Background
Good glucose control is an indicator of treatment adherence and insulin therapy. However, insulin rejection has become an increasingly concerning phenomenon and is underdiscussed in health modules. The effects of incomplete exploration and suboptimal analysis requirements have led to the problem of insulin rejection, which needs to be identified by considering the broader perceptions of informal caregivers and patients with type 2 diabetes mellitus. Photo-elicitation, a technique that combines images and interviews, has gained traction for in-depth exploration. This study aimed to explore insulin rejection using photo-elicitation in this population.
Methods
This study employed a qualitative phenomenological design. The photo-elicitation interview involved ten photographs, which were taken and discussed narratively. This involved 10 families of informal caregivers and patients with type 2 diabetes mellitus between 20 and 60 years of age as purposive sampling at the Hospital Sultanah Nur Zahirah, Kuala Terengganu. Glycated hemoglobin levels (%) were between 6.3% and 14.8% in patients with type 2 diabetes mellitus. Atlas.ti version 25 and an Excel spreadsheet were used to analyze qualitative data through thematic analysis based on Maslow’s hierarchy of needs.
Results
Four main themes were revealed: (1) financial challenges, (2) public stigma related to insulin therapy, (3) improving self-efficacy for self-action, and (4) improving glycemic levels for quality of life.
Conclusion
Photo-elicitation successfully explored trends in the management of type 2 diabetes mellitus in this population. This study provides insights into the use of needs analyses to create more engaging experiences when designing comprehensive evidence- and need-based interventions.

Background
Premenstrual syndrome (PMS) and dysmenorrhea are common symptoms in women. In this study, we investigated the effects of saffron on PMS and dysmenorrhea in women.
Methods
In this systematic review and meta-analysis, we comprehensively screened a range of databases, including PubMed, Web of Science, and Science Direct. We included randomized clinical trials investigating the effects of saffron on PMS or dysmenorrhea. Quality assessment of the identified studies was conducted using the Cochrane risk-of-bias assessment tool. Meta-analysis was performed using Comprehensive Meta-Analysis software ver. 2 based on the random effects model.
Results
Meta-analysis revealed that saffron had a significant positive effect on the symptoms of PMS in women (standardized mean difference [SMD], –0.64; 95% confidence interval [CI], –0.84 to –0.44). Furthermore, saffron was effective in reducing dysmenorrhea (SMD, –0.51; 95% CI, –1.01 to –0.01).
Conclusion
The findings of our meta-analysis indicate that saffron exerts beneficial effects on the symptoms of both PMS and dysmenorrhea in women.

Menopause is a natural part of the aging process that every woman experiences at some point in life. Menopausal symptoms have a negative impact on the quality of life. Common menopausal symptoms include vasomotor symptoms, mood swings, concentration issues, vaginal dryness, atrophy of secondary sexual traits, libido loss, musculoskeletal discomfort, osteopenia, and osteoporosis. The most effective treatment for the relief of menopausal symptoms is estrogen, with or without. Hormone replacement therapy (HRT) is most beneficial before 60 years of age or within 10 years of menopause. Other menopause-related symptoms including mood swings, sleep disturbance, sexual dysfunction, and myalgia may improve with HRT. HRT is also effective in preventing bone loss associated with menopause and in reducing the incidence of all osteoporosis-related fractures, including those of the vertebrae and hip.

Russell body gastritis (RBG) is a rare gastric inflammatory lesion characterized by dense infiltration of plasma cells containing Russell bodies (RBs) known as Mott cells. Here, we report a case of RBG that showed resolution 2 months after Helicobacter pylori eradication. A gastric biopsy revealed numerous eosinophilic globular RBs and signet ring cell-like Mott cells. H. pylori infection was identified on the surface of foveolar epithelial cells. Alcian blue staining was negative for RBs. Periodic acid–Schiff staining showed that most RBs were negative, with only a few RBs and Mott cells showing weak positivity. Immunohistochemical staining for immunoglobulin G (IgG), kappa, and lambda light chains was performed on paraffinembedded tissue. Plasma and Mott cells were positive for CD79a, CD138, IgG, kappa, and lambda. However, despite being traditionally considered as aggregates of immunoglobulin molecules, the majority of RBs are negative for IgG and light chain determinants. The marked reduction in RBs and reappearance of normal plasma cells following H. pylori eradication suggest that RB formation is a reversible and reactive process. However, the lack of staining in certain immunohistochemical analyses indicated the presence of unexpected alterations in immunoglobulin composition. The precise biochemical nature and fate of RBs warrant further investigation.

Background
This study examined disparities in 1-year mortality rates between infants born to married and unmarried single-parent families, emphasizing the need for targeted health policies.
Methods
Data from 3,298,263 cases, obtained from the South Korea National Statistical Office (2010–2017), were analyzed. T-tests and chi-square tests were used to assess the demographic characteristics of the study group. The number of deaths per 1,000 live births was calculated, and logistic and multivariable logistic regressions were employed to compare infant mortality rates between family types. Additional stratified analyses, based on gestational age and birth weight, further elucidated the relationship between parental marital status and infant mortality.
Results
Infants from unmarried families exhibited a 3.34-fold higher crude odds ratio (OR) for 1-year mortality (95% confidence interval [CI], 2.56–4.36; P<0.001) than that from married families. After adjusting for confounders, the adjusted OR was 1.40 (95% CI, 1.03–1.92). Stratification by gestational age and birth weight revealed crude ORs of 4.62 (95% CI, 3.34– 6.39) in non-preterm infants (≥37 weeks) and 4.76 (95% CI, 3.46–6.56) in non-low-birth-weight infants (≥2.5 kg), highlighting a more pronounced disparity in infants born at or above normal weight and full term. No significant difference (P>0.05) was found in the crude OR for 1-year mortality rates among low-birth-weight (<2.5 kg) or preterm (<37 weeks) infants between the two-family types.
Conclusion
This study highlights the significant disparity in infant mortality rates based on parental marital status, underscoring the need for enhanced social support and tailored policies for unmarried single-parent families.

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.

