• 약학회지
• /
• 제58권1호
• /
• pp.71-79
• /
• 2014

Although Korean patients with type 2 diabetes mellitus (T2DM) are generally treated by western medicine, many of them strongly believe in the traditional oriental Sasang constitutional classification and depend on it for food, health supplements, and oriental medicines decision making. Sasang constitutional classification is a part of traditional Korean medicine that divides people into four constitutional types (Tae-Yang: TY, Tae-Eum: TE, So-Yang: SY, and So-Eum: SE), which differ in inherited characteristics such as appearance, personality traits, susceptibility to diseases, and drug responses. It is recommended for T2DM patients to control their blood glucose very well from early stages with drugs and diet. However, many T2DM patients respond differently to their drugs, even though they receive the same medicine. Therefore, the present study investigated whether Sasang constitutional type can explain the therapeutic differences between oral hypoglycemic agents (OHAs) therapy (mono, dual and triple drug therapy). Patients of 618 with T2DM diagnosis and Sasang constitutional type known who received both western and oriental medicine treatment in a hospital between April 2006 and April 2013 retrospectively studied. HbA1c (%) and blood glucose (mg/dl) levels before OHAs therapy and 3 month after were collected for metformin (MET) or sulfonylurea (SU) monotherapy, MET+SU dual therapy, MET+except SU (where was either alpha-glucosidase inhibitor, dipeptidyl peptidase-4 inhibitor, meglitinide or thiazolidinedione) dual therapy, and triple therapy, according to Sasang constitutional type. For statistical analysis, ANOVA was used and paired t-test by SPSS 19.0 where P values less than 0.05 were considered statistically significant. Pattern was similar levels of HbA1c and blood glucose and which was decreased in order of mono, MET+SU dual, MET+except SU dual and triple therapy. In all patients comparison, for the So-yang (SY) constitutional type, either monotherapy was less effective; for Te-eum (TE) type, MET+SU dual therapy was less effective while MET+except SU dual therapy was more effective and the triple therapy was less effective; and for So-eum (SE) type, the triple therapy was more effective. For the management of TE type it is recommended to use drugs except SU when dual therapy is needed, restrict triple therapy and consider dual and insulin therapy; for SY type it is recommended to follow current guidelines; and for SE type it is advisable to skip dual therapy and start the triple therapy early. Finally, the therapeutic response to OHAs is different among Korean T2DM patients with different Sasang constitutional types. Taken together, the choice of effective OHAs therapy for each type is necessary in order to minimize the poor control of blood glucose level, the risk of complications, and the costs from a failure of therapy.

• Journal of Nutrition and Health
• /
• 제40권1호
• /
• pp.31-40
• /
• 2007

The purpose of this study was to investigate the association between insulin resistance and cardiovascular disease risk factors in Korean type 2 diabetes patients. The subjects were 429 (male: 218, female: 211) type 2 DM patients visited DM clinic, and they were classified into quartiles based on $K_{ITT}$ index (%/min, Insulin Tolerance Test). Anthropometric and biochemical characteristics, and dietary intakes by Food Frequency Questionnaire were assessed. The means of waist circumference, fat mass, percent body fat and abdominal fat thickness were significantly higher in the lowest quartile (the most insulin resistant group) than in the highest quartile (the least insulin resistant group) of $K_{ITT}$ index (%/min)(p<0.05), For hematological values, the lowest quartile showed significantly higher fasting blood glucose, HbA1c, C-peptide, insulin, triglyceride, ApoB/apoA-1 ratio and C-reactive protein compared to the highest quartile (p < 0.05). Moreover, $K_{ITT}$ index (%/min) was negatively correlated with waist circumference, fat mass, percent body fat, abdominal fat thickness and fasting blood concentrations of glucose, HbA1c, C-peptide, insulin, cholesterol, triglyceride, ApoB/apoA-1 ratio and C-reactive protein (p < 0.05). Nutrient intakes were not significantly different among the quartile groups of $K_{ITT}$ index (%/min) and also not correlated with insulin resistance, however, they showed correlation with obesity parameters (BMI, waist circumference, waist-hip ratio, vat mass, abdominal fat thickness), which were strongly associated with insulin resistance. In conclusion, cardiovascular disease risk would be higher as the insulin resistance grows in Korean type 2 DM patients, and nutrient intakes would affect to the insulin resistance through the effect on anthropometric parameters.

