Endocrinology and Metabolism

Original Article

Diabetes, obesity and metabolism
Effectiveness of a Social Networking Site Based Automatic Mobile Message Providing System on Glycemic Control in Patients with Type 2 Diabetes Mellitus: Kyuho Kim, Jae-Seung Yun, Joonyub Lee, Yeoree Yang, Minhan Lee, Yu-Bae Ahn, Jae Hyoung Cho, Seung-Hyun Ko; Endocrinol Metab. 2024;39(2):344-352. Published online December 27, 2023; DOI: https://doi.org/10.3803/EnM.2023.1871

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Abstract PDF Supplementary Material PubReader ePub: Background
This study investigated the effectiveness of a social networking site (SNS)-based automatic mobile message providing system on glycemic control in patients with type 2 diabetes mellitus (T2DM).
Methods
A 3-month, randomized, open-label, controlled, parallel-group trial was conducted. One hundred and ten participants with T2DM were randomized to a mobile message system (MMS) (n=55) or control group (n=55). The MMS group received protocolbased automated messages two times per day for 10 weeks regarding diabetes self-management through KakaoTalk SNS messenger. The primary outcome was the difference in the change in glycated hemoglobin (HbA1c) levels (%) from baseline to week 12.
Results
HbA1c levels were more markedly decreased in the MMS group (8.4%±0.7% to 8.0%±1.1%) than in the control group (8.5%±0.8% to 8.4%±0.8%), resulting in a significant between-group difference (P=0.027). No differences were observed in changes in fasting glucose levels, lipid profiles, and the number of participants who experienced hypoglycemia, or in changes in lifestyle behavior between groups. However, the self-monitoring of blood glucose frequency was significantly increased in the MMS group compared to the control group (P=0.003). In addition, sleep duration was increased in the MMS group, but was not changed in the control group.
Conclusion
An SNS-based automatic mobile message providing system was effective in improving glycemic control in patients in T2DM. Studies which based on a more individualized protocol, and investigate longer beneficial effect and sustainability will be required in the future.

Response

Diabetes, Obesity and Metabolism
Characteristics of Glycemic Control and Long-Term Complications in Patients with Young-Onset Type 2 Diabetes (Endocrinol Metab 2022;37:641-51, Han-sang Baek et al.): Han-sang Baek, Ji-Yeon Park, Jin Yu, Joonyub Lee, Yeoree Yang, Jeonghoon Ha, Seung Hwan Lee, Jae Hyoung Cho, Dong-Jun Lim, Hun-Sung Kim; Endocrinol Metab. 2022;37(6):945-946. Published online December 2, 2022; DOI: https://doi.org/10.3803/EnM.2022.602; [Original]

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Original Articles

Diabetes, Obesity and Metabolism
Characteristics of Glycemic Control and Long-Term Complications in Patients with Young-Onset Type 2 Diabetes: Han-sang Baek, Ji-Yeon Park, Jin Yu, Joonyub Lee, Yeoree Yang, Jeonghoon Ha, Seung Hwan Lee, Jae Hyoung Cho, Dong-Jun Lim, Hun-Sung Kim; Endocrinol Metab. 2022;37(4):641-651. Published online August 29, 2022; DOI: https://doi.org/10.3803/EnM.2022.1501

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Background
The prevalence of young-onset diabetes (YOD) has been increasing worldwide. As the incidence of YOD increases, it is necessary to determine the characteristics of YOD and the factors that influence its development and associated complications.
Methods
In this retrospective study, we recruited patients who were diagnosed with type 2 diabetes mellitus between June 2001 and December 2021 at a tertiary hospital. The study population was categorized according to age: YOD (age <40 years), middle-age-onset diabetes (MOD, 40≤ age <65 years), and late-onset diabetes (LOD, age ≥65 years). We examined trends in glycemic control by analyzing fasting glucose levels during the first year in each age group. A Cox proportional-hazards model was used to determine the relative risk of developing complications according to glycemic control trends.
Results
The fasting glucose level at the time of diagnosis was highest in the YOD group (YOD 149±65 mg/dL; MOD 143±54 mg/dL; and LOD 140±55 mg/dL; p=0.009). In the YOD group, glucose levels decreased at 3 months, but increased by 12 months. YOD patients and those with poor glycemic control in the first year were at a higher risk of developing complications, whereas the risk in patients with LOD was not statistically significant.
Conclusion
YOD patients had higher glucose levels at diagnosis, and their glycemic control was poorly maintained. As poor glycemic control can influence the development of complications, especially in young patients, intensive treatment is necessary for patients with YOD.

