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"Diabetes Mellitus"

Original Article

Single point insulin sensitivity estimator index is associated with predominance of atherogenic small, dense low-density lipoprotein cholesterol particles in Korean obese adults: a retrospective study
Jihoon Eor, Yaeji Lee, Yea-Chan Lee, Yu-Jin Kwon, Ji-Won Lee
Received August 23, 2024  Accepted November 10, 2024  Published online February 20, 2025  
DOI: https://doi.org/10.4082/kjfm.24.0202    [Epub ahead of print]
Background
Insulin resistance (IR) influences lipid metabolism, particularly small dense low-density lipoprotein cholesterol (sdLDL-C), a key feature of diabetic dyslipidemia and a predictor of cardiovascular disease. The single-point insulin sensitivity estimator (SPISE) index is an effective tool for assessing IR. This study explored the relationship between the SPISE index and average low-density lipoprotein cholesterol (LDL-C) particle size in obese Korean adults.
Methods
Cardiovascular risk was assessed in 161 obese individuals. The participants were divided into three groups based on SPISE index tertiles. Steiger’s Z test was used to assess the differences in correlation coefficients among various IR indices and average LDL-C particle size. Multivariate linear regression models were used to determine the independent association between the SPISE index and average LDL-C particle size. Receiver operating characteristic (ROC) curves established the SPISE index cut-off for sdLDL-C particle dominance.
Results
The SPISE index was positively correlated with mean LDL-C particle size after adjusting for confounders. It demonstrated a stronger independent association with average LDL-C particle size (r=0.679, P<0.001) than with fasting insulin, the homeostatic model assessment for IR, and the quantitative insulin sensitivity check index (P<0.001 for all). ROC analysis identified an optimal SPISE index cutoff for sdLDL-C predominance of 4.955, with an area under the curve of 0.745.
Conclusion
Our findings indicate a direct correlation between the SPISE index and average LDL-C particle size, suggesting that the SPISE index may complement labor-intensive IR indices and sdLDL-C measurement techniques for estimating IR-induced sdLDL-C predominance.
  • 383 View
  • 15 Download

Review Articles

Rethinking about Metformin: Promising Potentials
Kyunam Kim
Korean J Fam Med 2024;45(5):258-267.   Published online August 23, 2024
DOI: https://doi.org/10.4082/kjfm.24.0156
Metformin is widely used drugs in the treatment of type 2 diabetes mellitus. However, the mechanisms of action are complex and are still not fully understood yet. Metformin has a dose-dependent blood sugar-lowering effect. The most common adverse reactions of metformin are gastrointestinal symptoms, and women tend to be more experienced than men. A positive correlation between the administration of duration and the daily dose of metformin and the risk of vitamin B12 deficiency is confirmed. Novel glucose-lowering mechanism through the activation of AMP-activated protein kinase and alteration of gut microbiota composition is identified. In addition, metformin has immunomodulatory properties in various mechanisms, including anti-inflammatory actions, and so forth. Metformin improves insulin sensitivity, which may reduce the risk of tumor growth in certain cancers. The antiviral effects of metformin may occur through several mechanisms, including blocking angiotensin converting enzyme 2 receptor, and so forth. These potential mechanisms of metformin are promising in various clinical settings, such as inflammatory diseases, autoimmune diseases, cancer, and coronavirus disease 2019.

Citations

Citations to this article as recorded by  
  • USING BIOPELLETS WITH METFORMIN IN THE EXPERIMENTAL METABOLIC SYNDROME
    N. I. Voloshchuk, V. G. Zolotareva, A. V. Hara, O. S. Pashynska, I. V. Taran, A. V. Melnyk, V. O. Denysiuk
    World of Medicine and Biology.2024; 20(89): 220.     CrossRef
  • Metformin in Antiviral Therapy: Evidence and Perspectives
    Iryna Halabitska, Pavlo Petakh, Oleh Lushchak, Iryna Kamyshna, Valentyn Oksenych, Oleksandr Kamyshnyi
    Viruses.2024; 16(12): 1938.     CrossRef
  • 2,581 View
  • 112 Download
  • 2 Web of Science
  • 2 Crossref
Metformin is the most widely used antihyperglycemic drug in patients with type 2 diabetes (T2D). Over the past 2 decades, several studies have highlighted a substantial increase in the risk of vitamin B12 deficiency in patients with T2D on metformin therapy. This can lead to several complications and induce or exacerbate peripheral neuropathy. Despite these data, there are no definite guidelines for screening, diagnosing, and treating vitamin B12 deficiency in patients with T2D on metformin therapy. Therefore, in this narrative review, we aimed to suggest a practical diagnostic and therapeutic strategy to address vitamin B12 deficiency in patients with T2D receiving metformin treatment. Clinical evidence supporting an increased risk of vitamin B12 deficiency in patients with T2D on metformin therapy and its risk factors and potential complications are also discussed.

Citations

Citations to this article as recorded by  
  • Rethinking about Metformin: Promising Potentials
    Kyunam Kim
    Korean Journal of Family Medicine.2024; 45(5): 258.     CrossRef
  • Prevalence of Vitamin B12 Deficiency in Patients With Type 2 Diabetes Mellitus on Metformin Therapy: A Cross-Sectional Study
    Shoaib Asghar, Haider Tanvir, Asad Riaz, Muhammad Hamza Ejaz, Mamuna Akram, Al Muktadir Chowdhury Evan, Salman Shahid
    Cureus.2024;[Epub]     CrossRef
  • 2,639 View
  • 97 Download
  • 1 Web of Science
  • 2 Crossref

Case Report

A Case of Acute Neurologic Deficit and Hypoglycemia in the Setting of Thyroid Storm and Diabetic Ketoacidosis: A New Clinical Scenario
Alena Aleksashina, Svetlana Rachina, Gayrat Kiyakbaev, Girindu Hewathanthirige, Yulia Cherdantseva
Korean J Fam Med 2024;45(1):51-55.   Published online January 20, 2024
DOI: https://doi.org/10.4082/kjfm.23.0230
The simultaneous development of diabetic ketoacidosis (DKA) and thyroid storm (TS) is a rare but potentially lifethreatening condition that requires immediate and targeted treatment. However, their combined diagnosis poses a serious challenge because of the similarities between their clinical manifestations. To date, only a few dozen cases have been described; most of which have been linked to the progression of thyrotoxicosis or uncontrolled hyperglycemia as contributing factors. We present the case of a 37-year-old woman with type 1 diabetes mellitus and Graves’ disease who presented with both TS and DKA. She was initially admitted to the emergency department as a suspected case of stroke. Severe hypoglycemia significantly lowered her alertness to TS and probably provoked a sharp hyperthyroid decompensation, thereby leading to subsequent DKA development.
  • 2,753 View
  • 52 Download

Original Article

Fruits and the Risk of Type 2 Diabetes: The Korean Genome and Epidemiology Study Cohort
Hojun Yu, Cheol Min Lee, Seung-Won Oh
Korean J Fam Med 2024;45(1):44-50.   Published online November 23, 2023
DOI: https://doi.org/10.4082/kjfm.23.0201
Background
To determine the association between type 2 diabetes mellitus and the consumption of various fruits.
Methods
The Korean Genome And Epidemiology Study is an ongoing prospective longitudinal cohort study of community dwellers and participants (men and women, aged 40–69 years) recruited from the national health examinee registry of Korea. Their individual consumption habits for 12 different fruit types were recorded using food frequency questionnaires. The fruits were then divided into three groups according to their glycemic indexes and glycemic loads. Participants with extreme caloric intakes, pre-existing type 2 diabetes mellitus, chronic kidney diseases, chronic liver diseases, and ongoing cancer treatments were excluded. The incidence of type 2 diabetes in the cohort was identified through self-reporting and supplemented by glycated hemoglobin and fasting blood glucose levels.
Results
A total of 2,549 cases of type 2 diabetes were documented during 283,033.8 person-years of follow-up. After adjusting for personal, lifestyle, and dietary risk factors for diabetes, the pooled hazard ratio of type 2 diabetes for every serving per week of total whole fruit consumption was 1.02 (95% confidence interval [CI], 0.99–1.06; P=0.2). With mutual adjustment of individual fruits, the pooled hazard ratios of type 2 diabetes for every serving per week were 0.94 (95% CI, 0.88–1.00; P=0.039) for bananas, and 0.90 (95% CI, 0.84–0.96; P<0.001) for grapes.
Conclusion
Our findings suggest associations between the consumption of certain fruits and the risk of developing type 2 diabetes. A greater consumption of grapes was significantly associated with a lower risk of type 2 diabetes in our cohort, but the total amount of fruit consumption was not associated with a reduced risk.

Citations

Citations to this article as recorded by  
  • Guidelines for nutrition counseling in primary healthcare clinics
    Gyeongsil Lee, Seung-Won Oh
    Journal of the Korean Medical Association.2024; 67(4): 278.     CrossRef
  • 3,627 View
  • 101 Download
  • 1 Web of Science
  • 1 Crossref

Review Articles

Family Involvement to Stop the Conversion of Prediabetes to Diabetes
Denny Anggoro Prakoso, Yodi Mahendradhata, Wahyudi Istiono
Korean J Fam Med 2023;44(6):303-310.   Published online August 14, 2023
DOI: https://doi.org/10.4082/kjfm.23.0019
Prediabetes is a condition associated with an increased risk of developing diabetes, in which blood glucose levels are high but not high enough to be diagnosed as diabetes. The rapid increase in the prevalence of prediabetes is a major global health challenge. The incidence of prediabetes has increased to pandemic levels and can lead to serious consequences. Unfortunately, nearly 90% of prediabetic individuals are unaware of their ailment. A quarter of prediabetic individuals develop type 2 diabetes mellitus (T2DM) within 3–5 years. Although prediabetes is a reversible condition, the prevention of diabetes has received little attention. It is essential for prediabetic individuals to implement new health-improvement techniques. Focusing on family systems is one strategy to promote health, which is determined by health patterns that are often taught, established, and adjusted within family contexts. For disease prevention, a family-based approach may be beneficial. Family support is essential for the metabolic control of the disease. This study aimed to show several strategies for involving the patient’s family members in preventing the conversion of prediabetes to T2DM and to emphasize that the patient’s family members are a valuable resource to reduce the incidence of diabetes.

