• 대한족부족관절학회지
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• 제22권4호
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• pp.151-155
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• 2018

Purpose: Toe ulcers have been implicated as a causative factor in diabetic foot amputation. The aim of this study was to evaluate the outcomes of percutaneous needle flexor tenotomies of diabetic claw toes with ulcers or pending ulcers. Materials and Methods: The authors undertook a retrospective chart review between January 2014 and June 2016 to identify those patients who underwent a percutaneous needle flexor tenotomy for diabetic claw toe deformities. We evaluated 54 toes in 42 patients. Twenty-four patients were female and the mean age at the time of operation was 57 years. The mean follow-up time was 11 months. Thirty-four patients (46 toes) had tip toe ulcers or pending ulcers and 8 patients (8 toes) had dorsal pending ulcers. All patients had palpable pulses and good capillary refill. Results: Forty-three of 46 tip toe ulcers (93.5%) healed without significant complications and 8 dorsal ulcers showed no specific changes within 5 weeks. There were no recurrent ulcers at final follow-up. Four patients developed transfer lesion of the adjacent toe and needed subsequent tenotomy. Conclusion: Percutaneous needle tenotomy in an outpatient clinic was an effective and safe method for treating toe ulcers in neuropathic patients to offload the tip of the toe so that ulcer healing could occur.

• 동아시아식생활학회지
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• 제12권3호
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• pp.225-234
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• 2002

This study was designed to determine changes of nutritional status, diabetic indices and serum lipid composition in non-insulin dependent diabetes mellitus patients during intake of diabetic-oriented convenience food prepared from 7 medicinal plants and chicken. We conducted dietary, anthropometric and biochemical assessments before and after the intake of diabetic oriented food. Once a day, in the study, their normal lunch was replaced by the diabetic-oriented convenience food diet for 30 consecutive days. It was found that the nutrients of the diet were well-balanced, and the intake levels nearly approached those of the RDA. Obesity rate, body fat, and body weight were significantly lower than those of a normal diet. The average fasting blood glucose significantly decreased while the insulin level significantly increased after the intake of diabetic meal. Also the total serum cholesterol and triglyceride levels significantly decreased. The above results indicate that diabetic-oriented convenience food prepared from 7 medicinal plants and chicken may be used as a diet regime fer controlling the diabetes mellitus on a regular basis.

• 성인간호학회지
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• 제19권5호
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• pp.1-11
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• 2007

Purpose: The purpose of this study was to examine the effects of a cognitive behavioral stress management program on diabetic self-care and glycemic control with type 2 diabetic patients. Methods: Thirty three diabetic patients who were older than 40 were recruited from a public health center and conveniently assigned into both experimental(n=16) and control groups(n=17). Participants in the experimental group had attended the weekly cognitive behavioral program for 8 weeks. Data were collected from June 2005 to August 2006 and analyzed by independent t-test using the SPSS WIN program. Results: After an 8 week intervention, participants in the experimental group reported on increasement of diabetic self-care behaviors and an increasement of blood glucose levels, which were significantly different from those in the control group. Conclusion: On the basis of those findings, we concluded that the cognitive behavioral stress management program has positive effects on diabetic self-care and glycemic control for the patients with DM. Further research is needed to identify the long-term effects of the cognitive behavioral program.

• Journal of Periodontal and Implant Science
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• 제23권1호
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• pp.27-36
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• 1993

The purpose of the this study was to research the interrelationship of periodontal status and patient's age between diabetic group and non-diabetic group and compare that of periodontal status according to the blood sugar level and duration of diabetics. The participants of this study were 52 diabetic patients and 51 non-diabetic patients. The diabetic group and non-diabetic group were further divided into four subgroups according to the age(under 35 years old, 36 - 45 years old, 46 - 55 years old, over 56 years old) and the diabetic group was further divided into three subgroups according to the duration of diabetics (under 5 years, 6 - 10 years, over 11 years) and blood sugar level(under 140mg/100ml, 140-200mg/100ml, over 200mg /100ml), respectively. Author evaluated such periodontal status as plaque index and calculus index, gingival lndex, loss of attachment, papillary bleeding index, tooth mobility and missing teeth, and then data was statistically analyzed by SPSS/PC+ using ANOVA, respectively. The results were as follows: 1. The mean value of plaque index, gingival index, loss of attachment, papillary bleeding index, tooth mobility and missing teeth of diabetic patients were significantly higher than that of non-diabetic patients, respectively(p <0.01, p<0.01, p<0.01, p<0.01, p<0.001, p<0.001), but there was no significant difference between diabetic group and non-diabetic group in calculus index(P>0.05). 2. According to the increase of age, loss of attachment and missing teeth were increased in both group, and correlation of each subgroup was statistically significant, respectively(p<0.05, p<0.001). 3. According to the elevation of blood sugar level of diabetics, plaque index, gingival index, loss of attachment, papillary bleeding index, tooth mobility and missing teeth were increased in diabetic group, and correlation of each subgroup was statistically significant, respectively (p<0.05, p<0.05, p<0.05, p<0.05, p<0.001, p<0.001). 4. According to the duration of diabetics, plaque index, gingival index, loss of attachment, papillary bleeding index, tooth mobility and missing teeth were increased in diabetic group, and correlation of each subgroup was statistically significant, respectively(p<0.05, p<0.05, p<0.05, p<0.05, p<0.001, p<0.001).