Citations

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Increased risk of incident mental disorders in adults with new-onset type 1 diabetes diagnosed after the age of 19: A nationwide cohort study
Seohyun Kim, Gyuri Kim, So Hyun Cho, Rosa Oh, Ji Yoon Kim, You-Bin Lee, Sang-Man Jin, Kyu Yeon Hur, Jae Hyeon Kim
Diabetes & Metabolism.2024; 50(1): 101505. CrossRef
Association between age at diagnosis of type 2 diabetes and cardiovascular morbidity and mortality risks: A nationwide population-based study
Da Hea Seo, Mina Kim, Young Ju Suh, Yongin Cho, Seong Hee Ahn, Seongbin Hong, So Hun Kim
Diabetes Research and Clinical Practice.2024; 208: 111098. CrossRef
Impact of diabetes distress on glycemic control and diabetic complications in type 2 diabetes mellitus
Hye-Sun Park, Yongin Cho, Da Hea Seo, Seong Hee Ahn, Seongbin Hong, Young Ju Suh, Suk Chon, Jeong-Taek Woo, Sei Hyun Baik, Kwan Woo Lee, So Hun Kim
Scientific Reports.2024;[Epub] CrossRef
Early onset type 2 diabetes mellitus: an update
Myrsini Strati, Melpomeni Moustaki, Theodora Psaltopoulou, Andromachi Vryonidou, Stavroula A. Paschou
Endocrine.2024;[Epub] CrossRef
Complications and Treatment of Early-Onset Type 2 Diabetes
Fahimeh Soheilipour, Naghmeh Abbasi Kasbi, Mahshid Imankhan, Delaram Eskandari
International Journal of Endocrinology and Metabolism.2023;[Epub] CrossRef
Characteristics of Glycemic Control and Long-Term Complications in Patients with Young-Onset Type 2 Diabetes (Endocrinol Metab 2022;37:641-51, Han-sang Baek et al.)
Han-sang Baek, Ji-Yeon Park, Jin Yu, Joonyub Lee, Yeoree Yang, Jeonghoon Ha, Seung Hwan Lee, Jae Hyoung Cho, Dong-Jun Lim, Hun-Sung Kim
Endocrinology and Metabolism.2022; 37(6): 945. CrossRef
ISPAD Clinical Practice Consensus Guidelines 2022: Management of the child, adolescent, and young adult with diabetes in limited resource settings
Anju Virmani, Stuart J. Brink, Angela Middlehurst, Fauzia Mohsin, Franco Giraudo, Archana Sarda, Sana Ajmal, Julia E. von Oettingen, Kuben Pillay, Supawadee Likitmaskul, Luis Eduardo Calliari, Maria E. Craig
Pediatric Diabetes.2022; 23(8): 1529. CrossRef
Characteristics of Glycemic Control and Long-Term Complications in Patients with Young-Onset Type 2 Diabetes (Endocrinol Metab 2022;37:641-51, Han-sang Baek et al.)
May Thu Hla Aye, Sajid Adhi Raja, Vui Heng Chong
Endocrinology and Metabolism.2022; 37(6): 943. CrossRef

Hypothalamus and Pituitary Gland
Heart Rate Variability in Postoperative Patients with Nonfunctioning Pituitary Adenoma: Jeonghoon Ha, Hansang Baek, Chaiho Jeong, Minsoo Yeo, Seung-Hwan Lee, Jae Hyoung Cho, Ki-Hyun Baek, Moo Il Kang, Dong-Jun Lim; Endocrinol Metab. 2021;36(3):678-687. Published online June 10, 2021; DOI: https://doi.org/10.3803/EnM.2021.978

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Background
Decreased heart rate variability (HRV) has been reported to be associated with cardiac autonomic dysfunction. Hypopituitarism in nonfunctioning pituitary adenoma (NFPA) is often linked to increased cardiovascular mortality. We therefore hypothesized that postoperative NFPA patients with hormone deficiency have an elevated risk of HRV alterations indicating cardiac autonomic dysfunction.
Methods
A total of 22 patients with NFPA were enrolled in the study. Between 3 and 6 months after surgery, a combined pituitary function test (CPFT) was performed, and HRV was measured. The period of sleep before the CPFT was deemed the most stable period, and the hypoglycemic period that occurred during the CPFT was defined as the most unstable period. Changes in HRV parameters in stable and unstable periods were observed and compared depending on the status of hormone deficiencies.
Results
In patients with adrenocorticotropic hormone (ACTH) deficiency with other pituitary hormone deficiencies, the low frequency to high frequency ratio, which represents overall autonomic function and is increased in the disease state, was higher (P=0.005). Additionally, the standard deviation of the normal-to-normal interval, which decreases in the autonomic dysfunction state, was lower (P=0.030) during the hypoglycemic period. In panhypopituitarism, the low frequency to high frequency ratio during the hypoglycemic period was increased (P=0.007).
Conclusion
HRV analysis during CPFT enables estimation of cardiac autonomic dysfunction in patients with NFPA who develop ACTH deficiency with other pituitary hormone deficiencies or panhypopituitarism after surgery. These patients may require a preemptive assessment of cardiovascular risk.

