• Journal of agricultural medicine and community health
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• v.49 no.3
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• pp.179-193
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• 2024

Objectives: This study aimed to determine the time-series changes in provincial diabetes management indices using by results of the 2008-2022 Korea Community Health Survey. Methods: We collected diabetes diagnosis experience rate, treatment rate for people diagnosed with diabetes, annual screening rate for diabetic eye disease complications, and annual screening rate for diabetic kidney disease complications with age-standardized rates from the Regional Health Statistics. The unit of analysis was the nation and 17 provinces and the time-series trend analysis was performed by joinpoint regression using the Joinpoint Regression Program, and the annual percent change (APC) and average APC (AAPC) were estimated, and statistical significance was tested using 95% confidence interval (CI). Results: From 2008-2022, the national AAPC (95% CI) for diabetes diagnosis experience rate steadily increased to 2.77 (2.25-3.27), increasing in all regions, excluding Sejong. The national AAPC for treatment rate for people diagnosed with diabetes was 0.75 (0.47-1.04), with a slight but steady trend toward improvement, excluding Daejeon, Sejong, and Jeonbuk, which showed significant improvement. The national AAPCs for annual screening rates for diabetic eye disease and kidney disease complications were 1.82 (0.99-2.66) and 1.95 (0.60-3. 41), respectively, and the area with the largest change was Sejong. Conclusions: In Korea, the diabetes management indices tended to increase and improve, but the trends among provinces varied. Therefore, efforts are needed to address regional disparities in diabetes management.

• Journal of Nutrition and Health
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• v.42 no.7
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• pp.622-630
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• 2009

The purpose of this study was to establish an association between glycemic index (GI), glycemic load (GL), dietary carbohydrates and diabetes with the context of the current population dietary practice in Korea. The subjects of 3,389 adults (male 1,430, female 1,959) were divided into normal (serum fasting glucose < 100 mg/dL), impaired glucose tolerance (100 ${\leq}$ serum fasting glucose < 126 mg/dL), diabetes (serum fasting glucose > 126 mg/dL) by serum fasting glucose. Anthropometric and hematologic factors, and nutrient intakes, dietary glycemic index (DGI), dietary glycemic load (DGL) were assessed. Multiple logistic regression model was used to determine the odds ratios (ORs) and 95% confidence intervals for relationship of DGI, DGL, carbohydrates intakes, and diabetes. DGI and DGL were not significantly correlated with impaired glucose tolerance and diabetes. However, the risk of impaired glucose tolerance and diabetes showed a tendency to increase as increase of DGI after multivariate adjustment (age, education, income, region area, diabetes family history, smoking, drinking, exercise, energy intake) in male. The risk of impaired glucose tolerance and diabetes showed a tendency to increase in the DGI 71.1-74.8 after multivariate adjustment in female. DGL was inversely related to impaired glucose tolerance and diabetes in male. In female, however, DGL was positively related to impaired glucose tolerance and diabetes. In particular, the risk of diabetes increased positively in level of DGL 260.5, and remained after multivariate adjustment (Q5 vs Q1：2.38, 0.87-6.48). When percent energy intakes from carbohydrates were more than 70%, the risk of impaired glucose tolerance and diabetes increased in both male and female. In particular, when percent energy intakes from carbohydrates were more than 69.9%, the risk of diabetes increased positively in male (Q4 vs Q1：2.34, 1.16-4.17). In conclusion, above 70% energy intakes from carbohydrates appeared to be a risk factor of diabetes. It seemed that the meal with high GI and GL value must be avoided it. And also, the macronutrients of the meal must be properly balanced. In particular, it may be said that it is a preventive way for treatment of the diabetes to avoid eating carbohydrates of much quantity.

• Korean Journal of Artificial Intelligence
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• v.6 no.1
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• pp.16-20
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• 2018

The development of modern information technology has increased the amount of big data about patients' information and diseases. In this study, we developed a prediction model of diabetes using the health examination data provided by the public data portal in 2016. In addition, we graphically visualized diabetes incidence by sex, age, residence area, and income level. As a result, the incidence of diabetes was different in each residence area and income level, and the probability of accurately predicting male and female was about 65%. In addition, it can be confirmed that the influence of X on male and Y on female is highly to affect diabetes. This predictive model can be used to predict the high-risk patients and low-risk patients of diabetes and to alarm the serious patients, thereby dramatically improving the re-admission rate. Ultimately it will be possible to contribute to improve public health and reduce chronic disease management cost by continuous target selection and management.

