• Title/Summary/Keyword: 인슐린 비의존성 당뇨병 환자

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당뇨병 돋보기 II-당뇨병성 급성 합병증-케톤산증

  • Hong, Ji-Yeong
    • The Monthly Diabetes
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    • s.214
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    • pp.35-37
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    • 2007
  • 당뇨병환자에서 발생하는 가장 중요한 급성 합병증인 당뇨병성 케톤산증이나 고삼투성 비케톤성 혼수는 인슐린의 투여를 중단하였거나 감염, 외상 등의 신체적 손상이나 정신적 스트레스에 의하여 인슐린에 대한 길항 호르몬들이 과분비돼 발생한다. 일반적으로 당뇨병성 케톤산증은 인슐린 의존형 당뇨병환자 중 주로 젊은 층에서 자주 나타나며 병의 경과가 빠르게 진행되기 때문에 고삼투압 상태보다는 케톤산혈증이 주요 문제가 된다. 반면에 고삼투압성 비케톤성 혼수는 인슐린 비의존형 당뇨병환자 중 주로 노인층에서 호발하며 병의 경과가 서서히 진행하기 때문에 심한 고혈당 상태로 인한 고삼투압 상태가 주요 문제가 된다. 이와같은 당뇨병의 급성 대사성 합병증들은 치료가 지연되거나 적절한 치료가 행해지지 못했을 때는 예후가 극히 불량하며 사망률 또한 높은 것으로 보고되고 있다. 이에 급성 대사성 합병증 중 당뇨병성 케톤산증의 병인, 진단 및 치료 등을 알아보기로 한다.

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인슐린 비의존형 당뇨병 환자의 WHR에 따른 인체계측, 식행동, 영양소섭취, 생화학적 수치와의 관계

  • Noh, Hee-Gyung;Jung, Eun
    • Proceedings of the KSCN Conference
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    • 2004.05a
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    • pp.421-421
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    • 2004
  • 당뇨병은 급속한 경제발전과 함께 식생활의 서구화로 우리나라에서 높은 유병률을 보이는 만성퇴행성 질병의 하나이다. 당뇨병 발병에 가장 큰 영향을 미치는 위험요인으로 특히 비만을 제시하고 있다. 그 중 상체비만은 혈당, 당화혈색소 및 중성지질의 농도가 높아 당뇨병 예방과 혈당조절에 고려되어야 할 요인으로 대두되고 있다. 이에 따라 본 연구는 인슐린 비의존형 당뇨병 환자들의 인체계측과 식행동, 영양소섭취, 생화학적 수치를 상체비만의 정도를 나타내주는 지표중 하나인 허리-엉덩이둘레비 (WHR, 여자 : $\geq$ 0.85, 남자 : $\geq$ 0.95 상체비만)에 따라 비교 조사하였다.(중략)

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Effect of Short-Term Feeding of Dietary Fiber Supplements on Glucose Metabolism in Subjects with Non-Insulin-Dependent Diabetes Mellitus (단기간의 식이섬유 첨가물의 섭취가 인슐린 비의존성 당뇨병 환자의 당질대사에 미치는 영향)

  • 이연경;이혜성;김보완
    • Journal of the Korean Society of Food Science and Nutrition
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    • v.25 no.5
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    • pp.846-854
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    • 1996
  • High dietary fiber(DF) diets lower blood glucose and insulin requirements in diabetics. In this study we evaluated the effects of high dietary fiber(DF) food supplements on glucose metabolism in thirty-four subjects with non-insulin-dependent diabetes mellitus(NIDDM). The subjects were divided into three test groups. Each group's prescribed hospital diets were augmented by one of the three following DF supplements for two weeks: Soybean biscuits containing 5g of total DF-the control group(n=15); Biji biscuits containing 20g of total DF-the high insoluble DF group(n=9); and sea tangle biscuits containing 25g of total DF-the high soluble DF group(n=10). The mean daily DF intake of the subjects during the period were: $19.1\pm4.3g$ for the soybean control group; $32.5\pm4.1g$ for the Bijl group; and $38.1\pm5.5g$ for the sea tangle group. The supplementation of the Biji or sea tangle biscuits singnificantly lowered fasting serum glucose levels(p < 0.05) and resulted in the improvement of glucose tolerance. However, the secretions of insulin, C-peptide, and glucagon and Hb $A_{lc}$ concentration were not affected by the high fiber supplementary feeding for two weeks. The urinary excretion of glucose decreased remarkably after the addition of the DF supplements in all three groups(p<0.05). The results indicate that the supplementation of Biji or sea tangle bascuits possesses a beneficial effect on the improvement of glucose metabolism in subjects with NIDDM.

