• Journal of Korean Clinical Nursing Research
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• v.28 no.3
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• pp.277-288
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• 2022

Purpose: This study was conducted to evaluate the effects of the insulin therapy adherence program (INSTA GRAM) for patients with type 2 diabetes mellitus. Methods: This study examined a total of 63 patients with type 2 diabetes for whom the initiation of insulin therapy is being considered or within 6 months of undergoing insulin therapy. INSTAGRAM is a stage-specific intervention consisting of strategies for motivating patients to initiate and maintain insulin therapy using the transtheoretical model on the stages of change, the process of change, and self-efficacy. The participants were randomly assigned to either the INSTAGRAM group (experimental group, n=32) or the standard diabetes education group (control group, n=31). The INSTAGRAM group received 6 sessions over 8 weeks(face-to-face education was conducted in the first and last sessions, and telephone coaching was conducted from the second to fifth sessions). The outcomes were measured by psychological insulin resistance, self-efficacy, and glycosylated hemoglobin (HbA1c). Results: Psychological insulin resistance (p<.001), self-efficacy (p<.001), and HbA1c (p=.024) of the participants in the INSTAGRAM group significantly improved compared to those in the control group. Conclusion: INSTAGRAM is effective in overcoming psychological insulin resistance and improving self-efficacy and HbA1c. Therefore, the INSTAGRAM can be recommended as a nursing intervention for type 2 diabetic patients who delay the initiation of insulin therapy.

• Korean Journal of Clinical Pharmacy
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• v.32 no.1
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• pp.13-19
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• 2022

Background: The use of combination therapy and fixed-dose combination therapy is increasing for the treatment of type 2 diabetes. Sodium glucose cotransporter-2 inhibitor (SGLT2i) is a drug class used in combination with metformin. Methods: Type 2 diabetes patients on SGLT2i/metformin combination therapy were extracted from the 2019 Health Insurance Review & Assessment Service-National Patients Sample. On July 1, 2019, SGLT2i and metformin fixed-dose combination (SGLT2i/metformin FDC) and two-pill combination (TPC) groups were identified, and a chi-square test and multiple logistic regression were performed. Results: Of total 2,992 patients, 1,077 (36%) were prescribed SGLT2i/metformin FDC and 1,915 (64%) were prescribed TPC. We found that the most common comorbidities were in the order of dyslipidemia, gastrointestinal disease, and hypertension. Multiple logistic regression analysis showed that the use of SGLT2i/metformin FDC was lower than TPC in patients with diabetic neuropathy (OR=0.76, p=0.008). Clinic (OR=2.09, p<0.001) and general hospital (OR=1.40, p=0.019) showed higher tendency to prescribe SGLT2i/metformin FDC compared to tertiary hospital. The tendency of prescribing SGLT2i/metformin FDC was lower in Kyeonggi (OR=0.79, p=0.037), Gyeongsang (OR=0.77, p=0.025) and Chungcheong (OR=0.68, p=0.007) than Seoul. Conclusion: Factors related to the use of SGLT2i/metformin FDC in patients with type 2 diabetes were complication, medical institution and region. The tendency to prescribe SGLT2i/metformin FDC was relatively higher in clinics than in tertiary general hospitals and in Seoul than in other regions.

• Journal of Digestive Cancer Research
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• v.5 no.2
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• pp.91-96
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• 2017

Background: To evaluate whether DM affects the SUVmax of metastatic lesions on ¹⁸F-FDG PET/CT and whether the SUVmax can influence the prognosis of metastatic PDAC patients. Methods: We conducted a retrospective study of 86 patients with metastatic PDAC who underwent PET/CT before treatment. The SUVmax of primary and metastatic lesions and the ratios of the SUVmax were measured. Long-term survival was evaluated using clinical parameters. Results: The mean SUVmax of primary lesion was lower in the DM group than in the non-DM group (4.74 vs. 5.96, p=0.009). The SUVmax for all metastatic lesions, except those in the lung, were lower in the DM group than in the non-DM group, and these differences were statistically significant in the lymph nodes and peritoneum. In the 35 patients with hepatic metastasis, higher ratios of the liver SUVmax significantly correlated with shorter OS (HR, 2.625; p=0.013). Conclusion: DM can influence the lower SUVmax of metastatic lesions as well as primary lesions. The SUVmax ratio of hepatic metastasis could influence on prognosis in metastatic PDAC patients.

