대한지역사회영양학회지 (Korean Journal of Community Nutrition)

대한지역사회영양학회 (The Korean Society of Community Nutrition)
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영양관리과정에 의한 영양상담이 제 2형 당뇨병 환자의 식사요법 실천과 혈당 조절에 미치는 영향

Effect of Nutrition Counseling by Nutrition Care Process on Diet Therapy Practice and Glycemic Control in Type 2 Diabetic Patients

  • 배태정 (순천향대학교 부속 구미병원 영양팀) ;
  • 전나은 (영남대학교 식품영양학과) ;
  • 최수경 (울산과학대학교 식품영양학과) ;
  • 서정숙 (영남대학교 식품영양학과)
  • 투고 : 2020.06.04
  • 심사 : 2020.06.23
  • 발행 : 2020.06.30
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초록

Objectives: This study examined the effects of nutrition counseling by the nutrition care process (NCP) on diet therapy practice and glycemic control in patients with type 2 diabetes mellitus. Methods: The survey was conducted on 49 patients whose hemoglobin A1c (HbA1c) level ranged from 6.5% to below 10% among patients aged 30~60s with type 2 diabetes mellitus. Nutrition counseling by the NCP process was carried out twice: first nutrition counseling and follow up counseling. The questionnaires were composed of 54 questions in five fields (general characteristics, health-related behaviors, diet therapy-related items, dietary life, diet therapy-related knowledge, diet therapy-related barriers). Nutrition intervention in nutrition counseling was performed based on the individualized diagnosis of NCP. Results: All the subjects practiced self-monitoring of their blood glucose levels, regular exercise, and diet therapy after NCP-based nutrition counseling. Diet therapy-related knowledge and practice by the subjects were improved after nutrition counseling. While the intake of boiled white rice decreased, the intake of boiled brown rice and barley rice in the subjects increased significantly. After nutrition counseling, the weight and HbA1c of the subjects decreased. Conclusions: These results suggest that personalized nutrition counseling by NCP process is effective for diet therapy compliance and glycemic control of type 2 diabetic patients.

