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Original Article
TAZ WW Domain-Mediated Regulation of Gluconeogenesis and Tumorigenesis in Hepatocellular Carcinoma through Interaction with the Glucocorticoid Receptor
Hongxiang Huang, Jinhong Chen, Xingyu Tao, Peiyuan Zhong, Yanqiu Meng, Sujuan Peng, Wanying Luo, Zhiyong He, Shuai Luo, Xie Zhu, Zhihui Lu, Li Chen, Yangyang Liu
Received May 22, 2025  Accepted September 30, 2025  Published online February 10, 2026  
DOI: https://doi.org/10.3803/EnM.2025.2471    [Epub ahead of print]
  • 108 View
  • 8 Download
AbstractAbstract PDF
Background
Hepatocellular carcinoma (HCC) is a leading cause of cancer mortality, characterized by poor prognosis due to its high proliferative and invasive potential. Tumor metabolic reprogramming, particularly involving glucose metabolism, is essential for tumor survival. This study investigates the role of the Hippo pathway effector transcriptional co-activator with PDZ-binding motif (TAZ) in regulating gluconeogenesis and promoting tumorigenesis in HCC.
Methods
TAZ expression in HCC was analyzed using The Cancer Genome Atlas data and validated in clinical samples and cell lines. TAZ was overexpressed or silenced in HCC cell lines to evaluate its effects on cell proliferation, apoptosis, migration, and invasion. The expression and prognostic relevance of the gluconeogenesis-related genes phosphoenolpyruvate carboxykinase 1 (PCK1) and glucose-6-phosphatase (G6PC) were examined, along with their correlation with TAZ expression. Tumor growth was assessed in nude mice. Interactions between TAZ and the glucocorticoid receptor (GR) were investigated using co-immunoprecipitation, immunofluorescence, and chromatin immunoprecipitation assays.
Results
TAZ was significantly upregulated in HCC tissues and cell lines. TAZ overexpression enhanced proliferation, reduced apoptosis, and promoted migration and invasion. In contrast, PCK1 and G6PC were downregulated in HCC and showed a negative correlation with TAZ expression.
Conclusion
TAZ modulates gluconeogenesis and accelerates tumor growth, whereas its knockdown attenuates tumor progression. TAZ interacts with GR, suppressing its transcriptional activity on gluconeogenic gene promoters.
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Songwon Lecture 2025
Postpartum Glucose Intolerance in Women with a History of Gestational Diabetes Mellitus: An In-Depth Review
Kyung-Soo Kim, Soo-Kyung Kim, Yong-Wook Cho
Received December 15, 2025  Accepted December 23, 2025  Published online February 3, 2026  
DOI: https://doi.org/10.3803/EnM.2025.2852    [Epub ahead of print]
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  • 18 Download
AbstractAbstract PDF
Gestational diabetes mellitus (GDM) is increasing in prevalence worldwide, and postpartum glucose intolerance represents one of the major complications after delivery in women with GDM. A wide range of risk factors for postpartum glucose intolerance have been identified, including ethnicity, genetic predisposition, age, obesity, pre-pregnancy body mass index, gestational weight gain, history of GDM, family history of diabetes, degree of hyperglycemia, insulin treatment, lipid profiles, and other metabolic factors. Lifestyle interventions, including weight loss, are thought to reduce the risk of postpartum glucose intolerance. Careful attention should be paid to the screening of postpartum glucose intolerance in women with GDM, and concerted efforts should be made to prevent or delay the development of diabetes and other metabolic disorders.
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Review Article
Growth Hormone, Not Simply Just a Hormone for Growth
Kevin C. J. Yuen, Jaime Guevara-Aguirre, John J. Kopchick
Received November 21, 2025  Accepted December 18, 2025  Published online February 3, 2026  
DOI: https://doi.org/10.3803/EnM.2025.2806    [Epub ahead of print]
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  • 51 Download
AbstractAbstract PDF
Since its discovery almost 100 years ago, growth hormone (GH) has been extensively studied to elucidate its structural characteristics, receptor interactions and its physiologic and non-physiologic effects. These actions include but are not limited to its effects on somatic growth, substrate metabolism, body composition, bone mineral density, cardiovascular system, and cognitive function. Contextually, recombinant human GH was approved for growth promotion in children and to enhance metabolic health in adult patients with GH deficiency (GHD), along with other clinical indications. Studies involving individuals and animal models exhibiting dysregulated GH levels, ranging from complete or partial GHD to GH excess, have unveiled a spectrum of several less evident GH actions. In this review, we exclude discussing the classic GH therapeutic applications but instead focus on the interplay between GH and glucose metabolism, fibrosis, and carcinogenesis that is observed with varying GH levels and action. We also discuss clinical data derived from studies in acromegaly and GHD patients (including individuals with congenital GH and insulin-like growth factor I [IGF-I] deficiencies), and attempt to integrate findings from cellular, animal and human studies with the aim of highlighting novel characteristics and underlying molecular pathways through which both GH and IGF-I exert their more subtle actions.
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Original Article
Global Burden of Early-Onset Cancers Attributable to Metabolic Risk Factors from 1990 to 2021 and Projections to 2040
Wenmei Qiao, Kaijian Zhou, Liang He, Jiahui Guo, Qiqiang Guo, Jing Zhang, Yongze Li
Received July 24, 2025  Accepted October 21, 2025  Published online January 5, 2026  
DOI: https://doi.org/10.3803/EnM.2025.2577    [Epub ahead of print]
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AbstractAbstract PDFSupplementary MaterialPubReader   ePub   
Background
Early-onset cancers (diagnosed in individuals under 50 years of age) are increasingly contributing to the global cancer burden. Among the known contributors, specific metabolic risk factors—namely high body mass index (BMI) and high fasting plasma glucose (FPG)—have emerged as significant determinants. This study assessed the global burden of early-onset cancers attributable to these two metabolic risk factors and projected their trends through 2040.
Methods
Using data from the Global Burden of Disease 2021 study, we analyzed mortality, disability-adjusted life years (DALYs), and estimated annual percentage changes for early-onset cancers linked to metabolic risk factors, stratified by age, sex, and sociodemographic index (SDI). Future trends were projected based on these data.
Results
In 2021, the two metabolic risk factors (high FPG and high BMI) together accounted for 34,112 (95% uncertainty interval [UI], 15,037 to 54,888) deaths and 1,691,418 (95% UI, 762,923 to 2,698,657) DALYs from early-onset cancers, corresponding to mortality and DALY rates of 0.9 (95% UI, 0.4 to 1.4) and 42.8 (95% UI, 19.3 to 68.3) per 100,000 population, respectively. Between 1990 and 2021, both mortality and DALY rates rose significantly, with the greatest increases observed in individuals aged 30–34 years and in low-middle SDI regions. High FPG and high BMI were the leading contributors, with colorectal cancer showing the highest burden and liver cancer the most rapid growth. While high BMI predominated in most SDI regions, high FPG was more prominent in low-SDI countries, particularly among females. Projections indicate a continued rise in mortality and DALY rates through 2040.
Conclusion
High BMI and high FPG are major contributors to the global burden of early-onset cancers, with marked sex and socioeconomic disparities necessitating targeted interventions. Urgent strategies are required to mitigate metabolic risks and enhance early cancer detection, especially among vulnerable populations.
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Review Article
Diabetes, obesity and metabolism
SGLT2 Inhibitors as Systemic Metabolic Modulators: Linking Glucose Excretion to Liver Function Restoration
Seung Wan Noh, Han Sol Ryu, Yong-Ho Kim, Byung-Chul Oh
Endocrinol Metab. 2025;40(6):851-865.   Published online December 24, 2025
DOI: https://doi.org/10.3803/EnM.2025.2786
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AbstractAbstract PDFPubReader   ePub   
Sodium-glucose cotransporter 2 (SGLT2) inhibitors have emerged as paradigm-shifting therapeutics that extend beyond glycemic regulation, to conferring profound hepatometabolic benefits. This review delineates the multifaceted mechanisms underlying metabolic dysfunction-associated steatotic liver disease (MASLD), with an emphasis on systemic metabolic remodeling, mitochondrial protection, and intracellular calcium restoration. By promoting glucosuria-induced energy depletion, SGLT2 inhibition alleviates insulin resistance, suppresses hepatic lipogenesis, and activates adenosine monophosphate-activated protein kinase (AMPK)–sirtuin 1 (SIRT1)–peroxisome proliferator-activated receptor γ (PPARγ) coactivator-1α pathways that reprogram hepatocellular metabolism toward achieving lipid oxidation and autophagy. Mechanistically, SGLT2 inhibitors restore intracellular Ca2+ homeostasis via sarcoplasmic/endoplasmic reticulum calcium ATPase 2 (SERCA2) activation, mitigating endoplasmic reticulum (ER) stress and normalizing Ca2+–phosphoinositide (PIP)–protein kinase B (AKT) signaling, collectively reinforcing insulin responsiveness and ER-mitochondrial crosstalk. Clinically, these effects translate into consistently reducing hepatic fat, aminotransferases, and fibrosis markers in both diabetic and nondiabetic patients with MASLD. Furthermore, SGLT2 inhibitors uniquely integrate renal energy regulation with hepatic resilience through the Ca2+–PIP–SERCA axis, positioning them as prototype systemic modulators of metabolic homeostasis. Future translational efforts should refine patient stratification using metabolomic and Ca2+-imaging biomarkers to delineate therapeutic responders and advance next-generation SGLT2 analogs targeting Ca2+-dependent metabolic signaling. Collectively, SGLT2 inhibitors represent a new metabolic therapeutic class that unify glucose, lipid, and Ca2+ regulation to restore hepatocellular functions in metabolic liver diseases.

Citations

Citations to this article as recorded by  
  • Immune Determinants of MASLD Progression: From Immunometabolic Reprogramming to Fibrotic Transformation
    Senping Xu, Zhaoshan Zhang, Zhongquan Zhou, Jiawei Guo
    Biology.2026; 15(2): 148.     CrossRef
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Original Articles
Efficacy and Safety of Stage 5 Connected Insulin Pens in Type 1 or Type 2 Diabetes: Randomized Controlled Trial Protocol
Ji Yoon Kim, Nam Hoon Kim, Soo Heon Kwak, Chang Hee Jung, Eun Seok Kang, Jun Sung Moon, Sun Joon Moon, So Yoon Kwon, Jee Hee Yoo, Younghoon Kim, Tae-min Lee, Chung-il Yang, Jae Hyeon Kim, Sang-Man Jin
Received July 26, 2025  Accepted October 13, 2025  Published online December 12, 2025  
DOI: https://doi.org/10.3803/EnM.2025.2579    [Epub ahead of print]
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AbstractAbstract PDFPubReader   ePub   
Background
Stage 2 or 3 connected insulin pens (CIPs) refer to tracking insulin pens that are capable of transmitting insulin dose data via cloud connectivity. Stage 4 CIPs feature a bolus calculator that determines appropriate insulin doses based on real-time continuous glucose monitoring (CGM) data, carbohydrate intake, previous dosing history, and preset parameters. Stage 5 CIPs additionally offer advanced decision-support features, such as education modules and coaching. However, the efficacy and safety of Stage 5 CIPs have not yet been established.
Methods
In this prospective, open-label, parallel-group, multicenter, randomized controlled trial, we will include adults aged ≥19 and <75 years with type 1 or type 2 diabetes receiving multiple daily insulin injections (MDI) and having glycosylated hemoglobin (HbA1c) levels of 7.5% to 12.0%. In total, 152 participants will be randomized in a 1:1 ratio to receive either Stage 5 CIPs with CGM or tracking insulin pens with CGM. Stage 5 CIPs include a Setup Wizard that recommends individualized initial settings and an algorithm that provides advanced insulin dosing guidance based on analyses of each participant’s CGM and insulin injection data. The primary outcome will be the change in HbA1c levels from baseline to week 12 (ClinicalTrials.gov, NCT07004153).
Conclusion
This trial will determine whether Stage 5 CIPs are superior to tracking insulin pens in improving glycemic control among adults with type 1 or type 2 diabetes treated with MDI. Overall, this study may offer a promising strategy for enhancing the management and outcomes of patients with diabetes.
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Impact of Carbohydrate Intake Fluctuations on Glucose Profiles: Insights from Continuous Glucose Monitoring-Based Patient Clustering
Hyun Ah Kim, Kyung Hee Kim, Young Lee, Yoon-Ju Song, Joon Ho Moon, Sung Hee Choi, Tae Jung Oh
Received June 4, 2025  Accepted September 15, 2025  Published online December 12, 2025  
DOI: https://doi.org/10.3803/EnM.2025.2486    [Epub ahead of print]
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AbstractAbstract PDFPubReader   ePub   
Background
Continuous glucose monitoring (CGM) is widely applied in daily glucose management. However, its potential to categorize individuals based on glucose profiles is not fully established. This study employed CGM-based patient clustering and examined nutritional factors influencing glucose patterns.
Methods
This prospective observational study enrolled 34 individuals with diabetes. Retrospective professional CGM was conducted over 7 days, during which food intake was recorded. K-means clustering was performed using CGM-derived coefficient of variation (CV) and time in range. Macronutrient intake and its fluctuations were compared across clusters.
Results
Participants were grouped into cluster 1 (well-controlled), cluster 2 (highest CV), and cluster 3 (highest mean glucose). Baseline clinical characteristics, daily energy intake (kcal), and macronutrient intake did not differ significantly among clusters. However, carbohydrate intake fluctuations were greater in cluster 3 (CV 41.0%±32.1%, standard deviation [SD] 502.1±363.4 kcal) than in cluster 1 (CV 21.9%±9.0%, SD 260.2±94.1 kcal) and cluster 2 (CV 19.2%±9.1%, SD 250.2±126.1 kcal) (P=0.123 for CV; P=0.024 for SD). The SD (kcal) of carbohydrate intake was positively correlated with mean glucose levels (rho=0.88, P=0.023).
Conclusion
CGM enables categorization of individuals based on glucose profiles, and higher carbohydrate intake fluctuations are associated with poorer glycemic control. Personalized dietary strategies, particularly stabilizing carbohydrate intake, may support better glucose management in individuals with high mean glucose and low CV.
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Diabetes, obesity and metabolism
Big Data Articles (National Health Insurance Service Database)
Impact of Glucose Metabolism Status on the Association between Apolipoprotein A-I and Ischemic Risk in Patients with Coronary Artery Disease: A Large-Sample Cohort Study
Kailun Yan, Jiawen Li, Kexin Zhang, Menglu Liu, Pei Zhu, Xiaofang Tang, Deshan Yuan, Yuejin Yang, Runlin Gao, Jinqing Yuan, Xueyan Zhao
Endocrinol Metab. 2025;40(6):904-915.   Published online November 7, 2025
DOI: https://doi.org/10.3803/EnM.2025.2407
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AbstractAbstract PDFSupplementary MaterialPubReader   ePub   
Background
Apolipoprotein A-I (ApoA-I) is a key cardioprotective lipoprotein. Nevertheless, it remains unclear how ApoA-I relates to ischemic risk across glucose metabolism statuses in patients with coronary artery disease (CAD). This study investigated whether glucose metabolism status influences the association between ApoA-I and ischemic risk in CAD patients.
Methods
This cohort study included 10,724 consecutive CAD patients undergoing percutaneous coronary intervention, who were classified into diabetes mellitus (DM), pre-DM, and normal glucose regulation (NGR) groups. The primary clinical endpoint was major adverse cardiac and cerebrovascular event (MACCE), defined as a composite of all-cause death, myocardial infarction, revascularization, and stroke.
Results
Of the 10,232 patients ultimately included, 2,139 (20.9%) experienced MACCE over 5 years. A significant interaction was observed between ApoA-I levels and glucose metabolism status (P for interaction=0.041). In the DM group, an L-shaped association between ApoA-I and MACCE was found, with lower ApoA-I levels linked to a higher risk of MACCE (P for non-linearity= 0.044). Multivariate Cox regression analysis showed that patients in the lowest quintile of ApoA-I had a 1.327-fold increased risk of MACCE compared to those at the lowest risk (hazard ratio, 1.327; 95% confidence interval, 1.097 to 1.604). However, no significant association was observed in the pre-DM or NGR groups (both P>0.05).
Conclusion
This large-scale, 5-year follow-up study is the first to demonstrate that lower ApoA-I levels are associated with increased MACCE risk in CAD patients with DM, highlighting the potential value of ApoA-I in risk stratification and as a therapeutic target.
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Effects of Progranulin Deficiency on Inflammation and Fibrosis in the Kidneys and Liver of Diabetic Mice Fed a High-Fat Diet
Hiroko Sakuma, Maki Murakoshi, Shinji Hagiwara, Terumi Shibata, Yusuke Suzuki, Tomohito Gohda
Received February 6, 2025  Accepted July 23, 2025  Published online September 30, 2025  
DOI: https://doi.org/10.3803/EnM.2025.2339    [Epub ahead of print]
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  • 2 Crossref
AbstractAbstract PDFSupplementary MaterialPubReader   ePub   
Background
Progranulin (PGRN) is an important regulator of inflammation, insulin resistance, and autophagy. However, the effects of PGRN deficiency on these processes in the kidneys and liver in diabetes remain unclear. In addition, the differential effects of PGRN deficiency and sodium-glucose co-transporter-2 (SGLT2) inhibitors on these organs are unknown.
Methods
Three diabetic mouse models were used: high-fat diet and nicotinamide/streptozotocin-induced diabetic wild-type (WT) and PGRN-knockout (KO) mice (WT-diabetes mellitus [DM] and KO-DM, respectively) and WT-DM mice treated with an SGLT2 inhibitor (tofogliflozin; WT-DM/Tofo).
Results
Despite similar glycemic control in WT-DM/Tofo and KO-DM mice, expression of inflammation- and fibrosis-related genes in the kidneys was highest in WT-DM mice, lower in KO-DM mice, and lowest in WT-DM/Tofo mice. WT-DM/Tofo mice also showed increased anti-microtubule-associated protein 1A/1B-light chain 3B and decreased p62 protein levels compared with KO-DM mice. In contrast, hepatic mRNA levels related to inflammation and fibrosis were improved in both WT-DM/Tofo and KO-DM mice. Moreover, hepatic protein levels of peroxisome proliferator-activated receptor γ (PPARγ) were elevated in both groups compared with WT-DM mice, while those of PPARα were increased in WT-DM/Tofo mice compared with both WT-DM and KO-DM mice.
Conclusion
Kidney inflammation and fibrosis were ameliorated in WT-DM/Tofo mice, but these improvements were limited by autophagy insufficiency in KO-DM mice. Additionally, both WT-DM/Tofo and KO-DM mice demonstrated improved liver inflammation and fibrosis; in the former, this was associated with enhanced fatty acid oxidation via PPARα activation, while in the latter, it appeared to result from improved insulin sensitivity and anti-inflammatory effects through PPARγ activation.

