• Journal of Nutrition and Health
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• 제40권6호
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• pp.509-516
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• 2007

The purpose of this study was to investigate the impact DM duration on cardiovascular disease risk factors in Korean Type 2 diabetes mellitus patients. The subject were 250 (male: 134, female: 118) Korean Type 2 DM patients recruited from a general hospital's DM clinic. Anthropometric and hematological variables and dietary intake were assessed. The subject's mean age was 60.2 years and duration of diabetes was 9.5 years. As far as DM duration was concerned, male subjects with long duration (${\geq}$ 5 years and longer) showed significantly lower weight, fat free mass, skeletal muscle mass, BMI (p < 0.05) and higher 2hrs-postprandial plasma glucose (p < 0.05) and concentration of Hemoglobin A1c (p < 0.01) compared to those with less 5years of duration. In female subjects, same trend was found. Female subjects with long duration (${\geq}$ 5 years and longer) showed significantly higher fat free mass (p < 0.05) and skeletal muscle mass (p < 0.05), Hemoglobin A1c (p < 0.01), HDL-cholesterol (p < 0.01) and triglyceride (p < 0.05), dietary intakes of protein (p < 0.05) and fat (p < 0.05) compared to those with less 5years of duration. In conclusion, Type II DM patients of long duration had higher blood lipid concentrations and higher carbohydrates intakes. Subjects followed diet prescription strictly showed lower blood lipid concentration, suggesting the effectiveness of diet to manage Type 2 DM patients.

• 대한족부족관절학회지
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• 제7권1호
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• pp.83-87
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• 2003

Purpose: To evaluate the factors which affect the level of the amputation for treatment of DM foot excluding arterial occlusion. Materials and Methods: We selected 30 patients (10 of major amputations, 20 of minor amputations) who were amputated from May, 1999 to April, 2001 because of DM foot. Major amputation is BK amputation, and minor amputation is amputation below ankle joint. Gender, age, size of the wound, extent of the necrosis, infectious organism, medical com orbidity, duration of DM and blood glucose level, duration of DM foot and treatment history were investigated. Results: In major amputations, male to female ratio was 9:1, average of the age was 63.8, the average of sizes of the wound was 16cm2, duration of DM was 15.0 years, duration of DM foot was 10.6 weeks, and 80% of patients had necrosis and the organisms were S. aureus, E. faecium, Streptococcus, P. vulgaris, average of the blood glucose levels was 301 and 40% of them had been treated for DM foot. In minor amputations, male to female ration was 9:1, average of the age was 56.6, the average of sizes of the wound was 4.8cm2, duration of DM was 11.2 years, duration of DM foot was 5.7 weeks, and 40% of patients had necrosis and the organisms were S. aureus, Streptococcus, M. morganini, E. faecium, average of the blood glucose levels was 257 and 20% of them had been treated for DM foot. Conclusion: In DM foot patients, extents of the necrosis, duration of DM, duration of DM foot, the infectious organism were significant factors to decide extent of the amputation level.

• Nutrition Research and Practice
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• 제12권1호
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• pp.69-77
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• 2018

BACKGROUND/OBJECTIVES: Metabolic risk factors should be managed effectively in patients with type 2 diabetes mellitus (T2DM) to prevent or delay diabetic complications. This study aimed to compare the self-management levels of diet and metabolic risk factors in patients with T2DM, according to the duration of illness, and to examine the trends in self-management levels during the recent decades. SUBJECTS/METHODS: Data were collected from the Korea National Health and Nutrition Examination Surveys (KNHANES, 1998-2014). In our analysis, 4,148 patients with T2DM, aged ${\geq}30years$, were categorized according to the duration of their illness (< 5 years, 5-9 years, and ${\geq}10years$). Demographic and lifestyle information was assessed through self-administered questionnaires, and biomarker levels (e.g., fasting glucose level, blood pressure, or lipid level) were obtained from a health examination. Dietary intake was assessed by a 24-recall, and adherence level to dietary guidelines (meal patterns and intake levels of calories, carbohydrates, vegetable/seaweed, sodium, and alcohol) were assessed. Multivariable generalized linear regression and unconditional logistic regression models were used to compare the prevalence rates of hyperglycemia, dyslipidemia, and hypertension according to the duration of patients' illness, accounting for the complex survey design of the KNHANES. RESULTS: In the multivariable adjusted models, patients with a longer duration (${\geq}10years$) of T2DM had a higher prevalence of hyperglycemia than those with a shorter duration of T2DM (< 5 years) (odds ratio 2.20, 95% confidence interval 1.61-3.01, P for trend < 0.001). We did not observe any associations of disease duration with the prevalence of hypertension and dyslipidemia. In addition, the adherence levels to dietary recommendations did not significantly differ according to disease duration, except adherence to moderate alcohol consumption. There were significant decreasing trends in the prevalence of hyperglycemia in patients with a duration of illness ${\geq}10years$ (P for trend = 0.004). CONCLUSION: Although the proportion of patients with adequate control of glucose levels has improved in recent decades, poorer self-management has been found in those with a longer disease duration. These findings suggest the need for well-planned and individualized patient education programs to improve self-management levels and quality of life by preventing or delaying diabetic complications.

