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Self-management levels of diet and metabolic risk factors according to disease duration in patients with type 2 diabetes

  • Cho, Sukyung;Kim, Minkyeong;Park, Kyong
    • Nutrition Research and Practice
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    • v.12 no.1
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    • pp.69-77
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    • 2018
  • BACKGROUND/OBJECTIVES: Metabolic risk factors should be managed effectively in patients with type 2 diabetes mellitus (T2DM) to prevent or delay diabetic complications. This study aimed to compare the self-management levels of diet and metabolic risk factors in patients with T2DM, according to the duration of illness, and to examine the trends in self-management levels during the recent decades. SUBJECTS/METHODS: Data were collected from the Korea National Health and Nutrition Examination Surveys (KNHANES, 1998-2014). In our analysis, 4,148 patients with T2DM, aged ${\geq}30years$, were categorized according to the duration of their illness (< 5 years, 5-9 years, and ${\geq}10years$). Demographic and lifestyle information was assessed through self-administered questionnaires, and biomarker levels (e.g., fasting glucose level, blood pressure, or lipid level) were obtained from a health examination. Dietary intake was assessed by a 24-recall, and adherence level to dietary guidelines (meal patterns and intake levels of calories, carbohydrates, vegetable/seaweed, sodium, and alcohol) were assessed. Multivariable generalized linear regression and unconditional logistic regression models were used to compare the prevalence rates of hyperglycemia, dyslipidemia, and hypertension according to the duration of patients' illness, accounting for the complex survey design of the KNHANES. RESULTS: In the multivariable adjusted models, patients with a longer duration (${\geq}10years$) of T2DM had a higher prevalence of hyperglycemia than those with a shorter duration of T2DM (< 5 years) (odds ratio 2.20, 95% confidence interval 1.61-3.01, P for trend < 0.001). We did not observe any associations of disease duration with the prevalence of hypertension and dyslipidemia. In addition, the adherence levels to dietary recommendations did not significantly differ according to disease duration, except adherence to moderate alcohol consumption. There were significant decreasing trends in the prevalence of hyperglycemia in patients with a duration of illness ${\geq}10years$ (P for trend = 0.004). CONCLUSION: Although the proportion of patients with adequate control of glucose levels has improved in recent decades, poorer self-management has been found in those with a longer disease duration. These findings suggest the need for well-planned and individualized patient education programs to improve self-management levels and quality of life by preventing or delaying diabetic complications.

Effect on Instant Buckwheat Noodle on Digestibility and Lipids Profiles of Liver and Serum in Rats (인스탄트 메밀국소가 백서의 소화흡수율, 간장 및 혈청지질 농도에 미치는 영향)

  • Choi, Yong-Soon;Ahn, Cheol;Shim, Ho-Heum;Choe, Myeon;Oh, Sang-Yong;Lee, Sang-Young
    • Journal of the Korean Society of Food Science and Nutrition
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    • v.21 no.5
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    • pp.478-483
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    • 1992
  • To evaluate a possible effects of instant buckwheat noodle on hepatic and serum lipids profiles, apparent digestibilities and growth rate, male young rats were fed diets containing sucrose as a control group, instant 100% wheat flour noodle, or instant wheat noodle fortified with either 10% or 30% buckwheat flour as experimental groups for 4 weeks. Weight gain and feed intake in the two buckwheat noodle fed groups were similar to those of the wheat flour fed groups. In addition, no significant differences were found in the apparent digestibilities among the groups experimented. There were no differences in the hepatic and serum cholesterol levels due to the diets. However, Buckwheat noodle group showed a trend to decrease the liver and serum concentration of triacylglycerol, compared to the sucrose and 100% wheat flour groups. The addition of buckwheat flour to wheat flour up to 30% seemed to be effective in lowering the hepatic triacylglycerol level. After 10hr fasting, the serum glucose level of the buckwheat noodle group was similar to the levels of the other groups. The presented results indicate that instant noodle containing buckwheat at the level of 30% has a mild hypotriglyceridemic effects, and no adverse effects on the digestion of macronutrients in rats.

