• Diabetes and Metabolism Journal
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• 제42권6호
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• pp.513-518
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• 2018

Background: Recent studies have correlated serum cystatin C (CysC) with vascular complications, but few studies have investigated this correlation in diabetes patients without nephropathy. This study aimed to evaluate if higher serum CysC levels increase the risk for vascular complications in type 2 diabetes mellitus patients with normal renal function or mild renal impairment. Methods: A total of 806 consecutive patients with type 2 diabetes mellitus who were admitted to the diabetes center of Soonchunhyang University Hospital for blood glucose control were retrospectively reviewed. Patients with nephropathy were excluded. Subjects were categorized into quartiles of serum CysC levels (Q1, ${\leq}0.65mg/L$; Q2, 0.66 to 0.79 mg/L; Q3, 0.80 to 0.94 mg/L; and Q4, ${\geq}0.95mg/L$). Results: The proportion of patients with diabetic retinopathy (DR) (P for trend <0.001), coronary heart disease (CHD) (P for trend <0.001), and stroke (P for trend <0.001) increased across the serum CysC quartiles. After adjustment for confounding factors, the highest serum CysC level remained a significant risk factor for DR (odds ratio [OR], 1.929; 95% confidence interval [CI], 1.007 to 4.144; P=0.040). Compared with Q1, a significant positive association was observed between serum CysC and CHD in Q2 (OR, 7.321; 95% CI, 1.114 to 48.114; P=0.012), Q3 (OR, 6.027; 95% CI, 0.952 to 38.161; P=0.020), and Q4 (OR, 8.122; 95% CI, 1.258 to 52.453; P=0.007). No associations were observed between CysC and stroke after additional adjustment for confounding variables. Conclusion: Serum CysC levels are independently associated with DR and CHD, suggesting that CysC may be useful for identifying type 2 diabetes mellitus patients without nephropathy who are at high risk for vascular complications.

• 지역사회간호학회지
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• 제20권3호
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• pp.307-315
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• 2009

Purpose: This study was done to assess the effects of a self-help intervention on clinical, lifestyle and psycho-social outcomes in patients with Type II diabetes. Methods: Eligible adults with Type II diabetes were randomly assigned to either the intervention group receiving the diabetes self-help or the control group receiving usual care. Of the 36 patients who completed the study, 15 were in the intervention group and 21 were in the control group. The self-help group consisted of six weekly sessions covering aspects of diabetes self-care and using continuing education, discussion, and structured social activities. Outcomes included changes in glycemic control, knowledge, self-management behaviors, diabetes-related self-efficacy, and health-related quality of life. Analysis of covariance was used to compare outcomes between the groups, adjusting for baseline measures. Results: After the six week intervention, significant improvements from the baseline were observed in the measurements of self-management behaviors, diabetes-related self-efficacy, and health-related quality of life for the intervention group. Conclusion: The findings provide preliminary evidence that a diabetes self-help group intervention can benefit diabetes patients in self-management behaviors, diabetes-related self-efficacy, and health-related quality of life. However, larger longitudinal studies are needed to determine the most efficacious self-management methods to sustain long-term glycemic control and psychological well-being.

• 보건행정학회지
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• 제29권3호
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• pp.262-276
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• 2019

Background: The most important thing to strengthen primary care is to prove that the continuity of primary care is an essential area for good health outcomes. The purpose of this study is to analyze the effect of outpatient continuity of primary care on the hospitalization experience of diabetes mellitus in new diabetic patients. Methods: Using the Korean National Health Insurance Service national sample cohort (NHIS-NSC 2011-2015) data, 3,391 new diabetic patients in 2012 were selected for the study. Multiple logistic regression was performed to investigate the effect of outpatient continuity of primary care on hospitalization in new diabetic patients. Results: The outpatient continuity of primary care in new diabetic patients was measured by the continuity of care index, which showed that 69.4% (n=2,352) were high level and 30.6% (n=1,039) were low level. Patients who had high continuity of primary care at the early stage of diabetes diagnosis showed 3.49 times more likely to maintain high continuity of primary care in the second year (95% confidence interval [CI], 2.72-4.49). Patients with low continuity of primary care for 2 years from the initial diagnosis of diabetes were 2.56 times more likely to be hospitalized due to diabetes than those who did not (95% CI, 1.55-4.25). Conclusion: This study identified the need for policies to increase the continuity of primary care for new diabetic patients and could contribute to lowering the admission rate of diabetic patients if the policy for this would work effectively.

