• Journal of Preventive Medicine and Public Health
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• v.56 no.6
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• pp.504-514
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• 2023

Objectives: This study investigated the relationship between prescribing institutions and medication adherence among patients newly diagnosed with hypertension and diabetes. Methods: This study investigated patients with new prescriptions for hypertension and diabetes in Korea in 2019 with using data collected from general health screenings. A multilevel logistic regression model was applied to explore the relationship between patients' first prescribing institution and their medication adherence, defined as a medication possession ratio (MPR) over 80%. Results: The overall adherence rates were 53.7% and 56.0% among patients with hypertension and diabetes, respectively. The intra-class correlation coefficients were 13.2% for hypertension and 13.8% for diabetes (p<0.001), implying that the first prescribing institution had a significant role in medication adherence. With clinics as the reference group, all other types of hospitals showed an odds ratio (OR) less than 1.00, with the lowest for tertiary hospitals (OR, 0.30 for hypertension; 0.45 for diabetes), and the next lowest in health screening specialized clinics (OR, 0.51 for hypertension; 0.46 for diabetes). Among individual-level variables, female sex, older age, higher insurance premium level, and residing in cities were positively associated with adherence in both the hypertension and diabetes samples. Conclusions: This study showed that the prescribing institution had a significant relationship with medication adherence. When the first prescribing institution was a clinic, newly diagnosed patients were more likely to adhere to their medication. These results highlight the important role played by primary care institutions in managing mild chronic diseases.

• Journal of Convergence for Information Technology
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• v.11 no.9
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• pp.43-49
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• 2021

This study was conducted to investigate the correlation between diabetes empowerment, health perception, and diabetes self-care behaviors with diabetes for the elderly in the community, and to identify the factors affecting diabetes self-care behavior in the elderly with diabetes. A survey was conducted on 80 diabetic elderly people over the age of 65 who were registered at a local public health center. The mean age was 71.15 years, and 41 males and 39 females were included. Diabetes self-care behavior showed a significant positive correlation with economic status (r=.245, p=.029) and diabetes empowerment (r=.406, p<.001), but health perception (r=.127, p=.263) did not show a significant correlation. As a result of this study, diabetes empowerment and economic status of the diabetic elderly were found to be significant influencing factors on diabetes self-care behavior in the diabetic elderly, and the explanatory power of the model was 19.6% (F=10.623, p<.001). Therefore, if a community program is developed to improve the diabetes empowerment of the elderly with diabetes in the community and economic support policies are also provided at the level of public health, it will be possible to improve the self-care behavior of the elderly with diabetes in the community.

• Journal of Nutrition and Health
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• v.55 no.2
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• pp.263-277
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• 2022

Purpose: The present study examined the associations of Korean Food-based Index of Dietary Inflammatory Potential (FBDI) scores with the prevalence of diabetes and hemoglobin A1c (HbA1c) level of diabetes patients in Korean adults. Methods: The Korean Genome and Epidemiology Study (KoGES) Health Examinee baseline data, collected between 2004 and 2013 and followed up between 2012 and 2016, were used in our study. A total 56,391 participants including diabetes (n = 5,733) and non-diabetes (n = 50,658) were analyzed. The subjects were classified into quartiles of FBDI scores using the semi-quantitative food-frequency questionnaire developed for KoGES. The prevalence rate of diabetes under FBDI scores was assessed by Cox proportional risk models and the severity of the diabetes was analyzed by multiple regression analysis. Results: There were 775 incident cases of diabetes after a mean follow-up of 3.97 years. There was no statistically significant association between FBDI scores and incidence of diabetes. Among diabetes patients at baseline, FBDI scores were related to the risk of progression of diabetes which was represented by greater than 9% HbA1c (Q1 vs. Q4; odds ratio, 1.562 [95% confidence intervals, 1.13-2.15]; p for trend = 0.007). The stratified analysis showed a stronger association in females, irregular exercise group, and higher body mass index group. Conclusion: These results suggest that a pro-inflammatory diet is not associated with the incidence of diabetes but is related to the HbA1c level of diabetes patients. Thus, further longitudinal studies with longer periods are required to determine a relationship between dietary inflammatory index and diabetes in Korea.

