• Journal of Nutrition and Health
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• 제42권2호
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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.

• 근관절건강학회지
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• 제21권3호
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• pp.184-194
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• 2014

Purpose: The purpose of this study was to develop and validate a diabetes management self-efficacy scale for older adults (DMSES-O). Methods: A preliminary DMSES-O of 22 items was derived from a literature review and seven domains of self-management behaviors. Content validity was confirmed by experts in diabetes self-management education. To test the reliability and validity of the DMSES-O, data were collected from 150 older adults with type 2 diabetes. The data were analyzed using exploratory factor analysis, and Cronbach's ${\alpha}$ and Pearson's correlation coefficients were calculated. Results: From the exploratory factor analysis, 17 significant items in six subscales were derived. Factors derived were named "problem solving for hypoglycemia and self-monitoring blood glucose," "problem solving for hyperglycemia," "coping with psychological distress and taking medication," "reducing risks of diabetes complications," "appropriate exercise," and "healthy eating." The criterion-related validity of the DMSES-O was established by its correlation with the Summary of Diabetes Self-care Activities Questionnaire. Cronbach's ${\alpha}$, a measure of internal consistency, was .84 for the overall scale and ranged from .54 to .80 for the subscales. Conclusion: The DMSES-O is a reliable and valid instrument to measure selfefficacy for diabetes self-management among older adults.

• 한국주거학회논문집
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• 제18권5호
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• pp.11-22
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• 2007

The purpose of this study is to propose prototypical plans for a dwelling unit applying the concepts of 'open housing' and 'aging in place' for senior citizens living in cities focusing on specific life patterns with chronic disease. Especially, a unit was designed for diabetes patients because diabetes, a representative disease of elderly people, often accompanies complications such as arthritis and Alzheimer disease. A unit design suitable for the convenient life of the elderly people with diabetes will provide a guideline for the similar unit designs of the senior citizens with other diseases. In this study, three types of unit plan are proposed. A-type plan is for type-1 diabetes patients, B-type alt.1 for the independent seniors of type-2 diabetes patients, and B-type alt.2 for the dependant seniors of type-2 diabetes patients. And a support design for a unit plan with the exclusive area of $60\;m^2$ is proposed. The same support design is used for all three unit types. Although the locations of bathroom and storage room are fixed and the location of the kitchen is changeable only in wet-zone. In conclusion, senior residents with diabetes can choose one of three unit types before occupation and the chosen unit type can be renovated by replacing infill systems as the health condition or life style changes.

• Physical Therapy Rehabilitation Science
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• 제7권3호
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• pp.139-145
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• 2018

Objective: Older persons with diabetes mellitus (DM) are particularly more likely to have fallen in the previous year than those without DM. The purpose of this study was to investigate the relationship between the risk of falls and type 2 DM in older adults who are 65 years of age or above. Design: A systematic review. Methods: PubMed and other two databases were searched up to August 2, 2018. Observational and cohort studies evaluating fall risk in people who are 65 years of age or above with DM were included. This review extracted the following information from each study selected: first author's surname, year of publication, country, average follow-up period, sex, age at enrollment, study population, measurement variables, relative risk, 95% confidence intervals and controlled variables. Results: This review involved nine cohort studies with 3,765 older adults with DM and 12,989 older adults without DM. Six studies compared with or without DM and two studies compared fallers with non-fallers with DM. Risk factors for falls included impaired cognitive function, diabetes-related complications (peripheral nerve dysfunction, visual impairment), and physical function (balance, gait velocity, muscle strength, and severity of physical activities). Conclusions: People who are 65 years of age or above with DM have increased risk of falling caused by impaired cognitive function, peripheral nerve dysfunction, visual impairment, and physical function in community-dwellers. For adults who are 65 years of age or older with DM, research fields and clinical settings should consider therapeutic approaches to improve these risk factors for falls.

