Endocrinology and Metabolism

Original Articles

Diabetes, obesity and metabolism
Effects of an Electronic Medical Records-Linked Diabetes Self-Management System on Treatment Targets in Real Clinical Practice: Retrospective, Observational Cohort Study: So Jung Yang, Sun-Young Lim, Yoon Hee Choi, Jin Hee Lee, Kun-Ho Yoon; Endocrinol Metab. 2024;39(2):364-374. Published online March 21, 2024; DOI: https://doi.org/10.3803/EnM.2023.1878

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Abstract PDF Supplementary Material PubReader ePub: Background
This study evaluated the effects of a mobile diabetes management program called “iCareD” (College of Medicine, The Catholic University of Korea) which was integrated into the hospital’s electronic medical records system to minimize the workload of the healthcare team in the real clinical practice setting.
Methods
In this retrospective observational study, we recruited 308 patients. We categorized these patients based on their compliance regarding their use of the iCareD program at home; compliance was determined through self-monitored blood glucose inputs and message subscription rates. We analyzed changes in the ABC (hemoglobin A1c, blood pressure, and low-density lipoprotein cholesterol) levels from the baseline to 12 months thereafter, based on the patients’ iCareD usage patterns.
Results
The patients comprised 92 (30%) non-users, 170 (55%) poor-compliance users, and 46 (15%) good-compliance users; the ABC target achievement rate showed prominent changes in good-compliance groups from baseline to 12 months (10.9% vs. 23.9%, P<0.05), whereas no significant changes were observed for poor-compliance users and non-users (13.5% vs. 18.8%, P=0.106; 20.7% vs. 14.1%, P=0.201; respectively).
Conclusion
Implementing the iCareD can improve the ABC levels of patients with diabetes with minimal efforts of the healthcare team in real clinical settings. However, the improvement of patients’ compliance concerning the use of the system without the vigorous intervention of the healthcare team needs to be solved in the future.

The Short-term Effects of Bone Marrow Transplantation on Bone Metabolism.: Soon Jib Yoo, Yoo Bae Ahn, Kun Ho Yoon, Moo Il Kang, Kwang Woo Lee, Ho Young Son, Sung Koo Kang, Ki Ho Song, Yoon Hee Choi, Bong Yeon Cha, Hye Soo Kim, Ki Won Oh, Sung Dae Moon, Sang Ah Jang, Chun Choo Kim; J Korean Endocr Soc. 1999;14(2):355-364. Published online January 1, 2001

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Abstract PDF: BACKGROUND
The organ transplantation becomes the management of choice for many patients with chronic and life threatening heart, liver, kidney, bone marrow, and pancreatic diseases. A new set of side effects unique to this groups of patients has become recognized. Bone disease is one of these complications. It is well known that there is an interplay between the cells in the bone marrow and the surrounding bone tissue. Marrow stromal cells include the progenitors of the osteoblastic lineage are the sources of effector molecules that support and regulate both hematopoiesis and bone remodeling. But little is known about the effects of myeloablative treatment followed by bone marrow transplantation(BMT) on bone metabolism. METHODS: We have investigated prospectively in 29 patients undergoing BMT(4 autologous, 25 allogenic) for hematologic diseases(19 leukemia, 9 severe aplastic anemia, 1 myelodyspoietic syndrome). Serum concentrations of calcium, phosphorus, creatinine, gonadotropins, sex hormones and biochemical markers of bone turnover(osteocalcin and carboxyterminal cross-linked telopeptide of type I collagen(ICTP)] were measured. The samples were collected before BMT and 1, 2, 3, 4, 12 weeks, 6 months and 1 year thereafter. Bone mineral density was measured with DEXA(Dual Energy X-ray Absorptiometry) before and after 1 year of BMT. RESULTS: 1. ICIP was progressively increased until 4 weeks after BMT when peak values were reached. And then decreased thereafter and basal values were regained after 1 year. Osteocalcin was progressively decreased until 3 weeks after BMT when nadir values were reached. And then increased thereafter and basal values were regained after 3 months. No distinct differences were observed in serum biochemical turnover marker between both sexes and between patients who received total body irradiation and those who did not. 2. Lumbar BMD was 2.1% decreased from 1.113 +/- 0.132 g/cm to 1.089 +/- 0.137 g/cm, and femoral BMD was 6.2% decreased fiom 1.078 +/- 0.156 g/cm to 1.011 +/- 0.157 g/cm. 3. 92% of the women (11/12) became menopausal manifested by high gonadotropin and low estradiol levels immediately after BMT. In contrast to women, gonadotropins and testosterone levels were not changed significantly in men after BMT. CONCLUSION: The rapid impairment of bone formation and also increase in bone resorption, as mirrored by the biochemical markers in this study, might play a role for the post-BMT bone loss. Further studies over many patients with a longer follow up will be needed.

Case Reports

A Case of Alstrom Syndrome.: Kun Ho Yoon, Ho Young Son, Sung Koo Kang, Yoon Hee Choi, Bong Yeon Cha, Hwan Suk Cho, Ki Bum Kim, Ji Ho Kang, Young Mi Choo, Sang Soo Bae; J Korean Endocr Soc. 1998;13(3):501-508. Published online January 1, 2001

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Abstract PDF: The Alstrom syndrome is inherited autosomal recessive disorder, characterized by obesity, diabetes mellitus, pigmentary retinal degeneration, normal intelligence, sensorineural hearing loss, baldness, acanthosis nigricans, male hypogonadism, hyperuricemia and hypertriglyceridemia. There is no reported case of Alstrom syndrome in Korea yet. We experienced a 29-year-old female patient with clinical characteristics similar to Alstrom syndrome who was admitted due to poorly controlled diabetes mellitus and diabetic retinopathy with hemorrhage. We report this case with the review of literatures.

A Case of Functioning Parathyroid Cancer with Hypokalemia.: Yoon Hee Choi; J Korean Endocr Soc. 1997;12(1):81-89. Published online January 1, 2001

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Abstract PDF: The parathyroid carcinoma is rare disorder and its reported incidence is 1-2% of primary hyperparathyroidism. Parathyroid cancer shows more profound clinical symptoms and signs than adenoma or hyperplasia: more severe renal and bony complications, higher calcium levels (>15 mg/dL) and palpable neck mass. It usually diagnosed after operation when it shows malignant pathologic findings, local invasion, distant metastasis, or even recurrence. The treatment is surgical resection. Hypokalemia is relatively common feature of primary hyperparathyroidism but it should be marked because of its arrhythmogenic effect when accompanies with hypercalcemia. We experienced a hyperfunctioning parathyroid carcinoma in 53 year old rnan confirmed postoperatively which showed hypokalemia normalized after operation.

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