• 제목/요약/키워드: 제 2형 당뇨환자

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제 2형 당뇨환자의 우울, 자가간호 이행과 당화혈색소와의 관계 (The Relationship between Depression, Self-Care Activity and $HbA_1c$ in Clients with Type-2 Diabetes Mellitus)

  • 김선향;강희선
    • 기본간호학회지
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    • 제15권2호
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    • pp.178-185
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    • 2008
  • Purpose: This study was done to investigate the relationship between depression, self-care activity and $HbA_1c$ in clients with type-2 diabetes mellitus (DM) clients. Method: This was a cross sectional descriptive study and data were collected between October 4 and 27, 2006 using a questionnaire. The participants were inpatients and outpatients with type-2 diabetes being seen in one of two hospitals. The questionnaire included general as well as disease related characteristics, a depression scale (CES-D), and the self-care activity scale developed by Kim (1996). $HbA_1c$ was obtained from medical records. Results: There were 50 men (41.7%) and 70 women (58.3%). The mean scores for depression and self-care activity were $18.22{\pm}10.03$ and 3.51, respectively. Almost half of the Participants (46.7%) had an $HbA_1c$ greater than 7%. Self-care activity was negatively correlated with depression (r=-.436, p=0.00) and $HbA_1c$ (r=-.269, p=0.03). Depression was positively correlated with $HbA_1c$ (r=-.325, p=0.00). Participants who had diabetes education showed a significantly lower level of $HbA_1c$ than the group who had never had diabetes education. Conclusions: It is Important to make ensure that patients with diabetes have education on diabetes mellitus and to screen and manage depression as part of the care for these patients.

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제 2형 성인 당뇨병 유병자의 혈당조절 취약군 예측: 제7기(2016-2018년도) 국민건강영양조사 자료 활용 (Identification of Subgroups with Poor Glycemic Control among Patients with Type 2 Diabetes Mellitus: Based on the Korean National Health and Nutrition Examination Survey from KNHANES VII (2016 to 2018))

  • 김희선;정석희
    • Journal of Korean Biological Nursing Science
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    • 제23권1호
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    • pp.31-42
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    • 2021
  • Purpose: This study was performed to assess the level of blood glucose and to identify poor glycemic control groups among patients with type 2 diabetes mellitus (DM). Methods: Data of 1,022 Korean type 2 DM patients aged 30-64 years were extracted from the Korea National Health and Nutrition Examination Survey VII. Complex samples analysis and a decision-tree analysis were performed using the SPSS WIN 26.0 program. Results: The mean level of hemoglobin A1c (HbA1c) was 7.22±0.25%, and 69.0% of the participants showed abnormal glycemic control (HbA1c≥6.5%). The characteristics of participants associated with poor glycemic control groups were presented with six different pathways by the decision-tree analysis. Poor glycemic control groups were classified according to the patients' characteristics such as period after DM diagnosis, awareness of DM, sleep duration, gender, alcohol drinking, occupation, income status, low density lipoprotein-cholesterol, abdominal obesity, and number of walking days per week. Period of DM diagnosis with a cut-off point of 6 years was the most significant predictor of the poor glycemic control group. Conclusion: The findings showed the predictable characteristics of the poor glycemic control groups, and they can be used to screen the poor glycemic control groups among adults with type 2 DM.

제2형 당뇨환자에 대한 영양교육이 당뇨병 관리와 혈액 항산화 상태에 미치는 영향 (Effects of Nutrition Education in Type 2 Diabetes Mellitus on Diabetes Control and Blood Antioxidant Status)

