This study was carried out to investigate the relationship between diabetic control and related factors of the practice of diet therapy which affects mostly diabetic patients’ dietary compliance. A questionnaire survey was conducted on 128 diabetic patients who had visited Internal medicine endocrinology clinic at University Medical Center of Daegu area. The questionnaires including clinical characteristics, meal regularity and food intake which shows dietary compliance, intrinsic barriers to the practice of diet therapy and knowledge of diet therapy were asked and analyzed. The factor which affects HbA1c was intrinsic barriers and HbA1c became higher as the level of intrinsic barriers was increasing. The education on diet therapy had no influence on the intrinsic barriers, but the level of knowledge on diet therapy was shown higher in the educated patients. The above results suggest that the practice of diet therapy should be leaded to develop behavioral aspects through resonable motivation on dietary compliance along with removing intrinsic barriers rather than simply providing information.
Objectives: The purpose of this study was to investigate the relations between diabetic dietary compliance and dietary intake, physical activity and prevalence of metabolic syndrome (MS) in type 2 diabetic patients. Methods: Seventy five subjects diagnosed with type 2 diabetes visiting the D hospital in Dongducheon from May 2014 to Dec 2014 were included in this study. The subjects were divided into two groups according to their diabetic dietary compliance score (median 39); low diabetic dietary compliance (LDDC) group (n=44) and high diabetic dietary compliance (HDDC) group (n=31). Survey data collection was carried out by direct interview method. The nutrient intake, food intake and KDDS (Korean's dietary diversity score), DVS (dietary variety score) and GMVDF (grain, meat, vegetable, dairy and fruit) were analyzed using data from the 24-recall method. Metabolic parameters were obtained from the hospital records. Data was analyzed using Chi-square test and general linear model adjusted for sex. Results: The prevalence of MS was 59.7% in the participating diabetic patients. The prevalence of MS of the HDDC (39.3%) was significantly lower than that of the LDDC (72.7%). The distribution of physical activity showed a significant difference between the groups (p=0.006). The intakes of seeds and nuts of the HDDC were significantly lower than those of the LDDC. Fat and vegetable fat intakes and % fat of energy in the HDDC were significantly lower than those in the LDDC. But, carbohydrate (CHO) and potassium intake and %CHO of energy in the HDDC were significantly higher than those in the LDDC. KDDS and GMVDF showed significant differences between groups (p=0.033; p=0.012). Conclusions: Continuous intervention by specialized nutritionists for long-term self-regulation is needed for diabetic patients, and the high compliance to diabetic diet and increasing physical activity may be effective in the prevention of metabolic syndrome.
Kim, Sung-Woo;Lee, Ju-Hyung;Kang, Eun-Seok;Kim, Soo-Chan;Kim, Deok-Won
Proceedings of the KIEE Conference
/
2007.04a
/
pp.67-69
/
2007
Recently, the prevalence rate of diabetes in Korea has been increasing rapidly due to high growth of economy and changes in dietary lifestyle. Vascular complication is one of diabetic complications which have frequently occurred by obesity, hyperglycemia and impaired glucose metabolism. Photoplethysmogram(PPG) measured from finger and toe is very useful for evaluation of vascular aging and sclerosis level since the PPG signal represents characteristics of peripheral vascular. Several researchers have reported that second derivative of the finger PPG waveform was useful to evaluate vascular compliance and developed various analysis methods for vascular compliance. However, peripheral vascular compliance study for diabetic patient was never evaluated by using second derivative of PPG. Therefore, we aimed to objectively compare and to assess normal and diabetic group vascular compliance using the second derivative of PPG waveform in this study. The evaluated factors of second derivative of PPG are 'a', 'b', 'c', 'd', 'e' and b/a represents vascular compliance. Study found out that when vascular compliance is decreased, b/a is increased, the absolute value of b/a is decreased. The average vascular compliance of 50 diabetic patients with neuropathy is statistically lower than the normal group(p<0.05). We suggest an objective evaluation of peripheral vascular compliance for diabetic patients and prevention of vascular complication.
