• 보건교육건강증진학회지
• /
• 제31권4호
• /
• pp.1-10
• /
• 2014

Objectives: The effectiveness of Blood ${\beta}$-ketone testing by using self-monitoring strip on diabetic patients. Methods: Clinical effectiveness of blood ${\beta}$-ketone testing was assessed through correlation with reference test that measured blood ${\beta}$-ketone value through gas chromatography or enzyme method, diagnostic accuracy, time taken for the test and time taken for confirmative diagnosis of diabetic ketosis by selecting literatures on researches that conducted this test on ketosis(suspected) patients or diabetic ketosis(suspected) patients. Each of the stages from literature search to application of selection standards and extraction of data were carried out independently by the Subcommittee along with 2 researchers. Results: 7 reports were selected. ${\beta}$-ketone testing displayed high level of correlation in the range of r=0.92~0.99 with test using enzyme method as the reference standard. Regarding the diagnostic accuracy, sensitivity of 0.82, specificity of 0.74. The time taken for the test was 30seconds for the index test, which is shorter than reference standard test. Conclusion: Blood ${\beta}$-ketone testing was assessed to be a safe and effective test to monitor ketosis and assess the level of risk of ketosis by measuring the blood ${\beta}$-ketone on ketosis patients and diabetic ketosis patients since it has high level of correlation with reference test and short period of testing.

• 대한족부족관절학회지
• /
• 제13권1호
• /
• pp.50-54
• /
• 2009

Purpose: The authors evaluated the clinical results and prognosis after amputating the lower extremity due to diabetic foot. Materials and Methods: From 1991 to 2003, the patients who had suffered amputation of his lower extremity due to diabetic foot ulcer were evaluated retrospectively. 79 patients were male and 6 patients were female. The author evaluated the patient who had the ipsilateral additional surgery, contralateral amputation, level of blood sugar, combined disease and mortality rate within 5 years from medical record. Statistical analysis was done by Chi-square test and Kaplan-Meier survival test. Results: Mean age of patients who had first experienced amputation was 63.4 years old. The mean duration of diabetes until amputation was $14.5{\pm}7.5$ years. Major amputations were 50 cases and minor amputations 35 cases. 20 patients (23.5%) were suffered ipsilateral secondary surgery including revised stump. Overall 5-year mortality rate was 18.8% (16 cases). Death rate within 1 year was 8.2% (7 cases), mortality rate within 3 years was 14.1% (12 cases). 5-year mortality rate after major amputation was 20% (10 cases) and after minor amputation was 17.1% (6 cases). It was statistically significant (p<0.05). Patient who underwent more than 2 combined vascular related disease had higher mortality rate than diabetic amputee without combined disease (p<0.05). Conclusion: Mortality rate after major amputation was significant higher than amputation after minor amputation in diabetic patients from our data.

• Archives of Reconstructive Microsurgery
• /
• 제17권1호
• /
• pp.28-35
• /
• 2008

The purpose of this study was to present the clinical analysis of the results of lateral arm free flap for small sized and infected diabetic foot ulcer around toes. From May 2006 to December 2007, Seven patients were included in our study. Average age was 52.8 years, six were males and one was female. All had infected diabetic foot ulcer and had exposures of bone or tendon structures. Ulcers were located around great toe in four patients, 4th toe in one and 5th toe in two. Three patients had osteomyelitis of metatarsal or phalanx. After appropriate control of infection by serial wound debridement and intravenous antibiotics, lateral arm flap was applied to cover remained soft tissue defects. Posterior radial collateral artery of lateral arm flap was reanastomosed to dorsalis pedis artery of recipient foot by end to side technique in all cases in order to preserve already compromised artery of diabetic foot. All flaps were designed over lateral epicondyle to get longer pedicle and averaged pedicle length was 8 cm. Two cases were used as a sensate flap to achieve protective sensation of foot. All flaps survived and provided satisfactory coverage of soft tissue defects on diabetc foot ulcers. All patients could achieve full weight-bearing ambulation. No patients has had recurrence of infection, ulceration and further toe amputations. There were three complications, a delayed wound healing of flap with surrounding tissue, a partial peripheral loss of flap and a numbness of forearm below donor site. All patients were satisfied with their clinical results, especially preserving their toes and could return to the previous activity levels. Lateral arm free flap could be recommend for infected diabetic foot ulcers around toes, to preserve toes, coverage of soft tissue defect and control of infection with low donor site morbidity.