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Heart Rate Variability in Subjects with Severe Allergic Background Undergoing COVID-19 Vaccination
Maria Bernadette Cilona, Filippo D’Amico, Chiara Asperti, Giuseppe Alvise Ramirez, Stefano Turi, Giovanni Benanti, Shai Marc Bohane, Serena Nannipieri, Rosa Labanca, Matteo Gervasini, Federica Russetti, Naomi Viapiana, Martina Lezzi, Giovanni Landoni, Lor
Vaccines.2023; 11(3): 567. CrossRef
Pituitary Diseases and COVID-19 Outcomes in South Korea: A Nationwide Cohort Study
Jeonghoon Ha, Kyoung Min Kim, Dong-Jun Lim, Keeho Song, Gi Hyeon Seo
Journal of Clinical Medicine.2023; 12(14): 4799. CrossRef
Effect of a 16-Session Qigong Program in Non-Hodgkin Lymphoma Survivors: A Randomized Clinical Trial
Keyla Vargas-Román, Emilia I. De la Fuente-Solana, Jonathan Cortés-Martín, Juan Carlos Sánchez-García, Christian J. González-Vargas, Lourdes Díaz-Rodríguez
Journal of Clinical Medicine.2022; 11(12): 3421. CrossRef

Development of Clinical Data Mart of HMG-CoA Reductase Inhibitor for Varied Clinical Research: Hun-Sung Kim, Hyunah Kim, Yoo Jin Jeong, Tong Min Kim, So Jung Yang, Sun Jung Baik, Seung-Hwan Lee, Jae Hyoung Cho, In Young Choi, Kun-Ho Yoon; Endocrinol Metab. 2017;32(1):90-98. Published online February 28, 2017; DOI: https://doi.org/10.3803/EnM.2017.32.1.90

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Abstract PDF PubReader

Background

The increasing use of electronic medical record (EMR) systems for documenting clinical medical data has led to EMR data being increasingly accessed for clinical trials. In this study, a database of patients who were prescribed statins for the first time was developed using EMR data. A clinical data mart (CDM) was developed for cohort study researchers.

Methods

Seoul St. Mary's Hospital implemented a clinical data warehouse (CDW) of data for ~2.8 million patients, 47 million prescription events, and laboratory results for 150 million cases. We developed a research database from a subset of the data on the basis of a study protocol. Data for patients who were prescribed a statin for the first time (between the period from January 1, 2009 to December 31, 2015), including personal data, laboratory data, diagnoses, and medications, were extracted.

Results

We extracted initial clinical data of statin from a CDW that was established to support clinical studies; the data was refined through a data quality management process. Data for 21,368 patients who were prescribed statins for the first time were extracted. We extracted data every 3 months for a period of 1 year. A total of 17 different statins were extracted. It was found that statins were first prescribed by the endocrinology department in most cases (69%, 14,865/21,368).

Conclusion

Study researchers can use our CDM for statins. Our EMR data for statins is useful for investigating the effectiveness of treatments and exploring new information on statins. Using EMR is advantageous for compiling an adequate study cohort in a short period.

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Case Reports

Diabetic Ketoacidosis in a Patient with Long-term Clozapine Therapy.: Youn Joo Jeon, Seung Hwan Lee, Se Na Jang, Eun Sun Kim, Jeong Yo Min, Ji Hyun Kim, Soon Hwa Hong, Jae Hyoung Cho, Hyuk Sang Kwon, Kun Ho Yoon, Bong Yun Cha, Ho Young Son; J Korean Endocr Soc. 2007;22(5):376-380. Published online October 1, 2007; DOI: https://doi.org/10.3803/jkes.2007.22.5.376

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Abstract PDF

With the broad use of atypical anti-psychotics, altered glucose metabolism has become an item of concern to clinicians and patients. Among the atypical anti-psychotics, clozapine and olanzapine are associated with a relatively high incidence of diabetic ketoacidosis and newly developed diabetes. We report a case of diabetic ketoacidosis in a patient with long-term clozapine therapy. A 35-year-old male with schizophrenia, treated with clozapine for 9 years was admitted into hospital because of comatous mentality. Although never diagnosed with diabetes before, his clinical features were consistent with diabetic ketoacidosis and shock. The patient's serum amylase and lipase levels were elevated and an abdominal computed tomography showed peripancreatic fat infiltration, suggesting the possibility of acute pancreatitis. The patient's serum glucose levels normalized shortly after clozapine treatment. Moreover, the patient ceased all glucose lowering agents upon hospital discharge, and maintained normal blood glucose levels thereafter. As observed in this case, clinicians should carefully screen and monitor blood glucose levels and other clinical parameters in patients treated with atypical anti-psychotics.