Citations

Citations to this article as recorded by  
  • Effect of Tofogliflozin on Skeletal Muscle Mitochondrial Function in Male Diabetic Mice With Muscle Atrophy
    Chiaki Kishida, Maki Murakoshi, Hiroko Sakuma, Terumi Shibata, Yusuke Suzuki, Tomohito Gohda
    Journal of the Endocrine Society.2026;[Epub]     CrossRef
  • SGLT2 Inhibitors as Systemic Metabolic Modulators: Linking Glucose Excretion to Liver Function Restoration
    Seung Wan Noh, Han Sol Ryu, Yong-Ho Kim, Byung-Chul Oh
    Endocrinology and Metabolism.2025; 40(6): 851.     CrossRef
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Diabetes, obesity and metabolism
Big Data Articles (National Health Insurance Service Database)
The Triglyceride-Glucose Index and Risk of End-Stage Renal Disease across Different Durations of Type 2 Diabetes Mellitus: A Longitudinal Cohort Study
Mi-sook Kim, Kyu-Na Lee, Jeongmin Lee, Jeongeun Kwak, Seung-Hwan Lee, Hyuk-Sang Kwon, Jing Hughes, Kyung-Do Han, Eun Young Lee
Endocrinol Metab. 2025;40(5):718-726.   Published online May 19, 2025
DOI: https://doi.org/10.3803/EnM.2024.2271
  • 3,727 View
  • 92 Download
  • 1 Web of Science
  • 1 Crossref
AbstractAbstract PDFSupplementary MaterialPubReader   ePub   
Background
This study investigated the association between the triglyceride-glucose (TyG) index, a marker of insulin resistance, and the risk of end-stage renal disease (ESRD) in individuals with type 2 diabetes mellitus (T2DM), focusing on variations by diabetes duration.
Methods
We analyzed 1,219,148 Korean adults with T2DM from National Health Insurance Service data who underwent biennial health evaluations (2015 to 2016). ESRD was defined using specific procedural codes (V codes), and Cox proportional hazard models were employed to estimate hazard ratios (HRs) for ESRD across TyG index quartiles and diabetes duration categories, adjusting for various confounders.
Results
Over 6,967,381 person-years of follow-up, 7,548 participants developed ESRD. Higher TyG index quartiles were independently associated with increased risk of ESRD, which was more pronounced with longer diabetes duration. The adjusted HR for ESRD in the highest TyG quartile (Q4) compared to the lowest quartile (Q1) was 1.235 (95% confidence interval [CI], 0.995 to 1.533) in new-onset diabetes, and 1.592 (95% CI, 1.465 to 1.730) in those with diabetes for ≥10 years. Compared to the lowest TyG quartile in new-onset diabetes, the adjusted HR for ESRD in the highest quartile with diabetes duration ≥10 years increased to 10.239 (95% CI, 8.440 to 12.422). Subgroup analysis revealed that a higher TyG index consistently increased the risk of ESRD, with stronger associations observed in younger individuals and those without comorbidities.
Conclusion
The TyG index is a significant predictor of ESRD in T2DM, particularly in those with prolonged diabetes duration. Targeting insulin resistance early may mitigate the risk of ESRD in this population.

Citations

Citations to this article as recorded by  
  • Association between TYG-BMI index and asthma in adults over 45 years of age: analysis of Global Burden of Disease 2021, China Health and Retirement Longitudinal Study, and National Health and Nutrition Examination Survey data
    Zhuolin Qin, Longqian Li, Cheng Wang
    Journal of Asthma.2026; 63(2): 214.     CrossRef
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Review Article
Diabetes, obesity and metabolism
Advances in Continuous Glucose Monitoring: Clinical Applications
So Yoon Kwon, Jun Sung Moon
Endocrinol Metab. 2025;40(2):161-173.   Published online April 8, 2025
DOI: https://doi.org/10.3803/EnM.2025.2370
  • 20,382 View
  • 618 Download
  • 10 Web of Science
  • 15 Crossref
AbstractAbstract PDFPubReader   ePub   
Continuous glucose monitoring (CGM) has revolutionized diabetes management, significantly enhancing glycemic control across diverse patient populations. Recent evidence supports its effectiveness in both type 1 and type 2 diabetes management, with benefits extending beyond traditional glucose monitoring approaches. CGM has demonstrated substantial improvements in glycemic control across multiple metrics. Studies report consistent glycosylated hemoglobin reductions of 0.25%–3.0% and notable time in range improvements of 15%–34%. CGM effectively reduces hypoglycemic events, with studies reporting significant reductions in time spent in hypoglycemia. CGM also serves as an educational tool for lifestyle modification, providing real-time feedback that helps patients understand how diet and physical activity affect glucose levels. While skin-related complications remain a concern, technological advancements have addressed many initial concerns. High satisfaction rates and long-term use suggest that device-related issues are manageable with proper education and support. Despite high initial costs, CGM’s prevention of complications and hospitalizations ultimately reduces healthcare expenditures. With appropriate training and support, CGM represents a transformative technology for comprehensive diabetes care.

Citations

Citations to this article as recorded by  
  • Advancements in glucose biosensors: Innovations for wearable and real-time monitoring
    Reetu Singh, Priyanshu Nema, Arpana Purohit, Satyamshyam Vishwakarma, Shyamji Tantuway, Pradhumn Namdeo, Ajay Kumar, Vandana Soni, Sushil Kumar Kashaw
    Talanta.2026; 299: 129045.     CrossRef
  • Continuous glucose monitoring in high-risk individuals
    Zhiyue Chen, Yinbei Zhang, Lin Sun, Weiying Guo
    Clinica Chimica Acta.2026; 580: 120733.     CrossRef
  • Scoping review of subcutaneous glucose monitoring techniques
    Eva Hrubá, Jan Kubíček, Martin Augustynek
    Measurement.2026; 261: 119940.     CrossRef
  • Use of continuous glucose monitoring in non-intensively managed type 2 diabetes: a Saudi Arabian consensus
    Mohammed Almehthel, Abdulghani Al-Saeed, Fahad Al-Sabaan, Faisal Al-Malky, Hawazen Zarif, Lamya Al-Zubaidi, Mohammed E. Al-Sofiani, Omar Abdulaal, Reem Al Argan, Saud Al Sifri, Turki Al-Harbi, Raed Aldahash
    Frontiers in Endocrinology.2026;[Epub]     CrossRef
  • Wearable microneedle sensors for continuous interstitial fluid monitoring
    Junghyun Cho, Heeju Son, Jayoung Kim, Hyun Seok Song, Wonryung Lee
    Biosensors and Bioelectronics.2026; 297: 118385.     CrossRef
  • Efficacy of an AI-Enabled Low Glucose Prediction: A Pooled Performance Analysis With Capillary Blood Glucose as Ground Truth
    Timor Glatzer, Ajandek Peak, Eemeli Leppäaho, Patrick Lustenberger, Pau Herrero, Magí Andorrà, Ellen van Maren
    Journal of Diabetes Science and Technology.2026;[Epub]     CrossRef
  • Respiratory Signal Processing and Analysis Using Flexible Capacitive Sensor Data
    Bernardo A. Vicente, Raquel Sebastião, Alda Marques, Vitor Sencadas
    Advanced Materials Technologies.2026;[Epub]     CrossRef
  • Associations of time in tight range, time in range, and glycated hemoglobin with albuminuria in type 1 diabetes: A cross-sectional study
    Ji Yoon Kim, Seohyun Kim, Sang Ho Park, Jin A Lee, So Hyun Cho, Rosa Oh, Myunghwa Jang, You-Bin Lee, Gyuri Kim, Kyu Yeon Hur, Jae Hyeon Kim, Sang-Man Jin
    Diabetes Research and Clinical Practice.2025; 226: 112325.     CrossRef
  • Advancements in Continuous Glucose Monitoring: a Revolution in Diabetes Management
    Kondreddy Vinod Kumar, Kamal Raj Yerraguntla, Maruthi Prasad Jenne, Abhilash Gadi, Akhila Sepoori, Anusha Gunda, Madhu Sri Gudivada
    Biomedical Materials & Devices.2025;[Epub]     CrossRef
  • SMART CARE FOR DIABETES: INTEGRATING TECHNOLOGY AND LIFESTYLE FOR BETTER OUTCOMES
    Aleksandra Maciejczyk, Katarzyna Krupa, Weronika Głowacz, Janusz Świeczkowski-Feiz
    International Journal of Innovative Technologies in Social Science.2025;[Epub]     CrossRef
  • Identification of clinically meaningful automatically detected postprandial glucose excursions in individuals with type 1 diabetes using personal continuous glucose monitoring
    Sang Ho Park, Rosa Oh, Seohyun Kim, Seung Hee Yang, Hanna Lee, Ji Yoon Kim, So Hyun Cho, Soojin Park, Gyuri Kim, Jae Hyeon Kim, Sang–Man Jin
    Diabetes Research and Clinical Practice.2025; 229: 112951.     CrossRef
  • Bridging the digital divide: student-led literacy initiatives in diabetes management
    Pedro Almeida Moyano, Mohammed Raddaoui, Andrea de Barros Coscelli Ferraz, Gustavo José Martiniano Porfírio, Luciana Aparecida Campos, Ovidiu Constantin Baltatu
    Frontiers in Clinical Diabetes and Healthcare.2025;[Epub]     CrossRef
  • Continuous Glucose Monitoring for Pancreatogenic Diabetes After Total Pancreatectomy
    Young Jae Cho, Inhyuck Lee, Yoon Soo Chae, Go‐Won Choi, Younsoo Seo, Youngmin Han, Hye‐sol Jung, Wooil Kwon, Joon Seong Park, Jin‐Young Jang
    Journal of Hepato-Biliary-Pancreatic Sciences.2025;[Epub]     CrossRef
  • Efficacy and Safety of Stage 5 Connected Insulin Pens in Type 1 or Type 2 Diabetes: Randomized Controlled Trial Protocol
    Ji Yoon Kim, Nam Hoon Kim, Soo Heon Kwak, Chang Hee Jung, Eun Seok Kang, Jun Sung Moon, Sun Joon Moon, So Yoon Kwon, Jee Hee Yoo, Younghoon Kim, Tae-min Lee, Chung-il Yang, Jae Hyeon Kim, Sang-Man Jin
    Endocrinology and Metabolism.2025;[Epub]     CrossRef
  • Evolution and Future of Glucose Monitoring: From Blood Glucose Meters to Continuous Systems and Their Projected Impact in the Middle East and North Africa (MENA) Region
    Omar Darkhabani, Abdalla Ahmed
    Cureus.2025;[Epub]     CrossRef
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Original Articles
Diabetes, obesity and metabolism
Discrepancies in Dapagliflozin Response in Terms of Glycemic Control and Body Weight Reduction
Ji Eun Jun, Kyoung-Ah Kim, Nan-Hee Kim, Kwan-Woo Lee, In-Kyung Jeong, on Behalf of the BEYOND Investigators
Endocrinol Metab. 2025;40(2):278-288.   Published online March 19, 2025
DOI: https://doi.org/10.3803/EnM.2024.2142
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  • 2 Web of Science
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AbstractAbstract PDFSupplementary MaterialPubReader   ePub   
Background
Dapagliflozin, a sodium-glucose cotransporter 2 inhibitor, reduces hyperglycemia and obesity by inhibiting renal glucose reabsorption. This post hoc study evaluated clinical factors influencing patient response to dapagliflozin.
Methods
The analysis focused on patients treated with dapagliflozin (10 mg/day for 52 weeks) within the randomized, double-blind, parallel-group BEYOND trial. Adequate glycemic control (GC) was defined as a reduction in glycated hemoglobin (HbA1c) of ≥ 1.0% or the achievement of an HbA1c level <7.0% at week 52. Significant weight loss (WL) referred to a reduction in body weight of ≥3.0% at week 52. Participants were classified into four groups based on their GC and WL responses: GC+/WL+, GC+/WL−, GC−/WL+, and GC−/WL−.
Results
Among dapagliflozin recipients (n=56), at 52 weeks, HbA1c had decreased by 1.0%±0.8% from baseline, while body weight had declined by 2.4±3.1 kg. Overall, 69.6% of participants achieved GC+, and 57.1% achieved WL+. Male sex and shorter diabetes duration were significantly associated with achieving GC+. Conversely, higher estimated glomerular filtration rate was significantly linked to WL+. The only factor significantly associated with both GC+ and WL+ was shorter diabetes duration (odds ratio, 0.81; 95% confidence interval, 0.68 to 0.97; P=0.023). The GC+ and WL+ groups exhibited favorable responses beginning soon after dapagliflozin therapy was initiated. Furthermore, HbA1c decline was more strongly associated with reduction in visceral fat than with WL.
Conclusion
A short duration of diabetes and early response to treatment appear to represent key factors in maximizing the benefits of dapagliflozin for blood glucose and weight management.

