, Eun-Hee Jang, Seungmin Lee The relationship between phase angle (PhA) of bioelectrical impedance analysis (BIA) and glycemic parameters in diabetes mellitus (DM) patients has not been well studied. To evaluate the prognostic value of the PhA from BIA as a glycemic marker, we investigated the relationship of PhA with various variables such as age, body mass index (BMI), and glycemic parameters in Korean patients with type 2 DM (T2DM). We evaluated the anthropometric data, body composition, glycemic parameters, and PhA of 321 T2DM patients aged 30–83 years. The patients were classified by sex into men (n = 133) and women (n = 188). General linear models identified the independent effects of PhA after covarying for age, sex and BMI. The PhA, body cell mass (BCM), extracellular mass (ECM), lean body mass, intracellular water (ICW), extracellular water (ECW), total body water (TBW), fasting blood glucose, and hemoglobin A1c (HbA1c) of T2DM Korean patients were significantly higher in men than in women. However, fat mass, ECM/BCM, ECW/ICW, ECW/TBW, and serum insulin were significantly higher in women than in men. Statistically significant independent associations were observed between PhA and age, BCM, ECM, ECM/BCM, ICW, ECW, ECW/ICW, and ECW/TBW for both sexes. There was no significant association between PhA and BMI the patients. Glycemic parameters, such as HbA1c and fasting blood glucose were independently associated with PhA. These results suggest that PhA could be an indicator for assessing ability to control fasting blood glucose in T2DM patients in Korea.
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Type 2 diabetes mellitus (T2DM) is a serious public health problem accompanies with several complications. This study was conducted to evaluate the effects of chromium picolinate (CrPic) supplementation on the glycemic status and lipid profile in patients with T2DM. The patients with T2DM (n = 52) were randomly allocated into 2 groups. One group received 400 µg CrPic per day and the other group took placebo; the intervention duration was 8 weeks. Anthropometric indices and metabolic factors were measured at the beginning, and at end of the study. The patients were recommended not to change their normal diet, life style and medication. No significant changes were observed for weight, body mass index, and fasting blood glucose (FBG) in both groups; while intra-groups changes in homeostatic model assessment for insulin resistance (HOMA-IR) value was significant (p < 0.05). Results of analysis of covariance showed that there were significance differences between groups in total cholesterol, low density lipoprotein cholesterol and HOMA-IR at the end of the intervention adjusting for baseline levels (p = 0.035, 0.030 and < 0.001, respectively). In this study, oral supplementation with 400 µg CrPic for eight weeks did not alter FBG concentration as well as anthropometric parameters in individuals with T2DM. However, the modest beneficial effects of chromium supplementation on insulin resistance as indicated by HOMA-IR and lipid profile were found.
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This study was conducted to investigate the status of diabetes education in Korean diabetics and to analyze the association between blood sugar control and diabetes education. A total of 1,904 diabetic patients was classified into two groups (well-controlled group and uncontrolled group) using the 2008-2013 Korean National Health and Nutrition Survey data, and various variables were compared. Of the 1,904 patients, 15.9% had received diabetes education. The uncontrolled group had a low economic level, a high rate of drinking and obesity, and a low rate of moderate exercise. And the rate of drug treatment in the uncontrolled group was high, and the rate of education and nutrition education, and the total number of educations for diabetes were significantly lower than those in the control group. Factors affecting blood glucose control were analyzed drinking (odds ratio [OR], 1.34; 95% confidence interval [CI], 1.06–1.7), moderate exercise (OR, 0.45; 95% CI, 0.34–0.6), overweight and obesity (OR, 1.44; 95% CI, 1.17–1.78), duration of diagnosis (OR, 1.07; 95% CI, 1.05–1.08), treatment method (OR, 2.0; 95% CI, 1.45–2.77), nutritional education (OR, 0.62; 95% CI, 0.46–0.85), and education institution (OR, 0.71; 95% CI, 0.54–0.93). The results of this study support that education on lifestyle management, such as a balanced diet, regular exercise, and normal weight maintenance, is essential for blood glucose control, and patients with long-term treatment need cyclic and continuous education.