Hemicrania continua (HC) is an indomethacin-responsive headache, characterized by unilateral and continuous headaches with cranial autonomic symptoms. Various pathologies, including sinus-related conditions, are associated with HC. Here, we report the case of a 62-year-old man with HC and rhinosinusitis. The patient complained of a unilateral continuous headache with ipsilateral cranial autonomic symptoms, conjunctival injection, and eyelid edema for 20 months. HC was identified as a potential diagnosis based on the symptom criteria, and a response to indomethacin confirmed the diagnosis. Trigeminal autonomic cephalalgia should be considered in patients with unilateral headaches and cranial autonomic symptoms.

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

• 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

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

• Correlation between vitamin B12 deficiency and hemoglobin A1c in patients with diabetes mellitus
  Yahya Madkhali, Sami G. Almalki
  Journal of King Saud University – Science.2025; 37: 3542024.     CrossRef
• 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

Background
Adolescence is an essential stage of a child’s development, transitioning them into adulthood. During this time, they are vulnerable to various social issues, such as experimenting with alcohol, among others. Although alcohol consumption was proven to be detrimental to physical and cognitive development toward adulthood, and almost one in 10 Malaysian adolescents aged 13 years and above are current drinkers, studies concerning the driving factors are still scarce. This cross-sectional study aimed to determine alcohol use among 244 adolescents in Nabawan, Sabah.
Methods
This study assessed the associations between alcohol use and three potential factors: demographic, environmental, and psychological. Respondents who were selected through stratified proportionate random sampling answered a set of assessment tools.
Results
Results showed that 30.7% (95% confidence interval [CI], 24.91–36.48) of Nabawan adolescents use alcohol. Analysis revealed that older age adolescents 18 years and 19 years, respectively (adjusted odds ratio [aOR], 3.93; P=0.021; aOR, 5.38; P=0.003), having parents (aOR, 4.11; P=0.001) and peers (aOR, 11.57; P<0.001) who consume alcohol were significantly associated with alcohol use. Unexpectedly, good parental monitoring (aOR, 2.46; P=0.019) and discussing serious problems with parents (aOR, 3.86; P=0.001) were significantly associated with alcohol use.
Conclusion
Conclusively, policies on alcohol-related harm reduction and prevention should be developed, especially school-based programs, programs addressing family functioning, and parent-child communication, among others, should be further looked into. Future research on the school environment, adolescents’ drinking motives, and the development of practical adolescent-friendly alcohol screening tools are recommendations for improvements.

Citations

• Health behaviors, lifestyle factors, and healthcare challenges in family medicine: a comprehensive review of recent evidence from Asian populations
  Joung Sik Son
  Korean Journal of Family Medicine.2025; 46(4): 215.     CrossRef

The coronavirus disease 2019 (COVID-19) pandemic is notable among infectious diseases for its distinctive impact, which has halted millions of livelihoods owing to strict social distancing rules and lockdowns. Consequently, millions of individuals have turned to online sources, particularly social media, to remain informed about the virus. The transition to digital sources has resulted in an abundance of information, including both accurate and misleading or false content being shared and consumed on online platforms, contributing to what is commonly referred to as an “infodemic.” Although these platforms have been valuable tools for healthcare professionals and public health authorities in disseminating crucial public health messages, they have also aided in the spread of misleading and false information. The widespread dissemination of false information has been instrumental in propagating harmful beliefs and behaviors such as vaccine hesitancy, promoting discriminatory attitudes, and endorsing false beliefs about the efficacy of certain therapeutic products for treating COVID-19. False information has undoubtedly become a challenge and burden for governments, health professionals, and the general population. This review has three main objectives: (1) to assess the scope of the “infodemic” issue, including investigating the factors contributing to the spread of false information online; (2) to examine the multifaceted consequences resulting from false information; and (3) to argue that an interdisciplinary, multi-layered approach, encompassing a focus on prevention, deterrence, and education, should be adopted to prevent the conception and dissemination of false information in this modern digital age.

Citations

• Reflecting on progress and challenges: the Korean Journal of Family Medicine in 2024
  Seung-Won Oh
  Korean Journal of Family Medicine.2025; 46(2): 55.     CrossRef
• Clustering vaccine hesitancy and social media use of nurses and nursing students: a cross-sectional study
  Dania Comparcini, Valentina Simonetti, Melania Totaro, Letizia Governatori, Francesco Pastore, Antonio Di Lorenzo, Silvio Tafuri, Jeremia Keisala, Kristina Mikkonen, John Unsworth, Marco Tomietto, Giancarlo Cicolini
  Applied Nursing Research.2025; 84: 151976.     CrossRef
• The Interconnected Nature of Smoking, Depression, and Obesity in Behavioral Medicine
  Joung Sik Son
  Korean Journal of Family Medicine.2024; 45(4): 181.     CrossRef

Background
Since the World Health Organization’s pandemic declaration in March 2020, Korea has witnessed shifts in lifestyle behaviors, impacting habits tied to socioeconomic status and contributing to metabolic syndrome (MetS). To investigate this issue, the current study aimed to investigate changes in MetS prevalence, particularly based on income levels before and after the coronavirus disease 2019 (COVID-19) pandemic.
Methods
This study used data from the 8th Korea National Health and Nutrition Examination Survey (2019–2020). A total of 6,840 individuals aged 30–65 years were included in this study. Household income was divided into high (≥75th percentile), middle (25–75th percentile), and low (≤25th percentile). A multivariable logistic regression analysis was performed to explore the interaction between this association before and after the COVID-19 pandemic.
Results
A statistically significant difference was found in the prevalence of MetS before and after the COVID-19 pandemic (26.7% to 30.2%, P=0.001). These changes differed based on income levels. The increase in the prevalence of MetS was statistically significant in the low- and high-income groups but not in the middle-income group (low: 8.0%p increase [P=0.039], middle: 1.0%p increase [P=0.522], high: 6.4%p increase [P<0.001]). The interaction between household income and the COVID-19 pandemic on MetS was statistically significant (P for interaction=0.032).
Conclusion
This study revealed that P for interaction between household income, MetS, and the period before and after the COVID-19 pandemic was significant. Changes in physical activity and eating habits during the COVID-19 pandemic may have contributed to these differences.