• Health Policy and Management
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• v.21 no.1
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• pp.1-22
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• 2011

This study investigated unmet health care needs and associated factors among patients with hypertension and those with diabetes. Patients were identified by medical professionals. Patients who did not take pharmaceuticals to treat their disease(s) were defined as those with unmet health care needs. Using data from 2005 National Health and Nutrition Examination Survey, 3,635 hypertension patients and 1,431 diabetes patients were analyzed. A multivariate logistic regression analysis was employed to examine factors associated with unmet needs. Overall, 16.6% of hypertension patients, 20.3% of those with diabetes presented unmet needs. Common factors associated unmet needs for both hypertension and diabetes were sex, insurance type, self-reported health status and length of disease. Study findings suggest that hypertension and diabetes should be treated in early stage and further study is needed to examine the reasons for unmet needs to improve patient's status effectively.

• Journal of muscle and joint health
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• v.19 no.3
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• pp.308-318
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• 2012

Purpose: Diabetes Self Management Behavior (DSMB) is crucial for the elderly with diabetes to prevent diabetes complications and to improve their quality of life. The Purposes of this study were to investigate the current status of DSMB and to identify motivational factors related to DSMB in community dwelling older adults with diabetes. Methods: The subjects were 150 diabetic elderly who visited 2 community senior centers in S city. DSMB scale consisted of 5 sub-domains; Being active, healthy eating, regular medication, glucose monitoring, and foot care rated by a scale with a range of 0 to 7. Personal motivation(i.e., intention to behavior) and social motivation including family support and health professional support were measured. Results: The mean score of DSMB was 4.27. The mean score of intention to behavior was 2.52. DSMB was related to Intention to behavior (r=.461, p<.001), family support (r=.342, p<.001), and health professional support (r=.284, p<.001). In regression analysis, a total of 33.4% of variance in DSMB was accounted for by intention to behavior, family support, and health professional support. Conclusion: To improve DSMB of the elderly, diabetes educator should consider on the strategies across both personal and social motivation related to DSMB.

• Diabetes and Metabolism Journal
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• v.42 no.6
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• pp.451-464
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• 2018

Latent autoimmune diabetes in adults (LADA) is a heterogeneous disease characterized by a less intensive autoimmune process and a broad clinical phenotype compared to classical type 1 diabetes mellitus (T1DM), sharing features with both type 2 diabetes mellitus (T2DM) and T1DM. Since patients affected by LADA are initially insulin independent and recognizable only by testing for islet-cell autoantibodies, it could be difficult to identify LADA in clinical setting and a high misdiagnosis rate still remains among patients with T2DM. Ideally, islet-cell autoantibodies screening should be performed in subjects with newly diagnosed T2DM, ensuring a closer monitoring of those resulted positive and avoiding treatment of hyperglycaemia which might increase the rate of ${\beta}-cells$ loss. Thus, since the autoimmune process in LADA seems to be slower than in classical T1DM, there is a wider window for new therapeutic interventions that may slow down ${\beta}-cell$ failure. This review summarizes the current understanding of LADA, by evaluating data from most recent studies, the actual gaps in diagnosis and management. Finally, we critically highlight and discuss novel findings and future perspectives on the therapeutic approach in LADA.

• Korean Journal of Health Education and Promotion
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• v.30 no.4
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• pp.111-123
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• 2013

Objectives: This study aimed to share with experiences of a demonstration program based on a community for prevention and management of hypertension and diabetes mellitus, and to supply the evidence of accessible strategies within the community through the public-private partnershipin the near future. Methods: This study case was "the program of registration and management of hypertension and diabetes mellitus patients" which was conducted in Hogncheon-gun in Gangwon-province, 2012. Results: The infrastructure of this center was constructed with the public-private sector partnership according to the basic model of demonstration program since November, 2012. So, the total registered rate of hypertension and diabetes mellitus patients were 26.6% in comparison with suspected patients (to the result of 2011 Korea National Health and Nutrition Examination Survey), 37.8% in comparison with the real number of outpatient (to the claims data of 2011 Branch Honcheon-gun, National Health Insurance Corporation), and 107.8% in comparison with the project goal, sequentially. To the patients who were not treated for 30 and 60 days among the registered patients, a recall service was conducted. Through this intervention, it was monitored that this program has enhanced the consecutive treatment rate of the registered patients. Conclusions: To improve the continuous management of hypertension and diabetes mellitus patients, we are gotten to know that the community need the joint participation and mutual cooperation with public-private sector partnership.