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Effect of Intraoperative Glucose Fluctuation and Postoperative IL-6, TNF-α, CRP Levels on the Short-term Prognosis of Patients with Intracranial Supratentorial Neoplasms

  • Liu, Tie-Cheng;Liu, Qi-Ran;Huang, Ying
    • Asian Pacific Journal of Cancer Prevention
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    • v.15 no.24
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    • pp.10879-10882
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    • 2015
  • Objective: To investigate the effect of intraoperative glucose fluctuation and postoperative interlukin-6 (IL-6), tumor necrosis factor-${\alpha}$ (TNF-${\alpha}$), C-reactive protein (CRP) levels on the short-term prognosis of patients with intracranial supratentorial neoplasms. Materials and Methods: Eighty-six patients undergoing intracranial excision were selected in The Second Hospital of Jilin University. According to the condition of glucose fluctuation, the patients were divided into group A (glucose fluctuation <2.2 mmol/L, n=57) and group B (glucose fluctuation ${\geq}2.2mmol/L$, n=29). Glucose was assessed by drawing 2 mL blood from internal jugular vein in two groups in the following time points, namely fasting blood glucose 1 d before operation ($T_0$), 5 min after anesthesia induction ($T_1$), intraoperative peak glucose ($T_2$), intraoperative lowest glucose ($T_3$), 5 min after closing the skull ($T_4$), immediately after returning to intensive care unit (ICU) ($T_5$) and 2 h after returning to ICU ($T_6$). 1 d before operation and 1, 3 and 6 d after operation, serum IL-6 and TNF-${\alpha}$ levels were detected with enzyme-linked immunosorbent assay (ELISA), and CRP level with immunoturbidimetry. Additionally, postoperative adverse reactions were monitored. Results: There was no statistical significance between two groups regarding the operation time, anesthesia time, amount of intraoperative bleeding and blood transfusion (P>0.05). The glucose levels in both groups at $T_1{\sim}T_6$ went up conspicuously compared with that at $T_0$ (P<0.01), and those in group B at $T_2$, $T_4$, $T_5$ and $T_6$ were significantly higher than in group A (P<0.01). Serum IL-6, TNF-${\alpha}$ and CRP levels in both groups 1, 3 and 6 d after operation increased markedly compared with 1 d before operation (P<0.01), but the increased range in group A was notably lower than in group B (P<0.05 or P<0.01). Postoperative incidences of hypoglycemia, hyperglycemia and myocardial ischemia in group A were significantly lower than in group B (P<0.05), and respiratory support time obviously shorter than in group B (P<0.01). Conclusions: The glucose fluctuation of patients undergoing intracranial excision is related to postoperative IL-6, TNF-${\alpha}$ and CRP levels and those with small range of glucose fluctuation have better prognosis.

The Effects of Dietary Caloric Distribution on Insulin Secretion and Insulin Resistance in Sprague Dawley Rats (백서에서 식이내 열량 영양소의 배분이 인슐린 분비능과 인슐린 저항성에 미치는 영향)

