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International Congress of Diabetes and Metabolism update

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수록정보
수록범위 : 2011권0호(2011)~2021권0호(2021) |수록논문 수 : 3,782
International Congress of Diabetes and Metabolism
2021권0호(2021년 10월) 수록논문
최근 권호 논문
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We have been studying the role of cell death and cell death-associated inflammation/immunity in diabetes. Apoptosis of pancreatic β-cells contributes to the development not only of type 1 diabetes (T1D) but also of type 2 diabetes (T2D). In T1D, apoptosis of pancreatic β-cells is the last step in the development of disease. Apoptosis is also important in the initial event of T1D. During pancreas ontogeny, physiological β-cell apoptosis occurs, and such apoptotic β-cells may undergo secondary necrosis in autoimmune-prone mouse strains showing delayed macrophage removal of apoptotic cells. Such late apoptotic β-cells can stimulate antigen-presenting cells through innate immune receptors such as TLR2, which constitute the initial steps in T1D. In contrast to apoptosis, β-cell autophagy usually plays a protective role. β-cell autophagy is important in the maintenance of islet structure, mass and function, and its impairment undermines β-cell adaptation to metabolic stress and leads to β-cell apoptosis in obesity, suggesting that autophagy deficiency is a cause of the progression from obesity to diabetes. β-cell autophagy appears to be more important in human-type diabetes since human-type islet amyloid polypeptide (hIAPP) accumulating in islets of human T2D is amyloidogenic and cleared preferentially by autophagy. Recently, we developed an autophagy enhancer (MSL-7) that can improve metabolic profile of obese mice by enhancing lipid clearance and reducing inflammasome activation associated with mitochondrial dysfunction, in a manner dependent on Tfeb, a master regulator of lysosomal biogenesis and autophagy gene expression. MSL-7 also improved glucose tolerance andβ-cell function of hIAPP-transgenic mice on high-fat diet in vivo, accompanied by reduced islet hIAPP oligomer/amyloid accumulation and β-cell apoptosis. These results suggest that autophagy enhancer could have therapeutic potential against obese diabetes and human diabetes characterized by islet amyloid accumulation.

2S1-3 : Diabetes and COVID-19: Japanese perspectives

저자 : Mitsuru Ohsugi

발행기관 : 대한당뇨병학회 간행물 : International Congress of Diabetes and Metabolism 2021권 0호 발행 연도 : 2021 페이지 : pp. 1-2 (2 pages)

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Japan had experienced early waves of SARS-CoV-2 cases probably due to proximity to the mainland China and in part due to high volume of human flow in early 2020. Since then, although draconian lockdown seen in many other countries had not been implemented in Japan, state of emergency was declared several times by the Japanese government and partly volunteer-based but significant reduction of social and commercial activities was taken, the health care systems in Japan has barely evaded their collapse and waded multiple waves of COVID-19 case surge. Our Medical Center, National Center for Global Health and Medicine, took an initiative to build a nationwide registry of COVID-19 cases, which currently holds more that 50,000 cases. Insights from this registry was significant and in line with other global reports on risk factors for significant mortality and morbidity from COVID-19. In this lecture, two important risk factors for severe outcomes, obesity and hyperglycemia, will be focused and detailed.

3S1-2 : Diabetes and infection and COVID-19

저자 : Andrea Luk

발행기관 : 대한당뇨병학회 간행물 : International Congress of Diabetes and Metabolism 2021권 0호 발행 연도 : 2021 페이지 : pp. 1-1 (1 pages)

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Infection is a known complications of diabetes. In a very early communication by Dr John Lichty in 1915, deaths due to infection were reported in up to one third of people with diabetes. In a series of contemporary epidemiological studies, diabetes has been shown to associate with increased rates of infection of the respiratory tract, genitourinary tract, skin and musculoskeletal system. Most recently, severe complications and deaths from coronavirus 2019 (COVID-19) were reported to occur more frequently in people with diabetes than those without diabetes, matched for demographics and comorbidities.
Despite these strong associations, research in pharmacological and non-pharmacological approaches to prevent serious infections are lacking. From a recent analysis of the Hong Kong Diabetes Surveillance Database covering over 90% of the population with diabetes in Hong Kong, rates of hospitalisation due to influenza increased and hospitalisation due to pneumonia and other infection types were stagnant over a 16-year period from 2001 to 2016. In age-stratified analyses, rising trends for several infection types were detected in the youngest age group whose risk of pneumonia was increased 4-fold, tuberculosis 7-fold and general sepsis 11-fold compared with their age-matched counterparts without diabetes. As of now, pneumonia accounts for over 30% of deaths in Hong Kong adults with diabetes, surpassing cardiovascular disease and cancer. Hence the epidemiology of diabetes complication appears to have turned a full circle, with infection re-emerging once again as an important contributor to morbidities and mortality. These findings call for greater awareness of infection risks in our patients and improved public health measures including support for vaccination for this high-risk group.