• Nutrition Research and Practice
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• 제1권2호
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• pp.79-83
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• 2007

The present study was conducted to document the association between plasma homocysteine levels and the presence of macrovascular angiopathy with food and nutrient intake patterns among patients with Type II diabetes mellitus in Korea. Plasma total homocysteine concentration was analyzed by HPLC-fluorescence detector method in 127 patients with non-insulin dependent diabetes mellitus. Logistic regression analyses were performed respectively to study the association of plasma homocysteine levels with clinical and dietary characteristics and macroangiopathy (MA). The average plasma homocysteine level of patients with MA was $14.2{\mu}mol/l$, which was significantly higher than that of patients without MA ($11.4{\mu}mol/l$). The proportions of patients with MA showed a significant difference, being 32.3% in hyperhomocysteinemic ($>14.0{\mu}mol/l$) patients and 13.5% in others with homocysteine levels lower than $14.0{\mu}mol/l$. Odds ratios for macroangiopathy by tertile increase of plasma homocysteine concentration were 1.633 ($Q_2$) and 4.831 ($Q_3$), when adjusted for age, sex, and cigarette smoking. Patients with MA consumed reduced amounts of vitamin $B_1,\;B_2$, and folate. The results indicate that the plasma homocysteine levels are significantly increased in NIDDM patients who have macroangiopathy. Dietary management such as increased fruits and vegetables and decreased potatoes and starches might be beneficial for the prevention of macroangiopathy in diabetic patients.

• Journal of Yeungnam Medical Science
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• 제39권1호
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• pp.46-52
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• 2022

Background: The coronavirus disease 2019 (COVID-19) outbreak in the Daegu-Gyeongbuk area in 2020 has caused difficulties in the daily life and hospital care of children with type 1 diabetes mellitus (T1DM). We detected an increase in blood sugar levels in these children and the number of patients hospitalized with more severe diabetic ketoacidosis (DKA) compared to those before COVID-19. Methods: This single-center study was conducted at Kyungpook National University Children's Hospital. The following patient groups were included; 45 returning patients diagnosed with T1DM and undergoing insulin treatment for more than 2 years and 20 patients newly diagnosed with T1DM before and after COVID-19 were selected by age matching. Returning patients before and after the outbreak were selected, and changes in hemoglobin A1c (HbA1c) levels were retrospectively reviewed. The HbA1c levels and severity of symptoms in newly diagnosed patients during hospitalization were examined. Results: HbA1c levels in returning patients with T1DM were significantly increased after COVID-19 (before, 7.70%±1.38% vs. after, 8.30%±2.05%; p=0.012). There were 10 and 10 newly diagnosed patients before and after COVID-19, respectively. The proportion of patients with drowsiness and dyspnea at the time of admission was higher after COVID-19 than before (before, 2 of 10 vs. after, 4 of 10). The HbA1c levels were higher in newly diagnosed patients hospitalized after COVID-19 than before (before, 11.15% vs. after, 13.60%; p=0.036). Conclusion: Due to COVID-19 in the Daegu-Gyeongbuk area, there was an increase in blood glucose levels in children with T1DM and in the incidence of severe DKA in newly diagnosed diabetes mellitus patients.

