• 한국융합학회논문지
• /
• 제10권11호
• /
• pp.501-510
• /
• 2019

본 논문은 당뇨병의 관리전략 수립을 위해 일상생활에서 조절가능한 혈당조절 요인을 파악하고자 하였다. 개인이 조절하기 어려운 성별, 당뇨병 유병기간, 당뇨병 치료방법, 교육수준, 가구소득 등을 매칭한 코호트내 환자-대조군 디자인으로 분석을 하였다. 7기 국민건강영양조사(2016-2017) 원시자료를 이용하여, 983명의 당뇨병 환자를 분석한 결과, 289명(30%)만이 당화혈색소가 6.5% 미만으로 혈당이 조절되었다. 일상생활에서 조절이 가능한 당화혈색소 조절 요인 파악하기 위해 조건부 다변량 로짓스틱 회귀분석 시행한 결과, 매칭전 코호트에서는 당뇨병 유병기간, 당뇨병 치료 여부, 매칭 코호트에서는 체질량지수, 흡연, 안저검사가 당화혈색소 달성에 유의한 영향을 미치는 것으로 파악되었다. 본 결과는 집중 관리가 필요한 대상선정(장기 유병기간, 약물치료 대상자) 및 생활습관(체질량지수, 흡연, 안저검사 등) 관리전략을 마련하는데 근거자료로 활용되고, 지역사회내 국민건강 증진에 기여할 것으로 사료된다.

• Asian Pacific Journal of Cancer Prevention
• /
• 제14권10호
• /
• pp.5675-5680
• /
• 2013

Background: Preexisting type 2 diabetes mellitus (T2DM) affects the prognosis and mortality of patients with some cancers. Insulin like growth factor (IGF) and insulin receptor (IR) signaling axes play important roles in both cancer and diabetes development. We aimed to explore the expression characteristics of proteins in IGF/IR axis in non-small cell lung cancer (NSCLC) cases with preexisting T2DM. Methods: Fifty-five NSCLC patients with preexisting T2DM were retrospectively included and matched by 55 NSCLC without diabetes at a 1:1 ratio. The expression of proteins in IGF/IR axis was detected by immunohistochemical staining. Clinicopathological data were collected to analyze their relationship with the protein expression. Results: Both IGF 1 receptor (IGF-1R) and insulin receptor substrate 2 (IRS-2) showed higher expression in the NSCLC with T2DM group, compared with those without T2DM. The high expression of IGF-1R and IRS-2 were found to be negatively associated with lymph node metastases and T staging in the T2DM group, respectively, and IRS-2 expression was also found more in the subgroup whose T2DM duration was more than 4 years. No difference was detected in the expression of IRS-1, IGF-1, IGF-2, IGFBP3, IR and mTOR between groups with or without T2DM. Conclusion: Our study found higher expression of IGF-1R and IRS-2 proteins in NSCLC patients with preexisting T2DM, and that there was an association with early stage NSCLC, which suggested that IGF signaling may play an important early event in development of NSCLC associated with diabetes.

