• 보건행정학회지
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• 제26권3호
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• pp.207-218
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• 2016

Background: This study was performed to identify factors associated with the utilization of tests for diabetes complication and hemoglobin A1c (HbA1c) among diabetes patients in Jeollanam-do, Korea. Methods: The study subjects were 2,310 diabetes patients participated in 2014 community health survey in Jeollanam-do, Korea. Dependent variables were the utilizations of fundus examination, microalbuminuria test, and HbA1c test. The used statistical analysis methods were chi-square test and hierarchical regression analysis with weight in consideration of complex sample design. Results: The utilization rates of fundus examination, microalbuminuria test, and HbA1c test were 25.8%, 27.4%, and 12.3%, respectively. In the results of hierarchical regression, fundus examination was significantly related to age, education level in predisposing factors, residential area in enabling factors and recognition of blood sugar, drug therapy, and subjective health status in need factors. Microalbuminuria examination was significantly related to monthly income, residential area in predisposing and health screening, recognition of blood sugar, drug therapy, diabetic education, number of chronic disease, and subjective health status in need factors. HbA1c examination was significantly related to age, education level, marital status in predisposing factors, residential area in enabling factors and drinking, recognition of blood sugar, drug therapy, and diabetic education in need factors. Conclusion: The results of this study were shown that perception of their disease seriousness, education about diabetes management, and accessibility of tests were important to utilization of test for diabetes complication and HbA1c. It might be necessary to the develop and strength strategies for enhancing the utilization of tests for diabetes complication and management in diabetes patients.

• 임상간호연구
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• 제28권3호
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• pp.277-288
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• 2022

Purpose: This study was conducted to evaluate the effects of the insulin therapy adherence program (INSTA GRAM) for patients with type 2 diabetes mellitus. Methods: This study examined a total of 63 patients with type 2 diabetes for whom the initiation of insulin therapy is being considered or within 6 months of undergoing insulin therapy. INSTAGRAM is a stage-specific intervention consisting of strategies for motivating patients to initiate and maintain insulin therapy using the transtheoretical model on the stages of change, the process of change, and self-efficacy. The participants were randomly assigned to either the INSTAGRAM group (experimental group, n=32) or the standard diabetes education group (control group, n=31). The INSTAGRAM group received 6 sessions over 8 weeks(face-to-face education was conducted in the first and last sessions, and telephone coaching was conducted from the second to fifth sessions). The outcomes were measured by psychological insulin resistance, self-efficacy, and glycosylated hemoglobin (HbA1c). Results: Psychological insulin resistance (p<.001), self-efficacy (p<.001), and HbA1c (p=.024) of the participants in the INSTAGRAM group significantly improved compared to those in the control group. Conclusion: INSTAGRAM is effective in overcoming psychological insulin resistance and improving self-efficacy and HbA1c. Therefore, the INSTAGRAM can be recommended as a nursing intervention for type 2 diabetic patients who delay the initiation of insulin therapy.

• The Journal of Korean Physical Therapy
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• 제22권6호
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• pp.65-70
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• 2010

Purpose: Exercise has been shown to be a simple and economical therapeutic modality that may be considered as an effective aid for diabetic mellitus. For example, exercise training increases insulin sensitivity in type 2 diabetes. But we found no reported of how exercise affect type 1 diabetes. This study investigated the impact of aerobic and graduated treadmill exercise regimens on body weight, glucose and insulin concentrations, lipid profiles, and oxidative stress indicators in rats with streptozotocin (STZ) induced diabetes. Glycosylated hemoglobin ($HbA_{1c}$) was determined as an indicator of glucose control during exercise. Methods: In our study, a total of 40 rats were used. Three groups of 10 rats each were given STZ to induce diabetes. The remaining 10 rats became the normal group. After 28 days we determined biochemical parameters such as glucose, glycosylated hemoglobin ($HbA_{1c}$), insulin concentration, serum total cholesterol (TC), triglycerides (TG), and high-density lipoprotein (HDL). Superoxide dismutase (SOD) and catalase activities were also measured. Results: Concentrations of blood glucose and $HbA_{1c}$ in the moderated exercise groups were significantly decreased after 28 days compared with the control group (p<0.05). There was a significant reduction in serum TC and TG in the experimental groups. The activity of SOD increased significantly by 17.70% and 48.25% respectively. Conclusion: These results indicate that physical training and exercise training affects body weight, fasting blood glucose, $HbA_{1c}$, insulin, lipid profiles, and antioxidant status in rats with streptozotocin-induced diabetes. We suggest that graduated treadmill exercise may have therapeutic, preventative, and protective effects against diabetes mellitusby improving glycemic control, oxidant defenses, and lipid metabolism.

