• 한국융합학회논문지
• /
• 제12권3호
• /
• pp.389-399
• /
• 2021

본 연구는 당뇨병 자가관리교육이 포함된 수중운동 프로그램이 지역사회 당뇨병 환자의 자가간호행위와 자기효능감에 미치는 효과를 알아보기 위한 비동등성 대조군 유사실험연구이다. 연구대상자는 D광역시 W 보건진료소에 등록된 당뇨병 환자 중 수중운동 프로그램에 참여한 실험군 26명과 참여하지 않은 대조군 25명이다. 프로그램은 주 2회, 80분으로, 당뇨병 자가관리교육 30분과 50분의 수중운동 프로그램으로 구성되었다. 본 프로그램 후 공복혈당(p=.047), 당화혈색소(p<.001)는 유의하게 감소되었고, 당뇨병 자기효능감(p<.001), 당뇨병 자가간호행위(p<.001)는 유의하게 증가하였다. 본 연구결과로 자가관리 교육을 포함한 수중운동 프로그램이 자기효능감과 자가간호행위를 향상시켜 당뇨병 관리에 중요한 지표인 공복혈당과 당화혈색소를 완화하는데 효율적임을 알 수 있었다. 지역사회에서 당뇨병 유병율을 낮추고 합병증을 예방하기 위해 자가관리 교육이 포함된 수중운동 프로그램 상시운영이 필요한 것으로 사료된다.

• Nutrition Research and Practice
• /
• 제17권2호
• /
• pp.241-256
• /
• 2023

BACKGROUND/OBJECTIVES: Diabetes-specific oral nutritional supplements (ONS) have anti-hyperglycemic effects, while D-allulose exerts anti-diabetic and anti-obesity effects. In this study, we investigated the efficacy and safety of diabetes-specific ONS, including allulose, on glycemic and weight changes in overweight or obese patients with type 2 diabetes mellitus (T2DM). SUBJECTS/METHODS: A single-arm, historical-control pilot clinical trial was conducted on 26 overweight or obese patients with T2DM (age range: 30-70 yrs). The participants were administered 2 packs of diabetes-specific ONS, including allulose (200 kcal/200 mL), every morning for 8 weeks. The glycemic profiles, obesity-related parameters, and lipid profiles were assessed to evaluate the efficacy of ONS. RESULTS: After 8 weeks, fasting blood glucose (FBG) level significantly decreased from 139.00 ± 29.66 mg/dL to 126.08 ± 32.00 mg/dL (P = 0.007) and glycosylated hemoglobin (HbA1c) improved (7.23 ± 0.82% vs. 7.03 ± 0.69%, P = 0.041). Moreover, the fasting insulin (δ: -1.81 ± 3.61 μU/mL, P = 0.017) and homeostasis model assessment for insulin resistance (HOMA-IR) (δ: -0.87 ± 1.57, P = 0.009) levels decreased at 8 weeks, and body weight significantly decreased from 67.20 ± 8.29 kg to 66.43 ± 8.12 kg (P = 0.008). Body mass index (BMI) also decreased in accordance with this (from 25.59 ± 1.82 kg/m² to 25.30 ± 1.86 kg/m², P = 0.009), as did waist circumference (δ: -1.31 ± 2.04 cm, P = 0.003). CONCLUSIONS: The consumption of diabetes-specific ONS with allulose in overweight or obese patients with T2DM improved glycemic profiles, such as FBG, HbA1c, and HOMA-IR, and reduced body weight and BMI.

• 보건행정학회지
• /
• 제33권1호
• /
• pp.3-18
• /
• 2023

Background: A chronic disease management program including patient education, recall and remind service, and reduction of out-of-pocket payment was implemented in Korea through a chronic care model. This study aimed to assess the effect of a community-based intervention program for improving medication adherence of patients with diabetes mellitus in rural areas of Korea. Methods: We applied a non-equivalent control group design using Korean National Health Insurance Big Data. Hongcheon County has been continuously adopting this program since 2012 as an intervention region. Hoengseong County did not adopt such program. It was used as a control region. Subjects were a cohort of patients with diabetes mellitus aged more than 65 years but less than 85 years among residents for 11 years from 2010 to 2020. After 1:1 matching, there were 368 subjects in the intervention region and 368 in the control region. Indirect indicators were analyzed using the difference-in-difference regression according to Andersen's medical use model. Results: The increasing percent point of diabetic patients who continuously received insurance benefits for more than 240 days from 2010 to 2014 and from 2010 to 2020 were 2.6%p and 2.7%p in the intervention region and 3.0%p and 3.9%p in the control region, respectively. The number of dispensations per prescription of diabetic patient in the intervention region increased by approximately 4.61% by month compared to that in the control region. Conclusion: The intervention program encouraged older people with diabetes mellitus to receive continuous care for overcoming the rule of halves in the community. More research is needed to determine whether further improvement in the continuity of comprehensive care can prevent the progression of cardiovascular diseases.