Citations

Citations to this article as recorded by  
  • Assessment of burden of prediabetes and diabetes with oral glucose tolerance test in community-based settings of Bengaluru rural district
    Gokul Sarveswaran, Vaitheeswaran Kulothungan, Sukanya Rangamani, Deepadarshan Huliyappa, Pruthvish Sreekantaiah
    Journal of Family Medicine and Primary Care.2024; 13(9): 3806.     CrossRef
  • 6,275 View
  • 129 Download
  • 1 Web of Science
  • 1 Crossref
Diabetes Prevention and Measures to Ensuring a Healthy Lifestyle during COVID-19 Pandemic and after
Israel Oluwasegun Ayenigbara
Korean J Fam Med 2023;44(1):11-20.   Published online January 19, 2023
DOI: https://doi.org/10.4082/kjfm.21.0216
The incidence of diabetes mellitus (DM) is increasing exponentially globally, with 90% of the confirmed cases being type 2 DM. The global incidence of DM is expected to increase by 48% during 2017–2045. The coronavirus disease 2019 (COVID-19) pandemic continues to have a massive impact on human health, causing sudden lifestyle changes through quarantine measures, such as lockdown, social distancing, various curfews, and isolation at home. This in turn might increase the risk of developing numerous chronic diseases, such as DM, obesity, and cardiovascular diseases, which increase the severity of COVID-19. To this end, we performed a comprehensive review to determine viable measures for the prevention of DM and its subsequent upsurge globally. Additionally, we have determined strategies that should be adopted globally to ensure a healthy lifestyle during the COVID-19 pandemic and later.

Citations

Citations to this article as recorded by  
  • Enhancement of Virtues: Key to a Healthy Lifestyle against Chronic Diseases and Future Health Crisis
    Dalmacito A. Cordero Jr.
    Korean Journal of Family Medicine.2023; 44(4): 244.     CrossRef
  • 3,116 View
  • 76 Download
  • 1 Web of Science
  • 1 Crossref

Original Articles

Dietary Changes Leading to Euglycemic Diabetic Ketoacidosis in Sodium-Glucose Cotransporter-2 Inhibitor Users: A Challenge for Primary Care Physicians?
Manoj Kumar Reddy Somagutta, Utkarsha Uday, Nishat Shama, Narayana Reddy Bathula, Siva Pendyala, Ashwini Mahadevaiah, Greta Mahmutaj, Ngaba Negumadji Ngardig
Korean J Fam Med 2022;43(6):361-366.   Published online November 20, 2022
DOI: https://doi.org/10.4082/kjfm.22.0003
Background
The use of euglycemic diabetic ketoacidosis (EDKA) related to sodium-glucose cotransporter 2 inhibitors (SGLT2i) use in people with diabetes has been increasingly reported. The causes are multifactorial, and dietary changes in SGLT2i users were observed to trigger EDKA. A ketogenic diet or very low-carbohydrate diet (VLCD) enhances body ketosis by breaking down fats into energy sources, causing EDKA. This study aimed to understand the patient specific risk factors and clinical characteristics of this cohort.
Methods
Several databases were carefully analyzed to understand the patients’ symptoms, clinical profile, laboratory results, and safety of dietary changes in SGLT2i’s. Thirteen case reports identifying 14 patients on a ketogenic diet and SGLT2i’s diagnosed with EDKA were reviewed.
Results
Of the 14 patients, 12 (85%) presented with type-2 diabetes mellitus (DM) and 2 (15%) presented with type-1 DM. The duration of treatment with SGLT2i before the onset of EDKA varies from 1 to 365 days. The duration of consuming a ketogenic diet or VLCD before EDKA onset varies from 1 to 90 days, with over 90% of patients hospitalized <4 weeks after starting the diet. At presentation, average blood glucose was 167.50±41.80 mg/dL, pH 7.10±0.10, HCO3 8.1±3.0 mmol/L, potassium 4.2±1.1 mEq/L, anion-gap 23.6±3.5 mmol/L, and the average hemoglobin A1c was 10%±2.4%. The length of hospital stay ranged from 1 to 15 days. None of the patients were reinitiated on SGLT2i’s, and 50% (2/4) of the patients reported were on the ketogenic diet or VLCD upon patient questioning.
Conclusion
Despite the popularity of the ketogenic diet and VLCD for weight loss, their use in diabetics taking SGLT2i’s is associated with EDKA. Physicians should educate patients with diabetes taking SGLT2i’s about the risk of EDKA. In addition, patients should be encouraged to include their physicians in any decision related to significant changes in diet or exercise routines. Further research is needed to address if SGLT2i’s should be permanently discontinued in patients with diabetes on SGLT2i and whether the ketogenic diet developed EDKA.

Citations

Citations to this article as recorded by  
  • A Single Arm Pilot Observational Study to Evaluate the Safety and Feasibility of a Pre‐Operative Very Low Calorie Diet in Severely Obese Patients With Endometrial Cancer
    Chloe Ayres, Hanna Burbidge, Jayna Garratt, Ganendra Raj Mohan, Yee Leung, Stephanie Jeffares, Sanela Bilic, Paul A. Cohen
    Cancer Reports.2025;[Epub]     CrossRef
  • From Sweet to Sour: SGLT-2-Inhibitor-Induced Euglycemic Diabetic Ketoacidosis
    Andrijana Koceva, Nika Aleksandra Kravos Tramšek
    Journal of Personalized Medicine.2024; 14(7): 665.     CrossRef
  • 3,209 View
  • 87 Download
  • 2 Web of Science
  • 2 Crossref
Background
This study aimed to evaluate the association between the duration of workplace noise exposure and glucose metabolism status in a nationally representative Korean sample.
Methods
This cross-sectional study included 3,534 participants aged ≥40 years without tinnitus or hearing loss from the Korea National Health and Nutrition Examination Survey (2018). The primary exposure was noise in the workplace and its duration. We divided the noise exposure group into four groups according to the duration of noise exposure (<3 years, 3–10 years, 10–20 years, and ≥20 years). The primary outcomes were fasting blood sugar (FBS), hemoglobin A1c (HbA1c), and pre-diabetes and diabetes diagnosed using FBS. Logistic and linear regression analyses were used to test the association between noise exposure and glycemic status.
Results
After adjustment, HbA1c levels were significantly higher in the noise exposure than in the non-noise exposure group. HbA1c levels were significantly higher in those exposed to occupational noise for more than 20 years than in others. In the subgroup analysis among those who had been exposed to noise for >20 years, the non-aerobic physical activity group had significantly higher HbA1c levels than the physical activity group. Furthermore, among those who had been exposed to noise for >20 years, the without hearing protection group had significantly higher HbA1c levels than those using hearing protection.
Conclusion
The association between noise exposure and the prevalence of diabetes is unclear. However, our study clearly suggests that there is a relationship between elevated HbA1c levels and workplace noise exposure and that a long period of workplace noise exposure, no physical activity, and not wearing a hearing protection device could increase the risk of diabetes.

Citations

Citations to this article as recorded by  
  • Noise - an insidious stressor affecting xenobiotic metabolism?
    Rosemary Waring, Stephen Mitchell
    Xenobiotica.2025; 55(1): 1.     CrossRef
  • Dysregulations of metabolites and gut microbes and their associations in rats with noise induced hearing loss
    Ningning Li, Xiuzhi Zhang, Yanan Cui, Hui Wu, Yue Yu, Shanfa Yu
    Frontiers in Microbiology.2023;[Epub]     CrossRef
  • 3,129 View
  • 94 Download
  • 2 Web of Science
  • 2 Crossref
Background
In addition to its antidiabetic effects, metformin has pleiotropic effects, such as the inhibition of carcinogenesis. This study aimed to investigate the association between metformin use and pancreatic cancer risk in the Korean National Health Insurance Service (NHIS)-National Health Screening Cohort (HEALS).
Methods
Of the individuals in the Korean NHIS-HEALS, 29,271 men and 19,091 women were included in the final analysis after propensity score matching based on age, body mass index, and smoking status. The study population was categorized into three groups: metformin non-users with diabetes mellitus (DM), metformin users with DM, and non-diabetic users. A Cox proportional hazards regression model was used to examine the association between metformin use and pancreatic cancer.
Results
The median follow-up period was 12.9 years. The estimated pancreatic cancer incidence was highest in metformin users with DM, regardless of sex (P<0.001), and lowest in non-diabetic men and female metformin non-users (P=0.053). The hazard ratios (95% confidence interval) for pancreatic cancer incidence in metformin users and non-diabetic individuals were 1.116 (0.648–1.923) and 0.447 (0.259–0.771) in men and 2.769 (1.003–7.642) and 1.451 (0.529–3.984) in women, respectively, after full adjustment.
Conclusion
Women with diabetes using metformin are at a higher risk of pancreatic cancer than women with diabetes not using metformin. Meanwhile, men with DM using metformin have a similar risk of pancreatic cancer as men with DM not using metformin.