• 대한임상전기생리학회지
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• 제2권2호
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• pp.13-23
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• 2004

This study aimed at examining the effects of percutaneous electrical nerve stimulation(PENS) applied to different parts of the streptozotocin(STZ) induced diabetic rats on the change of glucose level and spinal neuron excitability. A total of twenty-eight SD rats, divided into four groups, were used as experiment animal. Experiment group I, the normal control group, was composed of normal rats without diabetes induction. Experiment group was composed II of the rats without any treatment after experimental diabetes induction. Experiment group III was composed of the rats with 2 Hz and $200\;{\mu}s$ of PENS to the acupuncture points related with diabetes for 20 minutes after diabetes induction. Experiment group IV was composed of the rats with 2 Hz and $200\;{\mu}s$ of PENS to the parts unrelated with diabetes for 20 minutes after diabetes induction. The results can be summarized as follow: As for glucose level, the group I showed no change within normal range, and the group III showed significant increase, compared with other groups (p<0.05). As for the change of H latency, M and H amplitude, the group III showed significant differences in decrease of latency and amplitude (p<0.05). As for Hmax/Mmax ratio, the normal and other groups showed no significant differences in decrease of amplitude. It can be concluded from the above results that PENS to the acupuncture points of the STZ-induced diabetic rats was effective for spinal neurone excitability, in particular, for those of the group with PENS to the acupuncture points. This study was conducted in the period of acute diabetes induction, and therefore, further study should be conducted in the period of chronic diabetes to research both acute and chronic diabetes.

• The Journal of Korean Physical Therapy
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• 제30권6호
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• pp.224-228
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• 2018

Purpose: The most common cause of plantar ulceration is an excessive plantar pressure in patients with peripheral neuropathy. Foot orthosis and therapeutic footwear have been used to decrease the plantar pressure and prevent the plantar ulceration in in diabetes patients. We investigated whether protective sock with functional insoles reduce plantar pressure while walking in 17 diabetes patients. Methods: An in-shoe measurement device was used to measure the peak plantar pressure while walking. Peak plantar pressure data were collected while walking under two conditions: 1) wearing diabetic sock and 2) wearing the protective sock with functional insoles. Each subject walked 3 times in 10-m corridor under three conditions, and data were collected in 3 steps in the middle of corridor with in right and left feet, respectively. Pared t-test was used to compare the peak plantar pressures in three plantar areas under these two conditions. Results: The protective sock with functional insoles significantly reduced the peak plantar pressure on the lateral rearfoot, but significantly increased the peak plantar pressure on the middle forefoot, and medial midfoot (p<0.05). However, there were not significant in medial and lateral forefoot, lateral midfoot, and medial rearfoot between diabetic sock and the protective sock conditions (p>0.05). Conclusion: The protective sock with functional insoles reduced plantar pressures in the rearfoot and supported the medial longitudinal arch. However, it is necessary to change the position of metatarsal pad in the insole design of forefoot area to prevent diabetic foot ulceration.

• The Journal of Korean Physical Therapy
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• 제18권2호
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• pp.47-58
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• 2006

Purpose: The study to pulsed ultrasound effects of diabetes mellitus fracture model in rat. Methods: We used 36 Sprague-Dawely rats which were divided into 3 groups; the animals were divided into group of 4 rats each 4th, 14th and 28th days. All animal was induced diabetes mellitus model to used streptozotocin with 45 mg/kg. Pulsed wave were divided into $50\;mW/cm^2$ and $100\;mW/cm^2$. Results: T-ALP value was significantly change from group II, III on 14th, 28th days (p<0.05). Especially T-ALP value to between groups was significantly change from group II on 14th days (p<0.05). Osteocalcin value was significantly change from group II on 28th days(p<0.05). At fracture site, osteoblast, osteoclast expression was observed from 4th days after treatment and it reached its maximum intensity at 28th days. At fracture site, $TGF-{\beta}_1$ expression was observed from 4th days after treatment and it reached maximum intensity at 14th days. Conclusion: According to this study, diabetes mellitus fracture model to the more effective is divided into $50m\;W/cm^2$ pulsed ultrasound.

• Journal of Korean Biological Nursing Science
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• 제24권1호
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• pp.58-66
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• 2022

Purpose: The purpose of this study was to identify the level of psychological insulin resistance and self-care activities and to evaluate the factors affecting self-care activities in patients with type 2 diabetes mellitus undergoing insulin therapy to provide basic data for the development of educational programs. Methods: Data were collected through the interviews using a structured questionnaire from August 29 to October 20, 2017, from the patients with type 2 diabetes mellitus visiting the Diabetes Mellitus Center at H-General Hospital in J-city. The subjects were 168 patients who had been being treated via self-injection for at least three months after the start of insulin therapy. Data analyses were conducted using t-test, ANOVA, Pearson's correlation coefficients, and stepwise multiple regression using the SAS WIN 9.2 program. Results: The mean score of psychological insulin resistance was 61.25 (range 19-95) and the mean score of self-care activities was 53.19 (range 18-90). Self-care activities were significantly different by gender (t = -2.94, p= .004), perceived health status (F= 7.00, p< .001), and hypoglycemia during the last three months (t= -2.47, p= .015). Negative correlation was observed between psychological insulin resistance and self-care activities (r= -.33, p< .001). Self-care activities were significantly predicted by psychological insulin resistance, perceived health status, gender, and hypoglycemia during the last three months, and 19.0% of the variance in self-care activities was explained (F= 9.01, p< .001). Conclusion: Psychological insulin resistance in patients undergoing insulin therapy and its effects on self-care activities identified in this study will be useful in starting and maintaining insulin therapy in the future.

