• Journal of Korean Neurosurgical Society
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• 제37권1호
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• pp.44-47
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• 2005

Objective: The purpose of this study is to investigate the elevated blood glucose levels in the postoperative period are associated with an increased risk of deep wound infection in diabetic individuals undergoing lumbar spine surgery. Methods: Of 2896 patients who underwent lumbar spine operations by one surgeon between 1993 and 2002, 329(11.4%) were diabetics. The rate of deep wound infections in diabetic patients was 6.4%, versus 3.2% for nondiabetics. 152 patients had their operation before implementation of the protocol and 177 after implementation. Charts of the diabetic patients were reviewed. Mean blood glucose levels were calculated from documented results of finger-stick glucometer testing. Results: Twenty-one diabetic patients suffered deep wound infection. Infected diabetic patients had a higher mean blood glucose level through the first 2 postoperative days than noninfected patients($230{\pm}6.9$ versus $175{\pm}3.8mg/dL$; p<0.003) and had a long operation time($216{\pm}57.9$ versus $167.5{\pm}42.2$ minute; p<0.05). Multivariable logistic regression showed that mean blood glucose level for the first 2 postoperative days, long operation time, and use of the instrumentation(p<0.02) were all related predictiors of deep wound infection. Institution of a protocol of postoperative continuous intravenous insulin to maintain blood glucose level less than 200mg/dL was began in september 1997. This protocol resulted in a decrease in blood glucose levels for the first 2 postoperative days and a concomitant decrease in the proportion of patients with deep wound infection, from 8.3%(11/132) to 5.1%(10/195) (p<0.02). Conclusion: The incidence of deep wound infection in diabetic patients is reduced after implementation of a protocol to maintain mean blood glucose level less than 200mg/dL in the immediate postoperative period.

• 핵의학기술
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• 제14권2호
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• pp.100-103
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• 2010

$^{18}F$-FDG PET 검사는 포도당 대사를 이용하여 전신의 종양을 평가하는 검사로 전처치 과정에서 혈당 측정의 중요성이 매우 높다. 혈당 수치가 높은 상태에서 FDG를 투여하면 FDG와 혈중 포도당이 세포 내 흡수에 서로 경쟁하게 되고 종양으로의 FDG 섭취가 감소되어 정확한 검사가 되지 않을 가능성이 있다. 혈당 측정에 사용되는 혈당 측정 검사지는 경우에 따라 모세혈관혈 전용 측정 검사지와 모세혈관혈과 정맥혈을 모두 측정 가능한 범용 측정 검사지로 구분되어 있는데, 정확한 혈당 측정 검사지(스트립)의 사용에 따른 혈당 수치의 차이를 비교 분석 하였다. 연구 대상은 2010년 3월부터 4월까지 서울아산병원 핵의학과에서 $^{18}F$-FDG whole body PET 검사를 시행한 환자 중 46명(남자: 32명, 여자: 14명, 평균연령 $57.3{\pm}12.3$세) 을 연구의 대상으로 하였다. 실험기기는 Abbott사의 Optium Xceed혈당 측정기를 이용하였고, 모세혈관혈과 정맥혈을 모두 측정 가능한 범용 측정 검사지를 사용하여 동일 환자의 모세혈관혈과 정맥혈의 혈당 수치의 차이를 분석하였다. 또한, 모세혈관혈 전용 측정 검사지를 사용하여 동일 환자의 모세혈관혈과 정맥혈의 혈당 수치의 차이를 비교 분석하였다. 분석방법은 MINITAB 통계 프로그램을 이용하여 paired t-test 검정을 시행하였다. 모세혈관혈과 정맥혈을 모두 측정 가능한 범용 측정 검사지로 측정한 동일 환자의 모세혈관혈과 정맥혈의 혈당 수치는 각각$95.2{\pm}12.4$ mg/dL, $104.1{\pm}14.4$ mg/dL (t=8.0, p<0.001)로 통계적으로 유의한 차이가 있었다. 모세혈관혈 전용 측정 검사지로 측정한 동일 환자의 모세혈관혈과 정맥혈의 혈당 수치는 각각 $91.5{\pm}13.6$ mg/dL, $108.1{\pm}16.2$ mg/dL (t=9.2, p<0.001)로 통계적으로 유의한 차이가 있었다. 선행연구에 의하면 모세혈관혈과 정맥혈의 혈당 수치는 여러 가지 이유로 인해 차이가 있는 것으로 보고 되었고 본 연구의 결과도 유사한 차이를 확인하였다. $^{18}F$-FDG PET 검사 전에 혈당 수치를 측정할 때 모세혈관혈 전용 측정 검사지로 정맥혈의 혈당을 측정하는 것은 부정확한 혈당 수치를 측정할 수 있으므로 주의해야 할 것이다. 그러므로 적합한 측정 검사지와 규정된 측정절차를 이행하는 것이 측정 편차를 줄일 수 있어 PET 검사의 전처치를 보다 명확하게 확인할 수 있을 것이다. 또한, 혈당 측정 시에 혈액 채취 부위를 모세혈관 또는 정맥혈관 중에서 항상 동일한 부위에서 측정하는 등의 표준화 과정이 필요할 것이다.