• 기본간호학회지
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• 제15권3호
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• pp.291-300
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• 2008

Purpose: The purpose of this study was to identify the effects of a cognitive behavioral stress management program on perceived stress, coping strategies, and cortisol in people with Diabetes Mellitus Type 2. Method: Patients with type 2 diabetes were recruited from of a public health center in an urban area. Thirty-five participants (experimental group=17, and control group=18) enrolled. The experimental group received small group-based cognitive behavioral stress management training for eighty minutes per session, once a week for eight weeks. Data were collected at baseline and ninth week for perceived stress, affect-oriented coping, problem-oriented coping, and cortisol. The data were analyzed using SPSS 12.0. Results: The experimental group had significantly less perceived stress (t=-9.82, P<.001) and cortisol (t=-2.14, p=.040) than the control group. No significant group differences were found in affect-oriented coping (t=-.43, p=.673) or problem-oriented coping (t=1.40, P<.170). Conclusion: These results suggest that a cognitive behavioral stress management program can have positive effects on perceived stress and cortisol in patients with diabetes mellitus type 2. Further research with a larger sample and for a longer period is needed to expand our understanding of the effects of the program for patients with diabetes mellitus type 2.

• Journal of Korean Biological Nursing Science
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• 제17권1호
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• pp.71-77
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• 2015

Purpose: This study was performed to identify lower urinary tract symptoms (LUTS), and to evaluate the factors affecting LUTS in patients with type 2 diabetes mellitus (T2DM). Methods: The cross sectional study was used with a structured questionnaire to collect data through interviews with 181 T2DM patients and their clinical data from a university hospital diabetes clinic from October 2010 to April 2012. LUTS were measured using the International Prostate Symptom Score (IPSS), depression using the Center for Epidemiologic Studies Depression Scale (CES-D), and glycosylated hemoglobin (HbA1c) from the clinical data. Results: Of all patients with T2DM, the mean IPSS of LUTS was $9.34{\pm}6.86$. Concerning the reported severity of LUTS, 53.6% of the subjects were in the moderate and severe group. In each symptom score of LUTS (range 0-5), nocturia was the highest 2.04, weak stream 1.62, and frequency 1.45. LUTS was significantly predicted by HbA1c and depression, and 14.3% of the variance in LUTS was explained. Conclusion: HbA1c and depression were found to be very important factors associated with LUTS in T2DM patients.

• 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.

• Clinical Nutrition Research
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• 제11권4호
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• pp.331-346
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• 2022

Coronavirus disease 2019 (COVID-19), a novel coronavirus named severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is now at pandemic levels leading to considerable morbidity and mortality throughout the globe. Patients with obesity, diabetes, and metabolic syndrome (MetS) are mainly susceptible and more probably to get severe side effects when affected by this virus. The pathophysiologic mechanisms for these notions have not been completely known. The pro-inflammatory milieu observed in patients with metabolic disruption could lead to COVID-19-mediated host immune dysregulation, such as immune dysfunction, severe inflammation, microvascular dysfunction, and thrombosis. The present review expresses the current knowledge regarding the influence of obesity, diabetes mellitus, and MetS on COVID-19 infection and severity, and their pathophysiological mechanisms.

• Journal of Preventive Medicine and Public Health
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• 제54권2호
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• pp.119-128
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• 2021

Objectives: Ongoing, proactive, planned, and patient-centered diabetes education is the cornerstone of care for all persons with diabetes. Thus, the aim of this study was to explore the information needs of type 2 diabetes mellitus patients receiving insulin treatment in North-East Ethiopia. Methods: The study was conducted from July 2019 to January 2020 using a qualitative enquiry (phenomenological approach) with purposive sampling. Face-to-face in-depth interviews were used to collect data until reaching theoretical saturation. The participants were type 2 diabetes patients receiving insulin treatment. They were identified from the diabetes patients' registration book at the diabetes clinic and interviewed at their appointment time, and were selected to include wide variations in terms of socio-demographic characteristics. Twenty-four participants (11 men and 13 women), with a median age of 57 years, were interviewed. The data were organized using QDA Miner Lite version 2.0.7 and analyzed thematically using narrative strategies. Results: Most participants had not heard of diabetes before their diagnosis. They had limited knowledge of diabetes, but ascribed different connotations for it in the local language (Amharic). The needs reflections of patients were categorized into diabetes education and participants' recommendations. Diabetes education was totally absent at hospitals, and patients received education primarily from the Ethiopian Diabetes Association and broadcast and digital media. Thus, the major concern of patients was the availability of diabetes education programs at health institutions. Conclusions: Patients' main concern was the absence of routine diabetes education, which necessitates urgent action to implement diabetes education programs, especially at health institutions.