The purpose of this study was to investigate the compliance and need for diet therapy among diabetics and their caregivers. A total of 625 respondents participated in this survey. Appropriate management for long-term blood glucose control and difficult-to-manage cases appeared to be diet therapy, physical activity, medical treatment and folk remedies, in that order. The most important educational avenues for diet therapy were books, magazines and TV, Most respondents were educated in diet therapy within a year after diagnosis and had practiced diet therapy for over four years. The most common diet therapy Practices were food selection and Quantity control. Of the specific problems in practicing diet therapy, time and labor, taste, and meal planning appeared to be equally difficult factors. The prevailing diet therapy skills were controlling food amounts at breakfast and supper, and selecting food for lunch and refreshments. Respondents practicing both skills were about 20% of the participants; this shows the need to improve the current situation. The nutrients most frequently considered in diet therapy practice were simple sugars (sugar and sweet goods) , total fats and cholesterol. Since the perception of the role of dietary fiber among respondents was very low, nutrition education about the importance of dietary fiber and food sources of dietary fiber was needed. Diabetics seemed to be concerned about diabetic menus. Three difficult problems in planning diabetic menus were daily menu planning, patient's preferences, and the calculation of calories. As a means of nutrition counseling, they preferred interviews. The higher the educational status and the lower the age, the higher the preference was for internet or PC counseling. Therefore, it is necessary to develop nutrition educational programs so that diabetics can obtain practical knowledge of diet therapy. Furthermore, it is also necessary to develop additional means of informing diabetics about menu planning, while still considering Korean dietary behavior.
Kim, Sung-Woo;Lee, Ju-Hyung;Nam, Ki-Chang;Kim, Su-Chan;Cha, Eun-Jong;Kim, Deok-Won
Journal of the Institute of Electronics Engineers of Korea SC
/
v.44
no.4
s.316
/
pp.15-20
/
2007
Recently the prevalence rate of diabetes in Korea has been increasing rapidly due to high growth of economy and changes in dietary lifestyle. Vascular complication is one of diabetic complications which have frequently occurred by obesity, hyperglycemia and impaired glucose metabolism. Photoplethysmogram(PPG) measured from finger and toe is very useful for evaluation of vascular aging and sclerosis level since the PPG signal represents characteristics of peripheral vascular Several researchers have reported that second derivative of the finger PPG waveform was useful to evaluate vascular compliance and developed various analysis methods for vascular compliance. However, peripheral vascular compliance study for diabetic patient was never evaluated by using second derivative of PPG. Therefore, we aimed to objectively compare and to assess normal(n=850) and diabetic(n=50) groups vascular compliance using the second derivative of PPG waveform in this study. The evaluated factors of the second derivative of PPG are 'a', 'b', 'c', 'd', 'e' and b/a rapresents vascular compliance. This study found out that when vascular compliance is decreased, the absolute value of b/a is decreased. The average vascular compliance of 50 diabetic patients with neuropathy, $-1.09{\pm}0.14$ is statistically lower than the normal group, $-0.81{\pm}0.09$ (p<0.05). In conclusion, we suggest an objective evaluation of peripheral vascular compliance for diabetic patients and prevention of vascular complication.
Park, Seong Hoon;Kim, Joo Hyun;Suh, In Suck;Kim, Kwang Yong;Jeong, Hii Sun
Archives of Reconstructive Microsurgery
/
v.26
no.1
/
pp.18-22
/
2017
Inevitable immobilization after surgery on lower extremities can induce chronic constipation. Elderly diabetic women usually express ambiguous gastrointestinal symptoms and signs. We present here a case of panperitonitis developed from severe fecal impaction in an elderly diabetic woman after hand reconstruction using material harvested from the lower extremities. A 68-year-old diabetic female underwent anterolateral thigh free flap and wound revision twice on the left thumb. Three weeks after surgery, she complained about mild abdominal pain though she had daily defecation. Despite encouraging ambulation, her compliance was low. Resection of the sigmoid colon and colostomy were performed after diagnosis with bowel perforation. However, the patient went into septic shock and died with multiorgan failure after the guardians issued a DNR (do not resuscitate) order. For preventing bowel perforation, increased uptake of dietary fiber and early ambulation postoperatively should be encouraged, after even hand surgeries.
