• Physical Therapy Rehabilitation Science
• /
• v.7 no.3
• /
• pp.139-145
• /
• 2018

Objective: Older persons with diabetes mellitus (DM) are particularly more likely to have fallen in the previous year than those without DM. The purpose of this study was to investigate the relationship between the risk of falls and type 2 DM in older adults who are 65 years of age or above. Design: A systematic review. Methods: PubMed and other two databases were searched up to August 2, 2018. Observational and cohort studies evaluating fall risk in people who are 65 years of age or above with DM were included. This review extracted the following information from each study selected: first author's surname, year of publication, country, average follow-up period, sex, age at enrollment, study population, measurement variables, relative risk, 95% confidence intervals and controlled variables. Results: This review involved nine cohort studies with 3,765 older adults with DM and 12,989 older adults without DM. Six studies compared with or without DM and two studies compared fallers with non-fallers with DM. Risk factors for falls included impaired cognitive function, diabetes-related complications (peripheral nerve dysfunction, visual impairment), and physical function (balance, gait velocity, muscle strength, and severity of physical activities). Conclusions: People who are 65 years of age or above with DM have increased risk of falling caused by impaired cognitive function, peripheral nerve dysfunction, visual impairment, and physical function in community-dwellers. For adults who are 65 years of age or older with DM, research fields and clinical settings should consider therapeutic approaches to improve these risk factors for falls.

• Nutrition Research and Practice
• /
• v.3 no.2
• /
• pp.141-148
• /
• 2009

The purpose of this study was to investigate the degree of family support for diabetic patients and the diet therapy practice of patients themselves, and to analyze the relationship between family support and diet therapy practice and blood glucose control, and thus to prepare basic data for the development of effective education programs to improve blood glucose control in diabetic patients. The study subjects were 82 patients with type II diabetes, aged over 20 in the Chungbuk area. The gender distribution of subjects was 52.4% males and 47.6% females, and BMI showed 29.3% overweight and 35.3% obesity. Among the 82 study subjects, the relationship between diet therapy related family support and blood glucose control was examined in 67 subjects who answered practicing diet therapy, and the results showed that the family support score of a group with excellent blood glucose control was significantly higher than those of groups with fair or poor control (p<0.001) and the correlation between the two factors was very high (r=0.341, p<0.001). For the relationship between diet therapy practice by patients themselves and blood glucose control, diet therapy practice of a group with excellent blood glucose control was significantly higher than those of other groups (fair or poor control groups) (p<0.001) and the correlation between two factors was very high (r=0.304, p<0.001). For other factors influencing blood glucose control, a group with diabetes education showed significantly better blood glucose control compared to other groups without education (p<0.05). From the above results, diet therapy practice by patients, family support, and the necessity of diabetes education were confirmed to control blood glucose of diabetic patients. In conclusion, development and operation of education program should include not only patients but also their family members.

• Korean Journal of Community Nutrition
• /
• v.5 no.1
• /
• pp.23-35
• /
• 2000

The purpose of this study was to find the sociopsychological factors influencing the compliance of dietary regimen in diabetes by using focus group interviews. The data were collected from fifty three diabetes patients in eleven focus groups from September 1997 to March , 1998 in Seoul and Suwon Korea. The interviews were tape-recorded and the contents of the interviews were analysed by researchers. The subjects knew the causes, complications, and therapies of diabetes although they were incorrect at times . Patients had a wide range of outcome expectations from very optimistic to pessimistic. They recognized diabetes as a disease which needs life-time care, and they though that good care could provide a normal life. One the other hand they thought diabetes could lead to death through complications, and cause financial problems as well as social isolation. As for self-efficacy they recognized the importance of compliance to diet regimen but they thought the diet therapy was very difficult and were not very willing to follow it. They felt medical professionals, especially doctors, were influential for the therapies. However they frequently felt counselling provided by doctors was insufficient in time and content and led to attitude problems. They felt support from families and others was often insufficient and inadequate. Nutrition education fostering outcome expectation, social support, and self-efficacy is needed to increased compliance. The most influential referents were medical professional including doctors, nurses, dieticians, so their role in diet therapy should by emphasized.

