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당뇨병(JKD) update

The Journal of Korean Diabetes

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  • : 임상 당뇨병(~2010)→ 당뇨병(JKD)(2011~)

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수록범위 : 1권1호(2000)~20권3호(2019) |수록논문 수 : 914
당뇨병(JKD)
20권3호(2019년 09월) 수록논문
최근 권호 논문
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1시론 : Sodium-Glucose Cotransporter 2 Inhibitor의 안전성: 임상에서 고려해야 할 점

저자 : 임수 ( Soo Lim )

발행기관 : 대한당뇨병학회 간행물 : 당뇨병(JKD) 20권 3호 발행 연도 : 2019 페이지 : pp. 127-135 (9 pages)

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Diabetes mellitus (DM) is linked to poor outcomes after cardiovascular events and renal complications. Recently, novel antidiabetic agents, such as dipeptidyl peptidase-4 inhibitors, sodium-glucose cotransporter 2 (SGLT2) inhibitors, and glucagon-like peptide-1 receptor agonists, are available. Among them, studies on SGLT2 inhibitors show favorable results both for cardiovascular and renal outcomes. SGLT2 inhibitors are well-tolerated with few side effects. Urinary tract infection has not been increased in many studies of SGLT2 inhibitors. The most frequent side-effect associated with SGLT2 inhibitors is mycotic infections in the genital area. Fortunately, these are generally mild in severity and easily treated with antibiotics. Hypoglycemia can occur when an SGLT2 inhibitor is added to sulfonylureas or insulin. Volume depletion and hypotension can be minimized by adjusting diuretics or other antihypertensive agents. Of note, acute kidney injury was observed in a few studies with SGLT2 inhibitors. However, in more recent observational studies, acute kidney injury was less frequently observed in conjunction with SGLT2 inhibitor treatment. An increased incidence of lower extremity amputation and fractures was observed in a large study with canagliflozin but not with other SGLT2 inhibitors. In conclusion, it is critical to understand the benefits and risks associated with use of SGLT2 inhibitors.

2Statement : 비만대사 수술과 제2형 당뇨병

저자 : 김진화 ( Jin Hwa Kim )

발행기관 : 대한당뇨병학회 간행물 : 당뇨병(JKD) 20권 3호 발행 연도 : 2019 페이지 : pp. 136-141 (6 pages)

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When type 2 diabetes and obesity occur together, disease burden is increased and this is an important public health concern due to the deleterious effects. Despite continuing advances in pharmacological approaches to diabetes, diabetes still remains a chronic, progressive, and irreversible disease. Recently, bariatric surgery, initially developed to treat severe obesity, has attracted growing interest for its beneficial effects on improvement in glucose outcomes and type 2 diabetes remission. Several studies suggest considering this surgery as metabolic surgery because it leads to improvement in obesity-related metabolic comorbidities. The Diabetes Surgery Summit recently recommended inclusion of bariatric surgery among glucose-lowering interventions for type 2 diabetes and obesity. Bariatric surgery can be considered as one effective treatment option and may present an appropriate opportunity to improve prognosis in selected people with type 2 diabetes.

3특집 : 제2형 당뇨병 환자의 경구약물요법

저자 : 고승현 ( Seung-hyun Ko )

발행기관 : 대한당뇨병학회 간행물 : 당뇨병(JKD) 20권 3호 발행 연도 : 2019 페이지 : pp. 142-148 (7 pages)

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For patients with newly diagnosed type 2 diabetes mellitus (T2DM), lifestyle modifications including medical nutrition therapy, weight control, physical activity, smoking cessation, and avoidance of alcohol abuse should be initiated. Metformin must be considered as the first-line oral glucose-lowering therapy, but other drugs such as dipeptidyl peptidase 4 (DPP-4) inhibitors, sodium-glucose cotransporter 2 (SGLT-2) inhibitors, thiazolidinediones, glucagon-like peptide 1 receptor agonists, sulfonylureas, glinides, α-glucosidase inhibitors, and insulin can be considered based on patient circumstances. If the initial HbA1c level of a patient is ≥ 7.5% or the HbA1c target is not achieved within three months of initiating monotherapy, dual combination therapy can be considered. If the HbA1c target is not achieved within 3 months of initiating dual therapy, a third agent with a complementary mechanism of action can be added for triple combination therapy. In addition, evidence from large clinical studies assessing cardiovascular outcomes following the use of SGLT-2 inhibitors in T2DM patients with cardiovascular risk factors have been incorporated into the updated recommendations.

