https://scholarworks.korea.ac.kr/kumedicine/handle/2020.sw.kumedicine/154 2026-04-04T15:25:51Z 2026-04-04T15:25:51Z Twigg, Stephen Lim, Soo Yoo, Seung-Hyun Chen, Liming Bao, Yuqian Kong, Alice Yeoh, Ester Chan, Siew Pheng Robles, Jeremyjones Mohan, Viswanathan Cohen, Neale McGill, Margaret Ji, Linong https://scholarworks.korea.ac.kr/kumedicine/handle/2021.sw.kumedicine/63482 2025-01-16T05:45:25Z 2024-11-01T00:00:00Z

Title: Asia-Pacific Perspectives on the Role of Continuous Glucose Monitoring in Optimizing Diabetes Management Authors: Twigg, Stephen; Lim, Soo; Yoo, Seung-Hyun; Chen, Liming; Bao, Yuqian; Kong, Alice; Yeoh, Ester; Chan, Siew Pheng; Robles, Jeremyjones; Mohan, Viswanathan; Cohen, Neale; McGill, Margaret; Ji, Linong Abstract: Diabetes is prevalent, and it imposes a substantial public health burden globally and in the Asia-Pacific (APAC) region. The cornerstone for optimizing diabetes management and treatment outcomes is glucose monitoring, the techniques of which have evolved from self-monitoring of blood glucose (SMBG) to glycated hemoglobin (HbA1c), and to continuous glucose monitoring (CGM). Contextual differences with Western populations and limited regionally generated clinical evidence warrant regional standards of diabetes care, including glucose monitoring in APAC. Hence, the APAC Diabetes Care Advisory Board convened to gather insights into clinician-reported CGM utilization for optimized glucose monitoring and diabetes management in the region. We discuss the findings from a pre-meeting survey and an expert panel meeting regarding glucose monitoring patterns and influencing factors, patient profiles for CGM initiation and continuation, CGM benefits, and CGM optimization challenges and potential solutions in APAC. While CGM is becoming the new standard of care and a useful adjunct to HbA1c and SMBG globally, glucose monitoring type, timing, and frequency should be individualized according to local and patient-specific contexts. The results of this APAC survey guide methods for the formulation of future APAC-specific consensus guidelines for the application of CGM in people living with diabetes.

2024-11-01T00:00:00Z Lee, D. Y. Jung, I. Park, S. Y. Yu, J. H. Kim, N. H. Yoo, H. J. Seo, J. A. Kim, S. G. Choi, K. M. Baik, S. H. Kim, N. H. https://scholarworks.korea.ac.kr/kumedicine/handle/2021.sw.kumedicine/64056 2024-09-06T04:00:13Z 2023-12-01T00:00:00Z

Title: Assessment of Clinical Determinants of Glycemic Variability in Patients with Type 2 Diabetes Authors: Lee, D. Y.; Jung, I.; Park, S. Y.; Yu, J. H.; Kim, N. H.; Yoo, H. J.; Seo, J. A.; Kim, S. G.; Choi, K. M.; Baik, S. H.; Kim, N. H. Abstract: Background Reducing glycemic variability (GV) has been an important target for glycemic control. However, there have been no studies considering various lifestyle habits. Aim We aimed to evaluate the clinical determinants of GV in patients with type 2 diabetes (T2DM) and to characterize the associated factors of adequate glycemic control in continuous glucose monitoring. Method We recruited Korean patients with T2DM treated with insulin between 2021 and 2022 at Korea University Ansan Hospital. All participants wore Dexcom G6 and Fitbit for 10 days. Dietary intake was investigated using a dietary record and taking pictures of food before and after eating. GV indices used were standard deviation (SD), coefficient of variation (CV), the mean of the interquartile range (IQR), and the mean of daily differences in glucose values (MODD). To explore the relationship between GV indices and clinical factors, multivariate regression analyses were conducted. The covariates included age, sex, BMI, eGFR, HbA1c, duration of diabetes, 2-hour postprandial C-peptide-to-glucose ratios (PCGR2), mean daily calorie, daytime step counts, and sleep duration. Adequate glycemic control was defined as co-achievement of time in range >70%, time above range (TAR) 180 mg/dL <25%, TAR 250 mg/dL <5%, time below range (TBR) 70 mg/dL <4%, and TBR 54 mg/dL <1%. Results A total of 97 patients were included in this analysis. The mean age was 53.9 ± 11.8 years, and about 70% of the participants used basal and prandial insulin. In the multivariate linear regression analysis, all GV indices showed an inverse association with eGFR and PCGR2 and a positive association with HbA1c except CV. The daytime step count was negatively associated with SD, IQR, and MODD. Multivariate-adjusted logistic regression analysis revealed that low HbA1c, high PCGR2, and women were associated with the concurrent achievement of the CGM-derived glucose target range. Conclusion We confirmed that renal function, and residual insulin secretion in addition to HbA1c are related to GV and the achievement of the expert-recommended glycemic targets.

