• 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.

• 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 Obesity & Metabolic Syndrome
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• 제27권4호
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• pp.213-222
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• 2018

Bariatric surgery has evolved from a surgical measure for treating morbid obesity to an epochal remedy for treating metabolic syndrome as a whole, which is represented by type 2 diabetes mellitus. Numerous clinical trials have advocated bariatric or metabolic surgery over nonsurgical interventions because of markedly superior metabolic outcomes in morbidly obese patients who satisfy traditional criteria for bariatric surgery (body mass index [BMI] >$35kg/m^2$) and in less obese or simply overweight patients. Nevertheless, not all diabetes patients achieve the most desirable outcomes; i.e., diabetes remission after metabolic surgery. Thus, candidates for metabolic surgery should be carefully selected based on comprehensive preoperative assessments of the risk-benefit ratio. Predictors for diabetes remission after metabolic surgery may be classified into two groups based on mechanism of action. The first is indices for preserved pancreatic beta-cell function, including younger age, shorter duration of diabetes, and higher C-peptide level. The second is the potential for an insulin resistance reduction, including higher baseline BMI and visceral fat area. Several prediction models for diabetes remission have been suggested by merging these two to guide the joint decision-making process between clinicians and patients. Three such models, DiaRem, ABCD, and individualized metabolic surgery scores, provide an intuitive scoring system and have been validated in an independent external cohort and can be utilized in routine clinical practice. These prediction models need further validation in various ethnicities to ensure universal applicability.

• 대한영양사협회학술지
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• 제7권2호
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• pp.138-143
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• 2001

Microalbuminuria is a strong predictor of diabetic nephropathy and is also associated with increased mortality in people with non-insulin-dependent diabetes mellitus(NIDDM) patients. Improved glycemic control and dietary protein restriction are recommended to retard and avoid developing microalbuminuria. The purpose of this study was to measure the dietary counseling effects for diabetes mellitus patients with microalbuminuria. To investigate the effects of the dietary counseling effect, thirty NIDDM patients with microalbuminuria were selected from outpatient diabetic clinic of Seoul National University Hospital for this study. None of them had evidence of renal and heart complications. For 24 weeks, they received individualized dietary counseling 3 times. The results of this study can be summarized as follows 1) Dietary protein and calorie intake decreased significantly from 79.8$\pm$29.9g/d to 66.6$\pm$16.5g/d, from 1845.4$\pm$631.9kcal to 1515.7$\pm$392.7kcal after dietary counseling, respectively (p<0.05). 2)The glycosylate hemoglobin level showed significantly decreased after dietary counseling(p<0.05). However there were no change in lipid profiles and blood pressure after counseling. 3) There was a significant correlation between the duration of disease and the amount of microalbuminuria. Any other cardiovascular risk factors, such as duration of diabetes, total cholesterol level and systolic blood pressure were not correlated with microalbuminuria. These results shown that dietary counseling can be used as an effective therapy to control blood sugar levels for NIDDM patients who are poorly controlled with microalbuminuria.

• 한국임상수의학회지
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• 제28권1호
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• pp.139-143
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• 2011

A Spitz (5-years old, castrated male) and a Maltese (9-years old, castrated male) were presented with weight loss, polyuria/polydipsia (PU/PD) and depression. Diabetic ketosis was diagnosed based on clinical signs, physical examinations and screening tests (CBC, serum chemistry and urinalysis). The dogs were treated with NPH initially. However, NPH was inadequate to control blood glucose level due to the short duration of the action (< 5 hours). Because of the poor glycemic control with NPH, the dogs showed diabetic complications including weight loss and cataract. After change to glargine, the duration of insulin action was extended up to 11 hours. As a result, there was significant improvement in clinical signs and serum fructosamine concentrations. This study suggests that glargine is useful as a long-acting insulin in dogs which have poor glycemic control due to the short duration of NPH.

• 대한물리의학회지
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• 제13권4호
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• pp.105-112
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• 2018

PURPOSE: Strengthening training is effective at improving the function of stroke patients. This study was conducted to compare the effects of exercise intensity on walking, balancing ability, and blood glucose in stroke patients with type 2 diabetes mellitus and to suggest more effective exercise intensity for stroke patients. METHODS: Twenty-two patients with type 2 diabetes mellitus were divided into an experimental group (n=11) and a control group (n=11). In the experimental group, a 40-70% strength of 1RM exercise program was applied for 40 minutes a day, three times a week for 4 weeks. The control group received a 50% intensity of 1RM for the same number and duration of interventions as the experimental group. RESULTS: Both the experimental group and the control group showed significant improvement in the gait function, balance ability, and blood glucose level after the intervention compared to before the intervention. In the FGA (functional gait assessment), the experimental group showed a 52.4% greater increase than the control group, and the fasting blood glucose level was 16.7% greater in the experimental group than the control group. CONCLUSION: The strengthening exercise program, which gradually increases exercise intensity, seems to be effective at improving the function of stroke patients with type 2 diabetes.

