• Journal of Nutrition and Health
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• 제32권7호
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• pp.775-780
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• 1999

We investigated the effects of antioxidant vitamins supplementation on antioxidative status and plasma lipid profile in female Korean non-insulin diabetes mellitus(NIDDM) patients. Forty-five patients were groups by types of vitamin to take into three groups-Vitam in E group(400IU/day, n=15), Vitamin C group (1,000mg/day, n=15) and Vitamin E plus C group (400 IU plus 1,000mg/day). Supplementation period was 4 weeks. After vitamins supplementation, plasma vitamin E concentration significantly increased in vitamin E and vitamin E + C group, but plasma retinol concentration were not affected by vitamin E or vitamin C supplementation. And plasma levels of lipid peroxide measured as thiobarbituric acid reactive substances(TBARS), indicator of lipid peroxidation and increased susceptibility of LDL towards lipid peroxidation, were significantly decreased in all three groups after vitamins supplementation. Also catalase activities in erythrocytes were significantly decreased after antioxidant vitamin supplementation in all subjects. And after vitamins supplementation, post prandial 2 hour glucose and total cholesterol levels was decreased in all subjects. And after vitamins supplementation, post prandial 2 hour glucose and total cholesterol levels was decreased in all patients, especially there was a significant difference in vitamin C, Vitamin E + C group. In this study, antioxidant vitamins supplementation might have a protective function against the free radical-mediated lipid peroxidation and decrease the plasma total cholesterol levels in Korean female NIDDM patients.

• Journal of Nutrition and Health
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• 제34권8호
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• pp.912-919
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• 2001

The increased oxidative stress may play an important role on the pathogenesis of diabetes and diabetic complications, and the blood level of vitamin C and lipid peroxidation in NIDDM patients may be used as an indicator for oxidative stress. However there is only scanty evidence on the blood level of vitamin C in NIDDM patients with or without diabetic complications. The study population consisted of 90 NIDDM patients(diabetes without complication, 48, and diabetes with complications, 42) and 41 normal subjects. The 42 diabetic complications were divided into 3 groups : 15 diabetic nephropathy, 18 diabetic neuropathy, 9 diabetic retinopathy. The anthropometric data and blood biochemical data were studied. The dietary intake was determined by 24 hour recall methods and food frequency questionnaire. The plasma concentrations of MDA and vitamin C were determined by fluorophotometer and HPLC respectively. 1) In blood lipoprotein study, diabetes with complication had higher level of TG than diabetes without complications, while no significant differences in total cholesterol, HDL, and LDL were shown. Diabetic neuropathy had the highest TG level among diabetic complication groups. 2) The intakes of vitamin B complexes(vitamin B$_2$, vitamin B$_{6}$, not vitamin B$_1$) and antioxidant vitamins(vitamin A and vitamin E, not vitamin C) and certain minerals such as iron and calcium in diabetes were not sufficient but the intakes of energy, protein, niacin, and phosphorus in diabetes were sufficient. The dietary intakes between diabetes with-and without complications were not significantly different. Among diabetic complications, the diabetic retinopathy had the lowest intake of vitamin B$_2$ and B$_{6}$(p < 0.05). the diabetic neuropathy or nephropathy consumed extremely low amount of vitamin A. 3) The MDA concentrations of NIDDM was significantly higher than that in controls(p < 0. 05) while no significant difference in the MDA concentration between with and without complications was shown. Although there were no statistical differences, the diabetic nephropathy and diabetic neuropathy showed the higher concentration of MDA than the diabetes without complications or diabetic retinopathy. 4) The plasma concentration of vitamin C in controls was higher than that in diabetes(p < 0.05) while the plasma vitamin C in diabetes with and without complications were similar. In diabetic complications, no differences in plasma vitamin C concentration of three groups were shown. This study showed that the oxidative stress in NIDDM patients was highly increased and the vitamin C reserve was significantly depleted, as compared with normals, although their intakes of vitamin C met korean RDA, which means that diabetes need more vitamin C intake to decrease oxidative stress in NIDDM patients.nts.