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Effects of Acute forest Walking Exercise on Blood Glucose of IGT, NIDDM in the Elderly (산림 걷기 운동이 내당능장애와 인슐린 비의존형 당뇨병 노인 환자의 혈당치에 미치는 효과)

  • Choi, Jong-Hwan;Shin, Won-Sop;Rho, Ki-Taek;Yeon, Poung-Sik
    • Journal of Korean Society of Forest Science
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    • v.99 no.1
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    • pp.47-51
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    • 2010
  • The purpose of this study was to analyze the effect of acute forest walking exercise on blood glucose of IGT (impaired glucose tolerance), NIDDM (non-insulin dependent diabetes mellitus) in the elderly. There were four groups (n=60): forest walking exercise with IGT group (n=15; $66.21{\pm}4.16$ yrs), forest walking exercise with NIDDM group (n=15; $64.85{\pm}3.23$ yrs), field walking exercise with IGT group (n=15; $67.44{\pm}1.78$ yrs), field walking exercise with NIDDM group (n=15; $65.55{\pm}8.21$ yrs). They were tested on blood glucose levels at the beginning and at the end of each walking exercise. While the forest walking groups (interval + resistance exercise) worked for 40minutes with HRmax 50~60% level, the field walking groups (only aerobic exercise) worked for 40 minutes with HRmax 50~60% level. For data analysis, mean and standard deviation scores were calculated, and paired t-test and ANCOVA test were used. This study resulted in as follows. First, both walking groups showed the significant decrease of blood glucose in impaired glucose tolerance (IGT) after completing each exercise. Second, while the forest walking group showed the significant decrease of blood glucose in insulin dependent diabetes mellitus (NIDDM) after completing the forest exercise, the field walking group did not present any decrease of blood glucose in NIDDM after the field walking exercise. Therefore, the present findings suggest that the forest walking exercise as an interval and resistance exercise may be more effective to decrease blood glucose for IGT and NIDDM peoples in comparison to the field walking exercise as an aerobic exercise.

Cognitive Function in Non-Insulin Dependent Diabetic Patients (인슐린 비의존성 당뇨병 환자의 인지기능)

  • Jung, Mi-Ha;So, Hee-Young
    • The Korean Journal of Rehabilitation Nursing
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    • v.8 no.1
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    • pp.38-49
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    • 2005
  • Purpose: The purpose of this study was to examine the cognitive function in NIDDM patients. Method: The data were collected at MI OPD in C University hospital. with Digit Span Forward & Backward, Trail Making Test-A, Trail Making Test-B, and MMSE. Result: There were significant differences in DF, DB, TMT-A, and TMT-B according to gender, and in TMT-A according to living with spouse and comorbidity. There were significant differences in DF, DB, TMT-A, TMT-B, and MMSE according to monthly income, and in DF, TMT-A, and TMT-B according to hypertensive state. But, there was no difference in cognitive function score according to diabetes-related complication and diabetes treatment modality. There was a significant positive correlation between duration of NIDDM and TMT-A(r=.215, p=.025). The global cognition score was explained 42.1% of varient by age, duration of education, monthly income, and hypertensive state. Conclusion: As above results showed, among age, duration of education, monthly income, and hypertensive state, prevented and managed hypertensive state which is modifiable factor may reduce or delay cognitive function impairment in NIDDM patients. And DF & DB, TMT-A & B could be more utilized as useful cognitive function measurements because those tests reflected cognitive function in NIDDM patients better than MMSE.

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Exenatide: a New Agent for the Treatment of type 2 Diabetes Mellitus as Adjunctive Therapy

