• Journal of Nutrition and Health
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• 제39권7호
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• pp.641-648
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• 2006

This study was designed to evaluate the effect of the individual nutrition education for type 2 diabetes who participate the diabetes buffet. The subjects were 66 patients and divided into education (n=34) and control groups (n=32). The mean age of education and control groups were 59.8 and 56.6 years old, respectively. There were no differences in age and body mass index (BMI) between two groups. Initial glycosylated hemoglobin (HbA1c), post prandial plasma glucose (PP2), total plasma cholesterol, and blood pressure were not different between two groups. But fasting blood sugar (FBS) was higher in education group than in control group. On completion of the study, the education group showed significant decreases in body weight, BMI, FBS and PP2, however, the control group showed no changes in body weight, BMI and PP2, and showed a significant increase in FBS. Initial calorie and protein intakes of the education group did not meet the prescribed amount, however, mineral and vitamin intakes were higher than estimated average requirement (EAR). By the end of study, calorie and protein intakes were significantly increased to meet the prescription. In order to evaluate the effect of diet education, awareness of calorie requirement was used as an index of understanding diet prescription. The degree of awareness of calorie requirement was dependent on age: younger patients showed higher awareness than older subjects. The subject who showed better understanding of diet prescription showed lower levels of HbA1c, FBS, and PP2 at the end of the experiment period. The results of this study clearly show that individual diabetes diet education is effective to make the patient understand their diet prescription, and is effective to control body weight and blood sugar level. Awareness of calorie requirement could be used as an index of understanding of prescribed diet. Since age is an important variable to determine the awareness of calorie requirement, different strategies of nutrition education should be developed for different age groups, especially patients over 70 years old.

• 대한임상검사과학회지
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• 제50권3호
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• pp.313-319
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• 2018

최근 골대사와 당뇨병 발생 기전의 관계에 대해 많은 연구가 진행되고 있으며, osteocalcin이 제 2형 당뇨병을 위한 치료법에 관련될 수 있다는 것이 밝혀지고 있다. 따라서 본 연구는 osteocalcin과 HbA1c의 상관관계를 알아보고자 한다. 2015년 1월 1일부터 2016년 12월 31일까지 광주 소재 한 종합병원 수진자 중 osteocalcin과 HbA1c를 비롯하여 칼슘, 카르복시말단펩티드, 총 콜레스테롤, 중성지방, 고밀도 지질단백 콜레스테롤, 저밀도 지질단백 콜레스테롤, 25-수산화비타민D, 키, 몸무게를 측정한 40세 이상의 성인 총 714명($70.8{\pm}10.4$세)을 연구대상자로 최종 선정하였다. 성별은 남자(452명, 63.3%)가 여자(262명, 36.7%)보다 많았다. 당뇨환자군에서 osteocalcin과 HbA1c는 약한 음의 상관관계(r=-0.183, P<0.001)가 있었고, 다른 요인들을 모두 보정했을 때에도 여전히 음의 상관관계(r=-0.251, P<0.001)가 있었다. 본 연구는 당뇨환자에서의 osteocalcin과 HbA1c가 음의 상관관계가 있음을 보여주었다. 골대사와 당대사의 생물학적 기전 및 관련요인들이 미치는 영향을 바탕으로 골대사와 당뇨병 발생의 상호관계에 대한 연구가 지속되어야 한다.

• 한국치위생학회지
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• 제12권6호
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• pp.1203-1211
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• 2012

Objectives : The aim of this study was to investigate the factor-related oral care self-efficacy among the type 2 diabetic patients. Methods : Questionnaire was conducted with 174 Type 2 diabetic patients from 9th January to 9th March in 2012. The following conclusion was obtained as a result of carrying out t-test and one-way ANOVA analysis and multiple linear regression analysis. Results : 1. Analysis of the level of each item concerning oral care self-efficacy showed tooth brushing self-efficacy was $13.3{\pm}2.9$, the highest of all. 2. The factor that was most highly related with oral care self-efficacy was oral health behaviors(${\beta}=0.474$). The other factors were found to be expected duration of diabetes(${\beta}=-0.205$), self-assessed physical health(${\beta}=0.177$) and oral health(${\beta}=0.111$) in such order (p<0.05). Conclusions : Diabetes causes a variety of complications in the mouth, and therefore it is very important to practice oral care activity in order to oral health promotion. This study showed oral care self-efficacy appeared to be the greatest factor of relevance in practicing oral care activity. So, dental hygienist is obliged to keep on motivating so that the patient may maintain the oral care activity for him/herself. Also, a study on various intervention methods to improve oral care self-efficacy should be continued.

