• Journal of the Korean Academy of Clinical Electrophysiology
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• v.4 no.1
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• pp.13-25
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• 2006

This study aims to suggest clinical basis of physical therapy of neuromuscular system complication in type diabetic patients through a variety II of analysis methods including echogenicity using ultrasound image and measurement of peripheral nerve function to their neuromuscular system and provide basic materials for preparing evaluation of physical therapy and intervention program. Subjects of this study were 75 type II diabetic patients between 40 and 80 years old and it obtained the following results through echogenisity and function of peripheral nerve. Incidence of neuropathy in type II diabetes was 55.8% in men and 53.1% in women, and total incidence of neuropathy was 54.7%. Echogenicity of patients with neuropathy was significantly increased compared to that of patients with neuropahty. It was also found that there were correlations between function of peripheral nerve and echogenicity of tibialis anterior and gastrocnemius muscle. In addition, it will be important for physical therapists to divide type II diabetic patients into neuropathy and myopathy and interpret and approach changes of neuro-muscular system from comprehensive side.

• Journal of the Korea Academia-Industrial cooperation Society
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• v.16 no.11
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• pp.7838-7843
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• 2015

In this study, metformin hydrochloride for first choice of type 2 diabetes patient is administered relatively high dose, 1000 to 2000 mg orally once a day, and had very high water solubility, so it make difficult to swallow tablet to requires high amount of sustained release agent. To overcome these challenges, we used novel metformin salts had relatively low water solubility to minimize sustaining excipient for small size of dosage form. six novel metformin salts were synthesized by making metformin free form under reaction with NaOH and adding acid salts. we confirmed metformin stearate had the lowest water solubility and showed half drug release in dissolution study at 12hour. In conclusion, novel metformin salts had low water solubility can be used to reduce the size of sustained metformin tablet for improving patient compliance.

• Journal of agricultural medicine and community health
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• v.27 no.2
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• pp.75-86
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• 2002

This study was conducted to investigate the changes in patients and medical services before and after the Separation of Prescription and Dispensing in Health Center. For the purpose of this study, prescription data of 5,890 prescribed patients in March 2000(before the Separation of Prescription and Dispensing) and 3,496 prescribed patients in March 2001(after the Separation) in 4 Health Centers located in Gyeongsangbuk-do and Gyeongsangnam-do were collected. For investigation of the change of character of prescribed patients and the disease, sex, age, chief diagnosis, the hind of medical insurance, days of visit, days of prescription were investigated by using National Health Insurance claim data. And for investigation of change of prescription, prescribed drugs per each claim, the use rate of antibiotics, injection, and high-price antiphlogistic drug were investigated for acute respiratory disease and musculoskeletal disease. The major results were as follows: For the changes of prescribed patients of each disease, patients with acute respiratory disease were decreased by 49.7% after the Separation of Prescription and Dispensing than before the Separation of Prescription and Dispensing and patients with hypertension(18.1%), patients with musculoskeletal disease(70.5%), patients with diabetes(8.5%), patients with digestive organ disease(71.2%), patients with chronic respiratory disease(76.4%) were decreased. But patients with urethritis were increased by 66.7%. The mean Health Center visited days of prescribed patients decreased significantly after the Separation of Prescription and Dispensing than before in both male and female(p<0.01) and in health insurance patients(p<0.01). For the each of the disease, hypertension, diabetes, musculoskeletal disease decreased. The mean prescribed days increased after the Separation of Prescription and Dispensing than before(p<0.01). According to the kine of disease, the mean prescribed days increased after the Separation of Prescription and Dispensing than before in all the diseases except the urethritis(p<0.01). For acute respiratory diseases, number of prescribed drugs per each claim decreased significantly after the Separation of Prescription and Dispensing(4.7 drugs) than before(4.9 drugs) and the prescription rate of injection decreased significantly from 63.8% to 7.70%, and the prescription rate of antibiotics decreased significantly from 337% to 19.1%(p<0.01). For musculoskeletal diseases before and after Separation of Prescription and Dispensing, number of prescribed drugs per each claim decreased significantly from 3.7 to 3.2 and the prescription rate of injection decreased significantly from 64.9% to 1.7%, and the prescription rate of high-price antiphlogistic drugs increased significantly from 29.1% to 397%(p<0.01). In consideration of above findings, the mean visited days decreased and on the contrary, the mean prescribed days per each prescription increased after Separation of Prescription and Dispensing than before in health centers. For the prescription pattern of physicians, number of prescribed drugs and the prescription rates of injection and antibiotics per each claim decreased, but the prescription rate of high-price antiphlogistic drugs increased after Separation of Prescription and Dispensing.

