Prevalence of Diabetes and Prediabetes according to Fasting Plasma Glucose and HbA1c

전자영,고승현,권혁상,김난희,김재현,김철식,송기호,원종철,최성희,김윤아,오경원,김대중,차봉연 대한당뇨병학회 2013 Diabetes and Metabolism Journal Vol.37 No.5

Background: Due to the inconvenience of performing oral glucose tolerance tests and day to day variability in glucose level, glycated hemoglobin (HbA1c) has been recommended by the American Diabetes Association as a method to diagnose diabetes. In addition, the Korean Diabetes Association has also recommended the use of HbA1c as a diagnostic test for diabetes. In this study, we evaluated the prevalence of diabetes according to fasting plasma glucose (FPG) level only or the combination of FPG and HbA1c tests. Methods: Data from the 2011 Korea National Health and Nutrition Examination Survey (KNHANES) were analyzed. Among 5,811 subjects aged 30 years or older, 5,020 were selected after excluding the data of fasting time <8 hours, missing values from fasting glucose or HbA1c level, previous diagnosis of diabetes made by physicians, or current use of antidiabetic medications. Diabetes was defined as FPG ≥126 mg/dL, previous diagnosis of diabetes made by a medical doctor, current use of antidiabetic medications, and/or HbA1c ≥6.5%. Prediabetes was defined as FPG of 100 to 125 mg/dL and/or HbA1c of 5.7% to 6.4%. Results: When we used FPG only, the prevalence of diabetes and prediabetes were 10.5% (men, 12.6%; women, 8.5%) and 19.3%(men, 23.8%; women, 14.9%), respectively. When HbA1c was included as a diagnostic test, the prevalence of diabetes and prediabetes increased to 12.4% (men, 14.5%; women, 10.4%) and 38.3% (men, 41%; women, 35.7%), respectively. Participants with HbA1c ≥6.5% and fasting glucose level <126 mg/dL were older and had lower estimated glomerular filtration rate. Conclusion: We concluded that using fasting glucose level only may result in an underestimation of diabetes and prediabetes. HbA1c is an acceptable complementary diagnostic test for diabetes in Korean patients. However, national standardization is needed to order to use HbA1c as a diagnostic method of diabetes and prediabetes.

“You have no stomach to them”: Indigestible Revenge and Disgusting Tyranny in Antonio’s Revenge

전자영 한국셰익스피어학회 2023 셰익스피어 비평 Vol.59 No.3

In John Marston’s Antonio’s Revenge (1600), the villain Piero Sforza’s loss of tongue directly follows on the banquet scene in which the play’s revenger Antonio stewards a dessert dish containing the limbs of Piero’s young son. Taking a major departure from the revenge tragedy’s convention of making the parent unnaturally consume his own children’s flesh, Marston allows Piero no chance to eat the meal. This essay suggests that this crucial difference presents a point of contact between the conversation about male subjectivity and the early modern discourse on eating. By contextualizing the centrality of the tongue within the period’s interest in the development of interiority linked to the consumption of food, I argue that the play’s gruesome scene of tongue-cutting reflects its broader interest in nondigestive and unwholesome eating such as vomiting, over-eating, and starving. Engaged and located in the play’s rich depictions of unhealthy food-related behaviors that culminate with the final banquet, Antonio arises as the triumphant male subject who insistently beats out his enemy not only in terms of theatrical and rhetorical brilliance, but also in the culinary aspects of food making and courtly service. While his victim Piero is deprived of access to inwardness, Antonio serves as an actor for a chain of food work leading from the preparation of the sweetmeats to the amputation of the tongue, thus winning a chance to gain and manifest masculine empowerment.