2023-12-01T00:00:00Z Kim, Kyoung Jin Son, Serhim Kim, Kyeong Jin Kim, Sin Gon Kim, Nam Hoon https://scholarworks.korea.ac.kr/kumedicine/handle/2021.sw.kumedicine/63807 2025-09-16T10:42:27Z 2023-10-01T00:00:00Z

Title: Weight-adjusted waist as an integrated index for fat, muscle and bone health in adults Authors: Kim, Kyoung Jin; Son, Serhim; Kim, Kyeong Jin; Kim, Sin Gon; Kim, Nam Hoon Abstract: BackgroundUnhealthy body composition, including high fat mass, low muscle mass and low bone mass, is a critical health issue in adults. The weight-adjusted waist index (WWI) estimates fat and muscle mass and may have implications for bone health. We examined its association with body composition outcomes in a large Korean adult cohort. MethodsThis study used data from the Korean National Health and Nutrition Examination Survey (2008-2011). WWI was calculated as waist circumference (cm) divided by the square root of body weight (kg). Dual-energy X-ray absorptiometry was used to measure bone mineral density (BMD), appendicular lean mass (ALM) and total body fat percentage. Unhealthy body composition was defined as combined presence of high fat mass, low bone mass and low muscle mass. ResultsA total of 5983 individuals (3034 men [50.7%] and 2949 women [49.3%]; mean age: 63.5 & PLUSMN; 8.7 years) were included. WWI was positively correlated with total body fat percentage (r = 0.478, P < 0.001) and inversely with ALM/weight (r = -0.485, P < 0.001) and BMD at the lumbar spine (r = -0.187, P < 0.001), femoral neck (r = -0.269, P < 0.001) and total hip (r = -0.255, P < 0.001). Higher WWI quartiles correlated with lower BMD, T-scores and ALM/weight, along with increased total body fat, evident in both genders and more pronounced in women, even after adjusting for confounders. This trend remained statistically significant across WWI quartiles for all analyses (P < 0.001). Higher WWI quartiles were also significantly associated with higher odds of unhealthy body composition, with adjusted odds ratio in the highest WWI group of 18.08 (95% CI, 4.32-75.61) in men and 6.36 (95% CI, 3.65-11.07) in women. The optimal cutoff values of WWI for unhealthy body composition were 10.4 cm/& RADIC;kg in men and 10.5 cm/& RADIC;kg in women. ConclusionsIn community-dwelling adults, high WWI values are associated with unfavourable body composition outcomes, indicating high fat mass, low muscle mass and low bone mass. WWI can potentially serve as an integrated index of body composition, underscoring the need for further research to validate its use in clinical settings.

2023-10-01T00:00:00Z Lee, Eun Young Cho, Jae-Hyoung Lee, Woo Je Kim, Nam Hoon Kim, Jae Hyeon Lee, Byung-Wan https://scholarworks.korea.ac.kr/kumedicine/handle/2021.sw.kumedicine/64122 2024-07-11T09:34:27Z 2023-09-01T00:00:00Z

Title: Glucometabolic control of once-weekly dulaglutide switched from DPP4 inhibitor versus daily empagliflozin add-on in patients with type 2 diabetes inadequately controlled with metformin, sulfonylurea, and DPP4 inhibitor: A randomised trial Authors: Lee, Eun Young; Cho, Jae-Hyoung; Lee, Woo Je; Kim, Nam Hoon; Kim, Jae Hyeon; Lee, Byung-Wan Abstract: Aims: To compare the effectiveness and safety of empagliflozin and dulaglutide in patients with type 2 diabetes (T2D) inadequately controlled by oral triple therapy.Methods: In this 24-week, multi-center, randomized trial, patients with T2D and HbA1c level =7.5% (58 mmol/ mol) on metformin, sulfonylurea, and dipeptidyl peptidase 4 inhibitor (DPP4-i) were randomly assigned into two groups: daily empagliflozin add-on or once-weekly dulaglutide switched from DPP4-i. The primary endpoint was changes from baseline HbA1c at 24 weeks.Results: In total, 152 patients were recruited to the empagliflozin-added quadruple group (n = 76) or the switched-to-dulaglutide triple group (n = 76). At week 24, both groups showed significant reduction in HbA1c level from baseline with greater reduction with empagliflozin (the mean treatment difference: -0.27% [95% CI -0.50 to -0.04, p = 0.024]) (-2.88 mmol/mol [95% CI -5.37 to -0.39], p = 0.024). Empagliflozin significantly reduced body weight from baseline to week 24 (-1.72 kg [95% CI -1.98 to -0.59, p < 0.001]). No serious adverse events were reported with either empagliflozin or dulaglutide.Conclusions: Empagliflozin, compared with once-weekly dulaglutide switched from DPP4-i, demonstrated greater HbA1c reduction and weight loss in patients with T2D inadequately controlled with metformin, sulfonylurea, and DPP4-i.Trial registration: cris.nih.go.kr (KCT0006157)

2023-09-01T00:00:00Z