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Article ; Online: Chronic disease management program applied to type 2 diabetes patients and prevention of diabetic complications: a retrospective cohort study using nationwide data.

Hyun, Min Kyung / Lee, Jang Won / Ko, Seung-Hyun

2023 Volume 23, Issue 1, Page(s) 928

Abstract: Background: The outcomes of education and counseling by medical professionals for patients with type 2 diabetes mellitus (T2DM) are unclear. This study examined the effects of the Chronic Disease Management Program (CDMP), a health insurance fee-for- ... ...

Abstract	Background: The outcomes of education and counseling by medical professionals for patients with type 2 diabetes mellitus (T2DM) are unclear. This study examined the effects of the Chronic Disease Management Program (CDMP), a health insurance fee-for-service benefit, on the incidence of diabetic complications in patients newly diagnosed with T2DM using the National Health Insurance data. Methods: Patients newly diagnosed with T2DM aged ≥ 20 years from 2010 to 2014 were followed up until 2015. Selection bias was minimized using propensity score matching. A stratified Cox proportional hazards model was used to analyze the association between the CDMP and the risk of incident diabetic complications. Subgroup analysis was performed for patients with high medication adherence, which was indicated by a medication possession ratio (MPR) ≥ 80. Results: Among the 11,915 patients with T2DM in the cohort, 4,617 were assigned to the CDMP and non-CDMP group each. The CDMP helped reduce the overall and microvascular risks of complications compared to the non-CDMP group; however, the protective effect against macrovascular complications was only observed in those aged ≥ 40 years. Subgroup analysis of the group aged ≥ 40 years with high adherence (an MPR ≥ 80) showed that the CDMP effectively reduced the incidence of micro- and macrovascular complications. Conclusions: Effective management of T2DM is crucial in preventing complications in patients with the condition, and includes regular monitoring and adjustment of treatment by qualified physicians. Nevertheless, long-term prospective studies on the effects of CDMP are required to confirm this finding.
MeSH term(s)	Humans ; Diabetes Mellitus, Type 2 ; Prospective Studies ; Retrospective Studies ; Educational Status ; Disease Management
Language	English
Publishing date	2023-05-23
Publishing country	England
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	2041338-5
ISSN	1471-2458 ; 1471-2458
ISSN (online)	1471-2458
ISSN	1471-2458
DOI	10.1186/s12889-023-15763-z
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Article ; Online: Severe hypoglycemia as a preventable risk factor for cardiovascular disease in patients with type 2 diabetes mellitus.

Choi, Soo-Yeon / Ko, Seung-Hyun

The Korean journal of internal medicine

2021 Volume 36, Issue 2, Page(s) 263–270

Abstract: Glucose-lowering medication and lifestyle modification are essential for optimal glycemic control in patients with type 2 diabetes mellitus (T2DM). However, glucose-lowering agents, particularly insulin and insulin secretagogues, may cause hypoglycemia, ... ...

Abstract	Glucose-lowering medication and lifestyle modification are essential for optimal glycemic control in patients with type 2 diabetes mellitus (T2DM). However, glucose-lowering agents, particularly insulin and insulin secretagogues, may cause hypoglycemia, which has multiple negative effects on the cardiovascular (CV) system and may cause death. Previous studies using institutional data from the Korean Nationwide Health Insurance database have consistently found a causal relationship between severe hypoglycemia and CV outcomes and mortality. Screening for high-risk patients, appropriate management, and intensive individualized education are the most effective measures and essential for the prevention of harmful hypoglycemic events. Based on identified risk factors that predict severe hypoglycemia, we developed an 1-year risk prediction model for severe hypoglycemia that can be used in clinical settings. In this review, we describe the current understanding of severe hypoglycemia and the clinical implications in patients with T2DM. Furthermore, we highlight the importance of intensive individualized education for high-risk patients and the risk prediction model to reduce severe hypoglycemia.
MeSH term(s)	Blood Glucose ; Cardiovascular Diseases/diagnosis ; Cardiovascular Diseases/epidemiology ; Cardiovascular Diseases/etiology ; Diabetes Mellitus, Type 2/complications ; Diabetes Mellitus, Type 2/diagnosis ; Diabetes Mellitus, Type 2/drug therapy ; Humans ; Hypoglycemia/chemically induced ; Hypoglycemia/prevention & control ; Hypoglycemic Agents/adverse effects ; Risk Factors
Chemical Substances	Blood Glucose ; Hypoglycemic Agents
Language	English
Publishing date	2021-01-08
Publishing country	Korea (South)
Document type	Journal Article ; Review
ZDB-ID	639023-7
ISSN	2005-6648 ; 1226-3303
ISSN (online)	2005-6648
ISSN	1226-3303
DOI	10.3904/kjim.2020.327
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Article ; Online: Current trends in epidemiology of cardiovascular disease and cardiovascular risk management in type 2 diabetes.