  • Park, Sun-Min;Ahn, Seoung-Hee;Choi, Mi-Kyung;Kim, Young-Hee;Park, Chun-Hee;Choi, Soo-Bong
    • Journal of Nutrition and Health
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    • v.34 no.5
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    • pp.485-492
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    • 2001
  • The prevalence of type 2 diabetes mellitus has been rapidly increased in parallel with the westernization of eating behavior in Korea. Increased consumption of animal fat and simple sugar can be potential contributors for insulin resistance. The purpose of the study was to determine whether Western-(WD) and Korean-style(KD) diets altered insulin secretion and insulin resistance in male Sprague Dawley rats. Rats weighing 98$\pm$5g were provided by KD(77 En% of starch, 5 En% of corn oil and 13 En% of gluten plus 5 En% of casein), WD(42 En% of starch, 40 En% of butter and 18% of casein) or control diet(62 En% of starch, 20 En% of corn oil and 18% of casein) for 12 weeks. Body weights were lower in KD compared to WD. Fasting blood glucose levels were not different among diets. Insulin secretion from the beta cells was higher by 2.2$\pm$0.4 folds in WD than KD at baseline. In hyperglycemic clamp insulin secretion was higher in WD than KD and CD. Whole body glucose disposal rates referred to the state of insulin sensitivity were lowest in WD among groups. Glycogen deposits in soleus and quadriceps muscles were lowest in WD among all groups, but their triglyceride contents were highest. GLUT4 contents and glycogen synthase were lowest in WD in both muscles. In conclusions, westernization of diets needed more insulin to normalization of blood glucose levels due to increased insulin resistance. Thus, WD would lead to increased prevalence of diabetes mellitus when increased insulin resistance could not be compensated by insulin secretion in the case of elevated blood glucose levels. (Korean J Nutriton 34(5) : 485~492, 2001)

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Associations of dietary intake and metabolic syndrome risk parameters in Vietnamese female marriage immigrants in South Korea: The KoGES follow-up study

  • Yang, Hyesu;Kim, Hyesook;Kim, Ji-Myung;Chung, Hye Won;Chang, Namsoo
    • Nutrition Research and Practice
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    • v.10 no.3
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    • pp.313-320
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    • 2016
  • BACKGROUND/OBJECTIVES: This study was conducted to compare the overall changes in dietary intake and metabolic syndrome risk parameters in Vietnamese marriage-based female immigrants over time. SUBJECTS/METHODS: The subjects of this study were 581 Vietnamese marriage-based female immigrants, who were recruited from local clinical centers in Korea. Baseline data were collected from 2006-2011 and the follow-up data were collected from 2012-2014. Dietary food intake was assessed by a 1-day 24-hour recall method. RESULTS: Compared to the baseline, the mean body weight, body mass index, waist circumference, high density lipoprotein (HDL)-cholesterol, systolic blood pressure and diastolic blood pressure increased while the fasting blood sugar, triglycerides and low density lipoprotein-cholesterol decreased at follow-up. The total consumption of foods such as vegetables/fruits/seaweeds/mushrooms, oil and fat, and eggs decreased during the follow-up period, whereas the consumption of sugars, beverages and meats increased. Partial correlation between the rate of change [(Follow-up - Baseline) / Baseline ${\times}100$] in metabolic syndrome risk parameters and food intake after controlling for confounding factors showed that the waist circumference was positively correlated with either the total plant food intake (r = 0.1042, P = 0.0129) or the total food intake (r = 0.0880, P = 0.0359). The plasma levels of total cholesterol (r = -0.1918, P = 0.0289) and HDL-cholesterol (r = -0.1424, P = 0.0007) were negatively correlated with the percentage of total intake from plant food, and HDL-cholesterol levels were positively correlated with the intake of total animal food (r = 0.0980, P = 0.0217). The serum C-reactive protein levels were positively correlated with the total intake of animal food (r = 0.2374, P < 0.0001) or the percentage of total intake from animal food (r = 0.1346, P = 0.0016). CONCLUSIONS: These results suggest that the change rate of dietary intake such as total plant food or animal food is associated with the change rates of metabolic syndrome risk parameters.