• Nutrition Research and Practice
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• v.12 no.5
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• pp.396-405
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• 2018

BACKGROUND/OBJECTIVES: This prospective study examined gender-specific associations between egg intake and the risk of developing type 2 diabetes using data from a large-scale cohort study. SUBJECTS/METHODS: A total of 7,002 Korean adults (40-69 years) without type 2 diabetes at baseline were analyzed. Dietary intake was evaluated by a food frequency questionnaire administered at baseline (2001-2002) and the second follow-up examination (2005-2006). Type 2 diabetes was diagnosed as a fasting glucose concentration ${\geq}126mg/dL$ or current use of glucose-lowering medications or insulin injection. Multivariate Cox proportional hazard models were used to calculate hazard ratios (HRs) with 95% confidence intervals (CIs) for incident type 2 diabetes according to egg consumption or cholesterol intake. RESULTS: During a 14-year follow up period, 857 subjects developed type 2 diabetes. In men, frequent egg intake (2- < 4 servings/week) was associated with a 40% lower risk of developing type 2 diabetes than infrequent egg intake (0- < 1 serving/week) (HR = 0.60, 95% CI: 0.37-0.97), whereas no association between egg intake and incidence of type 2 diabetes was observed in women (HR = 0.61, 95% CI: 0.27-1.37). There was no association between cholesterol intake and risk of incident type 2 diabetes in either men or women. CONCLUSIONS: Egg consumption was inversely related to the risk of incident type 2 diabetes in men, but not in women, suggesting gender differences in the relationship between diet and disease risk.

• Journal of Nutrition and Health
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• v.38 no.1
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• pp.56-66
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• 2005

The purpose of this study was to assess the zinc and copper status of type 2 diabetic women and to analyse the relation-ship among zinc and copper status, and diabetic control indices of diabetes. The mean age of diabetes was 57.9 years old. The mean duration of diabetes was 8.0 $\pm$ 6.5 years. The mean daily energy intake of diabetes was 1562 kcal. There were no significant differences of age, BMI, %body fat, nutritional intakes, total energy intake, and energy composition from carbohydrate, protein, and fat between diabetes (n = 50) and control group (n = 68). However, both zinc intake density (4.15 mg/1000 kcal) and zinc %RDA (62.0%) of diabetes were significantly lower than control group (p <0.05, P < 0.01, respectively). The plasma zinc level was not significantly different between diabetes and control group (90$\mu$g/dl, 91$\mu$g/dl respectively). The proportion of diabetic women whose plasma zinc levels were lower than 76 $\mu$g/dl(borderline zinc deficiency) was 18.8%. This was about 38% higher than control group. It has been suggested that insulin secretion might decrease in borderline plasma zinc and copper deficiency and increase in normal plasma zinc and copper status. The urinary zinc excretion was twice higher in diabetes than in control group (p < 0.001). The urinary zinc loss was positively correlated with the duration of diabetes (p < 0.05), hyperglycemia (p < 0.001) and insulin resistance (p < 0.05). These results lead us to conclude that normal blood glucose level controlled by diet therapy could improve the hyperzincuria in diabetic women.

• The Journal of Korean Academic Society of Nursing Education
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• v.6 no.1
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• pp.103-114
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• 2000

The purpose of this study was to determine the effect of nursing education in diabetes patient, and to define the strategy to promote their sick-roll behavior, self efficacy. The quasi-experimental design was designed non-equivalent control group, non-synchronized design. The study had been done by investigating the experimental group and control group through the questionnaire on 58 patients who had been hospitalized and visiting out-patient department in K hospital in Pusan from June 1, 1998 to September 30, 1998. Individual diabetes education was carried out experimental group for the average 45 minutes. Self-efficacy was measured by Diabetes Management Self-efficacy Instrument developed by Park(1984). Data was collected before and after the experimentation. Collected data was analyzed by means of frequency, percentage, chi-square test, mean, standard deviation, and t-test with SPSS/PC program. The results were summarized as follows : 1. 'The experimental group which received the individual diabetes education should be higher in self-efficacy than control group' was not supported. 2. 'The experimental group which received the individual diabetes education should be higher in sick-roll behavior than control group' was not supported(P=.043). In conclusion, the patient who received individual diabetes education showed the increase in degree of sick - roll behavior of diabetes patients. So individual diabetes education had been judged the nursing intervention to improve sick-roll behavior of diabetes patients. But there was no effect about self-efficacy so to have the program which can improve self-efficacy is needed.

• The Journal of Korean Academic Society of Nursing Education
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• v.20 no.1
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• pp.81-92
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• 2014