  • 신경남;이혜상;권정숙
    • 한국식품영양과학회지
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    • 제40권5호
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    • pp.689-695
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    • 2011
  • 본 연구는 효과적인 당뇨 교육 및 평가 방안을 모색하는데 기초 자료를 제시하고자 안동시 보건소를 내원하는 제2형 당뇨병 환자를 대상으로 4주간의 당뇨교육을 하고, 교육 전, 교육 후 및 교육 후 3개월에 각각 영양소 섭취, 혈당 관리와 항산화 영양상태 및 DNA 손상 정도를 조사하여 영양교육의 효과를 평가하였다. 시기에 따른 교육 효과를 반복 측정 분산 분석으로 검정한 결과, HbA1c와 총 콜레스테롤은 유의적으로 감소하였고, 혈장 레티놀(p=0.001)과 토코페롤(p=0.000), 그리고 CAT(p=0.000)와 GPx(p=0.000)의 활성은 유의적으로 상승하였으며, 혈장 과산화지질(TBARS) 농도(p=0.000)와 DNA 손상 정도(p=0.000)는 유의적으로 감소한 것으로 나타났다. 영양소 섭취 상태에 대한 영양교육의 효과는 에너지의 경우, 교육 전에 EER의 76.4% 수준으로 섭취하였으나 교육 직후와 교육 후 3개월에 각각 83.6%와 90.6%로 유의하게 증가한 것으로 나타났다(p=0.009). 에너지 섭취의 증가와 함께 인(p=0.033), 나트륨(p=0.001), 칼륨(p=0.019), 아연(p=0.043), 리보플라빈(p=0.050), 엽산(p=0.048) 및 비타민 C(p=0.008)의 섭취도 유의적으로 증가하였다. 한편, 영양소 섭취 상태의 변화와 생화학적 특성 변화 간의 관련성을 분석한 결과, 대부분의 영양소 섭취 변화는 공복혈당 및 HbA1c의 변화와 유의성은 없었으나 음의 상관성을 보였고, 칼륨(r=-0.418, p<0.05), 철분(r=-0.443, p<0.05), 리보플라빈(r=-0.432, p<0.05) 및 엽산(r=-0.446, p<0.05)의 섭취 상태 개선이 혈액의 과산화지질 감소와 관련성이 있는 것으로 나타났다. 에너지(r=0.543, p<0.01), 단백질(r=0.545, p<0.01), 인(r=0.425, p<0.05), 철분(r=0.485, p<0.05), 아연(r=0.570, p<0.01) 및 나이아신(r=0.510, p<0.05)의 섭취는 혈장 레티놀과, 엽산섭취(r=0.605, p<0.01)의 변화는 CAT와 각각 유의적인 양의 상관성을 보였다. 이처럼 당뇨병에서 식이를 통한 영양소의 섭취 증가는 항산화 상태 개선 및 산화 스트레스 감소와 일부 연관이 있는 것으로 사료된다.

시민건강증진실을 이용하는 노인 당뇨환자의 자가관리 이행 및 삶의 질 예측모형 (Structural Equation Modeling on Self-Care Behavior and Quality of Life in Older Adults with Diabetes Using Citizen Health Promotion Centers)

  • 이송흔;김현리
    • 대한간호학회지
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    • 제47권4호
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    • pp.514-525
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    • 2017
  • Purpose: The purpose of this study was to construct and test a structural equation model for Diabetes self-management (DSM) behavior and Quality of life (QoL) in older adults with diabetes who use Citizen Health Promotion Centers. The theory used this study was a combination of the Information-Motivation-Behavioral Model (IMB) and Self-Determination Theory (SDT) to reflect autonomous characteristics of participants. Methods: Data were collected from April 20 to August 31, 2015 using a self-report questionnaire. The sample was 205 patients with type 2 Diabetes who regularly visited a Citizen Health Promotion Center. SPSS 22.0 and AMOS 22.0 programs were used to analyze the efficiency of the hypothesized model and calculate the direct and indirect effects of factor affecting the participants' DSM behavior and QoL. Results: The supported hypotheses were as follows; 1) The variable that had a direct effect on QoL was health behavior adherence (${\gamma}=.55$, p=.007). 2) The variables that had a direct effect on DSM behavior were DSM information (${\gamma}=.15$, p=.023), DSM confidence (${\gamma}=.25$, p<.001), and autonomous motivation (${\gamma}=.13$, p=.048). 3) The variable that had a direct effect on DSM confidence was autonomy support (${\gamma}=.33$, p<.001). Conclusion: The major findings of this study are that supporting patient's autonomous motivation is an influential predictor for adherence to DSM behavior, and integrative intervention strategies which include knowledge, experience and psychosocial support are essential for older adults with diabetes to continue DSM behavior and improve QoL.

