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Approach to Fatty Liver Disease in Patients with Type 2 Diabetes 2型糖尿病患者脂肪肝的治疗方法
The Journal of Korean Diabetes Pub Date : 2023-09-30 DOI: 10.4093/jkd.2023.24.3.107
Ji Cheol Bae
{"title":"Approach to Fatty Liver Disease in Patients with Type 2 Diabetes","authors":"Ji Cheol Bae","doi":"10.4093/jkd.2023.24.3.107","DOIUrl":"https://doi.org/10.4093/jkd.2023.24.3.107","url":null,"abstract":"Type 2 diabetes is a major risk factor for development and progression of non-alcoholic fatty liver disease (NAFLD). Fatty liver is prevalent in people with type 2 diabetes, and overweight or obesity in these patients aggravates insulin resistance and steatohepatitis, which appear to be drivers for the disease progression. The goal of screening is not to identify steatosis itself, but rather to identify patients at risk for adverse hepatic outcomes such as cirrhosis, hepatocellular carcinoma, and death from liver disease. The most important risk factors for disease progression are liver fibrosis and its severity. There is a consensus that the FIB-4 (fibrosis-4 index) is the most cost-effective strategy for initial screening of hepatic fibrosis in a clinical setting. At present, there are no approved drugs for the treatment of NAFLD. Clinically significant improvements in NAFLD are achieved with weight loss. Glucagon-like peptide-1 receptor agonists (GLP-1 RAs) and sodium glucose cotransporter 2 (SGLT2) inhibitors are effective for inducing weight loss in patients with type 2 diabetes, and some GLP-1 RAs and SGLT2 inhibitors have been shown to be effective for treating steatohepatitis. Therefore, GLP-1 RAs and SGLT2 inhibitors should be considered when choosing antidiabetic agents in patients with type 2 diabetes and NAFLD, especially in those who are overweight or obese.","PeriodicalId":366252,"journal":{"name":"The Journal of Korean Diabetes","volume":"29 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135038929","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Diabetes and Dietary Fats 糖尿病与膳食脂肪
The Journal of Korean Diabetes Pub Date : 2023-09-30 DOI: 10.4093/jkd.2023.24.3.154
Jae Won Cho
{"title":"Diabetes and Dietary Fats","authors":"Jae Won Cho","doi":"10.4093/jkd.2023.24.3.154","DOIUrl":"https://doi.org/10.4093/jkd.2023.24.3.154","url":null,"abstract":"Fats are important nutrients that supply energy and help to regulate the processes of the human body. The proportion of fat in the energy intake of Koreans, as well as that of saturated fatty acids is continuously increasing. It has been reported that the quality of fat is more important than the intake of fat because of the effects on insulin sensitivity or blood lipid levels depending on the type of fat. To prevent excessive intake of energy or bad fat, total fat intake is recommended to be < 30% of total energy intake. Saturated fatty acids, which have the greatest adverse effect on the risk of cardiovascular disease, are recommended as < 7% of total energy, while trans fatty acids are suggested to be avoided and replaced with unsaturated fatty acids. Emphasis is placed on incorporating healthy eating patterns such as those of the Mediterranean diet and DASH (Dietary Approaches to Stop Hypertension), rich in mono- or polyunsaturated fatty acids. A balanced intake of fatty acids and a variety of nutritional foods in appropriate amounts is important for health.","PeriodicalId":366252,"journal":{"name":"The Journal of Korean Diabetes","volume":"46 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135038930","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
2023 Clinical Practice Guidelines for Diabetes: Management of Cardiovascular Risk Factors 2023糖尿病临床实践指南:心血管危险因素的管理
The Journal of Korean Diabetes Pub Date : 2023-09-30 DOI: 10.4093/jkd.2023.24.3.135
Ye Seul Yang
{"title":"2023 Clinical Practice Guidelines for Diabetes: Management of Cardiovascular Risk Factors","authors":"Ye Seul Yang","doi":"10.4093/jkd.2023.24.3.135","DOIUrl":"https://doi.org/10.4093/jkd.2023.24.3.135","url":null,"abstract":"To prevent cardiovascular disease (CVD), which is one of the ultimate goals in the management of patients with diabetes, it is important to control not only hyperglycemia, but also modifiable CVD risk factors such as hypertension and dyslipidemia. In addition, antiplatelet agents should be used under appropriate conditions. It is necessary to evaluate whether the patient has CVD, the degree of other complications, the presence of comorbidities or other CVD risk factors, and the duration of diabetes. In this article, I will review the revised and key points of the 8th edition of the Korean Diabetes Association clinical practice guidelines for management of hypertension and dyslipidemia and the use of antiplatelet agents in patients with diabetes.","PeriodicalId":366252,"journal":{"name":"The Journal of Korean Diabetes","volume":"40 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135038928","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Management of Dyslipidemia in Patients with Diabetes Mellitus 糖尿病患者血脂异常的处理
The Journal of Korean Diabetes Pub Date : 2023-09-30 DOI: 10.4093/jkd.2023.24.3.111
Kyung Ae Lee