Citations

Citations to this article as recorded by  
  • Metformin adverse event profile: a pharmacovigilance study based on the FDA Adverse Event Reporting System (FAERS) from 2004 to 2022
    Yikuan Du, Jinfeng Zhu, Zhuoming Guo, Zhenjie Wang, Yuni Wang, Mianda Hu, Lingzhi Zhang, Yurong Yang, Jinjin Wang, Yixing Huang, Peiying Huang, Mianhai Chen, Bo Chen, Chun Yang
    Expert Review of Clinical Pharmacology.2024; 17(2): 189.     CrossRef
  • Metformin: A Dual-Role Player in Cancer Treatment and Prevention
    Mariam Ahmed Galal, Mohammed Al-Rimawi, Abdurrahman Hajeer, Huda Dahman, Samhar Alouch, Ahmad Aljada
    International Journal of Molecular Sciences.2024; 25(7): 4083.     CrossRef
  • Anti-Diabetic Therapies and Cancer: From Bench to Bedside
    Dimitris Kounatidis, Natalia G. Vallianou, Irene Karampela, Eleni Rebelos, Marina Kouveletsou, Vasileios Dalopoulos, Petros Koufopoulos, Evanthia Diakoumopoulou, Nikolaos Tentolouris, Maria Dalamaga
    Biomolecules.2024; 14(11): 1479.     CrossRef
  • Exploring the Basic Molecular Pathways: Metformin as a Potential Treatment Option for Pancreatic Cancer
    Sepehr Ramezani, Dariush Moslemi, Faezeh Firuzpour, Hamidreza Didar, Seyedamirmohammad Mazloumi, Narjes rezaeiroushan
    Iranian Journal of Blood and Cancer.2024; 16(4): 56.     CrossRef
  • Diabetes Mellitus in Pancreatic Cancer: A Distinct Approach to Older Subjects with New-Onset Diabetes Mellitus
    Jan Bures, Darina Kohoutova, Jan Skrha, Bohus Bunganic, Ondrej Ngo, Stepan Suchanek, Pavel Skrha, Miroslav Zavoral
    Cancers.2023; 15(14): 3669.     CrossRef
  • 4,062 View
  • 94 Download
  • 4 Web of Science
  • 5 Crossref

Review Article

Fruit Intake to Prevent and Control Hypertension and Diabetes
Hyun Ah Park
Korean J Fam Med 2021;42(1):9-16.   Published online January 20, 2021
DOI: https://doi.org/10.4082/kjfm.20.0225
Fruits are considered healthy because of their high antioxidant, vitamin, mineral, fiber, and phytochemical contents. However, their high sugar content is a concern for glucose, lipid, and uric acid metabolism. We reviewed related articles published in the last 10 years and summarized evidence that relates fruit intake to the prevention and control of hypertension and diabetes mellitus. Clinicians should familiarize themselves with appropriate fruit intake to counsel at-risk patients on hypertension and diabetes.

Citations

Citations to this article as recorded by  
  • Associations between the Global Diet Quality Score and risk of type 2 diabetes: Tehran lipid and glucose study
    Shahrzad Daei, Firoozeh Hosseini-Esfahani, Azam Ildarabadi, Parvin Mirmiran, Fereidoun Azizi, Meisam Akhlaghdoust
    PLOS ONE.2025; 20(1): e0313886.     CrossRef
  • Is breakfast consumption detrimental, unnecessary, or an opportunity for health promotion? A review of cardiometabolic outcomes and functional food choices
    Heitor O. Santos, Grant M. Tinsley
    Diabetes/Metabolism Research and Reviews.2024;[Epub]     CrossRef
  • Undiagnosed hypertension and associated factors among adult population in central zone of Tigray, Northern Ethiopia 2020: A cross‐sectional study
    Haftea Hagos Mekonen, Tsegu Hailu Gebru, Kbrom Gemechu Kiros, Tesfay Gebreslassie Gebrehiwot, Yohannes Ashebir Tesfamichael
    Health Science Reports.2024;[Epub]     CrossRef
  • Drug-related problems among type 2 diabetic patients in Sunwal Municipality of Western Nepal
    Sushma Chapagain, Nabin Pathak, Kushal Subedi, Prakash Ghimire, Bijay Adhikari, Niranjan Shrestha, Nim Bahadur Dangi, Naeem Mubarak
    PLOS ONE.2024; 19(11): e0309781.     CrossRef
  • The Diet Quality of Athletes as Measured by Diet Quality Indices: A Scoping Review
    Stella Dion, Gabriel Walker, Kelly Lambert, Anita Stefoska-Needham, Joel C. Craddock
    Nutrients.2024; 17(1): 89.     CrossRef
  • Ultrasound-assisted extraction and characteristics of maize polysaccharides from different sites
    Zongyan Song, Xiong Xiong, Gangliang Huang
    Ultrasonics Sonochemistry.2023; 95: 106416.     CrossRef
  • Prevalence and Factors Associated with Prehypertension and Hypertension Among Adults: Baseline Findings of PURE Malaysia Cohort Study
    Rosnah Ismail, Noor Hassim Ismail, Zaleha Md Isa, Azmi Mohd Tamil, Mohd Hasni Ja'afar, Nafiza Mat Nasir, Suraya Abdul-Razak, Najihah Zainol Abidin, Nurul Hafiza Ab Razak, Philip Joseph, Khairul Hazdi Yusof
    American Journal of Medicine Open.2023; 10: 100049.     CrossRef
  • Effects of fresh vs dried mango consumption on satiety and postprandial glucose in healthy adults
    Candice Stamper, Sama Safadi, Andrew Gehr, Pia Asuncion, Mee Young Hong
    Metabolism Open.2023; 19: 100253.     CrossRef
  • Revisiting Fruit Allergy: Prevalence across the Globe, Diagnosis, and Current Management
    Thanachit Krikeerati, Pongsawat Rodsaward, Jutamard Nawiboonwong, Kanokkarn Pinyopornpanish, Songwut Phusawang, Mongkhon Sompornrattanaphan
    Foods.2023; 12(22): 4083.     CrossRef
  • The effect of dietary patterns on mild cognitive impairment and dementia incidence among community-dwelling older adults
    Nurul Fatin Malek Rivan, Suzana Shahar, Nik Nur Izzati Nik Mohd Fakhruddin, Yee Xing You, Normah Che Din, Roslee Rajikan
    Frontiers in Nutrition.2022;[Epub]     CrossRef
  • Current status of health promotion in Korea
    Soo Young Kim
    Journal of the Korean Medical Association.2022; 65(12): 776.     CrossRef
  • Current status of nutrient intake in Korea: focused on macronutrients
    Seung-Won Oh
    Journal of the Korean Medical Association.2022; 65(12): 801.     CrossRef
  • Role of Indian Fruits in the Prevention and Management of Hypertension
    Pankaj Prabhakar
    Journal of the Practice of Cardiovascular Sciences.2022; 8(3): 135.     CrossRef
  • Caregiver Perceptions of Child Diet Quality: What Influenced Their Judgment
    Lijing Shao, Yan Ren, Yanming Li, Mei Yang, Bing Xiang, Liping Hao, Xuefeng Yang, Jing Zeng
    Nutrients.2021; 14(1): 125.     CrossRef
  • 8,726 View
  • 204 Download
  • 14 Web of Science
  • 14 Crossref

Original Articles

The Association between Serum Uric Acid and Peripheral Neuropathy in Patients with Type 2 Diabetes Mellitus: A Multicenter Nationwide CrossSectional Study
Wisit Kaewput, Charat Thongprayoon, Ram Rangsin, Sarawut Jindarat, Ploypun Narindrarangkura, Tarun Bathini, Michael A. Mao, Wisit Cheungpasitporn
Korean J Fam Med 2020;41(3):189-194.   Published online May 20, 2020
DOI: https://doi.org/10.4082/kjfm.18.0205
Background
The role of uric acid in the development of diabetic peripheral neuropathy remains unclear. This study aimed to determine the association between uric acid and peripheral neuropathy among type 2 diabetes mellitus (T2DM) patients.
Methods
We conducted a nationwide cross-sectional study based on the diabetes and hypertension study of the Medical Research Network of the Consortium of Thai Medical Schools. Adult T2DM patients from 831 public hospitals in Thailand were evaluated. The serum uric acid level was categorized into five groups based on quintiles (<4.4, 4.4–5.3, 5.3–6.2, 6.2–7.3, and >7.3 mg/dL). A multivariate logistic regression model was used to assess the independent association between serum uric acid level and peripheral neuropathy.
Results
In total, 7,511 T2DM patients with available data about serum uric acid levels were included in the analysis. The mean age of the participants was 61.7±10.9 years, and approximately 35.6% were men. The prevalence rate of peripheral neuropathy was 3.0%. Moreover, the prevalence rates of peripheral neuropathy stratified according to uric acid levels <4.4, 4.4–5.3, 5.3–6.2, 6.2–7.3, and >7.3 mg/dL were 2.5%, 2.8%, 2.4%, 2.5%, and 4.7%, respectively. A serum uric acid level ≥7.3 mg/dL was found to be associated with an increase in odds ratio (1.54; 95% confidence interval, 1.02–2.32) for peripheral neuropathy compared with a serum uric acid level <4.4 mg/dL.
Conclusion
Serum uric acid level is independently associated with peripheral neuropathy in T2DM patients, and elevated serum uric acid levels should be considered a risk factor for diabetic peripheral neuropathy in clinical practice.