제2형 당뇨병 환자에 대한 대체 요법 [인슈몬]의 효과 및 안전성 (Effect and Safety of Replacement Therapy with Insumon in Type 2 Diabetes Mellitus)

  • 홍억기;김재수;박준홍;박세정;장학철;한인권
    • KSBB Journal
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    • 제18권4호
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    • pp.335-339
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    • 2003
  • 전반적인 유효율은 1차 유효성 평가항목인 당화혈색소가 0주 평균 7.0$\pm$1.1%에서 8주간 인슈몬 투여후 6.7$\pm$0.9%로 유의하게 감소하였으며 (p=0.0202), 특히 혈당 조절이 잘 되지 않는 당화혈색소 7.0% 초과(기저치)군에서도 0주 평균 8.1$\pm$0.8%에서 4주 투여후 7.7$\pm$0.7%로, 8주 투여 후 7.5$\pm$0.8%로 유의하게 감소하였다(p=0.0171). 당화혈색소 7%이하인 군에서도 유의차는 보이지 않으나 0주 평균 6.2$\pm$0.3%에서 8주 투여 후 6.2$\pm$0.6%로 다소 감소하여 당화혈색소가 7% 이하로 잘 유지되고 있음을 보여주었다. 본 연구를 통하여 당뇨병 관리를 목적으로 의약품이 아닌 기능성 식품의 대체요법에 대한 평가가 이루어진 전례가 거의 없는 상황에서 천연식물 추출물을 주원료로 한 기능성 식품인 인슈몬의 유효성과 안전성을 평가함으로써 제2형 당뇨병 개선에 많은 도움이 되리라 사료된다.

비조절성 제2형 당뇨 환자의 치아 탈구 손상에 따른 치수 괴사: 증례 보고 (Pulp necrosis following luxated injury to teeth in a patient with uncontrolled type II diabetes mellitus: a case report)

  • 신한얼;이승종;정일영;이찬영
    • Restorative Dentistry and Endodontics
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    • 제37권1호
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    • pp.61-65
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    • 2012
  • Patients with diabetes mellitus show delayed wound healing and increased susceptibility to infection. Therefore, the effects of diabetes on pulpal and periodontal healing should be taken into consideration when treating diabetic dental traumatized patients. This case presents the treatment for dental traumatized 20 yr old female with uncontrolled type II diabetes. The traumatized upper central incisors had showed pulpal healing in early days. However, 7 mon after the trauma, the teeth had been diagnosed with pulp necrosis with apical abscess. Eventually, non surgical root canal treatment on the teeth had been performed.

당조절이 되지 않는 지역사회 제2형 당뇨환자에서의 혈당수준과 자가관리 실천정도 간의 관계 (A Study on Blood Glucose Level and Self Management among Community Dwelling Type II Diabetes Patients)

  • 박주영;이태용;장경숙;오희영
    • 성인간호학회지
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    • 제22권3호
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    • pp.271-280
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    • 2010
  • Purpose: The purpose of this study was to examine relationships among blood glucose, HbA1c, and self management comparing these with general and illness characteristics of subjects with Type II Diabetes living in the community. Methods: Using a comprehensive survey developed for the study, data were collected from 82 type II diabetes patients who were registered at five community health departments. The variables of self management, blood glucose and HbA1c were assessed by nurses. Data were analyzed with descriptive statistics including t-test, ANOVA and Pearson's correlation coefficient to compare self management and level of HbA1c by subject's general and illness characteristics and to examine the relationships among variables. Results: About 73.2% of the subjects' HbA1c were 7.0% or higher and 54.9% of subjects' blood glucose were 200 mg/dL or higher. The level of self management was moderate. Most frequently perceived reasons for failure of blood glucose control were dietary failure (32.9%). There was significant relationship between self management and HbA1c(r=-.223, p=.040). The mean score of self management were higher among female (t=-2.37, p=.021), who are not on diabetes medication (t=6.70, p=.011). Conclusion: Comprehensive intervention is needed to improve dietary self management, especially for male and those who is on diabetes medication.

당뇨병 환자 교육에 따른 지식, 자기효능감 및 자기관리행위의 변화: 세종특별자치시 고혈압·당뇨병 등록교육센터 등록자를 중심으로 (Improvement of Knowledge, Self-Efficacy and Self-Care Behaviors among Diabetic Patients participated in the Education Program of Sejong Center for Hypertension and Diabetes Management)

