• 대한간호학회지
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• 제36권5호
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• pp.837-844
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• 2006

Purpose: This study was done to identify fat distribution and blood pressure according to anthropometric change patterns between NIDDM patients and control subjects. Methods: Cross-sectionally 167 NIDDM patients and 87 controls were studied. Previous maximal body weight and acute weight loss was obtained. Current height, body weight, BMI, waist-hip ratio(WHR), skinfold thicknesses(abdomen, subscapular & triceps), and blood pressure was measured. Three anthropometric change patterns were categorized by BMI changes from the maximum lifetim's BMI to the current time (obese-obese, obese-nonobese and nonobese-nonobese: obese: BMI$\geq$25kg/m$^2$, nonobese: BMI<25kg/m$^2$). The data was analyzed by $X^2$, t-test, age adjusted ANCOVA and Least Squares Means(LSM) for multiple comparison. Result: Acute body weight loss(p=0.01), anthropometric change types (p=0.001), WHR (p=0.05), and skinfold thickness (p=0.002) of NIDDM were significantly higher than those of the controls. The mean arterial pressure, WHR and skinfold thicknesses were greater in both obese-obese and obese-nonobese NIDDM and control subjects compared with both nonobese-nonobese NIDDM and control subjects. (all p's<0.05). Conclusion: NIDDM patients had more central and upper body adiposicity. Also both obese-obese and obese-nonobese NIDDM and control subjects had higher mean arterial pressures and central body obesity.

• Nutritional Sciences
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• 제8권1호
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• pp.35-41
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• 2005

Controlling dietary behaviors and health-related lifestyle habits is important to manage non-insulin dependent diabetes mellitus (NIDDM). If NIDDM is not treated properly, the prevalence of macro-vascular complications (MC) may increase. The goal of NIDDM therapy is to maintain normal concentrations of blood glucose and lipid profiles by having regular meals, controlling alcohol drinking, quitting smoking, and performing physical exercise regularly. This study was performed to investigate the dietary and health-related lifestyle habits and blood parameters of NIDDM patients of both genders and compared these characteristics between the patients with and without MC. Our results show that the subjects with MC compared to without MC and the female patients than the males controlled their diets more regularly, tended to regulate the number of meals better, and smoke less than those without MC. Although plasma lipid profiles were not significantly different between the genders and between the subjects with and without MC, the men had higher blood glucose and plasma tHcy concentrations than the women and plasma tHcy concentration was higher in the female subjects without MC. These results imply that the male patients of NIDDM without MC might have more problems in maintaining their blood glucose. In addition, smoking may be the most important life-style factor influencing some blood parameters like blood glucose, HbAlc, and total cholesterol in the NIDDM patients.

• 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.

• 대한간호학회지
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• 제27권3호
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• pp.694-704
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• 1997

This study was designed to assess the body fat distribution, and also to investigate the effects of body fat on glucose tolerance and on insulin secretion pattern by body mass index in offspring of parents with NIDDM. The subjects consisted of twenty parents with NIDDM who had been admitted to the Department of Internal Medicine or had been seen in the outpatient clinic at Kangnam St. Mary's Hospital, Catholic University between February to March, 1995. Twenty offspring were randomly selected from forty six offspring of twenty parents with NIDDM. As a control group, twenty healthy people without a family history of diabetes mellitus were matched by sex, age and body mass index(BMI). The results are as follows : 1. Mean fasting serum glucose and insulin levels and insulin / glucose ratio were significantly greater in offspring than in the control subjects with BMI 25kg /㎡ in the offspring and in the BMI<25kg /㎡ control subjects (P<0.05). 2. The total glucose area and insulin area were significantly greater in both the offsping and the control subjects with BMI≥25kg /㎡ than in both the offspring and the control subjects with BMI<25 kg /㎡(P<0.05). 3. Upper body skinfold thickness, Waist hip ratio(WHR), serum levels of total cholesterol and triglyceride(TG), total dietary calorie intake and protein intake in both the offspring and the control subjects with BMI≥25kg /㎡ were greater than those with BMI<25kg /㎡(P<0.05). On the other hand, HDL-cholesterol in both the offspring and the control subjects with BMI≥25kg /㎡ was lower than those with BMI< 25kg /㎡(P<0.05). 4. The major variables influencing the total glucose area were subscapular skinfold thickness and WHR and the major variables influencing the total insulin area were suprailiac skinfold thickness, WHR, TG and free fatty acid. In the light of the results, glucose intolerance and insulin resistance were affected by body mass index, Upper body fat, WHR and lipids(TG, Free fatty acid), it is implied that these are influencing factors on total glucose area and total insulin area. The identification of these factors might provide a useful tool to identify individuals at high risk of diabetes mellitus. Therefore, various nursing intervention programs to reduce obesity could be given to both the offspring of parents with NIDDM and to the obese healthy controls before diabetes mellitus develops.