• 대한지역사회영양학회지
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• 제14권2호
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• pp.236-244
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• 2009

Dietary therapy is a basic and emphasized treatment for diabetes. Several clinical studies have shown that diet can play a major role in preventing and managing diabetes. The purposes of this study were to evaluate the dietary behavior and to find solutions to barriers of diabetes mellitus patients. From February to July in 2007, questionnaires were distributed to one hundred and ten patients who were diagnosed DM by physicians and excluded first coming out-patients. One hundred and three data were used for statistical analysis using SPSS/Win 12.0. The main results of this study included the following: To measure dietary behaviors and barriers, a five point scale was used with the following labels: 'strongly yes', 'yes', 'fair', 'no', 'strongly no'. Thirteen dietary behaviors related to diabetes were grouped into the following 4 factors using factor analysis; 'taste control factor', 'blood glucose influence factor', 'practice volition factor', and 'exercise factor'. The mean scores of 4 factors were 3.88, 3.48, 3.55, 3.21, respectively. The 'taste control behaviors' score of subjects who had practiced diet therapy(4.00) was higher than those who had not practiced diet therapy(P<0.05). The 'blood glucose influence behaviors' score of subjects who had nutrition education(3.59) was higher than those who had no nutrition education(P<0.05) and subjects who had practiced diet therapy showed higher score(3.59) than those who had not practiced diet therapy(P<0.05). 'Exercise behaviors score' of subjects who were over 60(3.59) was the lowest(P<0.05). Subjects who had nutrition education showed higher 'exercise behaviors' scores(3.38) than those who had no nutrition education(P<0.05). Subjects who had practiced diet therapy showed higher 'practice volition behaviors' scores(3.72) than those who had not practiced diet therapy(P<0.001). Subjects who were over weight showed the highest 'practice volition behaviors' scores(3.78) concerning BMI(P<0.05). In conclusion, this study expected that Nutrition educators(Dietitian) applied to patient effective nutrition education and counseling through evaluation of Dietary behaviors and barriers considered management types and ecological factors of diabetes patients. Also diabetic patients were easy to change dietary habits because they formed behaviors through education and counsel and there were positive effects in their blood glucose control through removing barriers related to dietary therapy.

• 대한의용생체공학회:의공학회지
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• 제27권2호
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• pp.39-46
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• 2006

We have implemented the Artemisia Extract Moxibustion Method in order to improve the conventional moxibustion therapy. This method is aimed to eliminate burning wounds and smoke, which are the defects of conventional moxibustion therapy. We have verified the effectiveness of the method to the diabetes. We have performed a clinical test for the 23 cases of the diabetics. Level of FBS(fasting blood sugar) didn't show significant changes, but showed the tendency of the descent, and level of HbA1c significantly decreased after the treatments(P<0.001)(n=19).

• Nutrition Research and Practice
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• 제5권2호
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• pp.157-162
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• 2011

The importance of dietary intake in the treatment of type 2 diabetes was emphasized. This study was performed to investigate the dietary intakes of Korean type 2 diabetes patients according to the treatment and duration of diabetes and to examine the relationships between their diet and serum lipid profiles. The subjects were 111 type 2 diabetic patients who were treated by medical nutrition therapy only, oral hypoglycemic agents (OHA), or insulin with medical nutrition therapy. Dietary intake was assessed by a registered dietitian using semi-quantitative food frequency questionnaires Comparisons according to treatment type were made using covariance analyses. General linear models identified the independent effects of the different treatments after covarying for age, duration of diabetes, and 2-way interactions. There were no significant differences in age and BMI but was in duration of diabetes according to treatment type in these subjects. Carbohydrate to energy ratio was higher in the OHA group (P < 0.05), whereas the fat to energy ratio was higher in the insulin group for males (P < 0.05). Carbohydrate ($R^2$ = 0.24, P = 0.005) and fat ($R^2$ = 0.26, P = 0.02) to energy ratios were independently associated with the duration of diabetes after covarying for age, sex, treatment, and 2-way interactions. The levels of triglyceride (TG; $R^2$ = 0.32, P = 0.02) and total cholesterol (TC) were associated independently with energy intake and the carbohydrate ($R^2$ = 0.15, P = 0.02) and fat ($R^2$ = 0.15, P = 0.01) to energy ratios, respectively. The concern that the independent association of dietary intake with either duration of diabetes or dietary factors affects blood lipid levels could suggest that specific dietary recommendations may work better for identifiable groups of diabetes patients.