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Blood Biochemical Characteristics, Dietary Intake, and Risk Factors Related to Poor HbA1c Control in Elderly Korean Diabetes Patients: Comparison between the 4th(2007-2009) and the 7th(2016-2018) Korea National Health and Nutrition Examination Surveys

한국 당뇨병 노인의 혈액생화학적 특성, 식이 섭취, 당화혈색소 관련 위험 요인 및 위험도: 국민건강영양조사 제4기(2007-2009)와 제7기(2016-2018) 비교

  • Oh, Sung-Won (Department of Food Science & Human Nutrition, Graduate School, Jeonbuk National University) ;
  • Kim, Sook-Bae (Department of Food Science & Human Nutrition, Research Institute of Human Ecology, Jeonbuk National University)
  • 오성원 (전북대학교 대학원 식품영양학과) ;
  • 김숙배 (전북대학교 식품영양학과.인간생활과학연구소)
  • Received : 2022.09.29
  • Accepted : 2022.10.25
  • Published : 2022.10.31

Abstract

Objectives: The purpose of this study was to investigate the blood biochemical characteristics, comorbidities, dietary intake, and other risk factors leading to poor glycated hemoglobin (HbA1c) control in elderly Korean diabetes patients over 65 years of age. Methods: Data from the 4th (2007-2009) and the 7th (2016-2018) Korea National Health and Nutrition Examination Surveys (KNHANES) were used. Socio-demographic characteristics (age, gender, region, household income, education level, marital status, nutrition education, diabetes duration and diabetes treatment), lifestyle characteristics (drinking, smoking, regular walking, and subjective health perception), anthropometric characteristics (height, weight, and waist circumference), blood biochemical characteristics (HbA1c, high- density lipoprotein cholesterol, triglycerides, total cholesterol, blood urea nitrogen, and blood creatinine), co-morbidities (obesity, hypertension, hypercholesterolemia, hypertriglyceridemia, and anemia), energy and nutrients intake, food group intake, and HbA1c control-related risk factors were compared. Results: Compared to the 4th survey, the 7th survey showed an increase in diabetes prevalence among men, an increase in the prevalence of diabetes in the older patients, and an increase in the duration of diabetes. The energy ratio from carbohydrate consumption in the 7th survey was lower than in the 4th. Compared to the 4th survey, thiamine and riboflavin intake had improved, and the intakes of vitamin A, vitamin C, and niacin had worsened in the 7th. A comparison of food group intakes showed that there was a decrease in the consumption of whole grains, potatoes, and milk and an increase in the intake of beverages and alcoholic beverages. The risk factors for poor control of HbA1c were the duration of diabetes and co-morbid hypertriglyceridemia in the 4th survey, whereas subjective health perception, obesity, and hypercholesterolemia as co-morbidities were found to be risk factors in the 7th in addition to the risk factors highlighted in the 4th survey. Conclusions: For the future management of elderly Korean diabetes patients, greater care is indicated for men over 75 years, and those with low levels of education. It is necessary to increase the intake of milk and vegetables, and reduce the intake of beverages and alcoholic beverages. In addition, it is necessary to reduce the incidence of obesity, hypercholesterolemia, and hypertriglyceridemia for proper control of blood sugar.