• 혜화의학회지
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• 제13권2호
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• pp.251-258
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• 2004

Two cases of in patients with diabetic peripheral neuropathy were reported in this clinical study. After the study, the results were as follows: 1. Diabetic peripheral neuropathy was occurred with both insulin dependent diabetic mellitus(IDDM) patients, long and short durations, and non insulin dependent diabetic mellitus(NIDDM) patients. However, the degree of subjective symptom was stronger with the former patients. 2. Non insulin dependent diabetic mellitus(NIDDM) patients on dosage of Gamisamultang (加味四物湯) showed remarkable decrease of duration of illness and pain; however, plantar causalgic pain was unremarkable. In contrast to non insulin dependent diabetic mellitus(NIDDM) patients, long duration of insulin dependent diabetic mellitus(IDDM) patients showed remarkable decrease of plantar causalgic pain: however, pain decreased unremarkably. 3. The general treatment of diabetic patients was the control of blood glucose level; however it seemed to be no effect on the degree of subjective symptom. When patients were treated with acupuncture, followed by electropucture, on Palpung(八風), Taechung(太衝:Liv3), Chok-imup(足臨泣: Gb41), Hyonjong(縣鐘 : G39), Sungsan(承山 : B57), Chok-Samni(足三里 : S36), and Yangnungchon(陽陵泉 : G34) showed a great effect on decreasing the pain.

• 기본간호학회지
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• 제10권2호
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• pp.171-180
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• 2003

Purpose: The purpose of this study was to investigate the relationship of self-efficacy, knowledge about the disease, and self-care behavior to the metabolic level in patients with NIDDM. Method: Data were collected from March 15 to April 15, 2001. Participants in the study were 48 patients with NIDDM who were seen regularly at the endocrinology out-patient department of Gwangju Christian Hospital. The data were collected through individual interviews and patient blood samples. The data were analyzed with SPSS/PC+, using t-test, ANOVA, Pearson correlation coefficients and Cronbach's Alpha. Result: 1. The mean score for self-efficacy was $71.37{\pm}15.56$, knowledge $15.00{\pm}2.84$, self-care behavior $63.18{\pm}13.10$. The mean score for HbAlc level was $7.66{\pm}1.77%$, HDL cholesterol level, $46.22{\pm}13.04 mg/dl$ and total cholesterol level, $187.93{\pm}41.45 mg/dl$. 2. There was a significant difference between patients with a spouse and those without one (t=-2.08, p=0.042), in knowledge according to level of obesity (t=5.14, p=0.010), duration of illness (t=3.22, p=0.031) and presence of complications related to diabetes (t=-2.58, p= 0.013). There were no significant differences in self-care behavior, but there were significant differences in sugar metabolic level according to sex (t=-2.02, p=0.050). 3. The correlation between diabetic patients' self-efficacy, knowledge and self-care behaviour and metabolic control was significantly related only to self-efficacy and self-care behavior (r=.692, p=0.000). Conclusion: It is necessary to improve self-efficacy, knowledge, and self-care behavior for patients with NIDDM by using nursing intervention programs to promote and maintain metabolic control.

• 재활간호학회지
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• 제8권1호
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• pp.59-67
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• 2005

Purpose: The purpose of this study is to investigate the effect of Self-Efficacy Promoting Program on Self-Efficacy, Metabolic Control and Self-Care Behaviors in Patients with NIDDM. Method: Data was collected from March 15th to July 15th, 2001. The subjects of the study consisted of 23 NIDDM patients who had visited regularly the endocrinology out-patient department of Gwangju Christian Hospital. The instrument used in the study Paek's self-efficacy measurement scale, was modified by the researcher, self-care behaviors were created by health care teams, and HbA1c for the sugar metabolic control were measured from the patients blood. The Interventions of the self efficacy promoting program were applied 4 hours a week for 6weeks. Data were analyzed with SPSS/PC+, using T-test and Wilcoxon rank sum test. Result: The mean score for self-efficacy was $70.61{\pm}15.48$ of a 140 point scale, the mean score for $HbA_{1c}$ level was $8.07{\pm}1.86%$. The self efficacy promoting program significantly increased the score of self efficacy(Z=-4.198, P=.000). And the self efficacy promoting program was significantly decreased in metabolic control(Z=-2.585, p=.010). Taking medicine and controlling alcohol were the best self care behaviors of this program. Conclusion: It was established that the self efficacy promoting program was effective for improving self efficacy, metabolic level and self care behaviors in patients with NIDDM.

