Your browser doesn't support javascript.
loading
Show: 20 | 50 | 100
Results 1 - 20 de 49
Filter
1.
Article in English | WPRIM | ID: wpr-898197

ABSTRACT

Since the first outbreak of coronavirus disease 2019 (COVID-19), ongoing efforts have been made to discover an efficacious vaccine against COVID-19 to combat the pandemic. In most countries, both mRNA and DNA vaccines have been administered, and their side effects have also been reported. The clinical course of COVID-19 and the effects of vaccination against COVID-19 are both influenced by patients’ health status and involve a systemic physiological response. In view of the systemic function of endocrine hormones, endocrine disorders themselves and the therapeutics used to treat them can influence the outcomes of vaccination for COVID-19. However, there are very limited data to support the development of clinical guidelines for patients with specific medical backgrounds based on large clinical trials. In the current severe circumstances of the COVID-19 pandemic, position statements made by clinical specialists are essential to provide appropriate recommendations based on both medical evidence and clinical experiences. As endocrinologists, we would like to present the medical background of COVID-19 vaccination, as well as precautions to prevent the side effects of COVID-19 vaccination in patients with specific endocrine disorders, including adrenal insufficiency, diabetes mellitus, osteoporosis, autoimmune thyroid disease, hypogonadism, and pituitary disorders.

2.
Article in English | WPRIM | ID: wpr-898119

ABSTRACT

BackgroundOnly few studies have shown the efficacy and safety of glucose-control strategies using the quadruple drug combination. Therefore, the aim of the present study was to investigate the usefulness of the quadruple combination therapy with oral hypoglycemic agents (OHAs) in patients with uncontrolled type 2 diabetes mellitus (T2DM).MethodsFrom March 2014 to December 2018, data of patients with T2DM, who were treated with quadruple hypoglycemic medications for over 12 months in 11 hospitals in South Korea, were reviewed retrospectively. We compared glycosylated hemoglobin (HbA1c) levels before and 12 months after quadruple treatment with OHAs. The safety, maintenance rate, and therapeutic patterns after failure of the quadruple therapy were also evaluated.ResultsIn total, 357 patients were enrolled for quadruple OHA therapy, and the baseline HbA1c level was 9.0%±1.3% (74.9±14.1 mmol/mol). After 12 months, 270 patients (75.6%) adhered to the quadruple therapy and HbA1c was significantly reduced from 8.9%±1.2% to 7.8%±1.3% (mean change, −1.1%±1.2%; PPConclusionThis study shows the therapeutic efficacy of the quadruple OHA regimen T2DM and demonstrates that it can be an option for the management of T2DM patients who cannot use insulin or reject injectable therapy.

3.
Article in English | WPRIM | ID: wpr-890493

ABSTRACT

Since the first outbreak of coronavirus disease 2019 (COVID-19), ongoing efforts have been made to discover an efficacious vaccine against COVID-19 to combat the pandemic. In most countries, both mRNA and DNA vaccines have been administered, and their side effects have also been reported. The clinical course of COVID-19 and the effects of vaccination against COVID-19 are both influenced by patients’ health status and involve a systemic physiological response. In view of the systemic function of endocrine hormones, endocrine disorders themselves and the therapeutics used to treat them can influence the outcomes of vaccination for COVID-19. However, there are very limited data to support the development of clinical guidelines for patients with specific medical backgrounds based on large clinical trials. In the current severe circumstances of the COVID-19 pandemic, position statements made by clinical specialists are essential to provide appropriate recommendations based on both medical evidence and clinical experiences. As endocrinologists, we would like to present the medical background of COVID-19 vaccination, as well as precautions to prevent the side effects of COVID-19 vaccination in patients with specific endocrine disorders, including adrenal insufficiency, diabetes mellitus, osteoporosis, autoimmune thyroid disease, hypogonadism, and pituitary disorders.

