Purpose: This study aimed to provide basic data to enhance self-nursing ability by investigating the symptoms of autonomic neuropathy and self-management activities in patients with diabetes accompanying hypertension. Methods: Subjects were 113 type-2 diabetic patients who were diagnosed as hypertensive in two primary medical institutions and taking anti-hypertensive treatments. The existence of postural hypotension was evaluated by blood pressure and pulse rate, and the subjective symptoms of autonomic neuropathy and self-management activities were checked by structured questionnaires. The collected data were analyzed by chi-square test, Fisher's exact test, t-test, Wilcoxon rank sum test and analysis of covariance. Results: Postural hypotension occurred in 4.4% of the subjects. Urinary frequency and dizziness during postural changes were the most frequent symptoms of autonomic neuropathy, and 57.5% of the subjects complained of symptoms in two or more domains. The group with autonomic neuropathy symptoms showed higher age, higher living stress, and fewer self-management activities in the diet and foot management domains as compared to the group without autonomic neuropathy symptoms. Conclusion: From these results, we learned that strengthening education on self-management for diet and foot management and customized interventions considering age and living stress are required through early identification of the symptoms of autonomic neuropathy in patients with diabetes accompanying hypertension.
Background: We determined the differences in awareness of myocardial infarction and stroke according to the presence or absence of diabetes mellitus in the community. Methods: The 2018 Community Health Survey identified 20,812 people with diabetes mellitus aged 40-79 years. Using 1:1 matching by propensity score, 20,812 people without diabetes mellitus but with similar sociodemographic characteristics were selected as a comparison. Outcome variables were awareness of early symptoms of myocardial infarction and stroke and awareness of coping strategies in case of occurrence. Results: There was no significant difference between nondiabetic and diabetic people in terms of recognizing all early symptoms of myocardial infarction (nondiabetic, 42.7%; diabetic, 43.0%; p=0.43) and stroke (nondiabetic, 49.4%; diabetic, 49.4%; p=0.91). In addition, no significant difference was found between nondiabetic and diabetic people in the proportion of knowing correct emergency response to myocardial infarction (nondiabetic, 84.6%; diabetic, 84.4%; p=0.56) and stroke (nondiabetic, 81.3%; diabetic, 81.4%; p=0.77). Conclusion: Since people with diabetes are at greater risk of cardiovascular disease than the general public, it is important to lower the risk of disability and death by improving their awareness of early symptoms and correct emergency response to myocardial infarction and stroke.
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
/
v.42
no.5
/
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.
The purpose of this study was to assess vitamin $B_6$ intake and status in Korean patients with newly diagnosed type 2 diabetes. Sixty-four patients with newly diagnosed type 2 diabetes and 8-11% glycated hemoglobin (A1C), along with 28 age-matched non-diabetic subjects, participated. Dietary vitamin $B_6$ intake was estimated by the 24 hour recall method and plasma pyridoxal 5'-phosphate (PLP) was measured. There was a significant difference in daily total calorie intake between the diabetic and non-diabetic groups ($1,917{\pm}376$ vs $2,093{\pm}311\;kcal$). There were no differences in intake of total vitamin $B_6$ ($2.51{\pm}0.91$ vs $2.53{\pm}0.81\;mg/d$) or vitamin $B_6$/1,000 kcal ($1.31{\pm}0.42$ vs $1.20{\pm}0.32\;mg$) between the diabetic and non-diabetic groups, and I intakes of total vitamin $B_6$ were above the Korean RDA in both groups ($180.0{\pm}57.9$ vs $179.0{\pm}65.4$). There was a higher percentage of diabetic subjects whose plasma PLP concentration was < 30 nmol/L compared to non-diabetic group. Plasma PLP levels tended to be lower in the diabetic subjects than in the non-diabetic subjects, although the difference was not statistically significant due to a large standard deviation ($80.0{\pm}61.2\;nmol/L$ vs $68.2{\pm}38.5\;nmol/L$). Nevertheless, plasma PLP levels should be monitored in pre-diabetic patients with diabetic risk factors as well as in newly diagnosed diabetic patients for long-term management of diabetes, even though this factor is not a major risk factor that contributes to the development of degenerative complications in certain patients.
Objectives : This study aimed to evaluate the hypoglycemic, hepatoprotective, and nephroprotective effects of 'Saengjinyanghyul-tang($Sh\={e}ngj\={i}ny\v{a}ngxu\`{e}-t\={a}ng$ : SJYHT)' in streptozotocin (STZ)-induced diabetic SD rat model. Methods : SJYHT extracts were once a day dosed for 28 days at a dosage 1000, 500, and 250mg/kg/5ml from 25 days after STZ-dosing, and the changes on blood glucose levels, liver and kidney weight, serum AST, ALT, BUN and creatinine levels were observed with histological changes on the liver and kidney. Results : Increased blood glucose levels, and diabetic hepatopathy & nephropathy including increased serum AST, ALT, BUN and creatinine levels, histological changes after STZ-dosing were dose-dependently reduced by SJYHT extract-dosing. Conclusions : 'SJYHT' water extracts have favorable hypoglycemic, hepatoprotective, and nephroprotective effects on the STZ-induced diabetic SD rats. Therefore, it is expected that 'SJYHT' has potential for use in the management of diabetes and diabetic complications.
