Kyungah Han - Academia.edu (original) (raw)

Papers by Kyungah Han

Korean Journal of Family Practice, 2017

Korean diabetes journal, 2010

The Korean National Health and Nutrition Examination Surveys reported 65% of daily energy intake ... more The Korean National Health and Nutrition Examination Surveys reported 65% of daily energy intake (EI) as carbohydrate (CHO) in the Korean population and main source of CHO was cooked rice. We used a standardized-small sized rice bowl for diet education and investigated its effectiveness on body weight, glucose and lipid, compared to the conventional food exchange system in type 2 diabetes obese women. Type 2 diabetic women with body mass index >/= 23 kg/m(2) were randomly assigned to small rice bowl-based meal plan (BM) and food exchange-based meal plan (ExM) group. Both groups were asked to reduce their EI by 500 kcal/day for 12 weeks. The macronutrient composition was instructed: 55 to 60% of EI as CHO, 15 to 20% as protein, and 20 to 25% as fat. BM group received only a simple instruction for application of the rice bowl. Nutrient intake was estimated with the 3-day dietary records. Finally, 44 subjects finished the study. The percent reduction of body weight was significant b...

Korean diabetes journal, 2010

The main source of carbohydrate in the Korean diet is rice, which is usually served in a rice bow... more The main source of carbohydrate in the Korean diet is rice, which is usually served in a rice bowl. This study investigated the impact of a meal plan using smaller rice bowls on dietary energy intake and macronutrient composition in overweight or obese patients with type 2 diabetes mellitus. A total of 67 women with type 2 diabetes were enrolled in our study. We divided these participants into three groups: a normal-weight group (NW; body mass index [BMI] < 23 kg/m(2); n = 17), an overweight group (OW; 23 </= BMI < 25 kg/m(2); n = 24) and an obese group (OB; BMI >/= 25 kg/m(2); n = 26). Three-day dietary records were analyzed for total energy intake (TEI) and macronutrient composition both before enrollment and two weeks after patients received instruction in a dietary plan based on using a small (200 mL) rice bowl. After the intervention, TEI decreased in the OW and OB groups. Decreased carbohydrate (NW, -4 +/- 5%; OW, -4 +/- 5%; OB, -3 +/- 6%) and increased fat intakes...

Diabetes & Metabolism Journal, 2012

Background: Central fat mass (CFM) correlates with insulin resistance and increases the risk of t... more Background: Central fat mass (CFM) correlates with insulin resistance and increases the risk of type 2 diabetes and cardiovascular complications; however, peripheral fat mass (PFM) is associated with insulin sensitivity. The aim of this study was to investigate the relation of absolute and relative regional adiposity to insulin resistance index and adipokines in type 2 diabetes. Methods: Total of 83 overweighted-Korean women with type 2 diabetes were enrolled, and rate constants for plasma glucose disappearance (KITT) and serum adipokines, such as retinol binding protein-4 (RBP4), leptin, and adiponectin, were measured. Using dual X-ray absorptiometry, trunk fat mass (in kilograms) was defined as CFM, sum of fat mass on the lower extremities (in kilograms) as PFM, and sum of CFM and PFM as total fat mass (TFM). PFM/TFM ratio, CFM/TFM ratio, and PFM/CFM ratio were defined as relative adiposity. Results: Median age was 55.9 years, mean body mass index 27.2 kg/m 2 , and mean HbA1c level 7.12±0.84%. KITT was positively associated with PMF/TFM ratio, PMF/CFM ratio, and negatively with CFM/TFM ratio, but was not associated with TFM, PFM, or CFM. RBP4 levels also had a significant relationship with PMF/TFM ratio and PMF/CFM ratio. Adiponectin, leptin, and apolipoprotein A levels were related to absolute adiposity, while only adiponectin to relative adiposity. In correlation analysis, KITT in type 2 diabetes was positively related with HbA1c, fasting glucose, RBP4, and free fatty acid. Conclusion: These results suggest that increased relative amount of peripheral fat mass may aggravate insulin resistance in type 2 diabetes.