• 대한영양사협회학술지
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• 제10권3호
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• pp.322-332
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• 2004

The possibility that high, long-term intake of carbohydrates that are rapidly absorbed as glucose may increase the risk of type 2 diabetes has been long-standing controversy. A high consumption of carbohydrates with a high glycemic index produces greater insulin resistance than did the intake of low glycemic index carbohydrates. This study was designed to evaluate the cabohydrate intake status include glycemic index and correlation carbohydrtae intake status with anthropometry factors & other nutrients in usual diet of the Korean type 2 diabetes mellitus. In 104 tpye 2 diabetes mellitus patients(mean age : 51.8yr, male=44.femal=60), we determined carbohydrte intake status include glycemic index with 24hr recall method and measured anthropometry. Mean daily carbohydrtae intakes and glycemic index were 307.3g(male 323.1g, female 295.5g) and 90.7(male 93.4, female 88.8), respectively. We found a strong and statistically significant association between carbohydrate ratio and glycemic index in obese factors, other nutrient. But carbohydrate intake/kg of body weight was low a significant differences in obese factors, other nutrient. Also glycemic index was effected by total energy intake and carbohydrate ratio than carbohydrate intake/kg of body weight. In conclusion, emphasis for dietary modification should be total energy intake and carbohydrate ratio in diabetes mellitus patient.

• 기본간호학회지
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• 제10권2호
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• pp.181-186
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• 2003

Purpose: The purpose of this study was to investigate the adherence to diabetes control recommendations (blood glucose testing, medication, diet, exercise) in patients with type 2 diabetes at home and to analyse the correlation between adherence and blood glucose level. Method: Participants, numbering 214, were recruited from the endocrinology outpatient department of a tertiary care hospital in an urban city. The data were collected by a self report adherence questionnaire. Glycosylated haemoglobin (HbA1c) was determined by the high-performance liquid chromatography technique and fasting blood glucose was analyzed by the glucose oxidase method. Result: Medication adherence was higher than diet or exercise adherence. The frequency of blood glucose testing was lower for middle school graduates than college graduates. Diet adherence was significantly lower for participants who were obese, who did not have a spouse, and who had hyperglycemia. Medication and diet adherence were negatively correlated with HbA1c. Conclusion: A diet education program should be developed for patients with type 2 diabetes who are obese, who do not have a spouse, and who have hyperglycemia.

• 한국임상약학회지
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• 제25권3호
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• pp.131-137
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• 2015

Background: The protective effect of metformin against breast cancer is inconclusive. Objective: To evaluate the effect of metformin on breast cancer risk and mortality in patients with type 2 diabetes. Method: A comprehensive literature search was performed for pertinent articles published prior to June 30, 2014, using PubMed and EMBASE. Study heterogeneity was estimated with $I^2$ statistic. The data from the included studies were pooled and weighted by random-effects model. The quality of each included study was assessed on the basis of the 9-star Newcastle-Ottawa Scale and publication bias was evaluated by visual inspection of a funnel plot. Results: Ten studies were included in the meta-analysis of the association of metformin and breast cancer risk. By synthesizing the data from the studies, the pooled odds ratio (OR) was 0.72 (95% CI: 0.59, 0.87) (p = 0.0005). Three cohort studies were included for meta-analysis of the association between metformin and breast cancer-related mortality. Metformin was associated with a significant decrease in mortality (Risk ratio: 0.68; 95% CI: 0.51, 0.90, p = 0.007). Conclusion: The present meta-analysis suggests that metformin appears to be associated with a lower risk of breast cancer incidence and mortality in patients with type 2 diabetes.

• 기본간호학회지
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• 제20권4호
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• pp.389-399
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• 2013

Purpose: This study was done to identify effects of a 12 weeks Tai Chi exercise and education intervention program on HbA1C, sexual function and IL-12 (Interleukin 12), IL-4 (Interleukin 4), TNF-${\alpha}$ (Tumor Necrosis Factor) for women with type 2 diabetes. Methods: The study had a nonequivalent control group pretest posttest design. The participants were 64 women with diabetes recruited from an outpatient clinic of a university hospital. The Tai Chi exercise and education intervention program was provided twice a week for 12 weeks for the 32 women in the experimental group. The 32 women in the control group were maintained on basic outpatient treatment. Outcome variables were HbA1C, sexual dysfunction scores, IL-4, IL-12 and TNF-${\alpha}$. Results: The experimental group showed significantly improved HbA1C (F=3.10, p=.004), and sexual function (F=3.78, p=.001) compared to the control group. Also for the experimental group TNF-${\alpha}$ (F=-2.69, p=.004) significantly increased compared to the control group. Conclusion: Results indicate that a Tai Chi exercise and education intervention program can be utilized effectively for women with type 2 diabetes.

• 임상간호연구
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• 제28권3호
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• pp.277-288
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• 2022

Purpose: This study was conducted to evaluate the effects of the insulin therapy adherence program (INSTA GRAM) for patients with type 2 diabetes mellitus. Methods: This study examined a total of 63 patients with type 2 diabetes for whom the initiation of insulin therapy is being considered or within 6 months of undergoing insulin therapy. INSTAGRAM is a stage-specific intervention consisting of strategies for motivating patients to initiate and maintain insulin therapy using the transtheoretical model on the stages of change, the process of change, and self-efficacy. The participants were randomly assigned to either the INSTAGRAM group (experimental group, n=32) or the standard diabetes education group (control group, n=31). The INSTAGRAM group received 6 sessions over 8 weeks(face-to-face education was conducted in the first and last sessions, and telephone coaching was conducted from the second to fifth sessions). The outcomes were measured by psychological insulin resistance, self-efficacy, and glycosylated hemoglobin (HbA1c). Results: Psychological insulin resistance (p<.001), self-efficacy (p<.001), and HbA1c (p=.024) of the participants in the INSTAGRAM group significantly improved compared to those in the control group. Conclusion: INSTAGRAM is effective in overcoming psychological insulin resistance and improving self-efficacy and HbA1c. Therefore, the INSTAGRAM can be recommended as a nursing intervention for type 2 diabetic patients who delay the initiation of insulin therapy.