극단 뜬, 구름의 『베니스의 상인』: 메타포로서의 타자-됨을 비판하기

전자영 한국셰익스피어학회 2023 셰익스피어 비평 Vol.59 No.1

Cardiovascular Safety of Sodium Glucose Cotransporter 2 Inhibitors as Add-on to Metformin Monotherapy in Patients with Type 2 Diabetes Mellitus

전자영,하경화,김대중 대한당뇨병학회 2021 Diabetes and Metabolism Journal Vol.45 No.4

Background Using real-world data, cardiovascular safety was investigated in metformin users newly starting sodium glucose cotransporter 2 (SGLT2) inhibitors compared with other glucose-lowering drugs in Korea. Methods This was a retrospective observational study using the National Health Insurance Service claims database in Korea. The study period was from September 2014 to December 2016. The study included subjects who were newly prescribed SGLT2 inhibitors or other glucose-lowering drugs while on metformin monotherapy; cohort 1 was composed of new users of SGLT2 inhibitors versus dipeptidyl peptidase-4 (DPP-4) inhibitors and cohort 2 included new users of SGLT2 inhibitors versus sulfonylureas. To balance the patient characteristics, propensity score matching was performed at a 1:1 ratio. Cardiovascular outcomes included hospitalization for heart failure (HHF), all-cause mortality, HHF plus all-cause mortality, myocardial infarction (MI), stroke, and modified major adverse cardiovascular events (MACEs). Results After propensity score matching, each cohort group was well balanced at baseline (21,688 pairs in cohort 1 and 20,120 pairs in cohort 2). As the second-line treatment, use of SGLT2 inhibitors was associated with a lower risk of HHF and HHF plus all-cause mortality compared with DPP-4 inhibitors. In addition, use of SGLT2 inhibitors versus sulfonylurea as add-on therapy to metformin was associated with decreased risks of HHF, all-cause mortality, HHF plus all-cause mortality, MI, stroke, and modified MACEs. Conclusion SGLT2 inhibitors can be a good second-line drug to reduce the incidence of cardiovascular diseases compared with DPP-4 inhibitors or sulfonylureas in people with type 2 diabetes mellitus.

Nodular lymphoid hyperplasia of the stomach in a patient with multiple submucosal tumors

전자영,임선교,김장희,이기명,조성란,한재호 대한혈액학회 2013 Blood Research Vol.48 No.4

Nodular lymphoid hyperplasia of the stomach is a rare lymphoproliferative disorder. Here, we report a 38-year-old man who presented with multiple submucosal tumors of the stomach. Histologically, the lesions were characterized by multiple discrete submucosal nodules of lymphoid cells. The infiltrates between the lymphoid follicles were composed mainly of medium-sized lymphoid cells with abundant clear cytoplasm, as well as a few large cells with vesicular nuclei. The gastric mucosa exhibited multifocal lymphoid ag-gregates and some of the epithelial cells were infiltrated by small lymphocytes mimicking lymphoepithelial lesions. Histopathology was consistent with mucosa-associated lym-phoid tissue lymphoma. However, the infiltrating lymphoid cells were positive for CD2, CD3, CD5, and CD7. In addition, polymerase chain reaction analysis of the im-munoglobulin heavy chain and T-cell receptor gene rearrangements demonstrated polyclonality. This case was diagnosed as reactive lymphoid hyperplasia of the stomach.

초등교사의 목소리를 통한 TEE 수업 실천에 대한 기반연구

전자영,김정렬 한국외국어교육학회 2022 Foreign languages education Vol.29 No.3

This study is to explore and analyze three current English teachers’ thoughts and attitudes on their TEE practices in elementary English classroom settings. Adopting a qualitative approach, data were collected through interviews, teachers’ journals, and informal communications from the three elementary school English teachers. The analysis of data revealed three main themes: 1) thoughts on effective TEE classes, 2) factors affecting TEE classes, 3) the difficulties of conducting TEE classes. The participants presented their views on effective TEE classes. They also expressed their opinion on the timing and usage of TEE. The teachers said TEE classes are influenced by teachers’ English communication ability and willingness to use English as the instructional language, students’ English proficiency and the class atmosphere. Finally, the participants said that TEE classes were difficult due to the same factors influencing TEE class effectiveness. This study has implications for the direction of TEE implementation in elementary education.

