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제2형 당뇨병 환자의 영양섭취와 당뇨 합병증 위험도

Nutritional Intake Status according to the Risk of Diabetic Complications in Type 2 Diabetes Patients

  • Lee, Sangeun (College of Nursing, Pusan National University) ;
  • Lee, Haejung (College of Nursing, Pusan National University) ;
  • Park, Gaeun (College of Nursing, Pusan National University) ;
  • Lee, Dae Eun (College of Nursing, Pusan National University) ;
  • Lee, Min Jin (Department of Internal Medicine, Pusan National University Yangsan Hospital) ;
  • Khang, Ah Reum (Department of Internal Medicine, Pusan National University Yangsan Hospital)
  • 투고 : 2022.05.18
  • 심사 : 2022.08.02
  • 발행 : 2022.08.31

초록

Purpose: The purpose of this study was to investigate the nutritional intake status, according to the risk of diabetic complications in Type 2 diabetes patients. Methods: This was a secondary data analysis study that included 83 patients. The nutritional intake was assessed, using 24-hour dietary recall. The risk of diabetic complications was measured, using the Framingham Risk Score (FRS) and Michigan Neuropathy Screening Instrument Questionnaire (MNSIQ). The nutritional intake was analyzed using the CAN-pro 4.0 program. Data were analyzed using descriptive statistics, Chi-square test, and Independent t-test, using the SPSS WIN 26.0 program. Results: The mean FRS and MNSIQ scores for the participants was 14.46± 4.09 and 2.30± 2.22, respectively. Thirty two participants (38.6%) were in the high-risk groups for cardiovascular disease and peripheral neuropathy. The participants consumed high amounts of grain and low amounts of vegetables, fruits, and dairy products when compared to the recommended intake. However, the nutritional intake did not differ according to FRS or MNSIQ levels. Consumption of vegetables and fruits were significantly different between high and low risk groups of MNSIQ. Conclusion: It is necessary to consider the composition of dietary intake to improve the imbalanced diet in Type 2 diabetes patients and prevent diabetic complications. Type 2 diabetes patients should reduce the intake of grains and sodium, and increase vegetable intake. More deliberate future studies are needed, to investigate the relationship between food intake and the risk status for diabetic complication.

키워드

과제정보

이 논문은 2019년도 정부(교육부)의 재원으로 한국연구재단의 지원을 받아 수행된 기초연구사업임 (과제번호: NRF-2019R1I1A3A01062513).