• 한국식품영양과학회지
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• 제35권4호
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• pp.430-439
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• 2006

본 연구는 웹기반 영양상담 프로그램을 이용하여 당뇨병 환자들을 대상으로 8주 동안 6회의 영양상담을 실시한 후 웹기반 영양상담이 당뇨병 환자의 식행동 및 식품섭취양상의 변화에 미치는 영향과 영양상담 프로그램을 평가하였다 웹 기반 영양상담 프로그램은 식사관리, 영 양상담, 영양평가, 추후관리 프로그램으로 구성되었다. 추후관리 프로그램은 혈당수첩, 식습관 조사, 식품섭취빈도 조사, 온라인 상담파일로 구성되었으며 온라인 상담파일에 대화방을 두어 환자와 실시간으로 상담할 수 있도록 하였다 웹기반 영양상담후 운동습관은 상당히 개선되었으며 음주와 흡연은 상담 전 이미 그 빈도가 매우 낮음에 기인하여 큰 차이를 보이지 않았다. 식사요법에 대한 지식의 변화는 모든 항목에서 식사요법 지식이 향상되었으며 전체적으로도 비합병증군과 합병증군 두군 모두에서 유의 (p<0.001)하게 높아졌다. 식 행동 변화는 영앙상담 후 두군 모두에서 유의(p<0.001)하게 개선됨으로서, 8주 동안의 지속적인 영양상담이 환자 스스로 올바른 식행동 형성의 의지를 갖게 함으로서 당뇨병 관리의 가능성을 보여주었다. 식품섭취빈도의 변화는 두군 모두에서 어패류, 채소류, 해조류의 섭취 빈도가 영양상담후에 유의하게 높아졌으며 당류, 가공식품, 감자류, 빵류의 섭취빈도가 낮아져 환자들의 식품섭취패턴이 바람직하게 개선되었다. 웹기반 프로그램 및 영양상담에 대한 평가점수는 연령이 낮을 수록 평가점수가 높게 나타났으며, 컴류터 사용이 익숙하지 않아 보호자의 도움을 필요로 하고 있는 60대 이상에서는 상대적으로 낮은 점수를 보였다. 따라서 본 연구의 결과는 웹상에서의 영양상담을 통하여 지속적이고 반복적인 추후 관리를 하는 것이 당뇨병 환자의 바람직한 식품섭취양상 및 식행동 변화를 정착시켜 질병을 관리하는데 기여 할수 있음을 제시한다. 또한 웹을 이용한 프로그램 및 상담에 대한 평가결과도 연령에 따라 차이는 있지만 긍정적으로 나타남으로서 정보화시대에 맞는 새로운 영양상담 매체로서의 인터넷의 가능성을 제시한다.

• 한국건강관리협회지
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• 제4권1호
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• pp.12-27
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• 2006

"본 논문은 대한내과학회지 2006년 제70권 제3호에 실렸던 논문으로 대한내과학회 편집위원회의 승인을 득하고 본 협회지에 게재함. Background : Diabetes mellitus is a major independent risk factor for atherosclerosis. In recent years non-invasive high resolution B-mode ultrasound methods have been developed to measure the intima-media thickness(IMT) of the carotid artery as an indicator for early atherosclerosis. Itis known that obesity plays a role in the development of type 2 diabetes and cardiovascular disease, and it has also been reported that not only the amount but also the distribution of body fat is important. This study investigated the relationship between obesity and the development of carotid atherosclerosis in type 2 diabetic patients. Methods: Carotid IMT was measured by ultrasound B-mode imaging in 144 patients with type 2diabetes mellitus. All subjects underwent assessment for the degree and distribution of obesity, the presence of coronary artery disease risk factors, and the presence of diabetic complications. Resuts: Carotid IMT was increased in the abdominal obese group defined by waist circurference. However, there was no significant difference in carotid TMT between the non-obese group and obese group as defined by body mass index, waist to hip ratio, and total body fat percent measured by bio electrical impedance analysis. There were positive correlations between carotid IMT and age, duration of diabetes, systolic blood pressure, and waist circumference. Multiple linear regression analysis revealed the variable that interacted independently with carotid IMT was age in type 2 diabetic patients. Carotid IMT was significantly increased in type 2 diabetic patients with macrovascular complications and microvascvlar complications .Conclusion: This study suggested that abdominal obesity rather than general obesity was associated with carotid atherosclerosis reflected by increment of carotid IMT in type 2 diabetic subjects.