Background
Men with low testosterone levels are at an increased risk of developing metabolic syndrome, irrespective of age or obesity. However, the relationship between metabolic syndrome and testosterone levels in women remains unclear. We compared the total testosterone concentrations between premenopausal obese women with and without metabolic syndrome and identified the factors affecting these concentrations.
Methods
A single-center retrospective analysis was conducted using the medical records of 580 premenopausal women with obesity. The diagnostic criteria for metabolic syndrome were established using the National Cholesterol Education Program Adult Treatment Panel III guidelines.
Results
The mean±standard deviation age, weight, and body mass index were 38.8±8.4 years, 78.0±11.8 kg, and 30.0±4.1 kg/m², respectively. The mean total testosterone concentration was lower in the metabolic syndrome group than in the non-metabolic syndrome group (n=385 vs. n=195; 0.22±0.10 ng/mL vs. 0.24±0.11 ng/mL; P<0.001). In a model adjusted for age, body mass index, skeletal muscle mass, body fat mass, and body fat percentage, the odds ratio for metabolic syndrome with respect to the total testosterone level was 0.128 (P=0.028). Testosterone concentration was negatively correlated with age (r=-0.334), systolic blood pressure (r=-0.084), and triglyceride concentration (r=-0.093) but positively correlated with weight (r=0.144), body mass index (r=0.140), waist circumference (r=0.133), body fat mass (r=0.167), and body fat percentage (r=0.167). Stepwise regression analysis revealed that age (β=-0.004, P<0.001), body mass index (β=0.003, P=0.004), and high-density lipoprotein cholesterol concentration (β=0.001, P=0.019) were independently associated with total testosterone concentration (adjusted R2=12.6%).
Conclusion
Metabolic syndrome and obesity may be independently associated with testosterone levels in premenopausal women with obesity.

Citations

• The Interconnected Nature of Smoking, Depression, and Obesity in Behavioral Medicine
  Joung Sik Son
  Korean Journal of Family Medicine.2024; 45(4): 181.     CrossRef

Background
Depression is a mental disorder common worldwide. This study determined the relationships between demographics, health status, household parameters, and depression rates among working-age household heads.
Methods
We analyzed data from the Korea Welfare Panel Study Survey conducted in 2020. The 11-item version of the Center for Epidemiologic Studies Depression Scale was used to assess depression. Bivariate analyses and a multiple logistic regression model were used to evaluate the influence of these factors on depression among household heads.
Results
The overall prevalence of depression among working-age household heads was 11.69% (19.83% of females and 9.58% of males). The relative risk of depression was 1.71 times higher among the unemployed than among wage earners and 2.18 times higher among those with low income than among those with general income. The relative risk of depression was 3.23 times higher in those with poor health status than in those with good health, and 2.45 times more in those with severe disabilities than in those without disabilities. The rate of depression decreased with education level, number of family members, and presence of children but increased with the presence of the disabled or elderly.
Conclusion
This study provides a comprehensive overview of depression among working-age household heads and identifies factors strongly associated with depression. These findings may have implications for policymakers to reduce the burden on and improve the quality of life of household heads.

Citations

• Global, regional, and national burden of mental disorders in working-age population: a trend, health inequality, and frontier analyses
  Xizhi Zhang, Wenge Zhang, Chuxun Zhou, Jiaofeng Xiang, Zihan Xu, Yingbai Wang, Xuefei Hou, Jia Wang, Suru Yue, Xiaoming Chen, Jiayuan Wu
  Journal of Affective Disorders.2026; 393: 120367.     CrossRef
• Prevalence, Determinants and Wealth‐Related Inequality of Anxiety and Depression Symptoms Among Reproductive‐Aged Women (15–49 Years) in Nepal: An Analysis of Nationally Representative Nepal Demographic and Health Survey Data 2022
  Syed Toukir Ahmed Noor, Samin Yeasar, Sazid Siddique, Rajon Banik, Sahar Raza, Xinqiao Liu
  Depression and Anxiety.2025;[Epub]     CrossRef
• Prevalence of depression and its associated factors among Korean women: A cross-sectional study in Seoul
  Thi Thanh Lan Nguyen, Van Cuong Nguyen
  Archives of Psychiatric Nursing.2025; 57: 151928.     CrossRef
• The Interconnected Nature of Smoking, Depression, and Obesity in Behavioral Medicine
  Joung Sik Son
  Korean Journal of Family Medicine.2024; 45(4): 181.     CrossRef

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.

Background
Non-alcoholic fatty liver disease (NAFLD) recently became a leading liver disease that threatens health worldwide. Low muscle strength, obesity, insulin resistance, and metabolic syndrome are recognized key factors for NAFLD. However, the impact of low muscle strength itself in different metabolic conditions has not been widely studied.
Methods
A cross-sectional analysis was performed of a sample of 5,427 participants from the 2019 Korea National Health and Nutrition Examination Survey. Relative handgrip strength (rHGS, defined as handgrip strength/body mass index) was used to assess muscle strength. The cut-off values for a low rHGS were 1.405 for men and 0.850 for women. NAFLD was diagnosed if the Hepatic Steatosis Index was >36. Participants were stratified according to insulin resistance, metabolic syndrome, and central obesity for the subgroup analyses.
Results
Complex sample multivariate logistic regression analysis revealed a significant association between low muscle strength and NAFLD after the adjustment for other confounders (odds ratio [OR], 1.92; P<0.001). In the insulin resistance, metabolic syndrome, and central obesity subgroups, a significant association between low muscle strength and NAFLD remained (OR, 1.66–4.19 depending on subgroup; all P<0.05), whereas it did not in the no central obesity group.
Conclusion
This study demonstrated that low muscle strength is correlated with a risk of NAFLD. This relationship was independent of insulin resistance and metabolic syndrome but was dependent on the presence of central obesity.