• Nutrition Research and Practice
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• v.10 no.1
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• pp.67-73
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• 2016

BACKGROUND/OBJECTIVES: This study was aimed at examining the association between dietary flavanones intake and lipid profiles according to the presence of metabolic syndrome (MetS) in Korean women with type 2 diabetes mellitus (T2DM). SUBJECTS/METHODS: A cross-sectional analysis was performed among 502 female T2DM patients (non-MetS group; n = 129, MetS group; n = 373) who were recruited from the Huh's Diabetes Clinic in Seoul, Korea between 2005 and 2011. The dietary intake was assessed by a validated semi-quantitative food frequency questionnaire (FFQ) and the data was analyzed using the Computer Aided Nutritional Analysis program (CAN-Pro) version 4.0 software. The intake of flavanones was estimated on the basis of the flavonoid database. RESULTS: In the multiple linear regression analysis after adjustment for confounding factors, daily flavanones intake was negatively associated with CVD risk factors such as total cholesterol, LDL-cholesterol, and apoB and apoB/apoA1 ratio only in the MetS group but not in the non-MetS group. Multiple logistic regression analysis revealed that the odds ratio for a higher apoB/apoA1 ratio above the median (${\geq}0.74$) was significantly low in the $4^{th}$ quartile compared to that in the $1^{st}$ quartile of dietary flavanones intake [OR: 0.477, 95% CI: 0.255-0.894, P for trend = 0.0377] in the MetS group. CONCLUSIONS: Dietary flavanones intake was inversely associated with the apoB/apoA1 ratio, suggesting a potential protective effect of flavanones against CVD in T2DM women with MetS.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.45 no.4
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• pp.207-214
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• 2019

Objectives: Medically compromised patients often fear required dental surgical procedures that can increase the risk of medical emergency when combined with reduced tolerance for stress. A stress reduction protocol (SRP) helps doctors minimize treatment-related stress and improves patient management with minimum complications. Diabetes and co-morbid hypertension carry 4-fold risk of aggravation of cardiovascular emergencies and 7.2-fold risk of mortality. Diabetic neuropathy can result in difficult diagnosis of myocardial infarction and reduces chances of surviving a myocardial infarction compared with a non-diabetic person. The aim of the study was to assess the feasibility of a protocol for management of patients having both diabetes and hypertension who required minor oral surgery to minimize the rate of cardiovascular emergencies. Materials and Methods: A prospective study was conducted in 140 patients having both diabetes and hypertension who required minor oral surgical procedures. A systematic approachable protocol was designed for management of such patients. Results: Among 140 patients, 6 patients (4.3%) had cardiovascular complications, while 3 patients (1 with syncope and 2 with hypertension) did not require any intervention other than observation. Two patients were managed with aspirin and nitroglycerin, and 1 patient had possible myocardial infarction (overall incidence 0.7%) with chest pain, S-T segment elevation on electrocardiogram, and troponin level of 0.60 ng/mL. Conclusion: The proposed protocol helps to improve management of patients having both diabetes and hypertension. We recommend that patients with uncontrolled diabetes and uncontrolled hypertension and/or patients having history of cardiovascular complication should be treated in a medical facility with a readily available cardiology unit. This facilitates prompt response to emergency and instant implementation of treatment, helping to reduce morbidity and mortality.

• Journal of Korean Academy of Fundamentals of Nursing
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• v.12 no.1
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• pp.58-65
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• 2005

Purpose: To investigate the level of depression and self management behavior in patients with diabetes. Method: From May to August 2004, 124 diabetic patients 18 years or older were surveyed using the Korean version of the BDI, the self-management scale by Toobert(2000) and hospital lab data for HbAl, FBS and Blood Sugar-2hr. Results: 1. Mean score on the BDI for the patients was 10.85 points. The score on the BDI was significantly higher in hyperglycemic patients than in normoglycemic patients. 2. The level of self management for the past week showed care on an average of 4.2 days. According to level of depression, patients in the normal group and patients in the mild group had significantly higher levels of self management than those in the moderate group. 3. According to level of depression, patients in the normal group had significantly lower levels of blood glucose than those in the moderate group, and for HbAlc and FBS those in the mild group had lower levels compared to those in the moderate group. 4. The factors significantly associated with level of self management were depression (25.66%) and duration of illness. Conclusion: Programs should be developed to combat depression in patients with diabetes in order to increase compliance through self care management and thus increase of blood glucose levels.