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당뇨병(JKD) update

The Journal of Korean Diabetes

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

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당뇨병(JKD)
21권2호(2020년 06월) 수록논문
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1당뇨병과 바이러스 질환

저자 : 김성민 ( Sungmin Kim )

발행기관 : 대한당뇨병학회 간행물 : 당뇨병(JKD) 21권 2호 발행 연도 : 2020 페이지 : pp. 55-58 (4 pages)

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Patients with diabetes are more susceptible to viral diseases, which are more likely to progress to severe cases in such patients. Diabetes and hyperglycemia have been reported to be major risk factors and poor prognostic factors for 2019 flu, severe acute respiratory syndrome (SARS), Middle East respiratory syndrome (MERS), and the currently ongoing coronavirus disease-2019 (COVID-19). However, it is not clear yet whether diabetes itself leads to higher risk and becomes a poor prognostic factor for viral diseases or if the real main factors are actually cardiovascular and renal complications that often accompany diabetes. On the other hand, viral diseases have frequently been suggested to be one cause or a contributing factor to develop diabetes. Two typical examples are the association between enteroviruses such as Coxsackie B virus and type 1 diabetes and the relationship between hepatitis C virus and type 2 diabetes. Recently, there has been research on the potentiality of changes in the intestinal microflora being a cause for diabetes, and there is evidence to suggest that intestinal virome affects intestinal microbiota. There has also been a claim that extracellular vesicles secreted by gut microbiota, rather than the microbiota itself, get absorbed into the body and come to cause diabetes.

2당뇨병과 생체리듬

저자 : 김진화 ( Jin Hwa Kim )

발행기관 : 대한당뇨병학회 간행물 : 당뇨병(JKD) 21권 2호 발행 연도 : 2020 페이지 : pp. 59-63 (5 pages)

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All organisms on earth are governed by time-based biological rhythms. These biological rhythms are maintained by an endogenous circadian clock, which consists of the central clock in the suprachiasmatic nucleus of the hypothalamus and peripheral clocks. This clock sets its own program and builds networks for circadian timekeeping. The circadian clock regulates the cellular, physiological, and metabolic systems to synchronize biological cycles with environmental cycles. The flow of life in modern society is too complex and irregular to fit every endogenous circadian clock. Recently, the impact of circadian misalignment on health issues including diabetes, obesity, cardiovascular disease, and cancer, has attracted growing interest. Several studies suggest circadian rhythm of the association with glucose homeostasis. The understanding for circadian rhythm in glucose metabolism can present an opportunity for diabetes preventive strategies and improving glycemic control for people with diabetes.

3임신 중 포도당 대사의 변화

저자 : 구보경 ( Bo Kyung Koo )

발행기관 : 대한당뇨병학회 간행물 : 당뇨병(JKD) 21권 2호 발행 연도 : 2020 페이지 : pp. 64-68 (5 pages)

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Insulin resistance increases from conception into late pregnancy in women with normal glucose tolerance as well as women with gestational diabetes. Increasing insulin resistance during pregnancy permits adequate supply of glucose from the maternal side to the fetus. Understanding normal physiologic changes in glucose metabolism would help understand the pathophysiology of gestational diabetes mellitus.

4임신성 당뇨병의 진단 및 혈당 조절

저자 : 오태정 ( Tae Jung Oh ) , 장학철 ( Hak Chul Jang )

발행기관 : 대한당뇨병학회 간행물 : 당뇨병(JKD) 21권 2호 발행 연도 : 2020 페이지 : pp. 69-74 (6 pages)

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Gestational diabetes mellitus (GDM) is a major medical complication of pregnancy, and it is related with poor perinatal outcomes and long-term risk of type 2 diabetes. Therefore, adequate diagnosis and treatment are essential to improve pregnancy outcome. Both one-step, 75-g oral glucose tolerance test (OGTT) and two-step, 50- and 100-g OGTTs can be used for diagnosing GDM. The cut-off points of 100-g OGTT are used for the criteria of Carpenter-Coustan. The incidence of GDM can be increased about 2 to 3 times using the one-step method compared to the two-step approach. The mainstay of treatment is composed of life-style management, including exercise and medical nutritional therapy, and insulin therapy. Considering the Korean health-care system, oral hypoglycemic agents cannot be the firstline choice, and intensification of insulin treatment depends on patient self-monitoring of blood glucose. Furthermore, all treatments should be tailored to patient condition.

5임신성 당뇨병의 심혈관계 위험도

저자 : 김경수 ( Kyung-soo Kim )

발행기관 : 대한당뇨병학회 간행물 : 당뇨병(JKD) 21권 2호 발행 연도 : 2020 페이지 : pp. 75-80 (6 pages)

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Gestational diabetes mellitus (GDM) not only increases perinatal complications, but also increases lifetime risk of type 2 diabetes. Recently, many studies have shown that women with GDM also have an increased risk of cardiovascular disease (CVD). The risk of preeclampsia, hypertension, dyslipidemia, metabolic syndrome, atherosclerosis, and CVDs were elevated in women with GDM compared with in those without GDM. Although it was not confirmed whether the management of GDM could reduce the development of CVDs, it is important to identify and manage CVDs in women with GDM.

