈당강하제로 치료받는 제2형 노인 당뇨병 환자의 대사조절지표에 대한 목표달성률

저자 : 심강희 ( Kang Hee Shim ) , 황문숙 ( Moon Sook Hwang ) , 박정은 ( Jeong Eun Park ) , 정진희 (

발행기관 : 대한당뇨병학회 간행물 : 당뇨병(JKD) 19권 1호 발행 연도 : 2018 페이지 : pp. 58-70 (13 pages)

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Background: This study aimed to investigate the goal attainment rates for hemoglobin A1c (HbA1c), blood pressure (BP), and low-density lipoprotein cholesterol (LDL-C) in elderly patients with type 2 diabetes. Methods: The subjects were 762 over 65 years old patients with type 2 diabetes taking a hypoglycemic agent. Data were collected by reviewing medical records and included general characteristics, biochemical tests, prescribed pharmacologic agents, and complications. Results: The goal attainment rates (mean value) for HbA1c, BP, and LDL-C were 50.4% (7.3% ± 1.2%), 78.9% (126.0 ± 15.1/72.1 ± 10.0 mm Hg), and 60.6% (88.6 ± 29.9 mg/dL). Diabetes-related complications for retinopathy, nephropathy, neuropathy, and cardio-cerebral vascular disease were 36.3%, 37.2%, 23.6%, and 31.9%, respectively. Life habit-related variables positively associated with goal attainment were not drinking alcohol and exercise for HbA1c, not smoking for BP and not drinking alcohol for LDL-C. Metabolic adjustment indicator-related significant variables for complications were HbA1c in retinopathy, BP in nephropathy, and LDL-C in cardio-cerebral disease. Conclusion: We found that goal attainment rates for parameters of metabolic adjustment were not high in elderly patients with type 2 diabetes. Thus, diabetes educators should be concerned about metabolic adjustment indicators. Also, case management guidelines according to elderly patient health and functional status should be developed to help manage metabolic adjustment.

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