당뇨병환자에서 혈당조절의 목표

전자영,김대중 대한의사협회 2017 대한의사협회지 Vol.60 No.11

Diabetes is characterized by hyperglycemia, and chronic hyperglycemia leads to microvascular and macrovascular complications. Glycemic control is assessed and monitored by hemoglobin A1c and self-monitoring of blood glucose. Most guidelines recommend achieving hemoglobin A1c targets of <6.5% or 7%. Improved glycemic control reduces microvascular complications. However, intensive glycemic-control can have different effects on cardiovascular complications depending on the patient population. The glycemic targets should be individualized based on each patient’s characteristics, such as age, duration of diabetes, accompanying comorbidities, risk of severe hypoglycemia, life expectancy, and attitude towards treatment.

Leaky London: Permeability and Porosity of Spaces in Eastward Ho

전자영 한국중세근세영문학회 2015 고전·르네상스 영문학 Vol.24 No.1

When London is foregrounded as the most important space in Eastward Ho, it seems that the play follows the genre of city comedy’s established code of spatial setting. But London is not the only space that matters in the play. The city is presented and experienced along with other three nonurban spaces: the court, the country and the New World. By focusing on such a theatrical representation of different spaces, this essay investigates the issue of space and spatial practices in early modern England with which to go beyond a dichotomous opposition of urban and nonurban spaces. I look into each space’s individual functions and meanings but also the interrelationships among the different spaces. The nonurban spaces at once compete with and hinge on London for thematic significance. The royal court proves itself an object of social desire for Gertrude who tries to become a gentle lady by marrying Sir Petronel. The country is also at tension with the city when Gertrude runs away from it and wants to live in the country castle. Sir Petronel and his companies attempted to sail to the New World, but got shipwrecked at the Thames. This botched venture shows the ways in which the imaginary concept of the New World is intertwined with the perceptions of contemporaries on London’s cosmopolitan quality. When the play finishes by bringing all the characters back to the centripetal city, what we encounter is a variegated picture of cosmopolitan London with mobility, permeability, fluidity, and diversity. Eastward Ho, I suggest, represents the city of London in early modern England not as a single and detached entity but as a porous and permeable space. The interrelationships of the city with the three nonurban spaces reveal that spatial practices are constantly negotiated and refashioned by individual character’s experience within and without it.

Impact of Post-Transplant Diabetes Mellitus on Survival and Cardiovascular Events in Kidney Transplant Recipients

전자영,한승진,신한빛,박범희,이나미,김혜진,김대중,이관우 대한내분비학회 2023 Endocrinology and metabolism Vol.38 No.1

Background: Post-transplant diabetes mellitus (PTDM) is a risk factor for poor outcomes after kidney transplantation (KT). However, the outcomes of KT have improved recently. Therefore, we investigated whether PTDM is still a risk factor for mortality, majoratherosclerotic cardiovascular events (MACEs), and graft failure in KT recipients. Methods: We studied a retrospective cohort of KT recipients (between 1994 and 2017) at a single tertiary center, and compared therates of death, MACEs, overall graft failure, and death-censored graft failure after KT between patients with and without PTDM using Kaplan-Meier analysis and a Cox proportional hazard model. Results: Of 571 KT recipients, 153 (26.8%) were diagnosed with PTDM. The mean follow-up duration was 9.6 years. In the Kaplan-Meier analysis, the PTDM group did not have a significantly increased risk of death or four-point MACE compared with thenon-diabetes mellitus group (log-rank test, P=0.957 and P=0.079, respectively). Multivariate Cox proportional hazard modelsshowed that PTDM did not have a negative impact on death or four-point MACE (P=0.137 and P=0.181, respectively). In addition,PTDM was not significantly associated with overall or death-censored graft failure. However, patients with a long duration ofPTDM had a higher incidence of four-point MACE. Conclusion: Patient survival and MACEs were comparable between groups with and without PTDM. However, PTDM patientswith long duration diabetes were at higher risk of cardiovascular disease

Time to Reach Target Glycosylated Hemoglobin Is Associated with Long-Term Durable Glycemic Control and Risk of Diabetic Complications in Patients with Newly Diagnosed Type 2 Diabetes Mellitus: A 6-Year Observational Study (Diabetes Metab J 2021;45:368-78)

전자영 대한당뇨병학회 2021 Diabetes and Metabolism Journal Vol.45 No.4