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Abstract: The relationships between insulin secretion and resistance in subjects with newly diagnosed prediabetes (preDM) and type 2 DM according to the presence of metabolic syndrome (MS) were controversial. We performed OGTT on 322 drug naive subjects with a history of hyperglycemia of ≤3 months, and divided into three groups, NGT, preDM (IFG and/or IGT), and T2DM. We also diagnosed these subjects with respect to MS according to ATP III criteria modified by Asia-Pacific guidelines and compared IGI and HOMA-IR. When compare groups stratified by the presence of MS, preDM and T2DM groups with MS showed significantly higher mean HOMA-IR and IGI than those without. When compare groups with respect to glucose tolerance, NGT, preDM, and T2DM subgroups in MS group showed significant higher HOMA-IR and lower IGI according to glucose tolerance. However, NGT, preDM, and T2DM subgroups in non-MS group showed a significant decrease in IGI but no significant difference in HOMA-IR as glucose tolerance worsened. In conclusion, deterioration in IGI and aggravation of HOMA-IR are both important in the primary pathogenesis of diabetes in those with MS. However, IGI deterioration may be the only important factor in the primary pathogenesis of T2DM in the absence of MS. [Copyright &y& Elsevier]

Abstract: Both IFG and IGT are prediabetic conditions that can progress to type 2 DM. However, previous studies have shown that these are not identical. This study was conducted on 307 drug naïve prediabetic adults who did not meet the diagnostic criteria for diabetes based on the OGTT. According to the OGTT, the subjects were divided into isolated IFG (i-IFG), isolated IGT (i-IGT), and combined glucose intolerance (CGI) group. We also measured insulin resistance indices (HOMA-IR, WBISI), an insulin secretion indices (insulinogenic index [IGI], AUC I/G0–120, disposition index [DI]), and compared each of the three groups. The OGTT measurements showed that 87 subjects were diagnosed with i-IFG, 75 subjects had i-IGT, and 145 subjects had CGI. With respect to the insulin resistance indices, HOMA-IR and WBISI were not significantly different. However, insulin secretory capacity, the IGI and DI were significantly higher for the i-IFG group. Moreover, after confounders were adjusted, HOMA-IR, IGI, AUC I/G0–120, and the DI were significantly higher for the i-IFG group and WBISI was significantly higher for the i-IGT group. These results demonstrate that the pathogenesis of IFG is more closely associated with insulin resistance, and the pathogenesis of IGT is more closely associated with impaired insulin secretion. [ABSTRACT FROM AUTHOR]

Abstract: We analyzed the medical records of 884 type 2 DM patients who were taking different antiplatelet agents for more than 2 years. Based on the records, occurrences of cardiovascular events for 10 years were evaluated. The composite disease-free survival rate for cilostazol monotherapy group was similar to aspirin subgroup (p =0.133). [ABSTRACT FROM AUTHOR]

Abstract: Introduction: In recent studies, apolipoprotein E (apo E) genetic polymorphism in association with dyslipidemia have been proposed as the one of the risk factors for the development of diabetic nephropathy. We found that type 2 diabetic patients with microalbuminuria (MA) had higher plasma triglyceride levels than those with normoalbuminuria (NA) in our previous study. Therefore, we aimed for investigating the association among apo E genetic polymorphism, dyslipidemia and the development of diabetic nephropathy in type 2 diabetic patients. Method: We included 58 subjects with normoalbuminuria and 36 subjects with microalbuminuria in analysis. They were all Korean and type 2 diabetic patients who had normal renal function, history of diabetes longer than 10 years and the data of urine albumin excretion rate at 10th year diabetes duration. Mean HbA1c, plasma total cholesterol and triglyceride levels for 10 years and several clinical characteristics were examined. Apo E genotypes were confirmed by real time PCR. Results: The frequency of e3/e4 genotype (20.7% versus 5.6%, p =0.045) and E4 carrier (22.8% versus 5.9%, p =0.035) was significantly higher in NA group than in MA group. On logistic regression analysis, crude odds ratio of E2 carrier and E4 carrier were 0.833 (95% CI: 0.245–2.833) and 0.205 (95% CI: 0.043–0.986), respectively. However, after adjusted by HbA1c, hypertension, total cholesterol and triglyceride, odds ratio of E2 carrier and E4 carrier were 0.664 (95% CI: 0.134–3.289) and 0.365 (95% CI: 0.061–2.187) and the association became weak. There were no correlation between apo E carrier and lipid profile. HbA1c (7.6±1.3% versus 7.0±0.9%, p =0.012) and mean creatinine (1.2±0.7mg/dL versus 1.0±0.2mg/dL, p =0.004) levels were significantly higher in MA group than in NA group as expected. Conclusions: These data suggest that E4 carrier might be associated with the protection for the development of diabetic nephropathy in type 2 diabetic patients without respect to dyslipidemia. [Copyright &y& Elsevier]