The purpose of this study was to investigate effects of the developed nutrition education program focused on individual daily energy requirements and food exchange units using Food Exchange System for diabetes mellitus at a community health center. Developed the nutrition education program, four weeks' nutrition education including provided twice individual meal as diet therapy (2 hour/lesson/week, 4 week), was provided to 20 diabetic elderly (12 male, 8 female, 50-75 yrs): 1st lesson "Introduction: management of diabetes mellitus", 2nd lesson "6 Food groups and sources of 6 food groups", 3rd lesson "Individual daily energy requirements and food exchange units", and 4th lesson "Food choice for diabetes mellitus". For effects' analysis of the developed program, we assessed the changes in anthropometric characteristics; biochemical characteristics and nutrient intakes using 24 hr recall method. Effects of the developed nutrition education program were as follows: weight was significantly decreased, blood urea nitrogen (BUN) and glycosylated hemoglobin (HbA1c) were significantly decreased, and distribution of subjects in BUN and HbA1c was significantly changed. In protein : fat : carbohydrate (PFC) ratio, it was significantly changed from 15.98 : 16.30 : 66.69 to 17.51 : 18.94 : 64.10. In evaluation of nutrient intakes by Dietary Reference Intakes for Koreans (KDRI), protein, fiber, fat, vitamin E, niacin, folic acid, calcium and zinc were shown significantly positive changes in distribution of subjects according to intake level. The index of nutrition quality (INQ), nutrition adequacy ratio (NAR) and mean nutrition adequacy ratio (MAR) were significantly increased. In conclusion, the developed 4 weeks' nutrition education program focused on individual daily energy requirements and food exchange units using Food Exchange System for diabetes mellitus at community health center may improve the symptom of diabetes mellitus.
Objectives: The purpose of the study was to identify the oral care status and periodontal disease of middle aged daibetic patients in Korea. Methods: The primitive data were taken from 238 diabetic people in the 5th Korea National Health and Nutrition Examination Survey(KNHANES) in 2010 - 2012. The variables included general profiles(gender, age, occupied area, education, and smoking), oral care status(brushing time, brushing time, use of oral hygienic supplies, availability of oral hygienic supplies, oral examination, and recognition of oral health state), and diabetes management(morbidity period, treatment, education, and glycosylated hemoglobin levels). Results: Most of the subjects took gargling more than twice a day and it accounted for 73.5%. Oral hygienic supply users accounted for 24.8%, and most of them used floss brush. Oral examination was done in 19.3% of the respondents and 55.0% thought that their oral health status were very poor. The prevalence rate of the periodontal diseases was 46.6%. Female tended to have a higher rate of periodontal disease than the male. Oral hygienic supply users had lower rate of periodntal disease than those who did not use. Those who had poor subjective oral health status had higher prevalence rate of periodontal disease than those who did not. Conclusions: Periodontal disease is closely related to good oral care of middle aged diabetic patients. It is necessary to develop the program for the prevention of the periodontal disease for the diabetic patients.
This study examined the effects of plums produced in Gimcheon area on the glucose and lipid metabolism in streptozotocin-induced diabetic rats. Male Sprague-Dawley diabetic rats were divided into four groups: control, diabetic control, Diabetes-low plum (containing 10% plum powder), and Diabetes-high plum (containing 20% plum powder). The animals were fed isocaloric experimental diets based on an AIN-76 diet for 6 weeks. Feed efficiency ratio (FER) of the diabetic groups were significantly lower than that of the control. On the other hand, among the diabetic groups, the FER of the high plum intake group was higher than that of the diabetic control. The liver weight per 100 g body weight of each group was similar but the liver weights tended to decrease as the amount of plum intake was increased. Kidney weight per 100 g body weight of the plum intake groups were significantly different compared to that of the diabetic control. The supplementation of plums lowered the fasting blood glucose level of the diabetic groups and improved the glucose tolerance, thereby lowering the glycosylated hemoglobin index. In addition, the supplementation of plum was lowered the blood total cholesterol concentration and increased the HDL-C/TC (%) significantly, thereby lowering the atherosclerotic index (AI) and hepatic peroxide level. A steady diet of plums produced in Gimcheon may be effective in controlling the blood glucose level and preventing chronic diabetes mellitus.