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The effect of white rice (WR) mixed with high β-glucan-containing barley at 50% on improvement of postprandial blood glucose levels was assessed by meal tolerance test and continuous glucose monitoring (CGM) in 15 healthy subjects with normal glucose tolerance (age 31.6 ± 12.9 years old, 4 males and 11 females). A meal tolerance test (500 kcal) was conducted using 2 types of test meals: a test meal only with WR and a test meal WR mixed 50% barley, and the side dish was the same in both meals. Blood glucose levels of the subjects 180 minutes after ingestion of the test meals were compared. In addition, a CGM device was attached to the subjects for 2 days when the WR or barley as a staple food was provided 3 times a day for consecutive days, and the daily variation of glucose was investigated. The glucose levels 30 minutes after dietary loads and the area under the blood concentration-time curve over 180 minutes were significantly decreased in the barley consumption group. In CGM, 24-hour mean blood glucose and 24-hour standard deviation of blood glucose were also significantly decreased after ingestion of the barley. Postprandial glucose level elevation was suppressed by mixing high-β-glucan barley with WR in subjects with normal glucose tolerance.
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Gestational diabetes mellitus (GDM) is an impaired fasting glucose condition during pregnancy. Adiponectin is a polypeptide hormone that is extensively released by adipocytes which regulates energy homeostasis and carbohydrate and lipid metabolism. In addition, adiponectin has antidiabetic and anti-inflammatory properties. The aim of our research was to study about the relationship of adiponectin levels to GDM and glucose intolerance. We selected 25 GDM women and 35 healthy pregnant subjects (18–46 years) who were screened between 24 and 28 weeks of gestation based on the result of oral glucose tolerance test (OGTT). We designed a case-control study and measured the concentrations of serum adiponectin and compared the concentrations between the groups. Serum adiponectin concentration was measured using enzyme-linked immunosorbent assay (ELISA). Sociodemographic data were collected by personal interview. Serum adiponectin concentrations were significantly lower in the subjects with GDM (5.10 ± 2.15 ng/mL vs. 7.86 ± 3.52 ng/mL, p = 0.001) than in healthy pregnant subjects. The mean concentration of fasting blood glucose was considerably lower in control subjects (86.9 ± 9.0 mg/dL vs. 175.9 ± 20.1 mg/dL, p < 0.001) in comparison to GDM subjects. Our findings showed that serum concentrations of adiponectin were significantly lower in gestational diabetic women and this may help to predict the risk of GDM.
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Diabetes in pregnancy is associated with higher rates of miscarriage, pre-eclampsia, preterm labor, and fetal malformation. To prevent these obstetric and perinatal complications, women with diabetes have to control levels of blood sugar, both prior to and during pregnancy. Thus, individualized medical nutrition therapy for each stage of pregnancy is essential. We provided in-depth medical nutrition therapy to a 38-year-old pregnant woman with diabetes at all stages of pregnancy up to delivery. She underwent radiation therapy after surgery for breast cancer and was diagnosed with diabetes. At the time of diagnosis, her glycated hemoglobin level was 8.3% and she was planning her pregnancy. She started taking an oral hypoglycemic agent and received education regarding the management of diabetes and preconception care. She became pregnant while maintaining a glycated hemoglobin level of less than 6%. We provided education program for diabetes management during the pregnancy, together with insulin therapy. She experienced weight loss and ketones were detected; furthermore, she was taking in less than the recommended amount of foods for the regulation of blood sugar levels. By giving emotional support, we continued the counseling and achieved not only glycemic control but also instilled an appreciation of the importance of appropriate weight gain and coping with difficulties. Through careful diabetes management, the woman had a successful outcome for her pregnancy, other than entering preterm labor at 34 weeks. This study implicated that the important things in medical nutrition therapy for pregnant women with diabetes are frequent follow-up care and emotional approach through the pregnancy process.
This study aimed to compare the effects of activity-based personalized nutrition education (APNE) with a general instruction for diabetes (control, CTRL) in middle-aged and older Korean outpatients with type 2 diabetes. After an initial screening, 70 subjects were randomly assigned to APNE (n = 37) or CTRL (n = 33) group. APNE considered each patient’s anthropometry, blood chemistry data, and dietary habits in addition to planning meal choices with the aid of registered dietitians. After 3 months, dietary behavior, food intake, and anthropometric and blood measurement results were evaluated. Fasting blood glucose, 2-hour postprandial blood glucose, and glycated hemoglobin levels decreased in the APNE group (n = 33) but not in the CTRL group (n = 23). In the APNE group, the meal intervals and number of days of consuming high-fat food were decreased, while the number of days following a meal plan and balanced diet that entailed consuming fruits, vegetables, and healthy food was increased. A lower consumption of carbohydrates, saccharides, grains, and tuber crops and a higher protein, pulses, and fat-derived calorie intake compared with the initial values were observed in the APNE group. In contrast, only the number of days following the meal plan and balanced diet was increased in the CRTL group, without significantly changing the individual macronutrient-derived calorie intake. The APNE approach appeared to effectively educate outpatients with type 2 diabetes about changing their dietary behavior and food intake and improving the clinical parameters related to diabetic conditions.
