• Journal of Nutrition and Health
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• v.37 no.4
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• pp.302-309
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• 2004

This study was carried out to investigate the effect of nutrition education program for diabetic patients on the glycemic control at the public health center. The study subjects, aged 61.7 $\pm$ 9.4 years, were 93 sex-and age-matched patients with type 2 diabetes mellitus. They were divided into three groups: nutrition education ＆ diet practice group (EDG), nutrition education-only group (EG), and the control group (CG). Height, weight, and the postprandial 2 hour blood glucose (PP2) were measured at baseline, and 4, 6 and 8 week after the diabetic nutrition education program. At baseline there were no differences in height, weight, and blood glucose levels among the three groups. Nutrition education programs, especially that with group lunch practice sessions were found to be effective in lowering the blood glucose levels in patients with NIDDM patients. At 4 week blood glucose levels were decreased by 40.6% and 19.6% in EDG and EG, respectively, which was further dropped by 50.2% and 35.1% at 8 week, as compared to the CG group. For the EDG group, the total energy intake, which was 162.3% of the prescription before the diet counselling session, was decreased to 113.6% of the prescription after the lunch visit, with most decrease coming from the reduction in carbohydrate and fat intake. Multiple stepwise regression analysis revealed that the total energy intake explained 47.9% and 57% of blood glucose changes for men and women, respectively, and that percent energy intake from protein explained 15.8% for women. These results demonstrate that the public health center nutrition education programs for diabetic patients, especially that with group lunch practice sessions are very effective for the glycemic control in patients with diabetes mellitus.

• Journal of Periodontal and Implant Science
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• v.43 no.2
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• pp.79-86
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• 2013

Purpose: The purpose of study was to compare glycemic control using glycated hemoglobin levels ($HbA_{1c}$) in diabetic patients with chronic generalized periodontitis (CGP) undergoing scaling and root planing (SRP) with and without systemic doxycycline. Methods: Fifty subjects with type 2 diabetes mellitus ($T_2DM$) and CGP receiving antidiabetic therapy were selected for study. The selected subjects were randomly assigned to two groups (test group [TG] and control group [CG]) comprising 25 patients each. The TG received SRP followed by systemic doxycycline. The CG received treatment with SRP only. The periodontal parameters were recorded at baseline (day zero), and every 1 month for 4 months and included probing depth, clinical attachment level, plaque index, gingival index, and $HbA_{1c}$ level were recorded at baseline (day zero) and at the end of 4 months. Results: A statistically significant effect was demonstrated for the periodontal parameters for both the TG and CG. $HbA_{1c}$ values did not show a statistically significant difference in the treatment group as compared to the CG. Conclusions: The authors concluded that nonsurgical periodontal therapy improved glycemic control in patients with $T_2DM$ in both groups, but no statistical difference was observed with adjunctive systemic doxycycline therapy. A further study with a larger sample size is required.

• Journal of Korean Academy of Nursing
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• v.35 no.7
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• pp.1314-1324
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• 2005

Purpose: The purpose of the study was to identify the effects of problem solving nursing counseling and intensified walking exercise on diabetic self-care, coping strategies, and glycemic control among older adults with DM type II. Method: Ninety nine DM patients who were older than 50 were recruited from DM clinics or public health centers and conveniently assigned into three groups: the Polar(n=41), counseling(n=30) and control groups (n=28). Participants in both Polar and counseling groups attended weekly problem solving nursing counseling for 12 weeks. Polar heart rate monitors were used in the Polar group to intensify walking exercise. Data was collected from November 2003 to August 2004 and analyzed by ANOVA or ANCOVA using the SPSS WIN program. Result: After a 12 week intervention, participants in both the Polar and counseling groups reported increased diabetic self care behaviors and decreased blood glucose levels, which is significantly different from those in the control group. There were no distinctively different program effects between the Polar and counseling groups. Conclusion: Based on the findings, we concluded that problem solving counseling alone could have positive effects on diabetic self care and glycemic controls for older adults with DM. Future research is needed to identify long-term effects of the program.