Citations

• Possible association between metabolic dysfunction-associated steatotic liver disease predictors and hand grip strength
  Suyeon Lee, Jong-Koo Kim, Taesic Lee
  Scientific Reports.2025;[Epub]     CrossRef
• Association between muscular strength, abdominal obesity, and incident nonalcoholic fatty liver disease in a Korean population
  Jae Ho Park, Hyun-Young Park
  Scientific Reports.2025;[Epub]     CrossRef
• Association Between Relative Grip Strength, Insulin Resistance, and Nonalcoholic Fatty Liver Disease Among Middle-Aged and Older Adults: A Prospective Cohort Study
  DooYong Park, Byungul Lim, On Lee
  Metabolic Syndrome and Related Disorders.2024;[Epub]     CrossRef
• The impact of appendicular skeletal muscle index and trunk muscle index on stress urinary incontinence risk in female adults: a retrospective study
  Junwei Wang, Cunming Zhang, Aiwei Zhang
  Frontiers in Nutrition.2024;[Epub]     CrossRef
• Joint Association of Relative Grip Strength and Regular Exercise Participation with Nonalcoholic Fatty Liver Disease: A Prospective Cohort Study
  Sujung Yoo, Dooyong Park
  The Korean Journal of Sports Medicine.2024; 42(4): 262.     CrossRef

Background
Maintaining a usual source of care (USC), which is crucial for primary healthcare, encompasses initial contact, comprehensive services, coordinated care, and ongoing support. However, limited research exists on the relationship between USC and medication adherence in patients with hypertension. This study aimed to investigate the association between USC and medication adherence among patients with hypertension.
Methods
Data from the 2nd Korea Health Panel Survey 2020 were analyzed. The final sample consisted of 3,318 participants aged 19 years or older diagnosed with hypertension. USC was categorized into three groups: no USC, place only (without a regular doctor), and regular doctor. Medication adherence was assessed using detailed items (dose, frequency, time, no stop) and a 4-point Likert scale. A logistic regression analysis was conducted with control for relevant variables.
Results
Compared to the no USC group, the regular doctor group had significantly higher odds ratios (ORs) for overall perfect/high medication adherence rates: 1.70 (95% confidence interval [CI], 1.42–2.03) and 1.59 (95% CI, 1.14–2.20). Similar results were observed for each adherence item, including prefect dose (OR, 2.14; 95% CI, 1.73– 2.63), frequency (OR, 1.87; 95% CI, 1.53–2.28), time (OR, 1.72; 95% CI, 1.43–2.07), and no stop (OR, 1.56; 95% CI, 1.09–2.23)/high frequency (OR, 2.47; 95% CI, 1.21–5.01), time (OR, 2.30; 95% CI, 1.19–4.44). However, the place only group showed no significant differences in medication adherence except for perfect adherence to dose (OR, 1.35; 95% CI, 1.06–1.71).
Conclusion
These findings provide evidence supporting the need for healthcare policies that encourage having a regular doctor in South Korea, which has a healthcare system with limited primary care.

Citations

• Types of Usual Source of Care and Medication Adherence in Patients with Diabetes Mellitus
  Yoon-Eui Choi, Nak-Jin Sung
  Korean Journal of Family Practice.2025; 15(1): 47.     CrossRef
• Medication adherence and associated factors among hypertensive older adults: A study focusing on health literacy
  Ji Young Kim, Ju Young Yoon
  Korean Journal of Health Education and Promotion.2025; 42(2): 33.     CrossRef
• Lifestyle prescriptions for obesity treatment in primary care: a narrative review
  Ji-Hye Jung, YangIm Hur
  Ewha Medical Journal.2025; 48(4): e54.     CrossRef
• Supply of Primary Care Physicians: A Key Strategy to Reduce Population Mortality
  Young Gyu Cho
  Korean Journal of Family Medicine.2024; 45(2): 59.     CrossRef

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

• Guidelines for nutrition counseling in primary healthcare clinics
  Gyeongsil Lee, Seung-Won Oh
  Journal of the Korean Medical Association.2024; 67(4): 278.     CrossRef

Elderly abuse and neglect are among the primary public health problems linked to global demographic changes in the population, impacting not only the well-being of the elderly but also the growth of the nation or economy. This article discusses the effects of elder abuse and neglect on population health from the national and international perspectives through a narrative review of previously published articles on the concept of aging, the prevalence of elderly abuse and neglect, its risk factors and effects, and finally measures, legal perspectives, and recommendations to curb it. Interventions in Malaysia and selected nations, including Indonesia, South Korea, the United States, Australia, and Hong Kong, are examined. This issue is important as the majority of countries are moving toward being elderly populations. Improving global surveillance and the monitoring of instances is essential to inform policy actions to prevent elder abuse. In addition, a thorough assessment of the identified risk factors for violence and steps to prevent violence is required.

Citations

• Prevalence of elder abuse and its correlated factors in Iranian community-dowelling older adults: a cross-sectional study
  Mohadese Maleki, Seyedeh Ameneh Motalebi, Mehdi Ranjbaran, Seyedehzahra Hosseinigolafshani
  BMC Geriatrics.2025;[Epub]     CrossRef
• PTSD in Elder Abuse Survivors: Trauma Symptom Presentation and Treatment Outcomes With the PROTECT Intervention
  Clare Culver, Emily Carter, Olivia Fiallo, Nancy Wang, Talya Waxenberg, Samprit Banerjee, Isabel Rollandi, Jo Anne Sirey
  The American Journal of Geriatric Psychiatry.2025; 33(11): 1119.     CrossRef
• Prioritizing care and addressing distinct needs of older adults with disabilities in Ghana amidst challenges
  Evans Appiah Osei, Felicia Addasah, Jenifer Oware, Mary Ani-Amponsah, Agnes Acquah, Edward Obeng Amoah, Cindy Afoakwa-Acheampong, Emmanuel Opoku-Adjei
  Geriatric Nursing.2025; 65: 103524.     CrossRef

Background
Intravenous (IV) iron therapy is performed in community practices and hospitals with modern formulations when oral administration becomes impractical. Effective replacement of iron is important for the treatment of iron deficiency and anemia. Can IV iron be rechallenged in individuals with a history of adverse reactions? This review is to explore the challenge of this, when clinically indicated.
Methods
After performing a literature search, five studies (combined total sample number=1,006) for re-exposure of IV iron to individuals with a history of past reactions were identified, observed, and analyzed. Re-exposure included reactions ranging from mild to moderate and few cases of severe type.
Results
The majority (>80%) of IV iron rechallenges were tolerable, safe, and successful without major serious incidents. There were no reports of major reactions (severe hypersensitivity reactions or anaphylaxis) in these re-exposures.
Conclusion
Re-administration of IV iron therapy in patients with a previous adverse reaction is plausible, with benefit and risk stratification. A rechallenge would depend on the nature and degree of the adverse reaction and use of alternative formulations. Rechallenge to a previous severe hypersensitivity reaction or anaphylaxis with the same product has not been reported in these studies. Evidence on the benefit of premedication use is conflicting and requires further studies.