  • 정진규;정은영;김아련;박현진;김윤정;반영화;김종성;윤석준;김순영;안순기;남해성
    • 농촌의학ㆍ지역보건
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    • 제42권4호
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    • pp.234-243
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    • 2017
  • 본 연구는 2014년 5월부터 2015년 5월까지 세종특별자치시 고혈압 당뇨병 등록교육센터에서 교육 받은 당뇨병 환자 39명을 대상으로 교육 프로그램의 효과를 평가하고자 실시되었다. 프로그램은 제2형 당뇨병에 대한 질환, 영양, 운동 등에 관한 내용으로 2일 동안 2회의 세션(세션 당 45 분)으로 구성되었다. 교육 전에 당뇨병에 관한 지식, 자기효능감, 자기관리행위 등을 평가하였고, 교육 직후에 지식과 자기효능감 평가, 교육 후 12주째에 자기관리행위를 평가하여 다음과 같은 결과를 얻었다. 당뇨병 지식 점수(10점 만점)는 프로그램 전후 평균 5.72점에서 8.21점으로 유의하게 증가하였고(p<0.001), 자기효능감 점수(10점 만점)는 프로그램 전후 6.88점에서 8.16점으로 유의하게 증가하였다(p<0.001). 자기관리행위 점수는 프로그램 전 5점 만점 중 3.59점이었던 것이 프로그램 종료 12주째에 4.35점으로 유의하게 증가하였다(p<0.001). 본 프로그램은 당뇨병 지식, 자기효능감, 자기관리행위 등의 향상을 통해 등록환자의 효과적인 당뇨병 관리에 기여할 수 있을 것으로 사료된다.

새로 진단된 제1형 및 제2형 당뇨병 환자에서 말초신경이상 (Peripheral Nerve Abnormalities in Patients with Newly Diagnosed Type I and II Diabetes Mellitus)

  • 이상수;한헌석;김헌
    • Annals of Clinical Neurophysiology
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    • 제16권1호
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    • pp.8-14
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    • 2014
  • Background: Early detection of neuropathy may prevent further progression of this complication in the diabetic patients. The purpose of this study was to evaluate the prevalence of early neuropathic complication in patients with newly diagnosed type 1 and type 2 diabetes. Methods: Nerve conduction studies (median, ulnar, posterior tibial, peroneal, and sural nerves) were performed for 49 type 1 (27 males, mean $14.1{\pm}7.5$ years) and 40 type 2 (27 males, $42.0{\pm}14.1$ years) diabetic patients at onset of diabetes. Children with age at onset under 4 years and adults over 55 years were excluded to eliminate the aging effect and the influence of obstructive arteriosclerosis. Neuropathy was defined as abnormal nerve conduction findings in two or more nerves including the sural nerve. Results: Mean HbA1c level was $12.6{\pm}3.3%$ for type 1 and $10.5{\pm}2.9%$ for type 2 diabetes. The prevalence of neuropathy was 12.2% for type 1, and 35.0% for type 2 diabetes, respectively. There were significant trends in the prevalence of neuropathy with increasing age (p<0.05). The effect of the mean level of glycosylated hemoglobin on the prevalence of polyneuropathy at onset of diabetes was borderline (p=0.0532). Neither sex of the patients nor the type of diabetes affected the neurophysiologic abnormalities at the diagnosis. Conclusions: Even in a population with diabetes at the diagnosis, the prevalence of subclinical neuropathy was not low. Neuropathy has been significantly associated with increasing age indicating the possibility of longer duration of undetected diabetes among them, especially in type 2 diabetes.

제 2형 당뇨병을 동반한 고도 비만환자에 대한 한방 비만치료 증례보고 2례 (The effect of oriental obesity therapy on Morbid obese patient with Type 2 Diabetes : Two Cases Report)

  • 한효정;김현진;박은영;장정아;안태한;서호석;김진원
    • 한방비만학회지
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    • 제10권1호
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    • pp.57-63
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    • 2010
  • Objectives The purpose of this study is to investigate the clinical effect of oriental obesity therapy on morbid obese patient with Type 2 Diabetes. Methods Two cases of Type 2 Diabetes patient was treated with herbal medicine, electrolipolysis, dietetic therapy, and aerobic exercise during the treatment period. Results The diagnostic index (Weight, BMI, PBF, WHR, FPG, HgbA1C) was improved at the end of treatment. Conclusion The improvement of the patient with Type 2 Diabetes is identified through receiving oriental medical treatments, dietetic therapy, and aerobic exercises. Further research on medical treatments and long-term maintenance of weight loss for obese patients with Type 2 Diabetes should be needed in order to standardize the treatment methodology.