• Clinical and Experimental Pediatrics
• /
• v.58 no.8
• /
• pp.309-312
• /
• 2015

Permanent neonatal diabetes mellitus refers to diabetes that occurs before the age of 6 months and persists through life. It is a rare disorder affecting one in 0.2-0.5 million live births. Mutations in the gene KCNJ11, encoding the subunit Kir6.2, and ABCC8, encoding SUR1 of the ATP-sensitive potassium ($K_{ATP}$) channel, are the most common causes of permanent neonatal diabetes mellitus. Sulfonylureas close the $K_{ATP}$ channel and increase insulin secretion. KCNJ11 and ABCC8 mutations have important therapeutic implications because sulfonylurea therapy can be effective in treating patients with mutations in the potassium channel subunits. The mutation type, the presence of neurological features, and the duration of diabetes are known to be the major factors affecting the treatment outcome after switching to sulfonylurea therapy. More than 30 mutations in the KCNJ11 gene have been identified. Here, we present our experience with a patient carrying a novel p.H186D heterozygous mutation in the KCNJ11 gene who was successfully treated with oral sulfonylurea.

• Journal of Physiology & Pathology in Korean Medicine
• /
• v.23 no.6
• /
• pp.1399-1403
• /
• 2009

The aim of the present study was to evaluate the possibility of protective effectness of swimming exercise and Gastrodia elata blume oral administration against beta-cell damage in streptozotocin (STZ)-induced diabetes in rats. The animals were divided into five groups: the normal group(n=10), the STZ-induced diabetes group(n=10), the STZ-induced diabetes and moderate-intensity exercise group(n=10), the STZ-induced diabetes Gastrodia elata blume(300 mg/kg) oral administration group(n=10), the STZ-induced diabetes and moderate-intensity exercise and Gastrodia elata blume(300 mg/kg) oral administration group(n=10). Animals in the exercise groups were made to swim moderate swimming exercise protocols once a day for 4 consecutive weeks. Serum glucose concentration and insulin level, superoxide dismutase (SOD) and catalase (CAT) were measured in serum. Swimming exercise and Gastrodia elata blume extract administration has shown anti-diabetic effect probably through decreasing serum glucose and insulin level and increasing antioxidant enzyme activity.

• Journal of mucopolysaccharidosis and rare diseases
• /
• v.2 no.2
• /
• pp.35-37
• /
• 2016

Prader-Willi syndrome (PWS) often develops type 2 diabetes mellitus (T2DM) related to severe obesity. The prevalence of T2DM in adults with PWS (7-20%) exceeds greatly the prevalence in the general population (5-7%). It is uncommon for pre-pubertal children with PWS to develop overt diabetes or glucose intolerance. GH therapy and genotype did not influence the development of altered glucose metabolism. It has been assumed that T2DM in PWS develops as a consequence of morbid obesity and concomitant insulin resistance. However recent studies suggest the relationship between morbid obesity and T2DM development is more complex and appears to differ in PWS subjects compared to non-PWS subjects. PWS patients had relatively lower fasting insulin levels and increased adiponectin levels compared with BMI-matched obese control despite of similar levels of leptin. So PWS children may be protected to some extent form of obesity-associated insulin resistance. Although there's no data, it seems logical to approach diabetes management including weight loss and increased exercise, using similar pharmacological agents as with non-PWS obesity-related diabetes such as metformin or thiazolidinedione, with the introduction of insulin as required. On the other hand, several recent T2DM in PWS case reports suggest favorable outcomes using Glucagon-like peptide 1 (GLP-1) analog with regard to ghrelin reduction, control of glucose and appetite, weight loss and pre-prandial insulin secretion. The role of GLP-1 agonist therapy is promising, but has not yet been fully elucidated.

• Korean Journal of Human Ecology
• /
• v.18 no.1
• /
• pp.211-221
• /
• 2009

The study investigated medical treatment features of patients with type 2 diabetes mellitus, their further complications, levels of diet therapy education and the status of dietary compliance. The subjects were patients who came to oriental medicine clinics in Daejon. The percentage of male was 37.5% and female was 62.7% in the subject group's sex distribution. The outbreak of the disease was most common in the age of 50's. Also 40% of the subjects had been suffering for more than 5 years. 35.7% of men and 53.7% of women had family history. All the subjects had further complications, among them hypertension was the most common. Kidney, hepatic, vascular heart diseases were followed. 85.3% of the subjects answered they already had educations about diet therapy. Those educations were given in the public health center, general and private hospitals. 32% of subjects were not practicing diet therapy. The difficulties with which patients can be faced when they take dietary education were exchange(?exchanging?) food and calculating calories. Most of the subjects tend to overlook the importance of dietary habits and show low understanding to diet therapy, which leads to low participation rate of diabetes patients. Based on these results, therefore, we can conclude that diet therapy education to the patients should be more organized and easily practicable for them. To develop educational methods which can draw patients' attention and also be more effective is the most important task.