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참고문헌

  1. International Diabetes Federation. IDF Diabetes atlas ninth edition 2019 [Internet]. International Diabetes Federation; 2020 [cited 2020 Apr 22]. Available from: https://diabetesatlas.org/upload/resources/material/20200302_133351_IDFATLAS9e-finalweb.pdf#page=38&zoom=auto.
  2. Korean Diabetes Association. Diabetes fact sheet in Korea 2018 [Internet]. Korean Diabetes Association; 2018 [cited 2018 May 23]. Available from: http://www.diabetes.or.kr/pro/news/admin.php?code=admin&category=A&number=1546&mode=view.
  3. Lee SH, Kim HL. Comparison of health behaviors, diabetes mellitus (DM) management and health-related quality of life (HRQoL) between DM groups with and without diabetic education experience. Korean Society Rural Med Community Health 2018; 43(2): 85-96.
  4. Choi KI, Jung DY. The relationships between knowledge of diabetes, barrier and compliance with sick role behavior of diabetic patients. Health Nurs 2010; 22(2): 13-26.
  5. Kang JK. Special edition: Concept of lifestyle-related disease. Korean J Med 2003; 65(1): 121-126.
  6. Yoo JS, Lee SJ, Lee HC, Kim SH, Kang ES, Park EJ. The effects of short term comprehensive life style modification program on glycemic metabolism, lipid metabolism and body composition in type 2 diabetes mellitus. J Korean Acad Nurs 2004; 34(7): 1277-1287. https://doi.org/10.4040/jkan.2004.34.7.1277
  7. Funnell M, Donnelly M, Anderson R, Johnson P, Oh M. Perceived effectiveness, cost and availability of diabetes patient education methods and materials. Diabetes Educ 1992; 18(2): 139-145. https://doi.org/10.1177/014572179201800207
  8. Lee JH, Jeon HJ, Kim KA, Nam HW, Woo JT, Ahn KJ. Diabetes education recognition program. J Korean Diabetes 2012; 13(4): 219-223. https://doi.org/10.4093/jkd.2012.13.4.219
  9. Jun JE, Lee YM, Oh YJ. A factor analysis study on blood glucose control in diabetics mellitus patients (1)-focus on blood glucose control and lifestyle factors. Korean J Community Nutr 2009; 14(2): 236-244.
  10. Raidl M, Spain K, Lanting R, Lockard M, Johnson S, Spencer M et al. The healthy diabetes plate [Internet]. Centers for Disease Control and Prevention; 2007 [cited 2018 May 23]. Available from: http://www.cdc.gov/pcd/issues/2007.jan/06_0050.htm.
  11. Hu FB, Manson JE, Stampfer MJ, Colditz G, Liu S, Solomon CG et al. Diet, lifestyle, and the risk of type 2 diabetes mellitus in women. N Engl J Med 2001; 345(11): 790-797. https://doi.org/10.1056/NEJMoa010492
  12. American Dietetic Association. International dietetics and nutrition terminology (IDNT) reference manual: standardized language for the nutrition care process. Chicago: American Dietetic Association; 2008.
  13. Seo J S, K im E M, P ark M S, S on JM, Woo MH, Wie KE et al. Job standards and practical toolkits for clinical nutrition therapy: diabetes mellitus.cancer.dyslipidemia. Sejong: Ministry of Health and Welfare; 2014. p. 3-68.
  14. Chang MH, Jung SJ. Effects of nutrition education and exercise program on obesity index and behavioral modification in moderate obese women. Korean J Community Nutr 2018; 23(4): 318-332. https://doi.org/10.5720/kjcn.2018.23.4.318
  15. Yeo SJ, Kim BH. Effects of an intensive management program for diabetic patients on a blood biochemical profile and diabetes knowledge. Korean J Community Nutr 2018; 23(2): 148-161. https://doi.org/10.5720/kjcn.2018.23.2.148
  16. Hoogeveen EK, Kostense PJ, Beks PJ, Mackaay AJ, Jakobs C, Bouter LM et al. Hyperhomocysteinemia is associated with an increased risk of cardiovascular disease, especially in noninsulin-dependent diabetes mellitus: a population-based study. Arterioscler Thromb Vasc Biol 1998; 18(1): 133-138. https://doi.org/10.1161/01.ATV.18.1.133
  17. Choe SJ, Park HR, Park DY, Ahn HS. A study on the sociopsychological factors influencing the dietary compliance of diabetics by using focus group interview. Korean J Community Nutr 2000; 5(1): 23-35.
  18. Coppell KJ, Kataoka M, Williams SM, Chisholm AW, Vorgers SM, Mann JI. Nutritional intervention in patients with type 2 diabetes who are hyperglycaemic despite optimised drug treatmentlifestyle over and above drugs in diabetes (LOADD) study: randomised controlled trial. BMJ 2010; 341: c3337. https://doi.org/10.1136/bmj.c3337
  19. Liu H, Zhang M, Wu X, Wang C, Li Z. Effectiveness of a public dietitian-led diabetes nutrition intervention on glycemic control in a community setting in China. Asia Pac J Clin Nutr 2015; 24(3): 525-532.
  20. Chin YR, So ES, Lee HY. A meta-analysis of Korean diabetes patient studies from 1977 to 2008. J Korean Public Health Nurs 2011; 25(1): 5-16. https://doi.org/10.5932/JKPHN.2011.25.1.005
  21. Kim HS. Role of diabetes educators and effectiveness of diabetes education. J Korean Diabetes 2013; 14(4): 194-198. https://doi.org/10.4093/jkd.2013.14.4.194
