Browse > Article
http://dx.doi.org/10.5762/KAIS.2018.19.10.243

Effect of Glucose Control, SDSCA and Quality of Life of D-chiro-inositol(DCI) in patients with type 2 diabetes: A Path Analysis  

Kang, Young Mi (Research Center for Endocrine and Metabolic Diseases, Chungnam National University Hospital)
Kim, Hyun Jin (Division of Endocrinology and Metabolism, Chungnam National University Hospital)
Lee, Tae-Yong (Department of Preventive Medicine, Chungnam National University College of Medicine)
Ku, Bon-Jeong (Division of Endocrinology and Metabolism, Chungnam National University Hospital)
Publication Information
Journal of the Korea Academia-Industrial cooperation Society / v.19, no.10, 2018 , pp. 243-253 More about this Journal
Abstract
This study aimed to investigate the effects of DCI on glucose control, quality of life(SF-36 Version 2.0, Korean) and SDSCA(Summary of Diabetes Self-Care Activities) in patients with type 2 diabetes mellitus. A randomized, double-blind, placebo-controlled study was performed on 46 patients with HbA1c 7.0% taking triple anti-diabetic drug regimen who visited the department of Endocrinology and Metabolism in Chungnam National University Hospital between March 2015 and May 2016. As a result, DCI treatment in the intervention group resulted in significantly reduced HbA1c levels $8.75{\pm}0.79%$(baseline), $8.36{\pm}1.03%$(after 12weeks), and $8.65{\pm}0.81%$(after 24weeks). However, patients in the control group did not show any significant change. Interestingly, both DCI treatment group and the control group significantly showed improvements in SDSCA. Participants in the intervention group showed a small yet significant improvement in their only fasting blood glucose test in SDSCA and revealed significant increase in the quantitative levels of quality of life, from $73.05{\pm}16.85$ to $82.74{\pm}10.68$. By using pathway analysis, improvement of SDSCA scores(${\beta}=-0.505$, t=-2.743) was the most influential factor to the fasting blood glucose. The quality of life of patients with type 2 diabetes mellitus was affected by changes of SDSCA scores(${\beta}=0.411$, t=2.024) and fasting c-peptide(${\beta}=-0.445$, t=-2.668) in DCI treatment group. In conclusion, treatment of DCI effectively improved glucose control in patients with type 2 DM(HbA1c level>7.0%) after 12 weeks of treatment, although it had no impact on glucose control after 24 weeks of treatment. Improved glucose control may encourage diabetic patients to conduct self-care activities and improve the quality of life. Based on the present study, we suggest that diabetes self-management, as well as consideration of comprehensive laboratory findings, may be important factor in regulating the quality of life in type 2 DM patients.
Keywords
Type 2 diabetes mellitus; D-chiro-inositol; Glucose Control; SDSCA; Quality of Life;
Citations & Related Records
Times Cited By KSCI : 1  (Citation Analysis)
연도 인용수 순위
1 F. Faul, E. Erdfelder, A. G. Lang, A. Buchner, "G*Power 3: A flexible statistical power analysis program for the social, behavioral, and biomedical sciences", Behavior Research Methods, Vol.39, No.2, pp.175-191, 2007. DOI: https://dx.doi.org/10.3758/BF03193146   DOI
2 Korean Society for the Study of Obesity. Obesity Treatment Guidelines. 2017. Available From: http://www.kosso.or.kr
3 D. J. Toobert, S. E. Hampson, R. E. Glasgow, "The summary of diabetes self-care activities measure: Results from 7 studies and a revised scale", Diabetes Care, Vol.23, No.7, pp.943-950, 2000. DOI: https://dx.doi.org/10.2337/diacare.23.7.943   DOI
4 S. J. Jang, H. Park, H. Kim, S. J. Chang, "Factors Influencing Physical Activity among Community-dwelling Older Adults with Type 2 Diabetes: A Path Analysis", Journal of Korean Academy of Nursing, Vol.45, No.3, pp.329-336, 2015. DOI: https://dx.doi.org/10.4040/jkan.2015.45.3.329   DOI
5 S. K. Min, C. I. Lee, K. I. Kim, S. Y. Suh, D. K. Kim, "Development of Korean Version of WHO Quality of Life Scale Abbreviated Version(WHOQOL-BREF)", J Korean Neuropsychiatr Assoc, Vol.39, No.3, pp.571-579, 2000.