• 약학회지
• /
• 제59권6호
• /
• pp.270-277
• /
• 2015

There is a lack of evidence on the impact of pharmacist interventions in diabetes care in South Korea. The aim of this study was to investigate the effects of pharmacist counseling on clinical and humanistic outcomes in patients with type 2 diabetes. An uncontrolled before-and-after study was conducted at the outpatient diabetes clinic in a teaching hospital in Gyeongnam, South Korea between January 2 and November 30, 2014. A total of 37 patients were enrolled. During the study periods, the participants and pharmacists met every 2 weeks via follow-up telephone calls in addition to face-to-face meetings upon returning for care visit. At each meeting, a structured patient counseling was performed and the average duration of each meeting was 15~30 minutes. The participants were requested to record daily self-care activities. At the end of this study, patients' satisfaction on pharmacist care was evaluated using the questionnaire developed by us. Compared to baseline, significant reductions (mean${\pm}$standard deviation, p<0.05) in HbA1c were observed at each follow-up period: $-0.32{\pm}0.72%$ from baseline to 3 months; $-0.52{\pm}0.76%$ from baseline to 6 months; $-0.72{\pm}0.76%$ from baseline to 9 months. Over the same follow-up period, the proportions of patients achieving target HbA1c (defined as HbA1c<6.5%) were 3.1%, 10.3%, and 20%, respectively. The proportions of patients who never missed a dose during the same follow-up period were 43.8%, 31.0%, and 20.0%, respectively. The results from the patient satisfaction survey indicated that pharmacist counseling improved patients' knowledge about diabetes and possible drug interactions. Especially, the information on a healthy diet and lifestyle was the most satisfying. To conclude, follow-up telephone calls combined with face-to-face meetings improved clinical and humanistic outcomes in patients with type 2 diabetes mellitus.

• 대한지역사회영양학회지
• /
• 제20권5호
• /
• pp.351-361
• /
• 2015

Objectives: The purpose of this study was to investigate the relations between diabetic dietary compliance and dietary intake, physical activity and prevalence of metabolic syndrome (MS) in type 2 diabetic patients. Methods: Seventy five subjects diagnosed with type 2 diabetes visiting the D hospital in Dongducheon from May 2014 to Dec 2014 were included in this study. The subjects were divided into two groups according to their diabetic dietary compliance score (median 39); low diabetic dietary compliance (LDDC) group (n=44) and high diabetic dietary compliance (HDDC) group (n=31). Survey data collection was carried out by direct interview method. The nutrient intake, food intake and KDDS (Korean's dietary diversity score), DVS (dietary variety score) and GMVDF (grain, meat, vegetable, dairy and fruit) were analyzed using data from the 24-recall method. Metabolic parameters were obtained from the hospital records. Data was analyzed using Chi-square test and general linear model adjusted for sex. Results: The prevalence of MS was 59.7% in the participating diabetic patients. The prevalence of MS of the HDDC (39.3%) was significantly lower than that of the LDDC (72.7%). The distribution of physical activity showed a significant difference between the groups (p=0.006). The intakes of seeds and nuts of the HDDC were significantly lower than those of the LDDC. Fat and vegetable fat intakes and % fat of energy in the HDDC were significantly lower than those in the LDDC. But, carbohydrate (CHO) and potassium intake and %CHO of energy in the HDDC were significantly higher than those in the LDDC. KDDS and GMVDF showed significant differences between groups (p=0.033; p=0.012). Conclusions: Continuous intervention by specialized nutritionists for long-term self-regulation is needed for diabetic patients, and the high compliance to diabetic diet and increasing physical activity may be effective in the prevention of metabolic syndrome.