4.
Article in English | WPRIM | ID: wpr-890415

ABSTRACT

BackgroundOnly few studies have shown the efficacy and safety of glucose-control strategies using the quadruple drug combination. Therefore, the aim of the present study was to investigate the usefulness of the quadruple combination therapy with oral hypoglycemic agents (OHAs) in patients with uncontrolled type 2 diabetes mellitus (T2DM).MethodsFrom March 2014 to December 2018, data of patients with T2DM, who were treated with quadruple hypoglycemic medications for over 12 months in 11 hospitals in South Korea, were reviewed retrospectively. We compared glycosylated hemoglobin (HbA1c) levels before and 12 months after quadruple treatment with OHAs. The safety, maintenance rate, and therapeutic patterns after failure of the quadruple therapy were also evaluated.ResultsIn total, 357 patients were enrolled for quadruple OHA therapy, and the baseline HbA1c level was 9.0%±1.3% (74.9±14.1 mmol/mol). After 12 months, 270 patients (75.6%) adhered to the quadruple therapy and HbA1c was significantly reduced from 8.9%±1.2% to 7.8%±1.3% (mean change, −1.1%±1.2%; PPConclusionThis study shows the therapeutic efficacy of the quadruple OHA regimen T2DM and demonstrates that it can be an option for the management of T2DM patients who cannot use insulin or reject injectable therapy.

5.
Journal of Korean Diabetes ; : 168-173, 2021.
Article in Korean | WPRIM | ID: wpr-918936

ABSTRACT

Diabetes has become an increasing issue in the last century and even more pressing in the last few decades due to the exponential rise of obesity and has become one of the leading causes of death worldwide. Cardiovascular disease (CVD) remains a leading cause of morbidity and mortality in people with diabetes. Hyperglycemia, insulin resistance, and excess fatty acids increase oxidative stress, disrupt protein kinase C signaling, and increase advanced glycation end-products that result in vascular inflammation, vasoconstriction, thrombosis, and atherogenesis. Compared to non-diabetics, those with diabetes carry a higher mortality risk from CVD across ethnicity and sex. The most common cardiovascular manifestations in those with diabetes include heart failure, peripheral arterial disease, and coronary heart disease. CVD risk assessment in diabetes can present an opportunity for preventive strategies and decreased mortality for people with diabetes.

6.
Article in English | WPRIM | ID: wpr-811149

ABSTRACT

No abstract available.


Subject(s)
Diabetic Cardiomyopathies , MicroRNAs
7.
Article in Korean | WPRIM | ID: wpr-918895

ABSTRACT

All organisms on earth are governed by time-based biological rhythms. These biological rhythms are maintained by an endogenous circadian clock, which consists of the central clock in the suprachiasmatic nucleus of the hypothalamus and peripheral clocks. This clock sets its own program and builds networks for circadian timekeeping. The circadian clock regulates the cellular, physiological, and metabolic systems to synchronize biological cycles with environmental cycles. The flow of life in modern society is too complex and irregular to fit every endogenous circadian clock. Recently, the impact of circadian misalignment on health issues including diabetes, obesity, cardiovascular disease, and cancer, has attracted growing interest. Several studies suggest circadian rhythm of the association with glucose homeostasis. The understanding for circadian rhythm in glucose metabolism can present an opportunity for diabetes preventive strategies and improving glycemic control for people with diabetes.

8.
Article | WPRIM | ID: wpr-832341

ABSTRACT

Background@#Only few studies have shown the efficacy and safety of glucose-control strategies using the quadruple drug combination. Therefore, the aim of the present study was to investigate the usefulness of the quadruple combination therapy with oral hypoglycemic agents (OHAs) in patients with uncontrolled type 2 diabetes mellitus (T2DM). @*Methods@#From March 2014 to December 2018, data of patients with T2DM, who were treated with quadruple hypoglycemic medications for over 12 months in 11 hospitals in South Korea, were reviewed retrospectively. We compared glycosylated hemoglobin (HbA1c) levels before and 12 months after quadruple treatment with OHAs. The safety, maintenance rate, and therapeutic patterns after failure of the quadruple therapy were also evaluated. @*Results@#In total, 357 patients were enrolled for quadruple OHA therapy, and the baseline HbA1c level was 9.0%±1.3% (74.9± 14.1 mmol/mol). After 12 months, 270 patients (75.6%) adhered to the quadruple therapy and HbA1c was significantly reduced from 8.9%±1.2% to 7.8%±1.3% (mean change, –1.1%±1.2%; P<0.001). The number of patients with HbA1c <7% increased significantly from 5 to 68 (P<0.005). In addition, lipid profiles and liver enzyme levels were also improved whereas no changes in body weight. There was no significant safety issue in patients treated with quadruple OHA therapy. @*Conclusion@#This study shows the therapeutic efficacy of the quadruple OHA regimen T2DM and demonstrates that it can be an option for the management of T2DM patients who cannot use insulin or reject injectable therapy.

