• 대한지역사회영양학회지
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• 제27권5호
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• pp.406-421
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• 2022

Objectives: The purpose of this study was to investigate the blood biochemical characteristics, comorbidities, dietary intake, and other risk factors leading to poor glycated hemoglobin (HbA1c) control in elderly Korean diabetes patients over 65 years of age. Methods: Data from the 4^th (2007-2009) and the 7^th (2016-2018) Korea National Health and Nutrition Examination Surveys (KNHANES) were used. Socio-demographic characteristics (age, gender, region, household income, education level, marital status, nutrition education, diabetes duration and diabetes treatment), lifestyle characteristics (drinking, smoking, regular walking, and subjective health perception), anthropometric characteristics (height, weight, and waist circumference), blood biochemical characteristics (HbA1c, high- density lipoprotein cholesterol, triglycerides, total cholesterol, blood urea nitrogen, and blood creatinine), co-morbidities (obesity, hypertension, hypercholesterolemia, hypertriglyceridemia, and anemia), energy and nutrients intake, food group intake, and HbA1c control-related risk factors were compared. Results: Compared to the 4^th survey, the 7^th survey showed an increase in diabetes prevalence among men, an increase in the prevalence of diabetes in the older patients, and an increase in the duration of diabetes. The energy ratio from carbohydrate consumption in the 7^th survey was lower than in the 4^th. Compared to the 4^th survey, thiamine and riboflavin intake had improved, and the intakes of vitamin A, vitamin C, and niacin had worsened in the 7^th. A comparison of food group intakes showed that there was a decrease in the consumption of whole grains, potatoes, and milk and an increase in the intake of beverages and alcoholic beverages. The risk factors for poor control of HbA1c were the duration of diabetes and co-morbid hypertriglyceridemia in the 4^th survey, whereas subjective health perception, obesity, and hypercholesterolemia as co-morbidities were found to be risk factors in the 7^th in addition to the risk factors highlighted in the 4^th survey. Conclusions: For the future management of elderly Korean diabetes patients, greater care is indicated for men over 75 years, and those with low levels of education. It is necessary to increase the intake of milk and vegetables, and reduce the intake of beverages and alcoholic beverages. In addition, it is necessary to reduce the incidence of obesity, hypercholesterolemia, and hypertriglyceridemia for proper control of blood sugar.

• 가정의학회지
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• 제39권6호
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• pp.360-363
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• 2018

Background: Acute alcoholic intoxication patients (AAIP) are a common public health problem. The aim of this study was to perform a comprehensive laboratory analysis for these patients to investigate the co-morbid medical problem. Methods: We retrospectively reviewed laboratory findings of AAIP who were transferred to the emergency department (ED) from January 2017 to June 2017. Results: A total of 160 male patients were enrolled. Sixteen patients (16/160, 10.0%) and three patients (3/160, 1.9%) had macrocytic anemia and microcytic anemia, respectively. A total of 33 patients (33/160, 20.6%) showed thrombocytopenia ($<150{\times}10^9/L$). Twelve patients (12/159, 7.5%) showed low serum albumin level (<3.5 g/dL). Three patients (3/160, 1.9%) had chronic kidney disease stages 3-4 based on estimated glomerular filtration rate. Six patients (6/27, 22.2%) had high hemoglobin A1c (HbA1c) level (>7.0%). Positive rates of hepatitis B surface antigen and antiHBs antibody (anti-HBs Ab) were 3.5% (5/141) and 49.0% (68/141), respectively. Conclusion: Patients with AAIP who were transferred to ED had various laboratory abnormalities (anemia, thrombocytopenia, high HbA1c). They had low positive rate of anti-HBs Ab. This might be a public health problem, suggesting the need of hepatitis B virus vaccination program for AAIP. Our data suggest the need of further nationwide studies.

• Clinical Pain
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• 제19권1호
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• pp.32-35
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• 2020

Treatment-induced neuropathy in diabetes (TIND) is a reversible neuropathy that occurs in patients with diabetes, usually after a fast improvement in glycemic control. TIND is defined as the sudden onset of neuropathic pain or autonomic dysfunction with a large improvement in glycemic control (glycated hemoglobin [HbA1c] level of ≥ 2% over 3 months). We report the first case of a 24-year-old woman with type 1 diabetes mellitus who developed TIND in Korea. Her HbA1c level had decreased from 16.7% to 7.3% within a 3-month period. She developed acute-onset, severe, and continuous burning pain affecting her back and lower extremities. She was administered tapentadol (50 mg), pregabalin (75 mg), and vitamin B with minerals twice daily for neuropathic pain. She complained of orthostatic hypotension; thus, midodrine (2.5 mg) and anti-embolic stockings were prescribed. She almost completely recovered 6 months after the onset. A physician should be aware of TIND and gradually reduce HbA1c levels to prevent the occurrence of TIDN. They must also try to provide relief from severe pain or autonomic dysfunction and emphasize on an almost complete recovery.