• 대한임상검사과학회지
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• 제48권4호
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• pp.312-320
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• 2016

본 연구는 금식 여부에 따른 혈당치 분포 차이를 분석하였고 공복 혈당치와 혈당조절지표인 당화혈색소, 프록토사민, 1,5-AG의 상관성을 분석하여 전당뇨병 선별에 필요한 추가 정보를 제공하고자 하였다. 단국대학교병원에 내원한 707명의 외래 환자를 금식 군과 비금식 군으로 나누어 혈당 검사를 시행한 후 각 군의 혈당치 평균을 산출하고 성별, 연령별 및 임상과 별 결과치 분포를 분석을 하였다. 또한 건강검진을 목적으로 내원한 금식 상태의 153명에 대해 혈당치와 당화혈색소, 프록토사민, 1,5-AG을 측정하여 혈당치와 혈당조절지표의 상관성을 평가하였다. 비금식 군의 혈당 평균치는 111.9 mg/dL, 금식 군은 103.6 mg/dL로서 유의한 차이가 있었고 (p<0.05) 평균치 차이는 여자가 4.8 mg/dL로서 남자의 12.2 mg/dL보다 적었다. 연령대에 따른 중앙값의 차이는 비금식 군에서만 유의한 차이가 있었고(Kruskal-Wallis test, p<0.01) 금식 군에서는 유의하지 않았다. 공복 시 포도당 장애 선별 구간에서 혈당 농도와 상관성이 높은 검사 종목은 1,5-AG로 평가되었다. 저자들은 금식 여부에 따른 혈당치 분포의 차이를 외래 환자를 대상으로 분석하였으며, 건강검진 대상자의 결과치 분석을 통해 1,5-AG가 프록토사민, 당화혈색소보다 공복 혈당치와 유의한 상관성이 있는 것으로 평가하였다. 당뇨병 선별 시 혈당 측정과 함께 단기 혈당 조절능력을 반영하는 지표가 활용될 수 있을 것으로 사료된다.

• 대한임상검사과학회지
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• 제43권4호
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• pp.205-209
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• 2011

Gestational diabetes mellitus(GDM) is likely to develop type 2 diabetes mellitus, cardiovascular disease, metabolic syndrome after delivery. Infants of diabetic women have higher incidence of congenital malformations than those of non-diabetic women. This study was performed to determine elevation factors associated with increased blood glucose in 350 pregnant women. Subjects were examined in June, 2011 to September, 2011 in Geongnam province. Fasting blood glucose, total cholesterol, triglyceride levels were measured by Olympus AU 680, and their body mass index (BMI) calculated. The mean total cholesterol levels were 223.22 mg/dL, triglyceride 188.38 mg/dL, and fasting blood glucose 100.18 mg/dL. Serum glucose level was significantly higher in the age group of 40 years($109.51{\pm}16.26mg/dL$) than 20 years and 30 years. And increase in triglyceride(>250 mg/dL) was significantly related to high blood glucose level($110.83{\pm}24.78mg/dL$), and increase in BMI(>26) was significantly related to high blood glucose level($114.03{\pm}27.09mg/dL$). However, cholesterol levels were not significantly related to high blood glucose level. In conclusion, the significant elevation factors in relation to the glucose levels were age, triglyceride, and BMI.

