• 기본간호학회지
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• 제19권2호
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• pp.168-178
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• 2012

Purpose: The purpose of this study was to compare self-care behavior, diabetes-related stress and stress coping style among 3 blood glucose control groups (good, inadequate, and poor blood glucose control groups). Methods: Participants were 102 type 2 diabetic patients (good group: 41, inadequate group: 31, poor group: 30). Data were collected from Feb 19 to Mar 24, 2010 and were analyzed using Chi-square, Fisher's exact test and ANCOVA with SPSS/WIN 12.0. Results: Using ANCOVA with frequency of admission, and illness duration as covariates, significant differences were found among the 3 groups in self-care behavior (total score) and the exercise subscale. Using ANCOVA significant differences were found among 3 groups in diabetes-related stress (total score), emotional burden subscale and regimen distress subscale. Using ANCOVA no difference in stress coping was found among the 3 groups, but there was a significant difference in the problem-oriented coping subscale. Conclusions: Self-care behavior, diabetes-related stress, and stress coping style are factors influencing blood glucose control. The results of this study suggest that for improving blood glucose control, self care education program focused on diet and exercise in addition to stress management program for promoting problem oriented coping capability are recommended.

• BMB Reports
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• 제53권2호
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• pp.100-105
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• 2020

While liver histopathology is heterogeneous in diabetes, the underlying mechanisms remain unclear. We investigated whether glycemic variation resulting from differential diets can induce heterogeneity in diabetic liver and the underlying molecular mechanisms. We generated end-stage non-obese diabetic model rats by subtotal-pancreatectomy in male Sprague-Dawley rats and ad libitum diet for 7 weeks (n = 33). The rats were then divided into three groups, and fed a standard- or a low-protein diet (18 or 6 kcal%, respectively), for another 7 weeks: to maintain hyperglycemia, 11 rats were fed ad libitum (18AL group); to achieve euglycemia, 11 were calorie-restricted (18R group), and 11 were both calorie- and protein-restricted with the low-protein diet (6R group). Overnight-fasted liver samples were collected after the differential diets together with sham-control (18S group), and histology and molecular changes were compared. Hyperglycemic-18AL showed glycogenic hepatopathy (GH) without steatosis, with the highest GSK-3β inactivation because of Akt activation during hyperglycemia; mitochondrial function was not impaired, compared to the 18S group. Euglycemic-18R showed neither GH nor steatosis, with intermediate GSK-3β activation and mitochondrial dysfunction. However, euglycemic-6R showed both GH and steatosis despite the highest GSK-3β activity and no molecular evidence of increased lipogenesis or decreased ApoB expression, where mitochondrial dysfunction was highest among the groups. In conclusion, heterogeneous liver histopathology developed in end-stage non-obese diabetic rats as the glycemic levels varied with differential diets, in which protein content in the diets as well as glycemic levels differentially influenced GSK-3β activity and mitochondrial function in insulin-deficient state.

• 대한영양사협회학술지
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• 제5권1호
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• pp.64-73
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• 1999

Carbohydrate(CHO) counting is a meal planning approach used with diabetic patients that focuses on carbohydrate as the primary nutrient affecting post-prandial glycemic response. However, it has not been used in meal management of diabetic patients in Korea. CHO counting can be used by clients with type 1 and 2 diabetes. The purpose of the study was to determine the barriers to utilize the CHO counting when three levels of CHO counting were educated to type 2 diabetic patients who started continuous subcutaneous insulin infusion (CSⅡ) therapy by nutrition lectures and counseling. And the CHO-to-insulin ratios were determined for the individual patients who followed the carbohydrate counting as a meal management, and the factors to influence the CHO-to-insulin ratios were selected through the stepwise regression analysis. Twenty- four subjects were received three lectures, and one or two nutritional counseling for a month. The average age of the subjects was 50.7 years, and the duration of diabetes was 9.4 years. Their body mass index (BMI) was 21.5 kg/$m^2$. The difficulties of using CHO counting were 1) confusing the CHO exchange system to diabetic food exchange system, 2) lack of basic nutrition and not distinguishing nutrients such as CHO, fat and calorie, and 3) lack of motivation to make effort to count and record the amount of carbohydrates eaten. Nutritional counseling replenished the nutrition education and made patients practice CHO counting. Average CHO-to-insulin ratios at breakfast, lunch and dinner were 4.1$\pm$3.3, 2.9$\pm$2.6 and 2.9$\pm$3.0units/23g of CHO, respectively. CHO-to-insulin ratios were influenced by gender, age, BMI, post-prandial blood glucose levels and post-prandial c-peptide levels. The effective education and nutritional counseling of CHO counting can make CHO counting applicable to type 2 diabetic patients as meal management for improving glycemic control with less hypoglycemic episode.

