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Knowledge and Diffusion of Knowledge for Nursing Care of Patients with Diabetes Mellitus among Clinical Nurses (우리나라 임상간호사의 당뇨병 지식 및 지식 확산도 조사연구)

  • Hong, Myeong Hee;Yoo, Joo Wha;Kim, Soon Ai;Lee, Jeong Rim;Roh, Na Ri;Park, Jeong Eun;Gu, Mee Ock
    • Journal of Korean Clinical Nursing Research
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    • v.15 no.3
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    • pp.61-74
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    • 2009
  • Purpose: In order to increase the quality of nursing care for patients with diabetes mellitus, it is important for clinical nurses to accept changes in diabetes knowledge and correct their approach immediately. This approach will also contribute to effective nursing practice. Methods: The study was designed to investigate the level of knowledge and diffusion of knowledge for nursing care of patients with diabetes mellitus among clinical nurses. It was conducted with nurses from 29 general hospitals in Korea from November 3 to December 5, 2008. The questionnaire consisted of 129 items and it was sent to the participants by mail. Of the 1,060 questionnaires returned, only 930 were valid for use in the statistical analysis. Results: 1) The average score for clinical nurses' knowledge of diabetes mellitus was 0.67 out of 1.0. 2) The level of persuasion of knowledge for nursing care of patients with diabetes mellitus averaged 0.64 out of 1.0 3) The level of practical application of knowledge for nursing care of patients with diabetes mellitus averaged 1.05 out of 2.0, indicating that they applied their knowledge 'sometimes'. 4) The level of diffusion of knowledge for nursing care of patients with diabetes mellitus was 2.37 out of 4.0 and level was estimated as the stage of 'persuasion'. 5) There were significant differences in nursing knowledge of diabetes mellitus, according to experience in practical education for diabetes mellitus. Conclusion: The results indicate that nurses with a lower level of knowledge of diabetes mellitus have a lower level of persuasion of knowledge for nursing care of patients with diabetes mellitus and lower practical application. To improve the level of nurses' knowledge of diabetes mellitus, practical training programs are needed for areas in which knowledge level is low, such as 'diagnosis and management of diabetes mellitus', 'oral diabetes medication', and 'glucose control in special conditions'.

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Association between Glycemic Index, Glycemic Load, Dietary Carbohydrates and Diabetes from Korean National Health and Nutrition Examination Survey 2005 (2005 국민건강영양조사 자료 분석을 통한 한국 성인 남녀의 식이 중 Glycemic Index, Glycemic Load 및 탄수화물 섭취 수준과 당뇨 발병과의 관련성 연구)

  • Kim, Eun-Kyung;Lee, Jung-Sug;Hong, Hee-Ok;Yu, Choon-Hie
    • Journal of Nutrition and Health
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    • v.42 no.7
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    • pp.622-630
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    • 2009
  • The purpose of this study was to establish an association between glycemic index (GI), glycemic load (GL), dietary carbohydrates and diabetes with the context of the current population dietary practice in Korea. The subjects of 3,389 adults (male 1,430, female 1,959) were divided into normal (serum fasting glucose < 100 mg/dL), impaired glucose tolerance (100 ${\leq}$ serum fasting glucose < 126 mg/dL), diabetes (serum fasting glucose > 126 mg/dL) by serum fasting glucose. Anthropometric and hematologic factors, and nutrient intakes, dietary glycemic index (DGI), dietary glycemic load (DGL) were assessed. Multiple logistic regression model was used to determine the odds ratios (ORs) and 95% confidence intervals for relationship of DGI, DGL, carbohydrates intakes, and diabetes. DGI and DGL were not significantly correlated with impaired glucose tolerance and diabetes. However, the risk of impaired glucose tolerance and diabetes showed a tendency to increase as increase of DGI after multivariate adjustment (age, education, income, region area, diabetes family history, smoking, drinking, exercise, energy intake) in male. The risk of impaired glucose tolerance and diabetes showed a tendency to increase in the DGI 71.1-74.8 after multivariate adjustment in female. DGL was inversely related to impaired glucose tolerance and diabetes in male. In female, however, DGL was positively related to impaired glucose tolerance and diabetes. In particular, the risk of diabetes increased positively in level of DGL 260.5, and remained after multivariate adjustment (Q5 vs Q1:2.38, 0.87-6.48). When percent energy intakes from carbohydrates were more than 70%, the risk of impaired glucose tolerance and diabetes increased in both male and female. In particular, when percent energy intakes from carbohydrates were more than 69.9%, the risk of diabetes increased positively in male (Q4 vs Q1:2.34, 1.16-4.17). In conclusion, above 70% energy intakes from carbohydrates appeared to be a risk factor of diabetes. It seemed that the meal with high GI and GL value must be avoided it. And also, the macronutrients of the meal must be properly balanced. In particular, it may be said that it is a preventive way for treatment of the diabetes to avoid eating carbohydrates of much quantity.