• 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.

• Nutrition Research and Practice
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• 제14권3호
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• pp.218-229
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• 2020

BACKGROUND/OBJECTIVES: Type 2 Diabetes mellitus (T2DM) is a hereditary disease that is also strongly dependent on environmental factors, lifestyles, and dietary habits. This study explored the relationship between lifestyle habits and glycosylated hemoglobin management in T2DM patients to provide empirical outcomes to improve T2DM management and patient health literacy. SUBJECTS/METHODS: This study enrolled 349 diabetic patients with more than 5 care visits to a Diabetes Mellitus care network under the Health Management Plan led by Taiwan Department of Health (DOH). Based on relevant literature, an Outpatient Record Form of Diabetes Mellitus Care was designed and lipid profile tests were conducted for data collection and analysis. RESULTS: When modeling the data, the results showed that the odds for HbA1c > 7.5% in T2DM patients duration over 10 years was 3.785 (P = 0.002) times that in patients with disease duration of fewer than 3 years. The odds of HbA1c > 7.5% in illiterate patients was 3.128 (P = 0.039) times that in patients with senior high school education or above. The odds of HbA1c > 7.5% in patients with other chronic illness was 2.207 (P = 0.019) times that in participants without chronic illness. Among 5 beneficial lifestyle habits, the odds of HbA1c > 7.5% in patients with 2 or 3 good habits were 3.243 (P = 0.003) and 3.424 (P = 0.001) times that in patients with more than 3 good habits, respectively. CONCLUSION: This empirical outcome shows that maintaining a good lifestyle improves T2DM management and patients' knowledge, motivation, and ability to use health information. Patients with longer disease duration, education, or good lifestyle habits had optimal HbA1c management than those in patients who did not. Thus, effective selfmanagement and precaution in daily life and improved health literacy of diabetic patients are necessary to increase the quality of T2DM care.

• Journal of Nutrition and Health
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• 제43권1호
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• pp.46-56
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• 2010

This study was intended to assess the effects of low glycemic index (LGI) nutrition education on dietary management and glycemic control of patients with type 2 diabetes mellitus. The subjects were 48 sex-matched patients with type 2 diabetes mellitus, aged $66.5\;{\pm}\;6.2$ years, visiting a public health center. They were divided into two groups: the control group (males 10, females 14) and the educated group (males 10, females 14). The educated group was provided with a LGI nutrition education program for 7 weeks. The control group was educated only one time for general diabetic education. Anthropometric indices, knowledge and perception of efficacy of low glycemic index carbohydrates, dietary glycemic index (DGI) and glycemic load (DGL), fasting blood glucose, and HbA1c were assessed. In the educated group body weight, body mass index and systolic blood pressure (from $138.0\;{\pm}\;18.9\;mmHg$ to $130.6\;{\pm}\;15.0\;mmHg$) were significantly reduced after the nutrition education (p < 0.05). The scores of knowledge and perception of efficacy of low glycemic index carbohydrates increased significantly in the educated group. Dietary glycemic index and glycemic load of the educated group decreased significantly from $103.4\;{\pm}\;67.6$ to $45.4\;{\pm}\;27.1$ (p < 0.001), and from $173.3\;{\pm}\;135.9$ to $66.8\;{\pm}\;50.4$ (p < 0.001), respectively. Also fasting blood glucose and HbA1c levels of the educated group significantly decreased from $124.5\;{\pm}\;28.8\;mg/dL$ to $96.7\;{\pm}\;21.6\;mg/dL$ (p < 0.001) and from $7.1\;{\pm}\;1.3%$ to $6.4\;{\pm}\;1.2%$ (p < 0.05), respectively. The score of knowledge and perception of efficacy of low glycemic index significantly correlated with fasting blood glucose and HbA1c levels negatively. DGI, DGL and duration of diabetes significantly correlated with HbA1c level positively. From stepwise multiple linear regression analysis, DGI, DGL and the duration of diabetes were extracted as factors influencing HbA1c level of the subjects. The results of this study suggest that low glycemic index nutrition education programs is an effective intervention measure for the glycemic control in type 2 diabetic patients.

• 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.