• Journal of Korean Academy of Fundamentals of Nursing
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• v.19 no.2
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• pp.168-178
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• 2012

Purpose: The purpose of this study was to compare self-care behavior, diabetes-related stress and stress coping style among 3 blood glucose control groups (good, inadequate, and poor blood glucose control groups). Methods: Participants were 102 type 2 diabetic patients (good group: 41, inadequate group: 31, poor group: 30). Data were collected from Feb 19 to Mar 24, 2010 and were analyzed using Chi-square, Fisher's exact test and ANCOVA with SPSS/WIN 12.0. Results: Using ANCOVA with frequency of admission, and illness duration as covariates, significant differences were found among the 3 groups in self-care behavior (total score) and the exercise subscale. Using ANCOVA significant differences were found among 3 groups in diabetes-related stress (total score), emotional burden subscale and regimen distress subscale. Using ANCOVA no difference in stress coping was found among the 3 groups, but there was a significant difference in the problem-oriented coping subscale. Conclusions: Self-care behavior, diabetes-related stress, and stress coping style are factors influencing blood glucose control. The results of this study suggest that for improving blood glucose control, self care education program focused on diet and exercise in addition to stress management program for promoting problem oriented coping capability are recommended.

• BMB Reports
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• v.53 no.2
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• pp.100-105
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• 2020

While liver histopathology is heterogeneous in diabetes, the underlying mechanisms remain unclear. We investigated whether glycemic variation resulting from differential diets can induce heterogeneity in diabetic liver and the underlying molecular mechanisms. We generated end-stage non-obese diabetic model rats by subtotal-pancreatectomy in male Sprague-Dawley rats and ad libitum diet for 7 weeks (n = 33). The rats were then divided into three groups, and fed a standard- or a low-protein diet (18 or 6 kcal%, respectively), for another 7 weeks: to maintain hyperglycemia, 11 rats were fed ad libitum (18AL group); to achieve euglycemia, 11 were calorie-restricted (18R group), and 11 were both calorie- and protein-restricted with the low-protein diet (6R group). Overnight-fasted liver samples were collected after the differential diets together with sham-control (18S group), and histology and molecular changes were compared. Hyperglycemic-18AL showed glycogenic hepatopathy (GH) without steatosis, with the highest GSK-3β inactivation because of Akt activation during hyperglycemia; mitochondrial function was not impaired, compared to the 18S group. Euglycemic-18R showed neither GH nor steatosis, with intermediate GSK-3β activation and mitochondrial dysfunction. However, euglycemic-6R showed both GH and steatosis despite the highest GSK-3β activity and no molecular evidence of increased lipogenesis or decreased ApoB expression, where mitochondrial dysfunction was highest among the groups. In conclusion, heterogeneous liver histopathology developed in end-stage non-obese diabetic rats as the glycemic levels varied with differential diets, in which protein content in the diets as well as glycemic levels differentially influenced GSK-3β activity and mitochondrial function in insulin-deficient state.

• Journal of the Korean Dietetic Association
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• v.5 no.1
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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.

• Korean Journal of Food Science and Technology
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• v.41 no.6
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• pp.668-672
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• 2009

Cookies containing wheat flour mixed with 10, 30 or 50% esterified with octenylsuccinic anhydride (OSA, 3%) and dry-heated ($130^{\circ}C$, 2 hr) high amylose rice (Goami 2) starch (DH-OSAR) were prepared and then their physical and digestive properties were evaluated. When the amount of added DH-OSAR increased, the hardness and brittleness of the cookies decreased, and L (brightness) value increased. For the digestive properties, the cookies containing 50% DH-OSAR significantly increased the amount of slowly digestible starch (SDS), and decreased the amount of rapidly digestible starch (RDS), resulting in the lowest expected Glycemic Index (eGI) among tested cookies. Although the cookies containing DHOSAR were inferior to the control, the addition of xanthan gum (0.5% based on total powder amount) significantly improved their textural and sensory properties. Specially, the cookies containing 50% DH-OSAR and the addition of 0.5% xanthan gum showed the lowest eGI value, maintaining the improved textural and sensory properties.