Infection and Chemotherapy, 2011

Klebsiella pneumoniae is a pathogen that causes a wide range of infections in the human body and ... more Klebsiella pneumoniae is a pathogen that causes a wide range of infections in the human body and has a tendency to metastasize to multiple organs. Endogenous Klebsiella endophthalmitis is an infrequent but often devastating septic metastatic infection. It tends to be fulminant and often rapidly progresses to permanent visual loss beyond 24 hours after symptom onset, despite therapy with appropriate antibiotics, particularly with a delay in diagnosis and treatment. While endogenous Klebsiella endophthalmitis has mostly been reported in association with primary liver abscesses, it has rarely been reported with other Klebsiella infections including renal abscesses. Here, we present a case of a 73-year-old diabetic female diagnosed with a Klebsiella renal abscess and endogenous endophthalmitis, after developing left flank pain and bilateral decreased visual acuity. She was treated with systemic antibiotics, percutaneous abscess drainage, an intravitreal antibiotics injection, and a vitrectomy. While the renal abscess slowly resolved, the symptoms of endophthalmitis persisted despite treatment. This report suggests that endogenous endophthalmitis should be considered when diabetic patients with renal abscesses complain of ocular symptoms.

Korean Diabetes Journal, 2009

Background: The results of previous studies suggest that portion size is a major factor dictating... more Background: The results of previous studies suggest that portion size is a major factor dictating dietary energy intake. We investigated the relationship between frequencies of rice meals, bowl volumes, and dietary energy intake in a sample of patients with type 2 diabetes. Methods: A total of 203 type 2 diabetes patients were enrolled in the study. A one-week food diary was collected from each patient and used to assess the types of meal consumed as well as the context of consumption. The volumes of the eating vessels (rice, soup and side dish bowls) used by each patient were obtained by comparisons to measuring cylinders, and dietary energy and macronutrient intake were estimated for each patient by consulting three-day dietary records. Results: The mean age of the 203 subjects (male: 76, female: 127) was 53.9 ± 9.1 years and the average body mass index (BMI) was 25.6 ± 4.2 kg/m 2. Among the subjects who ate three times per day, 96.4% consumed rice more than twice out of three meals. The median volume of rice bowls used by patients was 350 cc, of soup bowls was 530 cc and of side dish bowls was 260 cc. Portion size, as estimated by rice bowl volume, was not associated with BMI. Male subjects tended to eat out of larger rice and soup bowls (P < 0.001). Portion size was correlated with energy intake from rice (P = 0.021), but not with total energy intake (kcal/kg/day), especially in male subjects. Conclusion: Portion size of rice bowl was correlated with energy intake from rice, but not with total energy intake in male subjects with type 2 diabetes. To design effective meal planning methods for patients with type 2 diabetes, further prospective studies are warranted to investigate causative relationships between portion size andmetabolic conditions as well as variation by gender.

Korean Diabetes Journal, 2009

Background: Exercise offers protection against atherosclerosis and insulin resistance. We evaluat... more Background: Exercise offers protection against atherosclerosis and insulin resistance. We evaluated the benefits of exercise at different levels of intensity for ameliorating inflammation, endothelial dysfunction, and insulin resistance in a sample of type 2 diabetic subjects. Methods: Fifty-nine overweight women with type 2 diabetes were randomly assigned to control (CG, N = 18), moderate-intensity exercise (MEG, N = 17), and vigorous-intensity exercise (VEG, N = 14) groups. Patients in the two experimental groups completed a 12-week exercise program, with their exercise activities monitored by accelerometers. We assessed the patients' body weights, total abdominal fat (TF), subcutaneous fat (SF) and visceral fat (VF) via computed tomography, measurements of plasma levels of hs-C-reactive protein (hs-CRP) and interleukin-6 (IL-6), assessment of endothelial function by brachial artery flow-mediated dilation (FMD), and evaluation of insulin sensitivity by insulin tolerance tests, at baseline, at the end of the 12-week interventions, and one year after initiation of the study. Results: At baseline, the average age of all subjects was 54 ± 7 years, and average body mass index (BMI) was 26.9 ± 2.5 kg/m 2. During the intervention, patients in the MEG and VEG groups expended comparable amounts of activity-related calories (488.6 ± 111.9 kcal/day, 518.8 ± 104.1 kcal/day, respectively). Although BMI, TF, and SF decreased similarly in the MEG and VEG groups (ΔBMI:-1.1 ± 0.7,-0.8 ± 0.5, ΔTF:-4,647 ± 3,613 mm 2 ,-2,577 ± 2,872 mm 2 , ΔSF:-2,057 ± 2,021 mm 2 ,-1,141 ± 1,825 mm 2 , respectively), compared to control (P < 0.01), hs-CRP, IL-6, and FMD remained constant in both exercise groups even after completion of the 12-week exercise intervention. Insulin sensitivity improved only in patients subjected to vigorous exercise (VEG). Visceral fat loss was observed only in patients subjected to moderate exercise (MEG). At one-year follow up, these values had all returned to baseline. Conclusion: Exercise vigorous enough to result in significant weight and fat reduction did not ameliorate