Keywords

References

  1. Statistics Korea. Future population estimation [Internet]. Statistic Korea; 2021 [updated 2021 Dec 9; cited 2022 Aug 17]. Available from: https://kosis.kr/statHtml/statHtml.do?mode=tab&orgId=101&tblId=DT_1BPA003.
  2. World Health Organization. Global report on diabetes. Geneva: World Health Organization; 2016. p. 6-9.
  3. Statistics Korea. Causes of death statistics in 2020 [Internet]. Statistics Korea; 2020 [cited 2022 Jun 9]. Available from: http://kostat.go.kr.
  4. Jung CH, Son JW, Kang SA, Kim WJ, Kim HS, Kim HS et al. Diabetes fact sheets in Korea, 2020: An appraisal of current status. Diabetes Metab J 2021; 45(1): 1-10. https://doi.org/10.4093/dmj.2020.0254
  5. Chentli F, Azzoug S, Mahgoun S. Diabetes mellitus in elderly. Indian J Endocrinol Metab 2015; 19(6): 744-752. https://doi.org/10.4103/2230-8210.167553
  6. Korean Diabetes Association. 2021 Clinical practice guidelines for diabetes. Seoul: Korean Diabetes Association; 2021. p. 243-249.
  7. American Diabetes Association. 3. Prevention or delay of type 2 diabetes and associated comorbidities: Standards of Medical Care in Diabetes-2022. Dibetes Care 2022; 45(S1): S39-S45. https://doi.org/10.2337/dc22-S003
  8. Lemon CC, Lacey K, Lohse B, Hubacher DO, Klawitter B, Palta M. Outcomes monitoring of health, behavior, and quality of life after nutrition intervention in adults with type 2 diabetes. J Am Diet Assoc 2004; 104(12): 1805-1815. https://doi.org/10.1016/j.jada.2004.09.024
  9. Kang HJ, Shin EM, Kim KW. Evaluation of nutrition education for diabetes mellitus management of older adults. Korean J Community Nutr 2009; 14(6): 734-745.
  10. Kang HJ. Current status and effects of nutrition education programs for diabetic patients in Korea. J Korean Diabetes 2018; 19(2): 106-112. https://doi.org/10.4093/jkd.2018.19.2.106
  11. Park HN. Relationship between diabetes education and treatment of aged patients in South Korea [master's thesis]. Yonsei University; 2017.
  12. Gu MO. Factors influencing glycemic control among type 2 diabetes mellitus patients: The sixth Korea National Health and Nutrition Examination Survey (2013~2015). Korean J Adult Nurs 2019; 31(3): 235-248. https://doi.org/10.7475/kjan.2019.31.3.235
  13. Pyo EY, Jung MH, Kim YS. Factors related to blood glucose control in patients with diabetes. Korean J Health Educ Promot 2012; 29(3): 15-22.
  14. 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). J Korean Biol Nurs Sci 2021; 23(1): 31-42. https://doi.org/10.7586/jkbns.2021.23.1.31
  15. Kang YJ, Park K. Health-related quality of life in elderly patients with diabetes mellitus according to age: Based on Korea National Health and Nutrition Examination Survey. J Nutr Health 2020; 53(2): 129-140. https://doi.org/10.4163/jnh.2020.53.2.129
  16. Kim DM, Kim KH. The changes in obesity prevalence and dietary habits in Korean adults by residential area during the last 10 years: Based on the 4th (2007-2009) and the 7th (2016-2018) Korea National Health and Nutrition Examination Survey Data. Korean J Community Nutr 2021; 26(1): 37-47. https://doi.org/10.5720/kjcn.2021.26.1.37
  17. Cho SK, Park K. Trends in metabolic risk factors among patients with diabetes mellitus according to income levels: The Korea National Health and Nutrition Examination Surveys 1998-2014. J Nutr Health 2019; 52(2): 206-216. https://doi.org/10.4163/jnh.2019.52.2.206
  18. Korean Society for the Study of Obesity (KSSO). Diagnosis and evaluation of obesity [Internet]. Korean Society for the Study of Obesity; 2022 [cited 2022 Aug 4]. Available from: http://general.kosso.or.kr/html/?pmode=obesityDiagnosis.
