Journal of agricultural medicine and community health (농촌의학ㆍ지역보건)

Korean Society for Rural Medicine and Community Health (한국농촌의학지역보건학회)
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The Level of Diabetes Management of Agriculture, Forestry, and Fishery Workers

농림어업인의 당뇨병 관리 수준

  • Oh, Gyung-Jae (Department of Preventive Medicine & Institute of Wonkwang Medical Science, Wonkwang University School of Medicine) ;
  • Lee, Young-Hoon (Department of Preventive Medicine & Institute of Wonkwang Medical Science, Wonkwang University School of Medicine)
  • 오경재 (원광대학교 의과대학 예방의학교실 및 원광의과학연구소) ;
  • 이영훈 (원광대학교 의과대학 예방의학교실 및 원광의과학연구소)
  • Received : 2017.06.20
  • Accepted : 2017.09.09
  • Published : 2017.09.29
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Abstract

Objectives: The purpose of this study was to compare the diabetic management indicators between agriculture, forestry, and fishery workers (AFF) and other occupational adults (non-AFF) in community-dwelling diabetes. Methods: The study population consisted of 22,127 diabetic population ${\geq}19years$ who participated in the 2015 Community Health Survey. Chi-square test and logistic regression analysis was used to compare the diabetic management indicators between AFF and non-AFF. Socioeconomic characteristics such as age, gender, education level, monthly household income, National Basic Livelihood Security status, and marital status was sequentially adjusted. Results: Among total diabetic population, 3,712 people (16.8%) was AFF and 18,415 people (83.2%) was non-AFF. The fully-adjusted odds ratio [OR] (95% confidence interval [CI]) of current non-medical treatment (0.72, 0.66-0.79), measurement of hemoglobin A1c (0.61, 0.55-0.67), screening for diabetic retinopathy (0.76, 0.70-0.83), screening for diabetic nephropathy (0.75, 0.70-0.81), non-alcoholic or moderate drinking (0.70, 0.64-0.78), nutrition label reading (0.83, 0.71-0.98), low salt preference (0.85, 0.78-0.93), dental examination (0.60, 0.54-0.66), scaling experience (0.84, 0.77-0.93), regular toothbrushing (0.66, 0.58-0.76), and diabetes management education (0.84, 0.77-0.92) was significantly lower in AFF compared to non-AFF. In contrast, the fully-adjusted OR (95% CI) of AFF's low stress level (1.39, 1.26-1.52) and adequate sleep duration (1.22, 1.13-1.32) was significantly higher than non-AFF, which are better indicators of diabetic management in AFF. Conclusions: Overall, the level of diabetes management of AFF was not as good as that of non-AFF. In order to improve the level of diabetes management of AFF, a delicate diabetes intervention strategy considering the occupational characteristics of AFF will be needed.

본 연구는 당뇨병이 있는 지역사회 성인을 대상으로 농림어업인과 비농림어업인으로 구분하여 당뇨병 관리 지표들의 차이를 살펴보았으며, 특히 다양한 사회경제적 특성들을 보정한 이후에도 직업에 따른 유의한 차이가 나타나는지를 평가하였다. 2015년 지역사회건강조사에 참여한 대상자 중, 당뇨병을 진단받은 19세 이상 22,127명을 분석대상으로 하였다. 카이제곱검정과 로지스틱 회귀분석을 이용하여 농림어업인과 비농림어업인 간의 당뇨병 관리 수준을 비교하였다. 성, 연령, 교육 수준, 월평균 가구소득, 국민기초생활수급, 혼인상태의 사회경제적 상태를 순차적으로 보정하여 교차비(odds ratio; OR)와 95% 신뢰구간(confidence interval; CI)을 산출하였다. 연구결과, 당뇨병 대상자 중 농림어업인은 3,712명(16.8%), 비농림어업인은 18,415명(83.2%)이었다. 모든 사회경제적 상태를 보정한 후, 비농림어업인에 비해 농림어업인에서의 교차비(OR, 95% CI)는 당뇨병 비약물요법(0.72, 0.66-0.79), 당화혈색소 측정(0.61, 0.55-0.67), 당뇨병성 안질환 검사(0.76, 0.70-0.83), 당뇨병성 신장질환 검사(0.75, 0.70-0.81), 비음주 또는 적정음주(0.70, 0.64-0.78), 영양표시 독해(0.83, 0.71-0.98), 저염 선호(0.85, 0.78-0.93), 구강검진(0.60, 0.54-0.66), 스케일링(0.84, 0.77-0.93), 정기적 칫솔질(0.66, 0.58-0.76), 당뇨병 관리교육(0.84, 0.77-0.92)이 유의하게 낮았다. 반면, 농림어업인에서의 낮은 스트레스(1.39, 1.26-1.52)와 적정 수면시간(1.22, 1.13-1.32)의 교차비는 비농림어업인에 비해 유의하게 높았다. 전반적으로 농림어업인의 당뇨병 관리 지표들의 수준은 비농림어업인에 비해 양호하지 못하였다. 농림어업인의 당뇨병 관리 수준을 개선하여 합병증을 예방하고 건강관련 삶의 질을 향상시키기 위해서는 농림어업인의 직업적 특성을 고려한 특화된 당뇨병 개입전략이 필요하다.

Keywords

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