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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~)

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수록범위 : 1권1호(1972)~44권4호(2020) |수록논문 수 : 2,737
Diabetes and Metabolism Journal (DMJ)
44권4호(2020년 08월) 수록논문
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1Sodium-Glucose Cotransporter-2 Inhibitor for Renal Function Preservation in Patients with Type 2 Diabetes Mellitus: A Korean Diabetes Association and Korean Society of Nephrology Consensus Statement

저자 : Tae Jung Oh , Ju-young Moon , Kyu Yeon Hur , Seung Hyun Ko , Hyun Jung Kim , Taehee Kim , Dong Won Lee , Min Kyong Moon

발행기관 : 대한당뇨병학회 간행물 : Diabetes and Metabolism Journal (DMJ) 44권 4호 발행 연도 : 2020 페이지 : pp. 489-501 (13 pages)

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Diabetes is a leading cause of end-stage renal disease. Therefore, prevention of renal dysfunction is an important treatment goal in the management of diabetes. The data of landmark cardiovascular outcome trials of sodium-glucose cotransporter-2 (SGLT2) inhibitor showed profound reno-protective effects. The Korean Diabetes Association and the Korean Society of Nephrology reviewed clinical trials and performed meta-analysis to assess the effects of SGLT2 inhibitors on the preservation of estimated glomerular filtration rate (eGFR). We limited the data of SGLT2 inhibitors which can be prescribed in Korea. Both eGFR value and its change from the baseline were significantly more preserved in the SGLT2 inhibitor treatment group compared to the control group after 156 weeks. However, some known adverse events were increased in SGLT2 inhibitor treatment, such as genital infection, diabetic ketoacidosis, and volume depletion. We recommend the long-term use SGLT2 inhibitor in patients with type 2 diabetes mellitus (T2DM) for attenuation of renal function decline. However, we cannot generalize our recommendation due to lack of long-term clinical trials testing reno-protective effects of every SGLT2 inhibitor in a broad range of patients with T2DM. This recommendation can be revised and updated after publication of several large-scale renal outcome trials.

KCI등재 SCI SCOPUS

2Role of CRTC2 in Metabolic Homeostasis: Key Regulator of Whole-Body Energy Metabolism?

저자 : Hye-sook Han , Yongmin Kwon , Seung-hoi Koo

발행기관 : 대한당뇨병학회 간행물 : Diabetes and Metabolism Journal (DMJ) 44권 4호 발행 연도 : 2020 페이지 : pp. 498-508 (11 pages)

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Cyclic adenosine monophosphate (cAMP) signaling is critical for regulating metabolic homeostasis in mammals. In particular, transcriptional regulation by cAMP response element-binding protein (CREB) and its coactivator, CREB-regulated transcription coactivator (CRTC), is essential for controlling the expression of critical enzymes in the metabolic process, leading to more chronic changes in metabolic flux. Among the CRTC isoforms, CRTC2 is predominantly expressed in peripheral tissues and has been shown to be associated with various metabolic pathways in tissue-specific manners. While initial reports showed the physiological role of CRTC2 in regulating gluconeogenesis in the liver, recent studies have further delineated the role of this transcriptional coactivator in the regulation of glucose and lipid metabolism in various tissues, including the liver, pancreatic islets, endocrine tissues of the small intestines, and adipose tissues. In this review, we discuss recent studies that have utilized knockout mouse models to delineate the role of CRTC2 in the regulation of metabolic homeostasis.

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3Consequences of Obesity on the Sense of Taste: Taste Buds as Treatment Targets?

저자 : Kerstin Rohde , Imke Schamarek , Matthias Blüher

발행기관 : 대한당뇨병학회 간행물 : Diabetes and Metabolism Journal (DMJ) 44권 4호 발행 연도 : 2020 페이지 : pp. 509-528 (20 pages)

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Premature obesity-related mortality is caused by cardiovascular and pulmonary diseases, type 2 diabetes mellitus, physical dis-abilities, osteoarthritis, and certain types of cancer. Obesity is caused by a positive energy balance due to hyper-caloric nutrition, low physical activity, and energy expenditure. Overeating is partially driven by impaired homeostatic feedback of the peripheral energy status in obesity. However, food with its different qualities is a key driver for the reward driven hedonic feeding with tre-mendous consequences on calorie consumption. In addition to visual and olfactory cues, taste buds of the oral cavity process the earliest signals which affect the regulation of food intake, appetite and satiety. Therefore, taste buds may play a crucial role how food related signals are transmitted to the brain, particularly in priming the body for digestion during the cephalic phase. Indeed, obesity development is associated with a significant reduction in taste buds. Impaired taste bud sensitivity may play a causal role in the pathophysiology of obesity in children and adolescents. In addition, genetic variation in taste receptors has been linked to body weight regulation. This review discusses the importance of taste buds as contributing factors in the development of obesity and how obesity may affect the sense of taste, alterations in food preferences and eating behavior.