• 대한영양사협회학술지
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• 제7권2호
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• pp.138-143
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• 2001

Microalbuminuria is a strong predictor of diabetic nephropathy and is also associated with increased mortality in people with non-insulin-dependent diabetes mellitus(NIDDM) patients. Improved glycemic control and dietary protein restriction are recommended to retard and avoid developing microalbuminuria. The purpose of this study was to measure the dietary counseling effects for diabetes mellitus patients with microalbuminuria. To investigate the effects of the dietary counseling effect, thirty NIDDM patients with microalbuminuria were selected from outpatient diabetic clinic of Seoul National University Hospital for this study. None of them had evidence of renal and heart complications. For 24 weeks, they received individualized dietary counseling 3 times. The results of this study can be summarized as follows 1) Dietary protein and calorie intake decreased significantly from 79.8$\pm$29.9g/d to 66.6$\pm$16.5g/d, from 1845.4$\pm$631.9kcal to 1515.7$\pm$392.7kcal after dietary counseling, respectively (p<0.05). 2)The glycosylate hemoglobin level showed significantly decreased after dietary counseling(p<0.05). However there were no change in lipid profiles and blood pressure after counseling. 3) There was a significant correlation between the duration of disease and the amount of microalbuminuria. Any other cardiovascular risk factors, such as duration of diabetes, total cholesterol level and systolic blood pressure were not correlated with microalbuminuria. These results shown that dietary counseling can be used as an effective therapy to control blood sugar levels for NIDDM patients who are poorly controlled with microalbuminuria.

• 대한영양사협회학술지
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• 제5권2호
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• pp.145-152
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• 1999

This study was to investigate the risk factors for the development of diabetes mellitus on healthy offsprings of Korea non-insulin dependent diabetes mellitus(NIDDM) patients. Forty four offsprings who have at least 1 parent with NIDDM and age, sex and body mass index(BMI) matched forty four healthy control subjects were collected for this study. BMI, skinfold thickness, waist/hip circumference ratio(WHR), fasting blood glucose, serum insulin, serum lipid profile, nutrient intakes and food behaviors were measured. There were no significant difference in BMI, WHR, fasting blood glucose, insulin, total cholesterol, triglyceride and daily nutrients intake between offsprings and controls. But skinfold thickness, LDL-cholesterol level and sweety food eating frequency were significantly higher in male offsprings than in male controls. And HDL-cholesterol was significantly lower in male offsprings than in male controls. Although there were no significant difference, offsprings had a overeating habit and ate more confectionery and greasy food than controls.

• Journal of Nutrition and Health
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• 제27권8호
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• pp.805-818
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• 1994

This study investigated the effect of enteral nutrition supplementation on glucose and lipid metabolism in non-insulin dependent diabetes mellitus(NIDDM) patients(n=29). Nutrition formula(400kcal/day) were supplied daily for eight weeks as a substitute for a snack or a meal. Subjects were divided into three groups based on changes of fasting blood glucose(FBG), glucose response area(GRA) on oral glucose tolerance test(OGTT), before and after intake of nutrition formula : group 1(the group of a decrease in FBG and GRA, n=20), group 2(the group of a decrease in FBG and an increase in GRA, n=4), and group 3(the group of an increase in FBF and GRA, n=5). Before nutrition supplementation, group 3 showed a longer tendency of DM duration and a lower tendency of insulin and C-peptide response are than those of group 1 and 2. At 8 weeks after nutrition supplementation, group 1 showed a significant increase in insulin and C-peptide response areas but group 2 and 3 showed no change in those areas. After nutrition supplementation, all three groups showed a tendency of decrease in glycated hemoglobin and no significant changes in the levels of serum triglycerides, HDL, LDL, total cholesterol, albumin, transferrin, creatinine, GOT and GPT. The results suggest that using an enteral nutrition formula in NIDDM patients is a good substitute for a meal or snack and could improve blood glucose control without any changes in lipid levels, and liver and kidney functions. The beneficial effect of nutrition supplementation on glycemic control resulted from components of nutrition formula had such as additional fiber and high monounsaturated fatty acid as the source of fat to be helpful 세 glycemic control in diabetics.