Citations

Citations to this article as recorded by  
  • Uric acid in diabetic microvascular complications: Mechanisms and therapy
    Xin Li, Bo Huang, Yue Liu, Meng Wang, Jing-Qiu Cui
    Journal of Diabetes and its Complications.2025; 39(2): 108929.     CrossRef
  • Causality between serum uric acid and diabetic microvascular complications - a mendelian randomization study
    Hongli Wu, Xuefeng Li, Wenning Zhang, Huifang Peng, Hongwei Jiang
    Diabetology & Metabolic Syndrome.2024;[Epub]     CrossRef
  • Association between serum uric acid levels and diabetic peripheral neuropathy in type 2 diabetes: a systematic review and meta-analysis
    Xieyu Zhang, Xinwen Zhang, Xiaoxu Li, Xin Zhao, Guangcheng Wei, Jinjie Shi, Yue Yang, Su Fan, Jiahe Zhao, Ke Zhu, Jieyang Du, Junyi Guo, Wei Cao
    Frontiers in Endocrinology.2024;[Epub]     CrossRef
  • Comparison of Serum Uric Acid-to-HDL Ratio and Triglyceride Glucose Index in Relation to Glycemic Control Among Patients with Type 2 Diabetes Mellitus
    Hafiza Farah Masood, Qurratul Ain, Hifza Noor Lodhi, Bilal Rafique Malik, Faheem Usman Sulehri, . Khushbakht, Mirza Zeeshan Sikandar, Sharoona Fatima
    Pakistan Journal of Health Sciences.2024; : 130.     CrossRef
  • Serum uric acid and diabetic peripheral neuropathy: a double-edged sword
    Yong Zhuang, Huibin Huang, Xin Hu, Jinying Zhang, Qingyan Cai
    Acta Neurologica Belgica.2023; 123(3): 857.     CrossRef
  • The Ratio of Serum Uric Acid to Glycosylated Haemoglobin as a Predictor of All-Mortality in Elderly Patients with Diabetic Foot Ulcers: A Longitudinal Cohort Study
    Xiuxian Huang, Licai Deng, Jianhao Huang, Jingxia Sun, Qiu Wang, Jiacheng Mo, Zhenwei Zhai, Yuechou Nong, Wensheng Lu
    Diabetes, Metabolic Syndrome and Obesity.2023; Volume 16: 2779.     CrossRef
  • Uric acid and diabetes mellitus: an update
    Shailendra K Singh, Rina Singh, Santosh K Singh, Mir A Iquebal, Sarika Jaiswal, Pradeep K Rai
    Postgraduate Medical Journal.2023; 99(1178): 1220.     CrossRef
  • Serum uric acid and risk of diabetic neuropathy: a genetic correlation and mendelian randomization study
    Youqian Zhang, Zitian Tang, Ling Tong, Yang Wang, Lin Li
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Influence of Facial Flushing on Pre- or Type 2 Diabetes Risk according to Alcohol Consumption in Korean Male
Jihan Kim, Jong Sung Kim, Sung-Soo Kim, Jin-Gyu Jung, Seok-Jun Yoon, Yu-Ri Seo, Sami Lee, Yoon-Kyung Bae, Won-Jin Lee
Korean J Fam Med 2020;41(3):153-160.   Published online May 20, 2020
DOI: https://doi.org/10.4082/kjfm.18.0120
Background
This study aims to examine the association between alcohol consumption and the risk of pre- or type 2 diabetes mellitus (T2DM) by alcohol-induced flushing response in Korean male adults, particularly based on their body mass index (BMI).
Methods
This study selected 1,030 (158 non-drinkers, 364 flushers, and 508 non-flushers) male adults who had medical checkups. A logistic regression analysis was used to compare the association between alcohol consumption and the risk of pre- or T2DM.
Results
In both the normal-weight group (BMI <23 kg/m2) and the overweight group (BMI ≥23 kg/m2 and <25 kg/ m2), the flushers had a higher risk of pre- or T2DM (odds ratio, 95% confidence interval) when consuming more than 8 drinks of alcohol per week than the non-drinkers (normal-weight group: 3.43, 1.06–11.07; overweight group: 4.94, 1.56–15.67). But in the non-flushers among the normal-weight group and the overweight group, there was no significant difference compared to non-drinkers regarding the risk of pre- or T2DM. Obese flushers had a significantly higher risk of pre- or T2DM when consuming more than 4 drinks of alcohol per week than the non-drinkers (>4 and ≤8 drinks: 2.64, 1.10–6.36; >8 drinks: 2.42, 1.11–5.27). However, obese non-flushers had only a significant higher risk of pre- or T2DM when consuming more than 8 drinks of alcohol per week than the non-drinkers (2.72, 1.39–5.30)
Conclusion
These results suggest that obese flushers have an increased risk of developing pre- or T2DM even with less alcohol consumption.

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    Hwa Jung Yook, Gyu-Na Lee, Ji Hyun Lee, Kyungdo Han, Young Min Park
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  • Current Status of Korean Alcohol Drinking in Accordance with the Korean Alcohol Guidelines for Moderate Drinking Based on Facial Flushing
    Sami Lee, Jihan Kim, Jong Sung Kim
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  • Does the Risk for Diabetes Related with Alcohol Drinking Depend on Facial Flushing?
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Review Articles

Exercise Strategies to Prevent Hypoglycemia in Patients with Diabetes
Ah Reum Jung, Hyunah Kim, Hun-Sung Kim, Churlmin Kim, Whan-Seok Choi
Korean J Fam Med 2021;42(2):91-95.   Published online May 13, 2020
DOI: https://doi.org/10.4082/kjfm.19.0043
The importance of adopting healthy exercise routines has been repeatedly emphasized to individuals with diabetes mellitus (DM). However, knowledge about the risk of exercise-induced hypoglycemia is limited. Regular exercise reduces and delays the onset of DM-related complications particularly in individuals who already have DM. However, an excessive exercise can lead to hypoglycemia. Excessive exercise in the evening can cause hypoglycemia while sleeping. Furthermore, if individuals with DM want to have a greater amount of exercise, the exercise duration rather than intensity must be increased. In weight resistance exercises, it is beneficial to first increase the number of repetitions, followed by the number of sets and gradually the weight of resistance. When performing intermittent high-intensity training within a short time period, hypoglycemia may develop for an extended period after exercise. In addition to adjusting exercise regimens, the medication doses must be modified accordingly. Delaying exercise, adjusting the number of snacks consumed prior to exercise, reducing insulin dose before exercise, and injecting insulin into the abdomen rather than the limbs prevent exercise-induced hypoglycemia prior to a spontaneous exercise. Ultimately, with personal knowledge on how to prevent hypoglycemia, the effects of exercise can be maximized in individuals with DM, and a healthy lifestyle can prevent future complications.

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    Lei Ma, Wenhao Hou, Zhi Ji, Ziheng Sun, Muxi Li, Bolin Lian
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    Marul Ivandic, Maja Cigrovski Berkovic, Klara Ormanac, Dea Sabo, Tea Omanovic Kolaric, Lucija Kuna, Vjera Mihaljevic, Silvija Canecki Varzic, Martina Smolic, Ines Bilic-Curcic
    International Journal of Environmental Research and Public Health.2023; 20(6): 4966.     CrossRef
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    Chronicle of Diabetes Research and Practice.2022; 1(2): 76.     CrossRef
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Increasing Individual Target Glucose Levels to Prevent Hypoglycemia in Patients with Diabetes
Juyoung Shin, Hyunah Kim, Hun-Sung Kim, Churlmin Kim, Whan-Seok Choi
Korean J Fam Med 2021;42(4):269-273.   Published online January 29, 2020
DOI: https://doi.org/10.4082/kjfm.19.0161
Hypoglycemia is one of the severe complications of diabetes. To prevent hypoglycemia, an emphasis is placed on maintaining an appropriate balance between nutrition, activity, and treatment, which can be achieved by the repetition of self-trials based on self-monitoring. Clinicians routinely focus on patients’ contribution, including timely intake of an adequate amount of carbohydrates, physical activity, antidiabetic medication, and abstinence from alcohol. Recently, many guidelines have highlighted the importance of clinicians’ factors and recommend individualized treatments according to lifestyle patterns and specific needs following the de-intensification of treatment. The optimal value of hemoglobin A1c (HbA1c) levels for blood glucose level regulation remains controversial among countries, but it generally does not exceed 8.0%. In populations that are at a risk of hypoglycemia, such as the older adults, it is advisable to adjust the target blood glucose level to less than 8.0%. Meanwhile, a blood glucose level of 7.0%–7.5% is generally recommended for healthy older adults. If the expected lifetime is shorter than 10 years or in patients with chronic kidney disease and severe cardiovascular disease, the HbA1c level target can be increased to 7.5%–8.0%. For even shorter lifetime expectancy, the target can be adjusted up to 8.0%–9.0%. To prevent hypoglycemia, the target blood glucose level needs to be adjusted, particularly in older adult patients. Ultimately, it is important to identify the maximum blood glucose levels that do not cause hypoglycemia and the minimum blood glucose levels that do not cause hyperglycemia-associated complications.