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This study aimed to investigate the association of Apolipoprotein B (ApoB) with the risk of diabetes in Koreans. Korean men (n = 790, 40-79 years) who had been never diagnosed for diabetes before participating were enrolled. Subjects were categorized into normal fasting glucose (NFG, n = 519), impaired fasting glucose (IFG, n = 188) and newly-onset diabetes (n = 83) according to fasting glucose levels. Age was not significantly different among the subgroups. Mean values of BMI, waist circumference, Blood pressure(BP), triglyceride, non-HDL cholesterol were significantly higher in IFG or newly-onset diabetic subjects compared to NFG subjects. The levels of glucose, insulin, free fatty acid, insulin resistance and ApoB were highest in diabetic patients and lowest in NFG subjects. According to ApoB level, subjects were divided into two groups (high-ApoB group: ≥ 87.0 mg/dL vs. low-ApoB group: < 87.0 mg/dL). The risk of diabetes was higher in the high-ApoB group than the low-ApoB group [OR0: 2.392, (95% CI: 1.470-3.893), P0 < 0.001]. This association was maintained after adjusted for age and BMI [OR1: 2.228, (95% CI: 1.362-3.646), P1 = 0.001] and further adjustment for blood pressure, triglyceride, HDL-cholesterol, LDL-cholesterol, non-HDL-cholesterol, ApoA1 and adiponectin [OR2: 1.984, (95% CI: 1.001-4.064), P2 = 0.049]. The association was much greater in subjects with metabolic syndrome (MetS) [OR1: 2.805 (95% CI: 1.137-5.737), P1 = 0.005] than in those without [OR1: 1.917 (95% CI: 0.989-3.718), P1 = 0.054]. After 3-month, further investigation was randomly performed in subjects with NFG or IFG who agreed to reinvestigation. Multiple stepwise regression analysis revealed that net change of ApoB levels was a main contributor to the net change of glucose levels (standardized b-coefficient: 0.315, p = 0.002). In conclusion, ApoB levels are closely associated with the increased risk of diabetes in Korean men.
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Diabetes and impaired fasting glucose are associated with incidence of cerebro-/cardio-vascular diseases. This study hypothesized that fasting glycemic status may reflect cerebrovascular risk in non-diabetic Koreans. Fasting glycemic status, lipid profiles, oxidative stress, and inflammation markers were measured in non-diabetic subjects (healthy controls, n = 112 and stroke n = 41). Systolic blood pressure, fasting glucose, glycated hemoglobin (HbA1C), triglycerides, high sensitivity C-reactive protein (hs-CPR), interleukin-6, and tumor necrosis factor-alpha were higher, and high density lipoprotein (HDL)-cholesterols were lower in patients with stroke than healthy controls. Fasting glucose positively correlated with hs-CRP, interleukin-6, tumor necrosis factor-alpha, oxidized low density lipoprotein (LDL) and malondialdehyde. The significances continued or at least turned to a trend after adjustments for confounding factors. Multiple regression analyses revealed that fasting glucose was mainly associated with cerebrovascular risk (β'-coefficient = 0.284, p < 0.0001) together with age, systolic blood pressure, total cholesterol, hs-CRP, body mass index, dietary poly unsaturated fatty acid/saturated fatty acid (PUFA/SFA), and HbA1C (r2 = 0.634, p = 0.044). The subjects were subdivided by their fasting glucose levels [normal fasting glucose: 70-99 mg/dL, n = 91 [NFG-control] and n = 27 [NFG-stroke]; higher fasting glucose: 100-125 mg/dL, n = 21 [HFG-control] and n = 14 [HFG-stroke]). In both controls and stroke patients, HFG groups show higher triglyceride, total- and LDL-cholesterol and lower HDL-cholesterol than NFG groups. Control-HFG group showed significantly higher levels of oxidative stress and inflammation than control-NFG group. Stroke-HFG group also showed significantly higher inflammatory levels than stroke-NFG group, moreover the highest among the groups. Additionally, stroke-NFG group consumed higher PUFA/SFA than stroke-HFG group. Fasting glucose may be a useful indicator for cerebrovascular risk in non-diabetic individuals which may be mediated by oxidative stress and inflammation status.
