• Research in Community and Public Health Nursing
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• v.33 no.4
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• pp.408-417
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• 2022

Purpose: This study aimed to investigate the prevalence and risk factors of diabetic retinopathy (DR) in people with diabetes mellitus (DM) using Korean National Health and Nutrition Examination Survey VII (2017~2018). Methods: DM was defined as in two ways; 1) doctor's diagnosis (Group 1, n=549), 2) one of doctor's diagnosis, medication, or hyperglycemia (Group 2, n=849). The DR prevalence was measured as the prevalence proportion (%). Risk factors for developing DR were analyzed using multiple logistic regression, and odds ratios (ORs) and 95% confidence intervals (CIs) were calculated. Results: The prevalence of DR was 25.87% in Group 1 and 20.14% in Group 2. Risk factors for DR were identified as insulin therapy (Group 1: OR=5.31, Group 2: OR=5.27), DM duration ≥10 years (Group 1: OR=2.20, Group 2: OR=3.10), and systolic blood pressure ≥140 mmHg (Group 1: OR=2.26, Group 2: OR=2.23) for both groups. Conclusion: Considering the DR prevalence, eye examinations education is highly recommended as part of a diabetes management programs in the community. It is also proposed to shorten the eye examination cycle for people with risk factors and establish a referral system to link between screening to treatment.

• Korean Journal of Adult Nursing
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• v.19 no.2
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• pp.283-294
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• 2007

Purpose: The purpose of this study was to identify predictors of cardiovascular risk factors of type 2 diabetic patients. Methods: Diabetic patients (N=160) were interviewed from November, 2003 to June, 2004. The 24 hour dietary recall, the International Physical Activity Questionnaire, the Diabetes Management Self-Efficacy Scale for patient with Type 2 diabetes, the Revised Summary of Diabetes Self-Care Activities Measure Scale and Parma Cardiovascular Risk Index were used to measure the predictors. Data were analyzed by descriptive analyses, Pearson correlation coefficients, and stepwise multiple regression using the SPSS WIN 10.0. Results: Mean dietary intakes of the participants were protein(P) of 64.5g, carbohydrate(C) of 280.74g, fat(F) of 30g, and calcium of 511.45mg. The ratio of CPF was 75:17:8. About 45% of the participants didn't exercise on a regular basis. The levels of self-efficacy, self-care, and cardiovascular risk factors of the participants were moderate. Self-efficacy was the most important predictor of cardiovascular risk factors along with self-care, exercising for more than 6 months, carbohydrate intakes and levels of physical activities. Conclusion: The findings of the study suggest that intervention programs increasing self-efficacy on diabetic management would be more beneficial than the fractional approach focusing only on diet or physical activities.

• Proceedings of the Korea Information Processing Society Conference
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• 2012.11a
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• pp.1321-1322
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• 2012

With the advance of Information Technology (IT) and dynamic requirements, diverse application services have been provided for end users. With huge volume of these services and information, users are required to acquire customized services that provide personalized information and decision at particular extent of time. The case is more appealing in healthcare, where patients wish to have access to their medical record where they have control and provided with recommendation on the medical information. PHR (Personal Health Record) is most prevailing initiative that gives secure access on patient record at anytime and anywhere. PHR should also incorporate decision support to help patients in self-management of their diseases. Available PHR system incorporates basic recommendations based on patient routine data. We have proposed decision support service called "Smart CDSS" that provides recommendations on PHR data for diabetic patients. Smart CDSS follows HL7 vMR (Virtual Medical Record) to help in integration with diverse application including PHR. PHR shares patient data with Smart CDSS through standard interfaces that pass through Adaptability Engine (AE). AE transforms the PHR CCR/CCD (Continuity of Care Record/Document) into standard HL7 vMR format. Smart CDSS produces recommendation on PHR datasets based on diabetic knowledge base represented in shareable HL7 Arden Syntax format. The Smart CDSS service is deployed on public cloud over MS Azure environment and PHR is maintaining on private cloud. The system has been evaluated for recommendation for 100 diabetic patients from Saint's Mary Hospital. The recommendations were compared with physicians' guidelines which complement the self-management of the patient.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.45 no.4
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• pp.207-214
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• 2019

