• Korean Journal of Community Nutrition
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• v.9 no.1
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• pp.98-112
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• 2004

This study was done to investigate and compare the nutritional status and plasma lipids in the diabetes and control elderly. Subjects were 105 persons (male 32, female 73) aged over 65 years and visited public health centers in Ulsan area. The subjects were divided into 2 groups, diabetes and control group. Athropometric measurement, dietary intakes, and plasma biochemical indices were examined. Body Mass Index (BMI), Percentage of Ideal Body Weight (PIBW) and Waist-Hip Ratio (WHR) of diabetes group were higher than those of control group. Overall eating behavior were worse in diabetes group than those of control group. There was no significant difference in smoking and exercise status among groups. The ratio of drinkers was significantly higher in control group. But the amount of alcohol consumed at once was higher in the diabetes group. There was no significant difference in most nutrient intakes between males and females. The intakes of fiber, natrium (Na), vitamin A, and $\beta$-carotene were significantly higher in diabetes group than control groups while that of potassium (K) was lower in diabetes group. Diabetes group had the higher levels in triglyceride, VLDL-cholesterol, Chol/HDL-cholesterol ratio, LDL/HDL-cholesterol ratio, while they had lower HDL-cholesterol level. Overall results might imply that the elderly with diabetes have to be more careful to their meals and health-related behaviors to increase the likelihood of a healthier life.

• Perspectives in Nursing Science
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• v.9 no.2
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• pp.94-101
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• 2012

Purpose: The purpose of this study was to examine the relationship between glucose control, diabetes self-care and depression in community dwelling older adults with type 2 diabetes mellitus. Methods: The cross-sectional survey data of 148 older adults at a senior center were analyzed in this study. We collected data on diabetes self-care, depression, and demographics by face-to-face interviews. Blood samples for HbA1C were obtained from the participants. Results: The average duration of diabetes for the participants was $10.6{\pm}9.31$ years. Fifty percent of the participants had HbA1c higher than 7.0% (mean 7.179%). The level of diabetes self-care was related to depression (r=-.225, p<.01). HbA1c was positively related with the duration of diabetes diagnosis (r=.224, p<.01). The only sub-dimension of diabetes self-care that was related to depression was exercise (r=-.307, p<.01). Conclusion: Only half of the community dwelling older adults with type 2 diabetes had an optimal level of diabetes control. Supported by the evidence, the longer the duration of diabetes since the initial diagnosis, the poorer the glucose control was. Identification and intervention for depression in people with diabetes should be considered to improve diabetes self-care, especially to perform more exercise.

• Journal of the Korean Magnetic Resonance Society
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• v.22 no.4
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• pp.149-157
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• 2018

Diabetes is known to be one of common causes for several types of peripheral nerve damage. Diabetic neuropathy (DN) is a significant complication lowering the quality of life that can be frequently found in diabetes patients. In this study, the metabolomic characteristic of DN and Diabetes was investigated with NMR spectroscopy. The sera samples were collected from DN patients, Diabetes patients, and healthy volunteers. Based on the pair-wise comparison, three metabolites were found to be noticeable: glucose, obviously, was upregulated both in DN patients (DNP) and Diabetes. Citrate is also increased in both diseases. However, the dietary nutrient and biosynthesized metabolite from glucose, ascorbate, was elevated only in DNP, compared to healthy control. The multivariate model of OPLS-DA clearly showed the group separation between healthy control-DNP and healthy control-Diabetes. The most significant metabolites that contributed the group separation included glucose, citrate, ascorbate, and lactate. Lactate did not show the statistical significance of change in t-test while it tends to down-regulated both in DNP and Diabetes. We also conducted the ROC curve analysis to make a multivariate model for discrimination of healthy control and diseases with the identified three metabolites. As a result, the discrimination model between healthy control and DNP (or Diabetes) was successful while the model between DNP and Diabetes was not satisfactory for discrimination. In addition, multiple combinations of lactate and citrate in the OPLS-DA model of healthy control and diabetes group (DNP + Diabetes patients) gave good ROC value of 0.952, which imply these two metabolites could be used for diagnosis of Diabetes without glucose information.