• Clinical and Experimental Pediatrics
• /
• 제48권6호
• /
• pp.624-633
• /
• 2005

목 적 : 본 연구는 한국인 제 1형 당뇨병 환자들에서 HLADR과 DQ 유전자형 및 갑상선 자가항체(항 TPO 자가항체와 항 thyroglobulin 자가항체)를 분석함으로써, 한국인 제 1형 당뇨병과 관련 있는 특정 HLA 유전자형을 알아보고자 하였고, 이들 제 1형 당뇨병 환자들에서의 갑상선 자가항체의 유병률, 갑상선 질환으로의 발현 및 이들 자가면역성 갑상선염과 HLA 유전자형과의 관련성을 알아보고자 하였다. 방 법 : 총 59명[남아 26명, 검사시 연령 13.7세(5.7-29.9세), 당뇨병 유병기간 7.6년(-1.7-22.5년)]의 제 1형 당뇨병 환자를 대상으로 하였고, 갑상선 질환의 병력 및 가족력이 없는 건강한 200명의 한국인의 HLA 유전자형을 대조군으로 하였다. 59명의 환자 중 갑상선 자가항체 양성인 17명은 중앙기간 3.96년(1일-10.7년) 동안 진찰 및 anti-TPO, anti-TG, $T_3$, $T_4$ 또는 free $T_4$, TSH 검사를 시행하면서 추적 관찰하였다. HLA-DR과 DQ의 유전자 분석은 PCR-SSO, PCR-SSCP, PCR-RFLP 및 PCR-SSP 방법을 이용하였다. 결 과 : 제 1형 당뇨병 환자들에서 대조군에서보다 HLADRB1*0301, *090102, DQB1*0201, *030302, DRB1*0301/*090102, DRB1*090102/*090102, DQB1*0201/*030302, *030302/*030302, *0201/*0302의 빈도가 높았다(Pc<0.05). 15명(25.4%)에서 TPO에 대한 자가항체 양성이었고, 12명(20.3%)에서 TG 자가항체 양성이었으며, 17명(28.8%)은 두 가지 항체 중 한 가지 이상의 항체를 갖고 있었다. 10명(16.9%)은 두 종류의 항체를 모두 갖고 있었다. 갑상선 항체 양성을 보인 이후부터의 추적기간 동안 갑상선기능저하증을 보인 경우는 없었다. 3명(5.1%)의 여아에서 당뇨병 진단 전 또는 후에 갑상선기능항진증이 진단(8.5세, 11세, 13.2세)되었다. 갑상선 자가항체의 유무 및 각각의 항체 종류에 따른 대상군간의 제 1형 당뇨병 진단연령, 갑상선 검사시 연령, 당뇨병 유병기간 및 성별의 차이는 보이지 않았다(P>0.05). 결 론 : 한국인에서는 HLA-DRB1*0301, *090102, DQB1*0201, *030302, DRB1*0301/*090102, *090102/*090102, DQB1*0201/*030302, *030302/*030302, *0201/*0302 등이 제 1형 당뇨병에 대한 감수성 인자였고, 코카시안과는 다른 HLA-DR 및 DQ의 분포가 한국인에서 제 1형 당뇨병의 발생률이 낮은 이유중의 하나를 차지하리라고 생각되었다. 한편, 제 1형 당뇨병 환자들에서 갑상선 자가항체 양성률은 28.8%였고, 이는 한국인 제 1형 당뇨병 환자에서도 갑상선 자가항체 검사가 규칙적으로 시행되어야 함을 시사한다고 하겠다. 한국인 제 1형 당뇨병 환자에서 자가면역성 갑상선 질환에 대한 선별검사 시작 시기와 횟수 등에 대해서는 이들 환자들의 장기적인 추적관찰을 통해 추후 좀더 연구가 필요하리라 생각된다.

