• Korean Journal of Clinical Pharmacy
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• v.25 no.2
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• pp.74-79
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• 2015

Objective: Treatment with sulfonylureas in combination with metformin improves glycemic control in type 2 diabetes mellitus (T2DM), but is associated with hypoglycemia and weight gain. This retrospective study aims to compare the effectiveness of dipeptidylpeptidase-4 (DPP-4) inhibitors and sulfonylureas as an add-on therapy to metformin in patients with T2DM. Methods: Data from medical records of 355 T2DM patients received therapy either DPP-4 inhibitors (DPP-4 inhibitor group) or sulfonylurea (SU group) in combination with metformin from 1 March 2009 to 30 September 2011 were retrospectively reviewed. Of total 355 patients, 231 patients were in DPP-4 inhibitor group and 124 patients were in SU group. Baseline Hemoglobin $A_{1c}$ ($HbA_{1c}$) level in SU group was higher than DPP-4 inhibitor group with a statistically significant difference (8.6% vs. 7.8%). Comparative analysis between DPP-4 inhibitor group and SU group was performed for $HbA_{1c}$ values, amounts of $HbA_{1c}$ changes, and rates of $HbA_{1c}$ changes from baseline at 6-month intervals and incidence rates of major cardiocerebral events. Results: SU group showed larger $HbA_{1c}$ changes in both amounts and rates compared to DPP-4 inhibitor group, although statistical significance was not found in all study periods. Proportions of patients with stable $HbA_{1c}$ <6.5% or 7% were significantly higher in DPP-4 inhibitor group than SU group (<6.5%: 30.4% vs. 13.4%, <7%: 72.3% vs. 41.2%). Time to achieve stable $HbA_{1c}$ <6.5% was not significantly different, but time to achieve stable $HbA_{1c}$ <7% was shorter in DPP4 inhibitor group than SU group with a significant difference. The incidence rate of cardiocerebral events in group of patients with or without previous events was 1.7%, not significantly lower than that in DPP-4 inhibitor group (4.0%). For newly encountered cardiocerebral events during the treatment, incidence rates of two groups did not differ significantly. Conclusion: DPP-4 inhibitors were as effective as sulfonylureas in achieving the $HbA_{1c}$ goal of less than 6.5% or 7% and cardiocerebral event rates did not differ between the two drugs.

• The Journal of Korean Academic Society of Nursing Education
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• v.20 no.1
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• pp.81-92
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• 2014

Purpose: This study was to identify the effect of the experience of diabetes education on knowledge, self-care behavior and glycosylated hemoglobin (HbA1C). Further, this study was held to examine about patient's preferred methods of education and re-education frequency. Methods: 166 type 2 diabetes patients from two hospitals in Incheon participated in this study. Data were analyzed by using descriptive analysis, t-test, ANOVA, Scheffe's test and multiple regression analysis. Results: 72.3% patients needed re-education and the average interval of re-education was 8.53 months. Patients preferred education methods were lectures, practical training, and studying from pamphlet. Depending on the frequency of diabetes education, there were significant differences in the level of diabetes knowledge (F=10.88, p<.001) and self-care behaviors (F=4.59, p=.012), but there was not significant difference with HbA1C (F=1.53, p=.220). As to how much the diabetes education helped managing diabetes, there was a significant difference in the level of self-care behaviors (t=2.01, p=.049), but there were not significant differences in level of knowledge (t=1.10, p=.275) and HbA1C (t=-.33, p=.746). The experience of diabetes education was a significant factor which influenced patient's knowledge (t=3.93, p<.001) and self-care behaviors (t=2.21, p<.001). But HbA1C was not influenced by the experience of diabetes education (t=-1.68, p=.096). Conclusion: It is necessary to provide diabetes education with appropriate interval and methods and subjects that reflect the needs of patient through the study results.