Background: Early detection of neuropathy may prevent further progression of this complication in the diabetic patients. The purpose of this study was to evaluate the prevalence of early neuropathic complication in patients with newly diagnosed type 1 and type 2 diabetes. Methods: Nerve conduction studies (median, ulnar, posterior tibial, peroneal, and sural nerves) were performed for 49 type 1 (27 males, mean $14.1{\pm}7.5$ years) and 40 type 2 (27 males, $42.0{\pm}14.1$ years) diabetic patients at onset of diabetes. Children with age at onset under 4 years and adults over 55 years were excluded to eliminate the aging effect and the influence of obstructive arteriosclerosis. Neuropathy was defined as abnormal nerve conduction findings in two or more nerves including the sural nerve. Results: Mean HbA1c level was $12.6{\pm}3.3%$ for type 1 and $10.5{\pm}2.9%$ for type 2 diabetes. The prevalence of neuropathy was 12.2% for type 1, and 35.0% for type 2 diabetes, respectively. There were significant trends in the prevalence of neuropathy with increasing age (p<0.05). The effect of the mean level of glycosylated hemoglobin on the prevalence of polyneuropathy at onset of diabetes was borderline (p=0.0532). Neither sex of the patients nor the type of diabetes affected the neurophysiologic abnormalities at the diagnosis. Conclusions: Even in a population with diabetes at the diagnosis, the prevalence of subclinical neuropathy was not low. Neuropathy has been significantly associated with increasing age indicating the possibility of longer duration of undetected diabetes among them, especially in type 2 diabetes.
Journal of the Korean Society of Food Science and Nutrition
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v.41
no.8
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pp.1086-1093
/
2012
The hypoglycemic and hypolipidemic effects of autoclaved soy flour and DJI chungkukjang powder fermented using Bacillus subtilis DJI were investigated in type 2 diabetic animal models. After a 2-week adaptation period, the diabetic animal model db/db mice were divided into the diabetic control group (D-C group), a diabetic group fed with soybean (D-S group), and a diabetic group fed with DJI chungkukjang (D-CJ group). The body weight gain, food intake, water intake, liver, and adipose tissue weights were not significantly different between the experimental groups. The supplementation of DJI chungkukjang or autoclaved soy flour diet induced a marked reduction of fasting blood glucose, blood glycosylated hemoglobin levels, and glucose levels in the oral glucose tolerance test and AUC for glucose compared with the diabetic control group. However, DJI chungkukjang showed a much stronger antidiabetic effect than unfermented autoclaved soy flour. Serum insulin levels were the same among the groups. The supplementation of DJI chungkukjang or autoclaved soy flour diet also significantly lowered the serum triglyceride, total cholesterol, and LDL-cholesterol levels compared with the control diabetic group, while it elevated the HDL-cholesterol level in the serum. This data suggests that the dietary supplementation of autoclaved soy flour or DJI chungkukjang may be useful in the control of blood glucose in animals with type 2 diabetes.
Grape products have been known to exert greater antioxidant and anti-obesity than anti-hyperglycemic effects in animals and humans. Omija is used as an ingredient in traditional medicine, and it is known to have an anti-hyperglycemic effect. We investigated whether the combined extracts of grape pomace and omija fruit (GE+OE) could reduce fat accumulation in adipose and hepatic tissues and provide beneficial effects against hyperglycemia and insulin resistance in type 2 diabetic mice. C57BL/KsJ-db/db mice were fed either a normal control diet or GE+OE (0.5% grape pomace extract and 0.05% omija fruit extract, w/w) for 7 weeks. GE+OE decreased plasma leptin and resistin levels while increasing adiponectin levels and reducing the total white adipose tissue weight. Furthermore, GE+OE lowered plasma free fatty acid (FFA), triglyceride, and total-cholesterol levels as well as hepatic FFA and cholesterol levels. Hepatic fatty acid synthase and glucose 6-phosphate dehydrogenase activities were decreased in the GE+OE group, whereas hepatic ${\beta}$-oxidation activity was increased. Furthermore, GE+OE supplementation not only reduced hyperglycemia and pancreatic ${\beta}$-cell failure but also lowered blood glycosylated hemoglobin and plasma insulin levels. The homeostasis model assessment of insulin resistance levels was also decreased and the decrease seems to be mediated by the lowered activities of hepatic glucose-6-phosphatase and phosphoenolpyruvate carboxykinases. The present data suggest that GE+OE may have the potential to reduce hyperglycemia, insulin resistance, and obesity in patients with type 2 diabetes.
This study investigated the effect of community-based health intervention program to improve metabolic disease in Jeju island. There were 50 obese local residents in the experimental group (body mass index, $BMI{\geq}25kg/m^2$). They participated in cooking therapy with nutrition education (4 times), exercise program with proprioceptive neuromuscular facilitation (PNF) and stretching training (9 times), and alternative medicine program with healing touch massage (3 times) during a 3-week period. To evaluate the effectiveness of the program, body composition, blood lipid profiles, blood glucose, and waist circumference were assessed before and after the intervention program. After the program, the value of total cholesterol (TC), glycosylated hemoglobin (HbA1C), diastolic blood pressure, percent body fat, and waist circumference were decreased, and became the normal value. Especially, HbA1C, percent body fat, and waist circumference were significantly decreased (P<0.001) in the experimental group, while HbA1C, percent body fat, and waist circumference were significantly increased (P<0.001) in the control group (N=50), who had no intervention. Our results suggest that metabolic syndrome associated markers need intervention program for improving them. In conclusion, although this study did not analyze the effect of the health intervention program and cooking therapy separately, considering the result of this 3-week, short term program, the effect will be more profuse if cooking therapy and exercise program were performed concurrently.
