• Diabetes and Metabolism Journal
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• v.42 no.6
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• pp.496-512
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• 2018

Background: This study aimed to investigate the association between the presence and severity of cardiovascular autonomic neuropathy (CAN) and development of long-term glucose fluctuation in subjects with type 2 diabetes mellitus. Methods: In this retrospective cohort study, subjects with type 2 diabetes mellitus who received cardiovascular autonomic reflex tests (CARTs) at baseline and at least 4-year of follow-up with ${\geq}6$ measures of glycosylated hemoglobin (HbA1c) were included. The severity of CAN was categorized as normal, early, or severe CAN according to the CARTs score. HbA1c variability was measured as the standard deviation (SD), coefficient of variation, and adjusted SD of serial HbA1c measurements. Results: A total of 681 subjects were analyzed (294 normal, 318 early, and 69 severe CAN). The HbA1c variability index values showed a positive relationship with the severity of CAN. Multivariable logistic regression analysis showed that CAN was significantly associated with the risk of developing higher HbA1c variability (SD) after adjusting for age, sex, body mass index, diabetes duration, mean HbA1c, heart rate, glomerular filtration rate, diabetic retinopathy, coronary artery disease, insulin use, and anti-hypertensive medication (early CAN: odds ratio [OR], 1.65; 95% confidence interval [CI], 1.12 to 2.43) (severe CAN: OR, 2.86; 95% CI, 1.47 to 5.56). This association was more prominent in subjects who had a longer duration of diabetes (>10 years) and lower mean HbA1c (<7%). Conclusion: CAN is an independent risk factor for future higher HbA1c variability in subjects with type 2 diabetes mellitus. Tailored therapy for stabilizing glucose fluctuation should be emphasized in subjects with CAN.

• Journal of Acupuncture Research
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• v.38 no.3
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• pp.192-199
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• 2021

Background: In this retrospective study, we aimed to determine which diagnostic tests were associated with an improvement in Bell's palsy symptoms. Methods: There were 30 patients who visited Kyung Hee University Korean Medicine Hospital from April 1, 2017 to February 29, 2020, and who received East-West collaboration treatment for Bell's palsy. The tests included electroneurography (ENoG), electromyography (EMG), hematology, and heart rate variability (HRV) results which were used to determine if any test correlated with improvement of Bell's palsy symptoms. Results: The initial severity of symptoms did not correlate with the tests performed, with the exception of mean corpuscular hemoglobin concentration (p = 0.013). For both ENoG for oculi degeneration and mean EMG tests, the rate of nerve degeneration showed a significant negative correlation with the improvement of Bell's palsy symptoms. Amongst the HRV test indicators, the square root of the mean of the sum of the squares of differences between the adjacent normal R-R wave interval, the standard deviation of intervals, total power, very low frequency, and high frequency of the wave was negatively correlated with improvement of Bell's palsy symptoms. Similarly, glycosylated hemoglobin Type A1c (HbA1c) and erythrocyte sedimentation rate (ESR) showed a negative correlation with improvement of symptoms of Bell's palsy. With the exception of HbA1c and ESR, the remaining hematology test results showed no significant difference when comparing before and after treatment. Conclusion: ENoG, EMG, HRV test, HbA1c, and ESR negatively correlated with improvements in Bell's palsy symptoms and may determine the prognosis of Bell's palsy.

• The Journal of Korean Physical Therapy
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• v.24 no.5
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• pp.362-369
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• 2012

Purpose: This study examined the effects of an elastic band resistance exercise program on the body functions and Glycosylated hemoglobin (HbA1c) of elderly people with type 2 diabetes. Methods: Twenty-seven elderly patients with type 2 diabetes were enrolled in this study (exercise group 14, control group 13). The subjects in the exercise group participated in the program for 60 minutes a day, three times a week, for 12 weeks. All the subject's body functions, HbA1c were measured to compare the following: before the intervention, at the completion of the 12 weeks intervention, and eight weeks after the intervention. Results: Compared to the control group, the exercise group showed significant improvements in the 12 week and follow-up measurement after the intervention in body function, such as the strength of the upper and lower limbs, agility and limit of stability. The body functions of the exercise group improved as the period of intervention progressed. On the other hand, the HbA1c level at each follow-up measurement was similar in the two groups. Conclusion: The 12 week elastic band exercise program is recommended as an effective intervention for improving the body functions of elderly people with type 2 diabetes. Nevertheless, a combined intervention of steady exercise, diet therapy and drug therapy will be needed for further active prevention and management of type 2 diabetes.