Citations

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  • A Pre‐Post Assessment of Blood Glucose Control Following Pharmacist‐Led Professional Continuous Glucose Monitoring in Rhode Island Primary Care Practices
    Kelley Doherty Sanzen, Natalya S. Salganik, Susanne M. Campbell, Carolyn A. Karner, Pano M. Yeracaris, Stephen J. Kogut
    JACCP: JOURNAL OF THE AMERICAN COLLEGE OF CLINICAL PHARMACY.2026;[Epub]     CrossRef
  • Identification of IL18/IL18R1 signaling as a predictive biomarker of SGLT2 inhibitor efficacy in type 2 diabetes
    I-Jou Teng, Chien-Hsing Lee, Ying-Chen Chen, Sheng-Chiang Su, Chieh-Hua Lu, Peng-Fei Li, Chia-Luen Huang, Li-Ju Ho, Ming-Hsun Lin, Hsin-Ya Liu, Feng-Chih Kuo
    iScience.2025; 28(10): 113594.     CrossRef
  • Sodium‐glucose cotransporter 2 inhibitor ameliorates thiazolidinedione‐induced fluid retention through vascular leakage reduction in white adipose tissue
    Ji Yoon Kim, Hye‐Min Jang, Hye‐Jin Lee, Ah Hyeon Lee, Dong‐Hoon Kim, Sin Gon Kim, Nam Hoon Kim
    Diabetes, Obesity and Metabolism.2025;[Epub]     CrossRef
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Diabetes, obesity and metabolism
Big Data Articles (National Health Insurance Service Database)
Association between the Triglyceride-Glucose Index and Cardiovascular Risk and Mortality across Different Diabetes Durations: A Nationwide Cohort Study
Jeongeun Kwak, Kyung-Do Han, Eun Young Lee, Seung-Hwan Lee, Dong-Jun Lim, Hyuk-Sang Kwon, Jeongmin Lee
Endocrinol Metab. 2025;40(4):548-560.   Published online March 5, 2025
DOI: https://doi.org/10.3803/EnM.2024.2205
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AbstractAbstract PDFSupplementary MaterialPubReader   ePub   
Background
We aimed to assess the association between triglyceride-glucose (TyG) index and cardiovascular disease (CVD) risk and mortality in a large cohort of diabetes patients.
Methods
A retrospective cohort study of 1,090,485 participants from the Korean National Health Insurance Service database was conducted. Participants were stratified into TyG quartiles.
Results
Higher TyG index quartiles were significantly associated with an increased CVD risk and mortality risk. In fully adjusted models, participants in the highest TyG quartile (Q4) had an 18% higher risk of CVD (hazard ratio [HR], 1.18; 95% confidence interval [CI], 1.13 to 1.23) and a 16% higher risk of mortality (HR, 1.16; 95% CI, 1.11 to 1.23) compared to those in the lowest quartile (Q1). The association was particularly pronounced in patients with fasting glucose ≥126 mg/dL (CVD [HR, 1.33; 95% CI, 1.29 to 1.37], mortality [HR, 1.23; 95% CI, 1.20 to 1.26]; P for interaction <0.001). Patients with a diabetes duration of ≥10 years showed the strongest association between the TyG index and CVD risk (HR, 1.44; 95% CI, 1.38 to 1.50), while the mortality risk was particularly elevated in those with a diabetes duration of less than 5 years (HR, 1.23; 95% CI, 1.18 to 1.30). Subgroup analyses revealed stronger associations between TyG index and CVD risk in younger participants, non-obese individuals, and non-smokers.
Conclusion
The TyG index is a significant predictor of CVD and mortality in diabetic patients, particularly in those with poor glycemic control or longer disease duration.

Citations

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  • Preoperative triglyceride–glucose index as a metabolic predictor of surgical site infection after posterior lumbar fusion
    Yu Hua, Shaoxing Li, Yuan Jiang, Jinwang Liu
    Journal of Orthopaedic Surgery.2026;[Epub]     CrossRef
  • Combined effect of triglyceride-glucose index and glucose disposal rate on cardio-cerebrovascular disease
    Hongfei Yang, Chao Sun, Ya Li, You Zhou, Rui Wang, Yingxue Li, Marwan Salih Al-Nimer
    PLOS One.2026; 21(2): e0342154.     CrossRef
  • The Triglyceride-Glucose Index: A Practical Tool for Enhanced Cardiovascular Risk Stratification in Type 2 Diabetes
    Jang Won Son
    Endocrinology and Metabolism.2025; 40(4): 545.     CrossRef
  • The association between triglyceride-glucose index and all-cause/cardiovascular mortality in patients with different glucose metabolism statuses
    Jiajun Liu, Jinhua Kang, Pengpeng Liang, Zhangxiao Song, Guiyun Li, Xueshan Jin, Hongyan Wu
    Cardiovascular Diabetology.2025;[Epub]     CrossRef
  • Standardized Triglyceride-Glucose and Plasma Atherogenic Indices as Predictors of Diabetic Nephropathy and Coronary Artery Disease in Patients with Type 1 Diabetes Mellitus
    Nazif Yalçın, Nizameddin Koca
    European Journal of Therapeutics.2025;[Epub]     CrossRef
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Diabetes, obesity and metabolism
Plasma C-Peptide Levels and the Continuous Glucose Monitoring-Defined Coefficient of Variation in Risk Prediction for Hypoglycemia in Korean People with Diabetes Having Normal and Impaired Kidney Function
So Yoon Kwon, Jiyun Park, So Hee Park, You-Bin Lee, Gyuri Kim, Kyu Yeon Hur, Jae Hyeon Kim, Sang-Man Jin
Endocrinol Metab. 2025;40(2):268-277.   Published online February 27, 2025
DOI: https://doi.org/10.3803/EnM.2024.2083
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AbstractAbstract PDFSupplementary MaterialPubReader   ePub   
Background
We aimed to investigate the predictive values of plasma C-peptide levels and the continuous glucose monitoring (CGM)-defined coefficient of variation (CV) in risk prediction for hypoglycemia in Korean people with diabetes with normal and impaired kidney function.
Methods
We analyzed data from 1,185 participants diagnosed with type 1 and type 2 diabetes who underwent blinded professional CGM between January 2009 and May 2021 at outpatient clinics. We explored correlations among CGM-defined CV, plasma C-peptide levels, and time below range at <70 and 54 mg/dL across different kidney function categories.
Results
In patients with chronic kidney disease (CKD) stages 1–2 (n=934), 89.3% who had a random plasma C-peptide level higher than 600 pmol/L exhibited a CV of ≤36%. Among those in CKD stage 3 (n=161) with a random plasma C-peptide level exceeding 600 pmol/L, 66.7% showed a CV of ≤36%. In stages 4–5 of CKD (n=90), the correlation between random C-peptide levels and CV was not significant (r=–0.05, P=0.640), including cases with a CV greater than 36% despite very high random plasma C-peptide levels. Random plasma C-peptide levels and CGM-assessed CV significantly predicted hypoglycemia in CKD stages 1–2 and 1–5, respectively.
Conclusion
The established C-peptide criteria in Western populations are applicable to Korean people with diabetes for hypoglycemic risk prediction, unless kidney function is impaired equivalent to CKD stage 3–5. The CGM-defined CV is informative for hypoglycemic risk prediction regardless of kidney function.

Citations

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  • Continuous glucose monitoring in high-risk individuals
    Zhiyue Chen, Yinbei Zhang, Lin Sun, Weiying Guo
    Clinica Chimica Acta.2026; 580: 120733.     CrossRef
  • The evolution of C-peptide's role in diabetes care
    Laura Briggs, Alexander Read, Sarah Darch, Emma L. Williams, Wann Jia Loh, Julia S. Kenkre
    Current Opinion in Endocrinology, Diabetes & Obesity.2026; 33(1): 16.     CrossRef
  • Plasma C-Peptide Level and Continuous Glucose Monitoring-Derived Coefficient of Variation as a Predictable Risk Factor for Hypoglycemia in Koreans with Diabetes
    Seung-Hyun Ko
    Endocrinology and Metabolism.2025; 40(2): 198.     CrossRef
  • Beneficial Role of Increased Glucose Infusion in Decompensated Type 2 Diabetes Patient
    Marie Ticha, Ondrej Sobotka, Pavel Skorepa, Lubos Sobotka
    Diabetology.2025; 6(6): 47.     CrossRef
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Review Articles
Diabetes, obesity and metabolism
Brown Fat and Metabolic Health: The Diverse Functions of Dietary Components
Zachary Brown, Takeshi Yoneshiro
Endocrinol Metab. 2024;39(6):839-846.   Published online November 20, 2024
DOI: https://doi.org/10.3803/EnM.2024.2121
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AbstractAbstract PDFPubReader   ePub   
Brown and beige adipocytes utilize a variety of substrates for cold-induced thermogenesis, contributing to the clearance of metabolites in circulation and, consequently, metabolic health. Food-derived compounds that exhibit agonistic activity at temperature-sensitive transient receptor potential channels may serve as cold mimics to elicit thermogenesis and substrate utilization in brown adipose tissue (BAT). In addition to fatty acids and glucose, branched-chain amino acids (BCAAs), which are essential amino acids obtained from foods, are actively catabolized in BAT through mitochondrial BCAA carrier (MBC). The relative contribution of BCAAs to fueling the tricarboxylic acid cycle as a substrate (i.e., anaplerosis) is estimated to be relatively small, yet BCAA catabolism in BAT exerts a critical role in systemic insulin sensitivity. The nature of this apparent tension remained unclear until the recent discovery that active BCAA catabolism in BAT through MBC is critical for the synthesis of metabolites such as glutathione, which is delivered to the liver to improve hepatic insulin sensitivity through redox homeostasis. Novel mechanistic insights into the control of BAT function and systemic metabolism reveal the therapeutic potential of food-derived compounds for improving metabolic flexibility and insulin sensitivity.

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  • Bioactive Phytoconstituents Targeting Energy Expenditure and Appetite to Combat Obesity: A Comprehensive Review
    Gayatri Thapa, Pervej Alom Barbhuiya, Manash Pratim Pathak
    Current Nutrition Reports.2026;[Epub]     CrossRef
  • Beyond Calories: Redox Interactions in Adipose Tissue That Lead to Metabolic Pathologies
    Alfredo Miranda-Martínez, Erika Rodríguez-Martínez, Pamela Barragán-Reséndiz, Selva Rivas-Arancibia
    Physiologia.2025; 5(4): 50.     CrossRef
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Diabetes, obesity and metabolism
Regulation of Energy and Glucose Homeostasis by the Nucleus of the Solitary Tract and the Area Postrema
Kyla Bruce, Ameth N. Garrido, Song-Yang Zhang, Tony K.T. Lam
Endocrinol Metab. 2024;39(4):559-568.   Published online August 1, 2024
DOI: https://doi.org/10.3803/EnM.2024.2025
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AbstractAbstract PDFPubReader   ePub   
The central nervous system regulates feeding, weight and glucose homeostasis in rodents and humans, but the site-specific mechanisms remain unclear. The dorsal vagal complex in the brainstem that contains the nucleus of the solitary tract (NTS) and area postrema (AP) emerges as a regulatory center that impacts energy and glucose balance by monitoring hormonal and nutrient changes. However, the specific mechanistic metabolic roles of the NTS and AP remain elusive. This mini-review highlights methods to study their distinct roles and recent findings on their metabolic differences and similarities of growth differentiation factor 15 (GDF15) action and glucose sensing in the NTS and AP. In summary, future research aims to characterize hormonal and glucose sensing mechanisms in the AP and/or NTS carries potential to unveil novel targets that lower weight and glucose levels in obesity and diabetes.

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  • Region-Specific Adult Neural Stem Cell Niches of the Mediobasal Hypothalamus and Medulla Oblongata
    Eriko Furube, Rena Fujii, Yuri Nambu, Daishi Hiratsuka, Ryoichi Yoshimura, Seiji Miyata
    Stem Cell Reviews and Reports.2026; 22(1): 222.     CrossRef
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    Jin Wang, Xuhong Zhang, Ye Zhu, Haixiang Sun, Xuetao Chen, Zhicong Zhao, Nina Zhang, Chenyu Zhang, Liang Li, Yan Bi
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    Jorge Mendoza
    npj Biological Timing and Sleep.2025;[Epub]     CrossRef
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    Zitian Lin, Yunxin Xuan, Yingshi Zhang, Qirui Zhou, Weiwei Qiu
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    Rae Silver, Yifan Yao, Jihwan Myung
    European Journal of Neuroscience.2025;[Epub]     CrossRef
  • The brainstem BBSome regulates glucose homeostasis and lean mass in a state-dependent manner
    Connor Laule, Deng-Fu Guo, Yuying Zhao, Paul A. Williams, Donald A. Morgan, Younes Rouabhi, Miriam McDonough, Trevor Butler, Jon Resch, Kamal Rahmouni
    Molecular Metabolism.2025; 100: 102222.     CrossRef
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    Die Zhang, Yingji Fu, Chenye Shen, Chaoqiang Liu, Nanguang Chen, Hua Cao, Kui Kai Lau, Anqi Qiu
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    Diego Espinoza, Finn Seibold, Sarah Stanley
    npj Biomedical Innovations.2025;[Epub]     CrossRef
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Brief Report
Diabetes, obesity and metabolism
Ketonuria as an Indicator of Improvement of Renal Function in Patients with Type 2 Diabetes Receiving SGLT2 Inhibitor Treatment
Hyun Ah Kim, Han Na Jang, Sung Hye Kong, Young Lee, Sung Hee Choi, Young Min Cho, Hak Chul Jang, Tae Jung Oh
Endocrinol Metab. 2024;39(4):653-658.   Published online May 16, 2024
DOI: https://doi.org/10.3803/EnM.2024.1919
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AbstractAbstract PDFSupplementary MaterialPubReader   ePub   
We investigated the potential association between ketonuria during treatment with sodium-glucose cotransporter-2 (SGLT2) inhibitors and its renoprotective effect in patients with type 2 diabetes. We included 192 patients who had received SGLT2 inhibitors for more than 6 months. After propensity score matching, 52 patients each were allocated into groups with or without ketonuria, respectively. The estimated glomerular filtration rate exhibited a significant improvement only in subjects with ketonuria (without ketonuria: mean difference, –0.02 mL/min/1.73 m2 [95% confidence interval (CI), –3.87 to 3.83 mL/min/1.73 m2] vs. with ketonuria: mean difference, 6.81 mL/min/1.73 m2 [95% CI, 3.16 to 10.46 mL/min/1.73 m2]; P<0.001). Improvement in estimated glomerular filtration rate at 6 months was associated with female sex and lower baseline body weight, blood pressure, and triglyceride levels in patients with ketonuria. In conclusion, the presence of ketonuria was associated with the renoprotective effect of SGLT2 inhibitors, and female sex and the absence of metabolic syndrome components may serve as additional indicators of these medications’ substantial renoprotective effects in individuals with ketonuria.

Citations

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  • Effects of a continuous remote care intervention including nutritional ketosis on kidney function and inflammation in adults with type 2 diabetes: a post-hoc latent class trajectory analysis
    Shaminie J. Athinarayanan, Caroline G. P. Roberts, Stephen D. Phinney, Thomas Weimbs, Allon N. Friedman, Jeff S. Volek
    Frontiers in Nutrition.2025;[Epub]     CrossRef
  • SGLT2 Inhibitors as Systemic Metabolic Modulators: Linking Glucose Excretion to Liver Function Restoration
    Seung Wan Noh, Han Sol Ryu, Yong-Ho Kim, Byung-Chul Oh
    Endocrinology and Metabolism.2025; 40(6): 851.     CrossRef
  • Trigger Warning: How Modern Diet, Lifestyle, and Environment Pull the Trigger on Autosomal Dominant Polycystic Kidney Disease Progression
    Melina Messing, Jacob A. Torres, Nickolas Holznecht, Thomas Weimbs
    Nutrients.2024; 16(19): 3281.     CrossRef
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Original Article
Diabetes, obesity and metabolism
Reference Standards for C-Peptide in Korean Population: A Korean Endocrine Hormone Reference Standard Data Center Study
Jooyoung Cho, Ho-Chan Cho, Ohk-Hyun Ryu, Hyo-Jeong Kim, Chang Geun Kim, Young Ran Yun, Choon Hee Chung, on Behalf of the Task Force Team for Korean Hormone Reference Standards
Endocrinol Metab. 2024;39(3):489-499.   Published online May 9, 2024
DOI: https://doi.org/10.3803/EnM.2023.1888
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AbstractAbstract PDFSupplementary MaterialPubReader   ePub   
Background
The Korean Endocrine Hormone Reference Standard Data Center (KEHRS DC) has created reference standards (RSs) for endocrine hormones since 2020. This study is the first of its kind, wherein the KEHRS DC established RSs for serum Cpeptide levels in a healthy Korean population.
Methods
Healthy Korean adults were recruited from May 2021 to September 2023. After excluding participants according to our criteria, serum samples were collected; each participant could then choose between fasting glucose only or fasting glucose plus an oral glucose tolerance test (OGTT). If their sample showed high glucose (≥100 mg/dL) or hemoglobin A1c (HbA1c) (≥5.70%), their C-peptide levels were excluded from analyzing the RSs.
Results
A total of 1,532 participants were recruited; however, only the data of 1,050 participants were analyzed after excluding those whose samples showed hyperglycemia or high HbA1c. Post-30-minute OGTT data from 342 subjects and post-120-minute OGTT data from 351 subjects were used. The means±2 standard deviations and expanded uncertainties of fasting, post-30-minute and 120-minute OGTT C-peptide levels were 1.26±0.82 and 0.34–3.18, 4.74±3.57 and 1.14–8.33, and 4.85±3.58 and 1.25–8.34 ng/mL, respectively. Serum C-peptide levels correlated with obesity, serum glucose levels, and HbA1c levels.
Conclusion
The RSs for serum C-peptide levels established in this study are expected to be useful in both clinical and related fields.