Yun, Jae-Seung / Ko, Seung-Hyun

Metabolism: clinical and experimental

2021 Volume 123, Page(s) 154838

Abstract: With the advances in diabetes care, the trend of incident cardiovascular disease (CVD) in patients with type 2 diabetes mellitus (T2DM) has been decreasing over past decades. However, given that CVD is still a major cause of death in patients with ... ...

Abstract	With the advances in diabetes care, the trend of incident cardiovascular disease (CVD) in patients with type 2 diabetes mellitus (T2DM) has been decreasing over past decades. However, given that CVD is still a major cause of death in patients with diabetes and that the risk of CVD in patients with T2DM is more than twice that in those without DM, there are still considerable challenges to the prevention of CVD in diabetes. Accordingly, there have been several research efforts to decrease cardiovascular (CV) risk in T2DM. Large-scale genome-wide association studies (GWAS) and clinical cohort studies have investigated the effects of factors, such as genetic determinants, hypoglycaemia, and insulin resistance, on CVD and can account for the unexplained CV risk in T2DM. Lifestyle modification is a widely accepted cornerstone method to prevent CVD as the first-line strategy in T2DM. Recent reports from large CV outcome trials have proven the positive CV effects of sodium-glucose cotransporter-2 (SGLT-2) inhibitors and glucagon-like peptide-1 receptor agonists (GLP-1RAs) in patients with high CVD risk. Overall, current practice guidelines for the management of CVD in T2DM are moving from a glucocentric strategy to a more individualised patient-centred approach. This review will discuss the current epidemiologic trends of CVD in T2DM and the risk factors linking T2DM to CVD, including genetic contribution, hypoglycaemia, and insulin resistance, and proper care strategies, including lifestyle and therapeutic approaches.
MeSH term(s)	Cardiovascular Diseases/complications ; Cardiovascular Diseases/epidemiology ; Cardiovascular Diseases/genetics ; Cardiovascular Diseases/prevention & control ; Diabetes Mellitus, Type 2/complications ; Diabetes Mellitus, Type 2/diet therapy ; Diabetes Mellitus, Type 2/drug therapy ; Diabetes Mellitus, Type 2/genetics ; Heart Disease Risk Factors ; Humans ; Hypoglycemic Agents/therapeutic use ; Insulin Resistance ; Life Style ; Risk Management
Chemical Substances	Hypoglycemic Agents
Language	English
Publishing date	2021-07-30
Publishing country	United States
Document type	Journal Article ; Review
ZDB-ID	80230-x
ISSN	1532-8600 ; 0026-0495
ISSN (online)	1532-8600
ISSN	0026-0495
DOI	10.1016/j.metabol.2021.154838
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Article ; Online: Sulfur Metabolism of the Gut Microbiome and Colorectal Cancer: The Threat to the Younger Generation.

Moon, Ji-Yeon / Kye, Bong-Hyeon / Ko, Seung-Hyun / Yoo, Ri Na

Nutrients

2023 Volume 15, Issue 8

Abstract: Colorectal cancer diagnosed in individuals under 50 years old is called early-onset colorectal cancer (EOCRC), and its incidence has been rising worldwide. Simultaneously occurring with increasing obesity, this worrisome trend is partly explained by the ... ...

Abstract	Colorectal cancer diagnosed in individuals under 50 years old is called early-onset colorectal cancer (EOCRC), and its incidence has been rising worldwide. Simultaneously occurring with increasing obesity, this worrisome trend is partly explained by the strong influence of dietary elements, particularly fatty, meaty, and sugary food. An animal-based diet, the so-called Western diet, causes a shift in dominant microbiota and their metabolic activity, which may disrupt the homeostasis of hydrogen sulfide concentration. Bacterial sulfur metabolism is recognized as a critical mechanism of EOCRC pathogenesis. This review evaluates the pathophysiology of how a diet-associated shift in gut microbiota, so-called the microbial sulfur diet, provokes injuries and inflammation to the colonic mucosa and contributes to the development of CRC.
MeSH term(s)	Colorectal Neoplasms/metabolism ; Diet, Western/adverse effects ; Gastrointestinal Microbiome/physiology ; Sulfur/metabolism ; Humans
Chemical Substances	Sulfur (70FD1KFU70)
Language	English
Publishing date	2023-04-19
Publishing country	Switzerland
Document type	Journal Article ; Review
ZDB-ID	2518386-2
ISSN	2072-6643 ; 2072-6643
ISSN (online)	2072-6643
ISSN	2072-6643
DOI	10.3390/nu15081966
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Article ; Online: Trends of severe hypoglycemia in patients with type 2 diabetes in Korea: A longitudinal nationwide cohort study.