4S1-1 : Diabetes and COVID-19: general introduction

저자 : Soo Lim

발행기관 : 대한당뇨병학회 간행물 : International Congress of Diabetes and Metabolism 2021권 0호 발행 연도 : 2021 페이지 : pp. 1-1 (1 pages)

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Initial studies found increased severity of coronavirus disease 2019 (COVID-19), caused by infection with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), in patients with diabetes mellitus. Furthermore, COVID-19 might also predispose infected individuals to hyperglycaemia. Interacting with other risk factors, hyperglycaemia might modulate immune and inflammatory responses, thus predisposing patients to severe COVID-19 and possible lethal outcomes. Angiotensin-converting enzyme 2 (ACE2), which is part of the renin-angiotensin-aldosterone system (RAAS), is the main entry receptor for SARS-CoV-2; although dipeptidyl peptidase 4 (DPP4) might also act as a binding target. Preliminary data, however, do not suggest a notable effect of glucose-lowering DPP4 inhibitors on SARS-CoV-2 susceptibility. Owing to their pharmacological characteristics, sodium-glucose cotransporter 2 (SGLT2) inhibitors might cause adverse effects in patients with COVID-19 and so cannot be recommended. Currently, insulin should be the main approach to the control of acute glycaemia. Most available evidence does not distinguish between the major types of diabetes mellitus and is related to type 2 diabetes mellitus owing to its high prevalence. However, some limited evidence is now available on type 1 diabetes mellitus and COVID-19. Most of these conclusions are preliminary, and further investigation of the optimal management in patients with diabetes mellitus is warranted.

5PL1 : The GDF15-GFRAL pathway in metabolic regulation

저자 : Samuel N Breit

발행기관 : 대한당뇨병학회 간행물 : International Congress of Diabetes and Metabolism 2021권 0호 발행 연도 : 2021 페이지 : pp. 1-1 (1 pages)

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Growth Differentiation Factor-15 (GDF15) is a cytokine of the glial derived neurotrophic factor family, within the TGFb superfamily. It circulates in normal humans at concentrations of about 200-1200pg/ml but these levels can rise markedly in pregnancy or as part of many disease processes. In disease processes, its expression can be induced or increased in many different tissues by cell stress, mediated by transcription factors such as p53, CHOP and ATF4. Common metabolic disorders associated with increased serum levels of GDF15 include obesity, diabetes and mitochondrial diseases. In some chronic diseases like advanced cancer, chronic heart, liver or lung failure serum GDF15 levels can rise markedly. This can lead to an anorexia/ cachexia syndrome, an observation that first identified GDF15 as a previously unrecognised appetite regulator causing anorexia.
Circulating GDF15's major site of action is in small adjacent regions of the brainstem with a semi=permeable blood brain barrier, called the area postrema (AP) and nucleus of the solitary tract (NTS). There it binds to its receptor, a divergent member of the glial cell derived neurotropic factor receptor (GFR) family called GFR alpha like (GFRAL), and signals through its co-receptor Ret. Activation of the GFRAL positive neurons by GDF15 initiates neuronal pathways which lead to reduced food intake, altered metabolism and energy homeostasis by mechanisms that are still only partly understood, but have clear therapeutic application.
A major role of GDF15 thus seems to be to deliver signals of increased cell stress from tissues, via the circulation, to the brain. This then orchestrates a response to try to correct the cell stress and restore homeostasis. Using both human and animal experimental data, this presentation will discuss the biology and mechanisms of actions of GDF15 in regulation of appetite and energy and glucose homeostasis both in health and disease.

6S2-3 : “Low Carb Diet” in diabetes/prediabetes, evidence evaluation on glycemic control

저자 : Jong Han Choi

발행기관 : 대한당뇨병학회 간행물 : International Congress of Diabetes and Metabolism 2021권 0호 발행 연도 : 2021 페이지 : pp. 2-2 (1 pages)

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The clinical practice guidelines for diabetes do not suggest standard carbohydrate, protein, and fat ratios in medical nutrition therapy for diabetic patients but recommend individualization according to the patient characteristics. Simultaneously, they recommend reducing carbohydrate intake to improve glycemic control, according to studies on the weight reduction and glucose-lowering efficacy of a low-carbohydrate diet. However, they also do not recommend specific ratios or amounts of carbohydrates but recommend individualizing it according to the judgment of the attending physician based on the medical history, medications, and eating habits of the patients. It is incredibly challenging to make standardized recommendations, especially in diabetic patients because they have higher risks of harm, such as hypoglycemia, from a low-carb diet than the general population. In the absence of expert recommendations, diabetic patients are uncritically accepting and widely spreading various trendy low-carb diets that have no medical evidence but can be harmful. Accordingly, the new guidelines of the Korean Diabetes Association (KDA) recommend that you avoid following highly trendy diets that have not been verified for medical efficacy and safety, such as extreme low-carbohydrate and high-fat diets. Therefore, the Food and Nutrition Committee of the KDA intends to update the novel medical evidence clarifying the benefits and harms of a low-carb diet in diabetes/prediabetes patients by conducting an extensive literature review and meta-analysis of recent studies on low-carb diets.