6 S. Fukuhara, J. E. Ware Jr, M. Kosinski, S. Wada, B. Gandek, "Psychometric and clinical tests of validity of the Japanese SF-36 Health Survey", Journal of Clinical Epidemiology, Vol.51, No.11, pp.1045-1053, 1998. DOI: https://dx.doi.org/10.1016/S0895-4356(98)00096-1   DOI
7 Y. M. Seo, W. H. Choi, "A Predictive Model on Self Care Behavior for Patients with Type 2 Diabetes: Based on Self-Determination Theory", Journal of Korean Academy of Nursing, Vol.41, No.4, pp.491-499, 2011. DOI: http://doi.org/10.4040/jkan.2011.41.4.491   DOI
8 Y. A. Lim, Y. C. Cho, "Covariance Structure Analysis of the Influence of Social Support, Physical and Mental Health Status on Quality of Life among the Elderly at Care Facilities", Journal of the Korea Academia-Industrial cooperation Society, Vol.18, No.8, pp.210-220, 2017. DOI: http://doi.org/10.5762/KAIS.2017.18.8.210   DOI
9 C. Mensing, J. Boucher, M. Cypress, K. Weinger, K. Mulcahy, P. Barta, G. Hosey, W. Kopher, A. Lasichak, B. Lamb, M. Mangan, J. Norman, J. Tanja, L. Yauk, K. Wisdom, C. Adams, "National Standards for Diabetes Self-Management Education", Diabetes Care, Vol.30, No.S1, pp.S96-S103, 2007. DOI: https://dx.doi.org/10.2337/dc07-S096   DOI
10 J. H. Jung, J. H. Lee, J. W. Noh, J. E. Park, H. S. Kim, J. W. Yoo, B. R. Song, J. R. Lee, M. H. Hong, H. M. Jang, Y. Na, H. J. Lee, J. M. Lee, Y. G. Kang, S. Y. Kim, K. H. Sim, "Current Status of Management in Type 2 Diabetes Mellitus at General Hospitals in South Korea", Diabetes & Metabolism Journal, Vol.39, No.4, pp.307-315, 2015. DOI: https://dx.doi.org/10.4093/dmj.2015.39.4.307   DOI
11 Y. J. Kim, N. S. Seo, S. J. Kim, I. S. Park, S. J. Kang, "Quality of Life and Its Correlated Factors among Elderly People with Diabetes in a Community", The Korean Journal of Health Service Management, Vol.8, No.1, pp.75-86, 2014. DOI: https://dx.doi.org/10.12811/kshsm.2014.8.1.075   DOI
12 Y. M. Jeong, M. Y. Kim, "Comparison of HbA1c, selfcare, and quality of life between depressive patients and non-depressive patients in type 2 diabetic patients", J Korean Acad Fundam Nurs, Vol.19, No.3, pp.353-361, 2012.   DOI
13 A. Altinok, K. Marakoglu, N. C. Kargin, "Evaluation of quality of life and depression levels in individuals with Type 2 diabetes", Journal of Family Medicine and Primary Care, Vol.5, No.2, pp.302-308, 2016. DOI: https://dx.doi.org/10.4103/2249-4863.192358   DOI
14 J. Gao, J. Wang, P. Zheng, R. Haardorfer, M. C. Kegler, Y. Zhu, H. Fu, "Effects of self-care, self-efficacy, social support on glycemic control in adults with type 2 diabetes", BMC Family Practice, Vol.14, Aritcle ID 66, pp.1-6, 2013. DOI: https://dx.doi.org/10.1186/1471-2296-14-66   DOI
15 D. Li, J. Inouye, J. Davis, R. F. Arakaki, "Associations between Psychosocial and Physiological Factors and Diabetes Health Indicators in Asian and Pacific Islander Adults with Type 2 Diabetes", Nursing Research and Practice, Vol.2013, Article ID 703520, pp.1-7, 2013. DOI: https://dx.doi.org/10.1155/2013/703520
16 S. H. Bates, R. B. Jones, C. J. Bailey, "Insulin-like effect of pinitol", British Journal of Pharmacology, Vol.130, No.8, pp.1944-1948, 2000. DOI: https://dx.doi.org/10.1038/sj.bjp.0703523   DOI
17 J. Meece, "Dispelling Myths and Removing Barriers About Insulin in Type 2 Diabetes", The Diabetes Educator, Vol.32, No.1, pp.9S-18S, 2006. DOI: https://dx.doi.org/10.1177/0145721705285638   DOI
18 M. J. Kim, K. H. Yoo, H. S. Park, S. M. Chung, C. J. Chin, Y. S. Choi, C. H. Chung, "Effect of Pinitol on Glucose Metabolism and Adipocytokines in Uncontrolled Type 2 Diabetes Mellitus", The Journal of Korean Diabetes Association, Vol.29, No.4, pp.344-351, 2005.