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Original Articles

Comparison of Health Status in Primary Care Underserved Area Residents and the General Population in Korea
Min So Kim, Kyae Hyung Kim, Sang Min Park, Jong-goo Lee, Yeon Seo Ko, A Ra Cho, Yoon Su Ku
Korean J Fam Med 2020;41(2):119-125.   Published online December 19, 2019
DOI: https://doi.org/10.4082/kjfm.18.0130
Background
This study compared chronic diseases and health-related quality of life (HRQoL) in between primary care underserved areas residents and the general population.
Methods
Underserved areas were identified according to accessibility and the time relevance index for primary care. Overall, 279 participants aged ≥60 years from four counties enrolled voluntarily. A total of 1,873 individuals were assigned in the control group using the Korea National Health and Nutrition Examination Survey database. We assessed the differences in prevalence, awareness, and control of hypertension and diabetes and HRQoL using both subjective health status and the Korean version of the EuroQol-5D (EQ-5D) questionnaire using multivariate logistic regression analysis between the two groups.
Results
For hypertension, prevalence did not differ significantly between the two groups, whereas awareness and control were lower in the underserved areas than that in the general population; the adjusted odds ratios (95% confidence interval) were 0.40 (0.25–0.64) and 0.27 (0.18–0.41), respectively. For diabetes, differences in prevalence, awareness, and control were statistically insignificant. The proportion reporting poor subjective health status and problems in four EQ-5D indexes (ability to exercise, daily activities, pain/discomfort, anxiety/depression) was higher in the underserved areas, which also had a lower EQ-5D index, than that in the general population.
Conclusion
Primary care underserved area residents were underdiagnosed and under-controlled for hypertension and reported poorer subjective health and HRQoL compared to the general population. Primary care is the attributable factor to awareness and control of chronic diseases and subjective health and QoL in communities.

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Frequency and Severity of Hypoglycemia in Type 2 Diabetes Mellitus Patients Treated with a Sulfonylurea-Based Regimen at University-Affiliated Hospitals in Korea: The Naturalistic Evaluation of Hypoglycemic Events in Diabetic Subjects Study
Yon Su Kim, Be Long Cho, Woo Sik Kim, Sang Hyun Kim, In Hyeon Jung, Won Yong Sin, Dong Hoon Choi, Sang Jae Lee, Chun Soo Lim, Kyung Pyo Kang, Byung Yeon Yu, Wonju Jeung, Chang Gyu Park
Korean J Fam Med 2019;40(4):212-219.   Published online July 20, 2019
DOI: https://doi.org/10.4082/kjfm.18.0051
Background
We assessed the frequency and severity of hypoglycemia in type 2 diabetes mellitus patients treated with sulfonylurea monotherapy or sulfonylurea+metformin.
Methods
We conducted a retrospective, observational, cross-sectional study in 2011 and 2012 including patients with type 2 diabetes mellitus aged ≥30 years who were treated with ≥6 months of sulfonylurea monotherapy or sulfonylurea+metformin at 20 university-affiliated hospitals in Korea. At enrollment, glycated hemoglobin (HbA1c) was assessed; participants completed self-reported questionnaires describing hypoglycemia incidents over the past 6 months. A review of medical records up to 12 months before enrollment provided data on demographics, disease history, comorbidities, laboratory results, and drug usage.
Results
Of 726 enrolled patients, 719 were included (55.6% male); 31.7% and 68.3% were on sulfonylurea monotherapy and sulfonylurea+metformin, respectively. Mean±standard deviation age was 65.9±10.0 years; mean HbA1c level was 7.0%±1.0%; 77.8% of patients had hypertension (89.4% used antihypertensive medication); 60.5% had lipid disorders (72.5% used lipid-lowering medication); and 52.0% had one or more micro- or macrovascular diseases. Among patients with A1c measurement (n=717), 56.4% achieved therapeutic goals (HbA1c <7.0%); 42.4% (305/719) experienced hypoglycemia within 6 months of enrollment; and 38.8%, 12.9%, 12.7%, and 3.9% of patients experienced mild, moderate, severe, and very severe hypoglycemia symptoms, respectively. Several reported hypoglycemia frequency as 1–2 times over the last 6 months. The mean number of very severe hypoglycemia episodes was 3.5±5.5.
Conclusion
Among type 2 diabetes mellitus patients treated with sulfonylurea-based regimens, glycemic levels were relatively well controlled but hypoglycemia remained a prevalent side effect.

Citations

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  • Increasing Individual Target Glucose Levels to Prevent Hypoglycemia in Patients with Diabetes
    Juyoung Shin, Hyunah Kim, Hun-Sung Kim, Churlmin Kim, Whan-Seok Choi
    Korean Journal of Family Medicine.2021; 42(4): 269.     CrossRef
  • Professional Continuous Glucose Monitoring Reveals Nocturnal Hypoglycemia in Patients with Type 2 Diabetes Mellitus and Cardiovascular Disease Treated with Oral Antidiabetics
    Maja Baretić, Valerija Bralić Lang
    Korean Journal of Family Medicine.2021; 42(2): 185.     CrossRef
  • Exercise Strategies to Prevent Hypoglycemia in Patients with Diabetes
    Ah Reum Jung, Hyunah Kim, Hun-Sung Kim, Churlmin Kim, Whan-Seok Choi
    Korean Journal of Family Medicine.2021; 42(2): 91.     CrossRef
  • 5,998 View
  • 142 Download
  • 4 Web of Science
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Review Article

An Overview of Current Physical Activity Recommendations in Primary Care
Yun Jun Yang
Korean J Fam Med 2019;40(3):135-142.   Published online May 20, 2019
DOI: https://doi.org/10.4082/kjfm.19.0038
Primary care physicians should encourage their patients to engage in adequate physical activity. Current recommendations for physical activity in adults are as follows: at least 150–300 minutes per week of moderate-intensity, 75–150 minutes per week of vigorous-intensity aerobic physical activity, or an equivalent combination of moderate- and vigorous-intensity aerobic activity. Adults should also perform muscle-strengthening activities of moderate intensity or higher that involve all major muscle groups for 2 or more days per week. The elderly should perform additional balance training and fall prevention exercises more than 3 times a week. Children and adolescents should perform at least 1 hour of moderate-to-vigorous physical activity daily, which includes vigorous aerobic activity at least 3 days per week. As part of their 60 minutes or more of daily physical activity, resistance training and bone strengthening exercise should be done at least 3 days per week. According to new evidence, one bout of any exercises can be shorter than 10 minutes. Previously, physical activities were recommended for more than 10 minutes. For patients with diabetes, it is advisable to perform resistance exercise or short-distance running before aerobic exercise to prevent hypoglycemia. New evidence shows that dynamic resistance training is safe and effective in patients with hypertension provided the load is not too heavy. Exercise reduces pain and improves quality of life and physical function in patients with osteoarthritis,. Therefore, the treatment guidelines for osteoarthritis have been changed recently from not recommending exercise to highly recommending it.

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Original Articles

Serum Branched Chain Amino Acids Are Associated with Type 2 Diabetes Mellitus in Jordan
Mahmoud A. Alfaqih, Zaina Abu-Khdair, Rami Saadeh, Nesreen Saadeh, Ahmed Al-Dwairi, Othman Al-Shboul
Korean J Fam Med 2018;39(5):313-317.   Published online July 31, 2018
DOI: https://doi.org/10.4082/kjfm.17.0122
Background
Diabetes mellitus is a global public health problem that is caused by the lack of insulin secretion (type 1) or resistance to its action (type 2). A low insulin-to-glucagon ratio predicts an increase in the serum levels of branched chain amino acids, a feature confirmed in several populations. This relationship has not been assessed in Jordan. The objective of this study was to investigate the association between serum branched chain amino acids and type 2 diabetes mellitus in patients in Jordan.
Methods
Two hundred type 2 diabetes mellitus patients and an additional 200 non-diabetic controls were recruited. Age, body mass index, and waist circumference of the subjects were recorded. Branched chain amino acid, total cholesterol, and triglyceride levels were measured from the collected serum samples.
Results
Serum branched chain amino acid levels were significantly higher in type 2 diabetes mellitus patients than in non-diabetes individuals (P<0.0001). In binomial regression analysis, serum branched chain amino acid levels remained significantly associated with diabetes mellitus and increased its risk (odds ratio, 1.004; 95% confidence interval, 1.001–1.006; P=0.003).
Conclusion
Type 2 diabetes mellitus is associated with higher branched chain amino acid levels in Jordan independent of age, sex, body mass index, waist circumference, and total serum cholesterol and serum triglyceride levels.