• BMB Reports
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• v.44 no.11
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• pp.713-718
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• 2011

In this study, the effects of sitagliptin analogue (SITA) or pioglitazone (PIO) treatment on glucose homeostasis and ${\beta}$-cell dynamics in animal models of type 2 diabetes-Akita and db/db mice were evaluated. After 4-6 weeks of treatment, both SITA and PIO were shown to lower non-fasting glucose levels and reduced glycemic excursion in the intraperitoneal glucose tolerance test. In addition, both drugs preserved normal islet structure and the proportion of ${\beta}$-cells in the islets. Compared to the controls, SITA treatment induced a higher ${\beta}$-cell proliferation rate in Akita mice and a lower rate of apoptosis in db/db mice, whereas PIO treatment induced a lower rate of apoptosis in db/db mice and reduced proliferation rates in Akita mice. In conclusion, both SITA and PIO appear to exert some beneficial effects on the islet structure in addition to glycemic control via different mechanisms that involve ${\beta}$-cell dynamics in Akita and db/db mice.

• Journal of the East Asian Society of Dietary Life
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• v.26 no.5
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• pp.450-456
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• 2016

Allulose, a monosaccharide isomer of fructose, was evaluated as a sucrose replacer for healthy cookie production with benefits such as low glycemic impact and low calorie content. Sucrose (as a reference), fructose, glucose, and allulose were used to explore the effects of sugar-replacer type on solvent retention capacity (SRC), differential scanning calorimetry (DSC), rapid visco-analyzer (RVA), and wire-cut cookie baking. SRC results indicated the lowest swelling of solvent-accessible arabinoxylans in allulose compared to that in other sugar solutions. DSC and RVA results showed retardation of starch gelatinization and onset of starch pasting, respectively, in the following order: water < allulose < fructose < glucose < sucrose. Among sugars, wire-cut cookies formulated with glucose showed the least desirable attributes with respect to cookie diameter and thickness. Although the baking response of allulose was slightly inferior to that of the sucrose control, the sugar exhibited a superior baking response to that of fructose, suggesting it could be used successfully as a fructose alternative or sucrose alternative for producing wire-cut cookies with reduced calorie content and low glycemic impact.

• Journal of Ginseng Research
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• v.45 no.5
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• pp.546-554
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• 2021

Background: Diabetes mellitus and hypertension often occur together, amplifying cardiovascular disease (CVD) risk and emphasizing the need for a multitargeted treatment approach. American ginseng (AG) and Korean Red Ginseng (KRG) species could improve glycemic control via complementary mechanisms. Additionally, a KRG-inherent component, ginsenoside Rg3, may moderate blood pressure (BP). Our objective was to investigate the therapeutic potential of coadministration of Rg3-enriched Korean Red Ginseng (Rg3-KRG) and AG, added to standard of care therapy, in the management of hypertension and cardiometabolic risk factors in type-2 diabetes. Methods: Within a randomized controlled, parallel design of 80 participants with type-2 diabetes (HbA1c: 6.5-8%) and hypertension (systolic BP: 140-160 mmHg or treated), supplementation with either 2.25 g/day of combined Rg3-KRG + AG or wheat-bran control was assessed over a 12-wk intervention period. The primary endpoint was ambulatory 24-h systolic BP. Additional endpoints included further hemodynamic assessment, glycemic control, plasma lipids and safety monitoring. Results: Combined ginseng intervention generated a mean ± SE decrease in primary endpoint of 24-h systolic BP (-3.98 ± 2.0 mmHg, p = 0.04). Additionally, there was a greater reduction in HbA1c (-0.35 ± 0.1% [-3.8 ± 1.1 mmol/mol], p = 0.02), and change in blood lipids: total cholesterol (-0.50 ± 0.2 mmol/l, p = 0.01), non-HDL-C (-0.54 ± 0.2 mmol/l, p = 0.01), triglycerides (-0.40 ± 0.2 mmol/l, p = 0.02) and LDL-C (-0.35 ± 0.2 mmol/l, p = 0.06) at 12 wks, relative to control. No adverse safety outcomes were observed. Conclusion: Coadministration of Rg3-KRG + AG is an effective addon for improving BP along with attaining favorable cardiometabolic outcomes in individuals with type 2 diabetes. Ginseng derivatives may offer clinical utility when included in the polypharmacy and lifestyle treatment of diabetes. Clinical trial registration: Clinicaltrials.gov identifier, NCT01578837;