Yun, Jae-Seung / Han, Kyungdo / Ko, Seung-Hyun

Journal of diabetes investigation

2022 Volume 13, Issue 8, Page(s) 1438–1443

Abstract: To estimate the trends in the prevalence of severe hypoglycemia (SH) in patients with type 2 diabetes in Korea, we investigated the total number of SH episodes among type 2 diabetes patients aged ≥30 years who visited the emergency department between ... ...

Abstract	To estimate the trends in the prevalence of severe hypoglycemia (SH) in patients with type 2 diabetes in Korea, we investigated the total number of SH episodes among type 2 diabetes patients aged ≥30 years who visited the emergency department between 2002 and 2019, using the Korean National Health Insurance Service database. The prevalence of SH events increased from 2002 to 2012; however, it has decreased gradually since 2012. In 2019, the prevalence of SH was 0.6%, with an incidence rate of 4.43 per 1,000 person-years. Approximately 23,000 SH events occur every year in Korea. Although the incidence is steadily decreasing, there are a considerable number of SH events in type 2 diabetes patients. The decline in the incidence of SH seems to most likely be due to the increased prescription rate of hypoglycemic agents without hypoglycemia risk, less-strict treatment goals and the individualization of therapy.
MeSH term(s)	Cohort Studies ; Diabetes Mellitus, Type 2/complications ; Diabetes Mellitus, Type 2/drug therapy ; Diabetes Mellitus, Type 2/epidemiology ; Humans ; Hypoglycemia/chemically induced ; Hypoglycemia/epidemiology ; Hypoglycemic Agents/adverse effects ; Republic of Korea/epidemiology ; Risk Factors
Chemical Substances	Hypoglycemic Agents
Language	English
Publishing date	2022-03-21
Publishing country	Japan
Document type	Journal Article
ZDB-ID	2625840-7
ISSN	2040-1124 ; 2040-1116
ISSN (online)	2040-1124
ISSN	2040-1116
DOI	10.1111/jdi.13786
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Article ; Online: Advanced Glycation End Products and Their Effect on Vascular Complications in Type 2 Diabetes Mellitus.

Lee, Jeongmin / Yun, Jae-Seung / Ko, Seung-Hyun

Nutrients

2022 Volume 14, Issue 15

Abstract: Diabetes is well established as a chronic disease with a high health burden due to mortality or morbidity from the final outcomes of vascular complications. An increased duration of hyperglycemia is associated with abnormal metabolism. Advanced glycation ...

Abstract	Diabetes is well established as a chronic disease with a high health burden due to mortality or morbidity from the final outcomes of vascular complications. An increased duration of hyperglycemia is associated with abnormal metabolism. Advanced glycation end products (AGEs) are nonenzymatic glycated forms of free amino acids that lead to abnormal crosslinking of extra-cellular and intracellular proteins by disrupting the normal structure. Furthermore, the interaction of AGEs and their receptors induces several pathways by promoting oxidative stress and inflammation. In this review, we discuss the role of AGEs in diabetic vascular complications, especially type 2 DM, based on recent clinical studies.
MeSH term(s)	Cardiovascular Diseases/complications ; Diabetes Complications/complications ; Diabetes Mellitus/metabolism ; Diabetes Mellitus, Type 2/complications ; Diabetic Angiopathies/etiology ; Glycation End Products, Advanced/metabolism ; Humans ; Oxidative Stress ; Receptor for Advanced Glycation End Products/metabolism
Chemical Substances	Glycation End Products, Advanced ; Receptor for Advanced Glycation End Products
Language	English
Publishing date	2022-07-27
Publishing country	Switzerland
Document type	Journal Article ; Review
ZDB-ID	2518386-2
ISSN	2072-6643 ; 2072-6643
ISSN (online)	2072-6643
ISSN	2072-6643
DOI	10.3390/nu14153086
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Article: Advanced Glycation End Products and Their Effect on Vascular Complications in Type 2 Diabetes Mellitus