{"title":"Management of Dyslipidemia in Patients with Diabetes Mellitus","authors":"Kyung Ae Lee","doi":"10.4093/jkd.2023.24.3.111","DOIUrl":"https://doi.org/10.4093/jkd.2023.24.3.111","url":null,"abstract":"Most patients with diabetes mellitus (DM) have dyslipidemia, which is characterized by increased triglycerides, decreased high-density lipoprotein cholesterol, and increased small dense low-density lipoprotein cholesterol (LDL-C). Dyslipidemia is an important modifiable risk factor for cardiovascular disease (CVD). Therefore active management is essential. Despite its increasing prevalence, the proportion of patients with adequately-controlled dyslipidemia is small, and efforts to improve this pattern are required. The Korean Diabetes Association guidelines recommend setting goals by evaluating each patient’s future CVD risk, including the presence or absence of CVD, target organ damage, major cardiovascular risk factors, and the duration of DM. The primary target is an LDL-C level below 55 mg/dL (and a reduction in LDL-C level by 50% or more from baseline), 70 mg/dL, and 100 mg/dL from the highest risk group to the lowest risk group, respectively. Statins are the first-line drug of choice, and if the LDL-C target is not reached by a maximum tolerable dose of statin, combination therapy with ezetimibe or proprotein convertase subtilisin/kexin type 9 inhibitors is recommended. In hypertriglyceridemia, lifestyle changes including weight loss and abstinence from alcohol are very important, along with glycemic control.","PeriodicalId":366252,"journal":{"name":"The Journal of Korean Diabetes","volume":"68 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135038931","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Trends and Effects in Evidence-Based Psycho-Social Interventions for Patients with Diabetes 糖尿病患者循证心理社会干预的趋势与效果
The Journal of Korean Diabetes Pub Date : 2023-09-30 DOI: 10.4093/jkd.2023.24.3.164
Jung-won Lim
{"title":"Trends and Effects in Evidence-Based Psycho-Social Interventions for Patients with Diabetes","authors":"Jung-won Lim","doi":"10.4093/jkd.2023.24.3.164","DOIUrl":"https://doi.org/10.4093/jkd.2023.24.3.164","url":null,"abstract":"The purpose of this study is to explore psycho-social interventions for patients with diabetes and to suggest the effects of such interventions based on findings from systematic review and meta-analysis. To date, many types of psycho-social interventions for patients with diabetes have been conducted, indicating that self-management, self-efficacy, glucose control, diabetes distress, and quality of life can be improved after psycho-social interventions. As the most frequently used psycho-social interventions, cognitive behavioral therapy, behavior change techniques, motivational interviewing, and self-care interventions have been introduced and their effectiveness on psycho-social outcomes and disease control have been indicated. Recent studies have conducted technology-based psycho-social interventions for patients with diabetes, focusing on glucose control. Future studies are required to conduct multidisciplinary interventions based on a multilateral and integrated approach to continuously manage and monitor disease.","PeriodicalId":366252,"journal":{"name":"The Journal of Korean Diabetes","volume":"22 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135038932","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Characteristics of the Latest Therapeutic Agent for Diabetes 最新糖尿病治疗剂的特点
The Journal of Korean Diabetes Pub Date : 2023-09-30 DOI: 10.4093/jkd.2023.24.3.148
Nuri Yun
{"title":"Characteristics of the Latest Therapeutic Agent for Diabetes","authors":"Nuri Yun","doi":"10.4093/jkd.2023.24.3.148","DOIUrl":"https://doi.org/10.4093/jkd.2023.24.3.148","url":null,"abstract":"The latest therapeutic agent for diabetes is characterized by a longer lasting blood glucose control effect than existing treatments and stable blood glucose control. In addition, it has the advantage of being able to manage not only diabetes, but also comorbidities by considering the characteristics of each patient, such as comorbidities (atherosclerotic cardiovascular disease, chronic kidney disease, etc.). In this chapter, new antidiabetic drugs will be introduced based on the latest clinical research results on drugs such as sodium glucose cotransporter 2 inhibitors and glucagon-like peptide-1 receptor agonists.","PeriodicalId":366252,"journal":{"name":"The Journal of Korean Diabetes","volume":"22 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135038924","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
2023 Clinical Practice Guidelines for Diabetes 2023糖尿病临床实践指南
The Journal of Korean Diabetes Pub Date : 2023-09-30 DOI: 10.4093/jkd.2023.24.3.120
Min Kyong Moon