4특집 : 당뇨병 주사제: Glucagon-Like Peptide-1 수용체작용제

저자 : 이인국 ( Inkuk Lee ) , 강은석 ( Eun Seok Kang )

발행기관 : 대한당뇨병학회 간행물 : 당뇨병(JKD) 20권 3호 발행 연도 : 2019 페이지 : pp. 149-156 (8 pages)

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According to the American Diabetes Association (ADA) and the European Association for the Study of Diabetes guideline for treatment of diabetes, glucagon-like peptide-1 receptor agonist (GLP- 1 RA) is recommended in diabetic patients with established atherosclerotic cardiovascular disease. This recommendation is based on the results of recent cardiovascular outcome trials of this kind of medications. GLP-1 RAs have a glucose lowering effect with weight loss and a lower incidence of hypoglycemia, and can improve cardiovascular outcomes such as three-point major cardiovascular events composed of death from cardiovascular causes, non-fatal myocardial infarction, and non-fatal stroke. Also, several GLP-1 RAs have beneficial effects on renal outcomes, mainly due to improvement in macroalbuminuria. In addition, high-dose liraglutide (3 mg/day subcutaneous injection) showed efficacy for reducing body weight. Therefore GLP-1 RA may be effective in patients with established cardiovascular disease, chronic kidney disease, and/or metabolic syndrome.

5특집 : 당뇨병 환자의 위험인자 관리

저자 : 김상용 ( Sang Yong Kim )

발행기관 : 대한당뇨병학회 간행물 : 당뇨병(JKD) 20권 3호 발행 연도 : 2019 페이지 : pp. 157-169 (13 pages)

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Diabetes mellitus is associated with a high frequency of complications related to cardiovascular disease as well as microvascular complications such as nephropathy, retinopathy, and neuropathy. Prevention of these vascular complications is the main issue for diabetic patients. Hyperglycemia, hypertension, and dyslipidemia are well-known risk factors for complications in diabetic patients. Moreover, these chronic conditions are often seen in many diabetic patients. So, multifactorial interventions are needed to manage these risk factors and prevent diabetic complications. However, there is still a debate about the optimal level required for glycemic control, the appropriate blood pressure target, and dyslipidemia management. Although many countries have written their own guidelines, there are some discrepancies between these different guidelines. Recently, the Korean Diabetic Association issued new guidelines for Korean diabetic patients. Here, I will introduce these new guidelines and discuss the optimal management of risk factors such as hyperglycemia, hypertension, and dyslipidemia in diabetic patients.

6특집 : 당뇨병 환자의 포괄적 관리

저자 : 김수경 ( Soo-kyung Kim )

발행기관 : 대한당뇨병학회 간행물 : 당뇨병(JKD) 20권 3호 발행 연도 : 2019 페이지 : pp. 170-175 (6 pages)

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Management of patients with diabetes mellitus should not be restricted to the treatment of hyperglycemia and diabetic complications. An integrated comprehensive approach is needed for successful management, which should include lifestyle changes, risk control, medications, early detection and treatment of complications, assessment of associated comorbidities, and self-management education and support. And these efforts should be made periodically and repeatedly after the first visit. The Korean Diabetes Association introduced the concept of comprehensive management for the first time in 2019 when it revised the Treatment Guidelines for Diabetes. Currently, it's limited mainly to assessment and cannot be applied in Korea as it is. However, the level of diabetes management in Korea will be further improved when understanding and applying the concept of comprehensive management for diabetes in any form.