A Study on the Polymorphisms in Parotid Salivary Proteins of the Patients with Diabetes Millitus (당뇨병 환자의 이하선 타액내 단백질의 다형현상에 대한 연구)

  • Jong-Mo Ahn;Chang-Lyuk Yoon
    • Journal of Oral Medicine and Pain
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    • v.17 no.2
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    • pp.99-108
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    • 1992
  • The purpose of this study was to evaluate the polymorphosms in parotid salivary proteins of the patients with diabetes mellitus. Saliva from the parotid glands was collected from 94 healthy Korean adults who were live in Kwang-ju and from 33 diabetes mellitus patients who had more than 140mg/dl of fastingblood sugar for one week. Diabetes mellitus patient group was subdivided to insulin dependent diatetes mellitus (IDDM) and non-insulin dependent diabetes mellitus (NIDDM). In the saliva collected from the parotid glands, parotid acidic protein(Pa), proline-rich protein(Pr) and double band protein(Db) were analyzed to evaluate the distribution of phenotype using alkaline slab polyacrylamide gel electrophoresis. The results were as follows : 1. The parotid acidic protein (Pa) was found more frequently in the diabetes mellitus patient group than in the control group, but the difference was not statistically significant. 2. The Pr(1-2) type was found more frequently in the control group, but the Pr(1-1) and Pr(2-2) type were found more freqnently in the diabetes mellitus patient group and the difference of phenotypic distribution was statistically significant between the two groups. (p<0.05) 3. The parotid acidic protein(Pa) and Pr(1-2) type were found more frequently in the noninsulin dependent diabetes mellitus (NIDDM) patients than in the insulin dependent diabetes mellitus patients, though the difference was not statistically significant.

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A Survey of Knowledge of Diabetes in Patients with Type 2 Diabetes (제2형 당뇨병 환자의 질병관련 지식)

  • Kim Hee-Seung
    • Journal of Korean Academy of Fundamentals of Nursing
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    • v.11 no.1
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    • pp.67-73
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    • 2004
  • Purpose: The purpose of this study was to investigate the knowledge of diabetes and insulin use in patients with type 2 diabetes. Method: Participants (139) were recruited from the endocrinology outpatient department of a tertiary care hospital in an urban city. Knowledge of diabetes knowledge was measured by a brief diabetes knowledge test which had two components: a 14-item general test and a 9-item insulin-use subscale. Result: The average scores for knowledge of diabetes and insulin were 62.4 and 41.8 respectively. Scores were lower for items on the definition of glycosylated hemoglobin, diabetic diet, signs of ketoacidosis, and insulin reaction compared to other items. Knowledge scores were significantly lower for older participants, those who had lower levels of education, those who did not have a spouse, those who did not have a job, those who were not being treated with insulin, and those who tested their blood glucose less than 3 times a day. Conclusion: Definition of glycosylated hemoglobin, diabetic diet, signs of ketoacidosis, and insulin reaction should be included in education for patients with type 2 diabetes. Special education programs should be developed for elderly people, those with low levels of education those without a spouse, or without a job, or who are not being treated with insulin.

