• 보건행정학회지
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• 제26권2호
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• pp.125-134
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• 2016

Background: Glycemic control is an effective way to reduce the cardiovascular complications of diabetes, but more than half of the adults with diabetes in Korea are improperly controlling their glycemic levels. The purpose of this study is to identify the factors associated with poor glycemic control in type 2 diabetes patients. Methods: This study analyzed 1,261 subjects ${\geq}30years$ old diagnosed with type 2 diabetes who participated in the fifth Korean National Health and Nutrition Examination Survey (2010-2012). Poor glycemic control rates were defined as hemoglobin A1c (HbA1c) level ${\geq}7%$. To shed light on the causes of poor glycemic control, socio-demographics, diabetes severity, health status, and health behavior factors were adjusted and logistic regression was done. Results: Of the total 1,261 patients, 53.0% of patients with type 2 diabetes had HbA1c ${\geq}7%$. After running a logistic regression model, the odds ratio of poor glycemic control was higher in high school graduates than elementary school graduates; in people living in Chungcheong and Jeolla/Jeju than those living in Seoul; in the group with diabetes for over 5 years had diabetes less than 5 years; in a group with insulin and oral hypoglycemic agent treatment than non-treatment; in a group with hypertriglyceridemia than without hypertriglyceridemia; and in the group with slept less than 6 hours slept 7-8 hours. Conclusion: We need a comprehensive public health policy to reduce the poor glycemic control rates in type 2 diabetes patients. We should recognize the education levels, duration of diabetes, diabetes treatment, hypertriglyceridemia, and sleep duration were associated with poor glycemic control.

• 지역사회간호학회지
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• 제22권4호
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• pp.377-388
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• 2011

Purpose: This study was to examine the relation between diabetes and cognitive function in older adults. Methods: Eighty community-dwelling patients with diabetes and 506 subjects without diabetes were studied with cognitive function test. Cognitive function was measured by Full-scale IQ, Basic IQ, Executive IQ, Attention Function Index, Working Memory Index, Language Function Index, Visuospatial Function Index, Memory Function Index, and MMSE-K1. Results: In model controlling for education, the diabetic group showed significantly lower scores than the non-diabetic group in in Full-scale IQ (p=.012), Basic IQ (p=.034), Executive IQ (p=.014), Attention Function Index (p=.002), Working Memory Index (p=.037), and Memory Function Index (p=.043). The diabetic and non-diabetic groups that were matched for gender, age, and education showed similar differences in 7 out of 9 cognitive measures. The impairments of Full-scale IQ and Memory Function Index in the diabetic group were, respectively, 2.7 and 2.8 times greater than that in the diabetic group. Conclusion: These results showed that diabetes should be considered to a factor of cognitive impairment in older adults.

• 한국보건간호학회지
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• 제13권2호
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• pp.161-173
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• 1999

The objectives of this study were to find the status of health education of residents. and to analyze the status of knowledge. attitude. and practice about adult disease. especially about hypertension. diabetes mullitus, cancer and health care system etc. and to find the relation between the factors and knowledge status. attitude and practice. The survey was carried out for half month from July 1 to 15. 1997. The subjects were 283 persons in the rural areas that were chosen from one country. Muan Gun near Mokpo City. To interview the rural residents, 5 volunteer interviewers were recruited from university students whose major is nursing, and they were trained about the questionnaire. The percentage of the acceptance of health education are $1.1\%-9.2\%$ of the subjects that the degree of the percentage of the health education was highest in diabetes mellitus. and the next were hypertension. cancer. joint disease. CVA. Therefore the need of the health education was very high. Of the subjects. $13.4\%-60.8\%$ wanted to receive the health education about each disease. Highest proportion of the subjects indicated hypertension and joint disease. Of the subjects $42.1\%-6.7\%$ knew each disease. The degree of knowledge was highest in cancer. followed by T.B., D.M., and hypertension. Of the subjects. $58.5\%$ practiced after receiving health education. and $47.3\%$ were getting periodic health examination during the last one year. Of the subjects. $76.1\%-94.4\%$ did not practice preventive methods such as low-salt diet. periodic health examination and exercise etc.. The knowledge and attitude. and practice of the health were more active in male persons and in highly educated persons significantly than their counterparts. As the adult diseases now are more prevalent than before. more attention should be put on health education to prevent adult diseases in the dimension of developed practice method.