This study was conducted to evaluate the nutritional status and diabetes management of diabetic patients in the Health Center. General characteristics, food habits, food intakes and the knowledge about diet therapy were investigated from ninety one diabetes subjects. Anthropometric assessment such as weight, hight, triceps skinfold thickness, and biochemical measurement of fasting blood glucose(FBG), post prandial 2 hours blood glucose(PP2), and hemoglobin A1c(HbA1c) were obtained form the subjects. The results were summarized as following : 1. The average of age was 60.9 years old and 83.5% of subjects was illiterate and primary school graduated. 2. Relative Body Weight(RBW) and % body muscle were 96.18${\pm}$13.6 and 33.56${\pm}$7.01%, respectively. Obese subjects whose body weight exceeded 120% of the ideal values were 3.3%. 3. The 86.8% of subjects were managed by oral hyperglycemic agents. 4. The mean of FBG, PP2, HbA1c were 140.75${\pm}$44.43mg/㎗, 7.60${\pm}$1.88%, respectively. 5. The mean daily intake of calorie was 1407㎉, and 73.6% of subjects lower caloric intake than prescribed calorie. when the degree of dietary compliance was expressed as Tunbridge score, 18.7% of total subjects was grouped as satisfactory, where as 20.9% and 60.4% could be considered as tolerable and hopeless, respectively. The nutrients intake were lower than RDA except for Vitamin A and Vitamin C and the ratio of carbohydrate : protein : fat was 72 : 14 : 14. 6. The mean score of knowledge test about diet therapy was 3.52${\pm}$2.19 out of possible 14.00 points. The above results suggested that the most of diabetic patient showed the poor nutritional status and they faced the lack of knowledge about diabetes management.
Journal of the Korea Academia-Industrial cooperation Society
/
v.10
no.5
/
pp.1141-1147
/
2009
This study has been conducted from July 30, 2007 to February 24, 2008 on 677 patients who were receiving diabetic treatment at the Health Centers of Deajeon City to find out their blood sugar level adjustment and their treatment compliance. As a result, 58.5% of them showed less than 200mg/dl of blood sugar level, and 67.9% showed their HbA1C of less than 7%, meaning that many of diabetic patients did not have their blood sugar level properly adjusted. And their after-meal blood sugar level and HbA1C adjustment varied depending upon the Health Centers. 88.0% of them were taking medicines for diabetic treatment regularly, and many of them were recognizing the need of dietary and exercise therapies to treat their diabetes. In conclusion, patients were recognizing that regular intakes of medicines, dietary and exercise therapies were very helpful to treatment of diabetes, but their treatments of HbA1C and blood level adjustment were not properly done as shown by their after-meal blood sugar level. The results were greatly different between the Health Centers, so there is a great need to cope with this situation.
Objectives: This study examined the effects of nutrition counseling by the nutrition care process (NCP) on diet therapy practice and glycemic control in patients with type 2 diabetes mellitus. Methods: The survey was conducted on 49 patients whose hemoglobin A1c (HbA1c) level ranged from 6.5% to below 10% among patients aged 30~60s with type 2 diabetes mellitus. Nutrition counseling by the NCP process was carried out twice: first nutrition counseling and follow up counseling. The questionnaires were composed of 54 questions in five fields (general characteristics, health-related behaviors, diet therapy-related items, dietary life, diet therapy-related knowledge, diet therapy-related barriers). Nutrition intervention in nutrition counseling was performed based on the individualized diagnosis of NCP. Results: All the subjects practiced self-monitoring of their blood glucose levels, regular exercise, and diet therapy after NCP-based nutrition counseling. Diet therapy-related knowledge and practice by the subjects were improved after nutrition counseling. While the intake of boiled white rice decreased, the intake of boiled brown rice and barley rice in the subjects increased significantly. After nutrition counseling, the weight and HbA1c of the subjects decreased. Conclusions: These results suggest that personalized nutrition counseling by NCP process is effective for diet therapy compliance and glycemic control of type 2 diabetic patients.
This study was conducted to evaluate changes in nutritional knowledge, attitudes, behavior intention and behavior in a sample of 27 insulin dependent diabetic students participating in diabetics' camp. Nutritional knowledge related to diabetes, attitudes toward diabetes treatment and behavior intention about dietary changes were tested before and after nutrition education. Six months after nutrition education, an open ended questionnaire about their actual behavior changes was mailed to all participants and 17 of them responded. Pre-and post-testing showed that nutrition education was effective in significant changes in knowledge and in promoting positive attitudes and behavior intention. Increases of knowledge were consistently the same regardless of sex, level of education, regularity of diet, and duration of disease. Compared to male students, female students showed more positive change in knowledge, attitudes and behavior intention. It also appeared that middle school students showed more positive improvement in knowledge, attitudes and behavior than elementary and high school students. A follow-up test showed that their actual behavior changes were not squared with their behavior intention. They pointed out difficulties in having proper amount of meals and snack and the conflict with school time schedule as the major reason for discordance. These findings suggest that nutrition education for diabetics can be effective to improve their knowledge, attitudes and behavior intention and understanding about barriers to behavior change is important for better compliance to the disease.
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