• Journal of Nutrition and Health
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• 제35권5호
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• pp.531-543
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• 2002

To assess the dietary therapy compliance of non-insulin-dependent diabetes mellitus (NIDDM) patients living in Daegu, we evaluated diet adequacy levels by index of nutritional quality (INQ), nutrient adequacy ratio (NAR), mean adequacy ratio (MAR), and dietary variety score (DVS) with food exchange system and Korean recommended dietary allowances (KRDA). One day dietary intake was measured by 24 hour recall method for 229 subjects over 20 years of age. Average daily energy intake was 1444 kcal. The relative ratio of carbohydrate, protein and fat in terms of energy intake was 69.4：14.5：16.0. The nutrient adequacy ratio (NAR) for Vitamin A, B$_2$, calcium were lower than 0.5 and MAR was 0.65. It appeared that the consumption of each food group as compared to prescribed food exchange unit was insufficient, in the order of dairy group (10.2 $\pm$ 25.2%), fruits group (58.2 $\pm$ 71.2%) and oils & fats group (42.9 $\pm$ 42.0%). The dietary variety score (DVS) was evaluated as an useful tool for diabetes' meal management when we accept minimum intake as 0.3 of food exchange unit. We found significant correlation between food groups and anthropometric indices: cereals group and % total body fat (r = 0.251, p < 0.01), meat group and waist circumference (r = 0.241, p < 0.01), vegetables group and WHR(r = 0.139, p < 0.05), and oils poop and WHR(r = 0.165, p < 0.05). from these results, we concluded that overall status of dietary intake of NIDDM patients in Daegu area was insufficient not only in quality but also in quantity. It is suggested that nutrition education for NIDDM patients should stress on balanced food consumption to meet proscribed amount by six food group to improve the inadequacy of dietary status.

• Journal of Nutrition and Health
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• 제27권10호
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• pp.1048-1057
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• 1994

Nonobese NIDDM patients were studied were studied with respect to changes in visceral protein status, serum glucose and lipids and insulin secretion capacity before and after intake of enteral formula. Patients with renal or hepatic disease, gastrectomy, malabsorption, weight gain over past 6 months and poorly controlled blood glucose level were excluded. Eighteen patients served as case and administered, in addition of their usual diet, 400ml of enteral formula for 8 weeks. Another 18 patients participated in controls and had usual food intake for 8 weeks. In the begining, the levels of fasting and postprandial glucose, glycated hemoglobin, triglyceride, HDL, LDL, total cholesterol, albumin, total protein and transferrin and glucose response area on oral glucose tolerance test were not different between two groups. The response areas of insulin, C-peptide and free fatty acid and serum IGF-1 level were higher in the case than in the control group. Energy intake of patients given enteral formula exceeded their estimated energy requirements(108%) and they consumed a mean of 112g protein per day. Patients given enteral formula showed an increase in body weight(4.4%), serum transferrin(10%), IGF-1(13%) and triglyceride(34%) while controls showed no changes in those parameters at 8 weeks compared to initial values. There were no significant changes after 8 weeks in the levels of glucose, glycated hemoglobin, HDL, LDL, total cholesterol, total protein and albumin and response areas of glucose, insulin, C-peptide and free fatty acid in both groups compared to initial values. This study suggests that nutrition supplement with enteral formula can increase body weight and visceral protein status in nonobese NIDDM patients without changes in blood glucose. However, excessive calorie intake could temporarily increase serum triglyceride. In addition, this study indicates that serum transferrin and IGF-1 are more sensitive indicators to changes of protein intake than serum albumin and total protein.