Citations

• The experiences of ferric carboxymaltose desensitization and provocation
  Fatma Dindar Çelik, Kurtuluş Aksu, Özgür Akkale, Hatice Çelik Tuğlu, Melis Yağdıran, Onur Telli, Gürgün Tuğçe Vural Solak, Enes Çelik
  World Allergy Organization Journal.2025; 18(2): 101025.     CrossRef
• Intravenous Iron Versus Oral Iron Administration for the Treatment of Iron Deficiency Anemia: A Patient-Preference Study
  Ranya Ghamri, Hadeel Alsulami
  Cureus.2024;[Epub]     CrossRef

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

• Plan, Track, and Live Mindfully: Insights from the Eat Smart, Move More, Prevent Diabetes Program
  Erin McCallum, Kelly Nordby, Surabhi Aggarwal, Christine Lavelle, Cathy Thomas, Carolyn Dunn
  Diabetology.2025; 6(5): 42.     CrossRef
• Facilitators and barriers affecting the implementation of diabetes prevention programs in primary care settings: A qualitative meta-synthesis from a multi-stakeholder perspective
  Jiali Chen, Zheng Lin, Yang Lei, Qingyu Wang, Lichen Tang, Hantian Cheng
  International Journal of Nursing Studies.2025; 170: 105156.     CrossRef
• A critical realist exploration of health professionals’ perspectives on prediabetes diagnosis, management and type 2 diabetes prevention programs in a rural setting
  Britney McMullen, Kerith Duncanson, David Schmidt, Clare Collins, Lesley MacDonald-Wicks
  Australian Journal of Primary Health.2025;[Epub]     CrossRef
• 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

Background
Physical activity is known to prevent several diseases and positively affect mental health. Previous studies have shown that smartphone addiction negatively affects the physical activity of children and adolescents. This study aimed to investigate the relationship between problematic smartphone use and physical activity among adolescents and the related factors using path analysis.
Methods
Using data from the 16th Youth Risk Behavior Web-based Survey from 2020, scores on the Smartphone Addiction Scale—Short Version for Adolescents, physical activity, sex, socioeconomic status (SES), academic performance, depression, smoking, drinking, and sitting time were assessed. Complex sampling and path analyses were performed.
Results
Of the total 54,948 students, 25.5% were smartphone risk users, including potential and high-risk users. The direct path coefficients of each factor indicated that female sex (-0.14 for male), low SES (-0.062), high academic performance (0.056), low sitting time for studying purposes (-0.033), high sitting time for non-studying purposes (0.071), and depressive mood (0.130) were related to problematic smartphone use (all P<0.001). Each factor affected problematic smartphone use, and subsequently had a negative effect on the amount of physical activity, with a direct path coefficient of -0.115 (P<0.001).
Conclusion
In this study, we confirmed that problematic smartphone use among adolescents was negatively associated with performing an adequate amount of physical activity and that various factors, such as sex, SES, academic performance, and sitting time, directly and indirectly affected this relationship.

Citations

• Global trends in importance of 24-hour movement behaviors to pediatric health: implications for South Korea
  Eun-Young Lee, Reyana Jayawardena, Seiyeong Park, Justin Y Jeon, Yeon-Soo Kim, Mark S. Tremblay
  Clinical and Experimental Pediatrics.2025; 68(1): 16.     CrossRef
• Exploring associations between problematic technology-dependent behaviors, physical and mental health, sleep quality, and academic procrastination among medical students
  Mitra Mojibpour, Alireza Salehi, Mohammad Reza Shadzi, Sahar Derakhshani
  BMC Public Health.2025;[Epub]     CrossRef
• Recommendations for Physical Exercise as a Strategy to Reduce Problematic Use of the Internet and Digital Devices: A Perspective
  Christel García-Ortiz, Miriam Lorenzo-González, Javier Fernández-Sánchez, Víctor Solano-Lizcano, Juan Del Coso, Daniel Collado-Mateo
  International Journal of Environmental Research and Public Health.2025; 22(5): 753.     CrossRef
• Smartphone and Social Network Usage is Influenced by Physical Activity and Self-Esteem: A Cross Sectional Study
  Javier Fernández-Sánchez, Daniel Trujillo-Colmena, Ana Myriam Lavín-Pérez, Juan Del Coso, Alfonso Jiménez, Daniel Collado-Mateo
  Psychological Reports.2025;[Epub]     CrossRef
• Determinants of early smartphone ownership: a research gap in the study of problematic smartphone use in children and adolescents
  Juan Albacete-Maza, Xavier Casanovas Combalia, Cristina Montañola-Sales
  Humanities and Social Sciences Communications.2025;[Epub]     CrossRef
• Impact of digital addiction on youth health: A systematic review and meta-analysis
  Blen Dereje Shiferaw, Jie Tang, Yingxue Wang, Yihan Wang, Yuhao Wang, Louisa Esi Mackay, Yunjiao Luo, Na Yan, Xinyu Shen, Tong Zhou, Yiran Zhu, Jialin Cai, Qingzhi Wang, Wenjun Yan, Xiuyin Gao, Haifeng Pan, Wei Wang
  Journal of Behavioral Addictions.2025; 14(3): 1129.     CrossRef
• Changes in smartphone dependence and depressive and anxiety symptoms among Chinese adolescents
  Yanzhi Li, Yi-Fan Lin, Herui Wu, Liwen Yang, Liwan Zhu, Xinchang Sun, Shuwen Dong, Wanxin Wang, Lei Yang, Bin Yan, Ciyong Lu
  BMC Medicine.2025;[Epub]     CrossRef
• The Association between Problematic Smartphone Use and Mental Health in Austrian Adolescents and Young Adults
  Doris Mayerhofer, Katja Haider, Manuela Amon, Afsaneh Gächter, Teresa O’Rourke, Rachel Dale, Elke Humer, Thomas Probst, Christoph Pieh
  Healthcare.2024; 12(6): 600.     CrossRef
• 2023 Obesity Fact Sheet: Prevalence of Obesity and Abdominal Obesity in Adults, Adolescents, and Children in Korea from 2012 to 2021
  Su-Min Jeong, Jin-Hyung Jung, Ye Seul Yang, Wonsock Kim, In Young Cho, You-Bin Lee, Kye-Yeung Park, Ga Eun Nam, Kyungdo Han
  Journal of Obesity & Metabolic Syndrome.2024; 33(1): 27.     CrossRef
• Guidelines for physical activity counseling in primary healthcare clinics
  Yun Jun Yang
  Journal of the Korean Medical Association.2024; 67(4): 265.     CrossRef
• Collaborative Physical Activity: Innovations in Primary Health Care and Educational Sector
  Fides A. del Castillo
  Korean Journal of Family Medicine.2024; 45(3): 178.     CrossRef
• How is parental psychological control associated with adolescent mental health in economically disadvantaged areas? The serial mediating role of psychological reactance and problematic smartphone use
  Qiangqiang Li, Shuwen Wei, Zixiao Liu
  Frontiers in Psychiatry.2024;[Epub]     CrossRef
• Depression, anxiety, and stress in the Chilean Educational System: children and adolescents post-pandemic prevalence and variables
  Jonathan Martínez-Líbano, María-Mercedes Yeomans-Cabrera
  Frontiers in Education.2024;[Epub]     CrossRef
• Does Excessive Smartphone Use Reduce Physical Activity in Adolescents?
  Soo Young Kim
  Korean Journal of Family Medicine.2023; 44(5): 247.     CrossRef

