• Journal of Korean Biological Nursing Science
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• 제23권1호
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• pp.31-42
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• 2021

Purpose: This study was performed to assess the level of blood glucose and to identify poor glycemic control groups among patients with type 2 diabetes mellitus (DM). Methods: Data of 1,022 Korean type 2 DM patients aged 30-64 years were extracted from the Korea National Health and Nutrition Examination Survey VII. Complex samples analysis and a decision-tree analysis were performed using the SPSS WIN 26.0 program. Results: The mean level of hemoglobin A1c (HbA1c) was 7.22±0.25%, and 69.0% of the participants showed abnormal glycemic control (HbA1c≥6.5%). The characteristics of participants associated with poor glycemic control groups were presented with six different pathways by the decision-tree analysis. Poor glycemic control groups were classified according to the patients' characteristics such as period after DM diagnosis, awareness of DM, sleep duration, gender, alcohol drinking, occupation, income status, low density lipoprotein-cholesterol, abdominal obesity, and number of walking days per week. Period of DM diagnosis with a cut-off point of 6 years was the most significant predictor of the poor glycemic control group. Conclusion: The findings showed the predictable characteristics of the poor glycemic control groups, and they can be used to screen the poor glycemic control groups among adults with type 2 DM.

• 보건행정학회지
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• 제26권2호
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• pp.125-134
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• 2016

Background: Glycemic control is an effective way to reduce the cardiovascular complications of diabetes, but more than half of the adults with diabetes in Korea are improperly controlling their glycemic levels. The purpose of this study is to identify the factors associated with poor glycemic control in type 2 diabetes patients. Methods: This study analyzed 1,261 subjects ${\geq}30years$ old diagnosed with type 2 diabetes who participated in the fifth Korean National Health and Nutrition Examination Survey (2010-2012). Poor glycemic control rates were defined as hemoglobin A1c (HbA1c) level ${\geq}7%$. To shed light on the causes of poor glycemic control, socio-demographics, diabetes severity, health status, and health behavior factors were adjusted and logistic regression was done. Results: Of the total 1,261 patients, 53.0% of patients with type 2 diabetes had HbA1c ${\geq}7%$. After running a logistic regression model, the odds ratio of poor glycemic control was higher in high school graduates than elementary school graduates; in people living in Chungcheong and Jeolla/Jeju than those living in Seoul; in the group with diabetes for over 5 years had diabetes less than 5 years; in a group with insulin and oral hypoglycemic agent treatment than non-treatment; in a group with hypertriglyceridemia than without hypertriglyceridemia; and in the group with slept less than 6 hours slept 7-8 hours. Conclusion: We need a comprehensive public health policy to reduce the poor glycemic control rates in type 2 diabetes patients. We should recognize the education levels, duration of diabetes, diabetes treatment, hypertriglyceridemia, and sleep duration were associated with poor glycemic control.

• Journal of Obesity & Metabolic Syndrome
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• 제27권4호
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• pp.238-247
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• 2018

Background: We aimed to estimate the proportion of patients with diabetes who achieved target glycemic control, to estimate diabetes-related costs attributable to poor control, and to identify factors associated with them in the United Arab Emirates. Methods: This retrospective cohort study used administrative claims data handled by Abu Dhabi Health Authority (January 2010 to June 2012) to determine glycemic control and diabetes-related treatment costs. A total of 4,058 patients were matched using propensity scores to eliminate selection bias between patients with glycosylated hemoglobin (HbA1c) <7% and HbA1c ${\geq}7%$. Diabetes-related costs attributable to poor control were estimated using a recycled prediction method. Factors associated with glycemic control were investigated using logistic regression and factors associated with these costs were identified using a generalized linear model. Results: During the 1-year follow-up period, 46.6% of the patients achieved HbA1c <7%. Older age, female sex, better insurance coverage, non-use of insulin in the index diagnosis month, and non-use of antidiabetic medications during the follow-up period were significantly associated with improved glycemic control. The mean diabetes-related annual costs were $2,282 and $2,667 for patients with and without glycemic control, respectively, and the cost attributable to poor glycemic control was $172 (95% confidence interval [CI], $164-180). The diabetes-related costs were lower with mean HbA1c levels <7% (cost ratio, 0.94; 95% CI, 0.88-0.99). The costs were significantly higher in patients aged ${\geq}65$ years than those aged ${\leq}44$ years (cost ratio, 1.45; 95% CI, 1.25-1.70). Conclusion: More than 50% of patients with diabetes had poorly controlled HbA1c. Poor glycemic control may increase diabetes-related costs.