KCI등재 SCI SCOPUS

4Obesity Degree and Glycemic Status: Factors That Should Be Considered in Heart Failure

저자 : Hye Soon Kim

발행기관 : 대한당뇨병학회 간행물 : Diabetes and Metabolism Journal (DMJ) 44권 4호 발행 연도 : 2020 페이지 : pp. 529-531 (3 pages)

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5Switching to Once-Daily Insulin Degludec/Insulin Aspart from Basal Insulin Improves Postprandial Glycemia in Patients with Type 2 Diabetes Mellitus: Randomized Controlled Trial

저자 : Kyu Yong Cho , Akinobu Nakamura , Chiho Oba-yamamoto , Kazuhisa Tsuchida , Shingo Yanagiya , Naoki Manda , Yoshio Kurihara , Shin Aoki , Tatsuya Atsumi , Hideaki Miyoshi

발행기관 : 대한당뇨병학회 간행물 : Diabetes and Metabolism Journal (DMJ) 44권 4호 발행 연도 : 2020 페이지 : pp. 532-542 (11 pages)

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Background: To explore the efficacy and safety of switching from once-daily basal insulin therapy to once-daily pre-meal injec-tion insulin degludec/insulin aspart (IDegAsp) with respect to the glycemic control of participants with type 2 diabetes mellitus (T2DM).
Methods: In this multicenter, open-label, prospective, randomized, parallel-group comparison trial, participants on basal insulin therapy were switched to IDegAsp (IDegAsp group; n=30) or continued basal insulin (Basal group; n=29). The primary end-point was the superiority of IDegAsp in causing changes in the daily blood glucose profile, especially post-prandial blood glucose concentration after 12 weeks.
Results: Blood glucose concentrations after dinner and before bedtime were lower in the IDegAsp group, and the improvement in blood glucose before bedtime was significantly greater in the IDegAsp group than in the Basal group at 12 weeks (-1.7±3.0 mmol/L vs. 0.3±2.1 mmol/L, P<0.05). Intriguingly, glycemic control after breakfast was not improved by IDegAsp injection before break-fast, in contrast to the favorable effect of injection before dinner on blood glucose after dinner. Glycosylated hemoglobin signifi-cantly decreased only in the IDegAsp group (58 to 55 mmol/mol, P<0.05). Changes in daily insulin dose, body mass, and record-ed adverse effects, including hypoglycemia, were comparable between groups.
Conclusion: IDegAsp was more effective than basal insulin at reducing blood glucose after dinner and before bedtime, but did not increase the incidence of hypoglycemia. Switching from basal insulin to IDegAsp does not increase the burden on the patient and positively impacts glycemic control in patients with T2DM.

KCI등재 SCI SCOPUS

6γ-Linolenic Acid versus α-Lipoic Acid for Treating Painful Diabetic Neuropathy in Adults: A 12-Week, Double-Placebo, Randomized, Noninferiority Trial

저자 : Jong Chul Won , Hyuk-sang Kwon , Seong-su Moon , Sung Wan Chun , Chong Hwa Kim , Ie Byung Park , In Joo Kim , Jihyun Lee , Bong Yun Cha , Tae Sun Park

발행기관 : 대한당뇨병학회 간행물 : Diabetes and Metabolism Journal (DMJ) 44권 4호 발행 연도 : 2020 페이지 : pp. 542-557 (16 pages)

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Background: This study was a multicenter, parallel-group, double-blind, double-dummy, randomized, noninferiority trial to evaluate the efficacy and safety of γ-linolenic acid (GLA) relative to α-lipoic acid (ALA) over a 12-week treatment period in type 2 diabetes mellitus (T2DM) patients with painful diabetic peripheral neuropathy (DPN).
Methods: This study included 100 T2DM patients between 20 and 75 years of age who had painful DPN and received either GLA (320 mg/day) and placebo or ALA (600 mg/day) and placebo for 12 weeks. The primary outcome measures were mean changes in pain intensities as measured by the visual analogue scale (VAS) and the total symptom scores (TSS).
Results: Of the 100 subjects who initially participated in the study, 73 completed the 12-week treatment period. Per-protocol analyses revealed significant decreases in the mean VAS and TSS scores compared to baseline in both groups, but there were no significant differences between the groups. The treatment difference for the VAS (95% confidence interval [CI]) between the two groups was -0.65 (-1.526 to 0.213) and the upper bound of the 95% CI did not exceed the predefined noninferiority margin (δ1=0.51). For the TSS, the treatment difference was -0.05 (-1.211 to 1.101) but the upper bound of the 95% CI crossed the non-inferiority margin (δ2=0.054). There were no serious adverse events associated with the treatments.
Conclusion: GLA treatment in patients with painful DPN was noninferior to ALA in terms of reducing pain intensity measured by the VAS over 12 weeks.