Citations

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  • Call for Standardization of C-Peptide Measurement
    Erwin Schleicher, Kuanysh Kabytaev, Matthias Nauck, Dirk Müller-Wieland, Andreas Peter, Randie R. Little, Lutz Heinemann
    Journal of Diabetes Science and Technology.2025;[Epub]     CrossRef
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Review Article
Diabetes, obesity and metabolism
Glucagon-Like Peptide-1 Based Therapies: A New Horizon in Obesity Management
Jang Won Son, Soo Lim
Endocrinol Metab. 2024;39(2):206-221.   Published online April 16, 2024
DOI: https://doi.org/10.3803/EnM.2024.1940
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AbstractAbstract PDFPubReader   ePub   
Obesity is a significant risk factor for health issues like type 2 diabetes and cardiovascular disease. It often proves resistant to traditional lifestyle interventions, prompting a need for more precise therapeutic strategies. This has led to a focus on signaling pathways and neuroendocrine mechanisms to develop targeted obesity treatments. Recent developments in obesity management have been revolutionized by introducing novel glucagon-like peptide-1 (GLP-1) based drugs, such as semaglutide and tirzepatide. These drugs are part of an emerging class of nutrient-stimulated hormone-based therapeutics, acting as incretin mimetics to target G-protein–coupled receptors like GLP-1, glucose-dependent insulinotropic polypeptide (GIP), and glucagon. These receptors are vital in regulating body fat and energy balance. The development of multiagonists, including GLP-1–glucagon and GIP–GLP-1–glucagon receptor agonists, especially with the potential for glucagon receptor activation, marks a significant advancement in the field. This review covers the development and clinical efficacy of various GLP-1-based therapeutics, exploring the challenges and future directions in obesity management.

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    André J. Scheen
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  • Amylin receptors as therapeutic targets in obesity: Emerging peptide-based strategies
    Mokhtar Rejili, Md Sadique Hussain, Yumna Khan, Faouzi Haouala, Subbulakshmi Ganesan, Samir Sahoo, Amrita Pal, Vimal Arora
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  • BIOTECHNOLOGY AND BIOENGINEERING INNOVATIONS IN PRECISION OBESITY MANAGEMENT: MECHANISTIC INSIGHTS, EMERGING PLATFORMS, AND TRANSLATIONAL PATHWAYS
    MIN HO HAN, YOUN SEON HWANG, DO HYEON JIN, JIN WOO KIM
    Journal of Mechanics in Medicine and Biology.2026;[Epub]     CrossRef
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    Jonathan P. Bennett, Soo Lim
    Journal of Obesity & Metabolic Syndrome.2025; 34(2): 120.     CrossRef
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    Marwin A. Farrugia, Enzo Pini, Albert Tran, Nicolas Chevalier, Rodolphe Anty, Philippe Gual
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    Kai Liu, Shu Liu, Dong Wang, Hong Qiao
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  • The multifaceted effects of semaglutide: exploring its broad therapeutic applications
    Mesk Alkhatib, Noor Almasri, Sakhr Alshwayyat, Hebah Almahariq, Bara M. Hammadeh, Zaid Taimeh, Lean Alkhatib, Anas Alshwayat, Nesreen A Saadeh, Mohammed Al-mahdi Al-kurdi
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    Seung‐Hwan Lee
    Journal of Diabetes Investigation.2025; 16(10): 1779.     CrossRef
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    Ting Jin, Yange Meng, Luping Ren, Yue Wang
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    Ji Yoon Kim, Jiyoon Lee, Sin Gon Kim, Nam Hoon Kim
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  • Time-restricted feeding in rodent obesity models: impact on body weights, lipid profile and glucoregulation
    Joyce Argaistieng, Bavani Visha Doraisamy, Hasseri Halim, Sharifah Sakinah Syed Alwi, Aida Azlina Ali, Sandra Maniam
    International Journal of Obesity.2025;[Epub]     CrossRef
  • Diabetes and Osteoarthritis: Exploring the Interactions and Therapeutic Implications of Insulin, Metformin, and GLP-1-Based Interventions
    Iryna Halabitska, Liliia Babinets, Valentyn Oksenych, Oleksandr Kamyshnyi
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  • Why you should not skip tailored exercise interventions when using incretin mimetics for weight loss
    Katharina Gross, Christian Brinkmann
    Frontiers in Endocrinology.2024;[Epub]     CrossRef
  • Beyond Glycemic Control: GLP-1 Receptor Agonists and Their Impact on Calcium Homeostasis in Real-World Patients
    Bandar T. Alenezi, Nadra Elfezzani, Rukhsana Uddin, Hinali Patel, Sydney Chester, Ahmed Abdelmaksoud, Mohammad H. Hussein, Sawsan A. Zaitone, Manal S. Fawzy, Hani Aiash, Eman A. Toraih
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    T. I. Romantsova
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    Anna Klasa, Aleksandra Ewa Sobaś, Kamil Biedka, Oliwia Ziobro, Katarzyna Błaszczyk, Jakub Maciej Bulski, Filip Maj, Karol Sornat, Barbara Pokora, Agata Estreicher
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Close layer
Original Article
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
Correction in: Endocrinol Metab 2024;39(3):537
  • 6,317 View
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AbstractAbstract PDFSupplementary MaterialPubReader   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.

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  • Stakeholder Perspectives on Implementing DiabeText: Exploring Barriers and Facilitators for a Personalized Diabetes Self-Management SMS Intervention in Spain
    Elena Gervilla-García, Patricia García-Pazo, Mireia Guillén-Solà, Federico Leguizamo, Ignacio Ricci-Cabello, María Jesús Serrano-Ripoll, Miquel Bennasar-Veny, Maria Antònia Fiol-deRoque, Escarlata Angullo-Martínez, Rocío Zamanillo-Campos
    Diabetology.2026; 7(1): 17.     CrossRef
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Namgok Lecture 2023
Diabetes, obesity and metabolism
Hypothalamic AMP-Activated Protein Kinase as a Whole-Body Energy Sensor and Regulator
Se Hee Min, Do Kyeong Song, Chan Hee Lee, Eun Roh, Min-Seon Kim
Endocrinol Metab. 2024;39(1):1-11.   Published online February 14, 2024
DOI: https://doi.org/10.3803/EnM.2024.1922
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AbstractAbstract PDFPubReader   ePub   
5´-Adenosine monophosphate (AMP)-activated protein kinase (AMPK), a cellular energy sensor, is an essential enzyme that helps cells maintain stable energy levels during metabolic stress. The hypothalamus is pivotal in regulating energy balance within the body. Certain neurons in the hypothalamus are sensitive to fluctuations in food availability and energy stores, triggering adaptive responses to preserve systemic energy equilibrium. AMPK, expressed in these hypothalamic neurons, is instrumental in these regulatory processes. Hypothalamic AMPK activity is modulated by key metabolic hormones. Anorexigenic hormones, including leptin, insulin, and glucagon-like peptide 1, suppress hypothalamic AMPK activity, whereas the hunger hormone ghrelin activates it. These hormonal influences on hypothalamic AMPK activity are central to their roles in controlling food consumption and energy expenditure. Additionally, hypothalamic AMPK activity responds to variations in glucose concentrations. It becomes active during hypoglycemia but is deactivated when glucose is introduced directly into the hypothalamus. These shifts in AMPK activity within hypothalamic neurons are critical for maintaining glucose balance. Considering the vital function of hypothalamic AMPK in the regulation of overall energy and glucose balance, developing chemical agents that target the hypothalamus to modulate AMPK activity presents a promising therapeutic approach for metabolic conditions such as obesity and type 2 diabetes mellitus.

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  • Cross-Talk Between Signaling and Transcriptional Networks Regulating Thermogenesis—Insights into Canonical and Non-Canonical Regulatory Pathways
    Klaudia Simka-Lampa
    International Journal of Molecular Sciences.2026; 27(2): 754.     CrossRef
  • Neurobiological mechanisms of nicotine's effects on feeding and body weight
    Ying Li, Jian Mao, Guobi Chai, Ruimao Zheng, Xingyu Liu, Jianping Xie
    Neuroscience & Biobehavioral Reviews.2025; 169: 106021.     CrossRef
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    Xuekai Zhang, Jin Xiao, Min Jiang, Clive J. C. Phillips, Binlin Shi
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  • Gestational saccharin consumption disrupts gut-brain axis glucose homeostasis control in adolescent offspring rats in a sex-dependent manner
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    Biology of Sex Differences.2025;[Epub]     CrossRef
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    Milind Umekar, Mohammad Qutub, Tanvi Premchandani, Amol Tatode, Jayshree Taksansde, Priyanka Singanwad, Mayur Kale, Mithun Maniyar, Ujban Md Hussain
    Precision Medication.2025; 2(4): 100051.     CrossRef
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    Cell Death & Disease.2025;[Epub]     CrossRef
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    Federico Losada-Díaz, Santiago Lizarazo-Bocanegra, Juan J. Perdomo-Lugo, Sebastián A. Gutiérrez-Romero, Isabella Correa-Osio, Carlos O. Mendivil
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Close layer
Original Article
Diabetes, obesity and metabolism
Inhibition of Sodium-Glucose Cotransporter-2 during Serum Deprivation Increases Hepatic Gluconeogenesis via the AMPK/AKT/FOXO Signaling Pathway
Jinmi Lee, Seok-Woo Hong, Min-Jeong Kim, Yu-Mi Lim, Sun Joon Moon, Hyemi Kwon, Se Eun Park, Eun-Jung Rhee, Won-Young Lee
Endocrinol Metab. 2024;39(1):98-108.   Published online January 3, 2024
DOI: https://doi.org/10.3803/EnM.2023.1786
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AbstractAbstract PDFSupplementary MaterialPubReader   ePub   
Background
Sodium-dependent glucose cotransporter 2 (SGLT2) mediates glucose reabsorption in the renal proximal tubules, and SGLT2 inhibitors are used as therapeutic agents for treating type 2 diabetes mellitus. This study aimed to elucidate the effects and mechanisms of SGLT2 inhibition on hepatic glucose metabolism in both serum deprivation and serum supplementation states.
Methods
Huh7 cells were treated with the SGLT2 inhibitors empagliflozin and dapagliflozin to examine the effect of SGLT2 on hepatic glucose uptake. To examine the modulation of glucose metabolism by SGLT2 inhibition under serum deprivation and serum supplementation conditions, HepG2 cells were transfected with SGLT2 small interfering RNA (siRNA), cultured in serum-free Dulbecco’s modified Eagle’s medium for 16 hours, and then cultured in media supplemented with or without 10% fetal bovine serum for 8 hours.
Results
SGLT2 inhibitors dose-dependently decreased hepatic glucose uptake. Serum deprivation increased the expression levels of the gluconeogenesis genes peroxisome proliferator-activated receptor gamma co-activator 1 alpha (PGC-1α), glucose 6-phosphatase (G6pase), and phosphoenolpyruvate carboxykinase (PEPCK), and their expression levels during serum deprivation were further increased in cells transfected with SGLT2 siRNA. SGLT2 inhibition by siRNA during serum deprivation induces nuclear localization of the transcription factor forkhead box class O 1 (FOXO1), decreases nuclear phosphorylated-AKT (p-AKT), and p-FOXO1 protein expression, and increases phosphorylated-adenosine monophosphate-activated protein kinase (p-AMPK) protein expression. However, treatment with the AMPK inhibitor, compound C, reversed the reduction in the protein expression levels of nuclear p- AKT and p-FOXO1 and decreased the protein expression levels of p-AMPK and PEPCK in cells transfected with SGLT2 siRNA during serum deprivation.
Conclusion
These data show that SGLT2 mediates glucose uptake in hepatocytes and that SGLT2 inhibition during serum deprivation increases gluconeogenesis via the AMPK/AKT/FOXO1 signaling pathway.

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  • Development of Cellular Energy Metabolism During Differentiation of Human iPSCs into Cortical Neurons
    Šárka Danačíková, Petr Pecina, Alena Pecinová, Jan Svoboda, David Vondrášek, Davide Alessandro Basello, Tomáš Čajka, Daniel Hadraba, Tomáš Mráček, Vladimír Kořínek, Jakub Otáhal
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    Fang Liu, Aihong Peng, Xiaoli Zhu, Guangming Wang
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    Dong Hee Kim, Min Jin Lee, Dasol Kang, Ah Reum Khang, Ji Hyun Bae, Joo Yeon Kim, Su Hyun Kim, Yang Ho Kang, Dongwon Yi
    Current Issues in Molecular Biology.2024; 46(7): 7505.     CrossRef
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    Jinmi Lee, Seok-Woo Hong, Min-Jeong Kim, Yu-Mi Lim, Sun Joon Moon, Hyemi Kwon, Se Eun Park, Eun-Jung Rhee, Won-Young Lee
    Biochemical and Biophysical Research Communications.2024; 735: 150620.     CrossRef
Close layer
Brief Report
Diabetes, obesity and metabolism
Partial Deletion of Perk Improved High-Fat Diet-Induced Glucose Intolerance in Mice
Jooyeop Lee, Min Joo Kim, Seoil Moon, Ji Yoon Lim, Kyong Soo Park, Hye Seung Jung
Endocrinol Metab. 2023;38(6):782-787.   Published online November 13, 2023
DOI: https://doi.org/10.3803/EnM.2023.1738
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AbstractAbstract PDFSupplementary MaterialPubReader   ePub   
Although pancreatic endoplasmic reticulum kinase (PERK) is indispensable to beta cells, low-dose PERK inhibitor improved glucose- stimulated insulin secretion (GSIS) and hyperglycemia in diabetic mice. Current study examined if partial deletion of Perk (Perk+/-) recapitulated the effects of PERK inhibitor, on the contrary to the complete deletion. Perk+/- mice and wild-type controls were fed with a high-fat diet (HFD) for 23 weeks. Glucose tolerance was evaluated along with serum insulin levels and islet morphology. Perk+/- mice on normal chow were comparable to wild-type mice in various metabolic features. HFD-induced obesity was not influenced by Perk reduction; however, HFD-induced glucose intolerance was significantly improved since 15-week HFD. HFD-induced compromises in GSIS were relieved by Perk reduction, accompanied by reductions in phosphorylated PERK and activating transcription factor 4 (ATF4) in the islets. Meanwhile, HFD-induced islet expansion was not significantly affected. In summary, partial deletion of Perk improved glucose tolerance and GSIS impaired by diet-induced obesity, without changes in body weights or islet mass.

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  • The UPR-oxidative stress nexus in diabetes and obesity: Exploring innovative therapeutic approaches for metabolic control
    Clinton Ayodeji Akanbi, Oluwafemi Adeleke Ojo
    Obesity Medicine.2025; 57: 100634.     CrossRef
  • Oral Indole-3-acetate Supplementation Increases the Abundance of Bifidobacterium pseudolongum and Akkermansia muciniphila in the Intestine of Mice on a High-Fat Diet
    O. P. Shatova, A. A. Zabolotneva, S. A. Rumyantsev, A. V. Shestopalov
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Close layer
Review Article
Diabetes, obesity and metabolism
The Benefits Of Continuous Glucose Monitoring In Pregnancy
Jee Hee Yoo, Jae Hyeon Kim
Endocrinol Metab. 2023;38(5):472-481.   Published online October 11, 2023
DOI: https://doi.org/10.3803/EnM.2023.1805
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  • 566 Download
  • 12 Web of Science
  • 13 Crossref
AbstractAbstract PDFPubReader   ePub   
Previous studies have consistently demonstrated the positive effects of continuous glucose monitoring (CGM) on glycemic outcomes and complications of diabetes in people with type 1 diabetes. Guidelines now consider CGM to be an essential and cost-effective device for managing type 1 diabetes. As a result, insurance coverage for it is available. Evidence supporting CGM continues to grow and expand to broader populations, such as pregnant people with type 1 diabetes, people with type 2 diabetes treated only with basal insulin therapy, and even type 2 diabetes that does not require insulin treatment. However, despite the significant risk of hyperglycemia in pregnancy, which leads to complications in more than half of affected newborns, CGM indications and insurance coverage for those patients are unresolved. In this review article, we discuss the latest evidence for using CGM to offer glycemic control and reduce perinatal complications, along with its cost-effectiveness in pregestational type 1 and type 2 diabetes and gestational diabetes mellitus. In addition, we discuss future prospects for CGM coverage and indications based on this evidence.

