• Journal of Korean Foot and Ankle Society
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• v.8 no.2
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• pp.153-156
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• 2004

Purpose: To investigate the status of foot, preventive foot care and appropriateness of shoe size in patients with diabetes. Materials and Methods: One hundred and sixty-five patients who visited endocrinology clinic due to clinically proven diabetes mellitus were studied. Average age was 59.3 years (range, 36-90 years) and average duration of diabetes was $9.6{\pm}8.2$ years. Patients were questioned about their basic educational level and their foot and ankle problems. Physical examination of the foot was done including sensation testing of four areas of plantar surface with the 5.07 monofilament. Both feet and shoes were measured for width, length and the height of toes and toebox. Shoes were defined as properly fitting the foot if it is 5mm wider than the foot, and $20{\pm}30\;mm$ longer than the foot, and the height of toebox is more than 5mm higher than the height of the toes. Results: 48.5 percent of the patients were educated about how to select an appropriate shoewear. 47.3 percent of the patients had symptoms of neuropathy and 42.4 percent of patients were unable to feel the monofilament in at least one area. 25.5 percent of the patients had appropriate shoes in length, 63.6 percent of the patients in width, and 72.7 percent of the patients in the height of toebox. Conclusion: This study suggets that more patients needs to be educated about foot care and appropriate shoes which have adequate height of toebox as well as the length and width.

• Journal of Korean Academy of Fundamentals of Nursing
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• v.18 no.2
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• pp.152-159
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• 2011

Purpose: This study was done to identify factors related to glycemic control in men with diabetes. Methods: Data from the Korean National Health and Nutrition Examination Survey 2007 2008 collected by the Korean Center for Disease Control were analyzed using chi-square test and t-test. Results: There was a difference in glycemic control according to the individual factor of economic status. Differences in glycemic control according to health related factors were as follows: fasting blood sugar, cholesterol, triglyceride, sleep duration, experience of depression and suicidal thoughts. Conclusion: The results of this study will contribute to improvements in management for men with diabetes through comprehensive identification of factors related to glycemic control.

• Journal of Korean Public Health Nursing
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• v.15 no.2
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• pp.334-341
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• 2001

The purpose of this study is to examine to control of glucose level and the occurrence of chronic complications of diabetes by compliance groups with health care regimen The subjects were consisted of 300 out patients with type 2 diabetes mellitus from beginning of March through the end of April in 2001, who visited at the endocrinology department at Kangnam St. Mary's Hospital of Catholic University in Seoul. The patient's compliance level with health care regimen was assessed at questionnaire. However, the blood glucose level and the occurrence of chronic complications of diabetes were assessed at medical record review. The data were analyzed by SAS program for chi square test and t-test. The results were as follows. 1. Significant differences were found among the factors such as duration of diabetes, the number of participation of diabetes educational program, job, smoking, self monitoring of blood glucose and the methods of diabetes therapy between high and low compliance groups. High compliance group patients had a diabetes longer than low compliance group patients. High compliance group patients more frequently attended the educational program and checked themselves monitoring blood glucose than low compliance group patients. Also, they did not work recently, smoked less and got more insulin injection therapy compared to low compliance group patients. 2. No significant differences were found among the result of fasting blood glucose. 2-hour postprandial blood glucose, and $HbA_{l}c}$ between high and low compliance groups. 3. The occurrence rate of macrovascular complications of chronic complications of diabetes were lower, however, the occurrence rate of microvascular complications were higher in high compliance group than in low compliance group with health care regimen.

• The Journal of Korean Medicine
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• v.27 no.4
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• pp.215-224
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• 2006

Objectives : In order to apply useful data to clinical practice, we undertook this study and tried to find factors related with sequelae of facial palsy in relation with patients' age and gender distribution, past history with the disease, condition before onset, duration of recovery time, existence of remaining sequelae, types of the sequelae, and duration for sequelae to disappear. Methods : We evaluated patients' condition (fatigue, stress, chills, cold and so on), past history (diabetes mellitus, hypertension, stroke, herpes zoster, cancer and so on), duration of recovery time, types of the sequelae, age and sequelae distribution as to when the treatments were started as we examined 473 patients who were diagnosed with facial palsy, and visited the Out-patient Department of Acupuncture and Moxibustion of Bundang Oriental Medicine Hospital of Dongguk University through 2003 and 2004. Results : The sequelae of facial palsy were not significantly relevant to the signs found before facial palsy occurred(fatigue, stress, chills, and cold), or to patients' past history (hypertension, diabetes mellitus, facial palsy, herpes zoster). The duration of recovery time was within 30 days for 45.3% of the patients examined in this study, and within 90 days for 72.6%. Evaluating the existence of sequelae in relation to age, we found more in the group comprised of patients aged 50 and over than under 50. We found more sequelae in the group which is consisted of patients who had not been treated until 6 days after than within 5 days from the onset. Conclusion: Attention to sequelae will be needed for patients aged 50 and over and who were not treated until 6 days after the onset, as they had more sequelae.