• Health Policy and Management
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• v.31 no.1
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• pp.114-124
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• 2021

Background: In this study, we aimed to investigate the interaction effects of individual socioeconomic status and regional deprivation on the onset of diabetes complications and diabetes-related hospitalization among type 2 diabetes patients. Methods: Korean National Health Insurance Service National Sample Cohort data from 2002 to 2013 were used. A total of 50,954 patients newly diagnosed with type 2 diabetes from 2004 to 2012 and aged 30 years or above were included. We classified patients into six groups according to individual income level and neighborhood deprivation: 'high in advantaged,' 'high in disadvantaged,' 'middle in advantaged,' 'middle in disadvantaged,' 'low in advantaged,' and 'low in disadvantaged.' We calculated hazard ratios (HR) of onset of diabetes complication and diabetes-related hospitalization using the Cox proportional hazard model, with the reference group as diabetes patients with high income in advantaged regions. Results: In terms of the interaction effects of individual income level and regional socioeconomic level, even with the same low individual income level, the group with a high regional socioeconomic level (low in advantaged) showed low HRs for the onset of diabetes complication (HR, 1.04; 95% confidence interval [CI], 1.00-1.08) compared to the 'low in disadvantaged' group (HR, 1.10; 95% CI, 1.05-1.16). In addition, the 'high in advantaged' group showed slightly higher HRs for the onset of diabetes complication (HR, 1.06; 95% CI, 1.00-1.11) compared to the 'low in advantaged' and it appeared to be associated with slight mitigation of the risk of diabetes complication. For the low-income level, the patients in disadvantaged regions showed the highest HRs for diabetes-related hospitalization (HR, 1.29; 95% CI, 1.19-1.41) compared to the other groups. Conclusion: Although we need to perform further investigations to reveal the mechanisms that led to our results, interaction effects individual socioeconomic status and regional deprivation might be associated with on onset of diabetes complications and diabetes-related hospitalization among type 2 diabetes patients.

• Journal of the Korean Dietetic Association
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• v.5 no.1
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• pp.64-73
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• 1999

Carbohydrate(CHO) counting is a meal planning approach used with diabetic patients that focuses on carbohydrate as the primary nutrient affecting post-prandial glycemic response. However, it has not been used in meal management of diabetic patients in Korea. CHO counting can be used by clients with type 1 and 2 diabetes. The purpose of the study was to determine the barriers to utilize the CHO counting when three levels of CHO counting were educated to type 2 diabetic patients who started continuous subcutaneous insulin infusion (CSⅡ) therapy by nutrition lectures and counseling. And the CHO-to-insulin ratios were determined for the individual patients who followed the carbohydrate counting as a meal management, and the factors to influence the CHO-to-insulin ratios were selected through the stepwise regression analysis. Twenty- four subjects were received three lectures, and one or two nutritional counseling for a month. The average age of the subjects was 50.7 years, and the duration of diabetes was 9.4 years. Their body mass index (BMI) was 21.5 kg/$m^2$. The difficulties of using CHO counting were 1) confusing the CHO exchange system to diabetic food exchange system, 2) lack of basic nutrition and not distinguishing nutrients such as CHO, fat and calorie, and 3) lack of motivation to make effort to count and record the amount of carbohydrates eaten. Nutritional counseling replenished the nutrition education and made patients practice CHO counting. Average CHO-to-insulin ratios at breakfast, lunch and dinner were 4.1$\pm$3.3, 2.9$\pm$2.6 and 2.9$\pm$3.0units/23g of CHO, respectively. CHO-to-insulin ratios were influenced by gender, age, BMI, post-prandial blood glucose levels and post-prandial c-peptide levels. The effective education and nutritional counseling of CHO counting can make CHO counting applicable to type 2 diabetic patients as meal management for improving glycemic control with less hypoglycemic episode.