• Journal of Korean Academy of Nursing
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• v.45 no.4
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• pp.533-543
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• 2015

Purpose: This study was conducted to develop and test the effects of a motivational interviewing self-management program for use with elderly patients with diabetes mellitus. Methods: A non-equivalent control group pretest-posttest design was used. The participants were 42 elderly diabetic patients (experimental group: 21, control group: 21). The motivational interviewing self-management program for elders with diabetes mellitus developed in this study consisted of a 12-week program in total (8 weeks for group motivational interviewing and education and 4 weeks for individual motivational interviewing on the phone). Data were collected between February 13 and May 3, 2013 and were analyzed using t-test, paired t-test, and repeated measure ANOVA with SPSS/WIN 18.0. Results: For the experimental group, significant improvement was found for self-efficacy, self-care behavior, glycemic control and quality of life (daily life satisfaction, influence of disease) as compared to the control group. Conclusion: The study findings indicate that the motivational interviewing self-management program is effective and can be recommended as a nursing intervention for elderly patients with diabetes mellitus.

• Journal of Korean Biological Nursing Science
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• v.8 no.2
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• pp.29-39
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• 2006

The aim of this study was to examine the effect of telephone follow-up on glycemic control, lipid profiles. and treatment method in diabetic patients with depressive symptoms over one year follow-up period. Twenty-two diabetic patients attended the structured diabetes education program between March 2004 and February 2005 and completed a questionnaire using the Beck Depression Inventory(BDI) to measure depressive symptoms. The patients showed depressive symptoms with the criterion being a BDI score at least 16. The intervention was applied to the telephone follow-up for one year. Data were analyzed using Wilcoxon signed rank test and McNemar test. The patients decreased their mean glycosylated hemoglobin(HbAlc) levels by 1.9%(p=0.001). There was a significant mean change in the fasting blood sugar(FBS) level, with a mean change of -61mg/$d{\ell}$(p=0.008). These findings indicated that the telephone follow-up may be effective in the HbAlc and FBS control.

• Korean Journal of Psychosomatic Medicine
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• v.6 no.2
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• pp.221-227
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• 1998

Although there has been a considerable research in psychoneuroendocrinology, particularly in relation to the biology of mood disorders, there has been a paucity of research regarding the effects of psychological factors on endocrine diseases. Of the existing literature, the most research is focused on diabetes mellitus, graves' disease. Especially diabetes appears to be the only endocrine disease that has been the focus of recent research studies. Most of the studies had retrospective designs or several methodological flaw. There has been no consistent results demonstrating that psychological factors affect the onset of diabetes mellitus. Several studies have suggested that psychological factors affect the course of diabetes. A small number of studies showed some evidence that psychological stress was associated with changes in glucose regulation in a subset of diabetic patients. There was also evidence to suggest that some temperament and coping skill influence glycemic control in child, adolescent diabetics. Studies of behavioral or psychosocial intervention on diabetic control have been small and have produced mixed results. There was a few controlled study suggested that stressful life events might be a causal role in Cushing's disease and Graves'disease, but there is no presently sufficient evidence to suggest that psychological factors affect the onset and the course of Cushing's disease and Graves' disease. In future, there is need for a well-designed biopsychosocial research with prospective designs, well defined patient population and control groups to study the relationship between psychological factors and endocrine diseases.