• Journal of Preventive Medicine and Public Health
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• 제48권4호
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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.

• 대한한의학회지
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• 제19권2호
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• pp.137-152
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• 1998

Acute complications of diabetes mellitus were diminished after Banting and Best discovered insulin. But chronic complications of diabetes mellitus have been increased. The main complications of diabetes mellitus are diabetic retinopathy, diabetic nephropathy, diabetic neuropathy, diabetic foot lesion and macrovascular complication. These complications can result in renal failure, loss of sight, cerebral infarction and myocardial infarction. So it is very difficult to treat the complications of diabetes mellitus. In oriental medicine, the transformations(傳變症) of Sogal(消渴) are edema, carbuncle, loss of sight and so on. The comparative study between the trcmsformations(傳變症) of SogaI(消渴) and the complications of diabetes mellitus has come to the following conclusions. 1. In oriental medicine, diabetic retinopathy was expessed as loss of sight and the treament of diabetic retinopathy should be started at an early stage, to prevent vitreous hemorrhage and traction retinal detachment. 2. In oriental medicine. diabetic nephropathy was expressed as edema and the treatment should be started at an early stage of renal injury when the protein comes from urine.3. Symmetrical distal polyneuropathy is the main part of diabetic neuropathy and it was expressed as weakness of the lower limbs and pain of joints in the symptoms of Haso(下消). In Oriental medicine, acupuncture and herb medicine which effect is SopungHwalHyul can treat polyneuropathy. 4. Chief macrovascular complications are coronary artery disease and cerebrovascular disease, The cause of macrovascular complication is atherosclerosis. So the method of treating atherosclerosis should be studied in oriental medicine. 5. Diabetic foot were expressed as carbuncle and its main causes are decreasing perfusion of fool, diabetic neuropathy and infection. So these causes should be studied in oriental medicine. 6. The complications of diabetes mellitus afe very similar to the transfonnatiuns of Sogal(消渴).The control of blood glucose is indispensable to prevent and delay the complication of diabetes mellitus.

• Journal of Nutrition and Health
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• 제34권8호
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• pp.912-919
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• 2001

The increased oxidative stress may play an important role on the pathogenesis of diabetes and diabetic complications, and the blood level of vitamin C and lipid peroxidation in NIDDM patients may be used as an indicator for oxidative stress. However there is only scanty evidence on the blood level of vitamin C in NIDDM patients with or without diabetic complications. The study population consisted of 90 NIDDM patients(diabetes without complication, 48, and diabetes with complications, 42) and 41 normal subjects. The 42 diabetic complications were divided into 3 groups : 15 diabetic nephropathy, 18 diabetic neuropathy, 9 diabetic retinopathy. The anthropometric data and blood biochemical data were studied. The dietary intake was determined by 24 hour recall methods and food frequency questionnaire. The plasma concentrations of MDA and vitamin C were determined by fluorophotometer and HPLC respectively. 1) In blood lipoprotein study, diabetes with complication had higher level of TG than diabetes without complications, while no significant differences in total cholesterol, HDL, and LDL were shown. Diabetic neuropathy had the highest TG level among diabetic complication groups. 2) The intakes of vitamin B complexes(vitamin B$_2$, vitamin B$_{6}$, not vitamin B$_1$) and antioxidant vitamins(vitamin A and vitamin E, not vitamin C) and certain minerals such as iron and calcium in diabetes were not sufficient but the intakes of energy, protein, niacin, and phosphorus in diabetes were sufficient. The dietary intakes between diabetes with-and without complications were not significantly different. Among diabetic complications, the diabetic retinopathy had the lowest intake of vitamin B$_2$ and B$_{6}$(p < 0.05). the diabetic neuropathy or nephropathy consumed extremely low amount of vitamin A. 3) The MDA concentrations of NIDDM was significantly higher than that in controls(p < 0. 05) while no significant difference in the MDA concentration between with and without complications was shown. Although there were no statistical differences, the diabetic nephropathy and diabetic neuropathy showed the higher concentration of MDA than the diabetes without complications or diabetic retinopathy. 4) The plasma concentration of vitamin C in controls was higher than that in diabetes(p < 0.05) while the plasma vitamin C in diabetes with and without complications were similar. In diabetic complications, no differences in plasma vitamin C concentration of three groups were shown. This study showed that the oxidative stress in NIDDM patients was highly increased and the vitamin C reserve was significantly depleted, as compared with normals, although their intakes of vitamin C met korean RDA, which means that diabetes need more vitamin C intake to decrease oxidative stress in NIDDM patients.nts.