• Korean Journal of Clinical Pharmacy
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• v.20 no.3
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• pp.183-192
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• 2010

While Self-monitoring of blood glucose (SMBG) has been recommended in some diabetes mellitus (DM) patients population according to the 2010 American Diabetes Association (ADA), 2007 Korean Diabetes Association (KDA), 2005 International Diabetes Federation guideline, it is excluded from a routine insurance coverage for outpatients in Korea. The objective of this study is to meta-analyze the impact of SMBG on HbA1c in non insulin-treated diabetes mellitus (NIT) DM patients. Published clinical literatures were identified through electronic database searches from inception and until May 2010. Studies were selected if they met the following inclusion criteria: 1) randomized controlled trials (RCTs), 2) comparing SMBG with non-SMBG in NIT type 2 diabetes, 3) measuring HbA1c as an outcome. Literature qualities were assessed by the Scottish Intercollegiate Guidelines Network Checklist. The mean difference of HbA1c between the 2 groups was pooled from non-heterogeneous 6 RCTs by meta-analysis using Review Manger (RevMan) Version 5.0 program. Pooled results demonstrated that SMBG is associated with a statistically significant improvement in glycemic control (mean HbA1c difference -0.23, 95%CI -0.32, -0.13). Sensitivity analysis showed that glycemic controls were significantly improved in patients with shorter study duration, more frequent self-monitoring, higher baseline HbA1c value, and without prior SMBG experiences. Conclusively SMBG is effective in improving glycemic control in NIT DM patients, but additional evidences from further researches in Korean patients and cost-effectiveness analysis would be necessary to make a suggestion for coverage expansion.

• Journal of Yeungnam Medical Science
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• v.36 no.3
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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.

• The Journal of Korean Medicine Ophthalmology and Otolaryngology and Dermatology
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• v.12 no.2
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• pp.212-221
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• 1999

Tongue examination is the most unique and important diagnostic method of oriental medicine. It reveals patients condition and give some information about direction of therapy and background of disease as well as produces clue of duration of disease changing that grasps it from outside. The aims of this study show that results of tongue examination is related to somewhat special pattern. we study 27 patients(age of means: 63.01 years old, male: 14, female: 13) who come to Wonkwang University Oriental-Medicine Hospital at Chonju with diabetes mellitus or diabetes mellitus complications. Tongue colors of this study result in pale-red 8 cases, pale 6 cases, red 6 cases, crimson 5 cases, blue-green-purple 2 cases and tongue fur of this study result in white-fur 16 cases, yellow-fur 7 cases, black-fur 1 case, none-fur 3 cases. And the condition of tongue fur with grimy and thin result in thin-white-fur 12 cases, white-grimy-fur 4 cases, thin-yellow-fur 5 cases, grimy-yellow-fur 2 cases, black-fur 1 case. Means level of fasting glucose during 7 days was $223.24{\pm}32.l7mg/dl$ and postprandial 2hours was $286.37{\pm}24.54mg/dl$ There were no changes in tongue body and tongue color but changes occur in tongue fur with 9cases in this period. 5 cases of patient make a difference between FBS(fasting blood glucose) and postprandial blood glucose level more than l00mg/dl (2 cases of patient with thin-white-fur gradually turned to slight-yellow-fur. There were no changes in 2 cases of patient with crimson-none-fur and pale-white-fur. 1 case of patient with slimy-yellow-fur turned to black fur.) 11 cases of patient had lesser than $10\%$ hemoglobin $A_lC$ and tongue color of these patient were pale-red 5cases, pale 2 cases, red 2 cases, crimson 2 cases. 16 cases of patient had more than $10\%$ Hemoglobin $A_1C$ and tongue color of these patients were pale-red 3 cases, pale 4 cases, red 4 cases, crimson 3 cases, blue 2 cases. This result shows that quantity of Hemoglobin $A_1C$ make a somewhat role in tongue color. The above results show that tongue color, fur color, condition and change of fur in diabetes mellitus patients is various in pale-red, pale, crimson, none-fur. So it is difficult to give an exact diagnosis on pathology of diabetes mellitus only with tongue examination because there are a little matches between blood glucose level, prevalence-period, short-term blood glucose regulation and tongue and fur colors.