• Advances in Traditional Medicine
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• v.8 no.2
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• pp.146-153
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• 2008

The present study is aimed at finding the influence of silymarin (a flavonoid) (25 mg/kg & 50 mg/kg) in streptozotocin (STZ)-induced diabetic rats. Type 2 diabetes was induced by single intraperitoneal injection of STZ (100 mg/kg) to 3 days old rat pups. Silymarin was administered for 15 days after the animals were confirmed diabetic (75 days after STZ injection). Blood glucose, glycosylated hemoglobin ($HbA_{1c}$), lipid peroxides (LPO) levels and reduced glutathione (GSH) contents in pancreas and liver were estimated following the established procedures. Biochemical observations were further substantiated with histological examination of pancreas. Blood glucose and $HbA_{1c}$ levels, which were elevated by STZ, were lowered to physiological levels by the administration of silymarin. The levels of LPO were significantly increased in STZ-induced diabetic rats. Silymarin reduced the LPO levels in both pancreas and liver. GSH contents which were reduced significantly in pancreas and liver of STZ-induced diabetic rats were brought back to near normal levels by silymarin treatment. Multifocal necrotic and degenerative changes of pancreas in STZ-diabetic rats were minimized to near normal morphology by administration of silymarin as evident by histopathological examination. Silymarin showed a dose dependent protective effect on STZ-induced $\beta$-cell damage. It could be attributed to the antioxidative and free radicals scavenging properties of the flavonoid. Thus, it may be considered as a natural antioxidant with potential therapeutic application in the treatment of type 2 diabetes.

• Journal of Nutrition and Health
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• v.39 no.7
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• pp.641-648
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• 2006

This study was designed to evaluate the effect of the individual nutrition education for type 2 diabetes who participate the diabetes buffet. The subjects were 66 patients and divided into education (n=34) and control groups (n=32). The mean age of education and control groups were 59.8 and 56.6 years old, respectively. There were no differences in age and body mass index (BMI) between two groups. Initial glycosylated hemoglobin (HbA1c), post prandial plasma glucose (PP2), total plasma cholesterol, and blood pressure were not different between two groups. But fasting blood sugar (FBS) was higher in education group than in control group. On completion of the study, the education group showed significant decreases in body weight, BMI, FBS and PP2, however, the control group showed no changes in body weight, BMI and PP2, and showed a significant increase in FBS. Initial calorie and protein intakes of the education group did not meet the prescribed amount, however, mineral and vitamin intakes were higher than estimated average requirement (EAR). By the end of study, calorie and protein intakes were significantly increased to meet the prescription. In order to evaluate the effect of diet education, awareness of calorie requirement was used as an index of understanding diet prescription. The degree of awareness of calorie requirement was dependent on age: younger patients showed higher awareness than older subjects. The subject who showed better understanding of diet prescription showed lower levels of HbA1c, FBS, and PP2 at the end of the experiment period. The results of this study clearly show that individual diabetes diet education is effective to make the patient understand their diet prescription, and is effective to control body weight and blood sugar level. Awareness of calorie requirement could be used as an index of understanding of prescribed diet. Since age is an important variable to determine the awareness of calorie requirement, different strategies of nutrition education should be developed for different age groups, especially patients over 70 years old.

• Preventive Nutrition and Food Science
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• v.20 no.2
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• pp.94-101
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• 2015

Grape products have been known to exert greater antioxidant and anti-obesity than anti-hyperglycemic effects in animals and humans. Omija is used as an ingredient in traditional medicine, and it is known to have an anti-hyperglycemic effect. We investigated whether the combined extracts of grape pomace and omija fruit (GE+OE) could reduce fat accumulation in adipose and hepatic tissues and provide beneficial effects against hyperglycemia and insulin resistance in type 2 diabetic mice. C57BL/KsJ-db/db mice were fed either a normal control diet or GE+OE (0.5% grape pomace extract and 0.05% omija fruit extract, w/w) for 7 weeks. GE+OE decreased plasma leptin and resistin levels while increasing adiponectin levels and reducing the total white adipose tissue weight. Furthermore, GE+OE lowered plasma free fatty acid (FFA), triglyceride, and total-cholesterol levels as well as hepatic FFA and cholesterol levels. Hepatic fatty acid synthase and glucose 6-phosphate dehydrogenase activities were decreased in the GE+OE group, whereas hepatic ${\beta}$-oxidation activity was increased. Furthermore, GE+OE supplementation not only reduced hyperglycemia and pancreatic ${\beta}$-cell failure but also lowered blood glycosylated hemoglobin and plasma insulin levels. The homeostasis model assessment of insulin resistance levels was also decreased and the decrease seems to be mediated by the lowered activities of hepatic glucose-6-phosphatase and phosphoenolpyruvate carboxykinases. The present data suggest that GE+OE may have the potential to reduce hyperglycemia, insulin resistance, and obesity in patients with type 2 diabetes.