Citations

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    Bhavadharini Balaji, Wesley Hannah, Polina V. Popova, Uma Ram, Mohan Deepa, Janeline Lunghar, Kumaran Uthra, Haritha Sagili, Sadishkumar Kamalanathan, Ranjit Mohan Anjana, Viswanathan Mohan
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Close layer
Original Articles
Diabetes, obesity and metabolism
Big Data Articles (National Health Insurance Service Database)
Risk of Cause-Specific Mortality across Glucose Spectrum in Elderly People: A Nationwide Population-Based Cohort Study
Joonyub Lee, Hun-Sung Kim, Kee-Ho Song, Soon Jib Yoo, Kyungdo Han, Seung-Hwan Lee, Committee of Big Data, Korean Endocrine Society
Endocrinol Metab. 2023;38(5):525-537.   Published online September 7, 2023
DOI: https://doi.org/10.3803/EnM.2023.1765
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AbstractAbstract PDFSupplementary MaterialPubReader   ePub   
Background
This study investigated the risk of cause-specific mortality according to glucose tolerance status in elderly South Koreans.
Methods
A total of 1,292,264 individuals aged ≥65 years who received health examinations in 2009 were identified from the National Health Information Database. Participants were classified as normal glucose tolerance, impaired fasting glucose, newly-diagnosed diabetes, early diabetes (oral hypoglycemic agents ≤2), or advanced diabetes (oral hypoglycemic agents ≥3 or insulin). The risk of system-specific and disease-specific deaths was estimated using multivariate Cox proportional hazards analysis.
Results
During a median follow-up of 8.41 years, 257,356 deaths were recorded. Diabetes was associated with significantly higher risk of all-cause mortality (hazard ratio [HR], 1.58; 95% confidence interval [CI], 1.57 to 1.60); death due to circulatory (HR, 1.49; 95% CI, 1.46 to 1.52), respiratory (HR, 1.51; 95% CI, 1.47 to 1.55), and genitourinary systems (HR, 2.22; 95% CI, 2.10 to 2.35); and neoplasms (HR, 1.30; 95% CI, 1.28 to 1.32). Diabetes was also associated with a significantly higher risk of death due to ischemic heart disease (HR, 1.70; 95% CI, 1.63 to 1.76), cerebrovascular disease (HR, 1.46; 95% CI, 1.41 to 1.50), pneumonia (HR, 1.69; 95% CI, 1.63 to 1.76), and acute or chronic kidney disease (HR, 2.23; 95% CI, 2.09 to 2.38). There was a stepwise increase in the risk of death across the glucose spectrum (P for trend <0.0001). Stroke, heart failure, or chronic kidney disease increased the risk of all-cause mortality at every stage of glucose intolerance.
Conclusion
A dose-dependent association between the risk of mortality from various causes and severity of glucose tolerance was noted in the elderly population.

Citations

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    Joonyub Lee, Seung-Hwan Lee, Mee-Kyoung Kim, Hyuk-Sang Kwon, Jae-Seung Yun, Yeoree Yang, Kun-Ho Yoon, Jae-Hyoung Cho, Chi-Un Pae, Kyungdo Han, Jang Won Son
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Close layer
Diabetes, obesity and metabolism
Triglyceride-Glucose Index Predicts Future Atherosclerotic Cardiovascular Diseases: A 16-Year Follow-up in a Prospective, Community-Dwelling Cohort Study
Joon Ho Moon, Yongkang Kim, Tae Jung Oh, Jae Hoon Moon, Soo Heon Kwak, Kyong Soo Park, Hak Chul Jang, Sung Hee Choi, Nam H. Cho
Endocrinol Metab. 2023;38(4):406-417.   Published online August 3, 2023
DOI: https://doi.org/10.3803/EnM.2023.1703
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  • 32 Web of Science
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AbstractAbstract PDFSupplementary MaterialPubReader   ePub   
Background
While the triglyceride-glucose (TyG) index is a measure of insulin resistance, its association with cardiovascular disease (CVD) has not been well elucidated. We evaluated the TyG index for prediction of CVDs in a prospective large communitybased cohort.
Methods
Individuals 40 to 70 years old were prospectively followed for a median 15.6 years. The TyG index was calculated as the Ln [fasting triglycerides (mg/dL)×fasting glucose (mg/dL)/2]. CVDs included any acute myocardial infarction, coronary artery disease or cerebrovascular disease. We used a Cox proportional hazards model to estimate CVD risks according to quartiles of the TyG index and plotted the receiver operating characteristics curve for the incident CVD.
Results
Among 8,511 subjects (age 51.9±8.8 years; 47.5% males), 931 (10.9%) had incident CVDs during the follow-up. After adjustment for age, sex, body mass index, diabetes mellitus, hypertension, total cholesterol, smoking, alcohol, exercise, and C-reactive protein, subjects in the highest TyG quartile had 36% increased risk of incident CVD compared with the lowest TyG quartile (hazard ratio, 1.36; 95% confidence interval, 1.10 to 1.68). Carotid plaque, assessed by ultrasonography was more frequent in subjects in the higher quartile of TyG index (P for trend=0.049 in men and P for trend <0.001 in women). The TyG index had a higher predictive power for CVDs than the homeostasis model assessment of insulin resistance (HOMA-IR) (area under the curve, 0.578 for TyG and 0.543 for HOMA-IR). Adding TyG index on diabetes or hypertension alone gave sounder predictability for CVDs.
Conclusion
The TyG index is independently associated with future CVDs in 16 years of follow-up in large, prospective Korean cohort.

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    Cardiovascular Diabetology.2024;[Epub]     CrossRef
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    Min Jin Lee, Ji Hyun Bae, Ah Reum Khang, Dongwon Yi, Mi Sook Yun, Yang Ho Kang
    Diabetes Research and Clinical Practice.2024; 210: 111640.     CrossRef
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    Tolga Han Efe, Engin Algül
    Biomarkers in Medicine.2024; 18(6): 243.     CrossRef
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    Bisher Sawaf, Sarya Swed, Hidar Alibrahim, Haidara Bohsas, Tirth Dave, Mohamad Nour Nasif, Wael Hafez, Fatema Ali Asgar Tashrifwala, Yazan Khair Eldien Jabban, Safwan Al-Rassas, Heba haj Saleh, Abdul Rehman Zia Zaidi, Baraa Alghalyini, Shaymaa Abdelmaboud
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    Beverley Adams-Huet, Ishwarlal Jialal
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Diabetes, obesity and metabolism
Efficacy of Gemigliptin Add-on to Dapagliflozin and Metformin in Type 2 Diabetes Patients: A Randomized, Double-Blind, Placebo-Controlled Study (SOLUTION)
Byung Wan Lee, KyungWan Min, Eun-Gyoung Hong, Bon Jeong Ku, Jun Goo Kang, Suk Chon, Won-Young Lee, Mi Kyoung Park, Jae Hyeon Kim, Sang Yong Kim, Keeho Song, Soon Jib Yoo
Endocrinol Metab. 2023;38(3):328-337.   Published online June 28, 2023
DOI: https://doi.org/10.3803/EnM.2023.1688
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AbstractAbstract PDFSupplementary MaterialPubReader   ePub   
Background
This study evaluated the efficacy and safety of add-on gemigliptin in patients with type 2 diabetes mellitus (T2DM) who had inadequate glycemic control with metformin and dapagliflozin.
Methods
In this randomized, placebo-controlled, parallel-group, double-blind, phase III study, 315 patients were randomized to receive either gemigliptin 50 mg (n=159) or placebo (n=156) with metformin and dapagliflozin for 24 weeks. After the 24-week treatment, patients who received the placebo were switched to gemigliptin, and all patients were treated with gemigliptin for an additional 28 weeks.
Results
The baseline characteristics were similar between the two groups, except for body mass index. At week 24, the least squares mean difference (standard error) in hemoglobin A1c (HbA1c) changes was –0.66% (0.07) with a 95% confidence interval of –0.80% to –0.52%, demonstrating superior HbA1c reduction in the gemigliptin group. After week 24, the HbA1c level significantly decreased in the placebo group as gemigliptin was administered, whereas the efficacy of HbA1c reduction was maintained up to week 52 in the gemigliptin group. The safety profiles were similar: the incidence rates of treatment-emergent adverse events up to week 24 were 27.67% and 29.22% in the gemigliptin and placebo groups, respectively. The safety profiles after week 24 were similar to those up to week 24 in both groups, and no new safety findings, including hypoglycemia, were noted.
Conclusion
Add-on gemigliptin was well tolerated, providing comparable safety profiles and superior efficacy in glycemic control over placebo for long-term use in patients with T2DM who had poor glycemic control with metformin and dapagliflozin.

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    Myung Jin Kim, Yun Kyung Cho, Sehee Kim, Jung Yoon Moon, Chang Hee Jung, Woo Je Lee
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    Miao Yu, Tong Wang, Chun Xu, Yan Bi, Ling Gao, Guang Wang, Guangda Xiang, Yaoming Xue, Tao Yang, Deying Kang, Zhiguang Zhou, Lixin Guo, Xinhua Xiao
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    Jaehyuk Kim, Eunjung Song, Siyoen Kil
    Communications for Statistical Applications and Methods.2025; 32(6): 783.     CrossRef
  • Dual add‐on therapy of gemigliptin and dapagliflozin in patients with type 2 diabetes inadequately controlled with metformin alone: The SOLUTION 2 study
    Kyung Ah Han, You‐Cheol Hwang, Shin Je Moon, Ho Chan Cho, Hye Jin Yoo, Sung Hee Choi, Suk Chon, Kyoung‐Ah Kim, Tae Nyun Kim, Jun Goo Kang, Cheol‐Young Park, Jong Chul Won, Eunjoo Cho, Jeongyun Kim, Kyong Soo Park
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Namgok Lecture 2022
Diabetes, Obesity and Metabolism
Incretin and Pancreatic β-Cell Function in Patients with Type 2 Diabetes
Chang Ho Ahn, Tae Jung Oh, Se Hee Min, Young Min Cho
Endocrinol Metab. 2023;38(1):1-9.   Published online February 13, 2023
DOI: https://doi.org/10.3803/EnM.2023.103
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  • 494 Download
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AbstractAbstract PDFPubReader   ePub   
To maintain normal glucose homeostasis after a meal, it is essential to secrete an adequate amount of insulin from pancreatic β-cells. However, if pancreatic β-cells solely depended on the blood glucose level for insulin secretion, a surge in blood glucose levels would be inevitable after the ingestion of a large amount of carbohydrates. To avoid a deluge of glucose in the bloodstream after a large carbohydrate- rich meal, enteroendocrine cells detect the amount of nutrient absorption from the gut lumen and secrete incretin hormones at scale. Since insulin secretion in response to incretin hormones occurs only in a hyperglycemic milieu, pancreatic β-cells can secrete a “Goldilocks” amount of insulin (i.e., not too much and not too little) to keep the blood glucose level in the normal range. In this regard, pancreatic β-cell sensitivity to glucose and incretin hormones is crucial for maintaining normal glucose homeostasis. In this Namgok lecture 2022, we review the effects of current anti-diabetic medications on pancreatic β-cell sensitivity to glucose and incretin hormones.

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    Dina Mostafa Mohammed, Mohamed A. Abdelgawad, Mohammed M. Ghoneim, Abdulaziz Alhossan, Rasha Hamed Al-Serwi, Amr Farouk
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    Muthanna K. Zaki, Mohammed N. Abed, Fawaz A. Alassaf
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  • Recent Glycemia Is a Major Determinant of β-Cell Function in Type 2 Diabetes Mellitus
    Ji Yoon Kim, Jiyoon Lee, Sin Gon Kim, Nam Hoon Kim
    Diabetes & Metabolism Journal.2024; 48(6): 1135.     CrossRef
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Review Articles
Diabetes, Obesity and Metabolism
Recent Updates to Clinical Practice Guidelines for Diabetes Mellitus
Jin Yu, Seung-Hwan Lee, Mee Kyoung Kim
Endocrinol Metab. 2022;37(1):26-37.   Published online February 28, 2022
DOI: https://doi.org/10.3803/EnM.2022.105
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  • 1,541 Download
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AbstractAbstract PDFPubReader   ePub   
Guidelines for the management of patients with diabetes have become an important part of clinical practice that improve the quality of care and help establish evidence-based medicine in this field. With rapidly accumulating evidence on various aspects of diabetes care, including landmark clinical trials of treatment agents and newer technologies, timely updates of the guidelines capture the most current state of the field and present a consensus. As a leading academic society, the Korean Diabetes Association publishes practice guidelines biennially and the American Diabetes Association does so annually. In this review, we summarize the key changes suggested in the most recent guidelines. Some of the important updates include treatment algorithms emphasizing comorbid conditions such as atherosclerotic cardiovascular disease, heart failure, and chronic kidney disease in the selection of anti-diabetic agents; wider application of continuous glucose monitoring (CGM), insulin pump technologies and indices derived from CGM such as time in range; more active screening of subjects at high-risk of diabetes; and more detailed individualization in diabetes care. Although there are both similarities and differences among guidelines and some uncertainty remains, these updates provide a good approach for many clinical practitioners who are battling with diabetes.

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Diabetes, Obesity and Metabolism
Homeostatic Regulation of Glucose Metabolism by the Central Nervous System
Jong Han Choi, Min-Seon Kim
Endocrinol Metab. 2022;37(1):9-25.   Published online February 28, 2022
DOI: https://doi.org/10.3803/EnM.2021.1364
  • 19,991 View
  • 659 Download
  • 26 Web of Science
  • 28 Crossref
AbstractAbstract PDFPubReader   ePub   
Evidence for involvement of the central nervous system (CNS) in the regulation of glucose metabolism dates back to the 19th century, although the majority of the research on glucose metabolism has focused on the peripheral metabolic organs. Due to recent advances in neuroscience, it has now become clear that the CNS is indeed vital for maintaining glucose homeostasis. To achieve normoglycemia, specific populations of neurons and glia in the hypothalamus sense changes in the blood concentrations of glucose and of glucoregulatory hormones such as insulin, leptin, glucagon-like peptide 1, and glucagon. This information is integrated and transmitted to other areas of the brain where it eventually modulates various processes in glucose metabolism (i.e., hepatic glucose production, glucose uptake in the brown adipose tissue and skeletal muscle, pancreatic insulin and glucagon secretion, renal glucose reabsorption, etc.). Errors in these processes lead to hyper- or hypoglycemia. We here review the current understanding of the brain regulation of glucose metabolism.