• 대한한방내과학회지
• /
• 제41권6호
• /
• pp.1066-1077
• /
• 2020

Objective: This study was conducted to evaluate the effect of herbal medicine on blood glucose in diabetic patients. Methods: The subjects were patients with diabetes mellitus (DM) who had been admitted to Kyung Hee University Korean Medicine Hospital for more than 8 weeks for a primary diagnosis other than DM and who had taken herbal medicine for more than 8 weeks from January 2010 to February 2020. The medical records were analyzed retrospectively to confirm the characteristics of the subjects, and examination results included hemoglobin A1c (HbA1c), total cholesterol, triglyceride, low-density lipoprotein cholesterol (LDL), high-density lipoprotein cholesterol (HDL), aspartate aminotransferase (AST), alanine aminotransferase (ALT), blood urea nitrogen (BUN), and creatinine. Changes in HbA1c before and after taking herbal medicine and changes according to subgroups were analyzed. Results: A total of 149 subjects with type 2 DM were selected as participants. After taking the herbal medicine, the HbA1c value was significantly decreased, and the statistical significance was maintained even when the effect of controlling antidiabetic agents was excluded. The decrease in HbA1c was higher in the poor glycemic control group. Liver and kidney functions did not show any significant changes after taking the herbal medicine. Conclusions: Administration of herbal medicine for a long period of 8 weeks or longer did not increase HbA1c in patients with DM complicated by other various diseases.

• Journal of Dairy Science and Biotechnology
• /
• 제32권1호
• /
• pp.17-29
• /
• 2014

Probiotics에 대한 많은 연구는 위장내 질환에서 장내 미생물 균총의 중요성을 강조하고 있으며, 최근에는 심장 혈관 위험에 초점을 맞추어서 연구가 시작되고 있다. 비만이 dysbiosis에 관련될 수 있는 의료 장애 및 대사 장애로 특정 되어진다. 이를 위해 위험 요인을 감소시키는 도구로 사용되는 probiotic 균주는 반드시 향후에 검사되어져야 한다. Probiotics는 체외 및 생체내 연구에서 여섯 가지 장애 및 장해에 대해서 긍정적인 효과를 보여주며, 특히 이것은 항 염증 성질 또는 효소활력에 기인한 것이다. 각각의 경우에 박테리아가 숙주에 영향을 미칠 수 있는 메카니즘은 잘 정리되어 보고되었다. 그러나, 특히 비만, 당뇨, 산화 스트레스에 대한 이중 맹검 무작위 임상 시험의 부족으로 불가능한 확정적인 결론을 만든다. 더구나, 지금까지 어떠한 연구결과에서도 직접적으로 심혈 관계 질환의 위험 인자에 대한 probiotics의 영향에 관해서는 언급된 것이 없었다. 심혈관계 질환으로는 동맥류, 협심증, 동맥 경화증, 뇌 혈관 사고, 뇌 혈관 질환, 울혈성 심부전, 관상 동맥 질환, 심근 경색, 말초 혈관 질환 등이 포함된다. 예측과 대표적인 검색 도구의 사용은 probiotic 균주의 새로운 기능을 가진 종류의 선택이 가능하게 해준다. 비만의 경우, 무균 동물 실험 방법의 확립은 probiotic 균주에 의한 미생물균총과 조절의 상호작용을 이해가 추후 진행되어야 할 것이다. 불행하게도, 이 엄격한 방법론은 거의 적용되지 않고 있으며, 현재의 추세는 경험적으로 특정 의료 장애에 대한 일반적인 메커니즘은 설명이 되지만, 반응의 정확한 모드는 완전히 알려지지 않음에도 불구하고 probiotic 균주를 테스트하고 있는 실정이다. 더욱이 많은 연구가 직접 동물 모델에서 진행되었지만, 그 결과를 항상 인간에게 바로 적용할 수는 없다. 이 방법론의 개선은 인간 미생물 균총과 관련된 생쥐를 사용하거나 자연적으로 질병을 유발할 수 있도록 개발된 다른 동물모델을 사용할 수 있을 것이다. 인간 Microbiome 프로젝트와 MetaHIT(인간의 창자의 metagomics)같은 현재 연구는 인간에게 생체외 및 동물 모델 자료의 이용에 있어서 자세한 정보를 제공해야만 하고, 또한 새로운 예측 가능한 모델의 개발이 이루어져야 할 것이다. 현재 의료 장애와 반응 메커니즘과의 연관성에 관해서 많은 관심과 연구가 진행되고 있고, 원하는 특정 활력을 가지고 있는 균주에 대해서 더 개선된 검증을 개발을 할 수 있는 방법이 필요하다. 장래에는 재조합 probiotics와 특정한 의학적 질환으로 고통 받는 환자의 미생물 균총의 조성을 재조합 probiotics으로 해결할 수 있을 것이며, 또한 probiotics의 사용은 장내 미생물균총을 조정할 수 있으며, 과체중과 비만 사람들을 위해 음식 섭취량을 관리할 수 있으며, 제1형 당뇨병과 고콜레스테롤 혈증을 줄일 수 다른 대안으로 이용될 것이다. 결론적으로 Probiotics 미생물은 역사적으로 장내 미생물의 균형을 방해하고, 설사 또는 염증성 장질환 같은 위장 장애를 감소하는 데 사용되어오고 있다. 최근의 연구는 의료 질환에 probiotics의 확장 사용에 대한 가능성을 탐구하고 있다. 왜냐하면 심혈관 질환 및 당뇨병 발병 위험을 증가(비만, 고 콜레스테롤 혈증, 동맥 고혈압 등)와 대상장애(hyperhomocysteinemia, 산화 스트레스 등) 등의 발병 위험이 점점 높아지기 때문이다. 따라서 probiotics와 숙주 간의 상호작용에 관여하는 기전을 재정립하여 probiotics에 의해서 생성된 유익한 효과의 특성을 식별하는 것이 요구된다. 특정 probiotics 균주는 (1) 면역 반응을 조절함으로써, (2) 특정 분자를 생산하여, (3) biopeptides을 발충하여, 그리고 (4) 신경계 활성을 조절함으로써 작용할 수 있다. 현재까지 대부분의 연구는 동물 모델에서 실시되었다. 따라서 인간에 관련된 메카니즘에 새로운 조사 probiotics 균주의 넓은 다양한 질환에 효율적인 사용을 가능하게 하기 위한 연구가 절실히 요구되어진다.