  • Yoo, Ju-No;Yoo, Dong-Joo;Yoo, Bong-Kyu
    • Korean Journal of Clinical Pharmacy
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    • v.15 no.2
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    • pp.165-172
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    • 2005
  • 엑세나타이드는 2005년 4월에 미국 FDA로부터 허가된 새로운 계열의 당뇨병치료제로서 적응증은 멧포르민이나 설포닐유레아계열의 당뇨병치료제로서 치료를 받고 있음에도 불구하고 혈당이 목표치로 저하되지 않는 제2형 당뇨병환자에게 기존의 치료법에 부가적으로 사용하는 것으로 제한되어 있다. 엑세나타이드는 39개의 아미노산으로 구성되어 있으며 미국 캘리포니아주에 자생하는 도마뱀의 타액에서 유래된 물질과 조성과 기능이 유사하도록 합성된 펩타이드 약물이다. 이 약물은 혈중포도당의 농도에 의존적으로 인슐린분비를 촉진하며, 비정상적으로 높은 혈중 글루카곤농도를 저하시키며, 음식물의 위통과시간을 연장하며, 식욕을 저하시키는 등의 여러 가지 기전을 통하여 혈당을 조절하는 것으로 알려져 있다. 멧포르민으로 1일 1500 mg을 사용하고 있는데도 불구하고 당화혈색소가 7%를 초과하는 제2형 당뇨병환자 336명을 대상으로 부가적으로 30주간 엑세나타이드 $5{\mu}g$또는 $10{\mu}g$을 1일 2회 피하주사 한 임상시험결과에 의하면, 당화혈색소가 7% 미만인 환자의 비율은 intent-to-treat 로서 각각 27%와 40%로 나타났다. 이는 기존의 치료법과 위약으로 치료받은 군에서의 13%에 비하여 통계적으로 매우 유의성 있는 결과인 것으로 분석되었다(p<0.01). 또 다른 임상시험에서는 상기 임상시험과 유사한 임상시험계획을 바탕으로 하여 설포닐유레아로 치료받고 있었지만 당화혈색소가 7%를 초과하는 제2형 당뇨병환자를 대상으로 임상시험을 실시하였으며, 그 결과에 의하면 엑세나타이드와 설포닐유레아의 병용치료 시 혈당조절에 매우 유리한 것으로 나타났다. 멧포르민과 설포닐유레아의 병용요법으로 치료받고 있던 당뇨병환자를 대상으로 실시한 임상시험에서도 동일한 결과가 나타났다. 이 약의 부작용은 치료개시 후 나타나는 메스꺼움이 문제로 지적되었으며 저 혈당현상은 큰 문제가 되지 않는 것으로 나타났다. 이 약은 인슐린 대용약물이 될 수 없으며 당뇨병성 케토산증의 치료에 사용할 수 없다. 또한 이 약물은 심한 신부전이 있거나 말기신장질환 환자에게 사용해서는 안 된다.

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Effect of Foot Reflex Massage on Stress Responses, and Glucose Level of Non-Insulin Dependent Diabetes Mellitus Patients (발반사 마사지가 인슐린 비의존성 당뇨병 환자의 스트레스반응과 혈당에 미치는 효과)

  • Kim, Keum-Soon
    • The Korean Journal of Rehabilitation Nursing
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    • v.6 no.2
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    • pp.152-163
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    • 2003
  • Purpose; This study was done to investigate the effect of foot reflexology on vital signs, general fatigue, foot fatigue, mood, and blood glucose levels in noninsulin dependent patients. Method: The Research design of this study was nonequivalent control group quasi-experimental design. 18 patients were assigned to the experimental group, 24 patients to the control group. The data were obtained diaberic patients with ambulatory endocrine outpatients clinic patients from 40 years old to 70 years old. Experimental groups received foot reflex massage for 30minutes three times/week every other days, and Control groups did not received foot reflex massage. The dependent variables were blood pressure, pulse rate, visual analogue scale for general fatigue, foot fatigue, mood, and blood sugar levels. Data were analyzed with $X^2$ test, t-test and repeated measure ANOVA at .0.05 level of significance. Results: There were significant difference in the pulse rate, general fatigue, foot fatigue and mood according to group and time between pre and post foot reflexology. But this research did not prove to decrease blood sugar levels. Conclusions : Foot reflexology can imorove pulse rate, general and foot fatigue, and mood status in diabetus patients. So further research need to explore the effect of decreasing of blood sugar levels.

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Effects of Red Ginseng on the Lipid Peroxidation of Erythrocyte and Antioxidant Superoxide Dismutase (SOD) Activity In NIDDM Patients (인슐린비 의존성 당뇨병 환자에서 출상이 적혈구의 지질과산화 및 항산화효소 슈퍼옥시드 디스뮤타제에 미치는 영향)

  • 최경묵;이은종
    • Journal of Ginseng Research
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    • v.21 no.3
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    • pp.153-159
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    • 1997
  • Living organisms have antioxidant enzymes, such as superoxide dismutase, catalase SE glutathione peroxidase, that protect themselves from the toxic effect of superoxide free radicals. Some report says that intracellular oxidation stress is involved in pathogenesis of chronic complications of diabetes mellitus. This study was performed to evaluate the effect of red ginseng on lipid peroxidation of red blood cell and antioxidant SOD activity of serum in NIDDM patients. As a result, there were trends for decrease of lipid peroxidases of RBC and Increase of SOD activity of serum in ginseng group but that were not statistically significant. Therefore, we suggest long term and large sized control study is necessary to confirm the protective effects of red ginseng on oxidative damage in NIDDM patients.

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