Lee, Jeongmin / Yun, Jae-Seung / Ko, Seung-Hyun

Nutrients. 2022 July 27, v. 14, no. 15

2022

Abstract	Diabetes is well established as a chronic disease with a high health burden due to mortality or morbidity from the final outcomes of vascular complications. An increased duration of hyperglycemia is associated with abnormal metabolism. Advanced glycation end products (AGEs) are nonenzymatic glycated forms of free amino acids that lead to abnormal crosslinking of extra-cellular and intracellular proteins by disrupting the normal structure. Furthermore, the interaction of AGEs and their receptors induces several pathways by promoting oxidative stress and inflammation. In this review, we discuss the role of AGEs in diabetic vascular complications, especially type 2 DM, based on recent clinical studies.
Keywords	chronic diseases ; crosslinking ; hyperglycemia ; inflammation ; metabolism ; morbidity ; mortality ; noninsulin-dependent diabetes mellitus ; oxidative stress
Language	English
Dates of publication	2022-0727
Publishing place	Multidisciplinary Digital Publishing Institute
Document type	Article
ZDB-ID	2518386-2
ISSN	2072-6643
ISSN	2072-6643
DOI	10.3390/nu14153086
Database	NAL-Catalogue (AGRICOLA)

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Article ; Online: Association between serum ferritin levels and colorectal cancer risk in Korea.

Kim, Hyunho / Han, Kyungdo / Ko, Seung-Hyun / An, Ho Jung

The Korean journal of internal medicine

2022 Volume 37, Issue 6, Page(s) 1205–1215

Abstract: Background/aims: The concentration of serum ferritin, a storage form of iron, may be associated with carcinogenesis in various cancers. There are only limited studies on the relationship between serum ferritin levels and colorectal cancer (CRC) risk, ... ...

Abstract	Background/aims: The concentration of serum ferritin, a storage form of iron, may be associated with carcinogenesis in various cancers. There are only limited studies on the relationship between serum ferritin levels and colorectal cancer (CRC) risk, especially in the Asian population. This study aimed to analyze the association between CRC incidence and serum ferritin levels. Methods: This was a national cohort study that used health checkup and insurance claims data of the Korean population. CRC incidence according to the serum ferritin level was analyzed during 2008-2018 in 17,116 participants. Results: The hazard ratio (HR) of CRC incidence decreased as serum ferritin levels increased (Q1: HR, 1.000 [95% confidence interval [CI], reference]; Q2: HR, 0.811 [95% CI, 0.558 to 1.178]; Q3: HR, 0.654 [95% CI, 0.442 to 0.968]; Q4: HR, 0.443 [95% CI, 0.285 to 0.687]; p = 0.0026). In subgroup analysis, 40 to 64 years of age, sex, body mass index of < 25 kg/ m2, presence of metabolic syndrome, absence of diabetes mellitus, and absence of anemia had HRs of < 0.5 (95% CI) in the highest quartiles compared with that in the lowest quartiles. Conclusion: This study shows an inverse association between serum ferritin and CRC risk. Serum ferritin measurement can aid in identifying young adults requiring active CRC screening.
MeSH term(s)	Humans ; Young Adult ; Cohort Studies ; Ferritins ; Metabolic Syndrome/epidemiology ; Republic of Korea/epidemiology ; Colorectal Neoplasms/diagnosis ; Colorectal Neoplasms/epidemiology ; Risk Factors
Chemical Substances	Ferritins (9007-73-2)
Language	English
Publishing date	2022-10-25
Publishing country	Korea (South)
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	639023-7
ISSN	2005-6648 ; 1226-3303
ISSN (online)	2005-6648
ISSN	1226-3303
DOI	10.3904/kjim.2022.007
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Article: Comparative Study of Intestinal Microbiome in Patients with Ulcerative Colitis and Healthy Controls in Korea.

Do, Kyung-Hyo / Ko, Seung-Hyun / Kim, Ki Bae / Seo, Kwangwon / Lee, Wan-Kyu

Microorganisms

2023 Volume 11, Issue 11

Abstract: Ulcerative colitis (UC) poses a contemporary medical challenge, with its exact cause still eluding researchers. This is due to various factors, such as the rising incidence, diagnostic complexities, and difficulties associated with its management. We ... ...