• Journal of the Korean Dietetic Association
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• v.17 no.2
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• pp.206-215
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• 2011

Currently, metabolic surgery (Laparoscopic Roux-en-Y gastric bypass, LRYGB) has an important role and should be recommended as an intervention in the management of obese patients with type 2 diabetes mellitus (T2DM). A successful outcome of surgery requires medical nutrition therapy. Therefore, we performed a retrospective study on 25 patients with T2DM who underwent LRYGB at Yeouido St. Mary's Hospital from October 2008 to May 2010. The patients were followed up for an average of 6 months after surgery (range: 2~19 months). Diabetes was resolved in 80% of the patients. Percentage of excess weight loss was (%EWL) was 56.2%. After surgery, fasting blood sugar (FBS) and HbA1c were significantly reduced (123 mg/dl, A1c 6.7%, P<0.001) and triglyceride was also significantly reduced to 107.6 mg/dl (P<0.05). As diets of the patients progressed from liquid to soft to regular diet, energy, carbohydrates, and fat intakes increased significantly (P<0.001). But protein intake did not change significantly. Nutrient intake of the patients after the surgery was significantly lower than the recommended diet for the non-surgery group. Patients experienced side-effects related to the diets after surgery, including hair-loss (76%), smelly gas (52%), vomiting (48%), etc. A significantly positive correlation was observed between vomiting and FBS (P<0.001). There was a significant relationship between side effects and the amount of nutrient intakes. Therefore, guide patients to a diet progression with treatment to minimize side effects, especially vomiting. And monitor their dietary life to be healthy and not to regain weight until remission of T2DM.

• The Korean Journal of Food And Nutrition
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• v.29 no.2
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• pp.290-299
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• 2016

This study was conducted to determine the association between dietary calcium intake and biomarkers related to lipid and glucose metabolism and inflammation in Korean patients with type 2 diabetes. Seventy-five subjects (41 males, 34 females) were recruited from a group of patients who had visited the department of endocrine medicine. Data on anthropometric characteristics, clinical indices such as hemoglobin A1c and C-reactive protein (CRP), and dietary nutrient intakes were collected. Subjects were divided into three groups on the basis of their calcium intake [< EAR (below estimated average requirement), EAR-RNI (between EAR and recommended nutrient intake), > RNI (above RNI)]. Average calcium intake of < EAR, EAR-RNI, > RNI groups were $462.7{\pm}18.7$, $649.7{\pm}12.8$, and $895.7{\pm}21.7mg$, respectively. Energy intake was not different among groups but intakes of protein, total and saturated fatty acids were significantly higher in > RNI group than < EAR group. Analysis of covariance revealed that HDL cholesterol level was significantly higher in EAR-RNI group, as compared to < EAR group after adjustment with confounders such as age, sex, BMI and energy intake (p < 0.05). Levels of CRP and homeostasis model assessment 2-insulin resistance (HOMA2-IR) were significantly lower in EAR-RNI group. Total cholesterol level was higher in EAR-RNI and > RNI groups, although within the normal range. Our results suggest that dietary calcium intake may influence the levels of HDL-cholesterol, CRP and HOMA2-IR and subsequently, help management/treatment of type 2 diabetes patients.

• Journal of Nutrition and Health
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• v.42 no.2
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• pp.107-118
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• 2009

In patients with type 2 diabetes, oxidative stress could be increased by their metabolic changes. Elevated plasma homocysteine is considered as one of markers of enhanced oxidative stress. Due to oxidative stress, some complications like cardiovascular or renal diseases may develop in type 2 diabetes patients. Plasma homocysteine concentration may be increased if folate status were inadequate. Protective effects against oxidative stress may be diminished if the status of anti-oxidative nutrient as vitamin C was poor. It is, therefore, important to maintain adequate status of folate and vitamin C in type 2 diabetes patients. Thus, this study was performed to determine the effects of supplementation of folate and/or ascorbate on blood glycated hemoglobin ($HbA_{1c}$) level, serum concentrations of homocysteine and cholesterol, plasma oxidized low density-lipoprotein (LDL), concentration and plasma glutathione peroxidase (GSH-Px) activity in the patients with type 2 diabetes. A total of 92 type 2 diabetes patients participated voluntarily with written consents. They were divided into one of the four experimental groups; Control (C), Folate-supplemented (F), Ascorbate-supplemented (A), and Folate plus ascorbate-supplemented (FA). The subjects in C were taken placebo, those in F were supplemented 1 mg of folate, those in A received 1,000 mg of ascorbate, and those in FA were given 1 mg of folate plus 1,000 mg of ascorbate daily for 4 weeks. Supplementation of folate or ascorbate resulted to increase serum folate level or plasma ascorbate concentration apparently, respectively. Folate supplementation not ascorbate seemed to decrease plasma concentrations of homocysteine and oxidized LDL and reduce plasma GSH-Px activity. There might not be synergic effect of the supplementation of folate plus ascorbate. The results indicate that oxidative stress in the patients with type 2 diabetes may lower mainly by folate supplementation.