• 한국융합학회논문지
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• 제8권3호
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• pp.79-89
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• 2017

본 연구는 농촌 지역 노인 당뇨병 환자의 자기관리 지식, 사회적 지지, 교육요구도의 융합적인 요인을 파악하여 노인 당뇨병 자기관리를 위한 중재방안을 모색하기 위한 서술적 조사연구이다. 연구대상은 U시 소재 군, 읍면, 보건소 및 보건지소에 당뇨병 관리 대상자로 등록되어 약물 치료 기간 6개월을 경과한 만 65세 이상 노인 115명을 대상으로 조사기간은 2016년 8월 24일부터 10월 31일까지였다. 연구결과 당뇨병 자기관리 지식은 성별, 교육수준, 당뇨병 유병기간, 당뇨교육 경험, 가족의 당뇨교육 참여 경험, 지각된 건강상태에 유의한 차이가 있었고(p<.05), 사회적 지지는 결혼 상태, 당뇨교육 경험, 당뇨 교육요구도는 성별, 당뇨병 유병기간, 당뇨병 자기관리 어려움의 인식정도에서 유의한 차이가 있는 것으로 나타났다(p<.05). 당뇨병 자기관리 지식과 사회적 지지, 사회적 지지와 교육요구도는 유의한 정(+)의 상관관계(p<.05)가 있는 것으로 나타났다. 본 연구결과를 바탕으로 노인 당뇨병 환자의 요구가 반영된 융합적인 자기관리 프로그램이 개발되기를 기대해 본다.

• 대한지역사회영양학회지
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• 제27권5호
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• pp.406-421
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• 2022

Objectives: The purpose of this study was to investigate the blood biochemical characteristics, comorbidities, dietary intake, and other risk factors leading to poor glycated hemoglobin (HbA1c) control in elderly Korean diabetes patients over 65 years of age. Methods: Data from the 4^th (2007-2009) and the 7^th (2016-2018) Korea National Health and Nutrition Examination Surveys (KNHANES) were used. Socio-demographic characteristics (age, gender, region, household income, education level, marital status, nutrition education, diabetes duration and diabetes treatment), lifestyle characteristics (drinking, smoking, regular walking, and subjective health perception), anthropometric characteristics (height, weight, and waist circumference), blood biochemical characteristics (HbA1c, high- density lipoprotein cholesterol, triglycerides, total cholesterol, blood urea nitrogen, and blood creatinine), co-morbidities (obesity, hypertension, hypercholesterolemia, hypertriglyceridemia, and anemia), energy and nutrients intake, food group intake, and HbA1c control-related risk factors were compared. Results: Compared to the 4^th survey, the 7^th survey showed an increase in diabetes prevalence among men, an increase in the prevalence of diabetes in the older patients, and an increase in the duration of diabetes. The energy ratio from carbohydrate consumption in the 7^th survey was lower than in the 4^th. Compared to the 4^th survey, thiamine and riboflavin intake had improved, and the intakes of vitamin A, vitamin C, and niacin had worsened in the 7^th. A comparison of food group intakes showed that there was a decrease in the consumption of whole grains, potatoes, and milk and an increase in the intake of beverages and alcoholic beverages. The risk factors for poor control of HbA1c were the duration of diabetes and co-morbid hypertriglyceridemia in the 4^th survey, whereas subjective health perception, obesity, and hypercholesterolemia as co-morbidities were found to be risk factors in the 7^th in addition to the risk factors highlighted in the 4^th survey. Conclusions: For the future management of elderly Korean diabetes patients, greater care is indicated for men over 75 years, and those with low levels of education. It is necessary to increase the intake of milk and vegetables, and reduce the intake of beverages and alcoholic beverages. In addition, it is necessary to reduce the incidence of obesity, hypercholesterolemia, and hypertriglyceridemia for proper control of blood sugar.

• 한국환경보건학회지
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• 제48권2호
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• pp.96-105
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• 2022

Background: Pyrethroid insecticides account for more than 30% of the global insecticide market and are frequently used in agricultural settings and residential and public pest control among the general population. While several animal studies have suggested that exposure to pyrethroids can alter glucose homeostasis, there is only limited evidence of the association between environmental pyrethroid exposure and diabetes in humans. Objectives: This study aimed to report environmental 3-phenoxybenzoic acid (3-PBA) concentrations in urine and evaluate its association with the risk of diabetes in Korean adults. Methods: We analyzed data from the Korean National Environmental Health Survey (KoNEHS) Cycle 2 (2012~2014) and Cycle 3 (2015~2017). A total of 10,123 participants aged ≥19 years were included. Multiple logistic regressions were used to calculate the odds ratios (ORs) for diabetes according to log-transformed urinary 3-PBA levels. We also evaluated age, sex, education, monthly income, marital status, alcohol drinking, physical activity, urinary cotinine, body mass index, and sampling season as potential effect modifiers of these associations. Results: After adjusting for all the covariates, we found significant dose-response relationships between urinary 3-PBA as quartile and the prevalence of diabetes in pooled data of KoNEHS Cycles 2 and 3. In subgroup analyses, the adverse effects of pyrethroid exposure on diabetes were significantly stronger among those aged 19~39 years (p-interaction<0.001) and those who consumed high levels of cotinine (p-interaction=0.020). Conclusions: Our findings highlight the potential diabetes risk of environmental exposure to pyrethroids and should be confirmed in large prospective studies in different populations in the future.