• 한국보건간호학회지
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• 제15권2호
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• pp.334-341
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• 2001

The purpose of this study is to examine to control of glucose level and the occurrence of chronic complications of diabetes by compliance groups with health care regimen The subjects were consisted of 300 out patients with type 2 diabetes mellitus from beginning of March through the end of April in 2001, who visited at the endocrinology department at Kangnam St. Mary's Hospital of Catholic University in Seoul. The patient's compliance level with health care regimen was assessed at questionnaire. However, the blood glucose level and the occurrence of chronic complications of diabetes were assessed at medical record review. The data were analyzed by SAS program for chi square test and t-test. The results were as follows. 1. Significant differences were found among the factors such as duration of diabetes, the number of participation of diabetes educational program, job, smoking, self monitoring of blood glucose and the methods of diabetes therapy between high and low compliance groups. High compliance group patients had a diabetes longer than low compliance group patients. High compliance group patients more frequently attended the educational program and checked themselves monitoring blood glucose than low compliance group patients. Also, they did not work recently, smoked less and got more insulin injection therapy compared to low compliance group patients. 2. No significant differences were found among the result of fasting blood glucose. 2-hour postprandial blood glucose, and $HbA_{l}c}$ between high and low compliance groups. 3. The occurrence rate of macrovascular complications of chronic complications of diabetes were lower, however, the occurrence rate of microvascular complications were higher in high compliance group than in low compliance group with health care regimen.

• 가정∙방문간호학회지
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• 제23권2호
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• pp.139-146
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• 2016

Purpose: This research seeks to identify differences between general characteristics, disease-related characteristics, glycated hemoglobin (HbAlc) levels, and aspects of chronic complications of diabetes mellitus in type 2 diabetes. Methods: This research was conducted from the 1st to the 15th of February in 2016, on 263 in patients. Patients' electronic medical records were used to identify their general characteristics, disease-related characteristics, HbAlc, and chronic diabetic complications. Chi-square test, ANOVA, ANCOVA, and the Cochran-Mantel-Haenszel test were used for data analysis. Results: Statistical significance was observed for general characteristics, based on smoking status, such as age, and education level; disease-related characteristics differed according to the duration of diabetes. Smoking status did not differ according to HbAlc level. In term of chronic diabetic complications, statistically significance was observed for diabetic nephropathy, based on smoking status. Conclusion: Patients who had a history of smoking, but were not currently smoking, were likely to display higher HbAlc levels and diabetic nephropathy. Therefore, there is need for regular checkups for diabetic complications among patients with a history of smoking and it is important to emphasize smoking cessation.

• Advances in Traditional Medicine
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• 제5권2호
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• pp.75-91
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• 2005

Great efforts have been made to improve both the quality of life and life expectancy of diabetes by treating problems associated with chronic complications such as neuropathy, retinopathy and nephropathy. In particular, diabetes is an increased risk of developing several types of kidney disease, and the predominant cause of end-stage renal disease in patients with this disorder is diabetic nephropathy. Therefore, prevention of the occurrence and progression of diabetes and its complications has become a very important issue. The scientific observations of an animal model of streptozotocin-induced diabetes, spontaneously occurring diabetes and diabetic nephropathy in this study suggest that one of the Kampo prescriptions, Hachimi-jio-gan comprising eight constituents, is a novel therapeutic agent.

• 기본간호학회지
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• 제16권2호
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• pp.144-152
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• 2009

Purpose: The purpose of this study was to predict the risk factors for vascular complications among patients with type 2 diabetes. Method: The data were collected from August to September, 2007 using clinical examination and questionnaires. Patients (N=101) were recruited from the endocrinology department of P University hospital in D city. Descriptive statistics, Pearson correlation coefficients and multiple linear regression were used to analyze the data. Results: The cardiovascular risk of patients with diabetes was significantly related to self care behavior, family history, and smoking status. The risk of peripheral vascular complications was not related to predictors included in the study. With multivariate analyses, significant predictors of cardiovascular risk for these patients were self care behavior, family history, and smoking status ($R^2=.40$, p<.0001). Conclusion: The findings of this study indicate that smoking cessation and improving self-care behavior are essential to reduce the risk of cardiovascular complications among patients with diabetes. To enhance self-care practices for the patients with diabetes, nursing interventions, such as telephone counseling, problem focused nursing counseling, and peer group activities should be considered.