Journal of diabetes, 2012

The aim of the present prospective observational study was to assess the tolerability and antihyp... more The aim of the present prospective observational study was to assess the tolerability and antihyperglycemic efficacy of metformin extended-release (MXR) in the routine treatment of patients with type 2 diabetes mellitus (T2DM) from six Asian countries. Data from 3556 patients treated with once-daily MXR for 12 weeks, or until discontinuation, were analyzed. Treatment with MXR was well tolerated, with 97.4% of patients completing 12 weeks of treatment. Only 3.3% of patients experienced one or more gastrointestinal (GI) side-effects and only 0.7% of patients discontinued for this reason (primary endpoint). The incidence of GI side-effects and related discontinuations appeared to be considerably lower during short-term MXR therapy than during previous treatment (mean 2.71 years' duration), most commonly with immediate-release metformin. A 12-week course of MXR therapy also reduced HbA1c and fasting glucose levels from baseline. The present study provides new insights into the incid...

Journal of the American Society of Hypertension, 2008

Endothelin contributes to abnormalities in peripheral blood vessel function of subjects with obes... more Endothelin contributes to abnormalities in peripheral blood vessel function of subjects with obesity, with or without concurrent type 2 diabetes mellitus, but it is unknown if endothelin contributes specifically to obesity and diabetes-associated changes in blood pressure. We evaluated the effect of systemic endothelin antagonism on peripheral and central hemodynamics and peripheral vascular tone in lean, obese, and type 2 diabetic subjects without overt hypertension by cuff plethysmography. We measured the effects of acute systemic infusions of BQ123 (an antagonist of type A endothelin receptors) in seven lean (body mass index [BMI] 22.7 Ϯ 3.2 kg/m 2), seven obese (BMI 35.8 Ϯ 4.6), and six diabetic subjects (BMI 38.2 Ϯ 5.0, glycosylated hemoglobin 8.1 Ϯ 2.2%). BQ123 was infused via antecubital vein sequentially at infusion rates from 0.1 to 1.0 mol/min. Diastolic blood pressure was significantly lower than baseline across this dose range, but without a clear dose dependence and without differences in the dose response across groups. Obese and diabetic subjects exhibited progressive dilation of peripheral blood vessels (P Յ .01), with 0.03 and 1.0 mol/min BQ123 (P ϭ .03 comparing integrated response across groups). No significant changes were observed in systolic blood pressure, cardiac index, or stroke index. These observations confirm the relevance of endothelin in the abnormal regulation of peripheral vascular tone in obesity and diabetes, but they argue against a specific effect of endothelin in diabetes-and obesity-associated blood pressure elevations.

Diabetes Research and Clinical Practice, 2000

For ideal glycemic control, the pump user should have a meal planning approach that is as precise... more For ideal glycemic control, the pump user should have a meal planning approach that is as precise and flexible as the pump. Counting carbohydrate is simple and it works, but it is not a perfect system. Research indicates that not all carbohydrates are created equal when it comes to their effect on blood glucose. For better match between the glucose and insulin profiles, glycemic index as well as counting carbohydrate might be considered. We investigated for whether same amount of carbohydrates with different glycemic index might require different insulin doses. Five type 1 diabetics on portable external pumps were enrolled, whose basal rates were set so that blood glucose levels remained in the target range under 12 hours fasting conditions. Four 50 gram carbohydrate containing foods with different glycemic index were given to diabetic patients in the morning under overnight fasting state, for four consecutive days. Test foods were rice, apple, milk, and soft drink, of which glycemic indices were 83,54,39, and 97, respectively. Insulin requirement for each food was determined so that blood glucose level reached to the target range four hours after eating. The glycemic index for each food/rice ratio was significantly correlated with insulin requirement for each food/rice ratio(t=O.619, p=O.O04). This result suggested that the meal-related insulin dose should changed with glycemic index of the food.