9.
Yonsei Medical Journal ; : 331-340, 2020.
Article in English | WPRIM | ID: wpr-816701

ABSTRACT

PURPOSE: Osteoarthritis (OA) of the temporomandibular joint (TMJ) elicits cartilage and subchondral bone defects. Growth hormone (GH) promotes chondrocyte growth. The aim of this study was to evaluate the efficacy of intra-articular injections of GH to treat TMJ-OA.MATERIALS AND METHODS: Monosodium iodoacetate (MIA) was used to induce OA in the TMJs of rats. After confirming the induction of OA, recombinant human GH was injected into the articular cavities of rats. Concentrations of GH and IGF-1 were measured in the blood and synovial fluid, and OA grades of cartilage and subchondral bone degradation were recorded by histological examination and micro-computed tomography.RESULTS: MIA-induced OA in the rat TMJ upregulated insulin-like growth factor-1 (IGF-1) rather than GH levels. GH and IGF-1 concentrations were increased after local injection of GH, compared with controls. Locally injected GH lowered osteoarthritic scores in the cartilage and subchondral bone of the TMJ.CONCLUSION: Intra-articular injection of GH improved OA scores in rat TMJs in both cartilage and subchondral bone of the condyles without affecting condylar bone growth. These results suggest that intra-articular injection of human GH could be a suitable treatment option for TMJ-OA patients in the future.

10.
Article in English | WPRIM | ID: wpr-739219

ABSTRACT

The Korean Endocrine Society (KES) published clinical practice guidelines for the treatment of acromegaly in 2011. Since then, the number of acromegaly cases, publications on studies addressing medical treatment of acromegaly, and demands for improvements in insurance coverage have been dramatically increasing. In 2017, the KES Committee of Health Insurance decided to publish a position statement regarding the use of somatostatin analogues in acromegaly. Accordingly, consensus opinions for the position statement were collected after intensive review of the relevant literature and discussions among experts affiliated with the KES, and the Korean Neuroendocrine Study Group. This position statement includes the characteristics, indications, dose, interval (including extended dose interval in case of lanreotide autogel), switching and preoperative use of somatostatin analogues in medical treatment of acromegaly. The recommended approach is based on the expert opinions in case of insufficient clinical evidence, and where discrepancies among the expert opinions were found, the experts voted to determine the recommended approach.


Subject(s)
Acromegaly , Consensus , Expert Testimony , Insurance Coverage , Insurance, Health , Octreotide , Somatostatin
11.
Article in Korean | WPRIM | ID: wpr-766799

ABSTRACT

Cardiovascular disease, including stroke, is one of the major causes of death in diabetes. Numerous studies have long suggested reducing macrovascular complication such as ischemic vascular disease through intensive glycemic control, but none was successful proving the effect of glycemic control. Recently, new possibilities in cardiovascular disease reduction have been proposed through cardiovascular safety trials of newly developed anti-hyperglycemic agents. The purpose of this review is to introduce the traditional and newly developed anti-diabetic medications and review their effects regarding cardiovascular outcomes mainly focusing on stroke.