  22. Korea Centers for Disease Control and prevention. Diabetes management status among adults in Republic of Korea, 2008-2012 [Internet]. Korea Centers for Disease Control and prevention; 2014 [cited 2018 May 23]. Available from: https://www.cdc.go.kr/board/board.es?mid=a20602010000&bid=0034&list_no=60457&act=view
  23. Lim HS, Chyun JH, Kim YS, Nam MS. Effect of nutrition education on diabetic management in diabetic patients. J Nutr Health 2001; 34(1): 69-78.
  24. Stratton IM, Adler AI, Neil HA, Matthews DR, Manley SE, Cull CA et al. Association of glycaemia with macrovascular and microvascular complications of type 2 diabetes (UKPDS 35): prospective observational study. BMJ 2000; 321(7258): 405-412. https://doi.org/10.1136/bmj.321.7258.405
  25. Song MS, Song KH, Ko SH, Ahn YB, Kim JS, Shin JH et al. The long-term effect of a structured diabetes education program for uncontrolled type 2 diabetes mellitus patients-a 4-year follow-up. Diabetes Metab J 2005; 29(2): 140-150.
  26. Korea Centers for Disease Control and prevention. National Health Statistics 2015 [Internet]. Korea Centers for Disease Control and prevention; 2016 [cited 2020 Jun 26]. Available from: https://knhanes.cdc.go.kr/knhanes/sub04/sub04_03.do?classType=7
  27. Statistics Korea. Cause of death statistics [Internet]. Statistics Korea; 2019 [cited 2020 Jun 17]. Available from: https://www.kostat.go.kr/portal/korea/kor_nw/1/6/2/index.board?bmode=read&bSeq=&aSeq=377606&pageNo=1&rowNum=10&navCount=10&currPg=&searchInfo=&sTarget=title&sTxt=.
  28. Song KE, Kim DJ, Park JW, Cho HK, Lee KW, Huh KB. Clinical characteristics of Korean type 2 diabetic patients according to insulin secretion and insulin resistance. J Korean Diabetes Assoc 2007; 31(2): 123-129. https://doi.org/10.4093/jkda.2007.31.2.123
  29. Pastors JG, Franz MJ, Warshaw H, Daly A, Arnold MS. How effective is medical nutrition therapy in diabetes care? J Am Diet Assoc 2003; 103(7): 827-831. https://doi.org/10.1016/S0002-8223(03)00466-8
  30. Wannamethee SG, Shaper AG, Perry IJ, Alberti KG. Alcohol consumption and the incidence of type II diabetes. J Epidemiol Community Health 2002; 56(7): 542-548. https://doi.org/10.1136/jech.56.7.542
  31. Lee NH, Park YM, Joung HS. A study on diet education of participants in diabetic education at public health center. J Korean Diet Assoc 2007; 13(1): 84-93.
  32. Pan XR, Li GW, Hu YH, Wang JX, Yang WY, An ZX et al. Effects of diet and exercise in preventing NIDDM in people with impaired glucose tolerance: The Da Qing IGT and Diabetes Study. Diabetes Care 1997; 20(4): 537-544. https://doi.org/10.2337/diacare.20.4.537
  33. Knowler WC, Barrett-Connor E, Fowler SE, Hamman RF, Lachin JM, Walker EA et al. Reduction in the incidence of type 2 diabetes with lifestyle intervention or metformin. N Engl J Med 2002; 346(6): 393-403. https://doi.org/10.1056/NEJMoa012512
  34. Kawamori R, Tajima N, Iwamoto Y, Kashiwagi A, Shimamoto K, Kaku K. Voglibose for prevention of type 2 diabetes mellitus: a randomised, double-blind trial in Japanese individuals with impaired glucose tolerance. Lancet 2009; 373(9675): 1607-1614. https://doi.org/10.1016/S0140-6736(09)60222-1
  35. Cho JW. Coaching for self-management of diabetes in medical nutrition therapy. J Korean Diabetes 2019; 20(3): 181-189. https://doi.org/10.4093/jkd.2019.20.3.181
  36. Kang HJ. Current status and effects of nutrition education programs for diabetic patients in Korea. J Korean Diabetes 2018; 19(2): 106-112. https://doi.org/10.4093/jkd.2018.19.2.106
  37. Park GS, Ly SY. Compliance and need assessment for diet therapy among diabetics and their caregivers. Korean J Community Nutr 2003; 8(1): 91-101.
  38. Lee SL, Kim YL, Lee SJ, Cho YK, Choi YK, Chun CH et al. Effects of diabetes education on diabetic management in noninsulin- dependent diabetics mellitus patients. J Korean Diet Assoc 2004; 10(3): 300-308.
  39. Kim DE, Hong SH, Kim JM. The relations between diabetic dietary compliance, dietary intake, and physical activity and the prevalence of metabolic syndrome (MS) in Type 2 diabetic patients. Korean J Community Nutr 2015; 20(5): 351-361. https://doi.org/10.5720/kjcn.2015.20.5.351
  40. Porter JM, Devine A, Vivanti A, Ferguson M, O'sullivan TA. Development of a nutrition care process implementation package for hospital dietetic departments. Nutr Diet 2015; 72(3): 205-212. https://doi.org/10.1111/1747-0080.12169
  41. Charney P. The nutrition care process and the nutrition support dietitian. Support Line 2007; 29(4): 18-22.
  42. Lee GJ. Nutrition care process and diabetes: Focus on nutrition diagnosis. J Korean Diabetes 2012; 13(1): 48-51. https://doi.org/10.4093/jkd.2012.13.1.48
  43. Corado L, Pascual R. Successes in implementing the nutrition care process and standardized language in clinical practice. Proceedings of ADA 2008 Food & Nutrition conference & Expo; 2008 Oct 26; Chicago, IL: p. A42.