{"title":"2023 Clinical Practice Guidelines for Diabetes","authors":"Min Kyong Moon","doi":"10.4093/jkd.2023.24.3.120","DOIUrl":"https://doi.org/10.4093/jkd.2023.24.3.120","url":null,"abstract":"The Committee on Clinical Practice Guidelines of the Korean Diabetes Association updated the previous clinical practice guidelines for Korean adults with diabetes and prediabetes and published the eighth edition in May 2023. We performed a comprehensive systematic review of recent clinical trials and evidence suitable for the Korean population that could be applicable to real-world practice. These guidelines were developed to enable all healthcare providers including physicians, diabetes experts, and certified diabetes educators nationwide to best care for individuals with diabetes in a clinical practice setting. The recommendations for screening, medical nutrition therapy, pharmacologic therapy for adults with type 2 diabetes, and obesity, hypertension, and lipid management were revised and updated. The use of real-time continuous glucose monitoring (CGM) devices was recommended for adults with type 1 diabetes and adults with type 2 diabetes treated with multiple insulin injections, and additional CGM metrics were added to the blood glucose control target.","PeriodicalId":366252,"journal":{"name":"The Journal of Korean Diabetes","volume":"27 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135038927","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 1
2023 Clinical Practice Guidelines for Diabetes: Continuous Glucose Monitoring and Insulin Pumps 2023糖尿病临床实践指南:持续血糖监测和胰岛素泵
The Journal of Korean Diabetes Pub Date : 2023-09-30 DOI: 10.4093/jkd.2023.24.3.141
Sang-Man Jin
{"title":"2023 Clinical Practice Guidelines for Diabetes: Continuous Glucose Monitoring and Insulin Pumps","authors":"Sang-Man Jin","doi":"10.4093/jkd.2023.24.3.141","DOIUrl":"https://doi.org/10.4093/jkd.2023.24.3.141","url":null,"abstract":"With the expanding use of continuous glucose monitoring (CGM) and insulin pumps worldwide, several international guidelines dedicated to diabetes technology have been developed. Recently, the Korean Diabetes Association released a new version of their clinical practice guidelines including substantial changes in recommendations on the use of CGM and insulin pumps. Of note, continuous use of real-time CGM is now recommended to all people with diabetes using insulin, including people with type 2 diabetes using once daily basal insulin. Convincing evidence from recent automated insulin delivery (AID) trials supports the recommendation of AID as standard therapy in type 1 diabetes. This review summarizes the results of recent clinical studies on CGM and AID and their influence on the new clinical recommendations.","PeriodicalId":366252,"journal":{"name":"The Journal of Korean Diabetes","volume":"31 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135038926","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
2023 Clinical Practice Guidelines for Diabetes: Recommendations for Pharmacological Treatment of Type 2 Diabetes 2023糖尿病临床实践指南:2型糖尿病药物治疗建议
The Journal of Korean Diabetes Pub Date : 2023-09-30 DOI: 10.4093/jkd.2023.24.3.127
Junghyun Noh
{"title":"2023 Clinical Practice Guidelines for Diabetes: Recommendations for Pharmacological Treatment of Type 2 Diabetes","authors":"Junghyun Noh","doi":"10.4093/jkd.2023.24.3.127","DOIUrl":"https://doi.org/10.4093/jkd.2023.24.3.127","url":null,"abstract":"The 2023 clinical practice guidelines for diabetes in Korea are reviewed and updated biennially by the Committee of Clinical Practice Guidelines of the Korean Diabetes Association based on the latest scientific research and clinical trials. The 2023 guidelines include several updates to recommendations for pharmacological treatment of type 2 diabetes. The new guidelines make it clear that the treatment plan should include antidiabetic agents proven to reduce cardiorenal risk in adults with type 2 diabetes and established atherosclerotic cardiovascular disease, heart failure, or chronic kidney disease. When considering injection-based combination therapy, GLP-1 receptor agonists (GLP-1 RAs) are recommended prior to basal insulin. If the target blood glucose level cannot be reached with GLP-1 RAs or basal insulin treatment alone, combination treatment with GLP-1 RAs and basal insulin is recommended. This review summarizes the recommendations for pharmacological treatment for type 2 diabetes in the 2023 Korean Diabetes Association treatment guidelines, focusing on major revisions.","PeriodicalId":366252,"journal":{"name":"The Journal of Korean Diabetes","volume":"56 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135038922","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Diabetes Self-Management in Vulnerable Populations
The Journal of Korean Diabetes Pub Date : 2023-06-30 DOI: 10.4093/jkd.2023.24.2.102
S. Jang
{"title":"Diabetes Self-Management in Vulnerable Populations","authors":"S. Jang","doi":"10.4093/jkd.2023.24.2.102","DOIUrl":"https://doi.org/10.4093/jkd.2023.24.2.102","url":null,"abstract":"For medically, socially, or economically vulnerable populations, diabetes self-management in daily life may be difficult due to trouble accessing healthcare and social, economic, and cultural barriers associated with poverty. Doctors, nurses, nutritionists, and social workers meet various patients from vulnerable populations (e.g., low-income single-person households) in clinical settings. However, there has been a lack of discussion on the characteristics and needs of vulnerable patients with diabetes and relevant interventions. The purpose of this study is, first, to examine the characteristics and psychosocial difficulties of low-income single-person households, and second, to discuss ways to support diabetes selfmanagement.","PeriodicalId":366252,"journal":{"name":"The Journal of Korean Diabetes","volume":"50 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"127824523","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
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