• 대한간호학회지
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• 제41권5호
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• pp.724-731
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• 2011

Purpose: The purpose of this study was to investigate the effectiveness of an educational intervention that used both cellular phones and the Internet to provide a short messaging service (SMS) relating to blood glucose, blood pressure, and serum lipid levels in postmenopausal women with impaired fasting glucose (IFG). Methods: Twenty-eight postmenopausal women were assigned to an intervention group and twenty-one postmenopausal women to a control group. The intervention was provided for 12 weeks. Patients in the intervention group were asked to access a web site by using a cellular phone or to use the Internet directly and input their blood glucose and blood pressure levels weekly. Participants were sent the optimal recommendations weekly by both cellular phone and Internet. Results: The intervention group had a mean decrease in systolic blood pressure (SBP) level of 8.1 mmHg but changes for the control group were not significant. There was a significant mean change in diastolic blood pressure (DBP) level for the intervention group (-7.7 mmHg). The mean change in the control group was not significant. Conclusion: This educational intervention using the Internet and a SMS by cellular phone improved levels of SBP and DBP in postmenopausal women with IFG.

• Maxillofacial Plastic and Reconstructive Surgery
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• 제27권5호
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• pp.463-471
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• 2005

Recently, the number of diabetic patients have been increased with westernized living way and meal habitation. The regulation of blood sugar concentration is very important for diabetic patients to keep homeostasis and, to prevent acute or chronic complications. Epinephrine combined with lidocaine is used in dental clinic extensively. And epinephrine combined with lidocaine also effects on decreasing the blood leakage volume by constricting micro vessle and arteriole. But, So far there are few researches about the effect of epinephrine contained in dental local anesthetic agent on the blood sugar of diabetes during minor oral surgery. The purpose of this study was intended to investigate whether epinephrine which combined with dental local anesthetics influence body glucose level in diabetes patients by glucose monitoring. The subject of this study were 38 diabetic patients and 38 normal adults, each patient was checked body glucose after a meal 2 hours later with resting state, and injection 1:100000 epinephrine with dental lidocaine 54 ml or lidocaine 54 ml only. And then the body glucose level was checked 5 minutes and 30 minutes after injection. The results were analyzed by two way ANOVA test (p<0.05). The results were as follows: In the experimental group 1, the mean of the blood sugar level was 180.3 mg/dl before an anesthetic injection, 182.8 mg/dl after 5minutes of the anesthetic injection and 182.2 mg/dl after 30minutes of the anesthetic injection. The change of the blood sugar level was not statistically by two-way ANOVA tests (p<0.05). In the experimental group 2, the mean of the blood sugar level was 237 mg/dl before an anesthetic injection, 234.5 mg/dl after 5minutes of the anesthetic injection and 231.8 mg/dl after 30minutes of the anesthetic injection. The change of the blood sugar level was not statistically by two-way ANOVA tests (p<0.05). In the controlled group 1, the mean of the blood sugar level was 117.6 mg/dl before an anesthetic injection, 119.1 mg/dl after 5minutes of the anesthetic injection and 129.3 mg/dl after 30minutes of the anesthetic injection. The change of the blood sugar level was not statistically by two-way ANOVA tests (p<0.05). In the controlled group 2, the mean of the blood sugar level was 104.2 mg/dl before an anesthetic injection, 102 mg/dl after 5minutes of the anesthetic injection and 105.3 mg/dl after 30minutes of the anesthetic injection. The change of the blood sugar level was not statistically by two-way ANOVA tests (p<0.05).

