• Title/Summary/Keyword: pre-diabetes

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The Effects of Exercise Therapy Applied in an Efficacy Expectation Promoting Program on Self-Efficacy and Metabolism.- in NIDDM(Non-Insulin Dependent Diabetes Mellitus) Patients - (효능기대증진프로그램을 적용한 운동요법이 자기효능과 대사에 미치는 영향-인슐린 비의존성 당뇨병 환자를 중심으로-)

  • 김춘자
    • Journal of Korean Academy of Nursing
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    • v.28 no.1
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    • pp.132-142
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    • 1998
  • This study was conducted to investigate whether exercise therapy applied in an efficacy expectation promoting program based on the self-efficacy theory of Bandura(1977) would increase self-efficacy and metabolism in NIDDM patients. The study design was a nonequivalent control group pre-test post-test quasi-experimental desist The exercise therapy applied in the efficacy expectation promoting program was composed of a staged exercise program, a small booklet relating personal experience with diabetes mellitus and a telephone coaching program on performance accomplishment. vicarious experience and verbal persuasion, which are all induction modes of efficacy expectation. The subjects of the study were twenty eight NIDDM patients who received follow-up care regularly through the out-patient department of endocrine medicine in one general hospital which had a diabetic clinic. Fourteen were assigned to the experimental group and fourteen to the control group. The experimental group participated in the exercise therapy applied in the efficacy expectation promoting program from three to five times per week for four weeks and the control group did not have the program. The collected data were analyzed using the X²-test, t-test, paired t-test, and Cronbach's Alpha using SPSS /PC/sup +/. The results are summarized as follows 1. Experimental group had higher efficacy score than control group(t=5.98, p=.00). And. There was a significant different in the efficacy score before exercise therapy applied in the efficacy expectation promoting program and after in experimental group(t=-6.42, p=.00). 2. Experimental group did not have lower level of glucose metabolism than control group(FBS : t=.32, p=.75, HbAlC : t=.60, p=.55, pc 2hrs. glucose : t=-.29, p=.78). But, There was a significant different in the aunt of glucose metabolism before exercise therapy applied in the efficacy expectation promoting program and after in experimental group(FBS : t=3.63, p=.003, HbAlC t=4.20, p=.00, pc 2hrs. glucose : t=1.93, p=.001). 3. Levels of lipid metabolism were partly a significant different between Experimental group and control group(triglyceride t=-1.87, p=.07, HDL cholesterol : t=-.29, p=.77. body weight : t=1.78, p=.09, Total cholesterol : t=-2.17, p=.04). And, There was partly a significant different in the amount of lipid metabolism before exercise therapy applied in the efficacy expectation promoting program and after in experimental group(triglyceride : t=2.50, p=.03, HDL cholesterol : t=-.43, p=.67, body weight : t=5.34. p=.00, Total cholesterol : t=2.26, p=.04). In conclusion, it was found that exercise therapy applied in an efficacy expectation promoting program was an effective nursing intervention for increasing self-efficacy and metabolism.

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Changes in the glucose and insulin responses according to high-protein snacks for diabetic patients

  • Yang, Junyoung;Park, Hae Jin;Hwang, Wonsun;Kim, Tae Ho;Kim, Hyeonmok;Oh, Jieun;Cho, Mi Sook
    • Nutrition Research and Practice
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    • v.15 no.1
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    • pp.54-65
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    • 2021
  • BACKGROUND/OBJECTIVES: This study aimed to develop healthy, appetizing high-protein snacks with enhanced isolated soy protein for diabetic patients and determine the blood glucose and insulin response after being consumed by these patients. MATERIALS/METHODS: Thirty adult patients aged between 30 and 75 years, with a ≤ 10-year history of type 2 diabetes and hemoglobin A1c of < 7.5%, were enrolled in this study. They made 3 clinical visits at one-week intervals. The control group consumed 50 g carbohydrates (white bread), whereas the test groups consumed high-protein grain (HP_G) or high-protein chocolate (HP_C) after an 8-hrs fast. Blood (2 ㎤) was drawn at 15, 30, 45, 60, 90, and 120 min before and after consumption to analyze the blood glucose and insulin concentrations. RESULTS: Compared to the commercial snacks, the developed high-protein snacks had below-average calorie, carbohydrate, and fat content and a 2.5-fold higher protein content. In diabetic patients who consumed these snacks, the postprandial blood glucose increased between 15 min and 2 h after consumption, which was significantly slower than the time taken for the blood glucose to increase in the patients who consumed the control food product (P < 0.001). Insulin secretion was significantly lower at 45 min after consumption (P < 0.05), showing that the high-protein snacks did not increase the blood glucose levels rapidly. The incremental area under the curve (iAUC), which indicated the degree of blood sugar and insulin elevation after food intake, was higher in the control group than the groups given the 2 developed snacks (P < 0.001), and there was no significant difference in insulin secretion. CONCLUSIONS: The results of the postprandial blood glucose and insulin response suggest that high-protein snacks are potential convenient sources of high-quality protein and serve as a healthier alternative for patients with type 2 diabetes, who may have limited snack product choices. Such snacks may also provide balanced nutrition to pre-diabetic and obese individuals.