Objectives: Medically compromised patients often fear required dental surgical procedures that can increase the risk of medical emergency when combined with reduced tolerance for stress. A stress reduction protocol (SRP) helps doctors minimize treatment-related stress and improves patient management with minimum complications. Diabetes and co-morbid hypertension carry 4-fold risk of aggravation of cardiovascular emergencies and 7.2-fold risk of mortality. Diabetic neuropathy can result in difficult diagnosis of myocardial infarction and reduces chances of surviving a myocardial infarction compared with a non-diabetic person. The aim of the study was to assess the feasibility of a protocol for management of patients having both diabetes and hypertension who required minor oral surgery to minimize the rate of cardiovascular emergencies. Materials and Methods: A prospective study was conducted in 140 patients having both diabetes and hypertension who required minor oral surgical procedures. A systematic approachable protocol was designed for management of such patients. Results: Among 140 patients, 6 patients (4.3%) had cardiovascular complications, while 3 patients (1 with syncope and 2 with hypertension) did not require any intervention other than observation. Two patients were managed with aspirin and nitroglycerin, and 1 patient had possible myocardial infarction (overall incidence 0.7%) with chest pain, S-T segment elevation on electrocardiogram, and troponin level of 0.60 ng/mL. Conclusion: The proposed protocol helps to improve management of patients having both diabetes and hypertension. We recommend that patients with uncontrolled diabetes and uncontrolled hypertension and/or patients having history of cardiovascular complication should be treated in a medical facility with a readily available cardiology unit. This facilitates prompt response to emergency and instant implementation of treatment, helping to reduce morbidity and mortality.

• Journal of Korean Society of Occupational and Environmental Hygiene
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• v.27 no.4
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• pp.380-389
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• 2017

Objectives: The purpose of this study was to investigate changes in HbA1c through an education and consultation intervention with diabetic workers. Methods: The participants were 65 workers with Type 2 diabetes. The data were collected from May to October 2014 using questionnaires. The intervention program included six monthly sessions on exercise, dietary habits, stress management, and diabetes knowledge. Changes in HbA1c were evaluated. The data were analyzed using descriptive statistics and paired t-tests with SPSS WIN23.0. Results: The mean of HbA1c was 7.67% before intervention and 7.28% after intervention, and this difference was statistically significant (P<0.01).The mean level of HbA1c was significantly different depending on job position, working hours, work duration, and smoking habit. Conclusion: In conclusion, these findings support the usefulness of intervention programs in reducing HbA1c. Therefore, appropriate intervention programs involving exercise, dietary habits, stress management and diabetes knowledge should be developed and provided to diabetic workers.

• Journal of Nutrition and Health
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• v.30 no.9
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• pp.1035-1044
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• 1997

There is substantial evidence that insulin sensitivity can be enhanced through appropriate dietary management . In this study, insulin sensitivity was evaluated using and insulin suppression test. Male Sprague-Dawley rats, were caused to be in a diabetic condition by the injection of streptozotocin, and divided into four groups. They were fed one of the following diets for 2 weeks : (group 1) a high-carbohydrate(CHO) low-fat low-fiber diet, (group 2) a high CHO low-fat and high-fiber diet, (group 3) a low-CHO high-fat and low-fiber diet, and (group 4) a low-CHO low-fat diet groups (as comparison between group 1 and group 2 shows). In the low-CHO high-fat diet groups, dietary fiber tended to decrease plasma glucose levels at the end of the experiment, but not significantly (as comparison between group 3 and group 4 shows). The average steady state plasma glucose level in rats on the group 3 diet was the highest among all four groups(p<0.05), indicating the poorest insulin sensitivity . However, high fiber increased insulin sensitivity in rats on the low-CHO high-fat diets(as shows by a comparison between group 3 and group 4). On the other hand , the high-CHO low-fat enhanced insulin sensitivity in rats on the low fiber diet(group 1 and group 3). The degree of enhancement of insulin sensitivity depends on the combination of CHO, fat , and fiber in the diet. In conclusion, this study demonstrates that a low-CHO high-fat low -fiber diet may be deleterious to diabetic rats. In view of insulin sensitivity enhancement , dietary fiber level is irrelevant, as long as the diet has a high-CHO and low-fat level.