• 한국보건간호학회지
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• 제15권1호
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• pp.172-181
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• 2001

This study was performed to explore the effects of walking exercise on blood glucose level in the diabetes mellitus patients. The design of this study was a equivalent pre-post test experiment. The subjects consisted of eighteen diabetes mellitus patients. The walking exercise consists of 22.5minutes, speed of 120walking per minute. Data were analyzed with mean, standard deviation, Wilcoxon signed rank test, Spearman correlation and percentage using SAS program. The results were as follows. 1. The blood glucose level has significantly decreased after walking exercise. 2. Strength of exercise and change of blood glucose level was revealed correlation. 3. Age and strength of exercise was revealed high correlation. 4. Satisfaction after walking exercise was revealed all patients. In conclusion, the walking exercise can decrease blood glucose level. This exercise was show a positive effect on the exercise compliance.

• Journal of Nutrition and Health
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• 제30권3호
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• pp.277-285
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• 1997

The purpose of this study was to investigate the relationship among nutrient intake, life style, and serum lipids level in 108 healthy middle-aged men in Taegu. A convenient method was to assess nutritional intake. Anthropometric measuement of body weight and hight were measured and average energy expenditure was calculated. The mean body mass index(BMI) was 22.8$\pm$2.4 and it was in the middle of the mean BMI of Korean men. Obesity rate of study subject were 13.2%. Daily energy intake was not sufficient as 88.4% of recommended dietary allowances and the energy percentage of carboydrate, fat protein was 65 : 21 : 14. Mean intake of vitamin A, B1, C and Ca were lower than RDA. There was a highly significant negative correlation between the systolic blood pressure and calcium intake(r=-0.28, p<0.05). Smokers showed significantly higher blood glucose than non-smokers. Skipping meals and uneven diurnal distribution(no breakfast and large evening meals) are associated with high triglyceride level in this population. There was a highly significant correlation between body weight and plasma lipids. Energy expenditure was negatively correlated with plasma triglyceride level. Especially, atherogenic index was significantly lower in job-time physically active worker than that in sedentary worker. Above data provides valuable imformation to the community for program planning as well as to health providers who work individual male adults to meet their nutrition needs and to control blood lipids.

• 성인간호학회지
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• 제17권3호
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• pp.444-451
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• 2005

Purpose: The purpose of this study was to evaluate whether the effect of the Internet diabetic education on plasma glucose in people with hyperglycemic diabetes. Method: A randomized design with control and experimental groups being assessed pre- and post-intervention was used. Twenty-two patients were randomly assigned to an intervention group and 21 to a control group. Participants were requested to input the blood glucose level weekly in http://www.biodang.com by cellular phone or wire Internet for 3 months. The researcher sends optimal recommendations to each patient using short message service(SMS) of cellular phone and wire Internet weekly. Results: Patients in the intervention group had a mean decrease of 1.3% in glycosylated haemoglobin ($HbA_1c$) levels and those in the control group had no significant difference. There was a significant mean change in 2-hour postprandial blood glucose(2HPPG) for the intervention group, with a mean change of-75.2mg/dl. The mean change in the control group was, however, not significant. Conclusion: These findings indicated that a web-based intervention using SMS of cellular phone improved $HbA_1c$ and 2HPPG.

• 대한임상독성학회지
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• 제13권2호
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• pp.55-61
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• 2015

Purpose: Many studies have examined the mechanisms of impaired glucose homeostasis after organophosphate (OP) exposure, however no study has evaluated the clinical utility of blood glucose measurements in patients with OP poisoning. The current study was conducted to evaluate the initial glucose level at presentation and the glycemic variables during the first 3 days after admission as a predictor of mortality. Methods: This retrospective observational case series included 228 patients with a history of OP poisoning. Among other clinical data, information on the initial glucose level at presentation and mean glucose level, delta glucose level, and the presence of a hypoglycemic event during the first 3 days of admission, was collected. Results: Survivors had lower initial glucose levels at presentation and glucose variability during the first 3 days of admission compared to non-survivors. The frequency of hypoglycemic events was higher in non-survivors. In multivariate analysis, the initial glucose level (> 233 mg/dl) was an independent predictor of mortality, along with age. Conclusion: The initial glucose level at presentation can be helpful in prediction of mortality in cases of OP intoxication at bedside. The physician should pay attention to patients with a glucose level >233 mg/dl at presentation after ingestion of OP.