7S2-2 : "Intermittent Fasting" in diabetes/prediabetes, evidence evaluation on glycemic control

저자 : Suk Chon

발행기관 : 대한당뇨병학회 간행물 : International Congress of Diabetes and Metabolism 2021권 0호 발행 연도 : 2021 페이지 : pp. 2-2 (1 pages)

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Recently, an intermittent fasting diet has been widely popularized as being helpful for weight loss. However, there is no sufficient evidence for the efficacy and safety of this diet. In particular, evidence on the efficacy and safety of glycemic control in diabetes and pre-diabetes is more unclear. In this lecture, systematic review and meta-analysis results will be introduced and discussed on the effects and safety of intermittent fasting on glycemic control in people with pre-diabetes and diabetes.

8S2-4 : Intermittent fasting and low carbohydrate diet on body weight in overweight/obese adults

저자 : Jee-hyun Kang

발행기관 : 대한당뇨병학회 간행물 : International Congress of Diabetes and Metabolism 2021권 0호 발행 연도 : 2021 페이지 : pp. 2-2 (1 pages)

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Recently, the intermittent fasting and the very low carbohydrate diet for the treatment of obesity have become popular with the public. This review will provide the recent evidence or the efficacy on body weight and the safety of the intermittent fasting and the low carbohydrate diet in overweight and obese adults.

9S3-1 : Glycometabolic control in COVID-19: considerations in the Asian population

저자 : Jae Hyun Bae

발행기관 : 대한당뇨병학회 간행물 : International Congress of Diabetes and Metabolism 2021권 0호 발행 연도 : 2021 페이지 : pp. 2-3 (2 pages)

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Diabetes mellitus (DM) is an established risk factor for severe coronavirus disease 2019 (COVID-19). Potential pathologic links between DM and COVID-19 include altered glucose homeostasis, inflammation, immune dysregulation, and activation of the renin-angiotensin-aldosterone system. The presence of diabetic complications, including atherosclerotic cardiovascular disease, heart failure, and chronic kidney disease, can increase the risk of severe COVID-19 and mortality. On the other hand, COVID-19 may precipitate new-onset hyperglycemia in patients without pre-existing DM. In addition, drugs used to care for COVID-19 patients, such as corticosteroids and anti-viral agents, might contribute to worsening hyperglycemia. Patients with new-onset hyperglycemia had poor clinical outcomes, including a longer hospital stay and more need for oxygen support or ventilation, compared to those with normoglycemia. In some of these patients, hyperglycemia persisted after recovering from COVID-19.Recent studies have shown that hyperglycemia in the diabetic and nondiabetic range is independently associated with the severity of COVID-19. Therefore, appropriate glycemic control and prevention of diabetic complications might be crucial to prevent severe courses of COVID-19. Asia has emerged as an epicenter of the global epidemic of type 2 DM with a rapid rise in obesity, which is a major risk factor for severe COVID-19. Compared to Caucasians, Asians have lower insulin secretory function and different risks and patterns of diabetic complications, requiring more attention to this population during the COVID-19 pandemic. Currently, few recommendations exist for the use of glucose-lowering drugs in COVID-19 patients. Based on available data, insulin and incretin-based therapies can be used safely in patients with DM and COVID-19. Although dapagliflozin was well-tolerated among noncritically ill COVID-19 patients, sodium-glucose cotransporter 2 inhibitors should be avoided in patients at risk of fluid imbalance or ketoacidosis. Further investigation is required to determine optimal glycometabolic control duringthe COVID-19 pandemic, especially in the Asian population.

10S1-4 : Covid-19 vaccine development in Taiwan

저자 : Szu-min Hsieh

발행기관 : 대한당뇨병학회 간행물 : International Congress of Diabetes and Metabolism 2021권 0호 발행 연도 : 2021 페이지 : pp. 2-2 (1 pages)

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In response to the pandemics of human infections due to SARS-CoV-2, many vaccine candidates from several platforms have been developed rapidly under rolling review process and EUA policy. Taiwan also has programs to establish and manufacture the protein-based Covid-19 vaccine to face the threat of pandemics, in addition to purchased adenovirus-vectored vaccines and mRNA vaccines. In this lecture, I will introduce the similarity between our domestic protein-based vaccine (MVC-1901) and Moderna mRNA vaccine, and up-to-date data and publication about the MVC-1901 vaccine.

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