The Impact of Menopause on Bone Fusion after the Single-Level Anterior Cervical Discectomy and Fusion

  • Park, Sung Bae;Chung, Chun Kee;Lee, Sang Hyung;Yang, Hee-Jin;Son, Young-Je;Chung, Young Seob
    • Journal of Korean Neurosurgical Society
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    • v.54 no.6
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    • pp.496-500
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    • 2013
  • Objective : To evaluate the successful fusion rate in postmenopausal women with single-level anterior cervical discectomy and successful fusion (ACDF) and identify the significant factors related to bone successful fusion in pre- and postmenopausal women. Methods : From July 2004 to December 2010, 108 consecutive patients who underwent single-level ACDF were prospectively selected as candidates. Among these, the charts and radiological data of 39 women were reviewed retrospectively. These 39 women were divided into two groups : a premenopausal group (n=11) and a postmenopausal group (n=28). To evaluate the significant factors affecting the successful fusion rate, the following were analyzed : the presence of successful fusion, successful fusion type, age, operated level, bone mineral density, graft materials, stand-alone cage or plating with autologous iliac bone, subsidence, adjacent segment degeneration, smoking, diabetes mellitus, and renal disease. Results : The successful fusion rates of the pre- and postmenopausal groups were 90.9% and 89.2%, respectively. There was no significant difference in the successful fusion rate or successful fusion type between the two groups. In the postmenopausal group, three patients (10.8%) had successful fusion failure. In the postmenopausal group, age and subsidence significantly affected the successful fusion rate (p=0.016 and 0.011, respectively), and the incidence of subsidence in patients with a cage was higher than that in patients with a plate (p=0.030). Conclusion : Menopausal status did not significantly affect bone successful fusion in patients with single-level ACDF. However, in older women with single-level ACDF, the combination of use of a cage and subsidence may unfavorably affect successful fusion.

The Inhibitory Mechanism on Acetylcholine-Induced Contraction of Bladder Smooth Muscle in the Streptozotocin-Induced Diabetic Rat

  • Han, Jong Soo;Kim, Su Jin;Nam, Yoonjin;Lee, Hak Yeong;Kim, Geon Min;Kim, Dong Min;Sohn, Uy Dong
    • Biomolecules & Therapeutics
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    • v.27 no.1
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    • pp.101-106
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    • 2019
  • Most diabetic patients experience diabetic mellitus (DM) urinary bladder dysfunction. A number of studies evaluate bladder smooth muscle contraction in DM. In this study, we evaluated the change of bladder smooth muscle contraction between normal rats and DM rats. Furthermore, we used pharmacological inhibitors to determine the differences in the signaling pathways between normal and DM rats. Rats in the DM group received an intraperitoneal injection of 65 mg/kg streptozotocin and measured blood glucose level after 14 days to confirm DM. Bladder smooth muscle contraction was induced using acetylcholine (ACh, $10^{-4}M$). The materials such as, atropine (a muscarinic receptor antagonist), U73122 (a phospholipase C inhibitor), DPCPX (an adenosine $A_1$ receptor antagonist), udenafil (a PDE5 inhibitor), prazosin (an ${\alpha}_1$-receptor antagonist), papaverine (a smooth muscle relaxant), verapamil (a calcium channel blocker), and chelerythrine (a protein kinase C inhibitor) were pre-treated in bladder smooth muscle. We found that the DM rats had lower bladder smooth muscle contractility than normal rats. When prazosin, udenafil, verapamil, and U73122 were pre-treated, there were significant differences between normal and DM rats. Taken together, it was concluded that the change of intracellular $Ca^{2+}$ release mediated by PLC/IP3 and PDE5 activity were responsible for decreased bladder smooth muscle contractility in DM rats.