Subject(s)
Cardiovascular Diseases , Cause of Death , Diabetes Complications , Diabetes Mellitus , Drug Therapy , Hypoglycemic Agents , Stroke , Vascular Diseases
12.
Article in English | WPRIM | ID: wpr-765157

ABSTRACT

BACKGROUND: In-hospital detection of newly diagnosed active pulmonary tuberculosis (TB) is important for prevention of potential outbreaks. Here, we report our experience of the aggressive contact investigation strategy in a university hospital in the Republic of Korea after healthcare workers (HCWs), patients, and visitors experience an in-hospital exposure to active pulmonary TB. METHODS: A contact investigation after the unexpected detection of newly diagnosed active pulmonary TB (index patients) was performed in a university hospital from August 2016 to April 2017. Initial and 3-month-post-exposure chest radiographs were advised for all patients, visitors, and HCWs in close contact with the index patients. An additional tuberculous skin test or interferon gamma releasing assay was performed at the time of exposure and 3 months post-exposure in HCWs in close contact with the index patients. RESULTS: Twenty-four index patients were unexpectedly diagnosed with active pulmonary TB after admission to the hospital with unassociated diseases. The median time from admission to TB diagnosis was 5 days (range, 1–22 days). In total, 1,057 people were investigated because of contact with the index patients, 528 of which had close contact (206 events in 157 HCWs, 322 patients or visitors). Three months post exposure, 9 (9.2%) among 98 TB-naïve close contact HCWs developed latent tuberculosis infections (LTBIs). Among the 65 close contact patients or visitors, there was no radiological or clinical evidence of active pulmonary TB. CONCLUSION: An aggressive contact investigation after an unexpected in-hospital diagnosis of active pulmonary TB revealed a high incidence of LTBI among TB-naïve HCWs who had contact with the index patients.


Subject(s)
Delivery of Health Care , Diagnosis , Disease Outbreaks , Humans , Incidence , Infection Control , Interferons , Latent Tuberculosis , Mycobacterium , Radiography, Thoracic , Republic of Korea , Skin Tests , Tuberculosis, Pulmonary
14.
Journal of Korean Diabetes ; : 136-141, 2019.
Article in Korean | WPRIM | ID: wpr-761492

ABSTRACT

When type 2 diabetes and obesity occur together, disease burden is increased and this is an important public health concern due to the deleterious effects. Despite continuing advances in pharmacological approaches to diabetes, diabetes still remains a chronic, progressive, and irreversible disease. Recently, bariatric surgery, initially developed to treat severe obesity, has attracted growing interest for its beneficial effects on improvement in glucose outcomes and type 2 diabetes remission. Several studies suggest considering this surgery as metabolic surgery because it leads to improvement in obesity-related metabolic comorbidities. The Diabetes Surgery Summit recently recommended inclusion of bariatric surgery among glucose-lowering interventions for type 2 diabetes and obesity. Bariatric surgery can be considered as one effective treatment option and may present an appropriate opportunity to improve prognosis in selected people with type 2 diabetes.


Subject(s)
Bariatric Surgery , Comorbidity , Diabetes Mellitus, Type 2 , Glucose , Obesity , Obesity, Morbid , Prognosis , Public Health
15.
Korean Journal of Medicine ; : 485-494, 2019.
Article in Korean | WPRIM | ID: wpr-786308

ABSTRACT

Acromegaly is a chronic disorder caused by excessive growth hormone (GH) secretion. In most cases, the excess GH originates from GH-producing pituitary adenomas. Surgery is the preferred first-line treatment for patients with acromegaly, but medical management is considered when the disease persists after surgery or in cases where patients refuse surgery or are poor candidates for surgery. Somatostatin analogues are commonly used to treat acromegaly. The Korean Endocrine Society and the Korean Neuroendocrine Study Group have developed a position statement for the use of somatostatin analogues in the medical treatment of acromegaly. This position statement is based on evidence from the current literature and expert opinions. In the case of discrepancies among expert opinions, the experts voted to determine the recommended approach.