참고문헌

  1. Shen J, Greenberg BH. Diabetes management in patients with heart failure. Diabetes Metabolism Journal. 2021;45(2):158-172. https://dx.doi.org/10.4093/dmj.2020.0296
  2. World Health Organization (WHO). Fact sheets-diabetes [Internet]. Geneva: WHO; 2021 [cited 2022 January 10]. Available from: https://www.who.int/news-room/fact-sheets/detail/diabetes
  3. Korea National Health and Nutrition Examination survey (KNHANES) fact sheet (1998-2018). 1st ed. Cheongju: Korea Disease Control and Prevention Agency (KDCA); 2020.
  4. Kwon DC, Jeong EK. Korea Health Statistics 2018: Korea National Health and Nutrition Examination Survey (KNHANES VII-3). Sejong, Cheongju: Ministry of Health and Welfare, Korea Disease Control and Prevention Agency (KDCA); 2020. p. 253-262.
  5. Davies MJ, D'Alessio DA, Fradkin J, Kernan WN, Mathieu C, Mingrone G, et al. Management of hyperglycemia in type 2 diabetes, 2018. A consensus report by the American Diabetes Association (ADA) and the European Association for the Study of Diabetes (EASD). Diabetes Care. 2018;41(12):2669-2701. https://dx.doi.org/10.2337/dci18-0033
  6. Go SH. Clinical practice guidelines for diabetes. 7th ed. Seoul: Korean Diabetes Association; 2021.
  7. Berger JS, Katona BG, Jones WS, Patel MR, Norgren L, Baumgartner I, et al. Design and rationale for the effects of ticagrelor and clopidogrel in patients with peripheral artery disease (EUCLID) trial. American Heart Journal. 2016;175:86-93. https://doi.org/10.1016/j.ahj.2016.01.018
  8. Sadosky A, Schaefer C, Mann R, Bergstrom F, Baik R, Parsons B, et al. Burden of illness associated with painful diabetic peripheral neuropathy among adults seeking treatment in the US: results from a retrospective chart review and cross-sectional survey. Diabetes, Metabolic Syndrome and Obesity: Targets and Therapy. 2013;6:79-92. https://doi.org/10.2147/DMSO.S37415
  9. American Diabetes Association. 11. Microvascular complications and foot care: standards of medical care in diabetes-2021. Diabetes Care. 2021;44(Supplement_1):S151-S167. https://doi.org/10.2337/dc21-S011
  10. Burch E, Ball L, Somerville M, Williams LT. Dietary intake by food group of individuals with type 2 diabetes mellitus: a systematic review. Diabetes Research and Clinical Practice. 2018;137:160-172. https://doi.org/10.1016/j.diabres.2017.12.016
  11. Einarson TR, Acs A, Ludwig C, Panton UH. Prevalence of cardiovascular disease in type 2 diabetes: a systematic literature review of scientific evidence from across the world in 2007-2017. Cardiovascular Diabetology. 2018;17(1):83. https://doi.org/10.1186/s12933-018-0728-6
  12. American Diabetes Association. 8. Obesity management for the treatment of type 2 diabetes: standards of medical care in diabetes - 2019. Diabetes Care. 2019;42(Supplement_1):S81-S89. https://doi.org/10.2337/dc21-S008
  13. Estruch R, Ros E, Salas-Salvado J, Covas M, Corella D, Aros F, et al. Primary prevention of cardiovascular disease with a Mediterranean diet supplemented with extra-virgin olive oil or nuts. The New England Journal of Medicine. 2018;378(25):e34. https://doi.org/10.1056/NEJMoa1800389
  14. Du H, Li L, Bennett D, Guo Y, Turnbull I, Yang L, et al. Fresh fruit consumption in relation to incident diabetes and diabetic vascular complications: a 7-y prospective study of 0.5 million Chinese adults. PLOS Medicine. 2017;14(4):e1002279. https://doi.org/10.1371/journal.pmed.1002279
  15. Bunner AE, Wells CL, Gonzales J, Agarwal U, Bayat E, Barnard ND. A dietary intervention for chronic diabetic neuropathy pain: a randomized controlled pilot study. Nutrition & Diabetes. 2015;5(5):e158. https://doi.org/10.1038/nutd.2015.8
  16. Hashemi R, Mehdizadeh Khalifani A, Rahimlou M, Manafi M. Comparison of the effect of dietary approaches to stop hypertension diet and American Diabetes Association nutrition guidelines on lipid profiles in patients with type 2 diabetes: a comparative clinical trial. Nutrition & Dietetics. 2020;77(2):204-211. https://doi.org/10.1111/1747-0080.12543
  17. Korsmo Haugen H, Brurberg KG, Mann J, Aas A. Carbohydrate quantity in the dietary management of type 2 diabetes: a systematic review and meta analysis. Diabetes, Obesity and Metabolism. 2019;21(1):15-27. https://doi.org/10.1111/dom.13499
  18. Casagrande SS, Cowie CC. Trends in dietary intake among adults with type 2 diabetes: NHANES 1988-2012. Journal of Human Nutrition and Dietetics. 2017;30(4):479-489. https://doi.org/10.1111/jhn.12443