• The Journal of Internal Korean Medicine
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• v.40 no.6
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• pp.1318-1324
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• 2019

Objectives: The purpose of this study was to evaluate the effectiveness of the management of blood glucose in diabetes mellitus using modified Jawonjihwang-tang in a Korean medical clinic, retrospectively. Methods: From 2006 to 2018, 150 patients diagnosed with diabetes who visited a Korean medical clinic were treated with Korean medicine. Then, 81 of them were prescribed Jawonjihwang-tang. Five cases who changed the formula during the procedure were excluded; therefore, 76 cases were finally selected. Their therapeutic effects were evaluated by the variance in glycated hemoglobin (HbA1c). Results: After administration of Jawonjihwang-tang, most patients exhibited a decreased level of HbA1c, and 24 patients had normalized the level of HbA1c. The HbA1c level of all patients decreased from 9.1±2.2 to 7.8±2.2 significantly (p<0.001). Conclusions: It is concluded that Jawonjihwang-tang may control blood glucose in diabetes patients. However, more prospective randomized clinical trials are warranted to verify this conclusion.

• Perspectives in Nursing Science
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• v.14 no.1
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• pp.21-31
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• 2017

Purpose: This study was conducted to identify the disease adaptation and related factors for the pediatric patients with diabetes mellitus. Methods: Participants in this study were 75 diabetic children or adolescent whose age were 10 to 18 years old visited the out-patient clinic in one general hospital located in Seoul. Data were collected using self-report questionnaires. Research tools measuring resilience, family support, psychological adaptation, Hemoglobin A1c (HbA1c) protein were used. Results: Resilience showed significant differences according to the age, gender, academic achievement, and hospitalization experience of the children. Family support was significantly different according to the age, religion, academic achievement, fathers' education level, and hospitalization experience of the children. Psychological adaptation to diabetes showed significant differences according to academic achievement. HbA1c was shown to be significant difference according to fathers' education level and hospitalization experience of the children. Positive correlations were identified among resilience, family support, and psychosocial adaptation, while negative correlations were found between HbA1c and all others including resilience, family support, and psychosocial adaptation. Conclusion: This study suggests that the educational programs as nursing intervention needs to be developed to enhance the resilience and family support for the pediatric diabetic patients.

• Perspectives in Nursing Science
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• v.9 no.2
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• pp.94-101
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• 2012

Purpose: The purpose of this study was to examine the relationship between glucose control, diabetes self-care and depression in community dwelling older adults with type 2 diabetes mellitus. Methods: The cross-sectional survey data of 148 older adults at a senior center were analyzed in this study. We collected data on diabetes self-care, depression, and demographics by face-to-face interviews. Blood samples for HbA1C were obtained from the participants. Results: The average duration of diabetes for the participants was $10.6{\pm}9.31$ years. Fifty percent of the participants had HbA1c higher than 7.0% (mean 7.179%). The level of diabetes self-care was related to depression (r=-.225, p<.01). HbA1c was positively related with the duration of diabetes diagnosis (r=.224, p<.01). The only sub-dimension of diabetes self-care that was related to depression was exercise (r=-.307, p<.01). Conclusion: Only half of the community dwelling older adults with type 2 diabetes had an optimal level of diabetes control. Supported by the evidence, the longer the duration of diabetes since the initial diagnosis, the poorer the glucose control was. Identification and intervention for depression in people with diabetes should be considered to improve diabetes self-care, especially to perform more exercise.

• Journal of agricultural medicine and community health
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• v.37 no.4
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• pp.215-222
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• 2012

Objective: A prediabetes hemoglobin A1c (HbA1c) level of 5.7%-6.4% is considered a risk factor for diabetes mellitus and cardiovascular disease (CVD) in the USA. In this study, we assessed the HbA1c and visceral fat levels as CVD risk factors in health check-up examinees who were not yet diagnosed with diabetes. Methods: Totally, 507 study subject were categorized as per criteria of the American Diabetes Association, depending on whether the HbA1c level was ${\geq}5.7%$ or <5.7%. Lipid levels, blood pressure, BMI (kg/$m^2$), total abdominal, and visceral fat levels were measured by computed tomography. Results: The mean of HbA1c in the male group was larger than the mean in the female group and their values were, respectively, $6.03{\pm}0.82%$ and $5.88{\pm}0.72%$(p<0.05). Only the mean values of age and visceral fat area were different between $HbA1c{\geq}5.7%$ and <5.7% in both male and female group(p<0.05). Visceral fat levels were significantly associated with HbA1c in the group of HbA1c ${\geq}5.7%$ (odds ratio=1.005, 95% CI 1.002~1.008). Conclusions: Visceral fat levels were significantly higher and correlated with the group which HbA1c level is ${\geq}5.7%$. This finding suggests that subjects who have high levels of HbA1c should be carefully monitored during prediabetes and should have chance to have health education programs.