• The Journal of Korean Physical Therapy
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• 제24권5호
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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.

• 대한임상검사과학회지
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• 제54권2호
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• pp.95-102
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• 2022

Lp(a)와 이상지질혈증의 관계가 명확하지 않아, 본 연구는 60세 이상 노인 환자를 대상으로 Lp(a)와 이상지질혈증의 관계를 조사하고자 하였다. 2014년 1월 1일부터 2020년 12월 31일까지 7년간 한 종합병원을 내원한 60세 이상 노인 중 나이, 성별, BMI, Lp(a), LDL-C, TG, HDL-C, hs-CRP, HbA1c, 지질강하제 복용 여부, 이상지질혈증 의사진단여부 등의 기록이 있는 2,580명을 최종 분석대상자로 선정하였다. Lp(a)와의 상관성은 hs-CRP (r=0.138), LDL-C (r=0.097), HDL-C (r=-0.089), TG (r=-0.073), 나이(r=0.072) 등이 유의하였으며, BMI, HbA1c는 유의하지 않았다. 변수들을 보정한 Lp(a)와 LDL-C의 편상관관계는 남성그룹에서만 유의하였다(r=0.158, P<0.001). 본 연구에서 이상지질혈증에 대한 Lp(a)의 4사분위의 교차비(교차비=1.376, 95% 신뢰구간=1.038~1.822)가 유의하게 나타남으로써 지질강하제 복용으로도 1차 표적인 LDL-C 수준을 낮추지 못했을 때, 2차적으로 고려해봐야 할 여러 요소 중 Lp(a)도 포함되어야 한다고 판단된다. 성별, 연령, 지질강하제 복용 여부 등에 따른 다양한 지질인자들에 대한 연구들이 필요하다고 사료된다.

• Journal of Nutrition and Health
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• 제15권3호
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• pp.171-180
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• 1982

The nutritional survey and blood sampling was conducted from May 23 to 27, 1971, in order to investigate the state of the nutritional intake in relation to blood contents of rural women. This survey covered a total of 47 women residing in Youngam-gun, Cholla-namdo, Korea. The daily diet of these subjects was observed by 24-hour recall method and weighing method for 3 days and hemoglobin (Hb), hematocrit(Hct), mean corpuscular hemoglobin concentration (MCHC), serum protein, serum albumin, A/G ratio, serum iron, total iron binding capacity (TIBC), transferrin saturation (TS), serum cholesterol and blood specific gravity (SG) were measured. The results were summarized as follows ; The rate of intake of vegetable foods was high, especially cereals, and that of animal foods was low, especially eggs and milk and milk products. The daily intake of niacin was sufficient, and the intakes of energy and iron were also tend to be adequate. On the contrary, the intakes of vitamin A, $B_2$ and C, calcium and protein were insufficient. The mean red blood cell number was $410.8{\pm}26.4{\times}10^{4}/mm^{3},$ the mean values of Hb, Hct and MCHC were $12.5{\pm}0.9gm%$, $37.5{\pm}2.4%$ and $33.2{\pm}0.5%$ thus the anemic prevalences were 21.3%, 12.8% and 93.6% comparing with the anemic criteria of WHO. The levels of serum protein and serum albumin were $7.1{\pm}0.4gm\;%$ and $4.3{\pm}0.3gm\;%$so the A/G ratio was indicated $1.6{\pm}0.2.$. The levels of serum iron and TIBC were $91.9{\pm}27.5{\mu}g/100ml and $297.5{\pm}31.4{\mu}g/100ml,$ so TS was calculated $31.2{\pm}9.7\;%$. The mean value of SG was $1.044{\pm}0.002,$ and the level of serum cholesterol was $164.3{\pm}25.4mg/dl$. In the relation between each of bloood content, Hb showed positive correlation not only with Hct but also protein at the level of significance of 1 per cent and 5 per cent, and protein also showed a positive correlation with serum cholesterol at the 1 per cent level of significance. In the relation between the nutrient intake and blood contents, vitamin C intake showed a positive correlation with Hb, serum protein and serum iron at the level of significance of 1 per cent, iron intake also showed a positive correlation with serum iron and serum cholesterol at the same significant level, and protein intake showed a positive correlation with serum iron at the at the level of significance of 5 per cent.