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This study aimed to investigate if glycated hemoglobin (HgbA1C) as compared to fasting blood glucose is better for reflecting cardiometabolic risk in non-diabetic Korean women. Fasting glucose, HgbA1C and lipid profiles were measured in non-diabetic women without disease (n = 91). The relationships of fasting glucose or HgbA1C with anthropometric parameters, lipid profiles, and liver and kidney functions were analyzed. Both fasting glucose and HgbA1C were negatively correlated with HDL-cholesterol (r = -0.287, p = 0.006; r = -0.261, p = 0.012), and positively correlated with age (r = 0.202, p = 0.008; r = 0.221, p = 0.035), waist circumference (r = 0.296, p = 0.005; r = 0.304, p = 0.004), diastolic blood pressure (DBP) (r = 0.206, p = 0.050; r = 0.225, p = 0.032), aspartate transaminase (AST) (r = 0.237, p = 0.024; r = 0.368, p < 0.0001), alanine transaminase (ALT) (r = 0.296, p = 0.004; r = 0.356, p = 0.001), lipid profiles including triglyceride (r = 0.372, p < 0.001; r = 0.208, p = 0.008), LDL-cholesterol (r = 0.315, p = 0.002; r = 0.373, p < 0.0001) and total cholesterol (r = 0.310, p = 0.003; r = 0.284, p = 0.006). When adjusted for age and body mass index, significant relationships of DBP (r = 0.190, p = 0.049), AST (r = 0.262, p = 0.018), ALT (r = 0.277, p = 0.012), and HDL-cholesterol (r = -0.202, p = 0.049) with HgbA1C were still retained, but those with fasting glucose disappeared. In addition, the adjusted relationships of LDL-cholesterol and total cholesterol with HgbA1C were much greater than those with fasting glucose. These results suggest that glycated hemoglobin may be a better predictor than fasting glucose for cardiometabolic risk in non-diabetic Korean women.
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Korean red ginseng (steam treated Panax ginseng C.A. Meyer), among most prized traditional herbal remedies, has been clinically shown to improve cardiovascular disease (CVD) risk factors. Whether this holds true for the dried non-steamed variety, known as Korean white ginseng (KWG) is unclear. This study therefore, investigated the efficacy and safety of escalating doses of KWG on vascular and glycemic parameters in type 2 diabetes (T2DM). Using an acute, randomized, placebo-controlled, double-blind, crossover design, 25 participants with well-controlled T2DM (12-males: 13-females, age: 63 ± 9 years, A1c: 6.9 ± 0.7%, BMI: 29.3 ± 4.3 kg/m2) underwent five visits during which they received 1 g, 3 g, or 6 g KWG or 3 g wheat-bran control (twice) together with 50 g-glucose load. For the duration of 240 minutes, augmentation index (AI), and central blood pressure were measured at baseline and at 60 min-intervals, and ambulatory blood pressure was assessed at baseline and at 10 min-intervals. Additionally, capillary blood was collected at time zero and at 15, 30, 45, 60, 90, 120, and 180 minutes post-treatment. A symptoms questionnaire was used to assess safety and adverse events. Two-way ANOVA demonstrated a significant time-treatment interaction effect on AI (p = 0.01) with one-way ANOVA showing significant reductions in AI with 3 g KWG relative to control (p = 0.04). Compared to control, acute administration of KWG appeared to be safe, but did not affect any other postprandial, vascular or glycemic parameters. KWG might have a beneficial effect on AI, a cumulative indicator of arterial health. However, these results are preliminary and highlight the need for long-term investigation with a focus on its accountable components. Clinical Trial Registration: NCT01699074
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The purpose of this study was to investigate effect of nutrition education at worksite program in male workers. The subjects were 75 male workers who had received nutrition education by a clinical dietitian for 4 months. The anthropometric data, blood pressure and biochemical blood indices were measured before and after nutrition education. Dietary habits and lifestyle were investigated by self-administered questionnaires. Nutrients intake was determined by 24-hour dietary recall method. The results showed significant decreases in body mass index (p < 0.05), fasting blood sugar (p < 0.01), total cholesterol (p < 0.05), and LDL-cholesterol (p < 0.05) after nutrition education. The correlation analyses among anthropometric and clinical parameters after nutrition education indicated that there was a significantly positive correlations between blood pressure and weight, r-GTP. A significantly positive correlations was observed between fasting blood sugar and triglycerides. A significantly positive correlations was observed between triglycerides and body mass index, r-GTP, SGPT. A significantly positive correlations was observed between SGPT and weight, body mass index. A significantly negative correlations was observed between HDL-cholesterol and weight. It could be concluded that nutrition education might be effective tool to improve anthropometric measures and clinical parameters in male workers. Continuing and systematic nutritional management programs should be developed and implemented for male workers at the worksites to maintain optimal health status.
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