• 한국식품과학회지
• /
• 제39권3호
• /
• pp.348-352
• /
• 2007

한국인이 상용하는 식물성 식품 30종의 에탄올 추출물을 이용하여 $sPLA_{2}$, COX-1, COX-2, 12-LOX 의 활성 억제 효과를 측정하여 식물 추출물이 염증 효소계에 미치는 영향을 포괄적으로 평가하였다. 그 결과 모든 식물 추출물은 적어도 한 개 이상의 염증 관련 효소의 활성을 저해하였다. 몇 가지 두류와 숙주나물, 일부 잎채소는 염증반응의 상위 단계 효소인 $sPLA_{2}$의 활성을 저해하였으며, 12-LOX 활성은 발아나물인 콩나물과 숙주나물에 의해서만 특이적으로 저해되었다. 대부분의 식품들은 COX-1과 COX-2 활성을 동시에 저해하였고, 미나리와 비름만이 COX-1 활성 저해 없이 COX-2만을 선택적으로 저해하였다. 모든 두류 유래식품과 식물 뿌리류는 COX-2에만 선택적이지는 않았으나, COX-1보다 더 낮은 농도에서 COX-2 활성을 억제하였다. 여러 식품들 중 염증반응의 상위단계 효소인 $sPLA_{2}$ 활성을 억제하는 일부 두류와 잎채소류 및 숙주나물은 염증 초기에 작용하여 염증 반응의 발전을 차단하는데 도움을 줄 수 있을 것으로 보인다. 특히, 녹두는 비교적 낮은 $IC_{50}$ 값을 보이며 $sPLA_{2}$와 COX-2를 효과적으로 저해하는 것으로 나타나 염증반응의 여러 단계에서 항염 효과를 나타낼 수 있는 유용한 식품으로 판단된다. 또한 각각의 염증 관련 효소에 대한 억제 능력이 크지는 않았지만, 염증 반응의 초기 및 후기 단계의 모든 효소를 저해 하였던 숙주나물과 12-LOX 및 COX-2를 동시에 저해한 콩나물도 여러 염증 효소를 복합적으로 억제시킴으로써 항염능을 나타낼 수 있다는 점에 주목 할 필요가 있다. 본 연구 결과 식물성 식품에 의한 염증 완화 및 예방 효과는 각기 다른 염증 효소의 활성을 다양한 정도로 저해함으로써 발현됨을 알 수 있다. 밝혀졌으며 제2형 당뇨모델인 $KK-A^{y}$ 마우스를 이용한 동물실험에서도 뚜렷한 혈당강하효과를 나타내어 인슐린 민감성 제재로 개발 할 수 있는 가능성을 보여 주었다.균은 $0.9{\sim}2.6%$이었으며, 8종류 약제에 저항성인 균도 1.7%있었다. 이상의 결과로 국내에서 분리된 M. pneumoniae 균주는 적게는 1-4 종류의 항생제에, 많게는 5-8 종류의 항생제에 저항성인 균주가 있으므로 마이코플라스마폐렴 환자를 치료할때는 macrolide계나 quinolone계의 항생제 선택에 신중을 기하여야 하며, 가급적이면 항생제 감수성 검사를 실시하여 적절한 항생제를 선택함으로써 저항성균의 출현율을 줄일 수 있고 효율적인 치료도 할 수 있도록 하여야 할 것으로 생각된다.이어트에도 도움이 되리라 생각한다. 56.3%, 엽산 81.3% 등으로 높게 나타나 근로자들의 영양 문제가 심각함을 알 수 있다.혁신지방분권위원회에서 제시한 자치경찰제도(안)을 중심으로 자치경찰제도 운용의 목적 충족과 실질적인 효과의 측면에서 분석하고 바람직한 자치경찰제도의 운용에 대해 살펴본다.rc}C$ 이내에서 높을수록, 염분은 20-35 psu 이내에서 높을수록 잠입률이 높은 경향을 나타내었다. 교수학습모형에 관련된 지식을 묻는 내용으로 주로 출제되었다. 이에 구체적인 개선방안으로 특정 교수학습모형의 이론적 토대가 되고 전체적인 교수설계를 하기 위한 기본 바탕이 될 수 있는 교수학습이론에 관한 내용, 또한 현재가정과교육에 있어서 유용한 교수학습법이라고 입증되고 있는 실천적 추론 가정과 수업에 관한 내용으로의 확대를 제안하였다. 가정과교육평가 문항의 출제는 대다수의 문항이 수행평가에 관한 문항내용으로 출제되었다. 이에 구체적인 개선방안으로 문항의 변별도 여부의 판단, 평가문항의 내용 타당도 분석, 평가결과를 해석하는 능력, 평가자의 철학적 관점과 같은 내용으로의 확대를 제안하였다.

