• 대한한방내과학회지
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• 제28권2호
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• pp.284-293
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• 2007

Objectives : Hypertension(HTN), diabetes mellitus(DM) and hyperlipidemia(HL) are the most common risk factors of cerebro-vascular attack(CVA). To prevent CVA, early diagnosis (awareness before CVA) of HTN, DM and HL is essential, and for the effective early diagnosis we need to analyze the data of CVA patients concerned with HTN, DM and HL. In this study, we studied characteristics of patients early diagnosed before CVA. Methods : We analyzed the data of 363 patients with acute ischemic stroke from Hanbang Stroke Registry supported by the Ministry of Science and Technology of Korea. Subjects' enrollment was done in the oriental medical hospitals of 3 universities located in the metropolitan region from October 2005 to October 2006. We analyzed all registered data about HTN. DM and HL, for example, how many patients were aware of their HTN, DM or HL before CVA, differences in characteristics of early diagnosed patients, effects of early diagnosis on CAV, etc. Results : Patients aware of their HTN. DM and HL before CVA have more past history and family history about HTN, DM or HL. Early diagnosis rate of HL is lower than HTN and DM, and early diagnosed HL patients were younger and deucated longer than patients who weren't aware of their HL before CVA. These results mean that publicity is the key to promoting early diagnosis rates of HTN, DM and HL. In DM and HL, early diagnosed patients had more SVO type cerebral infarction than patients who weren't aware of risk factors. We can thus see that early diagnosis even affects CVA types. Conclusion : This work helps us to understand the realities and importance of early diagnosis of HTN, DM and HL before CVA. There should be further research, which can contribute to much more improved early diagnosis rates of HTN, DM and HL.

• Journal of Periodontal and Implant Science
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• 제44권4호
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• pp.158-168
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• 2014

Purpose: The present study was conducted to evaluate the impact of scaling and root planing (SRP) on the C-reactive protein (CRP) levels of gingival crevicular fluid (GCF) and serum in chronic periodontitis patients with type 2 diabetes mellitus (T2DM-CP) or without type 2 diabetes mellitus (NDM-CP). Methods: Forty-eight human participants were divided into two groups: an experimental (T2DM-CP) group (group I, n=24) comprising chronic periodontitis patients with random blood sugar ${\geq}200mg/dL$ and type 2 diabetes mellitus, and control (NDM-CP) group (group II, n=24) of those with chronic periodontitis and random blood sugar <200 without T2DM for the study. All subjects underwent nonsurgical periodontal therapy (NSPT) including complete SRP and subgingival debridement. Periodontal health parameters, plaque index (PI), gingival index (GI), probing pocket depth (PPD), clinical attachment level (CAL), GCF volume (GCF vol), GCF-CRP, random blood glucose (RBS), glycated hemoglobin, and systemic inflammatory markers, serum CRP, total leukocyte count (TLC), neutrophil count (Neutr) and lymphocyte count (Lymph), were evaluated at baseline, 1 month, and 3 months after SRP. Results: NSPT resulted in statistically significant improvement in periodontal health parameters (PI, GI, PPD, CAL, GCF vol), CRP levels in serum as well as GCF of both groups I and II. The mean improvement in periodontal health parameters (PI, GI, PPD, CAL, GCF vol), CRP levels in serum and GCF was greater in group I than group II after NSPT. There was nonsignificant increase in GCF-CRP, TLC, Lymph, and RBS, and a significant increase in Neutr and Serum CRP in group II at 1 month. The Serum CRP level of 20 out of 24 group II patients had also increased at 1 month. Conclusions: The CRP levels in both GCF and serum were higher in T2DM-CP patients than in NDM-CP patients. Although there was a significant improvement in both the groups, greater improvement was observed in both GCF and serum samples of T2DM-CP patients.