Korean Clinical Diabetes, 2008

Diabetes Research and Clinical Practice, 2000

For ideal glycemic control, the pump user should have a meal planning approach that is as precise... more For ideal glycemic control, the pump user should have a meal planning approach that is as precise and flexible as the pump. Counting carbohydrate is simple and it works, but it is not a perfect system. Research indicates that not all carbohydrates are created equal when it comes to their effect on blood glucose. For better match between the glucose and insulin profiles, glycemic index as well as counting carbohydrate might be considered. We investigated for whether same amount of carbohydrates with different glycemic index might require different insulin doses. Five type 1 diabetics on portable external pumps were enrolled, whose basal rates were set so that blood glucose levels remained in the target range under 12 hours fasting conditions. Four 50 gram carbohydrate containing foods with different glycemic index were given to diabetic patients in the morning under overnight fasting state, for four consecutive days. Test foods were rice, apple, milk, and soft drink, of which glycemic indices were 83,54,39, and 97, respectively. Insulin requirement for each food was determined so that blood glucose level reached to the target range four hours after eating. The glycemic index for each food/rice ratio was significantly correlated with insulin requirement for each food/rice ratio(t=O.619, p=O.O04). This result suggested that the meal-related insulin dose should changed with glycemic index of the food.

Korean Diabetes Journal, 2009

Background: The food exchange-based meal plan is effective in controlling dietary energy intake w... more Background: The food exchange-based meal plan is effective in controlling dietary energy intake with a macronutrient balance. However, it is difficult to practice for relatively low-literacy patients. As an alternative, we developed a system employing a standardized-sized bowl and investigated its effectiveness on achieving proper energy intake and macronutrient composition and patient compliance, compared to the conventional food exchange system in Korean type 2 diabetes patients. Methods: Eighty subjects with type 2 diabetes were assigned to both the novel bowl-based meal plan group (BG) and the food exchange-based meal plan group (ExG). BG received limited simple instructions for the plan. Time spent for plan instruction was 10 min for BG and 40 min for ExG. Dietary energy and macronutrient intake were estimated with 3-day dietary records and patient comprehension of the plan was estimated with a 5-point Likert scale. Results: After 12 weeks, dietary energy compliance showed no difference between the groups (BG: 103 ± 10%, ExG: 101 ± 17%). Both groups showed significant reduction in carbohydrate and protein intake and there was no difference in the proportion of carbohydrate, protein and fat in energy intake between the groups despite the shorter instruction time for BG. Following the instruction period, there was no difference in the understanding score between the groups. Conclusion: This bowl-based plan was equally effective as the food exchange-based plan in controlling dietary energy intake and macronutrient composition, as well as patient comprehension and compliance. Our novel plan may allow for more cost-effective methods in terms of time needed for plan instruction. (Korean

Korean Diabetes Journal, 2009

Background: Weight loss through low-calorie diets (LCDs) decreases visceral fat (VF). However, th... more Background: Weight loss through low-calorie diets (LCDs) decreases visceral fat (VF). However, the effects on muscle mass, changes of dietary quality, and insulin sensitivity are unknown for Korean obese type 2 diabetic subjects. Therefore, this study examined such effects of LCDs. Methods: A total of 30 obese type 2 diabetic subjects (body mass index, 27.0 ± 2.2 kg/m 2) were randomly assigned to an LCD or control group. Subjects on LCDs took 500~1,000 kcal fewer energy than their usual dietary intake (1,000~1,500 kcal/day) over the course of 12 weeks. The abdominal VF and femoral muscle mass were evaluated by computed tomography, and insulin sensitivity was assessed using an insulin tolerance test (Kitt; rate constant for plasma glucose disappearance, %/min). Dietary nutrient intake consumed by subjects was assessed by 3-day food records. Results: The percent VF reduction was-23.4 ± 17.2% in the LCD group and-9.8 ± 11.8% in the control group after 12 weeks (P < 0.001, P = 0.002). However, significant decrease in femoral mass or proportional change of marcronutrient intake and mean adequacy ratio were not found in the LCD group, as compared to the control group. Insulin sensitivity improved in the LCD group, as compared to the control group (P = 0.040). Conclusion: LCD effectively improved insulin sensitivity and reduced abdominal VF without reduction of femoral muscle and dietary quality in obese type 2 diabetic subjects.