6임신성 당뇨병 자녀의 장기 예후

저자 : 성원준 ( Won Joon Seong )

발행기관 : 대한당뇨병학회 간행물 : 당뇨병(JKD) 21권 2호 발행 연도 : 2020 페이지 : pp. 81-87 (7 pages)

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The hyperglycemia and adverse pregnancy outcomes (HAPO) study demonstrated a linear increase in the risk of adverse pregnancy outcomes with increasing maternal glycemia that can be less severe than overt diabetes and is often untreated. Recently, HAPO follow-up studies were published on longterm consequences on children of gestational diabetes mellitus (GDM) gravidas. Two articles examined the association of untreated maternal glycemia with markers of glucose metabolism in a total of 4,160 ethnically diverse children 10~14 years of age. Children of mothers with GDM had higher prevalence of impaired glucose tolerance (IGT). Moreover, there were strong positive associations between maternal continuous and categorical glycemia status and child's 75-g glucose tolerance test, A1C, IGT, and impaired fasting glucose. Another two articles evaluated the risk of childhood adiposity of 4,832 children born from mothers with GDM. GDM was associated with childhood adiposity as evaluated by multiple methods. Additionally, maternal glucose level across a continuum was associated with childhood obesity, percentage body fat, and sum of skinfolds > 85th percentile after adjustment for maternal body mass index. These findings could have implications for glucose targets in mothers with GDM and indicate that even mild hyperglycemia can affect adversely glucose metabolism and obesity in the children of mothers with GDM.

71형 당뇨병 환자 재택의료 시범사업과 교육상담

저자 : 신은총 ( Eun Chong Shin )

발행기관 : 대한당뇨병학회 간행물 : 당뇨병(JKD) 21권 2호 발행 연도 : 2020 페이지 : pp. 88-92 (5 pages)

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Type 1 diabetes mellitus (T1DM) is an autoimmune disease that absolutely lacks insulin production. It requires lifelong care, including proper diet and exercise, along with insulin administration. It is important for these patients to visit hospitals regularly to identify their health conditions. It is also necessary to know and understand not only the test results but the lifestyle outside the hospital. The Ministry of Health and Welfare has set up a system to properly manage diseases at medical institutions and homes for T1DM patients. It was intended to provide economic, physical and psychological support by educating and managing diabetics. The home care team includes doctors, nurses and clinical nutritionists. The home care project is designed to periodically check patients' health conditions and blood glucose levels through phone calls and cross-text messages even in case of face-to-face education and non-face-to-face situations. It is also meaningful to maintain the health of patients and reduce complications to prevent unnecessary medical spending. In response, the home care team should improve the educational and counseling environment, develop educational materials, and apply measures to utilize non-face-to-face communication.

8임신성 당뇨병에서의 영양 관리

저자 : 최진선 ( Jin Sun Choi )

발행기관 : 대한당뇨병학회 간행물 : 당뇨병(JKD) 21권 2호 발행 연도 : 2020 페이지 : pp. 93-97 (5 pages)

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Maintaining blood glucose levels within recommended targets during pregnancy is associated with improved maternal and fetal outcomes. Optimal gestational nutrition care is required for maintenance of normoglycemia, appropriate gestational weight gain and prevention of ketosis. Energy intake is not different from pregnant women without diabetes and an optimal eating plan for gestational diabetes has not been not developed. Because carbohydrates affect blood glucose levels, especially postprandial levels, it is important to monitor the quantity and quality of carbohydrate intake in women with gestational diabetes. Macronutrient and micronutrient planning must be considered. After childbirth, postpartum care is important to women with gestational diabetes mellitus. To decrease the risk of type 2 diabetes, metabolic syndrome and hypertension, weight control and breastfeeding is recommended to women with gestational diabetes mellitus.

9임신성 당뇨병 산모의 가족 유형과 올바른 가족의 태도

저자 : 최지민 ( Ji Min Choi )

발행기관 : 대한당뇨병학회 간행물 : 당뇨병(JKD) 21권 2호 발행 연도 : 2020 페이지 : pp. 98-103 (6 pages)

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What this social worker learned from more than a decade of training and counseling on anxiety, depression, and stress factors felt by pregnant women diagnosed with diabetes was that diabetes itself had a large impact on families as well, so the impact of diabetes could be classified as a “family disease,” whether positive or negative. While training at the site (hospital), most of the time, rather than receiving direct questions from mothers or their families, social workers were told about the difficulties that mothers reported, which included that many people wanted to educate their families about their disease. In fact, most mothers who participated in education had big and small difficulties in these areas. Therefore, we learned that effective diabetes management requires active family cooperation and that positive interactions between pregnant women and their families are necessary.

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