• 한국식품영양과학회지
• /
• 제33권3호
• /
• pp.533-541
• /
• 2004

본 연구는 당뇨병 환자들의 체중분포별 식사요법 이행 및 자료의 활용 실태를 알아보기 위 해 부산 지역에 있는 보건소 및 종합병원을 방문하여 설문 조사하였다. 조사대상자의 체중분포는 BMI법에 의해 저체중군, 정상체중군, 과체중군, 비만군으로 나누었으며 저체중군이 18.5%, 정상체중군이 51.5%, 과체중군이 16.9%, 비만군이 13.1%이었다. 유병기간은 59.2%가5년 미만이었고, 당뇨 관리 기간중 체중이 감소한 환자가 62.3%, 당뇨병으로 입원한 경험이 있는 환자는 35.4%, 합병증이 있는 환자는 38.5%를 차지했다. 체중분포별로 식사요법 지식 정도를 살펴 본 결과 각 항목의 총점에서 비만군 및 과체중군이 낮았으며 특히 하루 열량 필요량과 식품교환표에 관한 항목의 지식정도가 낮았다. 식사요법 실천 정도 역시 비만군 및 과체중군이 낮았으며 특히 외식시 실천정도가 가장 낮아서 외식시 식사요법 실천 방안에 대한 교육이 필요하였다. 당뇨병 환자들의 대부분은 식사요법 자료를 전문인을 통해 얻었고 식사요법이 중요하다고 인식은 하고 있었으나, 실행하는데 문제가 있음을 알 수 있었다. 이에 앞으로는 환자들에게 식사요법을 실천할 수 있는 방안을 제시하고 아울러 실천정도를 향상시킬 수 있도록 하는 것이 중요하다고 할 수 있다. 식사요법 자료의 활용은 저 체중군이 50.0%, 정상체중군이 41.8%, 과체중군이 22.7%, 비만군이 35.3%이었으며, 식품교환표를 이용하여 식사요법을 실천하는 환자는 더욱 적었다. 식사요법 자료에서 당뇨병 환자들이 이해하기 힘든 내용은 식품교환표, 실제 섭취할 식품의 양, 끼니별 교환단위수 배분, 1일 총 열량 계산법 등이었으며, 가장 필요로 하는 내용은 식단작성방법, 식품 선택시 유의사항, 외식시 메뉴 선택방법 등이었다. 이처럼 당뇨병 환자들은 식사요법 지식이나 실천정도, 자료의 활용실태, 필요로 하는 내용 등이 체중분포에 따라 각기 달랐기에, 앞으로 당뇨병 프로그램을 만들 때 이들이 필요로 하는 내용, 이해하기 어려워하는 내용 등을 충분히 고려한 후 당뇨병 환자들의 체중분포별로 쉽고 체계적인 교육자료를 개발하여야 할 것이다.