Citations

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Hyun Ho Kim, Hae Kyung Yang, Hyoju Ham, Ho Wook Jeon, Joon Yub Lee, Sea Won Hwang, Bo Hyun Jang, Gi June Min, Jeong Min Lee, Seung-Hwan Lee
The Journal of Korean Diabetes.2014; 15(3): 178. CrossRef
Olanzapine-Induced Diabetic Ketoacidosis and Neuroleptic Malignant Syndrome with Rhabdomyolysis: A Case Report
Young Kyoung Sa, Hyeon Yang, Hee Kyoung Jung, Jang Won Son, Seong Su Lee, Seong Rae Kim, Bong Yeon Cha, Ho Young Son, Chi-Un Pae, Soon Jib Yoo
Endocrinology and Metabolism.2013; 28(1): 70. CrossRef

A Patient with Concurrent Medullary and Papillary Carcinoma of the Thyroid.: Seung Hee Yoo, Keun Joon Lim, Seung Hwan Lee, Ji Hyun Kim, Soon Hwa Hong, Jae Hyoung Cho, Chan Kwon Jung, Hyuk Sang Kwon, Kun Ho Yoon, Min Sik Kim, Bong Yun Cha, Ho Young Son; J Korean Endocr Soc. 2007;22(3):235-240. Published online June 1, 2007; DOI: https://doi.org/10.3803/jkes.2007.22.3.235

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Abstract PDF

The origin of medullary thyroid carcinoma and papillary thyroid carcinoma are embryogenically different, so these tumors have been thought to be independent of each other. We experienced a case of concurrent medullary and papillary thyroid carcinoma in one patient. The patient underwent total thyroidectomy and both two tumors were located at different lobes, respectively. Both tumors showed their own characteristic pathologic and immunohistochemical findings. The patient's elevated calcitonin level returned to the normal range after operation and there has been no evidence of recurrence. It is still controversial whether the concurrency is just coincidental or it arises from activation of a common tumorigenic pathway.

Citations

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A Case of Concurrent Papillary and Medullary Thyroid Carcinomas Detected as Recurrent Medullary Carcinoma after Initial Surgery for Papillary Carcinoma
Dongbin Ahn, Jin Ho Sohn, Ji Young Park
Journal of Korean Thyroid Association.2013; 6(1): 80. CrossRef

A Case of Antineutrophil Cytoplasmic Antibody (ANCA) Positive, Propylthiouracil-Induced Diffuse Alveolar Hemorrhage in Graves' Disease.: Der Sheng Sun, Dong Kyu Kim, Hyo Jin Lee, Hee Yun Lee, Dae Jun Kim, Eun Sook Kim, Jae Hyoung Cho, Seung Hyun Ko, Wan Ook Kim, Chi Hong Kim, Ki Ho Song, Yu Bae Ahn; J Korean Endocr Soc. 2007;22(3):215-219. Published online June 1, 2007; DOI: https://doi.org/10.3803/jkes.2007.22.3.215

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Abstract PDF

Graves' disease is one of the common autoimmune diseases, and it has been controlled by such antithyroid drugs as propylthiouracil (PTU) or methimazole. There are a number of side effects, including agranulocytosis, skin rash, hepatotoxicity, fever, arthralgia and a lupus-like syndrome during treatment. PTU has been recently observed to be associated with the development of antineutrophil cytoplasmic antibody (ANCA) positive vasculitis, and this can cause diffuse alveolar hemorrhage. A 32-year-old woman with Graves' disease had been treated with PTU for 4 years, and she had experienced intermittent hemoptysis for 2 weeks before she visited the hospital. Both myeloperoxidase and proteinase 3 ANCA were positive without other organ systems being involved. She was diagnosed with PTU-induced vasculitis. Cessation of PTU and administration of corticosteroids improved the clinical manifestations.

Citations

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A Case of Diffuse Alveolar Hemorrhage with Glomerulonephritis after Propylthiouracil Treatment
Ji Hyun Lee, Min Su Kim, Jae Gon Lee, Dae Sik Kim, Hae Jin Yang, Kyung Woo Kang
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