Since each person has a different ability to break down alcohol, it is inappropriate to apply a uniform standard to everyone when evaluating drinking status. In Korea, there has been a guideline for moderate drinking based not only on sex and age but Koreans’ alcohol metabolism capabilities that can be predicted by presence of facial flushing response. So far, there have been no studies that have investigated drinking habits of Koreans in accordance with the guideline. This study tried to identify the current drinking status of Koreans according to the guideline. As a result, it was confirmed that about 1/3 of the total population was accompanied by facial flushing when drinking alcohol, and it was found that different drinking habits were shown even in the same age and gender groups according to the presence of facial flushing. It is difficult to accurately evaluate drinking habits because facial flushing has not yet been investigated in some large data or various medical examinations. In the future, it is necessary to ensure that the presence of facial flushing can be confirmed at the medical treatment or examination site so that accurate drinking habit evaluation and prevention and resolution of drinking problems can be achieved.

Citations

• Unhealthy alcohol use: screening and behavioral counseling interventions
  Wonyoung Jung, Seung-Won Oh, Se-Hong Kim, Soo Young Kim
  Korean Journal of Family Medicine.2025; 46(1): 20.     CrossRef
• Associations of Body Mass Index and Lifestyle Factors with Suicidal Ideation, Planning, and Attempts Among Korean Adolescents: A Cross-Sectional Study
  Haitao Wang, Kyung-O Kim
  Healthcare.2025; 13(12): 1470.     CrossRef
• Association of Insulin Resistance with Dysglycemia in Elder Koreans: Age- and Sex-Specific Cutoff Values
  Sang Min Yoon, Boyoung Park
  Journal of Personalized Medicine.2025; 15(9): 438.     CrossRef
• The preventative effects of statin on lung cancer development in patients with idiopathic pulmonary fibrosis using the National Health Insurance Service Database in Korea
  Yoo Jung Lee, Nayoon Kang, Junghyun Nam, Eung Gu Lee, Jiwon Ryoo, Soon Seog Kwon, Yong Hyun Kim, Hye Seon Kang, Tsai-Ching Hsu
  PLOS ONE.2024; 19(3): e0299484.     CrossRef
• Cancer risk based on alcohol consumption levels: a comprehensive systematic review and meta-analysis
  Seunghee Jun, Hyunjin Park, Ui-Jeong Kim, Eun Jeong Choi, Hye Ah Lee, Bomi Park, Soon Young Lee, Sun Ha Jee, Hyesook Park
  Epidemiology and Health.2023; 45: e2023092.     CrossRef

Background
This study aimed to improve the clinical course of patients through rapid response by analyzing the characteristics of critically ill patients with confirmed coronavirus disease 2019 (COVID-19) in Busan between December 1, 2020, and December 31, 2021.
Methods
We divided patients diagnosed with COVID-19 into mild-to-moderate and critical groups based on their clinical severity. The critically ill patients were further sub-divided into delta and delta variant non-epidemic group.
Results
The following factors were significantly more frequent in critically ill patients than in patients with mild-tomoderate symptoms: male sex, age ≥60 years, symptoms at the time of diagnosis, and those with underlying diseases. The following factors were significantly more common in the non-delta variant epidemic group than in the delta variant epidemic group in critically ill patients: male sex, age ≥60 years, underlying diseases, and not being vaccinated. In the delta variant epidemic group, the duration between confirmation of disease and its progression to critically ill status was significantly shorter than that in the non-delta variant epidemic group.
Conclusion
COVID-19 is characterized by the emergence of new variants and repeated epidemics. Therefore, it is necessary to analyze the characteristics of critically ill patients to efficiently distribute and manage medical resources.

Background
Sleep duration is associated with hearing loss, especially presbycusis, which is the most common type of hearing loss; however, there is limited evidence regarding this association among the Korean population. We aimed to determine the relationship between sleep duration and high-frequency hearing loss in Korean adults aged ≥40 years.
Methods
We examined 5,547 Korean adults aged ≥40 years who completed audiometric tests and questionnaires regarding sleep duration during the 2010–2012 cycle of the Korea National Health and Nutrition Examination Survey. Mild presbycusis was defined as >25 decibels (dB) and <40 dB, whereas moderate-to-severe presbycusis was defined as >40 dB pure tone averages at high frequencies (3,000, 4,000, and 6,000 Hz) for both ears. Additionally, the sleep duration was divided into quartiles. Odds ratios and 95% confidence intervals were estimated using multivariable logistic regression after adjusting for covariates.
Results
The prevalence of presbycusis in South Korean adults was 62.1%, of which 61.4% showed moderate to severe presbycusis. The incidence of moderate-to-severe, but not mild, presbycusis showed a significant positive correlation with sleep duration.
Conclusion
Our findings suggest that sleep duration is associated with the prevalence of presbycusis.