Citations

Citations to this article as recorded by  
  • Higher Levels of Serum Leptin Are Linked with a Reduction in Gait Stability: A Sex-Based Association
    Mahmoud A. Alfaqih, Ebaa Ababneh, Yousef Khader, Khawla Mhedat, Mai Sater
    Biomolecules.2025; 15(2): 195.     CrossRef
  • Leptin and the rs2167270 Polymorphism Are Associated with Glycemic Control in Type Two Diabetes Mellitus Patients on Metformin Therapy
    Mahmoud A. Alfaqih, Mukhallad Aljanabi, Ebaa Ababneh, Mariam Khanfar, Mohammad Alqudah, Mai Sater
    Medicina.2023; 59(5): 997.     CrossRef
  • Normalization of Vitamin D Serum Levels in Patients with Type Two Diabetes Mellitus Reduces Levels of Branched Chain Amino Acids
    Mahmoud A. Alfaqih, Nebras Y. Melhem, Omar F. Khabour, Ahmed Al-Dwairi, Lina Elsalem, Tasnim G. Alsaqer, Mohammed Z. Allouh
    Medicina.2022; 58(9): 1267.     CrossRef
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    Nahla Hwalla, Zeinab Jaafar, Sally Sawaya
    Nutrients.2021; 13(4): 1060.     CrossRef
  • Health Impact and Therapeutic Manipulation of the Gut Microbiome
    Eric Banan-Mwine Daliri, Fred Kwame Ofosu, Ramachandran Chelliah, Byong Hoon Lee, Deog-Hwan Oh
    High-Throughput.2020; 9(3): 17.     CrossRef
  • Association of Circulating Branched-Chain Amino Acids with Gestational Diabetes Mellitus: A Meta-Analysis
    Liang Zhao, Meng Wang, Jun Li, Ye Bi, Minglong Li, Jie Yang
    International Journal of Endocrinology and Metabolism.2019;[Epub]     CrossRef
  • Association of Adiponectin and rs1501299 of the ADIPOQ Gene with Prediabetes in Jordan
    Mahmoud A. Alfaqih, Faheem Al-Mughales, Othman Al-Shboul, Mohammad Al Qudah, Yousef S. Khader, Muhammad Al-Jarrah
    Biomolecules.2018; 8(4): 117.     CrossRef
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  • 9 Web of Science
  • 7 Crossref
Association between Breastfeeding and Prevalence of Diabetes in Korean Parous Women: The Korea National Health and Nutrition Examination Survey, 2010–2014
Ha-Nui Kim, Young-Ah Jung, Li-Ly Kang, Hoon-Ki Park, Hwan-Sik Hwang, Kye-Yeung Park
Korean J Fam Med 2018;39(5):273-278.   Published online July 9, 2018
DOI: https://doi.org/10.4082/kjfm.17.0023
Background
It is well known that breastfeeding has a significant impact on the health of mothers and children. With the growing importance of breastfeeding, the present study aimed to investigate the relationship between breastfeeding and the prevalence of diabetes in Korean parous women.
Methods
The data of 5,448 premenopausal parous women aged 20–49 years who agreed to participate in the 5th– 6th Korea National Health and Nutrition Examination Survey were analyzed in this study. Control group included women who had not breastfed. The subjects who had breastfed were classified into three groups based on the duration of breastfeeding: 0–6 months, 6–12 months, and >12 months. The variables included age, body mass index, education level, income, alcohol drinking, smoking, family history of diabetes, use of oral contraceptives, the number of pregnancies, and regular exercise.
Results
Among the subjects, the prevalence of diabetes was significantly lower in women who had breastfed compared to those who had not, with an odds ratio of 0.534 (95% confidence interval [CI], 0.289–0.976) in women who breastfed for 0–6 months and 0.575 (95% CI, 0.321–0.990) in women who breastfed for 6–12 months (both P<0.05).
Conclusion
The present study found a reduced prevalence of diabetes in women who had breastfed compared to those who had not. However, no association between the duration of breastfeeding and the prevalence of diabetes could be found.

Citations

Citations to this article as recorded by  
  • Association of Childbirth and Breastfeeding with Diabetes Mellitus in Korean Women
    Seulkee Kim, So Yeon Ryu
    Journal of Health Informatics and Statistics.2024; 49(2): 109.     CrossRef
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    Rozeta Sokou, Stavroula Parastatidou, Zoi Iliodromiti, Katerina Lampropoulou, Dionysios Vrachnis, Theodora Boutsikou, Aikaterini Konstantinidi, Nicoletta Iacovidou
    Nutrients.2023; 15(13): 2822.     CrossRef
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    Saeideh Zareei, Fatemeh Behrasi, Mohammad Mehdi Naghizadeh, Fatemeh Talebzadeh, Ali Kharmandar, Mojtaba Farjam, Reza Homayounfar
    BMC Women's Health.2023;[Epub]     CrossRef
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    Farhanah Ahmad Shuhaimi, Syahrul Bariah Abdul Hamid, Nurul Ainfarhanah Md Yazid
    Journal of Education and Health Promotion.2023;[Epub]     CrossRef
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    Deepak Bhatnagar, Prachi Bhatnagar
    Current Opinion in Lipidology.2019; 30(1): 45.     CrossRef
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    Soo Young Kim
    Korean Journal of Family Medicine.2018; 39(5): 271.     CrossRef
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  • 133 Download
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  • 6 Crossref

Case Report

Hemiballismus in Uncontrolled Diabetes Mellitus
Juhaida Jaafar, Razlina Abdul Rahman, Nani Draman, Nor Akma Yunus
Korean J Fam Med 2018;39(3):200-203.   Published online May 18, 2018
DOI: https://doi.org/10.4082/kjfm.2018.39.3.200
Hemiballismus, a subtype of chorea, is a rare movement disorder, and is most commonly found secondary to stroke. Movements are involuntary, violent, coarse, and have a wide amplitude. There is increasing report of hemiballismus occurring in non-ketotic hyperglycemia. Spontaneous improvements or remissions were observed in many patients, and treatment should be directed towards the cause of hemiballismus. There is no randomized control trial to guide clinicians in deciding the best treatment option when managing hemiballismus. Symptomatic treatment includes the use of drugs such as dopamine receptor blocker and tetrabenazine. Surgical treatment is reserved for severe, persistent, and disabling hemiballismus. This case is of an elderly woman with long standing uncontrolled diabetes who presented with abnormal movement in her left upper limb for 2 months, which resolved slowly with good control of her glucose levels. Treating physicians need to have a high index of suspicion to prevent mismanagement of the condition.

Citations

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  • 6,255 View
  • 126 Download
  • 11 Web of Science
  • 13 Crossref

Review Article

The Bidirectional Relationship between Diabetes and Depression: A Literature Review
Abdallah Alzoubi, Rnad Abunaser, Adi Khassawneh, Mahmoud Alfaqih, Aws Khasawneh, Nour Abdo
Korean J Fam Med 2018;39(3):137-146.   Published online May 18, 2018
DOI: https://doi.org/10.4082/kjfm.2018.39.3.137
Diabetes is a major public health problem worldwide. Depression is a serious mental condition that decreases mental and physical functioning and reduces the quality of life. Several lines of evidence suggest a bidirectional relationship between diabetes and depression: diabetes patients are twice as likely to experience depression than nondiabetic individuals. In contrast, depression increases the risk of diabetes and interferes with its daily self-management. Diabetes patients with depression have poor glycemic control, reduced quality of life, and an increased risk of diabetes complications, consequently having an increased mortality rate. Conflicting evidence exists on the potential role of factors that may account for or modulate the relationship between diabetes and depression. Therefore, this review aims to highlight the most notable body of literature that dissects the various facets of the bidirectional relationship between diabetes and depression. A focused discussion of the proposed mechanisms underlying this relationship is also provided. We systematically reviewed the relevant literature in the PubMed database, using the keywords “Diabetes AND Depression”. After exclusion of duplicate and irrelevant material, literature eligible for inclusion in this review was based on meta-analysis studies, clinical trials with large sample sizes (n≥1,000), randomized clinical trials, and comprehensive national and cross-country clinical studies. The evidence we present in this review supports the pressing need for long, outcome-oriented, randomized clinical trials to determine whether the identification and treatment of patients with these comorbid conditions will improve their medical outcomes and quality of life.

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Case Report

A Diabetic Elderly Man with Finger Ulcer
Noraini Mohamad, Salziyan Badrin, Wan Noor Hasbee Wan Abdullah
Korean J Fam Med 2018;39(2):126-129.   Published online March 22, 2018
DOI: https://doi.org/10.4082/kjfm.2018.39.2.126

Fixed cutaneous sporotrichosis is a differential diagnosis that can be considered in diabetic patients who present with a poorly healing ulcer. Although its prevalence is low, it can occur in patients with immunocompromised status. Here we report a case of a 70-year-old man with diabetes mellitus who presented with a 1-month history of an unhealed ulcer over the tip of his left middle finger. He experienced a cat bite over his left middle finger 1 month prior to the appearance of the lesion. A skin biopsy revealed the presence of Sporothrix schenckii. Oral itraconazole 200 mg twice daily was started empirically and the patient showed marked improvement in the skin lesion after 2 months of therapy.

Citations

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    Xiujiao Xia, Huilin Zhi, Zehu Liu, Joshua Nosanchuk
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  • Nonhealing ulcer on the fingertip
    Vishal Gupta, Ananya Sharma, Neena Khanna, Swati Mahajan, Asit Ranjan Mridha
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  • Facial Cutaneous Sporotrichosis in a Boy
    Leonardo Lora Barraza, Jéssica Bissoli Tolomelli, Caroline Graça Cunha, Fred Bernardes Filho, Loan Towersey, Roderick Hay, Regina Casz Schechtman, José Augusto da Costa Nery
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  • Sporotrichosis In Immunocompromised Hosts
    Flavio Queiroz-Telles, Renata Buccheri, Gil Benard
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Original Articles

Association of Fasting Glucose Level with Neutrophil-Lymphocyte Ratio Compared to Leukocyte Count and Serum C-Reactive Protein
Jin-Kyu Kim, Ah-Young Lee, Jee-Hyun Kang, Byung-Yeon Yu, Seong-Ju Kim
Korean J Fam Med 2018;39(1):42-50.   Published online January 23, 2018
DOI: https://doi.org/10.4082/kjfm.2018.39.1.42
Background

The neutrophil-lymphocyte ratio (NLR) is often used as an inflammatory marker in chronic diseases such as cancer or cardiovascular diseases. However, there are few studies about the association between the NLR and diabetes mellitus (DM) or impaired fasting glucose (IFG) patients in Korea. This study investigated the association between the fasting plasma glucose (FPG) level and NLR in Koreans.

Methods

This cross-sectional retrospective study included 3,219 healthy subjects who visited Konyang University Hospital in South Korea for regular health examinations. Participants with a history of insulin administration, anti-diabetic drugs, anti-inflammatory drugs, or underlying diseases related to inflammation were excluded.