7당뇨병 교육을 위한 정보광장 : 당뇨병성 신증 환자의 자가관리

저자 : 신윤정 ( Uoon Jeong Shin )

발행기관 : 대한당뇨병학회 간행물 : 당뇨병(JKD) 20권 3호 발행 연도 : 2019 페이지 : pp. 176-180 (5 pages)

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Early intervention in patients with diabetes may slow the progression of kidney disease, and early recognition of renal impairment is critical to achieving optimal patient outcomes. Annual screening for the presence of albuminuria in diabetic patients is necessary to prevent diabetic neuropathy. Selection of the appropriate medication to control blood glucose and blood pressure is also important. In addition, however, patients should be willing to manage themselves to overcome diabetic kidney disease through lifestyle changes such as diet, smoking, and weight management, and restrictions on private therapies.

8당뇨병 교육을 위한 정보광장 : 임상영양요법(Medical Nutrition Therapy)에서의 당뇨병 자가관리를 위한 코칭

저자 : 조재원 ( Jae Won Cho )

발행기관 : 대한당뇨병학회 간행물 : 당뇨병(JKD) 20권 3호 발행 연도 : 2019 페이지 : pp. 181-189 (9 pages)

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From the early stage of diabetes diagnosis, it may necessary to modify lifestyle including nutrition and physical activity. Self-management instruction and support can result in healthy eating habits for effective blood sugar management. Clinical nutritionists must conduct accurate nutritional assessments for successful dietary change and patient health. They must also diagnose and prioritize the nutritional problems to be addressed. Through medical nutrition therapy, nutritionists must instruct and encourage patient self-management skills based on evidence-based nutritional guidelines and education about viable strategies. For this purpose, educators should strive continuously to acquire knowledge and professional training.

9당뇨병 교육을 위한 정보광장 : 노인 당뇨병 환자의 자가관리를 위한 돌봄 Tips

저자 : 유빈 ( Been Yoo )

발행기관 : 대한당뇨병학회 간행물 : 당뇨병(JKD) 20권 3호 발행 연도 : 2019 페이지 : pp. 190-193 (4 pages)

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With the increase in the elderly population, the number of elderly diabetics is also increasing rapidly. To educate older people with diabetes, we need to understand their characteristics and those of their main caregiver, establish careful and individualized treatment goals, and provide concrete and practical education. Diabetes educators should provide comprehensive geriatric assessment, personalized diabetes education through psychosocial assessment, practical guidance, family education, self-management skills for elderly diabetic patients and caregivers. Diabetes educators should keep in mind to consider elderly diabetic patients can support family or social resources to continue self-management.

10원저 : 2030 당뇨병 캠프 프로그램이 당뇨병 환자의 우울, 불안 및 스트레스에 대한 개선 효과 분석

저자 : 정진희 ( Jin Hee Jung ) , 이정화 ( Jung Hwa Lee ) , 캠프위원회 ( Camp Committee )

발행기관 : 대한당뇨병학회 간행물 : 당뇨병(JKD) 20권 3호 발행 연도 : 2019 페이지 : pp. 194-204 (11 pages)

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Background: The purpose of this study was to evaluate the effects of the 2030 Diabetes Camp program on depression, anxiety, and stress among diabetic patients.
Methods: This study enrolled diabetic patients who participated in the 16th 2030 Diabetes Camp program sponsored by the Korean Diabetes Association on January 18~19, 2014. Depression was measured using the Beck depression inventory scale. Anxiety was measured using Spielberger's state anxiety scale and stress was measured using the Problem Areas in Diabetes-Korea (PAID-K) scale.
Results: There was a total of 29 subjects, 13 male subjects (44.8%) and 16 female subjects (55.2%). The mean age was 29.9 ± 9.7 years. Twenty patients (69.0%) had type 1 diabetes mellitus, mean illness duration was 7.5 ± 6.5 years, and mean HbA1c was 8.3% ± 1.8%. Depression score was significantly reduced from 15.7 ± 10.3 before the camp program to 12.6 ± 10.5 after the camp program (P = 0.005). The degree of anxiety decreased significantly from 46.8 ± 10.9 before the start of the camp program to 37.8 ± 9.6 after the start of the camp program (P < 0.001). Stress level was also decreased significantly from 42.4 ± 15.9 points to 37.9 ± 15.5 points before and after the camp program, respectively (P = 0.023).
Conclusion: The degree of depression was high in diabetic patients, and this diabetic camp program was effective in reducing depression, anxiety, and stress in diabetic patients.

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