• Journal of Preventive Medicine and Public Health
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• v.38 no.2
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• pp.203-207
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• 2005

Objectives: Recently, the American Diabetes Association (ADA) redefined the criteria of prediabetes, which has lowered the diagnostic level of fasting plasma glucose (FPG) from 110 to 125 mg/dl, down to levels between 100 to 125mg/dl. The purpose of this study was to determine the predictive cutoff level of FPG as a risk for the development of diabetes mellitus in Korean men. Methods: A retrospective cohort study was conducted on 11,423 (64.5%) out of 17,696 males $\leq$30 years of age, and who met the FPG of $\leq$125 mg/dl and hemoglobin A1c of $\leq$ 6.4% criteria, without a history of diabetes, and who were enrolled at the screening center of a certain university hospital between January and December 1999. The subjects were followed from January 1999 to December 2002 (mean follow-up duration; 2.3(${\pm}0.7$) years). They were classified as normal (FPG <100mg/dl), high glucose (FPG $\geq$100mg/dl and <110mg/dl) and impaired fasting glucose (FPG $\geq$110mg/dl and $\leq$125mg/dl) on the basis of their fasting plasma glucose level measured in 1999. We compared the incidence of diabetes between the 3 groups by performing Cox proportional hazards model and used receiver operating characteristic analyses of the FPG level, in order to estimate the optimal cut-off values as predictors of incident diabetes. Results: At the baseline, most of the study subjects were in age in their 30s to 40s (mean age, 41.8(${\pm}7.1$) year). The incidence of diabetes mellitus in this study was 1.19 per 1,000 person-years (95% CI=0.68-1.79), which was much lower than the results of a community-based study that was 5.01 per 1,000 person-years. The relative risks of incident diabetes in the high glucose and impaired fasting glucose groups, compared with the normal glucose group, were 10.3 (95% CI=2.58-41.2) and 95.2 (95% CI= 29.3-309.1), respectively. After adjustment for age, body mass index, and log triglyceride, a FPG greater than 100mg/dl remained significant predictors of incident diabetes. Using the receiver operating characteristic (ROC) curve, the optimal cutoff level of FPG as a predictor of incident diabetes was 97.5 mg/dl, with a sensitivity and a specificity of 81.0% and 86.0%, respectively. Conclusion: These results suggest that lowering the criteria of impaired fasting glucose is needed in Korean male adults. Future studies on community-based populations, including women, will be required to determine the optimal cutoff level of FPG as a predictor of incident diabetes.

• The Journal of the Korea Contents Association
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• v.19 no.6
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• pp.461-470
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• 2019

In diabetes mellitus, renal disease is a common complication, characterized by increased urinary albumin excretion and reduced eGFR. According to KDIGO CKD stage classification, Korean characteristics were analyzed according to urinary albumin and eGFR using the National Health and Nutrition Examination Survey VI raw data. According to KDIGO classification, diabetic patients were classified as Low risk 72.0%, Moderate risk 19.3%, High risk 5.6% and Very high risk 3.0%. Low risk decreased from 74.7% to 52.2%, and moderate to very high risk increased from 25.4% to 47.8% as the duration of diabetes mellitus was prolonged. The risk factors were CKD stage 1 (HR 2.064) to stage 4 (HR 11.049), the highest risk of hypertension. The incidence of renal disease was elevated according to duration of hypertension and HR 0.42 of kidney disease was decreased in the group maintaining proper blood pressure. In the hypertensive patients, the group administered with target blood pressure had a reduction of the kidney disease by 42% than the group with the hypertension. Therefore, controlling and managing hypertension to target blood pressure is important for the prevention of kidney disease.

• The Journal of Internal Korean Medicine
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• v.33 no.3
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• pp.317-326
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• 2012

Objectives : To investigate the prevalence and utilization pattern of complementary and alternative medicine (CAM) in individuals with type 2 diabetes. Methods : We conducted a nationwide survey and a total of 535 individuals with type 2 diabetes were asked about their demographic, diabetes-related characteristics and CAM use. We used multiple logistic regression modeling to determine independent predictors of CAM use. Results : Of the 535 subjects, 417 (77.9%) used CAM in last 12 months. The most commonly used modality was red ginseng (17.9%). CAM use was independently associated with being married, northern area residence, higher education and diabetes duration of 3-5 years. More than half(58.3%) of the CAM users used it expecting a better outcome in addition to conventional therapy. Information sources about CAM were mostly friends (36.0%) and family (31.9%), only 28.1% of diabetic patients seek counsel from medical doctors or oriental medical doctors about CAM. Many people perceived CAM as effective (62.7%) and reported side effects only rarely (1.2%). Conclusions : Many diabetic patients used CAM and found it effective, which urges clinicians to pay attention to CAM use of their diabetic patients. Also, further studies are required regarding efficacy and safety about CAM.