• 동의생리병리학회지
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• 제25권4호
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• pp.683-690
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• 2011

The object of this study was to observe the effects of Hwanggeum-tang (HGT) aqueous extracts on Streptozotocin-induced rat's diabetes and related complications. Three different dosages of HGT extracts were orally administered oncea day for 28 days from 3 weeks after Streptozotocin treatment (60 mg/kg, single intraperitoneally administered). All the rats were checked at 3 weeks after Streptozotocin treatment as follows. Changes on the body weight, blood glucose level, kidney weight, serum BUN and creatinine level, liver weight, serum AST and ALT level, serum LDL, HDL, triglyceride and total cholesterol level were observed with changes on the pancreatic MDA content and GSH content. The results were compared with a potent antioxidant silymarin 100 mg/kg in which the effects on Streptozotocin-induced diabetes and related complications were already confirmed. As results of Streptozotocin-injected diabetes and related complications, dramatical decreases on the body weight, increase of the kidney and liver weight, increase of serum BUN, creatinine, AST, ALT, LDL, triglyceride, total cholesterol level and decreases of serum HDL level were detected in streptozotocin control as compared with intact control. In addition, marked increases of pancreatic MDA content and decreases of GSH content were also detected in streptozotocin control as compared with intact control. However, these diabetes and related complications, and inhibition of antioxidant effects induced by Streptozotocin were inhibited by 28 days continuous treatment of 50, 100 and 200 mg/kg of HGT extracts in the present study. HGT have favorable effects on the diabetes and various diabetic complications. Therefore, more detail mechanism studies should be conducedin future with the efficacy tests of individual herbal composition of HGT and the screening of the biological active compounds in herbs.

• 대한한의학방제학회지
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• 제32권1호
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• pp.11-28
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• 2024

Objectives : GunRyeong-Tang(GRT) is a traditional herbal prescription that combines Oryeongsan and Sagunja-tang. This study employed network analysis methods on the components of GRT and target genes related to diabetes complications to predict the improvement effects of GRT on diabetes complications. Methods : The collection of active compounds of GRT and related target genes involved the utilization of public databases and the PubChem database. We selected diabetes complication-related genes using GeneCards and confirmed their correlation through comparative analysis with the target genes of GRT. We constructed a network using Cytoscape 3.9.1 and conducted topological analysis. To predict the mechanism, we performed functional enrichment analysis based on Gene Ontology (GO) biological processes and Kyoto Encyclopedia of Genes and Genomes (KEGG) pathways. Results : Through network analysis, 234 active compounds and 1361 related genes were collected from GRT. A total of 9,136 genes related to diabetes complications were collected, and 1,039 target genes overlapping with the components of GRT were identified. The core genes of this network were TP53, INS, AKT1, ALB, and EGFR. In addition, GRT significantly reduced the H9c2 cell size and the expression of myocardial hypertrophy biomarkers (ANP, BNP), which were increased by high glucose (HG). Conclusions : Through this study, we were able to predict the activity and mechanism of action of GRT on diabetes and diabetic complications, and confirmed the potential of GRT as a treatment for diabetes complications through the effect of GRT on improving myocardial hypertrophy for diabetic cardiomyopathy.

• 대한약학회:학술대회논문집
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• 대한약학회 2002년도 Proceedings of the Convention of the Pharmaceutical Society of Korea Vol.2
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• pp.429.2-430
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• 2002

Complications of diabetes increase morbidity and motality and decrease quality of life. Recently. UKPDS has been reported that strict regulation of blood glucose. hypertension and hyperlipidemia could decrease complications of type 2 diabetes. This study evaluated use of hypoglycemic agents, control of blood glucose. frequency of complications and preventive management at a local 2ndary hospital in Korea. (omitted)