19 I. Varela-Nieto, Y. Leon, H. N. Caro, "Cell signalling by inositol phosphoglycans from different species", Comparative Biochemistry and Physiology Part B: Biochemistry and Molecular Biology, Vol.115, No.2, pp.223-241, 1996. DOI: https://dx.doi.org/10.1016/0305-0491(96)00087-9   DOI
20 B. J. Ku, H. J. Kim, K. S. Park, "The clinical study to evaluate the safety and efficacy of D-chiro-inositol in patients with type 2 diabetes", The Korean Association Journal of Medicine, Vol.72, No.1, pp.29-36, 2007.
21 M. J. Kim, K. H. Yoo, J. H. Kim, Y. T. Seo, B. W. Ha, J. H. Kho, Y. G. Shin, C. H. Chung, "Effect of pinitol on glucose metabolism and adipocytokines in uncontrolled type 2 diabetes", Diabetes Research and Clinical Practice, Vol.77, No.3, pp.S247-S251, 2007. DOI: https://dx.doi.org/10.1016/j.diabres.2007.01.066   DOI
22 H. J. Kim, K. S. Park, S. K. Lee, K. W. Min, K. A. Han, Y. K. Kim, B. J. Ku, "Effects of Pinitol on Glycemic Control, Insulin Resistance and Adipocytokine Levels in Patients with Type 2 Diabetes Mellitus", Annals of Nutrition Metabolism, Vol.60, No.1, pp.1-5, 2011. DOI: https://dx.doi.org/10.1159/000334834   DOI
23 H. J. Kim, K. S. Park, S. K. Lee, K. W. Min, K. A. Han, Y. K. Kim, B. J. Ku, "Effects of Pinitol on Glycemic Control, Insulin Resistance and Adipocytokine Levels in Patients with Type 2 Diabetes Mellitus", Annals of Nutrition Metabolism, Vol.60, No.1, pp.1-5, 2011. DOI: https://dx.doi.org/10.1159/000334834   DOI
24 J. Larner, L. C. Huang, C. F. Schwartz, A. S. Oswald, T. Y. Shen, M. Kinter, G. Tang, K. Zeller, "Rat liver insulin mediator which stimulates pyruvate dehydrogenase phosphatase contains galactosamine and D-chiroinositol", Biochemical and Biophysical Research Communications, Vol.151, No.3, pp.1416-1426, 1988. DOI: https://dx.doi.org/10.1016/S0006-291X(88)80520-5   DOI
25 H. K. Ortmeyer, L. C. Huang, L. Zhang, B. C. Hansen, L. Larner, "Chiroinositol deficiency and insulin resistance. II. Acute effects of D-chiroinositol administration in streptozotocin-diabetic rats, normal rats given a glucose load, and spontaneously insulin-resistant rhesus monkeys", Endocrinology, Vol.132, No.2, pp.646-651, 1993. DOI: https://dx.doi.org/10.1210/endo.132.2.8425484   DOI
26 A. S. Kennington, C. R. Hill, J. Craig, C. Bogardus, I. Raz, H. K. Ortmeyer, B. C. Hansen, G. Romero, J. Larner, "Low Urinary chiro-Inositol Excretion in Non-Insulin-Dependent Diabetes Mellitus", The New England Journal of Medicine, Vol.323, No.6, pp.373-378, 1990. DOI: https://dx.doi.org/10.1056/NEJM199008093230603   DOI
27 A. Davis, M. Christiansen, J. F. Horowitz, S. Klein, M. K. Hellerstein, R. E. Ostlund Jr, "Effect of pinitol treatment on insulin action in subjects with insulin resistance", Diabetes Care, Vol.23, No.7, pp.1000-1005, 2000. DOI: https://dx.doi.org/10.2337/diacare.23.7.1000   DOI
28 S. A. Kim, M. S. Song, "The Relation between Glucose Control, Self-care and Depression in Community Dwelling Older Adults with Diabetes", Perspectives in Nursing Science, Vol.9, No.2, pp.94-101, 2012.
29 Korean Diabetes Association. Diabetes fact sheet in Korea 2016. Available From: http://www.diabetes.or.kr
30 J. H. Ohn, J. H. Lee, E. S. Hong, B. K. Koo, S. W. Kim, K. H. Yi, M. K. Moon, "Subjective Assessment of Diabetes Self- Care Correlates with Perceived Glycemic Control but not with Actual Glycemic Control", Diabetes & Metabolism Journal, Vol.39, No.1, pp.31-36, 2015. DOI: https://dx.doi.org/10.4093/dmj.2015.39.1.31   DOI