• Journal of Nutrition and Health
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• 제34권2호
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• pp.158-164
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• 2001

The present study was conducted to investigate physical characteristics, food habits of pregnant women with gestational diabetes mellites(GDM). The subjects were consecutive pregnant women, 21 GDM and 43 non-GDM controls who received antenatal care at the Obstetrics and Gynecology clinic. There were no significant difference in the mean age between the two groups(GDM:30.8years, non-GDM:30.5years). Significant differences were observed in several anthropometric characteristics such as height(GDM:159.7cm, non-GDM:162.3cm), prepregnancy weight(GDM:61.6kg, non-GDM:54.1kg), body mass index(GDM:23.9kg/$m^2$, non-GDM:20.5kg/$m^2$), and triceps skin fold thicknesses(GDM:30.9mm, non-GDM:24.7mm) between the two groups. The GDM group had an high incidence of(52.4%) family history of diabetes mellitus than those of control group(23.3%). In the GDM group, more irregularities of meals and more bed-time snacking were observed than those of control group. The intake amount of carbohydrates as well as the total energy were significantly higher in the GDM group when thery were compared with the control. These results suggest that the GDM women in Korea do exhibit clearly distinctive anthropometric and dietary characteristics. Nutritional management such as weight control before conception and throughout pregnancy, monitoring total energy and carbohydrate intakes, and implementing more rigorous meal scheduling might be beneficial for the prevention or reduction of the prevalence of the GDM or its complications. (Korean J nutrition 34(2):158~164, 2001)

• 약학회지
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• 제44권6호
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• pp.539-544
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• 2000

Many diabetic patients develop serious complications during the course of the disease, including cardiovascalar disorders, nepropathy, neuropathy and retinopathy. Because some physiological changes occurring in diabetes mellitus patients could alter the pharmacokinetics of drugs used to treat the disease, the pharmacokinetics of gentamycin was investigated after intravenous administration (2 mg/kg) to control rabbits and acute or chronic alloxan-induced diabetes mellitus rabbits (AIDRs). After intravenous administration, the serum concentrations of gentamycin were significantly higher between 6 and 12 hr in chronic AIDRs compared with those in control rabbits. The AUC was significant greater in chronic ($31.91\;{\pm}\;3.76\;{\mu}g/ml{\cdot}hr$) AIDRs than that in control ($21.60\;{\pm}\;2.45\;{\mu}g/ml{\cdot}hr$) rabbits. Total body clearance (CLt) in AIDRs were significantly decreased compared with that in control rabbits. Cumulative urinary excretion of gentamycin was decreased, although not significantly, in AIDRs compared with that in control rabbits.

• Childhood Kidney Diseases
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• 제24권1호
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• pp.53-57
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• 2020

Streptococcus agalactiae or group B streptococcus (GBS) is associated with infections in neonates and pregnant women. Herein, we describe a rare case of GBS renal abscess with peritonitis and pleural effusion in a 17-year-old girl with type 1 diabetes mellitus. The girl was admitted due to fever and right flank pain. Laboratory findings included leukocytosis and increased C-reactive protein level and erythrocyte sedimentation rate. Her serum glucose level was 484 mg/dL. Urinalysis showed no pyuria. Renal sonography revealed parenchymal swelling in the right kidney. The patient was administered intravenous cefotaxime. Urine and blood cultures were negative. Fever seemed to improve, but the following day, she complained of abdominal pain and fever. Antibiotic was switched to imipenem, and abdominal and pelvic CT revealed a ruptured right renal abscess, peritonitis, and bilateral pleural effusion with atelectasis. Pigtail catheter drainage of the abscess was performed. Culture from the abscess was positive for GBS, and fever subsided 2 days after the drainage. She was discharged with oral cefixime. The clinical course of urinary tract infections (UTIs) can be atypical in patients with diabetes, and GBS can be a cause of UTIs. Prompt diagnosis and management are necessary to prevent complications in patients showing atypical courses.