• Physical Therapy Rehabilitation Science
• /
• v.7 no.4
• /
• pp.197-203
• /
• 2018

Objective: Independent walking is the most essential prerequisite to maintain quality of life in older persons. The purpose of this review was to investigate the effect of fall prevention strategies on fall risk for type 2 diabetes mellitus (T2DM) within community-dwelling older adults aged 65 and over. Design: A systematic review and meta-analysis. Methods: PubMed and three other databases were searched up to October 31st, 2018 and randomized controlled trials (RCTs) evaluating fall prevention strategies for fall risk in persons who were 65 years of age or above with T2DM were included. The review extracted the following information from each study selected: first author's surname, published year, country, study population, type of intervention, intensity of intervention, comparison, measurement variables, additional therapy, summary of results, and mean and standard deviation from selected studies. Results: This review selected fourteen RCTs with 460 older adults with diabetes mellitus. Of the 14 studies, the types of intervention used to improve the risk of falls were strengthening (5), aerobic exercises (2), multimodal exercises (4), one virtual reality exercise (1), whole body vibration with balance exercise (1), and Tai Chi exercise (1). Seven RCTs were eligible for the meta-analysis. Therapeutic interventions were more effective than the control group for the Timed Up-and-Go test (-1.11; 95% CI, -1.82 to -0.41) and the 6-minute Walk Test (-1.89; 95% CI, -8.33 to 4.54). Conclusions: The results of the review suggest that interventions to prevent fall risk in older adults with T2DM should focus on strengthening, balance, aerobic, and multimodal exercises.

• Asian-Australasian Journal of Animal Sciences
• /
• v.23 no.5
• /
• pp.672-679
• /
• 2010

Diabetes mellitus is a worldwide epidemic with high mortality. As concern over this disease rises, the number and value of research grants awarded by the National Research Foundation of Korea (NRF) have increased. Diabetes mellitus is classified into two groups. Type 1 diabetes requires insulin treatment, whereas type 2 diabetes, which is characterized by insulin resistance, can be treated using a variety of therapeutic approaches. Hyperglycemia is thought to be a primary factor in the onset of diabetes, although hyperlipidemia also plays a role. The major organs active in the regulation of blood glucose are the pancreas, liver, skeletal muscle, adipose tissue, intestine, and kidney. Diabetic complications are generally classified as macrovascular (e.g., stroke and heart disease) or microvascular (i.e., diabetic neuropathy, nephropathy, and retinopathy). Several animal models of diabetes have been used to develop oral therapeutic agents, including sulfonylureas, biguanides, thiazolidinediones, acarbose, and miglitol, for both type 1 and type 2 diseases. This review provides an overview of diabetes mellitus, describes oral therapeutic agents for diabetes and their targets, and discusses new developments in diabetic drug research.

• Research in Community and Public Health Nursing
• /
• v.33 no.4
• /
• pp.446-455
• /
• 2022

Purpose: This study investigated the mediating effects of acceptance action on the relationship between diabetes distress and self-stigma in older adults with diabetes. Methods: A descriptive research approach was adopted using 187 patients diagnosed with diabetes mellitus by an endocrinology doctor. The data were collected from 26 to 31 March, 2020 and were analyzed using descriptive statistics, t-test, one-way ANOVA, Pearson's correlation coefficient analysis, and hierarchical multiple regression. Results: The mean scores for diabetes distress, self-stigma, and acceptance action were 2.98±0.64, 2.54±0.74, and 4.16±0.35, respectively. Acceptance action partially mediated the relationship between diabetes distress and self-stigma (z=1.98, p=.024), with an explanatory power of 51.0%. Conclusion: To reduce diabetes self-stigma among old adults in diabetes distress situations, it is necessary to improve their acceptance action and develop step-by-step differentiated acceptance action enhancement programs through multidisciplinary collaborations.