• Clinical and Experimental Pediatrics
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• v.45 no.6
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• pp.754-763
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• 2002

Purpose : The incidence of type 2 diabetes in children and adolescents has been reported to increase recently. The aim of this study is to investigate the clinical features of type 2 diabetes developing during childhood and adolescent period. Methods : The medical records of 33 patients with type 2 diabetes were reviewed. We analysed clinical manifestations, demographic data, and modes and responses of treatment. Results : Age at diagnosis was $13.4{\pm}1.8$ years. Seventy percent of patients revealed pubertal signs at diagnosis. Half of the patients had BMI more than $25kg/m^2$. Seventy-three percent of patients had family history of type 2 diabetes. Acanthosis nigricans were found in 18% of patients. Nineteen(57.6%) patients were diagnosed incidentally by random urine or blood glucose test without any typical diabetic symptom or sign. The modes of therapy to control hyperglycemia were insulin alone(75.8%), oral hypoglycemic agents alone(9.1%), insulin and oral hypoglycemia agents(9.1%), and only diet with exercise(6%). At the time of investigation, 45.5% of patients were not using insulin. The typical diabetic symptoms at diagnosis were more prevalent in patients who required insulin for more than two years than patients who did not(P<0.05). Conclusion : The development of type 2 diabetes in children and adolescents is possibly related to puberty, obesity, family history, and defects in insulin secretion rather than insulin resistance. Many children and adolescents with type 2 diabetes required insulin initially and some of them could discontinue. More than half of the patients were diagnosed as diabetes without any typical symptom or sign, which might be one of the predictive factors of the prolonged insulin requirement.

• Korean Journal of Clinical Laboratory Science
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• v.50 no.3
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• pp.313-319
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• 2018

Recently, there have been many studies on the relationship between the bone metabolism and the mechanism of diabetes. In those studies, it was shown that osteocalcin can be involved in the treatment of type 2 diabetes. Therefore, this study examined the correlation between osteocalcin and HbA1c. From January 1, 2015 to December 31, 2016, a total of 714 adults aged 40 years or older ($70.8{\pm}10.4years$, 452 males), in whom both osteocalcin and HbA1c checked in a general hospital in Gwangju, were enrolled in the study. The serum calcium, total cholesterol, triglyceride, HDL-cholesterol, LDL-cholesterol, and 25-(OH) vitamin D were measured and basic information, such as the height and weight, were recorded. There was a weak negative correlation (r=-0.183, P<0.001) between the osteocalcin and HbA1c levels in diabetic patients but a negative correlation (r=-0.251, P<0.001) when adjusted by all other study variables. The present study showed that there was a negative correlation between the osteocalcin and HbA1c levels in diabetic patients. The relationship between the bone metabolism and the incidence of diabetes mellitus should be studied based on the influence of biological mechanisms and associated factors of bone and glucose metabolism.

• The Journal of the Korea Contents Association
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• v.18 no.12
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• pp.208-217
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• 2018

The purpose of this study was to provide information on the treatment and management of diabetic patients using all the available data of the Korea National Health and Nutrition Examination Survey (KNHANES, 2013-2015) on the serological and complication patterns of cardiovascular disease (CVD) according to the duration of diabetes mellitus (DM). KNHANES consists of health questionnaires, screenings, and nutrition surveys. The study subjects were 1,316 persons who were aged between 18 and 80 years and who answered the duration of DM. DM was classified as 0-5, 6-10, 11-15, 16-20, and over 20 years according to duration of DM. The longer the duration of DM, the older the BMI, the lower the smoker, the higher the HbA1c and the lower the glomerular filtration rate. Total cholesterol, LDL-C and triglyceride levels were low and HDL-C levels were similar. The proportion of patients receiving insulin and oral hypoglycemic agents increased. The longer the duration of DM, the worse blood glucose control and the increased risk of microvascular and macrovascular complications. To prevent these complications, intensive care and monitoring should be used to control the risk factors.