• Journal of Periodontal and Implant Science
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• 제43권2호
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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 Gastric Cancer
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• 제19권3호
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• pp.365-371
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• 2019

The role of surgical intervention in patients with diabetic gastroparesis is unclear. We report a case of a 37-year-old man with a history of recurrent episodes of vomiting and long-standing type 2 diabetes mellitus. Esophagogastroduodenoscopy did not reveal any findings of reflux esophagitis or obstructive lesions. A gastric emptying time scan showed prolonged gastric emptying half-time (344 minutes) indicating delayed gastric emptying. Laboratory tests revealed elevated fasting serum glucose and glycosylated hemoglobin (HbA1c, 12.9%) and normal fasting C-peptide and insulin levels. We performed Roux-en-Y reconstruction after subtotal gastrectomy to treat gastroparesis and improve glycemic control, and the patient showed complete resolution of gastrointestinal symptoms postoperatively. Barium swallow test and gastric emptying time scan performed at follow-up revealed regular progression of barium and normal gastric emptying. Three months postoperatively, his fasting serum glucose level was within normal limits without the administration of insulin or oral antidiabetic drugs with a reduced HbA1c level (6.9%). Long-limb Roux-en-Y reconstruction after subtotal gastrectomy may be useful to treat severe diabetic gastroparesis by improving gastric emptying and glycemic control.

• 동서간호학연구지
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• 제22권2호
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• pp.170-177
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• 2016

Purpose: The purpose of this study was to examine the mediating effect of regimen distress in the relationship between medication adherence and glycemic control in men with type 2 diabetes. Methods: A total of 116 patients with type 2 diabetes was recruited for the cross-sectional survey design. Data were analyzed using descriptive statistics, independent t-test, ANOVA, Pearson's correlation coefficient, and multiple regression using Baron and Kenny steps for mediation. Results: The mean score for medication adherence was 6.32, and the mean glycemic control level (HbA1c) was 7.47%. The mean score was 2.37 for regimen distress. There were significant correlations among medication adherence, regimen distress, and HbA1c. Regimen distress had a partial mediating effect (${\beta}$=.22, p=.005) in the relationship between medication adherence and HbA1c (Sobel test: Z=2.47, p=.013). Conclusion: Regimen distress was found to be associated with glycemic control in men with type 2 diabetes. Based on the findings of this study, nursing intervention programs focusing on decreasing regimen distress are highly recommended to improve level of glycemic control in patients with type 2 diabetes.

• Nutrition Research and Practice
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• 제13권2호
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• pp.105-114
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• 2019

BACKGROUND/OBJECTIVES: Several previous studies have investigated whether regular walnut consumption positively changes heart-health-related parameters. The aim of this study was to investigate the effects of daily walnut intake on metabolic syndrome (MetS) status and other metabolic parameters among subjects with MetS. SUBJECTS/METHODS: This study was a two-arm, randomized, controlled crossover study with 16 weeks of each intervention (45 g of walnuts or iso-caloric white bread) with a 6 week washout period between interventions. Korean adults with MetS (n = 119) were randomly assigned to one of two sequences; 84 subjects completed the trial. At each clinic visit (at 0, 16, 22, and 38 weeks), MetS components, metabolic parameters including lipid profile, hemoglobin A1c (HbA1c), adiponectin, leptin, and apolipoprotein B, as well as anthropometric and bioimpedance data were obtained. RESULTS: Daily walnut consumption for 16 weeks improved MetS status, resulting in 28.6%-52.8% reversion rates for individual MetS components and 51.2% of participants with MetS at baseline reverted to a normal status after the walnut intervention. Significant improvements after walnut intake, compared to control intervention, in high-density lipoprotein cholesterol (HDL-C) (P = 0.028), fasting glucose (P = 0.013), HbA1c (P = 0.021), and adiponectin (P = 0.019) were observed after adjustment for gender, age, body mass index, and sequence using a linear mixed model. CONCLUSION: A dietary supplement of 45 g of walnuts for 16 weeks favorably changed MetS status by increasing the concentration of HDL-C and decreasing fasting glucose level. Furthermore, consuming walnuts on a daily basis changed HbA1c and circulating adiponectin levels among the subjects with MetS. This trial is registered at ClinicalTrials.gov as NCT03267901.