Citations

• Joint association of sleep duration and depression with new-onset hearing loss: a national cohort study
  Fang Wang, Yu-Jun Xiong, Da-Ming Shao, Tian Lv, Shiqin Chen, Qian-Yuan Zhu
  Frontiers in Nutrition.2025;[Epub]     CrossRef
• Sleep characteristics and hearing loss in middle-aged and older adults: The National Health and Nutrition Examination Survey 2015–2018
  Kening Jiang, Adam P. Spira, Nicholas S. Reed, Frank R. Lin, Jennifer A. Deal
  Sleep Epidemiology.2024; 4: 100082.     CrossRef
• Age-related hearing loss and its potential drug candidates: a systematic review
  Shiyu Hu, Qingru Sun, Fei Xu, Ninghua Jiang, Jianli Gao
  Chinese Medicine.2023;[Epub]     CrossRef

Background
This study aimed to examine the association between coffee or green tea consumption and ferritin or hemoglobin levels in premenopausal women.
Methods
We used the fifth Korea National Health and Nutrition Examination Survey (2010–2012), and a total of 4,322 individuals were surveyed. In women of reproductive age, average ferritin and hemoglobin levels were calculated according to coffee or green tea consumption. Covariates included in the analysis were demographic variables, such as age, body mass index, education, drinking, smoking, history of hypertension, history of diabetes diagnosis, physical activity, total energy intake, and daily iron intake.
Results
In 4,322 participants, the average hemoglobin level was 12.90±0.02 g/dL, and the average level of ferritin was 31.95±0.67 ng/mL. As a result of testing, correlation between ferritin and coffee intake and difference in ferritin levels according to coffee consumption was significant (P<0.05). In this study, a post hoc test indicated that ferritin level significantly differed between one and two cups, two and three cups, and three and one cup groups (overall P<0.001). Additionally, there was a negative correlation between ferritin level and coffee intake; ferritin level decreased by 2.09 ng/mL with a one-cup increase in daily coffee consumption.
Conclusion
In premenopausal women, coffee intake is associated with low serum ferritin levels. Our results indicate that drinking >2 cups of coffee significantly affect ferritin levels in Korean premenopausal women.

Citations

• Accurate determination of aflatoxins in coffee by isotope dilution–ultrahigh-performance liquid chromatography–tandem mass spectrometry
  Yared Getachew Lijalem, Hyeonwoo Yu, So Young Woo, Hyang Sook Chun, Kihwan Choi, Byungjoo Kim
  Journal of Food Composition and Analysis.2025; 145: 107836.     CrossRef
• Hemoglobin response to iron-folic acid supplementation and associated factors among anemic pregnant women attending the University of Gondar Comprehensive Specialized Hospital ANC ward Northwest, Ethiopia 2023: A longitudinal follow up study
  Asefu Fekadie, Bisrat Birke Teketelew, Melak Aynalem, Aregawi Yalew, Tebelay Dilnessa
  PLOS One.2025; 20(9): e0331599.     CrossRef
• Women’s Health and Primary Care
  Seung-Won Oh
  Korean Journal of Family Medicine.2024; 45(1): 1.     CrossRef
• Guidelines for nutrition counseling in primary healthcare clinics
  Gyeongsil Lee, Seung-Won Oh
  Journal of the Korean Medical Association.2024; 67(4): 278.     CrossRef
• Dietary diversity and preferences among pregnant women and its association with anaemia
  Benedicta Twum - Dei, Richmond Aryeetey, Linda Nana Esi Aduku
  Nutrition & Food Science .2024; 54(4): 805.     CrossRef
• Association Between Tea Drinking and Anemia in Women of Reproductive Age: A Cross-Sectional Study From the Mekran Division, Balochistan, Pakistan
  Noman Sadiq, Yasmeen Gul, Muhammad M Bilal, Muhammad Afzal, Nasrin Mumtaz, Abdul Wahid
  Cureus.2024;[Epub]     CrossRef
• Does tea intake increase the risk of anemia? Evidence from a large prospective cohort and Mendelian randomization study
  Rui Hang Zhang, Wei Sen Zhang, Chao Qiang Jiang, Feng Zhu, Ya Li Jin, Shiu Lun Au Yeung, Tai Hing Lam, Lin Xu, Jiao Wang
  Food & Function.2024; 15(18): 9552.     CrossRef
• A Comparative Study of the Effect Coffee and Tea on Some Parameters in the Rats Blood
  Sadiq Al-Mansury, Suhad J. Hadi, Hawraa H. Naji, Adnan M. Jassim, Shatha M. Abbas, Nada Khazal K. Hindi
  Medical Journal of Babylon.2024; 21(3): 627.     CrossRef
• Association between Coffee and Green Tea Consumption and Iron Deficiency Anemia in Korea
  Jungun Lee
  Korean Journal of Family Medicine.2023; 44(2): 69.     CrossRef

Background
Oxidative stress plays an essential role in bone health among postmenopausal women. This study aimed to compare the oxidative stress biomarkers among postmenopausal women aged 50–65 years with normal bone mineral density, osteopenia, and osteoporosis.
Methods
In this observational study, 120 women with normal bone mineral density, 82 with osteopenia, and 86 with osteoporosis were selected based on the densitometry data obtained from the dual-energy X-ray absorptiometry method. The serum total antioxidant capacity (TAC), superoxide dismutase (SOD) activity, and malondialdehyde (MDA) levels were measured using biochemical methods. A binary logistic regression model adjusted for confounders was used to estimate the risk of osteopenia and osteoporosis. The P-value of <0.05 was considered statistically significant.
Results
There were significant differences between the three groups in age, menopausal age, body mass index, and education (P<0.05). According to the binary logistic regression model, higher SOD activity and serum TAC levels were associated with a lower risk of osteoporosis (adjusted odds ratio [aOR], 0.991; 95% confidence intervals [CI], 0.986 to 0.996; and aOR, 0.373; 95% CI, 0.141 to 0.986, respectively). MDA was a significant risk factor for osteopenia in postmenopausal women (aOR, 1.702; 95% CI, 1.125 to 2.576).
Conclusion
Higher SOD activity and serum TAC levels in the studied postmenopausal women were associated with a significantly lower risk of osteoporosis. Moreover, the risk of osteopenia increased significantly with higher serum MDA levels.

