• Title/Summary/Keyword: Poor glycemic control

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The influencing factors associated with glycemic control among adult diabetes patients (성인 당뇨병환자의 혈당조절에 따른 특성 및 영향요인)

  • Kim, Kisook
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.16 no.5
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    • pp.3284-3292
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    • 2015
  • The purpose of this study was to investigate influencing factors and characteristics in Korean adults with diabetes by glycemic control groups. A secondary data analysis was conducted using the data of "The Fifth Korea National Health and Nutrition Examination Survey, 2012" in this study. Finally, 608 participants who adults with diabetes were used for analysis. Selected data were processed using the SPSS 21.0 program. Diabetes duration(OR: 1.70, 95% CI 1.03-2.92) and age(OR: 2.06, 95% CI 1.16-3.65), hypertriglyceridemia(OR: 2.45, 95% CI 1.21-4.98) were positively associated glycemic poor control group. Therefore considering these factors and individualized diabetes intervention by glycemic control group are helpful for adult patients with diabetes.

Use of Insulin Glargine in 2 Dogs with Diabetes Mellitus (개의 당뇨병에서 Insulin Glargine의 적용 2례)

  • Ahn, Jin-Ok;Seo, Kyoung-Won;Hwang, Cheol-Yong;Youn, Hwa-Young
    • Journal of Veterinary Clinics
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    • v.28 no.1
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    • pp.139-143
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    • 2011
  • A Spitz (5-years old, castrated male) and a Maltese (9-years old, castrated male) were presented with weight loss, polyuria/polydipsia (PU/PD) and depression. Diabetic ketosis was diagnosed based on clinical signs, physical examinations and screening tests (CBC, serum chemistry and urinalysis). The dogs were treated with NPH initially. However, NPH was inadequate to control blood glucose level due to the short duration of the action (< 5 hours). Because of the poor glycemic control with NPH, the dogs showed diabetic complications including weight loss and cataract. After change to glargine, the duration of insulin action was extended up to 11 hours. As a result, there was significant improvement in clinical signs and serum fructosamine concentrations. This study suggests that glargine is useful as a long-acting insulin in dogs which have poor glycemic control due to the short duration of NPH.

Dietary Quality and Self-Management Status according to the Glycemic Control in the Elderly with Type 2 Diabetes (노인 당뇨환자에서 혈당조절에 따른 식사의 질과 당뇨자가관리상태)

  • Park, Soo-Jin;Woo, Mi-Hye;Choue, Ryo-Won
    • The Korean Journal of Food And Nutrition
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    • v.21 no.4
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    • pp.530-535
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    • 2008
  • Evidence for the effects of different health behaviors, including diet, in elderly diabetes is currently limited. The aim of this study was to compare the quality of diet and health behaviors in Korean elderly T2DM patients, using a glycemic control. T2DM elders(>65 yr, n=48) were recruited and categorized by the concentration of glycated-hemoglobin HbA1c; subjects with HbA1c<7% were the good control(GC) group, and subjects with $HbA1c{\geq}8%$ constituted the poor control(PC) group. General characteristics, self-management behavior questionnaires, and 3-d diet records were all collected and assessed. No significant differences in general characteristics between GC and PC were detected, with the exception of a higher level of education in GC(p<0.05). A twofold longer duration of diabetes was observed in PC as compared to GC(p<0.01). The GC group did exercise for a longer time(p<0.001), and had an earlier beginning of diabetes self-management education (DSME) by healthcare practitioners using a team teach as compared with the PC group(p<0.05). The total dietary quality index(p<0.001) and individual index for carbohydrate(p<0.001) or vegetables and fruit(p<0.05) were better in GC than in PC. Therefore, the earlier DSME including intensive exercise and balanced diet selection should be expected to improve glycemic control in diabetic Korean elders.

Identification of subgroups with poor lipid control among patients with dyslipidemia using decision tree analysis: the Korean National Health and Nutrition Examination Survey from 2019 to 2021 (의사결정나무 분석을 이용한 이상지질혈증 유병자의 지질관리 취약군 예측: 2019-2021년도 국민건강영양조사 자료)