• 대한한방내과학회지
• /
• 제28권4호
• /
• pp.902-910
• /
• 2007

Objective : Peroxisome proliferator-activated receptor (PPAR)-gamma, a transcription factor in adipocyte differentiation, has important effects on insulin sensitivity, atherosclerosis, endothelial cell function and inflammation. Through these effects, PPAR-gamma2 might be involved with type 2 diabetes and vascular disease, including diabetic complications. Recently, it has been reported that the C161T polymorphism in the exon 6 of PPAR-gamma is associated with type 2 diabetes interacting with uncoupling protein 2 (UCP2) gene, and is associated with acute myocardial infarction. We studied the association of this polymorphism with type 2 diabetes and its complications, such as retinopathy, ischemic stroke, nephropathy and neuropathy in Korean non-diabetic and type 2 diabetic populations. Methods : Three hundred and thirty eight type 2 diabetic patients (retinopathy: 64, ischemic stroke: 67, nephropathy: 39 and neuropathy: 76) and 152 healthy matched control subjects were evaluated. The PPAR-gamma C161T polymorphism was analyzed by PCR-RFLP. Results : PPAR-gamma C161T genotype and allele frequency did not show significant differences between type 2 diabetic patients and healthy controls (T allele: 17.0 vs. 14.5, OR= 1.21, P=0.3188). In the analysis for diabetic complications, T allele in diabetic nephropathy was significantly higher than controls (P=0.0358). T allele in the ischemic stroke patients was also higher than healthy controls, although it had no significance (P=0.1375). Conclusions : These results suggest that the C161T polymorphism of the PPAR-gamma gene might be associated with diabetic nephropathy in type 2 diabetes.

• 한국생활과학회지
• /
• 제17권4호
• /
• pp.797-805
• /
• 2008

The present study was investigated on type 2 diabetics' actual status of anti-diabetic functional food intake by patients who came to oriental medicine clinics in Daejeon. The male was 37.3% and female was 62.7% of the subjects. The onset of the disease was most common in the age of 50's. Also 40% of the subjects have been suffering for more than 5 years. 35.7% of men, 53.2% for women had family history. Also 61.5% of the patients chose to carry out both diabetic therapy and exercise at the same time. 69.3% of the subjects have had experiences in anti-diabetic functional foods. Anti-diabetic functional foods used to surveyed people were bean, ginseng, and ginseng steamed red of which efficacies were already well known. Besides these foods, other foods such as loach, crucian carp were also used as anti-diabetic foods, but their benefits as anti-diabetic functional foods are not yet fully investigated. Subjects first knew about the therapy because friends or relatives recommended to them and most of them have used for 6 months to 1 year. However, 78.9% of subjects answered 'not so effective' in a question about satisfaction of anti-diabetic functional food. Although many of the patients have tried taking functional foods, they only use them for short period of time and they don't show prominent effect. Therefore these results suggest that in order to use scientifically studied functional foods, education about anti-diabetic functional foods should taken.

• 대한영양사협회학술지
• /
• 제13권1호
• /
• pp.84-93
• /
• 2007

This study was carried out to see the effect of individualized diet education on the improvement of blood glucose level according to the changes of nutrient intake with the subjects of 25 people. Among 25 people who participated in diabetic education program held in Chilgok-gun public health center, Gyeongbuk, there were 15 diabetic patients(3 males and 12 females) and 10 healthy people(2 males and 8 females) and after the diet education, the results were as follows. As for clinical characteristics, the diabetic group tended to have slightly higher blood pressure than the control group, especially diastolic blood pressure of diabetic group was higher than the control group with a significant level(p<0.05). Blood glucose level measured 2 hours after the meal was higher in the diabetic group than the control group with significant level(p<0.0001). For the clinical characteristic changes before and after the diet education, the blood glucose level in the diabetic group reduced significantly(p<0.01). For the daily diet intake, intake of fat in the diabetic group increased significantly compared to the one before the education(p<0.05). When comparing the ratio of carbohydrate: protein: fat, it was changed from 72.9 : 16.2 : 12.9 before the education to 63.8 : 15.1 : 21.1 after the education. From the above results, it is necessary to perform the diet education which carries out in the health center for diabetic patients with individualized goal by stepwise way rather than as one time try, and by developing the diabetic education media which is appropriate for the patients.