Inhibitory activity of Euonymus alatus against alpha-glucosidase in vitro and in vivo

  • Lee, Soo-Kyung;Hwang, Ji-Yeon;Song, Ji-Hyun;Jo, Ja-Rim;Kim, Myung-Jin;Kim, Mi-Eun;Kim, Jung-In
    • Nutrition Research and Practice
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    • v.1 no.3
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    • pp.184-188
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    • 2007
  • The major goal in the treatment of diabetes mellitus is to achieve near-normal glycemic control. To optimize both fasting blood glucose and postprandial glucose levels is important in keeping blood glucose levels as close to normal as possible. ${\alpha}-Glucosidase$ is the enzyme that digests dietary carbohydrate, and inhibition of this enzyme could suppress postprandial hyperglycemia. The purpose of this study was to test the inhibitory activity of methanol extract of Euonymus alatus on ${\alpha}-glucosidase$ in vitro and in vivo to evaluate its possible use as an anti-diabetic agent. Yeast ${\alpha}-glucosidase$ inhibitory activities of methanol extract of E. alatus were measured at concentrations of 0.50, 0.25, 0.10, and 0.05 mg/ml. The ability of E. alatus to lower postprandial glucose was studied in streptozotocin-induced diabetic rats. A starch solution (1 g/kg) with and without E. alatus extract (500 mg/kg) was administered to diabetic rats by gastric intubation after an overnight fast. Plasma glucose levels were measured at 30, 60, 90, 120, 180, and 240 min. Plasma glucose levels were expressed in increments from baseline, and incremental areas under the response curve were calculated. Extract of E. alatus, which had an $IC_{50}$ value of 0.272 mg/ml, inhibited yeast ${\alpha}-glucosidase$ activity in a concentration-dependent manner. A single oral dose of E. alatus extract significantly inhibited increases in blood glucose levels at 60 and 90 min (p<0.05) and significantly decreased incremental response areas under the glycemic response curve (p<0.05). These results suggest that E. alatus has an antihyperglycemic effect by inhibiting ${\alpha}-glucosidase$ activity in this animal model of diabetes mellitus.

Chlorogenic Acid Enhances Glucose Metabolism and Antioxidant System in High-fat Diet and Streptozotocin-induced Diabetic Mice (고지방식이와 스트렙토조토신으로 유도한 당뇨마우스에서 Chlorogenic Acid의 혈당강하 및 항산화 효과)

  • Lee, Jin;Seo, Kwon-Il;Kim, Myung-Joo;Lee, Su-Jin;Park, Eun-Mi;Lee, Mi-Kyung
    • Journal of the Korean Society of Food Science and Nutrition
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    • v.41 no.6
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    • pp.774-781
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    • 2012
  • This study investigated dose-response effects of chlorogenic acid (CA) on glucose metabolism and the antioxidant system in streptozotocin (STZ)-induced diabetic mice with a high-fat diet (HFD). Male ICR mice were fed with a HFD (37% calories from fat) for 4 weeks prior to intraperitoneal injection with STZ (100 mg/kg body weight). Diabetic mice were supplemented with two doses of CA (0.02% and 0.05%, wt/wt) for 6 weeks. Both doses of CA significantly improved fasting blood glucose level, glucose tolerance and insulin tolerance without any changes in plasma insulin and C-peptide levels. Plasma leptin concentration was significantly higher in the CA-supplemented groups than in the diabetic control group. Both doses of CA significantly increased hepatic glucokinase activity and decreased glucose-6-phosphatase activity compared to the diabetic control group. The ratio of glucokinase/glucose-6-phosphatase was dose-independently higher in CA-supplemented mice than in diabetic control mice. CA supplementation dose-independently elevated superoxide dismutase and catalase activities, whereas it lowered lipid peroxide levels compared to the diabetic control mice in the liver and erythrocyte. These results suggest that low-dose CA may be used as a hypoglycemic agent in a high-fat diet and STZ-induced diabetic mice.