• Journal of Obesity & Metabolic Syndrome
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• v.27 no.4
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• pp.238-247
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• 2018

Background: We aimed to estimate the proportion of patients with diabetes who achieved target glycemic control, to estimate diabetes-related costs attributable to poor control, and to identify factors associated with them in the United Arab Emirates. Methods: This retrospective cohort study used administrative claims data handled by Abu Dhabi Health Authority (January 2010 to June 2012) to determine glycemic control and diabetes-related treatment costs. A total of 4,058 patients were matched using propensity scores to eliminate selection bias between patients with glycosylated hemoglobin (HbA1c) <7% and HbA1c ${\geq}7%$. Diabetes-related costs attributable to poor control were estimated using a recycled prediction method. Factors associated with glycemic control were investigated using logistic regression and factors associated with these costs were identified using a generalized linear model. Results: During the 1-year follow-up period, 46.6% of the patients achieved HbA1c <7%. Older age, female sex, better insurance coverage, non-use of insulin in the index diagnosis month, and non-use of antidiabetic medications during the follow-up period were significantly associated with improved glycemic control. The mean diabetes-related annual costs were $2,282 and $2,667 for patients with and without glycemic control, respectively, and the cost attributable to poor glycemic control was $172 (95% confidence interval [CI], $164-180). The diabetes-related costs were lower with mean HbA1c levels <7% (cost ratio, 0.94; 95% CI, 0.88-0.99). The costs were significantly higher in patients aged ${\geq}65$ years than those aged ${\leq}44$ years (cost ratio, 1.45; 95% CI, 1.25-1.70). Conclusion: More than 50% of patients with diabetes had poorly controlled HbA1c. Poor glycemic control may increase diabetes-related costs.

• Korean Journal of Health Education and Promotion
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• v.29 no.3
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• pp.15-22
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• 2012

Objectives: This study was conducted to determine factors related to glycemic control among Korean patients with diabetes. Methods: Data was collected from the Fourth (2007-2009) Korea National Health and Nutrition Examination Survey (KNHANES) which was a nationwide, cross-sectional survey. The study participants who are available for hemoglobin A1c (HbA1c) were 1,441 patients with diabetes aged 30 years and older. Poor glycemic control was defined as $HbA1c{\geq}7.0%$. Data were analysed using logistic regression. Results: The proportion of patients with the poor glycemic control ($HbA1c{\geq}7.0%$) was 49.5%. After adjusting for confounding factors, younger aged persons (30-49 years) were less likely to control the blood glucose than older aged persons (60-69 years) (Adjusted OR=0.533, 95% CI [0.295-0.960]) and longer duration of diabetes was positively related to poor glycemic control (Adjusted OR=2.018, 95% CI [1.418-2.873]). Conclusions: Age and duration of diabetes were significantly related to blood glucose control. Therefore, considering these factors is helpful for developing a strategy to improve blood glucose control in diabetes.

• Research in Community and Public Health Nursing
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• v.20 no.3
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• pp.307-315
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• 2009

Purpose: This study was done to assess the effects of a self-help intervention on clinical, lifestyle and psycho-social outcomes in patients with Type II diabetes. Methods: Eligible adults with Type II diabetes were randomly assigned to either the intervention group receiving the diabetes self-help or the control group receiving usual care. Of the 36 patients who completed the study, 15 were in the intervention group and 21 were in the control group. The self-help group consisted of six weekly sessions covering aspects of diabetes self-care and using continuing education, discussion, and structured social activities. Outcomes included changes in glycemic control, knowledge, self-management behaviors, diabetes-related self-efficacy, and health-related quality of life. Analysis of covariance was used to compare outcomes between the groups, adjusting for baseline measures. Results: After the six week intervention, significant improvements from the baseline were observed in the measurements of self-management behaviors, diabetes-related self-efficacy, and health-related quality of life for the intervention group. Conclusion: The findings provide preliminary evidence that a diabetes self-help group intervention can benefit diabetes patients in self-management behaviors, diabetes-related self-efficacy, and health-related quality of life. However, larger longitudinal studies are needed to determine the most efficacious self-management methods to sustain long-term glycemic control and psychological well-being.

