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Effect of Glucose Control, SDSCA and Quality of Life of D-chiro-inositol(DCI) in patients with type 2 diabetes: A Path Analysis

제2형 당뇨병 환자의 D-chiro-inositol의 혈당강하 효과와 당뇨 자가관리 및 삶의 질: 경로분석

  • Kang, Young Mi (Research Center for Endocrine and Metabolic Diseases, Chungnam National University Hospital) ;
  • Kim, Hyun Jin (Division of Endocrinology and Metabolism, Chungnam National University Hospital) ;
  • Lee, Tae-Yong (Department of Preventive Medicine, Chungnam National University College of Medicine) ;
  • Ku, Bon-Jeong (Division of Endocrinology and Metabolism, Chungnam National University Hospital)
  • 강영미 (충남대학교병원 내분비대사질환특성화연구센터) ;
  • 김현진 (충남대학교병원 내분비대사내과) ;
  • 이태용 (충남대학교 의과대학 예방의학교실) ;
  • 구본정 (충남대학교병원 내분비대사내과)
  • Received : 2018.07.04
  • Accepted : 2018.10.05
  • Published : 2018.10.31

Abstract

This study aimed to investigate the effects of DCI on glucose control, quality of life(SF-36 Version 2.0, Korean) and SDSCA(Summary of Diabetes Self-Care Activities) in patients with type 2 diabetes mellitus. A randomized, double-blind, placebo-controlled study was performed on 46 patients with HbA1c 7.0% taking triple anti-diabetic drug regimen who visited the department of Endocrinology and Metabolism in Chungnam National University Hospital between March 2015 and May 2016. As a result, DCI treatment in the intervention group resulted in significantly reduced HbA1c levels $8.75{\pm}0.79%$(baseline), $8.36{\pm}1.03%$(after 12weeks), and $8.65{\pm}0.81%$(after 24weeks). However, patients in the control group did not show any significant change. Interestingly, both DCI treatment group and the control group significantly showed improvements in SDSCA. Participants in the intervention group showed a small yet significant improvement in their only fasting blood glucose test in SDSCA and revealed significant increase in the quantitative levels of quality of life, from $73.05{\pm}16.85$ to $82.74{\pm}10.68$. By using pathway analysis, improvement of SDSCA scores(${\beta}=-0.505$, t=-2.743) was the most influential factor to the fasting blood glucose. The quality of life of patients with type 2 diabetes mellitus was affected by changes of SDSCA scores(${\beta}=0.411$, t=2.024) and fasting c-peptide(${\beta}=-0.445$, t=-2.668) in DCI treatment group. In conclusion, treatment of DCI effectively improved glucose control in patients with type 2 DM(HbA1c level>7.0%) after 12 weeks of treatment, although it had no impact on glucose control after 24 weeks of treatment. Improved glucose control may encourage diabetic patients to conduct self-care activities and improve the quality of life. Based on the present study, we suggest that diabetes self-management, as well as consideration of comprehensive laboratory findings, may be important factor in regulating the quality of life in type 2 DM patients.

Keywords

Type 2 diabetes mellitus;D-chiro-inositol;Glucose Control;SDSCA;Quality of Life

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