• Clinical and Experimental Pediatrics
• /
• 제46권6호
• /
• pp.585-590
• /
• 2003

목 적 : 심혈관계 자율신경 기능이상은 청소년기 당뇨병 환자의 7.7-28%에서 동반되며, 당뇨병성 자율신경병증은 심장 교감 신경계 이상으로 인한 돌발성 부정맥 및 돌연사를 초래할 수 있는 것으로 보고되었다. 본 연구는 소아 및 청소년기 당뇨병 환자에서 심혈관계 자율신경 기능이상의 빈도 및 이에 영향을 미치는 인자들을 파악하여 당뇨병성 자율신경병증의 조기진단 및 치료에 도움이 되고자 시행하였다. 방 법 : 8-26세의 1형 당뇨병 환자 80명(남자 27명, 여자 53명)과 2형 당뇨병 환자 12명(남자 4명, 여자 8명)을 대상으로, 발살바 동작시 R-R 간격의 변화(발살바 비), 심호흡시 심박수의 변화, 기립시 R-R 간격의 변화(30 : 15 비), 기립성 저혈압의 4가지 항목에 대하여 검사를 시행하여 환자의 연령, 유병기간, 당화혈색소, 소변 알부민 배설량, 신경전달속도 이상 및 당뇨병성 망막증 유무와의 연관성을 분석하였다. 결 과 : 검사 당시 연령 및 평균 유병기간은 1형과 2형 당뇨병 환자간에 의미있는 차이가 없었으나, 당뇨병의 발병연령은 2형에서 더 높았다. 체질량지수는 1형에 비해 2형에서 의미있게 높았으며, 혈압 및 당화혈색소는 두 군간에 차이가 없었다. 1형 당뇨병 환자의 22.5%에서 조기, 8.7%에서 중등도, 1.3%에서 심한 자율신경병증에 해당하였으며, 2형의 경우 16.7%에서는 조기, 8.3%에서 중등도, 8.3%에서 심한 자율신경병증에 해당하였다. 전체적으로, 심혈관계 자율신경 기능 이상은 1형의 32.5%에서, 2형의 33.3% 에서 나타나 빈도에 있어서 두 군간에 차이는 보이지 않았다. 1형에서는 발살바 비와 유병기간 간에 의미있는 상관관계가 있었으며, 2형에서는 발살바 비와 연령, 심호흡시 심박수 변화와 당화혈색소, 그리고 기립성 저혈압과 유병기간 간에 의미있는 상관관계가 관찰되었다. 1형과 2형 당뇨병 환자 전체를 대상으로 시행한 로지스틱 회귀분석상, 연령(OR=1.133(1.003-1.279), P<0.05) 및 유병기간(OR=1.148(1.009-1.307), P<0.05)만이 자율신경 기능 이상의 의미있는 예측인자로 나타났으며, 당화혈색소, 혈압, 소변 알부민 배설량, 신경전달속도 이상 및 당뇨병성 망막증 유무와는 관련이 없었다. 검사항목 중 발살바 비는 31.5%의 환자에서, 심호흡시 심박수의 변화는 41.3%의 환자에서 경계역 또는 이상소견을 보인 반면, 30 : 15 비 및 혈압변화는 각각 14.1%, 9.8%에서 경계역 또는 이상소견을 보였다. 발살바 비(OR=0.001(0.000-0.083), P<0.01)와 심호흡시 심박수의 변화(OR=0.840(0.754-0.934), P<0.01)는 자율신경 기능이상 유무에 의미있게 영향을 미쳤으나, 30 : 15 비 및 기립성 저혈압은 영향을 미치지 못하였다. 결 론 : 심혈관계 자율신경 기능이상은 소아 및 청소년 당뇨병 환자의 32.6%에서 동반되었으며, 중등도 이상의 뚜렷한 자율신경 기능이상도 10.8%에서 관찰되었다. 혈당 조절이 양호한 환자에서도 자율신경계 합병증의 가능성은 배제할 수 없으며 연령 및 유병기간이 증가할수록 그 위험은 더욱 증가하였다. 소아 및 청소년기 당뇨병 환자에서 자율신경 기능검사시, 발살바 비와 심호흡시 심박수의 변화가 가장 유용한 검사 항목으로 사료된다.

• 지역사회간호학회지
• /
• 제33권4호
• /
• pp.408-417
• /
• 2022

Purpose: This study aimed to investigate the prevalence and risk factors of diabetic retinopathy (DR) in people with diabetes mellitus (DM) using Korean National Health and Nutrition Examination Survey VII (2017~2018). Methods: DM was defined as in two ways; 1) doctor's diagnosis (Group 1, n=549), 2) one of doctor's diagnosis, medication, or hyperglycemia (Group 2, n=849). The DR prevalence was measured as the prevalence proportion (%). Risk factors for developing DR were analyzed using multiple logistic regression, and odds ratios (ORs) and 95% confidence intervals (CIs) were calculated. Results: The prevalence of DR was 25.87% in Group 1 and 20.14% in Group 2. Risk factors for DR were identified as insulin therapy (Group 1: OR=5.31, Group 2: OR=5.27), DM duration ≥10 years (Group 1: OR=2.20, Group 2: OR=3.10), and systolic blood pressure ≥140 mmHg (Group 1: OR=2.26, Group 2: OR=2.23) for both groups. Conclusion: Considering the DR prevalence, eye examinations education is highly recommended as part of a diabetes management programs in the community. It is also proposed to shorten the eye examination cycle for people with risk factors and establish a referral system to link between screening to treatment.