Subject(s)
Acromegaly , Expert Testimony , Growth Hormone , Humans , Octreotide , Pituitary Neoplasms , Somatostatin
17.
Article in Korean | WPRIM | ID: wpr-726886

ABSTRACT

Endocrine disrupting chemicals (EDCs) are exogenous chemicals contained in industrial substances and plasticizers commonly utilized worldwide. Human exposure to such chemicals, particularly at low-doses, is omnipresent, persistent, and occurs in complex mixtures. EDCs include bisphenol A, phthalates, pesticides, and persistent organic pollutants such as polychlorinated biphenyls. Burgeoning epidemiological, animal, and cellular data link environmental EDCs to metabolic dysfunction. In the last three decades, the number of diabetic patients has drastically increased worldwide, with current statistics suggesting that the number will double in the next two decades. There is epidemiological and experimental evidence linking background exposure to a selection of environmental EDCs with diabetes and impaired glucose metabolism. EDC may be related to increased risk of diabetes.


Subject(s)
Animals , Complex Mixtures , Endocrine Disruptors , Environmental Pollution , Glucose , Humans , Metabolism , Pesticides , Plasticizers , Plastics , Polychlorinated Biphenyls
18.
Journal of Korean Diabetes ; : 150-154, 2017.
Article in Korean | WPRIM | ID: wpr-727035

ABSTRACT

Diabetes can develop as a direct consequence of diseases of the exocrine pancreas. Diabetes due to diseases of the exocrine pancreas is described as pancreatogenic diabetes or type 3c diabetes. Pancreatogenic diabetes is not commonly recognized by clinicians and is frequently misclassified as type 1 diabetes or, more commonly, type 2 diabetes. The prevalence and clinical importance of pancreatogenic diabetes have been underestimated and underappreciated. Pancreatogenic diabetes has a unique pattern of hormonal and metabolic characteristics. The failure to correctly diagnose pancreatogenic diabetes leads to failure to implement an appropriate medical therapy in these patients. We will review the clinical implications and relevance of pancreatogenic diabetes.


Subject(s)
Diabetes Mellitus , Humans , Pancreas , Pancreas, Exocrine , Prevalence
19.
Article in English | WPRIM | ID: wpr-123920

ABSTRACT

In 2017, the Korean Diabetes Association (KDA) published a position statement on the use of antihyperglycemic agents for patients with type 2 diabetes mellitus (T2DM). The KDA regularly updates its Clinical Practice Guidelines, but since the last update in 2015, many results from clinical trials have been introduced, and domestic data from studies performed in Korean patients with T2DM have been published. Recently, evidence from large clinical studies assessing cardiovascular outcomes following the use of sodium-glucose cotransporter 2 inhibitors and glucagon-like peptide 1 receptor agonists in patients with T2DM were incorporated into the recommendations. Additionally, new data from clinical trials using dipeptidyl peptidase 4 inhibitors and thiazolidinediones in Korean patients with T2DM were added. Following a systematic review and assessment of recent evidence, the KDA updated and modified its clinical practice recommendations regarding the use of antihyperglycemic agents and revised the treatment algorithm for Korean adult patients with T2DM.


Subject(s)
Adult , Diabetes Mellitus, Type 2 , Dipeptidyl-Peptidase IV Inhibitors , Glucagon-Like Peptide 1 , Humans , Hypoglycemic Agents , Insulin , Thiazolidinediones
20.
Article in English | WPRIM | ID: wpr-123919

ABSTRACT

In order to improve the quality of life and to prevent chronic complications related to diabetes mellitus, intensive lifestyle modification and proper medication are needed from the early stage of diagnosis of type 2 diabetes mellitus (T2DM). When using the first medication for diabetic patients, the appropriate treatment should be selected considering the clinical characteristics of the patient, efficacy of the drug, side effects, and cost. In general, the use of metformin as the first treatment for oral hypoglycemic monotherapy is recommended because of its excellent blood glucose-lowering effect, relatively low side effects, long-term proven safety, low risk of hypoglycemia, and low weight gain. If metformin is difficult to use as a first-line treatment, other appropriate medications should be selected in view of the clinical situation. If the goal of achieving glycemic control is not achieved by monotherapy, a combination therapy with different mechanisms of action should be initiated promptly.


Subject(s)
Diabetes Mellitus , Diabetes Mellitus, Type 2 , Diagnosis , Humans , Hypoglycemia , Hypoglycemic Agents , Life Style , Metformin , Quality of Life , Weight Gain
SELECTION OF CITATIONS
SEARCH DETAIL