  • Hee Sun Kim;Seok Hee Jeong
    • Journal of Korean Biological Nursing Science
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    • v.25 no.2
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    • pp.131-142
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    • 2023
  • Purpose: The aim of this study was to assess lipid levels and to identify groups with poor lipid control group among patients with dyslipidemia. Methods: Data from 1,399 Korean patients with dyslipidemia older than 20 years were extracted from the Korea National Health and Nutrition Examination Survey. Complex sample analysis and decision-tree analysis were conducted with using SPSS for Windows version 27.0. Results: The mean levels of total cholesterol (TC), triglyceride (TG), low density lipoprotein-cholesterol (LDL-C), and high density lipoprotein cholesterol were 211.38±1.15 mg/dL, 306.61±1.15 mg/dL, 118.48±1.08 mg/dL, and 42.39±1.15 mg/dL, respectively. About 61% of participants showed abnormal lipid control. Poor glycemic control groups (TC ≥ 200 mg/dL or TG ≥ 150 mg/dL or LDL-C ≥ 130 mg/dL) were identified through seven different pathways via decision-tree analysis. Poor lipid control groups were categorized based on patients' characteristics such as gender, age, education, dyslipidemia medication adherence, perception of dyslipidemia, diagnosis of myocardial infarction or angina, diabetes mellitus, perceived health status, relative hand grip strength, hemoglobin A1c, aerobic exercise per week, and walking days per week. Dyslipidemia medication adherence was the most significant predictor of poor lipid control. Conclusion: The findings demonstrated characteristics that are predictive of poor lipid control and can be used to detect poor lipid control in patients with dyslipidemia.

Comparative Study on Self-Care Behavior, Diabetes-related Stress, and Stress Coping among Good, Inadequate, and Poor Glycemic Control Groups (혈당 조절 양호, 불충분, 불량 군 간의 자가간호행위, 당뇨관련 스트레스, 스트레스 대처의 비교)

  • Kang, Hye-Yeon;Gu, Mee-Ock
    • Journal of Korean Academy of Fundamentals of Nursing
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    • v.19 no.2
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    • pp.168-178
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    • 2012
  • Purpose: The purpose of this study was to compare self-care behavior, diabetes-related stress and stress coping style among 3 blood glucose control groups (good, inadequate, and poor blood glucose control groups). Methods: Participants were 102 type 2 diabetic patients (good group: 41, inadequate group: 31, poor group: 30). Data were collected from Feb 19 to Mar 24, 2010 and were analyzed using Chi-square, Fisher's exact test and ANCOVA with SPSS/WIN 12.0. Results: Using ANCOVA with frequency of admission, and illness duration as covariates, significant differences were found among the 3 groups in self-care behavior (total score) and the exercise subscale. Using ANCOVA significant differences were found among 3 groups in diabetes-related stress (total score), emotional burden subscale and regimen distress subscale. Using ANCOVA no difference in stress coping was found among the 3 groups, but there was a significant difference in the problem-oriented coping subscale. Conclusions: Self-care behavior, diabetes-related stress, and stress coping style are factors influencing blood glucose control. The results of this study suggest that for improving blood glucose control, self care education program focused on diet and exercise in addition to stress management program for promoting problem oriented coping capability are recommended.

Relationship between the Self-Reported Oral Health Status and Hemoglobin A1c Level among Diabetic Patients (일부 당뇨병 환자에서 당화혈색소 수치와 주관적 구강건강상태와의 연관성)

  • Choi, Jun-Seon
    • Korean Journal of Health Education and Promotion
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    • v.25 no.1
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    • pp.55-69
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    • 2008
  • Objective: This study was to investigate the relationship between hemoglobin A1c level and self-reported oral health status. Methods: The subjects of this study were 150 diabetic patients (60 male patients and 90 female patients) who went to the internal and family medicine departments of clinic. This study used the questionnaire and NYCOCARD$\square$ READERII to quantify hemoglobin A1c. Results: The proportion of well controlled diabetes subjects was 31.3%. When hemoglobin A1c levels became higher, subjects perceived that there were more decay teeth, bleeding, swollen gums, mobility teeth, and oral disease symptoms. In comparison with the well glycemic control group, poor glycemic control group perceived that the overall oral health status was worse, and had more bleeding teeth, swollen gums and mobility teeth. Conclusion: These results show that hemoglobin A1c level is related to the self-reported oral health status. Therefore, dental professionals should emphasize more the necessity of maintaining the hemoglobin A1c of normal range and monitoring it periodically, and the practice of thorough oral hygiene care in order to promote diabetic patients' oral health.