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Transformational Experience of a Student Nurse with Diabetes: A Case Study

  • Choi, Hye-Jung;Hong, Young-Sang
    • Journal of Korean Academy of Nursing
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    • v.37 no.2
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    • pp.192-200
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    • 2007
  • Purpose. The current study was aimed to investigate the transformational experience of a female student nurse living with type 1 diabetes. Methods. A case study of a 24-year-old diabetes patient was conducted, with interviews concerning the evolving process she had lived through during the period from her later high school years to her graduation from nursing college. Results. Followings were identified as 5-transformation process: With her diabetes-related limitation, the participant experienced 'conflict involving choosing a college and major'. The participant tried to be in charge of managing her diabetes and stepped forward to 'adaptation to college life as a new environment', and she learned more about the process of 'evolving awareness of caring' and developed herself further through the process of 'integration of the nurse identity into self-identity', and finally through the process of 'progression and preparation for getting a job' she achieved her goals, being positive about the future. Conclusions. The results of the study can provide individuals with diabetes a way of self-management and help the patients and their families in diabetes education. Further research will be needed to refine the results of this study and to learn more about the experiences of patients with type I diabetes in college years.

Hospital Nurses' Pre-diabetes Knowledge, Performance and Expectation of Patient Education (병원간호사의 당뇨병고위험군 지식, 교육수행과 기대)

  • Kim, Min Jung;Song, Misoon
    • Perspectives in Nursing Science
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    • v.12 no.1
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    • pp.33-41
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    • 2015
  • Purpose: This study attempted to describe hospital nurses' pre-diabetes knowledge, performance and expectation of patient. Methods: The total of 204 hospital nurses were administered the questionnaires. The questionnaire comprises general background information (including sex, age, religion, education and career), ten researcher-generated questions regarding knowledge about pre-diabetes, performance of patient education (including how many people encounter in workplace, how often teaching, how many minutes required to teach and course contents) and expectation (including need improvement of teaching, barrier to education and desirable course contents and teaching methods) Results: The average score of hospital nurses' pre-diabetes knowledge was as low as 0.82 (82% correctness). On comparison of the knowledge levels among ten pre-diabetes knowledge dimensions, the highest score was 0.95 for necessary of medical check-up. The lowest score was 0.57 for complication can rarely happen. Significant correlations were observed for education, career and knowledge regarding pre-diabetes. Moreover, 49.5% of the nurses did not instruct patients about pre-diabetes, 24.5% taught prevention skills to a third of the pre-diabetes patients they encountered, and 61.2% nurses disseminated information under 5 minutes. Improvement was necessary for 78 nurses (75.8%). Conclusion: Pre-diabetes awareness among nurses is necessary.

Latent Autoimmune Diabetes in Adults: A Review on Clinical Implications and Management

  • Pieralice, Silvia;Pozzilli, Paolo
    • Diabetes and Metabolism Journal
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    • v.42 no.6
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    • pp.451-464
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    • 2018
  • Latent autoimmune diabetes in adults (LADA) is a heterogeneous disease characterized by a less intensive autoimmune process and a broad clinical phenotype compared to classical type 1 diabetes mellitus (T1DM), sharing features with both type 2 diabetes mellitus (T2DM) and T1DM. Since patients affected by LADA are initially insulin independent and recognizable only by testing for islet-cell autoantibodies, it could be difficult to identify LADA in clinical setting and a high misdiagnosis rate still remains among patients with T2DM. Ideally, islet-cell autoantibodies screening should be performed in subjects with newly diagnosed T2DM, ensuring a closer monitoring of those resulted positive and avoiding treatment of hyperglycaemia which might increase the rate of ${\beta}-cells$ loss. Thus, since the autoimmune process in LADA seems to be slower than in classical T1DM, there is a wider window for new therapeutic interventions that may slow down ${\beta}-cell$ failure. This review summarizes the current understanding of LADA, by evaluating data from most recent studies, the actual gaps in diagnosis and management. Finally, we critically highlight and discuss novel findings and future perspectives on the therapeutic approach in LADA.