• YAKHAK HOEJI
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• v.44 no.6
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• pp.539-544
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• 2000

Many diabetic patients develop serious complications during the course of the disease, including cardiovascalar disorders, nepropathy, neuropathy and retinopathy. Because some physiological changes occurring in diabetes mellitus patients could alter the pharmacokinetics of drugs used to treat the disease, the pharmacokinetics of gentamycin was investigated after intravenous administration (2 mg/kg) to control rabbits and acute or chronic alloxan-induced diabetes mellitus rabbits (AIDRs). After intravenous administration, the serum concentrations of gentamycin were significantly higher between 6 and 12 hr in chronic AIDRs compared with those in control rabbits. The AUC was significant greater in chronic ($31.91\;{\pm}\;3.76\;{\mu}g/ml{\cdot}hr$) AIDRs than that in control ($21.60\;{\pm}\;2.45\;{\mu}g/ml{\cdot}hr$) rabbits. Total body clearance (CLt) in AIDRs were significantly decreased compared with that in control rabbits. Cumulative urinary excretion of gentamycin was decreased, although not significantly, in AIDRs compared with that in control rabbits.

• Journal of Korean society of Dental Hygiene
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• v.15 no.5
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• pp.925-932
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• 2015

Objectives: The aim of this study is to investigate the relationship between diabetes mellitus and oral disease in the Korea adults by using the representative data of Korea National Health and Nutrition Examination Survey (KNHANES) V. Methods: Using data from a cross-sectional survey of Korea National Health and Nutrition Examination Survey V. The subjects were 5,602 adults over 19 years old. The survey data and the examination data are used for the independent variables. KNHANES included health status, nutrition survey, and oral examination. The health status was obtained by a self-reported questionnaire of the study subjects and direct interview was carried out on economic status, prevalence rate, and use of medical services. Results: The regular dental checkup of diabetes patients was significantly lower than the general population. Regular dental visits allow adults to receive early diagnosis and obtain restorative care at the first visit. The regular annual oral examination is very important to prevent and manage the chronic diseases including diabetes mellitus. Conclusions: Diabetes mellitus can be fully prevented and managed by the regular annual dental checkup. The establishment of the regular dental checkup system can prevent and manage the complication due to diabetes mellitus and other chronic diseases.

• Korean Journal of Clinical Laboratory Science
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• v.46 no.1
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• pp.22-30
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• 2014

Research on the correlation between blood glucose and allergy of the trauma patient, and the changes of blood glucose after the injection of antibiotic Cephalosporins have been made in this study. In this research, we have investigated whether there is any correlation between allergies and blood glucose, and the changes of blood glucose after the injection of Cephalosporins. In case of the patients who have allergies, there has been a close correlationship between allergies and blood glucose by increasing the risk of developing sugar diabetes significantly to 3.273. And it showed that there is a correlation between Cephalosporins and glucose by the figure of Cephalosporins, before and one week after the operation, to become r=1**.*, bilateral significance probability (p<0.007). There has been significant changes in blood glucose (p<0.010), bun (p<0.025), Albumin (p<0.000), AST (p<0.001), total bilirubin (p<0.001) after the operation. It considered to be important indicator. preventing complications and allergies caused by diabetic history and also correlated (p<0.027) because there is allergy and the patient's.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.37
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• pp.39.1-39.6
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• 2015

Skull-base osteomyelitis is a rare disease affecting the medulla of the temporal, sphenoid, and occipital bones. In general, it occurs due to external ear canal infections caused by malignant external otitis. Skull-base osteomyelitis usually affects elderly diabetic patients. The patient, a 58-year-old man, was referred for evaluation and management of the left jaw. Clinical examination of the patient revealed pain in the left jaw and mouth-opening deflection to the left. The maximum active mouth opening was measured to about 27 mm. Panoramic, CT, and CBCT revealed bone resorption patterns in the left condyle. Through control of diabetes, continued pharmacological treatment, arthrocentesis, and occlusal stabilization appliance therapy were carried out. The extent of active mouth opening was increased to 45 mm, and pain in the left jaw joint was alleviated. This was a case wherein complications caused by failure to control diabetes induced skull-base osteomyelitis. There is a need for continued discussion about the advantages and disadvantages of arthrocentesis with lavage for patients with skull-base osteomyelitis and other treatment options.