• 한국식품과학회지
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• 제41권6호
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• pp.668-672
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• 2009

고아미쌀에서 분리해낸 전분에 octenyl succinic anhydride기를 도입하여 에스테르화한 후 $130^{\circ}C$에서 2시간 열처리하여 변성전분을 제조하고 이를 밀가루와 50:50으로 섞어 제조한 쿠키는 밀가루만을 사용한 쿠키와 비교해볼 때 혈당상승을 지연시키는 효과가 컸으나 쿠키의 단단함과 바삭거림은 많이 떨어졌다. 쿠키의 선호도는 색이나 고소한 냄새보다는 경도와 바삭거림과 같은 조직감 특성에 많이 좌우되므로 조직감 향상을 위해 밀가루와 변성전분을 50:50으로 섞은 후 총 가루함량의 0.5%에 해당하는 xanthan 검을 첨가하여 반죽을 만들고 쿠키를 제조하면 검류와 전분의 상호작용으로 인해 단단함과 바삭거림 등 조직감의 향상과 함께 당지수를 효과적으로 낮춰 당뇨환자들의 간식으로 소비될 수 있을 것으로 기대된다. 본 실험에 사용된 변성전분은 당지수를 충분히 감소시킬 수 있으므로 쿠키뿐 아니라 혈당조절이 필요한 식품에 밀가루를 대체할 식품소재로 사용될 수 있을 것이며, 동시에 고아미 쌀의 소비도 증가시킬 수 있을 것으로 생각된다.

• BMB Reports
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• 제44권11호
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• pp.713-718
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• 2011

In this study, the effects of sitagliptin analogue (SITA) or pioglitazone (PIO) treatment on glucose homeostasis and ${\beta}$-cell dynamics in animal models of type 2 diabetes-Akita and db/db mice were evaluated. After 4-6 weeks of treatment, both SITA and PIO were shown to lower non-fasting glucose levels and reduced glycemic excursion in the intraperitoneal glucose tolerance test. In addition, both drugs preserved normal islet structure and the proportion of ${\beta}$-cells in the islets. Compared to the controls, SITA treatment induced a higher ${\beta}$-cell proliferation rate in Akita mice and a lower rate of apoptosis in db/db mice, whereas PIO treatment induced a lower rate of apoptosis in db/db mice and reduced proliferation rates in Akita mice. In conclusion, both SITA and PIO appear to exert some beneficial effects on the islet structure in addition to glycemic control via different mechanisms that involve ${\beta}$-cell dynamics in Akita and db/db mice.

• 동아시아식생활학회지
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• 제26권5호
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• pp.450-456
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• 2016

과당의 이성체인 알룰로오스가 저혈당 및 저칼로리효과를 갖는 건강쿠키를 제조하는데 설탕대체제로 이용이 될 수 있는지 평가하였다. 설탕(대조군), 과당, 포도당, 알룰로오스를 사용하여 이들 설탕대체제들의 효과를 SRC, DSC, RVA, 와이어 컷 쿠키 방법으로 평가하였다. SRC 결과에서 용액에 접근 가능한(solvent-accessible) 아라비노자일란이 다른 당용액에 비해 알룰로오스에서 가장 적게 부푸는 것으로 관찰되었다. DSC와 RVA 결과들에서 각각 밀가루 전분의 호화 및 전분 pasting의 개시가 모두 물 < 알룰로오스 < 과당 < 포도당 < 설탕의 순서로 지연됨을 알 수 있었다. 사용한 당 중에서 포도당으로 만든 쿠키가 지름과 두께 측면에서 가장 선호되지 않는 특성을 나타냈다. 알룰로오스의 쿠키 베이킹 적성은 설탕에 비해 조금은 부족하지만 과당보다는 뛰어나 과당대 체제로나 설탕대체제로 저칼로리 저혈당효과가 있는 쿠키를 제조하는데 성공적으로 이용될 수 있음을 시사하였다.

• Journal of Ginseng Research
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• 제45권5호
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• pp.546-554
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• 2021