Determinant Factors of Mortality in Pre-elderly and Elderly Patients With COVID-19 in Jakarta, Indonesia

  • Thresya Febrianti;Ngabila Salama;Inggariwati;Dwi Oktavia
    • Journal of Preventive Medicine and Public Health
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    • v.56 no.3
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    • pp.231-237
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    • 2023
  • Objectives: This study aimed to identify risk factors associated with coronavirus disease 2019 (COVID-19) mortality in pre-elderly and elderly individuals in Jakarta, Indonesia. Methods: We employed a case-control study design, utilizing secondary data from the Epidemiology Surveillance, Immunization Prevention, and Disease Control Sections of the DKI Jakarta Provincial Health Office, collected from December 2020 to January 2021. The study included 188 cases and an equal number of controls. Cases were COVID-19 patients confirmed to have died, as reported by hospitals and communities and subsequently verified by healthcare workers. Control subjects were patients who completed a 14-day isolation period and had been officially declared recovered by healthcare professionals. The dependent variable was the mortality of COVID-19 patients in the January 2021 period. The independent variables consisted of demographic data (age and sex), clinical symptoms (cough, runny nose, anosmia, diarrhea, headaches, abdominal pain, muscle pain, and nausea/vomiting), and comorbidities (hypertension, heart disease, and diabetes). Multivariate analysis was conducted using multiple logistic regression. Results: The multiple logistic regression analysis revealed several factors associated with COVID-19 fatalities in Jakarta: age of 60 years or older (odds ratio [OR], 4.84; 95% CI, 3.00 to 7.80), male (OR, 2.38; 95% CI, 2.41 to 3.68), dyspnea (OR, 3.93; 95% CI, 2.04 to 7.55), anosmia (OR, 0.13; 95% CI, 0.04 to 0.46), and heart disease (OR, 4.38; 95% CI, 1.04 to 18.46). Conclusions: The control and prevention of COVID-19 among elderly individuals require particular vigilance. When a COVID-19 case is detected within this demographic, prompt treatment and medication administration are crucial to mitigate the presenting symptoms.

Cervical Necrotizing Fasciitis Caused by Dental Infection

  • Song, Chi-Woong;Yoon, Hyun-Joong;Jung, Da-Woon;Lee, Sang-Hwa
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.36 no.2
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    • pp.67-72
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    • 2014
  • Necrotizing fasciitis (NF) is defined as rapidly progressive necrosis of subcutaneous fat and fascia. Although NF of the face is rare, its mortality rate is nearly 30%. It usually originates from dental infection and can lead to involvement of the neck, mediastinum, and chest wall. Complications resulting from pre-existing systemic diseases can increase the mortality rate. Known complication factors for NF include diabetes, malnutrition, advanced age, peripheral vascular disease, renal failure, and obesity. Here, we report a case of NF originating from dental infection in an 88-year-old woman already diagnosed with hypertension, thoracic aortic aneurysm, and renal diseases. Such conditions limited adequate surgical and antibiotic treatment. However, interdisciplinary treatment involving multiple departments was implemented with good results.

The Effects of a Self-care Management Program for Patients with Diabetic Foot Ulcers (당뇨병성 족부 궤양을 가진 환자의 자가 관리 프로그램 적용 효과)

  • Kim, Jung Yoon;Cheon, Eui-Young
    • Journal of Korean Biological Nursing Science
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    • v.18 no.2
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    • pp.78-86
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    • 2016
  • Purpose: Diabetic foot ulcers are significant problems in diabetes mellitus and often result in lower extremity amputation. This study was conducted to evaluate the effects of a self-care management program on Korean patient's self-efficacy, self-care behavior, size of the wound, and wound related pain. Methods: This study was a quasi-experimental study of pre-test and post-test design in a non-equivalent control group. The intervention strategies of the self-care management program consisted of individual intervention (education, practice and demonstration), computer animation, and face-to-face counseling. There were thirty seven patients, and 20 were assigned to the experimental group while the other 17 were assigned to the control group. The experimental group was given a self-care management program. The control group received information on diabetic mellitus care by means of a leaflet. The data was analyzed using descriptive statistics, a chi-square test, an independent t-test, and a Mann-Whitney test. Results: There were significant differences in self-care behavior and wound related pain. Conclusion: A Self-care program is an effective way to increase patient's self-care ability. This program is highly applicable to diabetic foot ulcer patients in various settings.