• 기본간호학회지
• /
• 제10권2호
• /
• pp.171-180
• /
• 2003

Purpose: The purpose of this study was to investigate the relationship of self-efficacy, knowledge about the disease, and self-care behavior to the metabolic level in patients with NIDDM. Method: Data were collected from March 15 to April 15, 2001. Participants in the study were 48 patients with NIDDM who were seen regularly at the endocrinology out-patient department of Gwangju Christian Hospital. The data were collected through individual interviews and patient blood samples. The data were analyzed with SPSS/PC+, using t-test, ANOVA, Pearson correlation coefficients and Cronbach's Alpha. Result: 1. The mean score for self-efficacy was $71.37{\pm}15.56$, knowledge $15.00{\pm}2.84$, self-care behavior $63.18{\pm}13.10$. The mean score for HbAlc level was $7.66{\pm}1.77%$, HDL cholesterol level, $46.22{\pm}13.04 mg/dl$ and total cholesterol level, $187.93{\pm}41.45 mg/dl$. 2. There was a significant difference between patients with a spouse and those without one (t=-2.08, p=0.042), in knowledge according to level of obesity (t=5.14, p=0.010), duration of illness (t=3.22, p=0.031) and presence of complications related to diabetes (t=-2.58, p= 0.013). There were no significant differences in self-care behavior, but there were significant differences in sugar metabolic level according to sex (t=-2.02, p=0.050). 3. The correlation between diabetic patients' self-efficacy, knowledge and self-care behaviour and metabolic control was significantly related only to self-efficacy and self-care behavior (r=.692, p=0.000). Conclusion: It is necessary to improve self-efficacy, knowledge, and self-care behavior for patients with NIDDM by using nursing intervention programs to promote and maintain metabolic control.

• 한국보건간호학회지
• /
• 제15권2호
• /
• pp.334-341
• /
• 2001

The purpose of this study is to examine to control of glucose level and the occurrence of chronic complications of diabetes by compliance groups with health care regimen The subjects were consisted of 300 out patients with type 2 diabetes mellitus from beginning of March through the end of April in 2001, who visited at the endocrinology department at Kangnam St. Mary's Hospital of Catholic University in Seoul. The patient's compliance level with health care regimen was assessed at questionnaire. However, the blood glucose level and the occurrence of chronic complications of diabetes were assessed at medical record review. The data were analyzed by SAS program for chi square test and t-test. The results were as follows. 1. Significant differences were found among the factors such as duration of diabetes, the number of participation of diabetes educational program, job, smoking, self monitoring of blood glucose and the methods of diabetes therapy between high and low compliance groups. High compliance group patients had a diabetes longer than low compliance group patients. High compliance group patients more frequently attended the educational program and checked themselves monitoring blood glucose than low compliance group patients. Also, they did not work recently, smoked less and got more insulin injection therapy compared to low compliance group patients. 2. No significant differences were found among the result of fasting blood glucose. 2-hour postprandial blood glucose, and $HbA_{l}c}$ between high and low compliance groups. 3. The occurrence rate of macrovascular complications of chronic complications of diabetes were lower, however, the occurrence rate of microvascular complications were higher in high compliance group than in low compliance group with health care regimen.

• Archives of Plastic Surgery
• /
• 제45권6호
• /
• pp.564-571
• /
• 2018

Background Chronic wounds occur due to failure of the normal healing process, associated with a lack of deposition of cellular components and a suitable microenvironment such as the extracellular matrix (ECM). Acellular dermal matrix (ADM) is viewed as an ECM substitute, and a paste-type ADM has recently been introduced. We hypothesized that CGPaste, an injectable paste-type ADM, could serve as a scaffold and promote wound healing. Methods We retrospectively studied seven patients in whom CGPaste was applied between 2017 and 2018, who had pressure ulcers, necrotizing fasciitis, diabetic foot ulcers, traumatic defects, and osteomyelitis. The goal of applying CGPaste was to achieve complete wound healing with re-epithelialization or growth of granulation tissue, depending upon the wound bed status. CGPaste was injected based on the wound size along with the application of a dressing. Results Four of the seven patients showed granulation tissue on their wound bed, while the other three patients had a bony wound bed. The mean wound area was $453.57mm^2$ and the depth was 10.71 mm. Wound healing occurred in five of the seven patients (71.43%). The mean duration of complete healing was 2.4 weeks. Two patients showed failure due to paste absorption (29.57%); these patients had wound beds comprising bone with relatively large and deep wounds ($40{\times}30$ and $30{\times}20mm^2$ in area and 15 and 10 mm in depth). Conclusions CGPaste is an effective option for coverage of small and deep chronic wounds for which a flap operation or skin grafting is unfeasible.