Citations

• Exploring the application of dietary antioxidant index for disease risk assessment: a comprehensive review
  Hossein Pourmontaseri, Sina Bazmi, Matin Sepehrinia, Ayda Mostafavi, Reza Arefnezhad, Reza Homayounfar, Farhad Vahid
  Frontiers in Nutrition.2025;[Epub]     CrossRef
• Neurokinin Antagonists to Treat Vasomotor Symptoms—Possible Implications for Long-Term Health and Disease
  Angelo Cagnacci, Anjeza Xholli, Marta Fiamberti, Ambrogio Pietro Londero
  Journal of Clinical Medicine.2025; 14(19): 6852.     CrossRef
• Pilot Study Assessing the Efficacy of Melatonin and Osteogenic Loading on Bone Health in a Postmenopausal Population with Osteopenia: MelaOstrong Randomized Controlled Trial
  Afsana Jahan, Yong Myoung, Afsin Malik, Michael R. Gionfriddo, Paula A. Witt‐Enderby
  Journal of Pineal Research.2025;[Epub]     CrossRef
• Effects of Nigella sativa on bone turnover markers in postmenopausal women: a comprehensive review
  Seyedeh Fatemehzahra Mousavi zargar, Farhang Soltani Bajestani, Mohsen Sahebanmaleki, Elyas Nattagh Eshtivani, Mohammad Rashidmayvan
  Phytomedicine Plus.2025; 5(4): 100904.     CrossRef
• Investigating the Effects of Occupational Noise and Extremely Low‐Frequency Electromagnetic Field Exposure on Oxidative Response in Power Plant Workers
  Sediqeh Jafarimanesh, Hadi Ehsani, Fatemeh Shaki, Mahmood Moosazadeh, Seyed Ehsan Samaei
  Bioelectromagnetics.2025;[Epub]     CrossRef
• Women’s Health and Primary Care
  Seung-Won Oh
  Korean Journal of Family Medicine.2024; 45(1): 1.     CrossRef
• Effects of cosmos caudatus (Kenikir) antioxidant properties on bone metabolism marker in rat
  Gadis Meinar Sari, Idha Kusumawati, Yoga Akbar Arifandi, Julian Benedict Swannjo
  Current Research in Physiology.2024; 7: 100128.     CrossRef
• Exogenous and endogenous antioxidants in osteoporosis risk: causal associations unveiled by Mendelian Randomization analysis
  Yuancheng Li, Huaqian Qi, Xin Huang, Gang Lu, Huashan Pan
  Frontiers in Physiology.2024;[Epub]     CrossRef
• Proteomic Biomarkers Associated with Low Bone Mineral Density: A Systematic Review
  Adriana Becerra-Cervera, Anna D. Argoty-Pantoja, Diana I. Aparicio-Bautista, Priscilla López-Montoya, Berenice Rivera-Paredez, Alberto Hidalgo-Bravo, Rafael Velázquez-Cruz
  International Journal of Molecular Sciences.2024; 25(14): 7526.     CrossRef

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

• Post-COVID Metabolic Fallout: A Growing Threat of New-Onset and Exacerbated Diabetes
  Shaghayegh Hemat Jouy, Harry Tonchev, Sarah M. Mostafa, Abeer M. Mahmoud
  Biomedicines.2025; 13(6): 1482.     CrossRef
• Intertwined pathways of SARS-CoV-2 infection and its clinical repercussions on glucose homeostasis: Exploring the rise of new-onset diabetes
  Vertika Awasthi, Rupinder Kaur, Chirag Pasricha, Pratima Kumari, Suruchi Chaubey, Sarita Jangra, Sanjana Mehta, Ravinder Singh
  Obesity Medicine.2025; 56: 100624.     CrossRef
• 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

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

• 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
• Lifestyle prescriptions for diabetes management in primary care: a narrative review
  Hye Jun Lee, Jung-Ha Kim
  Ewha Medical Journal.2025; 48(4): e55.     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

Background
A usual source of care (USC) is related to longitudinal and personalized services, which are attributes of primary care. Patient-centered communication, an important element of patient-centered care, helps physicians understand health problems from a patient’s point of view. We analyzed the association between USC and patient-centered communication.
Methods
Data from the Korea Health Panel 2018 were used in the analysis. Patient-centered communication scores were obtained by combining the four communication-related questionnaire items. Usual source of care types were categorized based on responses to two questionnaire items: no USC, a place without a regular doctor and with a regular doctor. Multiple logistic regression analysis was used to adjust for confounders.
Results
Good communication rate was higher for those with a regular doctor (71.8%) than for those with no USC (61.8%) or a place only (61.5%). Those with a regular doctor had better communication (odds ratio, 1.49 for individuals with poor/moderate health, and 2.08 for those with good health) than those without a USC after adjusting for confounders. In terms of communication, no difference was observed between individuals with no USC and those with a place only.
Conclusion
Having a regular doctor promotes communication between patients and doctors. Good communication may be a mediator between having a regular doctor and related beneficial outcomes. Better communication by having a regular doctor, along with several other benefits identified in previous studies suggests the need for a health policy that encourages individuals to have regular doctors.

Citations

• Types of Usual Source of Care and Medication Adherence in Patients with Diabetes Mellitus
  Yoon-Eui Choi, Nak-Jin Sung
  Korean Journal of Family Practice.2025; 15(1): 47.     CrossRef
• Patterns of health literacy and influencing factors differ by age: a cross-sectional study
  Da Hae Kwon, Young Dae Kwon
  BMC Public Health.2025;[Epub]     CrossRef
• Correlation between Usual Source of Care and Medication Adherence in Patients with Hypertension
  Han-Kil Kang, Nak-Jin Sung
  Korean Journal of Family Medicine.2024; 45(2): 82.     CrossRef
• Determinants of Patient-Centered Communication, Its Impact On Quality of Services, Overall Health Status And Trust In The Healthcare System In The United States
  Cuma Çakmak, İsmail Biçer
  Celal Bayar Üniversitesi Sağlık Bilimleri Enstitüsü Dergisi.2024; 11(4): 630.     CrossRef