Korean Journal of Family Practice, 2017

Korean diabetes journal, 2010

The Korean National Health and Nutrition Examination Surveys reported 65% of daily energy intake ... more The Korean National Health and Nutrition Examination Surveys reported 65% of daily energy intake (EI) as carbohydrate (CHO) in the Korean population and main source of CHO was cooked rice. We used a standardized-small sized rice bowl for diet education and investigated its effectiveness on body weight, glucose and lipid, compared to the conventional food exchange system in type 2 diabetes obese women. Type 2 diabetic women with body mass index >/= 23 kg/m(2) were randomly assigned to small rice bowl-based meal plan (BM) and food exchange-based meal plan (ExM) group. Both groups were asked to reduce their EI by 500 kcal/day for 12 weeks. The macronutrient composition was instructed: 55 to 60% of EI as CHO, 15 to 20% as protein, and 20 to 25% as fat. BM group received only a simple instruction for application of the rice bowl. Nutrient intake was estimated with the 3-day dietary records. Finally, 44 subjects finished the study. The percent reduction of body weight was significant b...

Korean diabetes journal, 2010

The main source of carbohydrate in the Korean diet is rice, which is usually served in a rice bow... more The main source of carbohydrate in the Korean diet is rice, which is usually served in a rice bowl. This study investigated the impact of a meal plan using smaller rice bowls on dietary energy intake and macronutrient composition in overweight or obese patients with type 2 diabetes mellitus. A total of 67 women with type 2 diabetes were enrolled in our study. We divided these participants into three groups: a normal-weight group (NW; body mass index [BMI] < 23 kg/m(2); n = 17), an overweight group (OW; 23 </= BMI < 25 kg/m(2); n = 24) and an obese group (OB; BMI >/= 25 kg/m(2); n = 26). Three-day dietary records were analyzed for total energy intake (TEI) and macronutrient composition both before enrollment and two weeks after patients received instruction in a dietary plan based on using a small (200 mL) rice bowl. After the intervention, TEI decreased in the OW and OB groups. Decreased carbohydrate (NW, -4 +/- 5%; OW, -4 +/- 5%; OB, -3 +/- 6%) and increased fat intakes...

Diabetes & Metabolism Journal, 2012

Background: Central fat mass (CFM) correlates with insulin resistance and increases the risk of t... more Background: Central fat mass (CFM) correlates with insulin resistance and increases the risk of type 2 diabetes and cardiovascular complications; however, peripheral fat mass (PFM) is associated with insulin sensitivity. The aim of this study was to investigate the relation of absolute and relative regional adiposity to insulin resistance index and adipokines in type 2 diabetes. Methods: Total of 83 overweighted-Korean women with type 2 diabetes were enrolled, and rate constants for plasma glucose disappearance (KITT) and serum adipokines, such as retinol binding protein-4 (RBP4), leptin, and adiponectin, were measured. Using dual X-ray absorptiometry, trunk fat mass (in kilograms) was defined as CFM, sum of fat mass on the lower extremities (in kilograms) as PFM, and sum of CFM and PFM as total fat mass (TFM). PFM/TFM ratio, CFM/TFM ratio, and PFM/CFM ratio were defined as relative adiposity. Results: Median age was 55.9 years, mean body mass index 27.2 kg/m 2 , and mean HbA1c level 7.12±0.84%. KITT was positively associated with PMF/TFM ratio, PMF/CFM ratio, and negatively with CFM/TFM ratio, but was not associated with TFM, PFM, or CFM. RBP4 levels also had a significant relationship with PMF/TFM ratio and PMF/CFM ratio. Adiponectin, leptin, and apolipoprotein A levels were related to absolute adiposity, while only adiponectin to relative adiposity. In correlation analysis, KITT in type 2 diabetes was positively related with HbA1c, fasting glucose, RBP4, and free fatty acid. Conclusion: These results suggest that increased relative amount of peripheral fat mass may aggravate insulin resistance in type 2 diabetes.