• Nutrition Research and Practice
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• v.18 no.2
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• pp.239-256
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• 2024

BACKGROUND/OBJECTIVES: Over the past 10 yrs, the prevalence of diabetes in Korea has continued to incline, and the importance of lifestyle modification to manage diabetes has been highlighted. For patients with diabetes, carbohydrate intake reduction is effective in improving glycemic control; thus, we aimed to analyze the effect of carbohydrate intake ratio and suggest an appropriate carbohydrate intake ratio. SUBJECTS/METHODS: Using the 8th Korea National Health and Nutrition Examination Survey (2019-2021), we analyzed the data including participants aged 30 yrs or older with diabetes, and they were stratified into good and poor glycemic control groups. To analyze the correlation between the dietary behavior characteristics of participants with diabetes and the carbohydrate intake ratio, sociodemographic characteristics, dietary behavior, and health behavior were adjusted, and multivariate logistic regression analysis was conducted to present the adjusted odds ratio and 95% confidence interval (CI). RESULTS: In the unadjusted crude model, when carbohydrate intake ratio in total energy intake increased by 1%, the likelihood of poor glycemic control increased by 1.007-fold (95% CI, 0.998-1.016; P = 0.121). In model 1, which uses age and sex as adjustment variables, an increase of up to 1.011-fold was possible (95% CI, 1.001-1.021; P = 0.008). In model 2, which added variables such as diabetes duration, frequency of fruit consumption, frequency of lunch and, frequency of dinner, the risk of poor glycemic control increased by 1.010-fold as the carbohydrate intake ratio increased (95% CI, 0.998-1.022; P < 0.001). CONCLUSION: This study confirmed that as the ratio of carbohydrate intake to total energy intake increases the likelihood of poor glycemic control also increases in patients with diabetes. Therefore, to improve glycemic control in patients with diabetes, controlling the carbohydrate intake may be helpful.

• 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.

• 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.

• Journal of Korean Biological Nursing Science
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• v.22 no.1
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• pp.53-60
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• 2020

Purpose: This study used raw data from the fifth (2010-2012) Korea National Health and Nutrition Examination Survey (KNHANES) to assess the relationship between vitamin D level and glycemic control of diabetes, and to provide basic data about the use of vitamin D for preparation of a treatment plan for diabetes in South Korea. Methods: For this study, data of 1,713 diabetes from KNHANES (2010-2012) were used. The collected data were analyzed using SPSS 18.0 program, and complex sample frequency analysis, descriptive statistics, complex sample cross analysis, complex sample general linear regression, and complex sample logistic regression analysis were performed. Results: It was found that the poor glycemic control group among the diabetes subjects had significantly lower level of blood vitamin D than the good glycemic control group. Factors affecting glycemic control included drinking, vitamin D levels, hypertriglyceridemia, duration of diabetes, and treatment of diabetes. Also, diabetics with vitamin D deficiency or shortage showed 3.55- and 2.61-times higher odds ratios, respectively, to be diagnosed as the poor glycemic control group than diabetics without vitamin D deficiency or shortage. Conclusion: This study is significant because it provides rationale and basic data about the use of vitamin D for preparation of a treatment plan for diabetes in South Korea by assessing the dependence of glycemic control on the vitamin D level of diabetics. Additionally, future studies are necessary to determine the appropriate concentration of vitamin D for diabetes prevention and treatment to prevent the side effects of excessive supplementation.