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  • Knockout of Nur77 Leads to Amino Acid, Lipid, and Glucose Metabolism Disorders in Zebrafish
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Close layer
Original Articles
Diabetes, Obesity and Metabolism
Big Data Articles (National Health Insurance Service Database)
Frequency of Exposure to Impaired Fasting Glucose and Risk of Mortality and Cardiovascular Outcomes
Seung-Hwan Lee, Kyungdo Han, Hyuk-Sang Kwon, Mee Kyoung Kim
Endocrinol Metab. 2021;36(5):1007-1015.   Published online October 21, 2021
DOI: https://doi.org/10.3803/EnM.2021.1218
  • 8,045 View
  • 153 Download
  • 14 Web of Science
  • 15 Crossref
AbstractAbstract PDFSupplementary MaterialPubReader   ePub   
Background
Metabolic abnormalities, such as impaired fasting glucose (IFG), are dynamic phenomena; however, it is unclear whether the timing of IFG exposure and cumulative exposure to IFG are related to cardiovascular disease (CVD) and mortality risk.
Methods
Data were extracted from a nationwide population-based cohort in South Korea for adults (n=2,206,679) who were free of diabetes and had 4 years of consecutive health examination data. Fasting blood glucose levels of 100 to 125 mg/dL were defined as IFG, and the number of IFG diagnoses for each adult in the 4-year period was tabulated as the IFG exposure score (range, 0 to 4). Adults with persistent IFG for the 4-year period received a score of 4.
Results
The median follow-up was 8.2 years. There were 24,820 deaths, 13,502 cases of stroke, and 13,057 cases of myocardial infarction (MI). IFG exposure scores of 1, 2, 3, and 4 were associated with all-cause mortality (multivariable-adjusted hazard ratio [aHR], 1.11; 95% confidence interval [CI], 1.08 to 1.15; aHR, 1.16; 95% CI, 1.12 to 1.20; aHR, 1.20; 95% CI, 1.15 to 1.25; aHR, 1.18; 95% CI, 1.11 to 1.25, respectively) compared with an IFG exposure score of 0. Adjusting for hypertension and dyslipidemia attenuated the slightly increased risk of MI or stroke associated with high IFG exposure scores, but significant associations for allcause mortality remained.
Conclusion
The intensity of IFG exposure was associated with an elevated risk of all-cause mortality, independent of cardiovascular risk factors. The association between IFG exposure and CVD risk was largely mediated by the coexistence of dyslipidemia and hypertension.

Citations

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  • Impact of cumulative exposure to a high TG to HDL-C ratio on type 2 diabetes risk in young adults
    Jung Heo, Byungpyo Kim, Kyungdo Han, Jae-Hyuk Lee, Seo-Young Sohn, Jiyeon Ahn, Whi-An Kwon, Moon Jung Kim, Eun-Young Doo, Min-Kyung Lee
    Journal of Clinical Lipidology.2025; 19(2): 267.     CrossRef
  • Exposure to perfluoroalkyl and polyfluoroalkyl substances and risk of stroke in adults: a meta-analysis
    Min Cheol Chang, Seung Min Chung, Sang Gyu Kwak
    Reviews on Environmental Health.2024; 39(4): 791.     CrossRef
  • Cumulative exposure to impaired fasting glucose and gastrointestinal cancer risk: A nationwide cohort study
    Byeong Yun Ahn, Bokyung Kim, Sanghyun Park, Sang Gyun Kim, Kyungdo Han, Soo‐Jeong Cho
    Cancer.2024; 130(10): 1807.     CrossRef
  • Diabetes severity and the risk of depression: A nationwide population-based study
    Yunjung Cho, Bongsung Kim, Hyuk-Sang Kwon, Kyungdo Han, Mee Kyoung Kim
    Journal of Affective Disorders.2024; 351: 694.     CrossRef
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    Jie Liu, Feng Yi, Kai Duan, Haibo Liu
    Scientific Reports.2024;[Epub]     CrossRef
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    Kyungdo Han, Bongsung Kim, Seung Hwan Lee, Mee Kyoung Kim
    npj Parkinson's Disease.2023;[Epub]     CrossRef
  • Diabetes severity is strongly associated with the risk of active tuberculosis in people with type 2 diabetes: a nationwide cohort study with a 6-year follow-up
    Ji Young Kang, Kyungdo Han, Seung-Hwan Lee, Mee Kyoung Kim
    Respiratory Research.2023;[Epub]     CrossRef
  • Construction and Validation of a Model for Predicting Impaired Fasting Glucose Based on More Than 4000 General Population
    Cuicui Wang, Xu Zhang, Chenwei Li, Na Li, Xueni Jia, Hui Zhao
    International Journal of General Medicine.2023; Volume 16: 1415.     CrossRef
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    Kyungdo Han, Mee Kyoung Kim
    Journal of Obesity & Metabolic Syndrome.2023; 32(2): 163.     CrossRef
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    Jin Yu, Kyu-Na Lee, Hun-Sung Kim, Kyungdo Han, Seung-Hwan Lee
    Scientific Reports.2023;[Epub]     CrossRef
  • A Longitudinal Retrospective Observational Study on Obesity Indicators and the Risk of Impaired Fasting Glucose in Pre- and Postmenopausal Women
    Myung Ji Nam, Hyunjin Kim, Yeon Joo Choi, Kyung-Hwan Cho, Seon Mee Kim, Yong-Kyun Roh, Kyungdo Han, Jin-Hyung Jung, Yong-Gyu Park, Joo-Hyun Park, Do-Hoon Kim
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  • Low-Density Lipoprotein Cholesterol Level, Statin Use and Myocardial Infarction Risk in Young Adults
    Heekyoung Jeong, Kyungdo Han, Soon Jib Yoo, Mee Kyoung Kim
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    Seohyun Kim, Gyuri Kim, Jae Hyeon Kim
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Close layer
Diabetes, Obesity and Metabolism
How Can We Adopt the Glucose Tolerance Test to Facilitate Predicting Pregnancy Outcome in Gestational Diabetes Mellitus?
Kyeong Jin Kim, Nam Hoon Kim, Jimi Choi, Sin Gon Kim, Kyung Ju Lee
Endocrinol Metab. 2021;36(5):988-996.   Published online October 15, 2021
DOI: https://doi.org/10.3803/EnM.2021.1107
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  • 130 Download
  • 7 Web of Science
  • 7 Crossref
AbstractAbstract PDFSupplementary MaterialPubReader   ePub   
Background
We investigated how 100-g oral glucose tolerance test (OGTT) results can be used to predict adverse pregnancy outcomes in gestational diabetes mellitus (GDM) patients.
Methods
We analyzed 1,059 pregnant women who completed the 100-g OGTT between 24 and 28 weeks of gestation. We compared the risk of adverse pregnancy outcomes according to OGTT patterns by latent profile analysis (LPA), numbers to meet the OGTT criteria, and area under the curve (AUC) of the OGTT graph. Adverse pregnancy outcomes were defined as a composite of preterm birth, macrosomia, large for gestational age, low APGAR score at 1 minute, and pregnancy-induced hypertension.
Results
Overall, 257 participants were diagnosed with GDM, with a median age of 34 years. An LPA led to three different clusters of OGTT patterns; however, there were no significant associations between the clusters and adverse pregnancy outcomes after adjusting for confounders. Notwithstanding, the risk of adverse pregnancy outcome increased with an increase in number to meet the OGTT criteria (P for trend=0.011); odds ratios in a full adjustment model were 1.27 (95% confidence interval [CI], 0.72 to 2.23), 2.16 (95% CI, 1.21 to 3.85), and 2.32 (95% CI, 0.66 to 8.15) in those meeting the 2, 3, and 4 criteria, respectively. The AUCs of the OGTT curves also distinguished the patients at risk of adverse pregnancy outcomes; the larger the AUC, the higher the risk (P for trend=0.007).
Conclusion
The total number of abnormal values and calculated AUCs for the 100-g OGTT may facilitate tailored management of patients with GDM by predicting adverse pregnancy outcomes.

Citations

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  • Association of prenatal glycemic marker cumulative exposure with placental DNA methylation change
    Tesfa D Habtewold, Richard J Biedrzycki, Prabhavi Wijesiriwardhana, Nigus G Asefa, Fasil Tekola-Ayele
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    Fangping Zhou, Binbin Yin, Ya Xi, Jinghua Zhang, Yongying Bai
    Journal of Health, Population and Nutrition.2025;[Epub]     CrossRef
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    Xinyue Wang, Zhangya He, Jing Ji, Simin Zhang, Jinglin Li, Jiahui Zhang, Wenlu Yu, Hexiang Yang, Zhen Han, Yang Mi, Xiaoqin Luo
    BMC Medicine.2025;[Epub]     CrossRef
  • First Trimester Mean Glucose Level on Continuous Glucose Monitoring Is Associated with Infant Birth Weight
    Phaik Ling Quah, Lay Kok Tan, Serene Pei Ting Thain, Ngee Lek, Shephali Tagore, Bernard Su Min Chern, Seng Bin Ang, Ann Wright, Michelle Jong, Kok Hian Tan
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Close layer
Diabetes, Obesity and Metabolism
Role of TRPV4 Channel in Human White Adipocytes Metabolic Activity
Julio C. Sánchez, Aníbal Valencia-Vásquez, Andrés M. García
Endocrinol Metab. 2021;36(5):997-1006.   Published online October 14, 2021
DOI: https://doi.org/10.3803/EnM.2021.1167
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  • 147 Download
  • 7 Web of Science
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AbstractAbstract PDFPubReader   ePub   
Background
Intracellular calcium (Ca2+) homeostasis plays an essential role in adipocyte metabolism and its alteration is associated with obesity and related disorders. Transient receptor potential vanilloid 4 (TRPV4) channels are an important Ca2+ pathway in adipocytes and their activity is regulated by metabolic mediators such as insulin. In this study, we evaluated the role of TRPV4 channels in metabolic activity and adipokine secretion in human white adipocytes.
Methods
Human white adipocytes were freshly cultured and the effects of the activation and inhibition of TRPV4 channels on lipolysis, glucose uptake, lactate production, and leptin and adiponectin secretion were evaluated.
Results
Under basal and isoproterenol-stimulated conditions, TRPV4 activation by GSK1016709A decreased lipolysis whereas HC067047, an antagonist, increased lipolysis. The activation of TRPV4 resulted in increased glucose uptake and lactate production under both basal conditions and insulin-stimulated conditions; in contrast HC067047 decreased both parameters. Leptin production was increased, and adiponectin production was diminished by TRPV4 activation and its inhibition had the opposite effect.
Conclusion
Our results suggested that TRPV4 channels are metabolic mediators involved in proadipogenic processes and glucose metabolism in adipocyte biology. TRPV4 channels could be a potential pharmacological target to treat metabolic disorders.

Citations

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    Pengjiao Xi, Shuhui Ma, Derun Tian, Yanna Shen
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Close layer
Mineral, Bone & Muscle
Comparison of the Effects of Various Antidiabetic Medication on Bone Mineral Density in Patients with Type 2 Diabetes Mellitus
Jeonghoon Ha, Yejee Lim, Mee Kyoung Kim, Hyuk-Sang Kwon, Ki-Ho Song, Seung Hyun Ko, Moo Il Kang, Sung Dae Moon, Ki-Hyun Baek
Endocrinol Metab. 2021;36(4):895-903.   Published online August 9, 2021
DOI: https://doi.org/10.3803/EnM.2021.1026
  • 10,740 View
  • 279 Download
  • 9 Web of Science
  • 10 Crossref
AbstractAbstract PDFPubReader   ePub   
Background
Prospective comparative studies on the effects of various antidiabetic agents on bone metabolism are limited. This study aimed to assess changes in bone mass and biochemical bone markers in postmenopausal patients with type 2 diabetes mellitus (T2DM).
Methods
This prospective, multicenter, open-label, comparative trial included 264 patients with T2DM. Patients who had received a metformin, or sulfonylurea/metformin combination (Group 1); a thiazolidinedione combination (Group 2); a dipeptidyl peptidase-4 inhibitor (gemigliptin) combination (Group 3); or an sodium-glucose cotransporter 2 inhibitor (empagliflozin) combination (Group 4) were prospectively treated for 12 months; bone mineral density (BMD) and bone turnover marker (BTM) changes were evaluated.
Results
The femoral neck BMD percentage changes were −0.79%±2.86% (Group 1), −2.50%±3.08% (Group 2), −1.05%±2.74% (Group 3), and −1.24%±2.91% (Group 4) (P<0.05). The total hip BMD percentage changes were −0.57%±1.79% (Group 1), −1.74%±1.48% (Group 2), −0.75%±1.87% (Group 3), and −1.27%±1.72% (Group 4) (P<0.05). Mean serum BTM (C-terminal type 1 collagen telopeptide and procollagen type 1 amino-terminal propeptide) levels measured during the study period did not change over time or differ between groups.
Conclusion
Significant bone loss in the femoral neck and total hip was associated with thiazolidinedione combination regimens. However, bone loss was not significantly associated with combination regimens including gemigliptin or empagliflozin. Caution should be exercised during treatment with antidiabetic medications that adversely affect the bone in patients with diabetes at a high risk of bone loss.

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Close layer
Review Article
Diabetes
Cardiorenal Protection in Diabetic Kidney Disease
Jason F. Lee, Ecaterina Berzan, Vikas S. Sridhar, Ayodele Odutayo, David Z.I. Cherney
Endocrinol Metab. 2021;36(2):256-269.   Published online April 19, 2021
DOI: https://doi.org/10.3803/EnM.2021.987
  • 10,729 View
  • 334 Download
  • 12 Web of Science
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AbstractAbstract PDFPubReader   ePub   
Over the last 5 years there have been many new developments in the management of diabetic kidney disease. Glucagon-like peptide-1 receptor agonists (GLP-1 RA) and sodium-glucose cotransporter-2 (SGLT2) inhibitors were initially used for glycemic control, but more recent studies have now shown that their benefits extend to cardiovascular and kidney outcomes. The recent addition of data on the novel mineralocorticoid receptor antagonist (MRA) gives us another approach to further decrease the residual risk of diabetic kidney disease progression. In this review we describe the mechanism of action, key studies, and possible adverse effects related to these three classes of medications. The management of type 2 diabetes now includes an increasing number of medications for the management of comorbidities in a patient population at significant risk of cardiovascular disease and progression of chronic kidney disease. It is from this perspective that we seek to outline the rationale for the sequential and/or combined use of SGLT2 inhibitors, GLP-1 RA and MRAs in patients with type 2 diabetes for heart and kidney protection.

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Close layer
Original Article
Clinical Study
High Serum-Induced AhRL Is Associated with Prevalent Metabolic Syndrome and Future Impairment of Glucose Tolerance in the Elderly
Youngmi Kim Pak, Hoon Sung Choi, Wook Ha Park, Suyeol Im, P. Monica Lind, Lars Lind, Hong Kyu Lee
Endocrinol Metab. 2021;36(2):436-446.   Published online April 19, 2021
DOI: https://doi.org/10.3803/EnM.2020.883
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AbstractAbstract PDFSupplementary MaterialPubReader   ePub   
Background
High circulating levels of dioxins and dioxin-like chemicals, acting via the aryl hydrocarbon receptor (AhR), have previously been linked to diabetes. We now investigated whether the serum AhR ligands (AhRL) were higher in subjects with metabolic syndrome (MetS) and in subjects who had developed a worsened glucose tolerance over time.
Methods
Serum AhRL at baseline was measured by a cell-based AhRL activity assay in 70-year-old subjects (n=911) in the Prospective Investigation of the Vasculature in Uppsala Seniors (PIVUS) study. The main outcome measures were prevalent MetS and worsening of glucose tolerance over 5 years of follow-up.
Results
AhRL was significantly elevated in subjects with prevalent MetS as compared to those without MetS, following adjustment for sex, smoking, exercise habits, alcohol intake and educational level (P=0.009). AhRL at baseline was higher in subjects who developed impaired fasting glucose or diabetes at age 75 years than in those who remained normoglycemic (P=0.0081). The odds ratio (OR) of AhRL for worsening glucose tolerance over 5 years was 1.43 (95% confidence interval [CI], 1.13 to 1.81; P=0.003, continuous variables) and 2.81 (95% CI, 1.31 to 6.02; P=0.008, in the highest quartile) adjusted for sex, life style factors, body mass index, and glucose.
Conclusion
These findings support a large body of epidemiologic evidence that exposure to AhR transactivating substances, such as dioxins and dioxin-like chemicals, might be involved in the pathogenesis of MetS and diabetes development. Measurement of serum AhRL in humans can be a useful tool in predicting the onset of metabolic disorders.