KCI등재 SCI SCOPUS

7Differences in Clinical Outcomes between Patients with and without Hypoglycemia during Hospitalization: A Retrospective Study Using Real-World Evidence

저자 : Jeongmin Lee , Tong Min Kim , Hyunah Kim , Seung-hwan Lee , Jae Hyoung Cho , Hyunyong Lee , Hyeon Woo Yim , Kun-ho Yoon , Hun-sung Kim

발행기관 : 대한당뇨병학회 간행물 : Diabetes and Metabolism Journal (DMJ) 44권 4호 발행 연도 : 2020 페이지 : pp. 555-568 (14 pages)

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Background: Some patients admitted to hospitals for glycemic control experience hypoglycemia despite regular meals and de-spite adhering to standard blood glucose control protocols. Different factors can have a negative impact on blood glucose control and prognosis after discharge. This study investigated risk factors for hypoglycemia and its effects on glycemic control during the hospitalization of patients in the general ward.
Methods: This retrospective study included patients who were admitted between 2009 and 2018. Patients were provided regular meals at fixed times according to ideal body weights during hospitalization. We categorized the patients into two groups: those with and those without hypoglycemia during hospitalization.
Results: Of the 3,031 patients, 379 experienced at least one episode of hypoglycemia during hospitalization (HYPO group). Hy-poglycemia occurred more frequently particularly in cases of premixed insulin therapy. Compared with the control group, the HYPO group was older (61.0±16.8 years vs. 59.1±16.5 years, P=0.035), with more females (60.4% vs. 49.6%, P<0.001), lower body mass index (BMI) (23.5±4.2 kg/m2 vs. 25.1±4.4 kg/m2, P<0.001), and higher prevalence of type 1 diabetes mellitus (6.1% vs. 2.6%, P< 0.001), They had longer hospital stay (11.1±13.5 days vs. 7.6±4.6 days, P<0.001). After discharge the HYPO group had lower glycosylated hemoglobin reduction rate (-2.0%±0.2% vs. -2.5%±0.1%, P=0.003) and tended to have more frequent cases of cardiovascular disease.
Conclusion: Hypoglycemia occurred more frequently in older female patients with lower BMI and was associated with longer hospital stay and poorer glycemic control after discharge. Therefore, clinicians must carefully ensure that patients do not experi-ence hypoglycemia during hospitalization.

KCI등재 SCI SCOPUS

8Therapeutic Effects of Fibroblast Growth Factor-21 on Diabetic Nephropathy and the Possible Mechanism in Type 1 Diabetes Mellitus Mice

저자 : Wenya Weng , Tingwen Ge , Yi Wang , Lulu He , Tinghao Liu , Wanning Wang , Zongyu Zheng , Lechu Yu , Chi Zhang , Xuemian Lu

발행기관 : 대한당뇨병학회 간행물 : Diabetes and Metabolism Journal (DMJ) 44권 4호 발행 연도 : 2020 페이지 : pp. 566-580 (15 pages)

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Background: Fibroblast growth factor 21 (FGF21) has been only reported to prevent type 1 diabetic nephropathy (DN) in the streptozotocin-induced type 1 diabetes mellitus (T1DM) mouse model. However, the FVB (Cg)-Tg (Cryaa-Tag, Ins2-CALM1) 26OVE/PneJ (OVE26) transgenic mouse is a widely recommended mouse model to recapture the most important features of T1DM nephropathy that often occurs in diabetic patients. In addition, most previous studies focused on exploring the preventive effect of FGF21 on the development of DN. However, in clinic, development of therapeutic strategy has much more realistic value compared with preventive strategy since the onset time of DN is difficult to be accurately predicted. Therefore, in the present study OVE26 mice were used to investigate the potential therapeutic effects of FGF21 on DN.
Methods: Four-month-old female OVE26 mice were intraperitoneally treated with recombinant FGF21 at a dose of 100 μg/kg/day for 3 months. The diabetic and non-diabetic control mice were treated with phosphate-buffered saline at the same volume. Renal functions, pathological changes, inflammation, apoptosis, oxidative stress and fibrosis were examined in mice of all groups.
Results: The results showed that severe renal dysfunction, morphological changes, inflammation, apoptosis, and fibrosis were ob-served in OVE26 mice. However, all the renal abnormalities above in OVE26 mice were significantly attenuated by 3-month FGF21 treatment associated with improvement of renal adenosine 5´-monophosphate (AMP)-activated protein kinase (AMPK) activity and sirtuin 1 (SIRT1) expression.
Conclusion: Therefore, this study demonstrated that FGF21 might exert therapeutic effects on DN through AMPK-SIRT1 pathway.