• Journal of Periodontal and Implant Science
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• v.27 no.4
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• pp.701-722
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• 1997

It was reported that low dose doxycycline(LDD) regimen could inhibit pathologically elevated collagenase activity in the gingival crevicular fluid of petients with adult periodontitis without producing typical antibiotic side effects. The purpose of this study was to evaluate the effects of LDD regimen(20mg) administered during non-surgical therapy on clinical index and gingival crevicular fluid enzyme activity in diabetics who are at high risk for periodontal disease. Forty-nine subjects having at least two sites with probing pocket depths greater than 4mm were selected. In this double-blind, placebo-controlled study, the patients were administered 20 mg doxycycline capsule or placebo capsule b.i.d. for 2 weeks. Clinical parameters of dental plaque, gingival inflammation, probing pocket depth and probing attachment level were assessed at week 0, 2, 4, and 8. Gingival crevicular fluid samples were collected at the same time to evaluate the activities of collagenase and elastase. Clinical parameters and elastase activity were significantly reduced in all groups compared to the baseline value after treatment. Significantly greater reduction in pocket depth and gain in attachment level was shown in the LDD-administered group compared to placebo group in both adult periodontitis and diabetic patients. Total collagenase activity was also reduced significantly in all groups after treatment, but the greater reduction was seen in the LDD-administered diabetics group compared to relevant placebo group(at 4, 8week). Significantly greater reduction in active collagenase activity was also seen in the LDD-administered group compared to placebo group in diabetic patients(at 2, 4, 8week). These results indicated that use of low dose doxycycline could be aueseful adjunct to instrumentation therapy in the management of diabetic patient with periodontitis as well as adult periodontitis patient.

• The Journal of the Convergence on Culture Technology
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• v.7 no.2
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• pp.117-127
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• 2021

The purpose of this study was to identify nurses' communication style and the extent of their health literacy and to discern the impact of nurses' communication and health literacy on self-care behaviors, as perceived by elderly diabetic patients in comprehensive nursing-care service wards. This study provides basic data for establishing an efficient nursing-care service-system environment through high-quality self-management. The measurement and improvement of an accurate health literacy level of elderly diabetic patients is an important intervention method to increase the self-care behavior of patients. Therefore, by developing a distinguished nursing intervention plan, early treatment of diabetic patients and quality of care may be possible.

• Genomics & Informatics
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• v.20 no.3
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• pp.26.1-26.19
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• 2022

Diabetes and its related complications are associated with long term damage and failure of various organ systems. The microvascular complications of diabetes considered in this study are diabetic retinopathy, diabetic neuropathy, and diabetic nephropathy. The aim is to identify the weighted co-expressed and differentially expressed genes (DEGs), major pathways, and their miRNA, transcription factors (TFs) and drugs interacting in all the three conditions. The primary goal is to identify vital DEGs in all the three conditions. The overlapped five genes (AKT1, NFKB1, MAPK3, PDPK1, and TNF) from the DEGs and the co-expressed genes were defined as key genes, which differentially expressed in all the three cases. Then the protein-protein interaction network and gene set linkage analysis (GSLA) of key genes was performed. GSLA, gene ontology, and pathway enrichment analysis of the key genes elucidates nine major pathways in diabetes. Subsequently, we constructed the miRNA-gene and transcription factor-gene regulatory network of the five gene of interest in the nine major pathways were studied. hsa-mir-34a-5p, a major miRNA that interacted with all the five genes. RELA, FOXO3, PDX1, and SREBF1 were the TFs interacting with the major five gene of interest. Finally, drug-gene interaction network elucidates five potential drugs to treat the genes of interest. This research reveals biomarker genes, miRNA, TFs, and therapeutic drugs in the key signaling pathways, which may help us, understand the processes of all three secondary microvascular problems and aid in disease detection and management.

• The Korean Journal of Pain
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• v.9 no.1
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• pp.275-278
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• 1996

The placement of epidural catheter may cause complications such as epidural hematoma, epidural abscess and neural damage. Among the above complications, epidural abscess is a rare but serious complication. This report pertains to a diabetic metlitus patient who developed spinal epidural and subdural abscess after continuous epidural catheterization for management of pain caused by reflex sympathetic dystrophy. The patient experienced urinary incontinence, as a neurologic sign, 8 days after epidural catherization. In was considered that the poor prognosis was due to a combination effects of a delayed visit to the hospital for treatment, rapid progression of abscess and uncontrolled blood sugar level. We therefore recommend aseptic technique and proper control of blood sugar level to prevent infection during and after epidural catheterization for diabetic patients. Early diagnosis of epidural abscess following surgical procedure must be required to avoid sequelae.