• 지역사회간호학회지
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• 제28권4호
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• pp.386-396
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• 2017

Purpose: The purpose of this study was to investigate the influence of social support, self - esteem, hope, and health conservation of the vulnerable elderly people with diabetes. Methods: Participants were 100 vulnerable elderly people with diabetes living in D or K cities. Data collection was done through interviews from February to March, 2016. Social support was measured with the MOS-SSS (Medical Outcomes Study Social Support Survey), self-esteem with Self-Esteem Scale, hope with the Nowotny Hope Scale, and health conservation with the Sung's Health Conservation Scale. IBM SPSS 20.0 was used to analyze descriptive statistics, one-way ANOVA, independent t-test, Pearson correlation, and stepwise multiple regression. Results: Factors affecting the health conservation of the vulnerable elderly people were social support, hope, education level and subjective health status. These factors explained 64.9% of the health conservation. Conclusion: It is necessary to construct a comprehensive nursing classification system for elderly people with diabetes in vulnerable class and to develop integrated health conservation program and nursing care as a new social support resource.

• Diabetes and Metabolism Journal
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• 제42권6호
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• pp.538-543
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• 2018

Globally, diabetic retinopathy (DR) is one of the leading causes of blindness, that diminishes quality of life. This study aimed to describe the prevalence of DR, and its associated risk factors. This cross-sectional study was carried out among 478 diabetic patients in a referral center in Fars province, Iran. The mean${\pm}$standard deviation age of the participants was $56.64{\pm}12.45$ years old and DR prevalence was 32.8%. In multivariable analysis, lower education levels (adjusted odds ratio [aOR], 0.43; 95% confidence interval [CI], 0.24 to 0.76), being overweight (aOR, 1.70; 95% CI, 1.02 to 2.83) or obese (aOR, 1.88; 95% CI, 1.09 to 3.26), diabetes duration of 10 to 20 years (aOR, 2.35; 95% CI, 1.48 to 3.73) and over 20 years (aOR, 5.63; 95% CI, 2.97 to 10.68), receiving insulin (aOR, 1.99; 95% CI, 1.27 to 3.10), and having chronic diseases (aOR, 1.71; 95% CI, 1.02 to 2.85) were significantly associated with DR. In conclusion, longer diabetes duration and obesity or having chronic diseases are strongly associated with DR suggesting that control of these risk factors may reduce both the prevalence and impact of retinopathy in Iran.

• Journal of Nutrition and Health
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• 제39권7호
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• pp.641-648
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• 2006

This study was designed to evaluate the effect of the individual nutrition education for type 2 diabetes who participate the diabetes buffet. The subjects were 66 patients and divided into education (n=34) and control groups (n=32). The mean age of education and control groups were 59.8 and 56.6 years old, respectively. There were no differences in age and body mass index (BMI) between two groups. Initial glycosylated hemoglobin (HbA1c), post prandial plasma glucose (PP2), total plasma cholesterol, and blood pressure were not different between two groups. But fasting blood sugar (FBS) was higher in education group than in control group. On completion of the study, the education group showed significant decreases in body weight, BMI, FBS and PP2, however, the control group showed no changes in body weight, BMI and PP2, and showed a significant increase in FBS. Initial calorie and protein intakes of the education group did not meet the prescribed amount, however, mineral and vitamin intakes were higher than estimated average requirement (EAR). By the end of study, calorie and protein intakes were significantly increased to meet the prescription. In order to evaluate the effect of diet education, awareness of calorie requirement was used as an index of understanding diet prescription. The degree of awareness of calorie requirement was dependent on age: younger patients showed higher awareness than older subjects. The subject who showed better understanding of diet prescription showed lower levels of HbA1c, FBS, and PP2 at the end of the experiment period. The results of this study clearly show that individual diabetes diet education is effective to make the patient understand their diet prescription, and is effective to control body weight and blood sugar level. Awareness of calorie requirement could be used as an index of understanding of prescribed diet. Since age is an important variable to determine the awareness of calorie requirement, different strategies of nutrition education should be developed for different age groups, especially patients over 70 years old.

• 지역사회간호학회지
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• 제28권2호
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• pp.216-225
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• 2017

Purpose: The purpose of the study was to analyze the effects of self-care behavior, empowerment, and social support on glycosylated hemoglobin in patients with type 2 diabetes. Methods: The data were collected during the period of July 1 to July 31, 2016. In total, 172 participants were recruited from outpatients who had been diagnosed with type 2 diabetes at a health care center, a health promotion center at National Health Insurance Corporation, and a tertiary hospital. Statistical data were analyzed with SPSS 20.0 using frequency analysis, t-test, ANOVA, $Scheff{\acute{e}}$ test, Pearson's correlation coefficients, and hierarchical regression analysis. Results: The study results showed that self-care behavior (${\beta}=-.34$, p<.001), empowerment (${\beta}=-.34$, p<.001), and social support (${\beta}=-.20$, p=.018) were found to be influential factors affecting glycosylated hemoglobin, with an overall descriptive power of 69%. Conclusion: Self-care behavior, empowerment, and social support are considered to be important factors in blood glucose management for the patients with type 2 diabetes. Therefore, self-caring blood glucose programs and internal synchronizing education through social support and empowerment need to be improved.