• Nutrition Research and Practice
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• 제18권2호
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• pp.239-256
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• 2024

BACKGROUND/OBJECTIVES: Over the past 10 yrs, the prevalence of diabetes in Korea has continued to incline, and the importance of lifestyle modification to manage diabetes has been highlighted. For patients with diabetes, carbohydrate intake reduction is effective in improving glycemic control; thus, we aimed to analyze the effect of carbohydrate intake ratio and suggest an appropriate carbohydrate intake ratio. SUBJECTS/METHODS: Using the 8th Korea National Health and Nutrition Examination Survey (2019-2021), we analyzed the data including participants aged 30 yrs or older with diabetes, and they were stratified into good and poor glycemic control groups. To analyze the correlation between the dietary behavior characteristics of participants with diabetes and the carbohydrate intake ratio, sociodemographic characteristics, dietary behavior, and health behavior were adjusted, and multivariate logistic regression analysis was conducted to present the adjusted odds ratio and 95% confidence interval (CI). RESULTS: In the unadjusted crude model, when carbohydrate intake ratio in total energy intake increased by 1%, the likelihood of poor glycemic control increased by 1.007-fold (95% CI, 0.998-1.016; P = 0.121). In model 1, which uses age and sex as adjustment variables, an increase of up to 1.011-fold was possible (95% CI, 1.001-1.021; P = 0.008). In model 2, which added variables such as diabetes duration, frequency of fruit consumption, frequency of lunch and, frequency of dinner, the risk of poor glycemic control increased by 1.010-fold as the carbohydrate intake ratio increased (95% CI, 0.998-1.022; P < 0.001). CONCLUSION: This study confirmed that as the ratio of carbohydrate intake to total energy intake increases the likelihood of poor glycemic control also increases in patients with diabetes. Therefore, to improve glycemic control in patients with diabetes, controlling the carbohydrate intake may be helpful.

• 보건교육건강증진학회지
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• 제29권3호
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• pp.15-22
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• 2012

Objectives: This study was conducted to determine factors related to glycemic control among Korean patients with diabetes. Methods: Data was collected from the Fourth (2007-2009) Korea National Health and Nutrition Examination Survey (KNHANES) which was a nationwide, cross-sectional survey. The study participants who are available for hemoglobin A1c (HbA1c) were 1,441 patients with diabetes aged 30 years and older. Poor glycemic control was defined as $HbA1c{\geq}7.0%$. Data were analysed using logistic regression. Results: The proportion of patients with the poor glycemic control ($HbA1c{\geq}7.0%$) was 49.5%. After adjusting for confounding factors, younger aged persons (30-49 years) were less likely to control the blood glucose than older aged persons (60-69 years) (Adjusted OR=0.533, 95% CI [0.295-0.960]) and longer duration of diabetes was positively related to poor glycemic control (Adjusted OR=2.018, 95% CI [1.418-2.873]). Conclusions: Age and duration of diabetes were significantly related to blood glucose control. Therefore, considering these factors is helpful for developing a strategy to improve blood glucose control in diabetes.

• 기본간호학회지
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• 제23권3호
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• pp.245-255
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• 2016

Purpose: This study was conducted to compare self-care behaviors and self-care behavior related factors for groups of patients with good, inadequate and poor glycemic control. The study was based on variables of the Theory of Planned Behavior by Ajzen, habit and family support. (1991). Methods: Participants were 134 patients with type 2 diabetes (good glycemic control group: 57, inadequate glycemic control group: 40, poor glycemic control group: 37). Self-care behaviors, intention to self-care behavior and self-care behavior related variables (attitude, subjective norms, perceived behavior control, habits and family support) were measured. Data were collected from August 12 to September 25, 2014 and were analyzed using $x^2$-test, Fisher's exact test, ANCOVA, and logistic regression with SPSS/WIN 21.0. Results: Among the three glycemic groups, there were significant differences in self-care behavior, subjective norms, perceived behavior control, family support, and habits. Multinomial logistic regression showed that poor blood glucose probability was associated with duration of diabetes mellitus, method of DM therapy, perceived behavior control and habits. Conclusion: The study findings reveal the important role of self-care behavior, subjective norms, perceived behavior control, family support, and habits in blood glucose control in adults with type 2 diabetes.