• Journal of Korean society of Dental Hygiene
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• v.16 no.1
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• pp.1-9
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• 2016

Objectives: The purpose of the study was to identify the oral care status and periodontal disease of middle aged daibetic patients in Korea. Methods: The primitive data were taken from 238 diabetic people in the 5th Korea National Health and Nutrition Examination Survey(KNHANES) in 2010 - 2012. The variables included general profiles(gender, age, occupied area, education, and smoking), oral care status(brushing time, brushing time, use of oral hygienic supplies, availability of oral hygienic supplies, oral examination, and recognition of oral health state), and diabetes management(morbidity period, treatment, education, and glycosylated hemoglobin levels). Results: Most of the subjects took gargling more than twice a day and it accounted for 73.5%. Oral hygienic supply users accounted for 24.8%, and most of them used floss brush. Oral examination was done in 19.3% of the respondents and 55.0% thought that their oral health status were very poor. The prevalence rate of the periodontal diseases was 46.6%. Female tended to have a higher rate of periodontal disease than the male. Oral hygienic supply users had lower rate of periodntal disease than those who did not use. Those who had poor subjective oral health status had higher prevalence rate of periodontal disease than those who did not. Conclusions: Periodontal disease is closely related to good oral care of middle aged diabetic patients. It is necessary to develop the program for the prevention of the periodontal disease for the diabetic patients.

• Journal of the Korean Society of Food Culture
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• v.33 no.3
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• pp.291-298
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• 2018

This study examined the effects of plums produced in Gimcheon area on the glucose and lipid metabolism in streptozotocin-induced diabetic rats. Male Sprague-Dawley diabetic rats were divided into four groups: control, diabetic control, Diabetes-low plum (containing 10% plum powder), and Diabetes-high plum (containing 20% plum powder). The animals were fed isocaloric experimental diets based on an AIN-76 diet for 6 weeks. Feed efficiency ratio (FER) of the diabetic groups were significantly lower than that of the control. On the other hand, among the diabetic groups, the FER of the high plum intake group was higher than that of the diabetic control. The liver weight per 100 g body weight of each group was similar but the liver weights tended to decrease as the amount of plum intake was increased. Kidney weight per 100 g body weight of the plum intake groups were significantly different compared to that of the diabetic control. The supplementation of plums lowered the fasting blood glucose level of the diabetic groups and improved the glucose tolerance, thereby lowering the glycosylated hemoglobin index. In addition, the supplementation of plum was lowered the blood total cholesterol concentration and increased the HDL-C/TC (%) significantly, thereby lowering the atherosclerotic index (AI) and hepatic peroxide level. A steady diet of plums produced in Gimcheon may be effective in controlling the blood glucose level and preventing chronic diabetes mellitus.

• Journal of Korean Academy of Fundamentals of Nursing
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• v.21 no.3
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• pp.243-252
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• 2014

Purpose: The purpose of this study was to investigate diabetic knowledge, self-care behaviors, and HbA1c of patients with diabetic mellitus in public hospitals. Methods: Participants were 287 adult patients who had been diagnosed with diabetes in two public hospitals in Seoul. Collected data were analyzed using t-test, ANOVA, Pearson's correlation with the SPSS (PASW) 21.0 program. Results: For general characteristics of the participants, there were significant differences in the level of diabetic knowledge according to age (F=11.28, p<.001), educational level (F=11.07, p<.001), type of health insurance (F=9.38, p<.001), and monthly income (t=-4.58, p<.001) and in the self-care behaviors according to age (F=8.61, p<.001) and in HbA1c according to age (F=6.72, p=.001). As for disease related characteristics of the participants, significant differences were found for self-care behaviors according to education about diabetes (t=3.90, p<.001) and in HbA1c according to education about diabetes (t=3.26, p=.001) and current diabetic therapy methods (F=13.51, p<.001). The study results showed that there was no correlation between diabetic knowledge and self-care behavior, or between self-care behavior and HbA1c. Conclusion: Results indicate that when developing preliminary data on nursing intervention education programs on diabetes, increasing diabetic knowledge and self-care behaviors would help to improve blood glucose levels.

• Journal of Periodontal and Implant Science
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• v.43 no.4
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• pp.177-182
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• 2013

Purpose: Diabetes and periodontal disease are two common diseases with high prevalence rates. Recent evidence has shown a bidirectional relationship between diabetes and periodontitis. The aim of this study was to investigate the effects of nonsurgical periodontal therapy on glycemic control in type 2 diabetes mellitus patients. Methods: Sixty subjects aged 35-45 years with blood sugar controlled by oral hypoglycaemic agents were randomly divided equally among 3 groups: group A (scaling, mouthwash, and brushing), group B (mouthwash and brushing), and group C (brushing only). Glycated haemoglobin (HbA1c), fasting blood sugar (FBS), probing pocket depth (PPD), gingival index (GI), plaque index (PI), and the relevant drug history were recorded at baseline and after 3 months of intervention. Comparison of the mean difference among the variables was performed by parametric and nonparametric tests, which were further evaluated using multiple regression analysis. Results: The mean differences between the PPD, FBS, HbA1c, GI, and PI in groups A and B were found to be statistically significant (P<0.001). Multiple regression analysis in group A showed that out of all the independent variables, GI and frequency of drug administration independently (b=0.3761 and b=0.598) showed a significantly greater impact on HbA1c ($R^2$=0.832, P<0.05). Conclusions: Nonsurgical periodontal therapy can effectively decrease HbA1c levels in type 2 diabetes mellitus patients on medication.