  19. Kim DE, Hong SH, Kim J. The relations between diabetic dietary compliance, dietary intake, and physical activity and the prevalence of metabolic syndrome (MS) in type 2 diabetic patients. Korean Journal of Community Nutrition. 2015;20(5):351-361. https://doi.org/10.5720/kjcn.2015.20.5.351
  20. Park PS, Anthony K, Park MY. Evaluation of the relevance of nutritional status and dietary inflammation index to blood glucose levels in middle-aged women: in terms of 2013-2018's Korean national health and nutrition survey data. Journal of the Korea Convergence Society. 2021;12(7):69-82. https://doi.org/10.15207/JKCS.2021.12.7.069
  21. Cespedes EM, Hu FB. Dietary patterns: from nutritional epidemiologic analysis to national guidelines. The American Journal of Clinical Nutrition. 2015;101(5):899-900. https://doi.org/10.3945/ajcn.115.110213
  22. Previdelli A, de Andrade SC, Fisberg RM, Marchioni DM. Using two different approaches to assess dietary patterns: hypothesis-driven and data-driven analysis. Nutrients. 2016;8(10):593. https://doi.org/10.3390/nu8100593
  23. Oh JS, Kim H, Kim KN, Chang N. Relationship between fruit and fish intakes and cardiovascular disease risk factors in Korean women with type 2 diabetes mellitus: based on the 4th and 5th Korea National Health and Nutrition Examination Surveys. Journal of Nutrition and Health. 2016;49(5):304-312. https://doi.org/10.4163/jnh.2016.49.5.304
  24. U.S. Department of agriculture, U.S. department of health and human services. Dietary guidelines for Americans, 2020-2025. 9th ed. Washington, D.C; 2020. p 13-14.
  25. D'Agostino RB, Vasan RS, Pencina MJ, Wolf PA, Cobain M, Massaro JM, et al. General cardiovascular risk profile for use in primary care: the Framingham heart study. Circulation. 2008;117(6):743-753. https://doi.org/10.1161/CIRCULATIONAHA.107.699579
  26. Kwon HS, Song KH, Yu JM, Kim DS, Shon HS, Ahn KJ, et al. Framingham risk score assessment in subjects with pre-diabetes and diabetes: a cross-sectional study in Korea. Journal of Obesity & Metabolic Syndrome. 2021;30(3):261-270. https://doi.org/10.7570/jomes20137
  27. The Korean Nutrition Society. Dietary reference intakes for Koreans 2020. Sejong: Ministry of Health and Welfare; 2020. p. 2-200.
  28. Susan GD. Nutrition essentials for nursing practice. 8th ed. Philadelphia: Wolters Kluwer; 2013. p. 440-466.
  29. Guzder RN, Gatling W, Mullee MA, Mehta RL, Byrne CD. Prognostic value of the Framingham cardiovascular risk equation and the UKPDS risk engine for coronary heart disease in newly diagnosed type 2 diabetes: results from a United Kingdom study. Diabetic Medicine. 2005;22(5):554-562. https://doi.org/10.1111/j.1464-5491.2005.01494.x
  30. Feldman EL, Stevens MJ, Thomas PK, Brown MB, Canal N, Greene DA. A practical two-step quantitative clinical and electrophysiological assessment for the diagnosis and staging of diabetic neuropathy. Diabetes Care. 1994;17(11):1281-1289. https://doi.org/10.2337/diacare.17.11.1281
  31. Kaymaz S, Alkan H, Karasu U, Cobankara V. Turkish version of the Michigan Neuropathy Screening Instrument in the assessment of diabetic peripheral neuropathy: a validity and reliability study. Diabetology International. 2020;11(3):283-292. https://doi.org/10.1007/s13340-020-00427-9
  32. Bae JM. An illustrated guide to medical statistics using SPSS. 14th ed. Seoul: Hannarae; 2012. p 42-46.
  33. Kim HS, Jeong SH. Identification of subgroups with poor glycemic control among patients with type 2 diabetes mellitus: based on the Korean National Health and Nutrition Examination Survey from KNHANES VII (2016 to 2018). Journal of Korean Biological Nursing Science. 2021;23(1):31-42. https://doi.org/10.7586/jkbns.2021.23.1.31
  34. Zhang X, Chen X, Xu Y, Yang J, Du L, Li K, et al. Milk consumption and multiple health outcomes: umbrella review of systematic reviews and meta-analyses in humans. Nutrition & Metabolism. 2021;18(1):7. https://doi.org/10.1186/s12986-020-00527-y
  35. Gomes JMG, de Assis Costa J, de Melo Ribeiro PV, Alfenas RDCG. High calcium intake from fat-free milk, body composition and glycaemic control in adults with type 2 diabetes: a randomised crossover clinical trial. The British Journal of Nutrition. 2019;122(3):301-308. https://doi.org/10.1017/S0007114519001259