• Journal of Periodontal and Implant Science
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• 제41권3호
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• pp.109-116
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• 2011

Purpose: The purpose of this study was to compare and quantify the expression of C-reactive protein (CRP), matrix metalloproteinase (MMP)-14, and tissue inhibitor of metalioproteinases (TIMP)-2 in gingival tissues of patients with chronic periodontitis accompanied with inflammatory reaction related to alveolar bone resorption with or without type 2 diabetes mellitus (DM). Methods: Twelve patients with type 2 DM and chronic periodontitis (group 3), twelve patients with chronic periodontitis (group 2), and twelve healthy individuals (group 1) were included in the study. Gingival tissue biopsies were collected from each patient and from healthy individuals at the time of periodontal surgery (including surgical crown lengthening) or tooth extraction. The concentrations of cytokines were determined by a western blot analysis. Results: The expression levels of CRP and MMP-14 increased in group 2 and 3, and they were highest in group 3. The expressions of TIMP-2 also increased in group 2 and 3. Conclusions: This study demonstrated that the expression levels of CRP, MMP-14, and TIMP-2 might be inflammatory markers in periodontal inflamed tissue. It can be assumed that CRP, MMP-14, and TIMP-2 may be partly involved in the progression of periodontal inflammation associated to type 2 DM.

• 동서간호학연구지
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• 제1권1호
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• pp.72-81
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• 1997

Korean society is a mix of western and traditional cultures. Even though the patients try to recover through both aspects, hospital only utilizes a western approachs. When they have suffered from a chronic disease, especially diabeties meliitus(DM), application of folk medicine is more varied but the nurses are unaware of the practices. This study was done to describe the current use of the folk medicine with which the patients with DM have had an experience and to identify the relationships between the westernized medical care and folk medicine application. The 244 patients with non-insulin dependent diabetes millitus who participated were interviewed at a DM education clinic in a 1500-bed hospital. The results of the study are as follows: 1. 54.1%(N=133) of the participated patients in this study have had a folk medicine. 2. 44 kinds of folk medicine were used for the treatment of DM. Among them 14 items were used by more than two people and the rest were used by one person. Among the used items, 70.4% consisted of various types of plants, 11.4% was animal material and 18. 2% was the mixed group. As a single item, Commelina Communis(Dalgaebi) was the most frequently used(62.8%), followed by the root of Rosa rugosa(Haedangwha) 14.3%, and Youngi mushroom 13.6%. 3. In the analysis of the relationships between the general characters of the patients with regular fol1ow-up(F-U), self blood sugar test(BST) and folk medicine usage: 1) The higher the educational back ground patient had, the lower the folk medicine usage was ($X^2$=14.265, P=.003). 2) The more complex their treatment was($X^2$=24. 016. P=.000). and the longer they had suffered from DM($X^2$=75.739, P=.000), the fewer they visited regular F-U. On the other hand, they did self-BST well($X^2$=7.722, P=.021 : $X^2$=14. 775, P=.002) and had more folk medicine($X^2$=33.382, P=.000 ; $X^2$=43.410, P=.000). 3) If they had suffered many symptoms, they had fewer regular F-U ($X^2$=13.192. P=.001). On the other hand, they had more folk medicine($X^2$=6.070, P=.048). 4) The group of family history($X^2$=6.801. P=.009) and the group of DM education experience($X^2$=15.678, P=.000) carried out self BST well. DM education group used more folk medicine($X^2$=8.680, P=.003). In conclusion, DM education should be grouped according to the treatment type and suffering period. Then the management of DM would be effective and the vague application of folk medicine would be decreased.

• Clinical and Experimental Pediatrics
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• 제46권6호
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• pp.585-590
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• 2003