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9Inhibition of Ceramide Accumulation in Podocytes by Myriocin Prevents Diabetic Nephropathy

저자 : Chang-yun Woo , Ji Yeon Baek , Ah-ram Kim , Chung Hwan Hong , Ji Eun Yoon , Hyoun Sik Kim , Hyun Ju Yoo , Tae-sik Park , Ranjan Kc , Ki-up Lee , Eun Hee Koh

발행기관 : 대한당뇨병학회 간행물 : Diabetes and Metabolism Journal (DMJ) 44권 4호 발행 연도 : 2020 페이지 : pp. 581-591 (11 pages)

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Background: Ceramides are associated with metabolic complications including diabetic nephropathy in patients with diabetes. Recent studies have reported that podocytes play a pivotal role in the progression of diabetic nephropathy. Also, mitochondrial dysfunction is known to be an early event in podocyte injury. Thus, we tested the hypothesis that ceramide accumulation in podo-cytes induces mitochondrial damage through reactive oxygen species (ROS) production in patients with diabetic nephropathy.
Methods: We used Otsuka Long Evans Tokushima Fatty (OLETF) rats and high-fat diet (HFD)-fed mice. We fed the animals ei-ther a control- or a myriocin-containing diet to evaluate the effects of the ceramide. Also, we assessed the effects of ceramide on intracellular ROS generation and on podocyte autophagy in cultured podocytes.
Results: OLETF rats and HFD-fed mice showed albuminuria, histologic features of diabetic nephropathy, and podocyte injury, whereas myriocin treatment effectively treated these abnormalities. Cultured podocytes exposed to agents predicted to be risk factors (high glucose, high free fatty acid, and angiotensin II in combination [GFA]) showed an increase in ceramide accumula-tion and ROS generation in podocyte mitochondria. Pretreatment with myriocin reversed GFA-induced mitochondrial ROS generation and prevented cell death. Myriocin-pretreated cells were protected from GFA-induced disruption of mitochondrial integrity.
Conclusion: We showed that mitochondrial ceramide accumulation may result in podocyte damage through ROS production. Therefore, this signaling pathway could become a pharmacological target to abate the development of diabetic kidney disease.

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10Associations among Obesity Degree, Glycemic Status, and Risk of Heart Failure in 9,720,220 Korean Adults

저자 : Eun-jung Rhee , Hyemi Kwon , Se Eun Park , Kyung-do Han , Yong-gyu Park , Yang-hyun Kim , Won-young Lee

발행기관 : 대한당뇨병학회 간행물 : Diabetes and Metabolism Journal (DMJ) 44권 4호 발행 연도 : 2020 페이지 : pp. 592-605 (14 pages)

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Background: Recent studies suggest an association between diabetes and increased risk of heart failure (HF). However, the asso-ciations among obesity status, glycemic status, and risk of HF are not known. In this study, we analyzed whether the risk of HF in-creases in participants according to baseline glycemic status and whether this increased risk is associated with obesity status.
Methods: We analyzed the risk of HF according to baseline glycemic status (normoglycemia, impaired fasting glucose [IFG], and diabetes) in 9,720,220 Koreans who underwent Korean National Health Screening in 2009 without HF at baseline with a median follow-up period of 6.3 years. The participants were divided into five and six groups according to baseline body mass index (BMI) and waist circumference, respectively.
Results: Participants with IFG and those with diabetes showed a 1.08- and 1.86-fold increased risk of HF, respectively, compared to normoglycemic participants. Compared to the normal weight group (BMI, 18.5 to 22.9 kg/m2), the underweight group (BMI <18.5 kg/m2) showed a 1.7-fold increased risk of HF, and those with BMI ≥30 kg/m2 showed a 1.1-fold increased risk of HF, sug-gesting a J-shaped association with BMI. When similar analyses were performed for different glycemic statuses, the J-shaped as-sociation between BMI and HF risk was consistently observed in both groups with and without diabetes.
Conclusion: Participants with IFG and diabetes showed a significantly increased HF risk compared to normoglycemic partici-pants. This increased risk of HF was mostly prominent in underweight and class II obese participants than in participants with normal weight.

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