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Impact of age at diagnosis of type 2 diabetes on metabolic manifestations of diabetic ketoacidosi

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Impact of age at diagnosis of type 2 diabetes on metabolic manifestations of diabetic ketoacidosi

내분비대사내과

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한지현, 진준, 정진욱, 조동혁, 정동진, 정민영

Aim: The aim of this study was to investigate whether there are any differences in the manifestations of diabetic ketoacidosis (DKA) and in recurrence rate of DKA according to an age at diagnosis of type 2 diabetes. Methods: We enrolled 61 type 2 diabetic patients who presented with diabetic ketoa- cidosis from 2003 to 2015. We obtained clinical, biochemical and recurrence rate data from electronic records. The subjects were divided into two groups based on the age at diagnosis of diabetes: age of diagnosis ≥ 40 years and age of diagnosis <40 years. Mean follow-up period was 19.9 months (range 0-118). Results: There were no significant differences of body mass index, glucose levels, triglyceride levels and HbA1c levels between two groups at the presentation of DKA. There was no significant difference in frequency of severe DKA between two groups. In addition, there was no sig- nificant difference in recurrence rate of DKA between two groups during the follow-up period. Conclusions: Our results suggest that younger age at diagnosis of type 2 diabetes is not associated with poor metabolic conditions in regards to DKA, compared with usual age at diagnosis of type 2 diabetes.

S-428

단기간 인슐린 치료를 시행한 2형 당뇨병 환자의 인슐린 중단시점 예측 인자

좋은강안병원 내과

이용재

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, 박홍민, 김원진

서론: 혈당 조절이 불량한2형 당뇨병 환자에게 인슐린 치료를 시행하였을 때, 다양한 임상 변수를 확인하여 치료 종료 시점의 변화와 초기 당화혈색소와 임상 변수의 상관관계를 알아본다. 방법: 본원에서 2012년 1월부터 2015년 5월까지 당화혈색소가 9% 이상으로 혈당조절이 불량하여 인슐린 치료를 시행한 722명 의 2 형 당뇨병 환자를 대상으로 연구를 진행하였다. 임상 증상 및 자가 혈당 모니터링 결과의 호전을 인슐린 중단 시점으로 정했다. 인슐린과 경구약제 병용요 법을 시작했을 때(Insulin/+)와 인슐린 치료 중단 후 경구약제 단일요법으로 전환했을 때(Insulin/-) 임상 변수의 변화(∆), 초기 당화혈색소와 변화의 상관관 계를 알아보았다. 결과: 인슐린 치료를 시행한 기간은 평균 5개월이었고, 단기간 인슐린 치료 전후의 임상적 변화는 다음과 같다(표 1). 당화혈색소 및 공복 혈 당이 각각 7.30±1.52%, 136.74±47.63 mg/dL으로 감소했을 때 임상 증상의 호전을 보이며 인슐린 치료를 종료할 수 있었다. 초기 당화혈색소에 따른 임상 변 수 변화의 상관관계 분석에서 BMI, FBS, Insulin, C-peptide, T. chol, LDL-chol.의 변화량이 통계학적인 의미가 있었다(표 2). 결론 및 고찰: 혈당 조절이 불 량한 2 형 당뇨병 환자의 경우 당화혈색소가 7.30±1.52% 일 때 인슐린 치료 중단을 고려해볼 수 있을 것으로 판단된다.

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