Citations

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Close layer
Review Article
Diabetes
Continuous Glucose Monitoring in the Hospital
M. Citlalli Perez-Guzman, Trisha Shang, Jennifer Y. Zhang, Donna Jornsay, David C. Klonoff
Endocrinol Metab. 2021;36(2):240-255.   Published online March 31, 2021
DOI: https://doi.org/10.3803/EnM.2021.201
  • 29,979 View
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  • 41 Web of Science
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AbstractAbstract PDFPubReader   ePub   
Continuous glucose monitors (CGMs) have suddenly become part of routine care in many hospitals. The coronavirus disease 2019 (COVID-19) pandemic has necessitated the use of new technologies and new processes to care for hospitalized patients, including diabetes patients. The use of CGMs to automatically and remotely supplement or replace assisted monitoring of blood glucose by bedside nurses can decrease: the amount of necessary nursing exposure to COVID-19 patients with diabetes; the amount of time required for obtaining blood glucose measurements, and the amount of personal protective equipment necessary for interacting with patients during the blood glucose testing. The United States Food and Drug Administration (FDA) is now exercising enforcement discretion and not objecting to certain factory-calibrated CGMs being used in a hospital setting, both to facilitate patient care and to obtain performance data that can be used for future regulatory submissions. CGMs can be used in the hospital to decrease the frequency of fingerstick point of care capillary blood glucose testing, decrease hyperglycemic episodes, and decrease hypoglycemic episodes. Most of the research on CGMs in the hospital has focused on their accuracy and only recently outcomes data has been reported. A hospital CGM program requires cooperation of physicians, bedside nurses, diabetes educators, and hospital administrators to appropriately select and manage patients. Processes for collecting, reviewing, storing, and responding to CGM data must be established for such a program to be successful. CGM technology is advancing and we expect that CGMs will be increasingly used in the hospital for patients with diabetes.

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Close layer
Original Article
Clinical Study
Comparative Renal Effects of Dipeptidyl Peptidase-4 Inhibitors and Sodium-Glucose Cotransporter 2 Inhibitors on Individual Outcomes in Patients with Type 2 Diabetes: A Systematic Review and Network Meta-Analysis
Jae Hyun Bae, Eun-Gee Park, Sunhee Kim, Sin Gon Kim, Seokyung Hahn, Nam Hoon Kim
Endocrinol Metab. 2021;36(2):388-400.   Published online March 31, 2021
DOI: https://doi.org/10.3803/EnM.2020.912
  • 11,820 View
  • 418 Download
  • 17 Web of Science
  • 21 Crossref
AbstractAbstract PDFSupplementary MaterialPubReader   ePub   
Background
To compare the renal effects of dipeptidyl peptidase-4 (DPP-4) inhibitors and sodium-glucose cotransporter 2 (SGLT2) inhibitors on individual outcomes in patients with type 2 diabetes.
Methods
We searched electronic databases (MEDLINE, Embase, and the Cochrane Central Register of Controlled Trials) from inception to June 2019 to identity eligible randomized controlled trials of DPP-4 inhibitors or SGLT2 inhibitors that reported at least one kidney outcome in patients with type 2 diabetes. Outcomes of interest were microalbuminuria, macroalbuminuria, worsening nephropathy, and end-stage kidney disease (ESKD). We performed an arm-based network meta-analysis using Bayesian methods and calculated absolute risks and rank probabilities of each treatment for the outcomes.
Results
Seventeen studies with 87,263 patients were included. SGLT2 inhibitors significantly lowered the risks of individual kidney outcomes, including microalbuminuria (odds ratio [OR], 0.64; 95% credible interval [CrI], 0.41 to 0.93), macroalbuminuria (OR, 0.48; 95% CrI, 0.24 to 0.72), worsening nephropathy (OR, 0.65; 95% CrI, 0.44 to 0.91), and ESKD (OR, 0.65; 95% CrI, 0.46 to 0.98) as compared with placebo. However, DPP-4 inhibitors did not lower the risks. SGLT2 inhibitors were considerably associated with higher absolute risk reductions in all kidney outcomes than DPP-4 inhibitors, although the benefits were statistically insignificant. The rank probabilities showed that SGLT2 inhibitors were better treatments for lowering the risk of albuminuria and ESKD than placebo or DPP-4 inhibitors.
Conclusion
SGLT2 inhibitors were superior to DPP-4 inhibitors in reducing the risk of albuminuria and ESKD in patients with type 2 diabetes.

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    Advances in Pharmacological and Pharmaceutical Sciences.2023; 2023: 1.     CrossRef
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    Pavel Weber, Hana Meluzínová, Dana Weberová
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    Hongwei Cao, Tao Liu, Li Wang, Qiuhe Ji
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    Rüdiger Landgraf, Jens Aberle, Andreas L. Birkenfeld, Baptist Gallwitz, Monika Kellerer, Harald H. Klein, Dirk Müller-Wieland, Michael A. Nauck, Tobias Wiesner, Erhard Siegel
    Die Diabetologie.2022; 18(5): 623.     CrossRef
  • Significant reduction in chronic kidney disease progression with sodium‐glucose cotransporter‐2 inhibitors compared to dipeptidyl peptidase‐4 inhibitors in adults with type 2 diabetes in a UK clinical setting: An observational outcomes study based on inte
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    Diabetes, Obesity and Metabolism.2022; 24(11): 2138.     CrossRef
  • Therapy of Type 2 Diabetes
    Rüdiger Landgraf, Jens Aberle, Andreas L. Birkenfeld, Baptist Gallwitz, Monika Kellerer, Harald Klein, Dirk Müller-Wieland, Michael A. Nauck, Tobias Wiesner, Erhard Siegel
    Experimental and Clinical Endocrinology & Diabetes.2022; 130(S 01): S80.     CrossRef
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    Kaixuan Zhou, Xue Zi, Jiayu Song, Qiulu Zhao, Jia Liu, Huiwei Bao, Lijing Li
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    Jiandong Zhou, Xuejin Liu, Oscar Hou-In Chou, Lifang Li, Sharen Lee, Wing Tak Wong, Qingpeng Zhang, Carlin Chang, Tong Liu, Gary Tse, Fengshi Jing, Bernard Man Yung Cheung
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    Chan-Hee Jung
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Close layer
Review Article
Diabetes
Best Achievements in Clinical Medicine in Diabetes and Dyslipidemia in 2020
Eun-Jung Rhee, Mee-Kyung Kim, Won-Young Lee
Endocrinol Metab. 2021;36(1):41-50.   Published online February 24, 2021
DOI: https://doi.org/10.3803/EnM.2021.106
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AbstractAbstract PDFPubReader   ePub   
Over the last two decades, our understanding of diabetes and treatment strategies have evolved tremendously, from scientific, mechanistic, and human perspectives. The categories of anti-diabetic medications expanded from a few to numerous, enabling clinicians to personalize diabetes care and treatment. Thanks to rapid growth in the field of science and medical engineering, newer treatment options are coming to the market with various advantages and disadvantages to be aware of. Therefore, clinicians should rapidly adopt new trends based on guidelines and data from many clinical trials in the field of diabetes. In the treatment of dyslipidemia, trends and guidelines are changing every year, and novel therapies are being developed. In this review, we would like to summarize the major achievements in clinical medicine in 2020 in the field of diabetes mellitus and dyslipidemia.

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  • Efficacy and safety of enavogliflozin versus dapagliflozin added to metformin plus gemigliptin treatment in patients with type 2 diabetes: A double-blind, randomized, comparator-active study: ENHANCE-D study
    Kyung-Soo Kim, Kyung Ah Han, Tae Nyun Kim, Cheol-Young Park, Jung Hwan Park, Sang Yong Kim, Yong Hyun Kim, Kee Ho Song, Eun Seok Kang, Chul Sik Kim, Gwanpyo Koh, Jun Goo Kang, Mi Kyung Kim, Ji Min Han, Nan Hee Kim, Ji Oh Mok, Jae Hyuk Lee, Soo Lim, Sang S
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    Simin Zhang, Donghan Sun, Xiaoyi Qian, Li Li, Wenwen Wu
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    Heekyoung Jeong, Kyungdo Han, Soon Jib Yoo, Mee Kyoung Kim
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Close layer
Original Articles
Clinical Study
Predictive Performance of Glycated Hemoglobin for Incident Diabetes Compared with Glucose Tolerance Test According to Central Obesity
Suji Yoo, Jaehoon Jung, Hosu Kim, Kyoung Young Kim, Soo Kyoung Kim, Jungwha Jung, Jong Ryeal Hahm, Jong Ha Baek
Endocrinol Metab. 2020;35(4):873-881.   Published online December 23, 2020
DOI: https://doi.org/10.3803/EnM.2020.798
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  • 2 Web of Science
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AbstractAbstract PDFSupplementary MaterialPubReader   ePub   
Background
To examine whether glycated hemoglobin (HbA1c) test would be a suitable screening tool for detecting high-risk subjects for diabetes compared to oral glucose tolerance test (OGTT) according to accompanied central obesity.
Methods
In this prospective population-based cohort study, both OGTT and HbA1c tests were performed and continued every 2 years up to 12 years among individuals with non-diabetic state at baseline (aged 40 to 69 years, n=7,512). Incident diabetes was established by a doctor, HbA1c ≥6.5%, and/or fasting plasma glucose (FPG) ≥126 mg/dL, and/or 2-hour postprandial glucose (2hPG) level based on OGTT ≥200 mg/dL. Discriminative capacities of high HbA1c (≥5.7%) versus high 2hPG (≥140 mg/dL) for predicting incident diabetes were compared using Cox-proportional hazard regression and C-index.
Results
During the median 11.5 years of follow-up period, 1,341 (17.6%) developed diabetes corresponding to an incidence of 22.1 per 1,000 person-years. Isolated high 2hPG was associated with higher risk for incident diabetes (hazard ratio [HR], 4.29; 95% confidence interval [CI], 3.56 to 5.17) than isolated high HbA1c (HR, 2.79; 95% CI, 2.40 to 3.26; P<0.05). In addition, high 2hPG provided better discriminatory capacity than high HbA1c (C-index 0.79 vs. 0.75, P<0.05). Meanwhile, in subjects with central obesity, the HR (3.95 [95% CI, 3.01 to 5.18] vs. 2.82 [95% CI, 2.30 to 3.46]) and discriminatory capacity of incident diabetes (C-index 0.75 vs. 0.75) between two subgroups became comparable.
Conclusion
Even though the overall inferior predictive capacity of HbA1c test than OGTT, HbA1c test might plays a complementary role in identifying high risk for diabetes especially in subjects with central obesity with increased sensitivity.

Citations

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  • Assessing blood sugar measures for predicting new-onset diabetes and cardiovascular disease in community-dwelling adults
    Jung-Hwan Kim, Yaeji Lee, Chung-Mo Nam, Yu-Jin Kwon, Ji-Won Lee
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Close layer
Clinical Study
Cross-Sectional and Longitudinal Examination of Insulin Sensitivity and Secretion across Puberty among Non-Hispanic Black and White Children
Shannon E. Marwitz, Megan V. Gaines, Sheila M. Brady, Sarah J. Mi, Miranda M. Broadney, Susan Z. Yanovski, Van S. Hubbard, Jack A. Yanovski
Endocrinol Metab. 2020;35(4):847-857.   Published online November 18, 2020
DOI: https://doi.org/10.3803/EnM.2020.771
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  • 10 Web of Science
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AbstractAbstract PDFSupplementary MaterialPubReader   ePub   
Background
Few studies using criterion measures of insulin sensitivity (SI) and insulin secretory capacity (ISC) have been conducted across puberty to adulthood. We examined how SI and ISC change from pre-puberty through adulthood.
Methods
Hyperglycemic clamp studies were performed in a convenience sample of non-Hispanic Black (NHB) and White children evaluated at age 6 to 12 years and at approximately 5-year intervals into adulthood (maximum age 27 years). SI and ISC (first-phase and steady-state insulin secretion) were determined cross-sectionally in 133 unique participants across puberty and in adulthood. Additionally, longitudinal changes in SI and ISC were compared at two timepoints among three groups defined by changes in pubertal development: pre-pubertal at baseline and late-pubertal at follow-up (n=27), early-pubertal at baseline and late-pubertal at follow-up (n=27), and late-pubertal at baseline and adult at follow-up (n=24).
Results
Cross-sectionally, SI was highest in pre-puberty and early puberty and lowest in mid-puberty (analysis of covariance [ANCOVA] P=0.001). Longitudinally, SI decreased from pre-puberty to late puberty (P<0.001), then increased somewhat from late puberty to adulthood. Cross-sectionally, first-phase and steady-state ISC increased during puberty and decreased in adulthood (ANCOVA P<0.02). Longitudinally, steady-state and first-phase ISC increased from pre-puberty to late puberty (P<0.007), and steady-state ISC decreased from late puberty to adulthood. The NHB group had lower SI (P=0.003) and greater first-phase and steady-state ISC (P≤0.001), independent of pubertal development.
Conclusion
This study confirms that SI decreases and ISC increases transiently during puberty and shows that these changes largely resolve in adulthood.

Citations

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  • The relationship of changes in insulin demand and insulin adequacy over the life course
    Yingchai Zhang, Claudia H. T. Tam, Eric S. H. Lau, Noel Y. H. Ng, Aimin Yang, Baoqi Fan, Hongjiang Wu, Cadmon K. P. Lim, Elaine Y. K. Chow, Andrea O. Y. Luk, Alice P. S. Kong, Wing Hung Tam, Juliana C. N. Chan, Ronald C. W. Ma
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    Jody Beth Grundman, Elizabeth Estrada, Rachel Longendyke, Stephanie T. Chung
    Journal of Clinical Medicine.2025; 14(22): 7995.     CrossRef
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    Ioana Țaranu, Nicoleta Răcătăianu, Cristina Drugan, Cristina-Sorina Cătană, Andreea-Manuela Mirea, Diana Miclea, Sorana D. Bolboacă
    Children.2023; 10(1): 124.     CrossRef
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    Sonia M. Najjar, Sonia Caprio, Amalia Gastaldelli
    Annual Review of Physiology.2023; 85(1): 363.     CrossRef
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    Esther A. Kwarteng, Lisa M. Shank, Loie M. Faulkner, Lucy K. Loch, Syeda Fatima, Suryaa Gupta, Hannah E. Haynes, Kaitlin L. Ballenger, Megan N. Parker, Sheila M. Brady, Anna Zenno, Marian Tanofsky-Kraff, Jack A. Yanovski
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    Andrea Foppiani, Fabiana Ciciriello, Arianna Bisogno, Silvia Bricchi, Carla Colombo, Federico Alghisi, Vincenzina Lucidi, Maria Catena, Mariacristina Lucanto, Andrea Mari, Giorgio Bedogni, Alberto Battezzati
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    Diana Paola Córdoba-Rodríguez, Iris Iglesia, Alejandro Gomez-Bruton, Gerardo Rodríguez, José Antonio Casajús, Hernan Morales-Devia, Luis A. Moreno
    BMC Pediatrics.2022;[Epub]     CrossRef
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    Kyung-Soo Kim, Sangmo Hong, You-Cheol Hwang, Hong-Yup Ahn, Cheol-Young Park
    Journal of General Internal Medicine.2022; 37(16): 4153.     CrossRef
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    Veronica Maria Tagi, Sona Samvelyan, Francesco Chiarelli
    Frontiers in Endocrinology.2022;[Epub]     CrossRef
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    Stephanie T. Chung, Sheela N. Magge
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Close layer
Clinical Study
Insulin Secretion and Insulin Resistance Trajectories over 1 Year after Kidney Transplantation: A Multicenter Prospective Cohort Study
Jun Bae Bang, Chang-Kwon Oh, Yu Seun Kim, Sung Hoon Kim, Hee Chul Yu, Chan-Duck Kim, Man Ki Ju, Byung Jun So, Sang Ho Lee, Sang Youb Han, Cheol Woong Jung, Joong Kyung Kim, Su Hyung Lee, Ja Young Jeon
Endocrinol Metab. 2020;35(4):820-829.   Published online November 18, 2020
DOI: https://doi.org/10.3803/EnM.2020.743
  • 8,261 View
  • 139 Download
  • 10 Web of Science
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AbstractAbstract PDFSupplementary MaterialPubReader   ePub   
Background
We investigated the changing patterns of insulin secretion and resistance and risk factors contributing to the development of post-transplant diabetes mellitus (PTDM) in kidney recipients under tacrolimus-based immunosuppression regimen during 1 year after transplantation.
Methods
This was a multicenter prospective cohort study. Of the 168 subjects enrolled in this study, we analyzed a total 87 kidney transplant recipients without diabetes which was assessed by oral glucose tolerance test before transplantation. We evaluated the incidence of PTDM and followed up the index of insulin secretion (insulinogenic index [IGI]) and resistance (homeostatic model assessment for insulin resistance [HOMA-IR]) at 3, 6, 9 months, and 1 year after transplantation by oral glucose tolerance test and diabetes treatment. We also assessed the risk factors for incident PTDM.
Results
PTDM developed in 23 of 87 subjects (26.4%) during 1 year after transplantation. More than half of total PTDM (56.5%) occurred in the first 3 months after transplantation. During 1 year after transplantation, insulin resistance (HOMA-IR) was increased in both PTDM and no PTDM group. In no PTDM group, the increase in insulin secretory function to overcome insulin resistance was also observed. However, PTDM group showed no increase in insulin secretion function (IGI). Old age, status of prediabetes and episode of acute rejection were significantly associated with the development of PTDM.
Conclusion
In tacrolimus-based immunosuppressive drugs regimen, impaired insulin secretory function for reduced insulin sensitivity contributed to the development of PTDM than insulin resistance during 1 year after transplantation.