• Nutrition Research and Practice
• /
• 제2권3호
• /
• pp.152-157
• /
• 2008

The purpose of this study was to investigate the effect of soybean on blood glucose and lipid concentrations, and antioxidant enzyme activity in type 2 diabetes mellitus(DM) patients. We divided patients into two groups and fed them, respectively, a basal diet(control group) and a basal diet with 69 g/d of soybean(soybean group) for 4 weeks. Pills with roasted soybean powder were provided to the soybean supplementation group three times a day. Macronutrients intake except dietary fiber was similar between the two groups. No significant differences were observed in dietary intakes or body weight before and after the supplementation. Energy composition ratio of C:F:P was 65:19:16 in the control group, 64:20:16 in the soybean group. The blood parameters of subjects before supplementation, such as fasting blood glucose, postprandial glucose level, total cholesterol, triglyceride, LDL-cholesterol and $HbA_1C$ were not different between the two groups. After supplementation, fasting blood glucose(p<0.001), postprandial glucose level(p<0.001) and serum triglyceride level(p<0.05) were significantly reduced in the soybean group in comparison with the control group. The total cholesterol level was not significantly different between the control and the supplemented group after 4 weeks of treatment. TBARS levels of the soybean group were not significantly different from those of the control group. The activities of catalase(p<0.01) and glutathione peroxidase(p<0.05) were significantly higher in the soybean group compared to the control group. The results of this study suggest that soybean supplementation would be helpful to control blood glucose and serum lipid in diabetic patients. Also, soybean showed an antioxidant activity that may contribute to enhance the effect of antioxidant defense. This activity contributes to protection against oxidative damage in type 2 DM patients. Soybean may have potential use in the disease management of patients with DM.

• 보건교육건강증진학회지
• /
• 제33권5호
• /
• pp.47-57
• /
• 2016

Objectives: To develop and evaluate the applicability of a health literacy instrument in patients with diabetes by measuring their ability to understand diabetes-related words. Methods: Diabetes-related words were extracted from the Korean Diabetes Association's website and literature reviews. In the first phase, three nursing researchers evaluated 2,661 diabetes-related words based on graded lexical vocabularies and what patients need to know about self-care, and the narrowed them to 255 words. In the second phase, a content validity assessment was conducted by an expert panel. In the third phase, the remaining 25 words were administered to 200 conscientious with type 2 patients aged 40 years old and using a Gallup survey from March 3 to 17, 2016 in Seoul, Korea. Descriptive analysis and Rasch analysis were performed to test psychometric properties. Results: The mean score was 21.47 with a range of 0 to 25. The Cronbach's ${\alpha}$ was .92. The health literacy instrument using diabetes-related words had a ceiling effect response. Conclusions: Diabetes-related words are useful and reliable items for testing the health literacy of diabetes patients. Future study is needed to develop and validate health literacy measures for diabetic patients.

• Nutrition Research and Practice
• /
• 제17권2호
• /
• pp.297-306
• /
• 2023

BACKGROUND/OBJECTIVES: The prevalence of diabetes has continued to increase globally. Changes in eating habits, lack of exercise, increased stress, and aging are major contributors. Glycemic control is the key strategy of diabetes management. The purpose of this study was to analyze the utilization of nutrition labels and related factors among patients with diabetes. MATERIALS/METHODS: Data from the 7th Korea National Health and Nutrition Examination Survey were used. General, health-related, diabetes-related characteristics from 1,587 adults with diabetes history were included. Nutrition label utilization was assessed with awareness and use of nutrition labels and effects on food choice. For statistical analyses, chi-square test and multiple logistic regression analysis were performed. RESULTS: The prevalence of awareness, use, and effects of nutrition labels on food choice among diabetic patients were 48.8%, 11.4%, and 9.6%, respectively. High monthly income, walking frequency, family history of diabetes, younger age at diagnosis, and shorter duration of diabetes were associated with higher nutrition label awareness. Nutrition label use and effect on food choice were higher in women, those with high monthly income, those diagnosed at younger than 45 yrs, those with diabetes for less than 10 yrs, those with meal therapy, or patients who had undergone a fundus examination. CONCLUSIONS: Nutrition label utilization status was low in Korean patients with diabetes. Strategies are needed to promote nutrition label use as a diet management tool for patients with diabetes.

• 한국보건간호학회지
• /
• 제37권1호
• /
• pp.80-96
• /
• 2023

Purpose: This study examined the trends in domestic research that applied theory to diabetes patients to suggest future directions of nursing practice and research for diabetes patients. Methods: This scoping review followed the Joanna Briggs Institute guidance. The population was diabetes patients; the concept was a research that applied theory and had no limitations in context. Eligible studies were retrieved from electronic databases of RISS, KMbase, KoreaMed, NDSL, NAL, and nine major domestic nursing journals. Of the 509 retrieved articles, 20 studies met the inclusion criteria. Results: The study included the community (57.1%), and the subjects were mainly type 2 diabetes patients (42.9%). The Information-Motivation-Behavior skills (IMB) model was the most applied theory (36.4%). The theories were primarily from psychology disciplines (72.7%) and predominantly applied as a conceptual framework of the study (55%). Conclusion: The studies that applied theory were conducted mainly in the community. The IMB model was the most applied theory, and the theory was most applied as the conceptual framework. Efforts to close the theory-practice gap and further studies on developing nursing interventions based on theory and verifying their effectiveness are needed to improve nursing practice and study for diabetic patients.