• Journal of Veterinary Clinics
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• v.18 no.1
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• pp.74-77
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• 2001

A ten-year-old, male cat presented with recent loss of body weight, depression, vomiting, anorexia, polydipsia, and polyuria. General physical findings included depression, weakness, severe dehydration and a strong acetone odor on the breath. A complete blood count and serum biochemical profiles were leukocytosis, hyperglycemia (286 mg/dl), hypokalemia (2.6 mEq/L), hyponatremia, and high serum fructosamine (600 $\mu$mol/L). In blood gas analysis the cat had acidosis (pH 7.127, p$CO_2$26.7 mmHg). In urinalysis glycosuria and ketouria were appeared. On the basis of clinical signs, serum chemistry, blood gas analysis and urinalysis, diabetic ketoacidosis was diagnosed. Treatment included subcutaneous administration of protamine zinc insulin (0.75 U/head) and intravenous administration of 0.9% saline. Potassium phosphate and sodium bicarbonate was added to the fluids. Serum fructosamine for assessment of glycemic control was measured on occasion calls. On day 296, the patient improved clinically and did not experience any problems resulting from diabetic ketoacidosis.

• Journal of Korean Academy of Nursing
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• v.34 no.7
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• pp.1277-1287
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• 2004

Purpose: This study was to evaluate the effects of a short term comprehensive life style modification program on glycemic metabolism, lipid metabolism and body composition in type 2 diabetes mellitus patients. Method: A nonequivalent control group with a pre post test was designed. Data collection was done from October 2003 to June, 2004 at a hospital. Glycemic metabolism was measured by a.c., p.c. and $HbA_{1}c$, and lipid metabolism was measured by cholesterol, HDL cholesterol, LDL cholesterol and triglycerides. Body Composition was measured by body weight, body mass index, waist, measurement waist per hip ratio, body fat, muscle weight and abdominal fat tissue(intra abdominal distance). The Experimental group, which was composed of 29 participants, was educated based on a life style modification protocol at a weekly meeting for 12 weeks and carried out exercise, diet along individual parameters and self monitoring, while 24 participants in the control group received only diet education. Result: 1. The experimental group showed a significant lower a.c.(t=2.11, p=.04) and $HbA_{1}c$(t=2.65, p=.01) compared to those of the control group. 2. The experimental group showed a significant lower LDL than the results of the control group(t=2.42, p=.02). 3. The experimental group showed a significant lower weight(t=3.09, p=.00), BMI(t=3.01, p=.00), body fat(t=2.94, p=.01) and abdominal fat tissue(t=3.05, p=.01) than those of the control group. Conclusion: The results provided evidence for the effectiveness of a short term comprehensive life style modification program composed of exercise, diet, support, self efficacy elevation and self monitoring in type 2 diabetes mellitus.

• Journal of Gastric Cancer
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• v.17 no.4
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• pp.283-294
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• 2017

Purpose: This study primarily aimed to investigate the short- and long-term remission rates of type 2 diabetes (T2D) in patients who underwent surgical treatment for gastric cancer, especially patients who were non-obese, and secondarily to determine the potential factors associated with remission. Materials and Methods: We retrospectively reviewed the clinical records of patients with T2D who underwent radical gastrectomy for gastric cancer, from January 2008 to December 2012. Results: T2D improved in 39 out of 70 (55.7%) patients at the postoperative 2-year follow-up and 21 of 42 (50.0%) at the 5-year follow-up. In the 2-year data analysis, preoperative body mass index (BMI) (P=0.043), glycated hemoglobin (A1C) level (P=0.039), number of anti-diabetic medications at baseline (P=0.040), reconstruction method (statistical difference was noted between Roux-en-Y reconstruction and Billroth I; P=0.035) were significantly related to the improvement in glycemic control. Unlike the results at 2 years, the 5-year data analysis revealed that only preoperative BMI (P=0.043) and A1C level (P=0.039) were statistically significant for the improvement in glycemic control; however, the reconstruction method was not. Conclusions: All types of gastric cancer surgery can be effective in short- and long-term T2D control in non-obese patients. In addition, unless long-limb bypass is considered in gastric cancer surgery, the long-term glycemic control is not expected to be different between the reconstruction methods.