PPARγ Physiology and Pathology in Gastrointestinal Epithelial Cells

  • Thompson, E. Aubrey
    • Molecules and Cells
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    • v.24 no.2
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    • pp.167-176
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    • 2007
  • Peroxisome proliferator-activated receptor-gamma ($PPAR{\gamma}$) is expressed at very high levels in the gastrointestinal epithelium. Many of the functions of $PPAR{\gamma}$ in gastrointestinal epithelial cells have been elucidated in recent years, and a pattern is emerging which suggests that this receptor plays an important role in gastrointestinal physiology. There is also strong evidence that $PPAR{\gamma}$ is a colon cancer suppressor in pre-clinical rodent models of sporadic colon cancer, and there is considerable interest in exploitation of $PPAR{\gamma}$ agonists as prophylactic or chemopreventive agents in colon cancer. Studies in mice and in human colon cancer cell lines suggest several mechanisms that might account for the tumor suppressive effects of $PPAR{\gamma}$ agonists, although it is not in all cases clear whether these effects are altogether mediated by $PPAR{\gamma}$. Conversely, several reports suggest that $PPAR{\gamma}$ agonists may promote colon cancer under certain circumstances. This possibility warrants considerable attention since several million individuals with type II diabetes are currently taking $PPAR{\gamma}$ agonists. This review will focus on recent data related to four critical questions: what is the physiological function of $PPAR{\gamma}$ in gastrointestinal epithelial cells; how does $PPAR{\gamma}$ suppress colon carcinogenesis; is $PPAR{\gamma}$ a tumor promoter; and what is the future of $PPAR{\gamma}$ in colon cancer prevention?

Comparison of the Effects of Internet Diabetic Education on Obesity in Type 2 Diabetic Patients (제 2형 당뇨환자 비만도별 인터넷 당뇨 교육 효과 비교)

  • Kim Hee-Seung;Kim Kyung-Mi
    • Journal of Korean Academy of Fundamentals of Nursing
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    • v.11 no.3
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    • pp.275-280
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    • 2004
  • Purpose: The purpose of this study was to evaluate the effects on obesity of nurse education using the short message service (SMS) of cellular phones and wire Internet. Method: Forty patients in an experimental group, which was assessed pre- and post intervention, completed this study. The patients were divided into two groups according to degree of obesity. The goal of the intervention was to keep blood glucose concentrations close to the normal range. The intervention was applied weekly for 3 months. Participants were requested to input the blood glucose level everyday at http://www.biodang.com by cellular phone or wire internet. The researcher sent optimal recommendations to each patient using SMS of cellular phones and wire Internet. The plasma glucose levels and serum lipids were measured before and after the intervention. Results: After 3 months of education, Glycosylated hemoglobin (HbAlc) decreased by 1.4% in non-obese patients and 0.7% in obese patients. Fasting plasma glucose (FPG) decreased 22.6mg/dl in non-obese patients and 22.3mg/dl in obese patients. Two-hour plasma glucose (2HPG) decreased 97.0mg/dl in non-obese patients and 67.8mg/dl in obese patients. Conclusion: These results indicate that a nurse SMS intervention would improve HbAlc, FPG, and 2HPG in both non-obese and obese patients.

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Effect of Foot Reflex Massage on Stress Responses, and Glucose Level of Non-Insulin Dependent Diabetes Mellitus Patients (발반사 마사지가 인슐린 비의존성 당뇨병 환자의 스트레스반응과 혈당에 미치는 효과)

  • Kim, Keum-Soon
    • The Korean Journal of Rehabilitation Nursing
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    • v.6 no.2
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    • pp.152-163
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    • 2003
  • Purpose; This study was done to investigate the effect of foot reflexology on vital signs, general fatigue, foot fatigue, mood, and blood glucose levels in noninsulin dependent patients. Method: The Research design of this study was nonequivalent control group quasi-experimental design. 18 patients were assigned to the experimental group, 24 patients to the control group. The data were obtained diaberic patients with ambulatory endocrine outpatients clinic patients from 40 years old to 70 years old. Experimental groups received foot reflex massage for 30minutes three times/week every other days, and Control groups did not received foot reflex massage. The dependent variables were blood pressure, pulse rate, visual analogue scale for general fatigue, foot fatigue, mood, and blood sugar levels. Data were analyzed with $X^2$ test, t-test and repeated measure ANOVA at .0.05 level of significance. Results: There were significant difference in the pulse rate, general fatigue, foot fatigue and mood according to group and time between pre and post foot reflexology. But this research did not prove to decrease blood sugar levels. Conclusions : Foot reflexology can imorove pulse rate, general and foot fatigue, and mood status in diabetus patients. So further research need to explore the effect of decreasing of blood sugar levels.

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