Kim, Hye-Yeon;Yun, Woo-Jun;Shin, Min-Ho;Kweon, Sun-Seong;Ahn, Hye-Ran;Choi, Seong-Woo;Lee, Young-Hoon;Cho, Dong-Hyeok;Rhee, Jung-Ae
Journal of Preventive Medicine and Public Health
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v.42
no.5
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pp.315-322
/
2009
Objectives : Knowledge about the management status of diabetic melitus (DM) is essential to improve diabetic management. Moreover, low income is associated with poor adherence to treatment and increased mortality. This study was performed to evaluate the management status of DM in low-income patients in a rural area. Methods : We enrolled 370 patients with type 2 DM living in Gokseong county, JeollaNamdo. A well-trained examiner measured the height, weight, waist circumference, blood pressure, total cholesterol, triglyceride, high density lipoprotein cholesterol, fasting blood sugar and glycosylated hemoglobin (HbA1c) levels. Carotid ultrasonography was used to measure carotid artery carotid artery intima media thickness (IMT) and plaque. anklebrachial index (ABI) was used to evaluate peripheral artery disease. A fundoscopic examination was performed to evaluate diabetic retinopathy. A history of diabetes complications and health-related questionnaires were also completed. Results : The age of diabetic subjects was 68.7$\pm$8.7 years and the duration of diabetes was 8.9$\pm$8.2 years. Most (63.5%) had hypertension, and 45.7% had triglycerides below 150 mg/dl, 38.1% had low density lipoprotein cholesterol (LDL) cholesterol below 100 mg/dl, 48.7% had urine albumin to creatinine ratio (UACR) below 30 mg/g. Less than half (45.9%) achieved the goal of HbA1c less than 7% suggested by the American Diabetes Association (ADA). 10.6% had peripheral vascular disease, 11.9% had retinopathy, and 60.8% had chronic kidney disease. Conclusions : DM management in low income patients is very poor and requires further work to improve.
This study was conducted to evaluate the association between periodontal disease and diabetes mellitus. The final analysis population of this study was composed of 4,830 adults with diabetes mellitus or periodontal disease and aged 19 years or older, based on the third-edition data of the 4th Korea National Health and Nutrition Examination Survey (KNHANES) (in 2009). Diabetic status and potential confounders were used in questionnaire materials and physical examination materials, and the presence of periodontal disease was used in the materials for oral health examination by a dentist. For diabetic status, fasting plasma glucose (FPG) levels <100 mg/dl were subcategorized into normal group and FPG levels ${\geq}100mg/dl$ into impaired fasting glucose group; glycosylated hemoglobin (HbA1c) levels <7% into normal group and HbA1c ${\geq}7%$ into diabetes group, on the basis of the American Diabetes Association. According to the 2009 Korea Health Statistics, the case where the pocket depth is 3 mm or more was defined as periodontal disease. The association between the two diseases was evaluated through $x^2$-test and logistic regression analysis using R-commander 2.14. In impaired fasting glucose group, community periodontal index (CPI) groups 3 to 4 had higher risks for periodontal disease 1.23 times (95% confidence interval, 1.07~1.42) than those of CPI groups CPI 0~2, even after adjustment for several confounders. In addition, periodontal disease and diabetes mellitus showed statistically significant differences depending on age, sex, income level, educational background, smoking status, alcohol consumption, and snack intake. The analyses of the third-edition data of the 4th KNHANES showed that there was a statistically significant association between periodontal disease and diabetes mellitus as examined by means of CPI in this study.
This study is the quasi-experimental research of nonequivalent groups and is designed to investigate the effects of an aquatic exercise program with diabetes self management education on the self care efficacy, self care behaviors in diabetic patients in community. The subjects of this study were 26 patients in the experimental group who participated in the aquatic exercise program and 25 patients in the control group who did not paricipated in. And they were registered at the W Health Clinic in D city. The aquatic exercise program was conducted twice a week for 80 minutes, and consisted of a 30 minutes diabetes self management education and a 50 minutes aquatic exercise. After this program, there were significant differences in FBS(p=.047), HbA1c(p<.001), diabetes self efficacy(p<.001), and self care behaviors(p<.001). In order to reduce the prevalence of diabetes and prevent complications in the community, it is believed that the constant operation of aquatic exercise programs including self management education is necessary.
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