• 월간산업보건
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• s.277
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• pp.48-53
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• 2011

• Journal of Nutrition and Health
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• v.35 no.10
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• pp.1060-1069
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• 2002

High insulin level is known to be a risk factor of coronary heart disease. High insulin level with normal glycemic control is known to be an indicator for insulin resistance. This study was aimed to find out the influencing factors for the fasting serum insulin levels in elderly females with normal glycemic control. One hundred thirty-eight older females aged over 60 years without diabetes medication and high blood HBA1c level were examined on the serum fasting insulin concentration, anthropometry and asked about nutrient intake and exercise habits. The elderly were categorized into 3 group according to the fasting insulin level. The high insulin group was in a state of hyperinsulinemia. Except vitamin C, the nutrient intakes showed no difference according to fasting serum insulin level. But the intakes of calorie and protein per kg body weight were significantly lower in the high insulin group. The intakes of most nutrients except vitamin B$_1$, C and niacin were lower than the korean RDA in all the insulin group. Especially, the intakes of vitamin B$_1$ and Ca were below 75% of the korean RDA. Weight, BMI, body fat percent, body fat mass and fat-free mass, circumferences of waist and hip, WHR of elderly females were significantly higher in the group with the highest insulin level. The body fat percent in the highest insulin group was 35.8%. showing a state of obesity. The high insulin group showed higher proportion of low exercise frequencies per week and short exercise duration. Therefore, the mean energy expenditure for exercise were lower in this group, showing a state of very low exercise activity. Age and waist circumference in elderly females could explain to the 14.5% variances of the fasting insulin level according to multiple stepwise regression. It can be concluded that aging and central body fat deposition influence independently the serum fasting insulin level in elderly females with normal glucose level.

• Diabetes and Metabolism Journal
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• v.42 no.6
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• pp.480-487
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• 2018

Background: This study aimed to evaluate the relationship between the frequency of self-monitoring of blood glucose (SMBG) and glycosylated hemoglobin (HbA1c) levels among Korean adolescents with type 1 diabetes mellitus (T1DM). Factors affecting the SMBG frequency were analyzed in order to improve their glycemic control. Methods: Sixty-one adolescents aged 13 to 18 years with T1DM were included from one tertiary center. Clinical and biochemical variables were recorded. Factors associated with SMBG frequency were assessed using structured self-reported questionnaires. Results: Average total daily SMBG frequency was $3.8{\pm}2.1$ and frequency during the school day was $1.3{\pm}1.2$. The mean HbA1c level was $8.6%{\pm}1.4%$. As the daily SMBG frequency increased, HbA1c levels declined (P=0.001). The adjusted odds of achieving the target HbA1c in participants who performed daily SMBG ${\geq}5$ significantly increased 9.87 folds (95% confidence interval [CI], 1.58 to 61.70) compared with those performed SMBG four times a day. In the subjects whose SMBG frequency <1/day during the school day, an 80% reduction in the adjusted odds ratio 0.2 (95% CI, 0.05 to 0.86) showed compared to the group with performing two SMBG measurements in the school setting. The number of SMBG testing performed at school was significantly high for individuals assisted by their friends (P=0.031) and for those who did SMBG in the classrooms (P=0.039). Conclusion: Higher SMBG frequency was significantly associated with lower HbA1c in Korean adolescents with T1DM. It would be necessary to establish the school environments that can facilitate adequate glycemic control, including frequent SMBG.

• Research in Community and Public Health Nursing
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• v.20 no.3
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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.