Infection and Chemotherapy, 2011

Klebsiella pneumoniae is a pathogen that causes a wide range of infections in the human body and ... more Klebsiella pneumoniae is a pathogen that causes a wide range of infections in the human body and has a tendency to metastasize to multiple organs. Endogenous Klebsiella endophthalmitis is an infrequent but often devastating septic metastatic infection. It tends to be fulminant and often rapidly progresses to permanent visual loss beyond 24 hours after symptom onset, despite therapy with appropriate antibiotics, particularly with a delay in diagnosis and treatment. While endogenous Klebsiella endophthalmitis has mostly been reported in association with primary liver abscesses, it has rarely been reported with other Klebsiella infections including renal abscesses. Here, we present a case of a 73-year-old diabetic female diagnosed with a Klebsiella renal abscess and endogenous endophthalmitis, after developing left flank pain and bilateral decreased visual acuity. She was treated with systemic antibiotics, percutaneous abscess drainage, an intravitreal antibiotics injection, and a vitrectomy. While the renal abscess slowly resolved, the symptoms of endophthalmitis persisted despite treatment. This report suggests that endogenous endophthalmitis should be considered when diabetic patients with renal abscesses complain of ocular symptoms.

Korean Diabetes Journal, 2009

Background: The results of previous studies suggest that portion size is a major factor dictating... more Background: The results of previous studies suggest that portion size is a major factor dictating dietary energy intake. We investigated the relationship between frequencies of rice meals, bowl volumes, and dietary energy intake in a sample of patients with type 2 diabetes. Methods: A total of 203 type 2 diabetes patients were enrolled in the study. A one-week food diary was collected from each patient and used to assess the types of meal consumed as well as the context of consumption. The volumes of the eating vessels (rice, soup and side dish bowls) used by each patient were obtained by comparisons to measuring cylinders, and dietary energy and macronutrient intake were estimated for each patient by consulting three-day dietary records. Results: The mean age of the 203 subjects (male: 76, female: 127) was 53.9 ± 9.1 years and the average body mass index (BMI) was 25.6 ± 4.2 kg/m 2. Among the subjects who ate three times per day, 96.4% consumed rice more than twice out of three meals. The median volume of rice bowls used by patients was 350 cc, of soup bowls was 530 cc and of side dish bowls was 260 cc. Portion size, as estimated by rice bowl volume, was not associated with BMI. Male subjects tended to eat out of larger rice and soup bowls (P < 0.001). Portion size was correlated with energy intake from rice (P = 0.021), but not with total energy intake (kcal/kg/day), especially in male subjects. Conclusion: Portion size of rice bowl was correlated with energy intake from rice, but not with total energy intake in male subjects with type 2 diabetes. To design effective meal planning methods for patients with type 2 diabetes, further prospective studies are warranted to investigate causative relationships between portion size andmetabolic conditions as well as variation by gender.

Korean Diabetes Journal, 2009

Background: Exercise offers protection against atherosclerosis and insulin resistance. We evaluat... more Background: Exercise offers protection against atherosclerosis and insulin resistance. We evaluated the benefits of exercise at different levels of intensity for ameliorating inflammation, endothelial dysfunction, and insulin resistance in a sample of type 2 diabetic subjects. Methods: Fifty-nine overweight women with type 2 diabetes were randomly assigned to control (CG, N = 18), moderate-intensity exercise (MEG, N = 17), and vigorous-intensity exercise (VEG, N = 14) groups. Patients in the two experimental groups completed a 12-week exercise program, with their exercise activities monitored by accelerometers. We assessed the patients' body weights, total abdominal fat (TF), subcutaneous fat (SF) and visceral fat (VF) via computed tomography, measurements of plasma levels of hs-C-reactive protein (hs-CRP) and interleukin-6 (IL-6), assessment of endothelial function by brachial artery flow-mediated dilation (FMD), and evaluation of insulin sensitivity by insulin tolerance tests, at baseline, at the end of the 12-week interventions, and one year after initiation of the study. Results: At baseline, the average age of all subjects was 54 ± 7 years, and average body mass index (BMI) was 26.9 ± 2.5 kg/m 2. During the intervention, patients in the MEG and VEG groups expended comparable amounts of activity-related calories (488.6 ± 111.9 kcal/day, 518.8 ± 104.1 kcal/day, respectively). Although BMI, TF, and SF decreased similarly in the MEG and VEG groups (ΔBMI:-1.1 ± 0.7,-0.8 ± 0.5, ΔTF:-4,647 ± 3,613 mm 2 ,-2,577 ± 2,872 mm 2 , ΔSF:-2,057 ± 2,021 mm 2 ,-1,141 ± 1,825 mm 2 , respectively), compared to control (P < 0.01), hs-CRP, IL-6, and FMD remained constant in both exercise groups even after completion of the 12-week exercise intervention. Insulin sensitivity improved only in patients subjected to vigorous exercise (VEG). Visceral fat loss was observed only in patients subjected to moderate exercise (MEG). At one-year follow up, these values had all returned to baseline. Conclusion: Exercise vigorous enough to result in significant weight and fat reduction did not ameliorate