A Case of Diabetic Nephropathy Progressed to End-Stage Renal Disease in an Adolescent with Type 1 Diabetes (사춘기에 말기 신질환으로 조기 진행한 소아 제1형 당뇨병성 신병증 1례)

  • Yoon, Ji-Eun;Kwon, Soon-Kil;Ha, Tae-Sun
    • Childhood Kidney Diseases
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    • v.13 no.2
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    • pp.242-247
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    • 2009
  • Type 1 diabetes mellitus (T1DM) commonly occurs in childhood and adolescence and diabetic nephropathy is a serious metabolic complication of T1DM that leads to serious morbidity. With poor glycemic control prepubertal diabetes duration contributes to the risk of long-term microvascular complications, however, the younger age at onset or longer prepubertal diabetes duration seems to prolong the time to development of microalbuminuria or later end-stage renal disease (ESRD). Therefore, there have been a few cases of diabetic nephropathy in prepubertal patients and therefore the ESRD cases developed during adolescence in T1DM children were very rare. Here we report an adolescent with T1DM who had poor glycemic control and was diagnosed as diabetic nephropathy in a prepubertal period and leading to end-stage renal disease during adolescence.

A Case of Diabetic Nephropathy in a Child with Type 1 Diabetes (제 1형 당뇨병 소아환자에서 발생한 당뇨병성 신병증 1례)

  • Jung, Hwan-Hee;Park, Sung-Sin;Kim, Sung-Do;Cho, Byoung-Soo
    • Childhood Kidney Diseases
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    • v.12 no.2
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    • pp.250-255
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    • 2008
  • Diabetes mellitus(DM) is a metabolic syndrome caused by deficiency of insulin secretion and a consequence of insulin resistance. Poor glycemic control is a common finding in children with Type 1 DM(T1DM). Approximately 60% of the young patients with T1DM develop abnormalities in the eyes and 15-20% in the kidney. Diabetic nephropathy (DN) is a serious metabolic complication of T1DM that leads to renal failure. Some clinical studies report that the duration of prepubertal diabetes may contribute less to the development of microvascular complications than pubertal and postpubertal duration. There have been few cases of DN in prepubertal patients with T1DM in Korea. Thus we report a case of a 12-year-old female with T1DM who had poor glycemic control and was diagnosed as DN in a prepubertal period. It was proven by renal biopsy after microscopic hematuria and proteinuria were detected through the mass school urinary screening program.

Hepatic glycogenosis in type 1 diabetes mellitus mimicking Mauriac syndrome

  • Jung, In Ah;Cho, Won Kyoung;Jeon, Yeon Jin;Kim, Shin Hee;Cho, Kyoung Soon;Park, So Hyun;Jung, Min Ho;Suh, Byung-Kyu
    • Clinical and Experimental Pediatrics
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    • v.58 no.6
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    • pp.234-237
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    • 2015
  • Hepatic glycogenosis in type 1 diabetes mellitus (DM) can be caused by poor glycemic control due to insulin deficiency, excessive insulin treatment for diabetic ketoacidosis, or excessive glucose administration to control hypoglycemia. Mauriac syndrome, which is characterized by hepatomegaly due to hepatic glycogenosis, growth retardation, delayed puberty, and Cushingoid features, is a rare diabetic complication. We report a case of hepatic glycogenosis mimicking Mauriac syndrome. A 14-year-old girl with poorly controlled type 1 DM was admitted to The Catholic University of Korea, Seoul St. Mary's Hospital for abdominal pain and distension. Physical examination revealed hepatomegaly and a Cushingoid face. The growth rate of the patient had decreased, and she had not yet experienced menarche. Laboratory findings revealed elevated liver enzyme levels. A liver biopsy confirmed hepatic glycogenosis. Continuous glucose monitoring showed hyperglycemia after meals and frequent hypoglycemia before meals. To control hyperglycemia, we increased insulin dosage by using an insulin pump. In addition, we prescribed uncooked cornstarch to prevent hypoglycemia. After strict blood glucose control, the patient's liver functions and size normalized. The patient subsequently underwent menarche. Hepatic glycogenosis is a complication of type 1 DM that is reversible with appropriate glycemic control.

Diabetic Neuropathy (당뇨 신경병증)

  • Shim, Jung-In;Chung, Jin-Wha
    • Journal of Korean Foot and Ankle Society
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    • v.17 no.4
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    • pp.251-256
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    • 2013
  • Neuropathy is a common complication of diabetes. It is characterized by a progressive loss of peripheral nerve fibers. The development of the neuropathy is linked to poor glycemic control, age, and the duration of diabetes. Peripheral sensory polyneuropathy is the most common type in neuropathy. Diabetic neuropathy is the most significant etiologic factor of the foot ulcer that may leads to amputation. Current treatments in diabetic neuropathy have no definitive effects on repair or reverse the damaged nerve but only to relieve of symptoms, especially on pain. When the focal compressive neuropathy is combined with diabetic neuropathy, the nerve would be more vulnerable and symptoms might get worse. Surgery is indicated for decompression of an entrapped nerve, like posterior tibial nerve in tarsal tunnel, after failure of the initial conservative treatments.