• 보건행정학회지
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• 제20권1호
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• pp.125-136
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• 2010

Objectives: The purpose of this study is to analyze the proportion of fundus examination of DM patients for preventing microvascular complication and to examine the factors related to fundus examination in DM patients. Methods: This study used 2005 Korean national health and nutrition survey data. We selected all 1,129 diabetes mellitus patients from the data. And we choose 8 factors related to diabetes mellitus patients. These are sex, age group, type of residential area(rural or urban), education level, income level, comorbidity with hypertension, current insulin use, and duration of suffering from DM. We have analysed these factors by whether he had been examined fundus or no through Chi-square and logistic regression analysis. Results: Female DM patients have tendency to get more fundus examination than Male DM patients. And Young patients, patients who live in urban area, well educated patients, high income patients, comorbidity with hypertension, patients have got the insulin injection, patients have long duration of suffering from DM are to get more fundus examination. According to multivariate logistic regression analysis, sex and education level, income level, and duration of suffering from DM, comorbidity with hypertension, patients have got the insulin injection are significant factors on fundus examination for prevent microvascular diabetes mellitus complications. Conclusions and Discussion: We have concluded that physicians and policy makers should consider to fundus examination especially of man and DM patients who have more shorter disease period and low educated patients and low incomed patients and patients who have taken insulin therapy.

• Childhood Kidney Diseases
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• 제12권2호
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• pp.250-255
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• 2008

당뇨병은 인슐린 분비 또는 인슐린 작용의 장애로 발생하는 대사질환이다. 그 중 제1형 당뇨병은 흔히 혈당 조절이 어려우며 눈과 신장을 침범하는 미세혈관합병증이 발생할 수 있다. 당뇨병성 신병증은 소아에서 흔하지 않지만 신부전까지 일으킬 수 있는 심각한 질환이다. 그런데, 많은 연구들에서 당뇨병이 사춘기 전에 발생하는 경우보다 사춘기나 그 이후에 발생하는 경우에 미세혈관 합병증의 발생이 증가한다는 사실이 알려졌다. 사춘기 전에 발생한 소아 당뇨병성 신병증은 국내에서 보고된 예가 거의 없는 상태로, 저자들은 여러 차례의 당뇨병성 케톤산혈증의 과거력이 있으며 혈당 조절이 불량했던 제 1형 당뇨병 소아 환자에서 혈뇨와 단백뇨가 관찰되어 조직 검사를 통해 사춘기 전에 발생한 당뇨병성 신병증을 확진한 1례를 경험하였기에 문헌고찰과 함께 보고하는 바이다.

• 한국콘텐츠학회논문지
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• 제18권12호
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• pp.208-217
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• 2018

당뇨병 유병기간에 따른 심혈관 질환의 혈청학적, 합병증의 양상을 국민건강영양조사 6기(2013-2015)의 모든 가용 데이터를 사용하여 당뇨병 환자의 치료뿐 아니라 향후 관리에 대한 정보를 제공함에 목적을 두고 있다. 국민건강영양조사는 건강 설문, 검진, 영양조사로 이루어져 있으며, 18~80세 미만으로 나이를 제한하였고, 당뇨병 유병기간을 응답한 1,316명을 조사 대상으로 하였다. 당뇨병 유병기간에 따라 0-5, 6-10, 11-15, 16-20, 20년 이상으로 구분하였다. 당뇨병 유병기간이 길어질수록 나이는 많아지고, BMI는 낮고, 흡연자의 비율은 떨어지며, HbA1c는 상승하고 사구체 여과율은 낮아졌다. 총 콜레스테롤, LDL-C, 중성 지방 수치는 낮고, HDL-C 수치는 비슷하였다. 인슐린 및 경구용 항고혈당제제를 치료 받는 환자의 비율은 증가하였다. 당뇨병 기간이 길수록 혈당 조절이 악화되었고, 미세혈관 및 대혈관합병증의 위험도는 상승하였다. 이러한 합병증을 예방하기 위해 집중적인 치료와 모니터링으로 위험요인을 통제해야 할 것이다.

• 보건행정학회지
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• 제29권1호
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• pp.68-76
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• 2019

Background: This study investigates the association between sleep duration and diabetes mellitus (DM) in a large representative population-based survey in South Korea. Methods: The fourth (2007-2009), fifth (2010-2012), and sixth (2013) Korea National Health and Nutrition Examination Survey data sets were used. A total of 37,989 individuals were selected for the study. Chi-square tests and multivariate logistic regression analyses were used to analyze whether general characteristics, health status, and health risk behaviors were associated with DM. Results: After adjusting for confounders, the odds of DM in short sleepers (${\leq}5hr/day$) and long sleepers (${\geq}9hr/day$) were 1.033-times higher (95% confidence interval [CI], 0.913-1.169) and 1.334-times higher (95% CI, 1.140-1.562), respectively, compared with individuals who slept 7 hr/day. Subgroup analysis according to gender showed a U-shaped association for both genders, although it appeared stronger in men. Conclusion: This study identified a U-shaped association between sleep duration and the risk for DM. Additional studies should help clarify the important information in this study.