Journal of diabetes, 2012

The aim of the present prospective observational study was to assess the tolerability and antihyp... more The aim of the present prospective observational study was to assess the tolerability and antihyperglycemic efficacy of metformin extended-release (MXR) in the routine treatment of patients with type 2 diabetes mellitus (T2DM) from six Asian countries. Data from 3556 patients treated with once-daily MXR for 12 weeks, or until discontinuation, were analyzed. Treatment with MXR was well tolerated, with 97.4% of patients completing 12 weeks of treatment. Only 3.3% of patients experienced one or more gastrointestinal (GI) side-effects and only 0.7% of patients discontinued for this reason (primary endpoint). The incidence of GI side-effects and related discontinuations appeared to be considerably lower during short-term MXR therapy than during previous treatment (mean 2.71 years' duration), most commonly with immediate-release metformin. A 12-week course of MXR therapy also reduced HbA1c and fasting glucose levels from baseline. The present study provides new insights into the incid...

Journal of the American Society of Hypertension, 2008

Endothelin contributes to abnormalities in peripheral blood vessel function of subjects with obes... more Endothelin contributes to abnormalities in peripheral blood vessel function of subjects with obesity, with or without concurrent type 2 diabetes mellitus, but it is unknown if endothelin contributes specifically to obesity and diabetes-associated changes in blood pressure. We evaluated the effect of systemic endothelin antagonism on peripheral and central hemodynamics and peripheral vascular tone in lean, obese, and type 2 diabetic subjects without overt hypertension by cuff plethysmography. We measured the effects of acute systemic infusions of BQ123 (an antagonist of type A endothelin receptors) in seven lean (body mass index [BMI] 22.7 Ϯ 3.2 kg/m 2), seven obese (BMI 35.8 Ϯ 4.6), and six diabetic subjects (BMI 38.2 Ϯ 5.0, glycosylated hemoglobin 8.1 Ϯ 2.2%). BQ123 was infused via antecubital vein sequentially at infusion rates from 0.1 to 1.0 mol/min. Diastolic blood pressure was significantly lower than baseline across this dose range, but without a clear dose dependence and without differences in the dose response across groups. Obese and diabetic subjects exhibited progressive dilation of peripheral blood vessels (P Յ .01), with 0.03 and 1.0 mol/min BQ123 (P ϭ .03 comparing integrated response across groups). No significant changes were observed in systolic blood pressure, cardiac index, or stroke index. These observations confirm the relevance of endothelin in the abnormal regulation of peripheral vascular tone in obesity and diabetes, but they argue against a specific effect of endothelin in diabetes-and obesity-associated blood pressure elevations.

Diabetes Research and Clinical Practice, 2000

For ideal glycemic control, the pump user should have a meal planning approach that is as precise... more For ideal glycemic control, the pump user should have a meal planning approach that is as precise and flexible as the pump. Counting carbohydrate is simple and it works, but it is not a perfect system. Research indicates that not all carbohydrates are created equal when it comes to their effect on blood glucose. For better match between the glucose and insulin profiles, glycemic index as well as counting carbohydrate might be considered. We investigated for whether same amount of carbohydrates with different glycemic index might require different insulin doses. Five type 1 diabetics on portable external pumps were enrolled, whose basal rates were set so that blood glucose levels remained in the target range under 12 hours fasting conditions. Four 50 gram carbohydrate containing foods with different glycemic index were given to diabetic patients in the morning under overnight fasting state, for four consecutive days. Test foods were rice, apple, milk, and soft drink, of which glycemic indices were 83,54,39, and 97, respectively. Insulin requirement for each food was determined so that blood glucose level reached to the target range four hours after eating. The glycemic index for each food/rice ratio was significantly correlated with insulin requirement for each food/rice ratio(t=O.619, p=O.O04). This result suggested that the meal-related insulin dose should changed with glycemic index of the food.