  19. The Korean Society of Lipid and Atherosclerosis. Dyslipidemia_diagnostic criteria [Internet]. The Korean Society of Lipid and Atherosclerosis [cited 2022 Aug 4]. Available from: https://www.lipid.or.kr/artery/diagnose1_2.php.
  20. The Korean Nutrition Society. Dietary reference intakes for Koreans. 1st revision. Seoul: The Korean Nutrition Society; 2010. p. xxv-xxix
  21. Jang SR. Chronic illnesses and limited daily activities in the Korean elderly. Proceedings of the Health and Welfare Policy Forum. 2015 Jul: p. 6-17.
  22. Ogurtsova K, da Rocha Fernandes JD, Huang Y, Linnenkamp U, Guariguata L, Cho NH et al. IDF Diabetes Atlas: Global estimates for the prevalence of diabetes for 2015 and 2040. Diabetes Res Clin Pract 2017; 128: 40-50. https://doi.org/10.1016/j.diabres.2017.03.024
  23. Cavelaars AEJM, Kunst AE, Geurt JJM, Helmart U, Lundberg O, Mielck A et al. Morbidity differences by occupational class among men in seven European countries: An application of the Erikson-Goldthorpe social class scheme. Int J Epidemiol 1998; 27(2): 222-230. https://doi.org/10.1093/ije/27.2.222
  24. Kim HR. The relationship of socioeconomic position and health behaviors with morbidity in Seoul, Korea. Health Soc Welf Rev 2005; 25(2): 3-35.
  25. Badedi M, Solan Y, Darraj H, Sabai A, Mahfouz M, Alsabaani A et al. Factors associated with long-term control of type 2 diabetes mellitus. J Diabetes Res 2016; 1-21.
  26. Lee YM, Choi YR, Park HR, Song KH, Lee KE, Yoo CH et al. Comparative analysis of dietary behavior and nutrient intake of elderly in urban and rural areas for development of "Village Lunch Table" program: Based on 2014 Korea National Health and Nutrition Examination Survey data. J Nutr Health 2017; 50(2): 171-179. https://doi.org/10.4163/jnh.2017.50.2.171
  27. Badawi G, Schmitz N, Garipy G. Self-rated health in diabetes: Should the question be the first administered? Diabetes Res Clin Pract 2012; 97(2): e27-30. https://doi.org/10.1016/j.diabres.2012.05.007
  28. Sherifali D, Bai JW, Kenny M, Warren R, Ali MU. Diabetes self-management programmes in older adults: A systematic review and metaanalysis. Diabet Med 2015; 32(11): 1404-1414. https://doi.org/10.1111/dme.12780
  29. Yoo JS, Lee SJ, Lee HC, Kang ES, Kim SH, Park EJ. The effects of short term comprehensive life style modification program on glycemic metabolism, lipid metabolism and body composition in type 2 diabetes mellitus. J Korean Acad Nurs 2004; 34(7): 1277-1287. https://doi.org/10.4040/jkan.2004.34.7.1277
  30. Shin HY, Min HS. Factors associated with sarcopenia among hemodialysis patients. J Korean Crit Care Nurs 2022; 15(1): 24-34. https://doi.org/10.34250/jkccn.2022.15.1.24
  31. Miller SL, Wolfe RR. The danger of weight loss in the elderly. J Nutr Health Aging 2008; 12(7): 487-491. https://doi.org/10.1007/BF02982710
  32. Han GS, Yang EJ. Evaluation of dietary habit and nutritional intake of Korean elderly: Data from Korea National Health and Nutrition Examination Survey 2013-2015. J East Asian Soc Diet Life 2018; 28(4): 258-271. https://doi.org/10.17495/easdl.2018.8.28.4.258
  33. Yang SH, Jang W, Kim YJ. Association between frailty and dietary intake amongst the Korean elderly: Based on the 2018 Korean National Health and Nutrition Examination Survey. J Nutr Health 2021; 54(6): 631-643. https://doi.org/10.4163/jnh.2021.54.6.631
  34. Lee SJ, Lee SM. Association of dietary quality with subjective health-related perception and chronic diseases according to age segmentation of Korean elderly. Korean J Community Nutr 2021; 26(5): 363-381. https://doi.org/10.5720/kjcn.2021.26.5.363