• Asian Journal for Public Opinion Research
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• 제2권2호
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• pp.121-139
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• 2015

"Living in the present moment," a Buddhist concept, was applied in this research. This concept urges the patients to cling neither to the past nor the future as well as being mindful of their body, feelings, mind, and mental qualities. The purpose of the study was to develop a "living in the present moment" model and to evaluate the power of "living in the present moment" in terms of physical and mental results. The study used non-participatory action research with quasi-experimental research design that included 3 camps composed of 6 main activities. The percentages, SD, and paired t-test statistics were used to analyze and compare 17 purposively selected diabetic patients from Pak Thong Chai Hospital before and after they attended the 3 camps. The patients improved significantly in terms of waistline, body weight, body mass index (BMI) and blood pressure (SBP and DBP). The mean of fasting plasma glucose (FPG) level was also changed considerably. The results revealed that the treatment helped the patients to gain self-awareness and self-realization (Yonisomanasikara), as well as knowledge and increased support from friends (Kalyanamitta). They also let go of their attachment to their physical and mental oppressions. This helped the patients to relieve their daily pain, fatigue, insomnia, and diabetes-related complications. About 75% of all patients were able to achieve lifestyle modifications. Therefore, implementation of the model should be expanded and utilized in other diabetic centers. The model might also be expanded to pre-diabetes.

• 혜화의학회지
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• 제21권1호
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• pp.11-21
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• 2012

New onset diabetes is a major complication after kidney transplantation. However, the natural course of posttransplantation diabetes mellitus (PTDM) remains unclear. The aim of this study was to demonstrate the detailed natural courses of PTDM according to the onset and persistency of hyperglycemia, and to investigate risk factors for development of different courses of PTDM in renal allograft recipients. The purpose of this study is to develop novel immune suppressants for PTDM using of action mechanism of them. The use of immunosuppressive drugs in transplanted patients is associated with the development of diabetes, possibly due to ${\beta}$-cell toxicity. To better understand the mechanisms leading to post-transplant diabetes, we investigated the actions of prolonged exposure of ${\beta}$-cells to therapeutical levels of tacrolimus (FK506) or cyclosporin A(CsA). The immunosuppressive drug cyclosporine(CsA) is a potent agent widely used after organ transplantations and various autoimmune disorders. After using CsA, some patients suffer severe complications including renal and vascular toxicity. The renal or vascular toxicity is influenced by the degree of the endothelial damage. FK506(tacrolimus) is a widely used immunosuppressive agent in the treatment of various medical conditions, including autoimmune disease, bone marrow and organ transplantations. We found some interesting clusters and confirmed the feasibility of cDNA microarray in the study of Immunosuppressant. In this study, we investigated gene expression patterns induced by Immunosuppressant in RIN-m5F of rat insulinoma cell line. Gene expressions evaluated using cDNA microarry in two clusters were increased or decreased. this study provides comprehensive comparison of the patterns of gene expression changes induced by CsA and FK506 in ${\beta}$-cells. This study could establish that the mode of action mechanism by which currently used insulin inhibitors inducing PTDM could be elucidated at least in part, which raises the possibility that novel immune suppressive PTDM can be developed. The molecular biological study on PTDM will also contribute the progress in diabetes research field as well as in that of PTDM.

• 한국식품영양학회지
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• 제26권4호
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• pp.909-918
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• 2013

The objective of this study is to investigate the effects of dietary nutrient intakes for markers of blood glucose and inflammation which is important to the progress of type 2 diabetes and the development of its complications. For this study, 76 adults with diabetes (42 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 (HbA1c) and C-reactive protein (CRP), and dietary nutrient intakes were collected. Our results have shown that 66% of subjects were either overweight or obese. Serum analysis indicates that levels of C-peptide, glucose, HbA1c, CRP, triglyceride, LDL-cholesterol were higher than normal range. Results from the dietary nutrient intake survey displayed that intakes of cholesterol and sodium were higher than Dietary Reference Intakes for Koreans. On the contrary, folate intake was lower than the guideline. Within the females, energy contribution from carbohydrate was higher than Korean Diabetes Association guideline. Statistical analysis has revealed a negative correlation between serum HbA1c level and dietary intakes of polyunsaturated fatty acid (PUFA), n-3 PUFA, ${\beta}$-carotene and vitamin E after adjustments for age, BMI, smoking habits, alcohol consumption, exercise and ingestion of diabetes mellitus medication (p<0.05). Serum CRP level was inversely associated with dietary intakes of carbohydrate, protein, vitamin C and fiber (p<0.05). Our results suggest that dietary nutrient intakes may influence the levels of HbA1c and CRP, and subsequently, it may help in the management/treatment of type 2 diabetes.