Korean Clinical Diabetes, 2008

Diabetes Research and Clinical Practice, 2000

For ideal glycemic control, the pump user should have a meal planning approach that is as precise... more For ideal glycemic control, the pump user should have a meal planning approach that is as precise and flexible as the pump. Counting carbohydrate is simple and it works, but it is not a perfect system. Research indicates that not all carbohydrates are created equal when it comes to their effect on blood glucose. For better match between the glucose and insulin profiles, glycemic index as well as counting carbohydrate might be considered. We investigated for whether same amount of carbohydrates with different glycemic index might require different insulin doses. Five type 1 diabetics on portable external pumps were enrolled, whose basal rates were set so that blood glucose levels remained in the target range under 12 hours fasting conditions. Four 50 gram carbohydrate containing foods with different glycemic index were given to diabetic patients in the morning under overnight fasting state, for four consecutive days. Test foods were rice, apple, milk, and soft drink, of which glycemic indices were 83,54,39, and 97, respectively. Insulin requirement for each food was determined so that blood glucose level reached to the target range four hours after eating. The glycemic index for each food/rice ratio was significantly correlated with insulin requirement for each food/rice ratio(t=O.619, p=O.O04). This result suggested that the meal-related insulin dose should changed with glycemic index of the food.

Korean Diabetes Journal, 2009

Background: The food exchange-based meal plan is effective in controlling dietary energy intake w... more Background: The food exchange-based meal plan is effective in controlling dietary energy intake with a macronutrient balance. However, it is difficult to practice for relatively low-literacy patients. As an alternative, we developed a system employing a standardized-sized bowl and investigated its effectiveness on achieving proper energy intake and macronutrient composition and patient compliance, compared to the conventional food exchange system in Korean type 2 diabetes patients. Methods: Eighty subjects with type 2 diabetes were assigned to both the novel bowl-based meal plan group (BG) and the food exchange-based meal plan group (ExG). BG received limited simple instructions for the plan. Time spent for plan instruction was 10 min for BG and 40 min for ExG. Dietary energy and macronutrient intake were estimated with 3-day dietary records and patient comprehension of the plan was estimated with a 5-point Likert scale. Results: After 12 weeks, dietary energy compliance showed no difference between the groups (BG: 103 ± 10%, ExG: 101 ± 17%). Both groups showed significant reduction in carbohydrate and protein intake and there was no difference in the proportion of carbohydrate, protein and fat in energy intake between the groups despite the shorter instruction time for BG. Following the instruction period, there was no difference in the understanding score between the groups. Conclusion: This bowl-based plan was equally effective as the food exchange-based plan in controlling dietary energy intake and macronutrient composition, as well as patient comprehension and compliance. Our novel plan may allow for more cost-effective methods in terms of time needed for plan instruction. (Korean

Korean Diabetes Journal, 2009

Background: Weight loss through low-calorie diets (LCDs) decreases visceral fat (VF). However, th... more Background: Weight loss through low-calorie diets (LCDs) decreases visceral fat (VF). However, the effects on muscle mass, changes of dietary quality, and insulin sensitivity are unknown for Korean obese type 2 diabetic subjects. Therefore, this study examined such effects of LCDs. Methods: A total of 30 obese type 2 diabetic subjects (body mass index, 27.0 ± 2.2 kg/m 2) were randomly assigned to an LCD or control group. Subjects on LCDs took 500~1,000 kcal fewer energy than their usual dietary intake (1,000~1,500 kcal/day) over the course of 12 weeks. The abdominal VF and femoral muscle mass were evaluated by computed tomography, and insulin sensitivity was assessed using an insulin tolerance test (Kitt; rate constant for plasma glucose disappearance, %/min). Dietary nutrient intake consumed by subjects was assessed by 3-day food records. Results: The percent VF reduction was-23.4 ± 17.2% in the LCD group and-9.8 ± 11.8% in the control group after 12 weeks (P < 0.001, P = 0.002). However, significant decrease in femoral mass or proportional change of marcronutrient intake and mean adequacy ratio were not found in the LCD group, as compared to the control group. Insulin sensitivity improved in the LCD group, as compared to the control group (P = 0.040). Conclusion: LCD effectively improved insulin sensitivity and reduced abdominal VF without reduction of femoral muscle and dietary quality in obese type 2 diabetic subjects.