• 한국치위생학회지
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• 제20권1호
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• pp.19-27
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• 2020

Objectives: This study aimed to analyze the association between self-assessed periodontal symptoms and glycated hemoglobin levels in patients with type 2 diabetes. Methods: This cross-sectional study involved 156 patients with type 2 diabetes who were aged 50 years or older. Structured questionnaires were used to investigate the self-assessed periodontal symptoms of the patients. The glycated hemoglobin test was performed to evaluate their long-term blood glycemic control. Chi-square test and logistic multiple regression were performed to analyze the factors associated with glycated hemoglobin levels. Results: Compared with patients aged 65 years and above, more patients aged 64 years and below showed poor glycemic control (p=0.020). Further, compared with patients without self-perceived gingival bleeding and halitosis, more patients with these two conditions showed poor glycemic control (p<0.05). Compared with the group of patients without any periodontal symptoms, the group of patients that had at least one periodontal symptom had a higher proportion of patients with poor glycemic control (p<0.001). In the logistic regression model, gingival bleeding and halitosis were the factors most associated with hyperglycemia (p<0.05). Conclusions: The results of our study suggest that gingival bleeding and halitosis can predict hyperglycemia in patients with type 2 diabetes.

• Journal of Korean Biological Nursing Science
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• 제22권1호
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• pp.53-60
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• 2020

Purpose: This study used raw data from the fifth (2010-2012) Korea National Health and Nutrition Examination Survey (KNHANES) to assess the relationship between vitamin D level and glycemic control of diabetes, and to provide basic data about the use of vitamin D for preparation of a treatment plan for diabetes in South Korea. Methods: For this study, data of 1,713 diabetes from KNHANES (2010-2012) were used. The collected data were analyzed using SPSS 18.0 program, and complex sample frequency analysis, descriptive statistics, complex sample cross analysis, complex sample general linear regression, and complex sample logistic regression analysis were performed. Results: It was found that the poor glycemic control group among the diabetes subjects had significantly lower level of blood vitamin D than the good glycemic control group. Factors affecting glycemic control included drinking, vitamin D levels, hypertriglyceridemia, duration of diabetes, and treatment of diabetes. Also, diabetics with vitamin D deficiency or shortage showed 3.55- and 2.61-times higher odds ratios, respectively, to be diagnosed as the poor glycemic control group than diabetics without vitamin D deficiency or shortage. Conclusion: This study is significant because it provides rationale and basic data about the use of vitamin D for preparation of a treatment plan for diabetes in South Korea by assessing the dependence of glycemic control on the vitamin D level of diabetics. Additionally, future studies are necessary to determine the appropriate concentration of vitamin D for diabetes prevention and treatment to prevent the side effects of excessive supplementation.

• 한국융합학회논문지
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• 제6권6호
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• pp.95-103
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• 2015

본 연구는 직장인 당뇨병 환자의 혈당조절 정도와 융합적인 영향요인을 파악하여 당뇨병관리를 위한 중재방안을 모색하기 위한 서술적 조사연구이다. 연구 대상은 2009-2013년 국민건강영양조사를 활용하였으며, 만19세 이상 65세 미만의 성인 중 당뇨병을 진단받고, 직장을 가지고 있는 총 764명을 대상으로 하였다. 당화혈색소 7.0% 미만을 혈당조절군, 7.0% 이상을 혈당비조절군으로 분류하였으며, SPSS 18.0 프로그램을 이용하여 분석하였다. 일반적 특성 중 성별, 질병관련 및 건강행태 특성 중 당뇨병이환기간, 당뇨병치료여부, 고혈압진단여부, 흡연, 중등도 신체활동, 걷기 실천여부가 그룹간 통계적으로 유의하게 나타났으며, 로지스틱회귀분석결과 성별, 당뇨치료여부, 고혈압진단여부, 걷기 실천여부가 당화혈색소 조절에 영향을 주는 요인으로 나타났다. 이상의 결과를 바탕으로, 직장인 당뇨병 환자들의 적극적인 당뇨치료와 일상생활에서의 걷기실천이 중요하며, 이를 지지해 줄 수 있는 직장 내 환경조성이 이루어져야 할 것이다.

• 성인간호학회지
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• 제23권3호
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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.