• 생명과학회지
• /
• 제18권10호
• /
• pp.1455-1463
• /
• 2008

The purpose of this study was to evaluate the effect of various exercise intensity on Excess post exercise energy expenditure (EPEE), Resting Metabolic Rate (RMR),thyroid hormonal changes and biochemical variables in obese and NIDDM patients. The subject of the present study were divided into four groups and four periods: trained (T; n=10), control (C; n=10), obese (O; n=10) and NIDDM (N; n=10) group. And the periods were divided as follows; Resting (RE), Maximal (MA), High intensity (HI), and Low intensity (LI). There was significant difference in RMR among different intensity of exercise. in the T (p<0.05) not in the C, O, and N groups. however, there was no significant different percent body fat among all groups. In the energy expenditure, there was significant different among C, O, N groups compare to T in HIEE (high intensity exercise energy expenditure), LIEE (low intensity exercise energy expenditure), HIEEPE (high intensity exercise energy expenditure post exercise) and LIEEPE (low intensity exercise expenditure post exercise). In the hormonal level, there was significant different in T4 level in the T group at LI period and there was also significant difference in T4, Free T3, & Free T4 levels in T group at LI period, however there was no significant different in the O and N groups except LI period. In the fatigue variables, there was significant different in lactate and ammonia levels in the N group in the period of HI compare to C. The present cross-sectional study was design to investigate the relationship between exercise intensity and RMR in four groups. The focus of this investigation was to compare RMR in aerobically trained (T), control (C), obese (O) and NIDDM (N) group. The relationship among RMR, exercise intensity and percent body fat would best be investigated using Meta Lyzer 3B, MMX3B and body composition analyzer. Each subject completed measurement of percent body fat, RMR, hormone in the period of maximal oxygen uptake exercise (MA), high intensity exercise (HI), and low intensity exercise (LI). From the results, High and Low intensity of exercise, there was a trend for an increased RMR (kcal/day) in the trained groups and control group (in case of LI) not for the obese and N groups. This is best explained not by the reduced percent body fat but by the highly induced energy expenditure (during exercise and post exercise energy expenditure) and increased T4, Free T3, and Free T4 hormonal levels in the low intensity exercise for the T group and sometimes C group.