• 대한지역사회영양학회지
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• 제16권4호
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• pp.488-496
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• 2011

The purpose of this study was to investigate the perception and utilization of Complementary and Alternative Medicine (CAM) for diabetic patients in Busan. The subjects were 227 patients at two general hospitals (over 400 bed). This study was performed through the interviewing process using questionnaires conducted from January to April, 2010. Of a total of subjects, 109 patients (48.0%) had taken CAM at least one time. The patients used CAM recognized that they were 'auxiliary medicines' (39.4%), 'supplementary health foods' (32.1%) and 'medicines' (19.3%), but inexperienced patients perceived them as 'supplementary health foods' (29.6%), 'unscientific treatment' (22.6%) and 'medicines' (20.2%), It was significantly different between two groups of patients (p < 0.001). The number of CAM types used for the patients was 51. The CAM types were plant foods (64.3%), dietary supplement (23.6%) and animal diets (12.1%). The patients used an average of 5.9 different kinds of CAM and an average of 3.8 years them and paid \93,345 per month. The patients with diabetic complications and for longer morbidity periods used CAM for significantly (p < 0.05) longer periods. The mean effectiveness scores of the patients used CAM were 3.31/5.00 for efficacy satisfaction, 3.58/5.00 for fewer side effects compared to those of oral drugs, 3.60/5.00 for psychological stability, 3.81/5.00 for easiness to use, and 3.06/5.00 for economic satisfaction. Of the patients that used CAM, 55.9% did not consult with doctors about CAM. More than two-thirds of the patients (77.1%) did not feel the need to consult with doctors.

• Archives of Plastic Surgery
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• 제38권5호
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• pp.585-589
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• 2011

Purpose: Microcirculation of diabetic patients is commonly comporomised, regardless of the condition of the macrocirculation. Therefore, direct tissue oxygenation measurement is recommended in determining tissue viability and predicting wound healing potential. This study was designed to determine cut-off value of the tissue oxygenation in predicting wound healing in diabetic foot patients. Methods: This study included 41 feet of 41 diabetic foot patients who were treated in the Diabetic Wound Center of author's institution between January and June, 2009. Main inclusion criteria were type 1 or 2 diabetes and a foot ulcer (duration > 3 weeks) and ulcer area (from 1 $cm^2$ to 4 $cm^2$). Measurements of the area of diabetic foot ulcer were carried out before treatment. Transcutaneous oxygen pressure ($TcpO_2$) was measured at adjacent site of ulcer. The healing wound was defined as complete wound closure within 12 weeks. Results: Average diabetic foot ulcer areas with healing and nonhealing wounds were $2.67{\pm}0.76$ and $2.59{\pm}0.75\;cm^2$, respectively. There was no significant difference in the wound area between the groups. Average foot $TcpO_2$ in healing and nonhealing wounds were $68.56{\pm}23.07$ and $30.98{\pm}16.66$ mmHg, respectively ($p$ <0.01). The rate of healing wound increased as $TcpO_2$ increased. In particular, $TcpO_2$ lower than 40 mmHg and higher than 40 mmHg showed the most significant difference (wound healing rates of 25% and 71%, respectively). Conclusion: Based on the results of the study, the minimal $TcpO_2$ value thought to be required for adequate wound healing in diabetic wounds (cut-off value) is 40 mmHg.

• 대한영양사협회학술지
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• 제5권1호
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• pp.64-73
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• 1999

Carbohydrate(CHO) counting is a meal planning approach used with diabetic patients that focuses on carbohydrate as the primary nutrient affecting post-prandial glycemic response. However, it has not been used in meal management of diabetic patients in Korea. CHO counting can be used by clients with type 1 and 2 diabetes. The purpose of the study was to determine the barriers to utilize the CHO counting when three levels of CHO counting were educated to type 2 diabetic patients who started continuous subcutaneous insulin infusion (CSⅡ) therapy by nutrition lectures and counseling. And the CHO-to-insulin ratios were determined for the individual patients who followed the carbohydrate counting as a meal management, and the factors to influence the CHO-to-insulin ratios were selected through the stepwise regression analysis. Twenty- four subjects were received three lectures, and one or two nutritional counseling for a month. The average age of the subjects was 50.7 years, and the duration of diabetes was 9.4 years. Their body mass index (BMI) was 21.5 kg/$m^2$. The difficulties of using CHO counting were 1) confusing the CHO exchange system to diabetic food exchange system, 2) lack of basic nutrition and not distinguishing nutrients such as CHO, fat and calorie, and 3) lack of motivation to make effort to count and record the amount of carbohydrates eaten. Nutritional counseling replenished the nutrition education and made patients practice CHO counting. Average CHO-to-insulin ratios at breakfast, lunch and dinner were 4.1$\pm$3.3, 2.9$\pm$2.6 and 2.9$\pm$3.0units/23g of CHO, respectively. CHO-to-insulin ratios were influenced by gender, age, BMI, post-prandial blood glucose levels and post-prandial c-peptide levels. The effective education and nutritional counseling of CHO counting can make CHO counting applicable to type 2 diabetic patients as meal management for improving glycemic control with less hypoglycemic episode.