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    Mehdi Maanaoui, Florence Debillon, Rémi Lenain, Frédérique Defrance, Marie-Christine Vantyghem, Marine Van Triempont, François Provôt, Mikael Chetboun, Julie Kerr-Conte, Aghiles Hamroun, Marie Frimat, Violeta Raverdy, François Pattou, Marc Hazzan, Françoi
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    Lourdes Balcázar-Hernández, Victoria Mendoza-Zubieta, Baldomero González-Virla, Brenda González-García, Mariana Osorio-Olvera, Jesús Ubaldo Peñaloza-Juarez, Irene Irisson-Mora, Martha Cruz-López, Raúl Rodríguez-Gómez, Ramón Espinoza-Pérez, Guadalupe Varga
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    Lourdes Balcázar-Hernández, Victoria Mendoza-Zubieta, Baldomero González-Virla, Brenda González-García, Mariana Osorio-Olvera, Jesús Ubaldo Peñaloza-Juarez, Irene Irisson-Mora, Martha Cruz-López, Raúl Rodríguez-Gómez, Ramón Espinoza-Pérez, Guadalupe Varga
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    Arminda Fariña-Hernández, Domingo Marrero-Miranda, Estefania Perez-Carreño, Antonia De Vera-Gonzalez, Alejandra González, Cristian Acosta-Sorensen, Ana Elena Rodríguez-Rodríguez, Tatiana Collantes, Marta del Pino García, Ana Isabel Rodríguez-Muñoz, Carla
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Close layer
Review Article
Diabetes
Lessons from Use of Continuous Glucose Monitoring Systems in Digital Healthcare
Hun-Sung Kim, Kun-Ho Yoon
Endocrinol Metab. 2020;35(3):541-548.   Published online September 22, 2020
DOI: https://doi.org/10.3803/EnM.2020.675
  • 12,976 View
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AbstractAbstract PDFPubReader   ePub   
We live in a digital world where a variety of wearable medical devices are available. These technologies enable us to measure our health in our daily lives. It is increasingly possible to manage our own health directly through data gathered from these wearable devices. Likewise, healthcare professionals have also been able to indirectly monitor patients’ health. Healthcare professionals have accepted that digital technologies will play an increasingly important role in healthcare. Wearable technologies allow better collection of personal medical data, which healthcare professionals can use to improve the quality of healthcare provided to the public. The use of continuous glucose monitoring systems (CGMS) is the most representative and desirable case in the adoption of digital technology in healthcare. Using the case of CGMS and examining its use from the perspective of healthcare professionals, this paper discusses the necessary adjustments required in clinical practices. There is a need for various stakeholders, such as medical staff, patients, industry partners, and policy-makers, to utilize and harness the potential of digital technology.

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Close layer
Original Article
Clinical Study
Fasting Plasma Glucose Level Independently Predicts the Mortality of Patients with Coronavirus Disease 2019 Infection: A Multicenter, Retrospective Cohort Study
Min Cheol Chang, Jong-Moon Hwang, Jae-Han Jeon, Sang Gyu Kwak, Donghwi Park, Jun Sung Moon
Endocrinol Metab. 2020;35(3):595-601.   Published online August 26, 2020
DOI: https://doi.org/10.3803/EnM.2020.719
  • 10,552 View
  • 190 Download
  • 21 Web of Science
  • 22 Crossref
AbstractAbstract PDFSupplementary MaterialPubReader   ePub   
Background
Coronavirus disease 2019 (COVID-19) has become a global pandemic, which prompts a consensus for the necessity to seek risk factors for this critical disease. Risk factors affecting mortality of the disease remain elusive. Diabetes and hyperglycemia are known to negatively affect a host’s antiviral immunity. We evaluated the relationship between a history of diabetes, fasting plasma glucose (FPG) levels and mortality among severely ill patients with COVID-19.
Methods
This was a retrospective cohort study that assessed 106 adult inpatients (aged ≥18 years) from two tertiary hospitals in Daegu, South Korea. The participants were transferred to tertiary hospitals because their medical condition required immediate intensive care. The demographic and laboratory data were compared between COVID-19 patients who survived and those who did not.
Results
Compared with the survivor group, age, and the proportions of diabetes, chronic lung disease and FPG were significantly higher in the deceased group. In the Cox proportional hazards regression model for survival analysis, FPG level and age were identified as significant predictors of mortality (P<0.05). The threshold values for predicting high mortality were age >68 years and FPG of 168 mg/dL, respectively. Among those without diabetes, high FPG remained a significant predictor of mortality (P<0.04).
Conclusion
High FPG levels significantly predicted mortality in COVID-19, regardless of a known history of diabetes. These results suggest intensive monitoring should be provided to COVID-19 patients who have a high FPG level.

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Brief Report
Diabetes
Comparison of Serum PCSK9 Levels in Subjects with Normoglycemia, Impaired Fasting Glucose, and Impaired Glucose Tolerance
Eugene Han, Nan Hee Cho, Seong-Su Moon, Hochan Cho
Endocrinol Metab. 2020;35(2):480-483.   Published online June 24, 2020
DOI: https://doi.org/10.3803/EnM.2020.35.2.480
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AbstractAbstract PDFPubReader   ePub   
We investigated proprotein convertase subtilisin/kexin type 9 (PCSK9) concentrations in individuals with normoglycemia, impaired fasting glucose (IFG), and impaired glucose tolerance (IGT). This was a pilot, cross-sectional study including 92 individuals who had not been diagnosed with or treated for diabetes. We measured PCSK9 levels in three groups of subjects; namely, normoglycemia (n=57), IFG (n=21), and IGT (n=14). Individuals with IFG and IGT showed higher PCSK9 concentrations than those in the normoglycemic group, with the highest serum PCSK9 concentrations found in individuals with IGT (55.25±15.29 ng/mL for normoglycemia, 63.47±17.78 ng/mL for IFG, 72.22±15.46 ng/mL for IGT, analysis of variance P=0.001). There were no significant differences in high- or low-density lipoprotein cholesterol among groups. Serum PCSK9 levels are increased in patients with prediabetes compared to subjects with normoglycemia.

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Original Article
Clinical Study
Glycemic Efficacy and Metabolic Consequences of an Empagliflozin Add-on versus Conventional Dose-Increasing Strategy in Patients with Type 2 Diabetes Inadequately Controlled by Metformin and Sulfonylurea
Yujin Shin, Ji Hye Moon, Ho Jun Chin, Ele Ferrannini, Soo Lim
Endocrinol Metab. 2020;35(2):329-338.   Published online June 24, 2020
DOI: https://doi.org/10.3803/EnM.2020.35.2.329
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AbstractAbstract PDFSupplementary MaterialPubReader   ePub   
Background
We assessed the glucose-lowering efficacy of adding empagliflozin versus dose escalating existing medications in patients with uncontrolled type 2 diabetes (T2D).
Methods
This was a 6-month retrospective case-control study in subjects with uncontrolled T2D (glycated hemoglobin [HbA1c] >7%) on conventional treatment. The study group started add-on therapy with empagliflozin (10 mg once a day) while the control group was up-titrated with existing medication, using either monotherapy or a combination of metformin, sulfonylurea, and a dipeptidyl peptidase-4 inhibitor. The primary endpoints included changes in HbA1c, fasting plasma glucose (FPG), and 2-hour postprandial glucose (PP2) levels. Secondary outcomes included changes in body composition, body mass index (BMI), and serum ketone bodies, and urinary excretion of sodium, potassium, chlorine, calcium, phosphorus, and glucose.
Results
After treatment, the reduction in HbA1c was significantly greater in the empagliflozin group than in controls (from 8.6%±1.6% to 7.6%±1.5% vs. 8.5%±1.1% to 8.1%±1.1%; P<0.01). Similar patterns were found in FPG and PP2 levels. Empagliflozin decreased systolic and diastolic blood pressure, triglycerides, and alanine and aspartate aminotransferase levels. Body weight, BMI, waist circumference, fat mass, and abdominal visceral fat area decreased significantly while lean body mass was maintained. Total ketones, β-hydroxybutyrate, and acetoacetate levels increased significantly after empagliflozin.
Conclusion
In addition to glucose lowering, an empagliflozin add-on regimen decreased blood pressure and body fat, and improved metabolic profiles significantly. Empagliflozin add-on is superior to dose escalation in patients with T2D who have inadequate glycemic control on standard medications.

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Close layer
Review Article
Obesity and Metabolism
Effects of Cardiovascular Risk Factor Variability on Health Outcomes
Seung-Hwan Lee, Mee Kyoung Kim, Eun-Jung Rhee
Endocrinol Metab. 2020;35(2):217-226.   Published online June 24, 2020
DOI: https://doi.org/10.3803/EnM.2020.35.2.217
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AbstractAbstract PDFPubReader   ePub   
Innumerable studies have suggested “the lower, the better” for cardiovascular risk factors, such as body weight, lipid profile, blood pressure, and blood glucose, in terms of health outcomes. However, excessively low levels of these parameters cause health problems, as seen in cachexia, hypoglycemia, and hypotension. Body weight fluctuation is related to mortality, diabetes, obesity, cardiovascular disease, and cancer, although contradictory findings have been reported. High lipid variability is associated with increased mortality and elevated risks of cardiovascular disease, diabetes, end-stage renal disease, and dementia. High blood pressure variability is associated with increased mortality, myocardial infarction, hospitalization, and dementia, which may be caused by hypotension. Furthermore, high glucose variability, which can be measured by continuous glucose monitoring systems or self-monitoring of blood glucose levels, is associated with increased mortality, microvascular and macrovascular complications of diabetes, and hypoglycemic events, leading to hospitalization. Variability in metabolic parameters could be affected by medications, such as statins, antihypertensives, and hypoglycemic agents, and changes in lifestyle patterns. However, other mechanisms modify the relationships between biological variability and various health outcomes. In this study, we review recent evidence regarding the role of variability in metabolic parameters and discuss the clinical implications of these findings.

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Close layer
Original Article
Clinical Study
Vitamin D Deficiency at Mid-Pregnancy Is Associated with a Higher Risk of Postpartum Glucose Intolerance in Women with Gestational Diabetes Mellitus
Kyung-Soo Kim, Seok Won Park, Yong-Wook Cho, Soo-Kyung Kim
Endocrinol Metab. 2020;35(1):97-105.   Published online March 19, 2020
DOI: https://doi.org/10.3803/EnM.2020.35.1.97
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  • 13 Crossref
AbstractAbstract PDFPubReader   ePub   
Background

To evaluate the association between serum 25-hydroxyvitamin D (25(OH)D) at mid-pregnancy and postpartum glucose intolerance in women with gestational diabetes mellitus (GDM).

Methods

We enrolled 348 pregnant women diagnosed with GDM from August 2012 to October 2016. We measured serum 25(OH)D levels at mid-pregnancy and carried out a 75-g oral glucose tolerance test at 6 to 12 weeks after delivery. Vitamin D deficiency was defined as serum 25(OH)D <20 ng/mL.

Results

The prevalence of vitamin D deficiency was 76.7% (n=267). Women with vitamin D deficiency had a higher prevalence of postpartum glucose intolerance than did those without vitamin D deficiency (48.7% vs. 32.1%, P=0.011). Serum 25(OH)D level was negatively correlated with hemoglobin A1c at antepartum and postpartum period (antepartum: r=−0.186, P=0.001; postpartum: r=−0.129, P=0.047). Homeostasis model assessment of β-cell function was positively correlated with serum 25(OH)D level only postpartum (r=0.138, P=0.035). The risk of postpartum glucose intolerance was 2.00 times (95% confidence interval, 1.13 to 3.55) higher in women with vitamin D deficiency than in those without vitamin D deficiency (P=0.018).

Conclusion

In women with GDM, vitamin D deficiency at mid-pregnancy is associated with an elevated risk of postpartum glucose intolerance.

Citations

Citations to this article as recorded by  
  • Prevalence of Vitamin D Deficiency in Pregnant Women: Systematic Review and Meta-analysis
    Milena Martello Cristófalo, Júlio Oliva de Almeida Garcia, José Fernando Santos Aldrighi, Renan Martello Cristófalo, Maria Laura Marconi França, Liania Alves Luzia, Suleima Pedroza Vasconcelos, José Mendes Aldrighi
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    Rakesh Kumar Gupta, Sonal Tiwari, Sakshi Agarwal, Amita Diwakar, Pawan K. Dubey
    Diabetology & Metabolic Syndrome.2025;[Epub]     CrossRef
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    Sathaphone Inthavong, Phudit Jatavan, Theera Tongsong
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Close layer
Case Report
Evaluation of Glucone Tolerance and Insulin Secretion in Two Patients with Primary Hyperparathyroidism Before and After Surgery.
Sung Hee Ihm, Moon Gi Choi, Hyung Joon Yoo, Sang Hyun Chun, Yong Seok Choi, Gun Yong Lee, In Seo Lim, Sung Woo Park
J Korean Endocr Soc. 1994;9(1):54-58.   Published online November 6, 2019
  • 1,819 View
  • 22 Download
AbstractAbstract PDF
It is reported that patients with primary hyperparathyroidism(PHPT) have disturbances in carbohydrate metabolism: in particular, hyperinsulinemia and insulin resistance are characteristic early metabolic aberrations of this disease. However, it is not clear whether changes of insulin secretion or insulin sensitivity are observed in all patients with PHPT, including those with normal glucose tolerance. Also, it is not clear whether these changes are reversible after surgical correction of PHPT. In the present study, glucose tolerance and insulin secretion were evaluated in 2 symptomatic patients with PHPT during 100g oral glucose tolerance test before and after parathyroid adenoma removal. Comparing these patients before and after surgery, glucose tolerance was not significantly different. However, C-peptide and insulin secretion was low after surgical correction of PHPT compared to the preoperative situation. This observation suggests that insulin hypersecretion in patients with PHPT precedes glucose intolerance and this early disturbance is reversible after surgery.
Close layer
Review Article
Diabetes
A Review of the Effects of Glucagon-Like Peptide-1 Receptor Agonists and Sodium-Glucose Cotransporter 2 Inhibitors on Lean Body Mass in Humans
Jack Alistair Sargeant, Joseph Henson, James Adam King, Thomas Yates, Kamlesh Khunti, Melanie Jane Davies
Endocrinol Metab. 2019;34(3):247-262.   Published online September 26, 2019
DOI: https://doi.org/10.3803/EnM.2019.34.3.247
  • 24,244 View
  • 742 Download
  • 150 Web of Science
  • 161 Crossref
AbstractAbstract PDFPubReader   ePub   

Weight loss is an important goal in the management of several chronic conditions, including type 2 diabetes mellitus, and pharmacological therapies that aid weight loss are appealing. Glucagon-like peptide-1 receptor agonists (GLP-1RAs) and sodium-glucose cotransporter 2 inhibitors (SGLT2is) are novel glucose-lowering therapies that have been shown to induce clinically significant reductions in body weight. However, this weight loss may not be attributed solely to fat mass (FM). Given the importance of skeletal muscle and lean body mass (LBM) on cardio-metabolic health and physical function, we reviewed the available literature reporting the effects of GLP-1RAs and SGLT2is on body composition. Results demonstrate that, in most circumstances, the weight loss associated with both therapies predominantly comprises a reduction in FM, although significant heterogeneity exists between studies. In over half of the studies identified, the proportion of LBM reduction ranged between 20% and 50% of total weight lost, which is consistent with diet-induced weight loss and bariatric surgery. No clear differences existed between GLP-1RAs and SGLT2is. Consequently, the loss of LBM and skeletal muscle associated with weight loss induced by GLP-1RAs and SGLT2is warrants attention. Strategies to preserve skeletal muscle and improve physical function, for example through structured exercise, are of great importance.

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