Purpose: This study was to identify the effect of the experience of diabetes education on knowledge, self-care behavior and glycosylated hemoglobin (HbA1C). Further, this study was held to examine about patient's preferred methods of education and re-education frequency. Methods: 166 type 2 diabetes patients from two hospitals in Incheon participated in this study. Data were analyzed by using descriptive analysis, t-test, ANOVA, Scheffe's test and multiple regression analysis. Results: 72.3% patients needed re-education and the average interval of re-education was 8.53 months. Patients preferred education methods were lectures, practical training, and studying from pamphlet. Depending on the frequency of diabetes education, there were significant differences in the level of diabetes knowledge (F=10.88, p<.001) and self-care behaviors (F=4.59, p=.012), but there was not significant difference with HbA1C (F=1.53, p=.220). As to how much the diabetes education helped managing diabetes, there was a significant difference in the level of self-care behaviors (t=2.01, p=.049), but there were not significant differences in level of knowledge (t=1.10, p=.275) and HbA1C (t=-.33, p=.746). The experience of diabetes education was a significant factor which influenced patient's knowledge (t=3.93, p<.001) and self-care behaviors (t=2.21, p<.001). But HbA1C was not influenced by the experience of diabetes education (t=-1.68, p=.096). Conclusion: It is necessary to provide diabetes education with appropriate interval and methods and subjects that reflect the needs of patient through the study results.

• Korean Journal of Health Education and Promotion
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• v.33 no.5
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• pp.47-57
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• 2016

Objectives: To develop and evaluate the applicability of a health literacy instrument in patients with diabetes by measuring their ability to understand diabetes-related words. Methods: Diabetes-related words were extracted from the Korean Diabetes Association's website and literature reviews. In the first phase, three nursing researchers evaluated 2,661 diabetes-related words based on graded lexical vocabularies and what patients need to know about self-care, and the narrowed them to 255 words. In the second phase, a content validity assessment was conducted by an expert panel. In the third phase, the remaining 25 words were administered to 200 conscientious with type 2 patients aged 40 years old and using a Gallup survey from March 3 to 17, 2016 in Seoul, Korea. Descriptive analysis and Rasch analysis were performed to test psychometric properties. Results: The mean score was 21.47 with a range of 0 to 25. The Cronbach's ${\alpha}$ was .92. The health literacy instrument using diabetes-related words had a ceiling effect response. Conclusions: Diabetes-related words are useful and reliable items for testing the health literacy of diabetes patients. Future study is needed to develop and validate health literacy measures for diabetic patients.

• Journal of Preventive Medicine and Public Health
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• v.48 no.4
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• pp.188-194
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• 2015

Objectives: The goal of this study was to identify association between the continuity of ambulatory care of diabetes patients in South Korea (hereafter Korea) and the incidence of macrovascular complications of diabetes, using claims data compiled by the National Health Insurance Services of Korea. Methods: This study was conducted retrospectively. The subjects of the study were 43 002 patients diagnosed with diabetes in 2007, who were over 30 years of age, and had insurance claim data from 2008. The macrovascular complications of diabetes mellitus were limited to ischemic heart disease and ischemic stroke. We compared the characteristics of the patients in whom macrovascular complications occurred from 2009 to 2012 to the characteristics of the patients who had no such complications. Multiple logistic regression was used to assess the effects of continuity of ambulatory care on diabetic macrovascular complications. The continuity of ambulatory diabetes care was estimated by metrics such as the medication possession ratio, the quarterly continuity of care and the number of clinics that were visited. Results: Patients with macrovascular complications showed statistically significant differences regarding sex, age, comorbidities, hypertension, dyslipidemia and continuity of ambulatory diabetes care. Visiting a lower number of clinics reduced the odds ratio for macrovascular complications of diabetes. A medication possession ratio below 80% was associated with an increased odds ratio for macrovascular complications, but this result was of borderline statistical significance. Conclusions: Diabetes care by regular health care providers was found to be associated with a lower occurrence of diabetic macrovascular complications. This result has policy implications for the Korean health care system, in which the delivery system does not work properly.

• Korean Journal of Community Nutrition
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• v.18 no.2
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• pp.101-111
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• 2013

Type 1 diabetes is on the rise worldwide. Although nutrition education for patients with diabetes has become a routine practice, specifics and impacts of such educations need to be more researched. This study examined the status of nutrition knowledge, dietary attitude, and dietary behavior among children and adolescents with type 1 diabetes (9-19 year-old) and explored factors influencing dietary behaviors related to diabetes by applying the Theory of Planned Behavior. Face-to-face interviews, using a pre-tested structured questionnaire, were conducted with 32 participants (11 boys and 21 girls) with type 1 diabetes followed by a diabetes clinic in a university hospital. This study found that the level of nutrition knowledge related to diabetes was generally low at 4 points out of a possible 10, however, the dietary attitude related to diabetes was found to be generally good at 26 points out of a possible 30. Participants were motivated to follow medical staff recommendations the most; however, their family was also important. Perceived behavioral control was low especially for eating-out and portion control. The dietary behavior related to blood glucose control showed low at 13 points out of a possible 20. Regression analysis showed that perceived behavioral control (p < 0.001) was significantly related to the dietary behavior related to blood glucose control. This rare study with children and adolescents with type 1 diabetes showed that nutrition education should include a component to improve perceived behavioral control through high-risk situation management.