• Journal of dental hygiene science
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• v.17 no.4
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• pp.290-297
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• 2017

The purpose of this study was to compare dental health status of South Korean adults, according to the control protocol of glycated hemoglobin A1c (HbA1c). From the measurements of HbA1c levels of 4,991 individuals over the age of 19 who participated in the sixth Korea National Health and Nutrition Examination Survey, the following conclusions were obtained. Glycated hemoglobin was 7.2% in the HbA1c ${\geq}6.6$ diabetic group and 5.9% in women and 8.5% in men. The ratio in the glucose non-control group was higher in the older age group, the lower average monthly household income group, and the lower education level group. Both the tissue health index and functioning teeth index indices were slightly higher in both men and women in the glucose control group. The tissue health index was higher in the younger age group, in the higher average monthly household income group, and in the higher education level group. The missing teeth (MT) index was greater among women (3.775 pieces) than among men (2.317 pieces) in the glucose non-control group. Higher age correlated with a greater number of MT, while higher income and education levels correlated with a lower number of MT. In conclusion, we will continue to provide counseling and education on oral health problems, thereby widening the awareness of the importance of oral health care and providing a variety of media and education methods related to medical and oral health that can manage diabetic patients according to the level of HbA1c It should be developed.

• Journal of the Korean Society of Food Science and Nutrition
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• v.26 no.5
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• pp.914-919
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• 1997

We investigated the effects of vitamin E supplementation on the protein glycosylation in vivo. Weaned KK-mice were fed high fat diet containing 20% corn oil(wt/wt), and sacrificed at 4, 6, and 0 months of age. High vitamin E diet was the high fat diet supplemented with an excess amount of 이-$\alpha$-tocopheryl acetate(2080IU/kg diet). We measured $HbA_{1C}$ as a glycosylation early product, and collagen-linked fluorescence (CLF) of skin as a glycosylation and product. We found that diabetic group had increased levels of $HbA_{1C}$ within 2 months after onset of diabetes and during the experiments. The skin CLF increased dramatically 5 months after onset of diabetics. Treatment with vitamin E did not modify the level of blood glucose. However, we observed a significant lowering in CLF and $HbA_{1C}$ in diabetic mice.

• 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.

• Korean Journal of Adult Nursing
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• v.23 no.3
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• pp.298-307
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• 2011

Purpose: The purpose of this study was to examine the effects of physical activity on glycemic control among Koreans with type 2 diabetes. Methods: A total of 215 patients with type 2 diabetes (82 male and 133 female) were recruited (mean age = $59.0{\pm}9.7$ years). The amounts of physical activity was assessed using the physical activity scale for elderly (PASE). Fasting blood glucose (FBG), Hemoglobin A1c ($HbA_1c$), and 2 hours post-prandial glucose (2hrPG) were measured. Results: The highest PASE score was housework-related physical activity. However, the amounts of walking was significantly higher in good FBG level (Z = 1.39, p=.041) and the amounts of leisure-time physical activity was higher in good HbA1 and 2hrPG level than in the poor glycemic control group (Z = 2.29, p<.001; Z = 1.99, p=.001). A logistic regression analysis showed that patients with leisure-time physical activity in the top quartile more likely presented with good glycemic control in $HbA_1c$, OR=3.84 (95% Confidence Interval (CI) = 1.65~8.95) and in 2hrPG, OR=4.06 (95%CI = 1.77~9.27), compared to patients in the lowest quartile. Conclusion: Leisure-time physical activity is effective for controlling the glucose levels, especially $HbA_1c$ and 2hrPG among type 2 diabetic patients. It is suggested that health providers need to more focus on providing aggressive recommendations on physical activity considering physical activity patterns by individuals.