Background: Diabetes mellitus and hypertension often occur together, amplifying cardiovascular disease (CVD) risk and emphasizing the need for a multitargeted treatment approach. American ginseng (AG) and Korean Red Ginseng (KRG) species could improve glycemic control via complementary mechanisms. Additionally, a KRG-inherent component, ginsenoside Rg3, may moderate blood pressure (BP). Our objective was to investigate the therapeutic potential of coadministration of Rg3-enriched Korean Red Ginseng (Rg3-KRG) and AG, added to standard of care therapy, in the management of hypertension and cardiometabolic risk factors in type-2 diabetes. Methods: Within a randomized controlled, parallel design of 80 participants with type-2 diabetes (HbA1c: 6.5-8%) and hypertension (systolic BP: 140-160 mmHg or treated), supplementation with either 2.25 g/day of combined Rg3-KRG + AG or wheat-bran control was assessed over a 12-wk intervention period. The primary endpoint was ambulatory 24-h systolic BP. Additional endpoints included further hemodynamic assessment, glycemic control, plasma lipids and safety monitoring. Results: Combined ginseng intervention generated a mean ± SE decrease in primary endpoint of 24-h systolic BP (-3.98 ± 2.0 mmHg, p = 0.04). Additionally, there was a greater reduction in HbA1c (-0.35 ± 0.1% [-3.8 ± 1.1 mmol/mol], p = 0.02), and change in blood lipids: total cholesterol (-0.50 ± 0.2 mmol/l, p = 0.01), non-HDL-C (-0.54 ± 0.2 mmol/l, p = 0.01), triglycerides (-0.40 ± 0.2 mmol/l, p = 0.02) and LDL-C (-0.35 ± 0.2 mmol/l, p = 0.06) at 12 wks, relative to control. No adverse safety outcomes were observed. Conclusion: Coadministration of Rg3-KRG + AG is an effective addon for improving BP along with attaining favorable cardiometabolic outcomes in individuals with type 2 diabetes. Ginseng derivatives may offer clinical utility when included in the polypharmacy and lifestyle treatment of diabetes. Clinical trial registration: Clinicaltrials.gov identifier, NCT01578837;

• 대한간호학회지
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• 제45권4호
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• pp.533-543
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• 2015

Purpose: This study was conducted to develop and test the effects of a motivational interviewing self-management program for use with elderly patients with diabetes mellitus. Methods: A non-equivalent control group pretest-posttest design was used. The participants were 42 elderly diabetic patients (experimental group: 21, control group: 21). The motivational interviewing self-management program for elders with diabetes mellitus developed in this study consisted of a 12-week program in total (8 weeks for group motivational interviewing and education and 4 weeks for individual motivational interviewing on the phone). Data were collected between February 13 and May 3, 2013 and were analyzed using t-test, paired t-test, and repeated measure ANOVA with SPSS/WIN 18.0. Results: For the experimental group, significant improvement was found for self-efficacy, self-care behavior, glycemic control and quality of life (daily life satisfaction, influence of disease) as compared to the control group. Conclusion: The study findings indicate that the motivational interviewing self-management program is effective and can be recommended as a nursing intervention for elderly patients with diabetes mellitus.

• Journal of Korean Biological Nursing Science
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• 제8권2호
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• pp.29-39
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• 2006

The aim of this study was to examine the effect of telephone follow-up on glycemic control, lipid profiles. and treatment method in diabetic patients with depressive symptoms over one year follow-up period. Twenty-two diabetic patients attended the structured diabetes education program between March 2004 and February 2005 and completed a questionnaire using the Beck Depression Inventory(BDI) to measure depressive symptoms. The patients showed depressive symptoms with the criterion being a BDI score at least 16. The intervention was applied to the telephone follow-up for one year. Data were analyzed using Wilcoxon signed rank test and McNemar test. The patients decreased their mean glycosylated hemoglobin(HbAlc) levels by 1.9%(p=0.001). There was a significant mean change in the fasting blood sugar(FBS) level, with a mean change of -61mg/$d{\ell}$(p=0.008). These findings indicated that the telephone follow-up may be effective in the HbAlc and FBS control.

• 정신신체의학
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• 제6권2호
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• pp.221-227
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• 1998

Although there has been a considerable research in psychoneuroendocrinology, particularly in relation to the biology of mood disorders, there has been a paucity of research regarding the effects of psychological factors on endocrine diseases. Of the existing literature, the most research is focused on diabetes mellitus, graves' disease. Especially diabetes appears to be the only endocrine disease that has been the focus of recent research studies. Most of the studies had retrospective designs or several methodological flaw. There has been no consistent results demonstrating that psychological factors affect the onset of diabetes mellitus. Several studies have suggested that psychological factors affect the course of diabetes. A small number of studies showed some evidence that psychological stress was associated with changes in glucose regulation in a subset of diabetic patients. There was also evidence to suggest that some temperament and coping skill influence glycemic control in child, adolescent diabetics. Studies of behavioral or psychosocial intervention on diabetic control have been small and have produced mixed results. There was a few controlled study suggested that stressful life events might be a causal role in Cushing's disease and Graves'disease, but there is no presently sufficient evidence to suggest that psychological factors affect the onset and the course of Cushing's disease and Graves' disease. In future, there is need for a well-designed biopsychosocial research with prospective designs, well defined patient population and control groups to study the relationship between psychological factors and endocrine diseases.