Abstract	Ulcerative colitis (UC) poses a contemporary medical challenge, with its exact cause still eluding researchers. This is due to various factors, such as the rising incidence, diagnostic complexities, and difficulties associated with its management. We compared the intestinal microbiome of patients with UC to that of healthy controls to determine the qualitative and quantitative changes associated with UC that occur in the intestinal microbiota. The intestinal bacterial abundance in 40 Korean patients with UC and 25 healthy controls was assayed using via next-generation sequencing. There were five major phyla in both groups: Firmicutes (UC patients: 51.12%; healthy controls: 46.90%), Bacteroidota (UC patients: 37.04%; healthy controls: 40.34%), Proteobacteria (UC patients: 6.01%; healthy controls: 11.05%), Actinobacteriota (UC patients: 5.71%; healthy controls: 1.56%), and Desulfobacteriota (UC patients: 0.13%; healthy controls: 0.14%). Firmicutes was more prevalent in patients with UC (51.12%) compared to that of healthy controls (46.90%). Otherwise, Bacteroidota was more prevalent in healthy controls (40.34%) compared to patients with UC (37.04%). Although there was no significant difference, our results showed a substantially lower gut microbiome diversity in patients with UC (mean: 16.5; 95% confidence interval (CI) = 14.956-18.044) than in healthy controls (mean: 17.84; 95% CI = 15.989-19.691), the beta diversity and the flora structure of the microbiome in patients with UC differed from those in healthy controls. This will be helpful for the development of new treatment options and lay the groundwork for future research on UC. To understand the disease mechanism, it is essential to define the different types of microbes in the guts of patients with UC.
Language	English
Publishing date	2023-11-11
Publishing country	Switzerland
Document type	Journal Article
ZDB-ID	2720891-6
ISSN	2076-2607
ISSN	2076-2607
DOI	10.3390/microorganisms11112750
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Article ; Online: A Multicenter, Randomized, Open-Label Study to Compare the Effects of Gemigliptin Add-on or Escalation of Metformin Dose on Glycemic Control and Safety in Patients with Inadequately Controlled Type 2 Diabetes Mellitus Treated with Metformin and SGLT-2 Inhibitors (SO GOOD Study).

Kim, Hae Jin / Noh, Jung Hyun / Moon, Min Kyong / Choi, Sung Hee / Ko, Seung-Hyun / Rhee, Eun-Jung / Hur, Kyu Yeon / Jeong, In-Kyung

Journal of diabetes research

2024 Volume 2024, Page(s) 8915591

Abstract: Background: We aimed to compare efficacy and safety between gemigliptin add-on and escalation of the metformin dose in patients with inadequately controlled type 2 diabetes mellitus (T2DM) despite treatment with metformin and SGLT2 inhibitors.: ... ...

Abstract	Background: We aimed to compare efficacy and safety between gemigliptin add-on and escalation of the metformin dose in patients with inadequately controlled type 2 diabetes mellitus (T2DM) despite treatment with metformin and SGLT2 inhibitors. Methods: This study was a multicenter, randomized, open-label, active-controlled, parallel-group comparative study. Patients with T2DM uncontrolled on metformin and SGLT2 inhibitors were randomized to receive gemigliptin 50 mg as an add-on (GEM group, Results: At weeks 12 and 24, the reduction in HbA1c levels was significantly greater in the GEM group than in the MET group (GEM vs. MET = -0.64% ± 0.34% vs. -0.36% ± 0.50%, Conclusions: Gemigliptin add-on therapy may be more effective than metformin dose escalation in patients with T2DM insufficiently controlled using metformin and SGLT2 inhibitors, without safety concerns. This trial is registered with CRIS_number: KCT0003520.
MeSH term(s)	Humans ; Blood Glucose ; Diabetes Mellitus, Type 2/drug therapy ; Double-Blind Method ; Drug Therapy, Combination ; Glycated Hemoglobin ; Glycemic Control ; Hypoglycemic Agents/administration & dosage ; Metformin/administration & dosage ; Piperidones ; Pyrimidines ; Sodium-Glucose Transporter 2 Inhibitors/therapeutic use ; Treatment Outcome
Chemical Substances	Blood Glucose ; Glycated Hemoglobin ; Hypoglycemic Agents ; LC15-0444 ; Metformin (9100L32L2N) ; Piperidones ; Pyrimidines ; Sodium-Glucose Transporter 2 Inhibitors
Language	English
Publishing date	2024-01-05
Publishing country	England
Document type	Randomized Controlled Trial ; Multicenter Study ; Journal Article
ZDB-ID	2711897-6
ISSN	2314-6753 ; 2314-6753
ISSN (online)	2314-6753
ISSN	2314-6753
DOI	10.1155/2024/8915591
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