• Asian Pacific Journal of Cancer Prevention
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• 제14권1호
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• pp.441-447
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• 2013

Background: Prior studies examining the relation between diabetes mellitus (DM) and prostate cancer risk have reported controversial findings. We examined this association by conducting a detailed meta-analysis of the peer-reviewed literature. Methods: A comprehensive search for articles of MEDLINE and EMBASE databases and bibliographies of retrieved articles published up to November, 2012 was performed. Methodological quality assessment of the trials was based on the Newcastle-Ottawa Scaleq and the meta-analysis was performed using STATA 12.0. Dose-response regression was conducted with SPSS 19.0. Results: We included 29 studies in the meta-analysis (13 case-control studies, 16 cohort studies), and found an inverse association between DM and prostate cancer (relative risk (RR) 0.84, 95% confidence interval (CI), 0.78-0.91). An inverse association was also observed in non-Asian populations (RR 0.81, 95% CI 0.76-0.87) and population-based studies (RR 0.80, 95% CI 0.77-0.91). No statistical significance was found of the association between prostate cancer risk and the duration of DM (p=0.338), and risk seemed not related with the age of DM diagnosis. Conclusions: This study suggested an inverse relationship between DM and prostate cancer, but without links to duration of disease or age of diagnosis.

• Journal of Yeungnam Medical Science
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• 제36권3호
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• pp.183-191
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• 2019

Some patients with type 1 and type 2 diabetes mellitus (DM) present with cognitive dysfunctions. The pathophysiology underlying this complication is not well understood. Type 1 DM has been associated with a decrease in the speed of information processing, psychomotor efficiency, attention, mental flexibility, and visual perception. Longitudinal epidemiological studies of type 1 DM have indicated that chronic hyperglycemia and microvascular disease, rather than repeated severe hypoglycemia, are associated with the pathogenesis of DM-related cognitive dysfunction. However, severe hypoglycemic episodes may contribute to cognitive dysfunction in high-risk patients with DM. Type 2 DM has been associated with memory deficits, decreased psychomotor speed, and reduced frontal lobe/executive function. In type 2 DM, chronic hyperglycemia, long duration of DM, presence of vascular risk factors (e.g., hypertension and obesity), and microvascular and macrovascular complications are associated with the increased risk of developing cognitive dysfunction. The pathophysiology of cognitive dysfunction in individuals with DM include the following: (1) role of hyperglycemia, (2) role of vascular disease, (3) role of hypoglycemia, and (4) role of insulin resistance and amyloid. Recently, some investigators have proposed that type 3 DM is correlated to sporadic Alzheimer's disease. The molecular and biochemical consequences of insulin and insulin-like growth factor resistance in the brain compromise neuronal survival, energy production, gene expression, plasticity, and white matter integrity. If patients claim that their performance is worsening or if they ask about the effects of DM on functioning, screening and assessment are recommended.

• 대한임상검사과학회지
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• 제52권3호
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• pp.188-193
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• 2020

뇌졸중은 사망발생 및 장애를 일으키는 주요 원인 질환이며, 당뇨병은 뇌졸중의 주요 위험인자이다. 당뇨병 환자가운데 뇌졸중을 동반한 환자에서 적정 혈압 관리의 중요성을 알아보고자 한다. 제6기 국민건강영양조사 자료를 바탕으로 18세 이상 80세 미만자 총 16,389명을 대상으로 회귀분석을 통하여 당뇨병 유병기간에 따른 혈압조절을 통한 뇌졸중의 위험도를 산정하였다. 당뇨병 유무에 따른 뇌졸중의 유병률은 당뇨병 환자 군에서 높았고, 당뇨병의 유병기간이 길어질수록 고혈압과 뇌졸중의 위험도는 상승하였으며, 당뇨병과 고혈압에 대한 치료 비율은 높았다. 고혈압군에 비해 적정 혈압 유지군(<140/<90 mmHg)에서 뇌졸중 위험비(HR)는 0.57 낮았다. 당뇨병과 고혈압에 대한 치료가 동반됨에도 불구하고 고혈압의 빈도는 상승하였고, 당뇨병 유병기간 5년 이후 뇌졸중의 유병률이 상승함에 따라 이 시기의 효과적인 혈압관리가 더욱 중요하다. 당뇨병 환자에서 지속적으로 적정 혈압으로 관리함으로써 뇌졸중 위험도를 낮추는 것이 중요하다.