Clinical characteristics in Japanese children with nonobese type 2 diabetes

  • Urakami, Tatsuhiko
    • Annals of Pediatric Endocrinology and Metabolism
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    • v.23 no.3
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    • pp.113-118
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    • 2018
  • It is well known that the incidence of youth-onset type 2 diabetes is increasing worldwide. On the other hand, most studies have shown that the majority of youth-onset type 2 diabetes occurs in obese individuals, generally with a body mass index (BMI) greater than the 90th or 95th centile for sex- and age-matched children and adolescents. However, we identified some Japanese children with nonobese type 2 diabetes and BMI less than 90th centile by a urine glucose screening program at schools in the Tokyo Metropolitan Area. According to the results obtained from the screening, clinical characteristics of patients with nonobese type 2 diabetes seemed to be different from those in obese type 2 diabetes. Nonobese patients tended to show lower insulin secretion abilities and milder, but evident, insulin resistance from the time of diagnosis. Female, low birth weight (small for gestational age), and genetic background, not related to ${\beta}-cell-associated$ autoimmunity, may play a role in development of nonobese type 2 diabetes. In addition, nonobese patients tend to progress earlier to pharmacological treatment including oral hypoglycemic drugs and insulin. Further studies are needed to confirm to these findings and clarify the pathophysiology of children with nonobese type 2 diabetes.

Diabetes and Cancer: Cancer Should Be Screened in Routine Diabetes Assessment

  • Suh, Sunghwan;Kim, Kwang-Won
    • Diabetes and Metabolism Journal
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    • v.43 no.6
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    • pp.733-743
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    • 2019
  • Cancer incidence appears to be increased in both type 1 and type 2 diabetes mellitus (DM). DM represents a risk factor for cancer, particularly hepatocellular, hepatobiliary, pancreas, breast, ovarian, endometrial, and gastrointestinal cancers. In addition, there is evidence showing that DM is associated with increased cancer mortality. Common risk factors such as age, obesity, physical inactivity and smoking may contribute to increased cancer risk in patients with DM. Although the mechanistic process that may link diabetes to cancer is not completely understood yet, biological mechanisms linking DM and cancer are hyperglycemia, hyperinsulinemia, increased bioactivity of insulin-like growth factor 1, oxidative stress, dysregulations of sex hormones, and chronic inflammation. However, cancer screening rate is significantly lower in people with DM than that in people without diabetes. Evidence from previous studies suggests that some medications used to treat DM are associated with either increased or reduced risk of cancer. However, there is no strong evidence supporting the association between the use of anti-hyperglycemic medication and specific cancer. In conclusion, all patients with DM should be undergo recommended age- and sex appropriate cancer screenings to promote primary prevention and early detection. Furthermore, cancer should be screened in routine diabetes assessment.

Soluble Dipeptidyl Peptidase-4 Levels Are Associated with Decreased Renal Function in Patients with Type 2 Diabetes Mellitus

  • Cho, Eun-Hee;Kim, Sang-Wook
    • Diabetes and Metabolism Journal
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    • v.43 no.1
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    • pp.97-104
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    • 2019
  • Background: Dipeptidyl peptidase-4 (DPP-4) is strongly expressed in the kidney, and soluble levels of this protein are used as a marker in various chronic inflammatory diseases, including diabetes, coronary artery disease, and cancer. This study examined the association between the serum soluble DPP-4 levels and renal function or cardiovascular risk in patients with type 2 diabetes mellitus. Methods: In this retrospective analysis, soluble DPP-4 levels were measured in preserved sera from 140 patients with type 2 diabetes mellitus who had participated in our previous coronary artery calcium (CAC) score study. Results: The mean±standard deviation soluble DPP-4 levels in our study sample were 645±152 ng/mL. Univariate analyses revealed significant correlations of soluble DPP-4 levels with the total cholesterol (r=0.214, P=0.019) and serum creatinine levels (r=-0.315, P<0.001) and the estimated glomerular filtration rate (eGFR; estimated using the modification of diet in renal disease equation) (r=0.303, P=0.001). The associations of soluble DPP-4 levels with serum creatinine and GFR remained significant after adjusting for age, body mass index, and duration of diabetes. However, no associations were observed between soluble DPP-4 levels and the body mass index, waist circumference, or CAC score. Conclusion: These data suggest the potential use of serum soluble DPP-4 levels as a future biomarker of deteriorated renal function in patients with type 2 diabetes mellitus.