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4 "Type 2 Diabetes"
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Original articles
Immediate Changes of Glucose Metabolism After Gastretomy for Early Gastric Cancer in Patients with Type 2 Diabetes
Ki Hyun Kim, Yoon Hong Kim, Kyung Won Seo, Ki Young Yoon, Yeon Myeong Shin, Young Sik Choi, Bu Kyung Kim
Kosin Med J. 2021;36(1):25-33.   Published online June 30, 2021
DOI: https://doi.org/10.7180/kmj.2021.36.1.25
  • 1,235 View
  • 11 Download
  • 1 Citations
Abstract PDFPubReader   ePub   
Objectives

It is well known that type 2 diabetes (T2DM) is dramatically improved after bariatric surgery, although the mechanisms have not been clearly identified. The skill required for gastric surgery for gastric cancer is very similar to that needed in bariatric surgery. In this study, we evaluated the immediate improvement of T2DM after gastrectomy for gastric cancer.

Methods

A total of nine patients who were diagnosed with early gastric cancer (EGC) and already had T2DM underwent a 75 g oral glucose tolerance test (OGTT) before surgery and within two weeks after gastrectomy. Glucose, insulin, and c-peptide were measured before, and 30 and 60 minutes after ingesting 75 g of glucose. From these trials, we calculated the HOMA-IR, insulinogenic index, Matsuda index, and area under the curve (AUC).

Results

The mean age of participants was 57.23 ± 11.08 years and eight of them were men. HOMA-IR (4.2 vs. 2.3, P = 0.012) levels were decreased after surgery. There were no significant differences of insulinogenic index, fasting blood sugar before and after surgery. The Matsuda index (3.3 vs. 8.3, P = 0.002) was significantly increased and AUC (512.9 vs. 388.7 mg-hr/dL, P > 0.001) upon 75 g OGTT was significantly decreased after surgery.

Conclusions

Insulin sensitivity was immediately improved after gastrectomy for early gastric cancer in patients with T2DM.

Citations

Citations to this article as recorded by  
  • Remote health monitoring services in nursing homes
    Jiwon Kim, Hyunsoo Kim, Sungil Im, Youngin Park, Hae-Young Lee, Sookyung Kwon, Youngsik Choi, Linda Sohn, Chulho Oak
    Kosin Medical Journal.2023; 38(1): 21.     CrossRef
Predictive Factors for the Therapeutic Response to Concomitant Treatment with DPP-4 Inhibitors in Type 2 Diabetes with Short-Term Follow-Up
Jong-Ha Baek, Bo Ra Kim, Jeong Woo Hong, Soo Kyoung Kim, Jung Hwa Jung, Jaehoon Jung, Jong Ryeal Hahm
Kosin Med J. 2016;31(2):146-156.   Published online January 20, 2016
DOI: https://doi.org/10.7180/kmj.2016.31.2.146
  • 846 View
  • 3 Download
Abstract PDFPubReader   ePub   
Abstract Objectives

To evaluate the efficacy and predictive factors of Dipeptidyl peptidase-4 (DPP-4) inhibitors in type 2 diabetes mellitus (T2DM) patients who were not well controlled with other oral antidiabetic drugs or insulin in real clinical practice.

Methods

From December 2012 to January 2014, retrospective longitudinal observation study was conducted for patients with T2DM who were not reached a glycemic target (glycated hemoglobin [HbA1c] > 6.5%) with other oral antidiabetic drugs or insulins. Type 1 diabetes or other types of diabetes were excluded. Responders were eligible with decreased HbA1c from baseline for more than 5% during follow up period.

Results

Of total 135 T2DM patients having an average 9.0 months follow-up period, 84 (62.2%) of patients were responder to DPP-4 inhibitors. After concomitant treatment with DPP-4 inhibitors, patients had a mean decrease in HbA1c of 0.69 ± 1.3%, fasting plasma glucose of 13 ± 52 ㎎/㎗, and postprandial plasma glucose of 29 ± 85 ㎎/㎗ from baseline (all P< 0.05). Independent predictive factor for an improvement of glycemic control with DPP-4 inhibitors was higher baseline HbA1c (odds ratio 2.07 with 95% confidence interval 1.15–3.72) compared with non-responders.

Conclusions

A clinical meaningful improvement in glycemic control was seen when DPP-4 inhibitors were added to other anti-diabetic medications in patients with T2DM regardless of age, duration of T2DM, type of combination treatment regimen. Patients who had higher HbA1c were more easily respond to DPP-4 inhibitors treatment in short-term follow-up period.

Case report
A Case of Spontaneous Bladder Rupture Mimicking Diabetic Nephropathy in a Patient with Type 2 Diabetes Mellitus
Hae Kyung Yang, Na-Young Kim, Soo Jeong Yeom, Ji Hyun Kim, Jung Min Lee, Sang Ah Chang
Kosin Med J. 2012;27(2):161-165.   Published online December 27, 2012
DOI: https://doi.org/10.7180/kmj.2012.27.2.161
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  • 2 Download
Abstract PDFPubReader   ePub   

Spontaneous rupture of the urinary bladder is a rare clinical entity, with the incidence reported as 1 in 126,000 hospital admissions. It is often associated with malignancy, inflammatory lesions, irradiation, calculus, diverticulum, binge alcohol drinking, continuous bladder irrigation, and neurogenic bladder. In rare instances, bladder rupture occurs without obvious causes. This rare clinical condition is difficult to diagnose because of vague symptoms. High index of suspicion is needed as the mortality rate is high if untreated. A 37-year-old woman with uncontrolled type 2 diabetes, was admitted to the emergency room complaining of progressive abdominal distension and discomfort. She had a past history of tubo-ovarian and bladder abscess, and had undergone multiple surgical operations. From ascites fluid study, she was diagnosed as spontaneous bladder rupture. A transurethral catheter was inserted and the symptoms and signs resolved. Bladder rupture, mimicking acute kidney injury of diabetic nephropathy was disclosed without surgery.

Original article
The Effects of a Short-Term Telephone Consults on Glucose Control in Using Long Acting Insulin in Type 2 Diagetes
In Hwoan Choi, Young Sik Choi, Yo Han Park
Kosin Med J. 2008;23(4):88-93.   Published online December 31, 2008
  • 222 View
  • 0 Download
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KMJ : Kosin Medical Journal