• Journal of Nutrition and Health
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• v.32 no.1
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• pp.17-23
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• 1999

The purpose of this study was to determine the extent of oxidative stress in NIDDM patients with diabetic complications and to determine the relationship between oxidative stress and diabetic complications. For this study, 139 NIDDM patients were recruited, 85 with diabetic complications and 54 without complications were recruited. The concentration of malondialdehyde(MDA) and the activities of antioxidant enzymes including catalase, superoxide dismutase(SOD), gluthatione peroxidase(GSH-Px)were determined. The daily intakes and plasma concentrations of beta-carotene, lycopene, lutein nd alpha-tocopherol were determined by food frequency questionnaire and by high performance liquid chromatography(HPLC), respectively. Among the antioxidant enzymes studied, only GSH-Px activity was lower in NIDDM patient, with diabetic complications than in those without complications(2.91$\pm$0.80 vs 3.54$\pm$0.44 U/mgHb, p<0.05). Those NIDDM patients with diabetic complications had higher MDA concentrations than those without diabetic complications(1.40$\pm$0.25 vs 1.25$\pm$0.11 nmol/ml, p<0.05). There were no significant differences in the dietary intakes of total carotenoids(2854 vs 2824ug/day)or vitamin E (9.5$\pm$3.2 vs 9.5$\pm$2.0mg/day)between NIDDA patients with and without complications. However, the plasma concentrations of beta-carotene and lycopene were significantly lower in NIDDM patients with complications than in NIDDM patients without complications (Beta-carotene : 24.2$\pm$12.5 vs 33.1$\pm$16.2(ug/dl), lycopene : 2.8$\pm$2.1 vs 4.3$\pm$2.8(ug/dl)). This study showed that in NIDDM patients with complications, the lipid peroxidation of erythrocytes was higher increased and the antioxidant reserves were significantly dipleted, compared with NIDDM patients without complications. The lower plasma concentrations of beta-carotene and lycopene in NIDDM patients may be due to the presence of diabetic complication, not due to the lower dietary intakes of antioxidant vitamins. To define the role of carotenoids in diabetes, more experimental and clinical studies are needed.

• Journal of Nutrition and Health
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• v.40 no.6
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• pp.509-516
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• 2007

The purpose of this study was to investigate the impact DM duration on cardiovascular disease risk factors in Korean Type 2 diabetes mellitus patients. The subject were 250 (male: 134, female: 118) Korean Type 2 DM patients recruited from a general hospital's DM clinic. Anthropometric and hematological variables and dietary intake were assessed. The subject's mean age was 60.2 years and duration of diabetes was 9.5 years. As far as DM duration was concerned, male subjects with long duration (${\geq}$ 5 years and longer) showed significantly lower weight, fat free mass, skeletal muscle mass, BMI (p < 0.05) and higher 2hrs-postprandial plasma glucose (p < 0.05) and concentration of Hemoglobin A1c (p < 0.01) compared to those with less 5years of duration. In female subjects, same trend was found. Female subjects with long duration (${\geq}$ 5 years and longer) showed significantly higher fat free mass (p < 0.05) and skeletal muscle mass (p < 0.05), Hemoglobin A1c (p < 0.01), HDL-cholesterol (p < 0.01) and triglyceride (p < 0.05), dietary intakes of protein (p < 0.05) and fat (p < 0.05) compared to those with less 5years of duration. In conclusion, Type II DM patients of long duration had higher blood lipid concentrations and higher carbohydrates intakes. Subjects followed diet prescription strictly showed lower blood lipid concentration, suggesting the effectiveness of diet to manage Type 2 DM patients.