• 가정간호학회지
• /
• 제15권2호
• /
• pp.106-114
• /
• 2008

Purpose: We analyzed the self-care behavior and metabolic control rates in diabetic patients based on the National Health and Nutrition Examination Survey in Korea (2005). Methods: The study group included 311 patients who were over 126 mg/dL on the FBS test. Data were analyzed using SPSS PC WIN 12.0. Results: The average score of self-care behavior was $12.08{\pm}1.05$ points, and significantly different according to DM treatment status, disease duration (years), admission experiences (within 1 year) and education about DM. Glucose, total cholesterol, triglycerides were decreased in self care subjects, but not significantly. Conclusion: An educational program for diabetic patients would help maintain metabolic control rates to improve self-care behavior.

• Asian-Australasian Journal of Animal Sciences
• /
• 제31권3호
• /
• pp.395-402
• /
• 2018

Objective: An experiment was conducted to evaluate effects of inclusion level of palm kernel meal (PKM) and adaptation duration on the digestible energy (DE) and apparent total tract digestibility (ATTD) of chemical constituents in diets fed to growing-finishing pigs. Methods: Thirty crossbred barrows ($Duroc{\times}Landrace{\times}Large\;White$) with an average initial body weight of $85.0{\pm}2.1kg$ were fed 5 diets in a completely randomized design. The diets included a corn-soybean meal basal diet and 4 additional diets in which corn and soybean meal were partly replaced by 10%, 20%, 30%, or 40% PKM. After 7 d of adaptation to the experimental diets, feces were collected from d 8 to 12, d 15 to 19, d 22 to 26, and d 29 to 33, respectively. Results: The DE and ATTD of gross energy (GE), dry matter (DM), ash, organic matter (OM), neutral detergent fiber (NDF), acid detergent fiber (ADF), and crude protein (CP) in diets decreased linearly as the dietary PKM increased within each adaptation duration (p<0.01). Diet containing 19.5% PKM had less DE value and ATTD of all detected items compared with other diets when fed to pigs for 14 days (p<0.05). The ATTD of CP in PKM calculated by 19.5% and 39.0% linearly increased as adaptation duration prolonged from 7 to 28 days (p<0 .01). Conclusion: Inclusion level of PKM and adaptation duration had an interactive effect on DE and the ATTD of GE, DM, OM, and CP (p<0.01 or 0.05) but ash, NDF, and ADF in diet (p>0.05). Considering a stable determination, 21 days of adaptation to a diet containing 19.5% PKM is needed in pigs and a longer adaptation time is recommended as dietary PKM increases.

• Journal of Preventive Medicine and Public Health
• /
• 제49권1호
• /
• pp.45-52
• /
• 2016

Objectives: Previous large-scale cohort studies conducted in Korea have found a positive association between diabetes mellitus (DM) and colorectal cancer (CRC) in men only, in contrast to studies of other populations that have found significant associations in both men and women. Methods: A total of 1070 CRC cases and 2775 controls were recruited from the National Cancer Center, Korea between August 2010 and June 2013. Self-reported DM history and the duration of DM were compared between cases and controls. Odds ratios (ORs) and 95% confidence intervals (CIs) were calculated by binary and polytomous logistic regression models. Results: DM was associated with an elevated risk of CRC in both men (OR, 1.47; 95% CI, 1.13 to 1.90) and women (OR, 1.92; 95% CI, 1.24 to 2.98). This association remained when we controlled for age, body mass index, alcohol consumption, and physical activity level. In sub-site analyses, DM was associated with distal colon cancer risk in both men (multivariate OR, 2.04; 95% CI, 1.39 to 3.00) and women (multivariate ORs, 1.99; 95% CI, 1.05 to 3.79), while DM was only associated with rectal cancer risk in women (multivariate OR, 2.05; 95% CI, 1.10 to 3.82). No significant association was found between DM and proximal colon cancer risk in either men (multivariate OR, 1.45; 95% CI, 0.88 to 2.41) or women (multivariate OR, 1.79; 95% CI, 0.78 to 4.08). Conclusions: Overall, DM was associated with an increased risk of CRC in Koreans. However, potential over-estimation of the ORs should be considered due to potential biases from the case-control design.