The purpose of this survey was to investigate eating habits, life styles and nutritional care of diabetic outpatients and to provide basic data for developing individualized nutritional care and diabetic education programs. This survey was carried out by nutritional counseling with a questionnaire and checking medical record. Information about the general characteristics of the subjects, eating habits, health-related life styles and attitude and perception of subjects to diet therapy was gathered from 200 randomly-sampled diabetic outpatients at a University Hospital located in Inchon. All data were analyzed by Statistical Analysis System(SAS) software. The results are summarized as follows : Female subjects were 63.5% of total subjects and 65.5% of total subjects were 50 years or more. The average Body Mas Index(BMI) of male and female subjects were 23.06kg/㎡ and 25.02kg/㎡ respectively and 44% of all subjects wee obese. Among subjects, type II diabetic patients were 81.0% and 82.5% of subjects had suffered from diabetes for more than one year. Also 41% subjects had diabetic history in their family. More than half of the subjects had nutrition education concerning diabetes. Also 75.5% of them thought that nutrition education was effective. The most important guideline in diet therapy was to eat cooked rice with dietary fiber-rich grains. Therefore, it might be necessary to develop nutrition education program adjusted according to diabetic patient's needs and life styles, which may increase feasibility of self-care and implementation of management guidelines.
Purpose: This study aimed to systematically review the contents and effectiveness of education programs for preventing diabetic foot ulcer among patients with type 2 diabetes mellitus in Korea. Methods: Six electronic databases were searched using search terms, and 748 articles were identified. Ten articles were eligible based on inclusion and exclusion criteria. Article quality was evaluated using a critical evaluation checklist for manuscripts before performing the systematic review. Results: Although education programs for preventing diabetic foot ulcers have been continuously studied for 20 years, the number of studies is small, and to our knowledge, there have been no studies reporting on the subsequent prevalence of foot ulcers or amputations. While the effect of these education programs on knowledge (ES=1.23) and self-management behavior (ES=.96) was shown to be statistically significant, it was not shown to be significant in preventing diabetic foot ulcers (ES=.03). Conclusion: The actual preventive effect on the prevalence of foot ulcers, through education programs for preventing diabetic foot ulcer could not be determined. Our findings highlight a potential need for studies aimed at developing effective programs to improve education on preventing diabetic foot ulcers.
Purpose: This study examined how a pair-work based health coaching program for the self-care of elderly diabetic patients effects the patients' diabetes self-management knowledge, perceived social support, diabetes self-efficacy, and diabetes self-management behaviors in patients with diabetes. Method: The participants of this study were 55 elderly diabetic patients aged 65 years or older enrolled at elderly welfare centers in U city;26 patients in the experimental group and 29 in the control group. The program consisted of eight group coaching sessions and four sessions of phone-based individual interviews and coaching, that were implemented once a week for 12 weeks. Results: Compared to the control groups, the experimental group showed significant improvement in self-care knowledge, social support, diabetes self-efficacy, self-management behavior, fasting blood sugar and glycated hemoglobin level. Conclusion: The health coaching program is an effective intervention for the self-management of elderly diabetics.
Objectives: In recent decades, the trend for treating diabetes mellitus (DM) has shifted toward alternative medicines that are obtained from plant sources. Existing literature suggests that phenolic compounds derived from plants possess promising health-promoting properties. This study aimed to discuss the role of plant-derived phenolic compounds in the effective treatment and management of diabetes. Methods: Information about plant secondary metabolites, phenolic compounds, and their role in the treatment and management of diabetes was collected from different databases, such as Pubmed, ScienceDirect, Scopus, and Google Scholar. Keywords like secondary metabolites, phenolic compounds, simple phenol, flavonoids, lignans, stilbenes, and diabetes were searched. Research and review articles with relevant information were included in the study. Results: Anti-diabetic studies of the four major classes of phenolic compounds were included in this review. The plant-derived phenolic compounds were reported to have potent anti-diabetic activities. However, each class of phenolic compounds was found to behave differently according to various mechanisms. Conclusion: The obtained results suggest that phenolic compounds derived from natural sources display promising anti-diabetic activities. Based on the available information, it can be concluded that phenolic compounds obtained from various natural sources play key roles in the treatment and management of diabetes.
Jang, Hana;Han, Jung Hoon;Bang, Joon Seok;Sohn, Uy Dong
Korean Journal of Clinical Pharmacy
/
v.24
no.1
/
pp.33-38
/
2014
Background: Diabetes is accompanied by complications. One of the chronic complications, diabetic retinopathy is the most common cause of the loss of eyesight and thus has enormous impacts on the quality of life to the patients. It has been reported that thorough glucose regulation can prevent or postpone the outset of diabetic retinopathy in diabetic patients and that the patients who received anti-diabetic manage & care education would be capable of more thorough glucose-level regulation than those who did not. Method: This study set out to investigate the current state of education on anti-diabetic manage & care in South Korea and connections between anti-diabetic manage & care education and occurrence of diabetic retinopathy in diabetic patients based on the Korea National Health and Nutrition Examination Survey of 2011. Results: Of the 410 diabetes patients, 74 received anti-diabetic manage & care education, which means that only 15% of diabetic patients benefited from the education in the nation. The occurrence rate of diabetic retinopathy was 28% in the education group and 24% in the non-education group with no significant differences between them. The anti-diabetic manage & care education group recorded a higher occurrence rate of diabetic retinopathy, one of the chronic diabetic complications, than the non-education group contrary to the hypothesis. One of the reasons was that the educated group had a significantly longer duration of diabetes and significantly higher HbA1c than the noneducated group, which indicates that anti-diabetic manage & care education is provided to those who have progressed farther along the course of diabetes instead of the early stage and cannot regulate their glucose-level well in the nation. Conclusion: Those findings raise a need for active educational policies in order to provide anti-diabetic manage & care education under the goals of preventing complications through anti-diabetic education for many patients in early stages of diabetes.
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