• 동아시아식생활학회지
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• 제4권2호
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• pp.17-26
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• 1994

This study was an attempt to investigate various factions, such as the calorie, nutrient intake, physical activity, blood lipids, obesity prevalence and body fat distribution on NIDDM male diabetics. General characteristics, physical activity and exercise levels of subjects were invesigated by interviewing, daily calorie and nutrient intake were measured by convenient method. The following anthropometric measurements were made on all participats : weight, height. Also waist and hip circumference were measured on 174 male diabetics to get waist-to-hip circumference ratio as index of the body fat distribution. For measurement of plasma lipids, 12-hour fasting blood samples were drawn The results of this study were summarized as follows : 1. At the onset of diabetes, the major self-diagnosed symptoms were polydipsia, fatigue, and body weight redution 2. The average of daily energy intake of male diabetics was 2106 Kcal which is 96% of the RDA Percentage of energy is that carbohydrate:protein : pat=70:14:16. 3. Among the NIDDM male subjects, 59% was exercise regularly. 4. Obese subjects above in the ideal body weight of 120% are presently 17%, but 39% of subjects were reported to be obese in the past. The mean BMI of the male NIDDM diabetics is 23.3${\pm}$2.6 and the past mean BMI was 25.2${\pm}$2.7 The mean WHR was 0.93${\pm}$0.10. 5. When diabetics were divided into obese and nonobese group according to RBW, energy intake, blood pressure, blood glucose and total cholesterol were not significantly different between the two groups, but LDL and VLDL-cholesterol were significantly higher in the obese group. 6. RBW did not correlate with cholesterol and triglyceride, but WHR correlated significantly with cholesterol and triglyceride. In conclusion, these results from a present study support previous findings indicating that not only the degree of obesity but also the localization of fat is a risk factor for diabetes.

• 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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• 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.

• 대한간호학회지
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• 제30권3호
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• pp.741-749
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• 2000

This study was performed to investigate the relationship between reversed circadian blood pressure and risk factors of peripheral vascular disease in non-insulin-dependent diabetes mellitus (NIDDM) subjects. The subjects in this study were 18 NIDDM patients who were hospitalized in a medical unit of an university medical center located in Incheon, Korea, between November, 1998 and March, 1999. Blood pressure was measured with a mercury sphygmomanometer by 2 trained examiners every 2 hours during 24 hours. NIDDM subjects were divided into a dipper group and non-dipper group. Dippers are defined as those who show a mean nighttime blood pressure(BP) drop of more than 10% compared with daytime BP. Non-dippers are defined as those who show a mean nighttime BP drop of less than 10%, or an elevation in BP compared with daytime BP. Daytime BP included values obtained between 6 a.m. and 10 p.m. Night time BP included values obtained between 10 p.m. and 6 a.m. Data was analyzed by SPSS/PC package. Chi-square( $^2$) test was used for the comparison of sex between The dipper group and non-dipper group. Mann-Whitney test was used for comparisons of values of the risk factors of peripheral vascular disease and the frequency of complications of diabetes between the dipper group and non-dipper group. The results are as follows. There were no significant differences in daytime systolic, diastolic, and mean blood pressures between the dipper group and non-dipper group. However, night time systolic, diastolic, and mean blood pressures in the non-dipper group were significantly nigher than those in the dipper group (p=.021). There were no differences in sex, age, body, weight, duration of diabetes, serum lipid levels, BUN and HbA1c between the two groups. On the contrary, 87.5% of non-dipper group subjects showed having hypertension, 30% of dipper group subjects showed having hypertension and this difference was statistically significant (p=.018). All of the non-dipper group subjects (N=8) showed having at least one diabetic complication. However, 40% of the dipper group subjects (N=10) showed having no diabetic complication at all and this difference was also statistically significant (p=.049). There were no significant differences in frequency of nephropathy, neuropathy and retinopathy between the dipper group and non-dipper group.

• 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.