Results

All statistical evaluation was performed by dividing participants into males and females. Based on FPG levels, the subjects were classified into three groups, with normal fasting glucose (n=1,969), IFG (n=1,138), and DM (n=122). The NLR had no significant mean differences among these groups for both sexes. Multiple linear regression analysis between FPG level and NLR showed an independent and significantly negative association (β±standard error, −0.67±0.24; P=0.006) in normal subjects after adjustment. Log(serum C-reactive protein [S-CRP]) showed an independently and significantly positive association with FPG in male IFG/DM patients. Total leukocyte (white blood cell [WBC]) showed an independently and significantly positive association with FPG in female IFG/DM patients.

Conclusion

In normal subjects, NLR shows an independently and significantly negative association with FPG. In IFG/DM patients, NLR was not significantly related to FPG. WBC count in female patients and S-CRP level in male patients were significantly positively associated with FPG only in IFG/DM.

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    Zahra Sarrafan-Chaharsoughi, Ninet Sinaii, Andrew P Demidowich, Jack A Yanovski
    Journal of Clinical & Translational Endocrinology.2025; 39: 100382.     CrossRef
  • Follow-up study to explore the relationship between Neutrophil to lymphocyte ratio and impaired fasting glucose—using the group-based trajectory modeling
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Correlation of Cardiovascular Risk Factors with Central Obesity and Multiple Body Mass Index in Korea
Bora Yoo, Hosuk Nam, In Cheol Hwang, Youngmin Park
Korean J Fam Med 2017;38(6):338-345.   Published online November 14, 2017
DOI: https://doi.org/10.4082/kjfm.2017.38.6.338
Background

Body mass index (BMI) and waist circumference (WC) are associated with cardiovascular (CV) risk factors. The aim of this study was to investigate the correlation of CV risk factors by cross-tabulating central obesity with multiple BMI categories in Korea.

Methods

A total of 328,789 adults aged 30–84 years who completed health assessments for National Health Insurance in 2012–2013 in Korea were examined. The participants were divided into two WC and five BMI groups to investigate CV risk factors, including metabolic syndrome (MetS), hypertension, diabetes, and dyslipidemia.

Results

The proportions of central obesity and obesity were 24.2% and 39.5% in men and 19.4% and 28.1% in women, respectively, according to the Korean Society for the Study of Obesity and World Health Organization Asia-Pacific Guideline criteria. The odds ratios (ORs) of CV risk factors in all sexes increased with increases in BMI and WC. Compared to the group with a normal WC and BMI, the adjusted ORs (95% confidence intervals) for having MetS and diabetes in the centrally obese and highest BMI group (BMI ≥30.0 kg/m2) were 35.95 (33.75–38.30) and 3.51 (3.26–3.77) in men and 29.22 (27.36–31.20) and 4.35 (4.02–4.70) in women, respectively. Participants who were centrally obese and obese (BMI ≥25.0 kg/m2) had the strongest correlation with all CV risk factors compared with those who were not centrally obese or obese.

Conclusion

The presence of central obesity in multiple BMI categories may significantly identify individuals at increased risk of CV risk factors.

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    Inger M. Oellingrath, Martin V. Svendsen, Anne K. M. Fell
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    Jong Yeon Kim, Sung Min Cho, Youngmin Yoo, Taesic Lee, Jong Koo Kim
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    Seung Eun Lee, Nam Young Lee, Se Hyun Kim, Kyoung-Ah Kim, Yong Sik Kim
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  • Framingham Risk Score Assessment in Subjects with Pre-diabetes and Diabetes: A Cross-Sectional Study in Korea
    Hyuk Sang Kwon, Kee Ho Song, Jae Myung Yu, Dong Sun Kim, Ho Sang Shon, Kyu Jeung Ahn, Sung Hee Choi, Seung Hyun Ko, Won Kim, Kyoung Hwa Lee, Il Seong Nam-Goong, Tae Sun Park
    Journal of Obesity & Metabolic Syndrome.2021; 30(3): 261.     CrossRef
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    Miji Kim, Anam Basharat, Ramchandani Santosh, Syed F. Mehdi, Zanali Razvi, Sun K. Yoo, Barbara Lowell, Amrat Kumar, Wunnie Brima, Ann Danoff, Rachel Dankner, Michael Bergman, Valentin A. Pavlov, Huan Yang, Jesse Roth
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    Chen Hu, Guiyang Wang, Wenjun Yin, Yun Zhou, Jian Hou, Xian Wang, Weihong Chen, Jing Yuan
    Metabolism.2019; 91: 53.     CrossRef
  • Cardiovascular Risk Assessment Based on Combined Body Mass Index and Waist Circumference in Korean Adults
    Young Gyu Cho
    Korean Journal of Family Medicine.2017; 38(6): 313.     CrossRef
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Effect of Coffee Consumption on the Progression of Type 2 Diabetes Mellitus among Prediabetic Individuals
Ji-Ho Lee, Mi-Kyeong Oh, Jun-Tae Lim, Haa-Gyoung Kim, Won-Joon Lee
Korean J Fam Med 2016;37(1):7-13.   Published online January 27, 2016
DOI: https://doi.org/10.4082/kjfm.2016.37.1.7
Background

A previous large-scale cohort study investigated the relationship between coffee intake and the progression of diabetes mellitus in the United States. However, studies on the effects of coffee on diabetes are rare in South Korea. Therefore, this study assessed the amount and method of coffee intake in Koreans in order to determine if coffee intake has a prophylactic effect on diabetes progression.

Methods

This study included 3,497 prediabetic patients from a single medical institution, with glycated hemoglobin levels ranging from 5.7% to 6.4%. Cross-tabulation and Kaplan-Meier survival analyses were performed to compare patients with and without diabetes progression based on the frequency and method of coffee intake. Cox proportional hazard analysis was performed to correct for confounding variables.

Results

The observation period (mean±standard deviation) was 3.7±2.3 years. Kaplan-Meier survival analysis revealed that the risk of diabetes progression was lowest in patients who drank black coffee three or more times per day (P=0.036). However, correction for confounding variables in Cox proportional hazard analysis revealed that, while the risk was lower for the patients who typically consumed black coffee than for those who mixed creamer and sugar into their coffees, the difference was not significant.

Conclusion

The results of this study suggest that drinking coffee without sugar and creamer at least three times daily has the greatest preventive effect on diabetes onset.

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    Marcia Ribeiro, Livia Alvarenga, Ludmila F. M. F. Cardozo, Julie A. Kemp, Ligia S. Lima, Jonatas S. de Almeida, Viviane de O. Leal, Peter Stenvinkel, Paul G. Shiels, Denise Mafra
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  • Habitual coffee drinking and the chance of prediabetes remission: findings from a population with low coffee consumption
    Shabnam Hosseini, Zahra Bahadoran, Parvin Mirmiran, Fereidoun Azizi
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  • Impact of coffee and its bioactive compounds on the risks of type 2 diabetes and its complications: A comprehensive review
    Almahi I. Mohamed, Ochuko L. Erukainure, Veronica F. Salau, Md Shahidul Islam
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  • Coffee constituents with antiadipogenic and antidiabetic potentials: A narrative review
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    Food and Chemical Toxicology.2022; 161: 112821.     CrossRef
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    Maria Lazo-Porras, Antonio Bernabe-Ortiz, Andrea Ruiz-Alejos, Liam Smeeth, Robert H. Gilman, William Checkley, German Málaga, J. Jaime Miranda
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    An Na Kim, Jiyoung Youn, Hyun Jeong Cho, Taiyue Jin, Sangah Shin, Jung Eun Lee
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  • Adjuvant Therapies in Diabetic Retinopathy as an Early Approach to Delay Its Progression: The Importance of Oxidative Stress and Inflammation
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    Journal of Food Science and Technology.2020; 57(12): 4345.     CrossRef
  • Lack of Association of Coffee Consumption with the Prevalence of Self-Reported Type 2 Diabetes Mellitus in a Mexican Population: A Cross-Sectional Study
    Ana Karen Gil-Madrigal, Thelma Beatriz González-Castro, Carlos Alfonso Tovilla-Zárate, Daniela Georgina Aguilar-Velázquez, Tania Guadalupe Gómez-Peralta, Isela Esther Juárez-Rojop, María Lilia López-Narváez, Elizabeth Carmona-Díaz, Ana Fresan, Jorge Luis
    International Journal of Environmental Research and Public Health.2018; 15(10): 2100.     CrossRef
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    Bernd Richter, Bianca Hemmingsen, Maria-Inti Metzendorf, Yemisi Takwoingi
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    Taylor A. Breuninger, Anna Riedl, Nina Wawro, Wolfgang Rathmann, Konstantin Strauch, Anne Quante, Annette Peters, Barbara Thorand, Christa Meisinger, Jakob Linseisen
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    Keyhoon Kim, Kyuwoong Kim, Sang Min Park, Pratibha V. Nerurkar
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Differences in Factors Associated with Albuminuria according to Gender and Comorbidities of Hypertension and Diabetes
Miae Jang, Sohee Oh, Hye-Mi Noh, Sunyoung Chun, Hye young Oh, Kyung Hee Park, Yu Jin Paek, Hong Ji Song
Korean J Fam Med 2015;36(6):316-322.   Published online November 20, 2015
DOI: https://doi.org/10.4082/kjfm.2015.36.6.316
Background

This study examined the differences in factors associated with albuminuria according to gender and comorbidities of hypertension (HTN) and diabetes mellitus (DM).