The Relation of Biochemical Examination, Metabolic Syndrome and Life Style of the Gallbladder Polyp in Health Examination Examinees (건강검진 수진자에서 담낭용종과 생화학적검사, 대사증후군 및 생활습관의 관련성)

  • Park, Yoen-Hwa;Kang, Jae-Sun;Lee, Hea-Nam
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.17 no.2
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    • pp.386-393
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    • 2016
  • The incidence of gallbladder polyps are increasing due to the extended use of ultrasonography. Although there are various reports on the risk of gallbladder polyps, there are few studies of the relationships among the presence of metabolic syndrome including serum biochemistry, lifestyle and the development of gallbladder polyps. The aim of this study was to determine association of the presence of metabolic syndrome, including serum biochemistry, with the development of gallbladder polyps in the Korean population. Among the health examination examinees, 596 people, who underwent abdominal ultrasonography from January, 2013 to December 2013, were included in this study. Physical measurements also taken, such as height, weight, blood pressure, waist measurement, and BMI. The general characteristics including age, sex, smoking, and drinking as the related factors were checked. At the same time, various blood tests were performed and the fasting blood sugar was analyzed through blood-gathering to determine the presence of metabolic syndrome. Regarding the factors associated with gallbladder polyps, the results showed that being male, smoking, non-drinking were significantly high. In addition, testing positive for HBsAg and an increasing BMI was apparently higher the group with metabolic syndrome than the non-metabolic syndrome group. The highest predictive factors for gallbladder polyps was being male (1.8 times), followed by metabolic syndrome (2.3 times) and testing positive for HBsAg (2.6 times).

Relationship between Psychosocial Stress and Coronary Risk Factors of Employees in a Research Institute (일부 남성 연구원들의 사회심리적 스트레스와 관상동맥질환 위험인자의 관련성)

  • Park, Chun-Ja;Kwon, In-Sun;Cho, Young-Chae
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.11 no.1
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    • pp.392-401
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    • 2010
  • The purpose of the present study was intended to assess psycosocial stress of male researchers working in a Research Institute, and to reveal the relationship between psycosocial stress and coronary risk factors. Data were obtained from 356 male researchers who underwent health package check-up at the health promotion center of a university hospital from May to June 2007, using by self-administered questionnaire & health check-up. For psycosocial stress, we used the questionnaire with 18 items developed as Psychosocial Well-bing Index(PWI). For coronary risk factors, systolic and diastolic blood pressure(SBP, DBP), triglyceride(TG), total cholesterol(TC), high and low density lipoprotein cholesterol(HDL, LDL), fasting blood sugar(FBS) and % fat rate were measured. As a results, the level of psycosocial stress is influenced by socio-demographic characteristics, job-related characteristics and health-related behaviors. Especially, it was found to have the inter-relational effects that the higher the blood pressure, the higher the level of psycosocial stress.

Effect of Dietary Bellflower(Platycodon glandiflorum) and Red Ginseng on Hypercholesterolemic Rats (홍삼 및 도라지 분말이 흰쥐의 혈청 및 지질에 미치는 영향)

  • Noh, Kyung-Hee;Kim, Eul-Sang
    • Journal of the Korean Society of Food Science and Nutrition
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    • v.13 no.4
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    • pp.413-420
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    • 1984
  • Effects of bellflower and red ginseng on plasma and liver lipid metabolism in rats receiving dietary cholesterol were studied. During experimental period of 14 days the rats were divided into four dietary groups: standard diet: Control diet containing 1% cholesterol and 0.25% sodium cholate to the standard diet: bellflower diet containing 5% bellflower to the control diet, and red ginseng diet containing 5% red ginseng to the control diet. The contents of total cholesterol (TC), HDL-cholesterol(HC), total lipid(TL) and triglyceride(TG) in the plasma and liver were determined after 12 hours fasting. Liver weight of the rats fed control, bellflower or red ginseng diets was greater than that of the rats fed standard diet, however, kidney weight was greater at the standard group. Spleen weight was slightly greater in bellflower diet group. Rats fed control, bellflower and red ginseng diets showed significantly higher concentrations of TL, TC and TG, but lower concentration of HC in the plasma and liver than rats fed standard diet. Neither dietary bellflower nor red ginseng changed the levels of these four classes of lipid in the plasma of control diet group. But bellflower reduced the level of TG in the liver.

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