• 대한족부족관절학회지
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• 제15권1호
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• pp.7-12
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• 2011

Purpose: To evaluate the incidence and risk factors of ipsilateral reamputation after lower limb amputation in the patient with diabetic foot lesions. Materials and Methods: Between May 2005 and June 2009, 88 patients who underwent lower limb amputation were analyzed. Group 1 consisted of 73 patients who didn't have a ipsilateral reamputation after lower limb amputation and group 2 consisted of 15 patients who underwent reamputation. We compared several factors between two groups, such as age, gender, BMI, ABI, Wagner classification, wound culture, site of amputation, vascular surgery, the period of diabetes mellitus, chronic renal failure. Results: Fifteen (17%) of 88 patients had a ipsilateral limb reamputation and 13 patients (87%) of them underwent reamputation within 6 months. When we compared the two groups, average age was 59.3 (range, 48-74 years); 62.9(range, 44-78 years). Age was significantly associated with reamputation rate (p=0.02) and no reamputation after initial amputation above ankle joint was found. Other factors did not show statistically difference between both groups. Conclusion: There were no significant difference between diabetic limb amputation and reamputation group in our concerned risk factors except age and amputation level. There should be careful consideration when determine level of amputation in diabetic foot lesions especially in elder patients.

• 보건행정학회지
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• 제28권2호
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• pp.107-118
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• 2018

Background: The purpose of this study was to investigate the estimated proportion for influenza vaccination and to identify factors associated with influenza vaccination in Korean diabetic patients. Methods: Data from the fourth, fifth, and sixth (except for 2013) Korea National Health and Nutrition Examination Survey (n=3,726) was used. A chi-square test was performed to investigate the estimated proportion for influenza vaccination, and a multiple logistic regression analysis was used to identify the factors associated with self-reported influenza vaccination. Results: In men, 28.8% of diabetes patients 30-64 years of age, and 76.1% of elderly (over 65 years of age) diabetes patients received influenza vaccination. In women, 37.7% of diabetes patients 30-64 years of age, and 78.4% of elderly diabetes patients received influenza vaccination (p<0.0001). The determinants of influenza vaccination were marriage, hypertension (odds ratio [OR], 1.55; 95% confidence interval [CI], 1.07-2.24), residence within a mega city, unemployment (OR, 3.94; 95% CI, 1.24-12.54), and exercise via (weekly) walking for diabetic men; and hypertension (OR, 1.71; 95% CI, 1.16-2.52), chronic disease (OR, 1.81; 95% CI, 1.08-3.02), and exercise via walking (OR, 2.65; 95% CI, 1.49-4.73) for diabetic women. Conclusion: Influenza vaccination remains relatively low in young diabetic patients. It is necessary to recommend vaccination to young diabetic patients, and to devise other strategies to improve vaccination.

• Archives of Plastic Surgery
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• 제40권4호
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• pp.403-408
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• 2013

Background For patients with neuropathy, vasculopathy, and impairment of wound healing, treatment of a diabetic foot ulcer poses many challenges. A large number of dermal analogues have been invented in an effort to overcome these challenges. Matriderm, a dermal analogue, is made from bovine collagen and elastin. This study was conducted in order to evaluate the effectiveness of Matriderm for treatment of diabetic foot ulcers, in comparison with skin grafting. Methods Sixty patients with diabetic foot ulcer were included in this prospective study. The average age of the patients, who had type II diabetes mellitus, was 58 years old. The patients were allocated to an experimental or control group with their consents. The patients were selected with their consent for inclusion in an experimental group and a control group. Patients in the experimental group received a Matriderm appliance and a split-thickness skin graft, while those in the control group received only a split-thickness skin graft. Results A shorter hospitalization period (7.52 weeks) was observed in the experimental group than in the control group (9.22 weeks), and a shorter period of time (8.61 weeks) was required for complete healing, compared with the control group (12.94 weeks), with statistical significance (P<0.05). A higher elasticity ratio of the affected side to the non-affected side was observed in the experimental group, compared with the control group (P<0.01). Conclusions Matriderm enables effective healing and improves elasticity in treatment of patients with diabetic foot ulcer.