Methods

We included 3,859 participants aged 20 to 79 years (55% female) from the 5th Korea National Health and Nutrition Examination Survey. Participants were excluded if they took antihypertensive or anti-diabetic medication, had chronic renal failure, had malignant tumor, were pregnant or menstruating during the health examination, or had missing urine albumin data. Albuminuria was defined by the participant's urine albumin-creatinine ratio (uACR). Relationships between dependent and independent variables were analyzed using the Pearson's correlation test and simple linear regression. Due to possible muticollinearity, multiple linear regression analysis was used to determine whether the association between the dependent and independent variables of interest remained significant after adjustment for other potentially confounding independent variables.

Results

The variables significantly correlated with uACR were different between the genders and between subjects with HTN or DM as a comorbidity. In the multiple linear regression models, hemoglobin A1c (P=0.01) was positively associated with uACR in men without HTN and DM. In men with HTN or DM, systolic blood pressure and fasting glucose (P<0.01) were positively associated with uACR. In women with HTN or DM, waist circumference (P=0.011) and gamma-glutamyl transpeptidase (P<0.001) were positively correlated with uACR (P<0.05) and glucose level (P=0.019) was negatively correlated with uACR.

Conclusion

The study suggested factors correlated with albuminuria were different for men and women according to comorbidities such as HTN and DM.

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    Mosepele Mosepele, Ponego Ponatshego, Kesaobaka Molebatsi, Christopher Williams, Lucky Mokgatlhe, Shahin Lockman, Nabila Youssouf, Robert Gross, Joseph Jarvis, Duolao Wang, Shabbar Jaffar
    Scientific Reports.2024;[Epub]     CrossRef
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    Nurbadriah binti Jasmiad, Rohana binti Abd Ghani, Renu Agarwal, Zaliha binti Ismail, Azlindarita Aisyah Mohd Abdullah, Mohd Yusri Idorus
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    Sindhu Varghese, S. Gowtham Kumar
    Biocatalysis and Agricultural Biotechnology.2019; 21: 101316.     CrossRef
  • Differential Association of Vitamin D Deficiency With Albuminuria by Sex in the Korean General Population: A Cross-sectional Study of the Korea National Health and Nutrition Examination Survey 2011-2012
    Yongwoo Jeon, Jaeyong Shin, Jong Hyun Jhee, Youngdae Cho, Eun-Cheol Park
    Journal of Preventive Medicine and Public Health.2018; 51(2): 92.     CrossRef
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Brief Communication

Incidence of Type 2 Diabetes Mellitus among Emirati Residents in Ajman, United Arab Emirates
Jayadevan Sreedharan, Jayakumary Muttappallymyalil, Shatha al Sharbatti, Sana Hassoun, Rawda Safadi, Iehab Abderahman, Wathib Abdulsamad Hameed, Abdul Mohsen Ibrahim, Mohamed Tahir Takana, Ahmad Mohammad Fouda
Korean J Fam Med 2015;36(5):253-257.   Published online September 18, 2015
DOI: https://doi.org/10.4082/kjfm.2015.36.5.253
Background

Diabetes mellitus (DM), particularly type-2 is a major public health concern worldwide. Not much information is available with regard to the incidence of DM in United Arab Emirates (UAE). This study aimed at determining the incidence rate of diabetes mellitus among Emirati population in Ajman, UAE. This is a retrospective cohort study.

Methods

This study was conducted in all primary health care centers and Shaikh Khalifa and GMC Hospitals, Ajman, UAE where the Emirati population primarily go for diagnosis and treatment. The incident cases of diabetes mellitus were collected during the period 2010 January to December.

Results

A total of 158 cases newly detected in 2010, 54 were among non-Emiratis and one was type-1 diabetes. Eliminating these, the remaining 101 were included in the analysis. The age of the patients ranged from 23 years to 78 years; 35 (34.7%) males and 66 (65.3%) were females. The overall incidence observed was 4.8/1,000 person-years (PY) with a female predominance of 6.3/1,000 PY against incidence among males of 3.3/1,000 PY. With regard to age specific incidence rate among males, it increases with age till 60 years and then showed a decreasing trend. Among females also the same trend was observed but not as similar to males.

Conclusion

The highest incidence rate was observed in the 55-59 age group among males, 23.4/1,000 PY and females, 32.4/1,000 PY. Among males the incidence rate was much less compared to females in-the age groups older than 59 years.

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    Mustafa Jamal Ahmed, Omer Ali, Saf Naqvi, Aisha Ahmed, Waseem Omar
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    Ayşe Doğru, Selim Buyrukoğlu, Murat Arı
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    Hind Al Razooqi, Bashayer AlNajjar, Ebrahim AlShamsi, Kaltham Ibrahim, Wadeia Sharief, Hamda Khansaheb, Marwan Zidan
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    Aus Alzaid, Patricia Ladrón de Guevara, Maud Beillat, Valérie Lehner Martin, Petar Atanasov
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    Dybesh Regmi, Saif Al-Shamsi, Romona D. Govender, Juma Al Kaabi
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    Mohammed A Alateeq, Moath Aljohani, Sondos S Kinani, Ibrahim A Aljabr , Abdullah A Alduayji , Abdulrhman Aloud , Elham Alzahrani, Khalid Alharbi
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    Walaa Abuelmagd, Bachar Afandi, Helle Håkonsen, Seham Khmidi, Else-Lydia Toverud
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    Samir H. Assaad Khalil, Magdy H. Megallaa, Kamel H. Rohoma, Hanaa Ismael, Myriam AbouSeif, Ibrahim Kharboush, Dalal Elkaffash, Mohamed Hassanein, Moataza M. Abdel Wahab, Amin Malaty, Hassan Sallam
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Original Articles
Barrier Factors to the Completion of Diabetes Education in Korean Diabetic Adult Patients: Korea National Health and Nutrition Examination Surveys 2007-2012
Hee-Tae Kim, Kiheon Lee, Se Young Jung, Seung-Min Oh, Su-Min Jeong, Yoon-Jung Choi
Korean J Fam Med 2015;36(5):203-209.   Published online September 18, 2015
DOI: https://doi.org/10.4082/kjfm.2015.36.5.203
Background

Diabetes is a disease with high social burdens and is expected to increase gradually. A long-term management is essential for the treatment of diabetes, requiring patient self-cares. Diabetes education is important for such self-cares, but it does not sufficiently take place. In addition, little studies have been conducted on the barriers to the completion of diabetes education. This study, thus, aimed to analyze the factors related to the completion of diabetes education and investigate its barriers.

Methods

Of 50,405 respondents to the fourth and fifth Korea National Health and Nutrition Examination Survey, a total of 3,820 were selected for the analysis, excluding those aged 29 or younger and those with missing values. The completion of diabetes education was set as a dependent variable and an analysis was made on the factors that affect the dependent variable. A multivariable logistic regression was employed for the analysis.

Results

Lower educational level was associated with less diabetes education, and the degree of diabetes education was lower in the group with male, the group that didn't have a family history or was not aware of a family history, the group that was not currently aware of diabetes and the group without a spouse. There was no difference in the completion of diabetes education by underlying diseases, family income level, age, residing area, economic activity status, insurance coverage, smoking, and drinking.

Conclusion

Diabetes education is of importance for the treatment and management of diabetes. Currently, however, diabetes education is not sufficiently carried out in Korea. The completion rate of diabetes education was low in male, patients without or not knowing a family history, patients who were not currently aware of their diabetes, patients without a spouse, and patients with low educational level. Therefore, encouraging these patients to take the education will be a more effective approach to increase the completion rate of diabetes education.

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    Eunji Nam, Changyong Choi, Jeongmyeong Lee
    Korean Journal of Health Education and Promotion.2024; 41(5): 125.     CrossRef
  • Sociodemographic Factors Associated with Participation in Diabetes Education among Community-Dwelling Adults with Diabetes
    Young-Hoon Lee
    Yonsei Medical Journal.2020; 61(2): 169.     CrossRef
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    Yunxia Ni, Suzhen Liu, Jiping Li, Simin Li, Ting Dong
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    Kyung Do Han, Yong Gyu Park
    Korean Journal of Family Medicine.2015; 36(6): 357.     CrossRef
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Diabetes and Depressive Symptoms in Korean Women: The Fifth Korean National Health and Nutrition Examination Survey (2010-2011)
Han Na Sung, Hong Seok Chae, Eung Soo Kim, Jong Sung Kim
Korean J Fam Med 2014;35(3):127-135.   Published online May 22, 2014
DOI: https://doi.org/10.4082/kjfm.2014.35.3.127
Background

The purpose of this study was to investigate the association between diabetes and depressive symptoms among Korean women.

Methods

We performed an analysis of data for 6,572 women aged 30 or over obtained from the Fifth Korean National Health and Nutrition Examination Survey conducted in 2010 to 2011. We examined the presence of depressive symptoms and the treatment of depression according to diabetes status.

Results

The presence of depressive symptoms was observed in 22.6% of subjects with diabetes. In the multiple logistic regression model, diabetes was associated with an increased risk of depressive symptoms (odds ratio [OR], 1.21; 95% confidence interval [CI], 1.20 to 1.21) but the treatment of depression among diabetics was less common (OR, 0.54; 95% CI, 0.54 to 0.55). Uncontrolled diabetes (glycosylated hemoglobin ≥ 7%) was associated with an increased risk of depressive symptoms (OR, 1.71; 95% CI, 1.69 to 1.73) among diabetics.

Conclusion

Physicians should manage individuals with diabetes in consideration of the presence of depressive symptoms, especially in those with uncontrolled diabetes.

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    You Lee Yang, Eun-Ok Im, Yunmi Kim
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