• Journal of Preventive Medicine and Public Health
• /
• 제44권6호
• /
• pp.260-266
• /
• 2011

Objectives: We evaluated the association between common carotid artery intima-media thickness (CCA-IMT), brachialankle pulse wave velocity (baPWV), carotid plaque, and peripheral arterial disease (PAD) as indicators of macroangiopathy and diabetic retinopathy as an indicator of microangiopathy in type 2 diabetic patients. Methods: We analyzed 605 type 2 diabetic patients registered at a public health center in Korea. Following overnight fasting, venous blood and urine samples were collected and analyzed. The CCA-IMT, levels of carotid plaque, baPWV, and ankle-brachial index (ABI) of the subjects were assessed. We used non-mydriatic fundus photography to diagnose diabetic retinopathy. Multiple logistic regression analyses were used to evaluate the association between macroangiopathy and diabetic retinopathy. CCA-IMT and baPWV were divided into tertiles: CCA-IMT, 0.39 to 0.65 mm, 0.66 to 0.78 mm, and 0.79 to 1.30 mm; baPWV, 9.9 to 15.8 m/s, 15.9 to 18.9 m/s, and 19.0 to 38.0 m/s. Results: The association between baPWV and diabetic retinopathy remained significant after adjustment, with an increasing odds ratio (OR) in the second tertile (OR, 2.41; 95% confidence interval [CI], 1.27 to 4.55) and the third tertile (OR, 4.63; 95% CI, 2.33 to 9.21). No significant differences were observed in carotid plaque, PAD, and each tertile of CCA-IMT. Conclusions: BaPWV was associated with diabetic retinopathy, while CCA-IMT, carotid plaque, and PAD were not. This study suggests that the association between macroangiopathy and microangiopathy may be attributable to functional processes rather than structural processes within the vascular system.

• 대한간호학회지
• /
• 제33권5호
• /
• pp.633-642
• /
• 2003

Purpose: This study was conducted to evaluate the effects of foot care education program using foot-reflexo-massage in diabetic patients. Method: A convenience sample of non-equivalent control group time series design was used. It provided foot care education to diabetic patients through small book for both group. For the experimental group, foot-reflexo-massage was taught by a researcher and research assistants. Analysis was done by Repeated Measured ANOVA. Result: There was significant increase in foot care knowledge, self care behavior, between the experimental group and the control group over three different times. There was significant in skin temperature and pulse of foot over three different times and interaction by groups or over time, but there was no significant difference between groups. There was no significant difference in blood flow volume and capillary filling time over three different times, between groups, but there was interaction by groups or over time. But there was significant difference in discrimination in change of dosalis pedis artery blood flow. Conclusion: Findings indicate that this study may contribute to develop nursing intervention for foot care of diabetic patients.

• Journal of Nutrition and Health
• /
• 제23권4호
• /
• pp.270-278
• /
• 1990

This study was an attempt to investigate the usefulness of maltitol as an alternative sweetener. The acute effects of oral ingestion of 50g of maltitol or glucose on blood glucose and insulin levels following test dose were investigated by using five healthy normal subjects and ten diabetic patients. The data demonstrated marked differences between the utilization of maltitol and of glucose in both groups. Blood glucose and insulin responses to glucose were significantly greater than to maltitol in normal subjects(p<0.05). In diabetic patients, the peaks of the mean increment in blood glucose concentration after glucose and maltitol were reached at 60 minutes with mean values of 135mg/dl and 49mg/dl, respectively, and these differences were statistically significant(p<0.001). As for blood insulin responses in diabetic patients, the peak of the mean increment after glucose was 25.03$\mu$U/ml at 120 minutes. In contrast insulin responses to maltitol were significantly lower than to glucose(p<0.05), and the peak value was 7.98$\mu$u/ml at 60min. From these results it can be concluded that ingestion of maltitol resulted in significantly lower blood glucose and insulin increments than did glucose in both normal and diabetic patients.