• 근관절건강학회지
• /
• 제19권1호
• /
• pp.57-70
• /
• 2012

Purpose: This study aimed to investigate the level of physical activity and to identify factors related with physical activity for the elderly with Diabetes Mellitus (DM). Methods: The subjects were 154 diabetic outpatient at 3 hospitals located in J city. Data were collected from February 1 to 17 in 2012. Data were analysed using Chi-square test, ANOVA, and logistic regression by SPSS/WIN 18.0. Results: Mean physical activity level per week measured by International Physical Activity Questionnaire (IPAQ) was $2247.01{\pm}2533.73$ MET-minutes (minimally active). There were significant differences in the level of physical activity by age, spouse, education, job, admission, duration of DM, and DM therapy. There were significant differences in subjective health status, objective and subjective obesity, satisfaction with physical body, perception of aging, self-efficacy, perceived benefits, perceived barriers, and social support among the inactive, minimally active, and health enhancing physical activity groups. Factors influencing the level of health enhancing physical activity were spouse (OR=10.192), self-efficacy (OR=5.351), subjective obesity (OR=.114), and perceived barriers (OR=.069). Conclusions: The level of physical activity of elderly patients with DM was minimally inactive. Physical activity program enhancing self-efficacy and decreasing perceived barriers, as well as improving the correct perception of subjective obesity is recommended as a nursing intervention.

• 대한간호학회지
• /
• 제31권1호
• /
• pp.7-19
• /
• 2001

In our country, patients with diabetes mellitus are searching for complementary treatments to recover from illness, while they received treatments from the doctor. However, have been evaluated or investigated systematically. This study was carried out to explore application of complementary treatments for patients with DM. For this survey, questionnaires were developed by researchers and the data was collected from July to October of 1999. Among the 223 subjects, there is one general hospital, one oriental hospital, 15 area C.H.P, ahd 2 area health centers. The results were as follows: 1. The total number of cases was 223 and the average age was 62.85 years old and average duration of DM was 8.1 years. The number of patients who had experience with alternative therapies was 145 (65%). The number of those who have not undergone treatments was 78 (35%). 2. The 43.5% of experienced CAM were advised family and relatives. Only 30.3% approved the effect of CAM and 52.5% said that If another a new CAM is introduced, they will try it. 4. Ninety three kinds of complementary treatments were used. Among the used items, 63.7% was various types of plants, 21.6% was animal material and 14.7% was the mixed group. As a single item, Bombyx Mori (Silkworm) was the most frequently used (10.5%) followed by the bean, mushroom, Morus bombycis (mulberry), Ginseng, Commelina Communis (Dalgaebi), Chinese medicine, root of Rosa rugosa (Haedangwha). 5. Among the used items, Trichosanthes kirilowii Max. Eucommia ulmoides Oliver, Commelina Communis, Aralia elata, pine needle, mulberry fruit, root of Rosa rugosa. Ginseng, Lycii Fructus, Dioscorea radix, Polygonatum odoratum, Cassia tora L, Bombyx Mori, loach, Crucian carp were based upon the pharmacological function of effect for control of diabetes mellitus symptom. 6. In the analysis of the relationships between the general characters of the patients with new complementary alternative medicine try and hospital treatment; 1) The shorter group suffered from DM (p=.038), poor Self-MBG (p=.037) and wanted to try new complementary alternative medicine. 2) The group of DM education experience were carried out hospital treatment well (p=.045). In conclusion, further study will be required for the patients experience using alternative therapies as the D-M in terms of holistic view of patients.