목 적 : 심혈관계 자율신경 기능이상은 청소년기 당뇨병 환자의 7.7-28%에서 동반되며, 당뇨병성 자율신경병증은 심장 교감 신경계 이상으로 인한 돌발성 부정맥 및 돌연사를 초래할 수 있는 것으로 보고되었다. 본 연구는 소아 및 청소년기 당뇨병 환자에서 심혈관계 자율신경 기능이상의 빈도 및 이에 영향을 미치는 인자들을 파악하여 당뇨병성 자율신경병증의 조기진단 및 치료에 도움이 되고자 시행하였다. 방 법 : 8-26세의 1형 당뇨병 환자 80명(남자 27명, 여자 53명)과 2형 당뇨병 환자 12명(남자 4명, 여자 8명)을 대상으로, 발살바 동작시 R-R 간격의 변화(발살바 비), 심호흡시 심박수의 변화, 기립시 R-R 간격의 변화(30 : 15 비), 기립성 저혈압의 4가지 항목에 대하여 검사를 시행하여 환자의 연령, 유병기간, 당화혈색소, 소변 알부민 배설량, 신경전달속도 이상 및 당뇨병성 망막증 유무와의 연관성을 분석하였다. 결 과 : 검사 당시 연령 및 평균 유병기간은 1형과 2형 당뇨병 환자간에 의미있는 차이가 없었으나, 당뇨병의 발병연령은 2형에서 더 높았다. 체질량지수는 1형에 비해 2형에서 의미있게 높았으며, 혈압 및 당화혈색소는 두 군간에 차이가 없었다. 1형 당뇨병 환자의 22.5%에서 조기, 8.7%에서 중등도, 1.3%에서 심한 자율신경병증에 해당하였으며, 2형의 경우 16.7%에서는 조기, 8.3%에서 중등도, 8.3%에서 심한 자율신경병증에 해당하였다. 전체적으로, 심혈관계 자율신경 기능 이상은 1형의 32.5%에서, 2형의 33.3% 에서 나타나 빈도에 있어서 두 군간에 차이는 보이지 않았다. 1형에서는 발살바 비와 유병기간 간에 의미있는 상관관계가 있었으며, 2형에서는 발살바 비와 연령, 심호흡시 심박수 변화와 당화혈색소, 그리고 기립성 저혈압과 유병기간 간에 의미있는 상관관계가 관찰되었다. 1형과 2형 당뇨병 환자 전체를 대상으로 시행한 로지스틱 회귀분석상, 연령(OR=1.133(1.003-1.279), P<0.05) 및 유병기간(OR=1.148(1.009-1.307), P<0.05)만이 자율신경 기능 이상의 의미있는 예측인자로 나타났으며, 당화혈색소, 혈압, 소변 알부민 배설량, 신경전달속도 이상 및 당뇨병성 망막증 유무와는 관련이 없었다. 검사항목 중 발살바 비는 31.5%의 환자에서, 심호흡시 심박수의 변화는 41.3%의 환자에서 경계역 또는 이상소견을 보인 반면, 30 : 15 비 및 혈압변화는 각각 14.1%, 9.8%에서 경계역 또는 이상소견을 보였다. 발살바 비(OR=0.001(0.000-0.083), P<0.01)와 심호흡시 심박수의 변화(OR=0.840(0.754-0.934), P<0.01)는 자율신경 기능이상 유무에 의미있게 영향을 미쳤으나, 30 : 15 비 및 기립성 저혈압은 영향을 미치지 못하였다. 결 론 : 심혈관계 자율신경 기능이상은 소아 및 청소년 당뇨병 환자의 32.6%에서 동반되었으며, 중등도 이상의 뚜렷한 자율신경 기능이상도 10.8%에서 관찰되었다. 혈당 조절이 양호한 환자에서도 자율신경계 합병증의 가능성은 배제할 수 없으며 연령 및 유병기간이 증가할수록 그 위험은 더욱 증가하였다. 소아 및 청소년기 당뇨병 환자에서 자율신경 기능검사시, 발살바 비와 심호흡시 심박수의 변화가 가장 유용한 검사 항목으로 사료된다.

• 한국임상약학회지
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• 제29권3호
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• pp.186-192
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• 2019

Background: Diabetes is associated with cancer risk in the aging population. Observational studies have indicated the beneficial effects of metformin against breast cancer, making studies on the anticancer potential of antidiabetic drugs worthwhile. This study investigated cancer incidence in patients on antidiabetic monotherapy. Methods: Using National Health Insurance Service data (2002-2013), a retrospective cohort study that included type 2 diabetes mellitus (T2DM) patients was conducted. Study subjects were enrolled if they were ${\geq}30$ years old, on monotherapy for diabetes, and cancer-free. They were followed up for cancer occurrence or death, until December 31st, 2013. A Cox proportional hazard model analysis was conducted between metformin and sulfonylurea (including meglitinide) users, to determine cancer risk, with adjustment for age, gender, comorbidity index, dyslipidemia, hypertension, and T2DM duration. Results: The number of antidiabetic monotherapy-treated T2DM patients without a history of cancer was 9,554 (metformin, n = 5,825; sulfonylurea, n = 3,225; others, n = 504). During the follow-up period (mean, 2.04; IQR, 3.18 years), the cancer incidence rate was 5.48/100 and 5.45/100 patient-years for metformin and sulfonylurea, respectively. The hazard ratio (HR) for risk of cancer incidence in the metformin group was 0.74 (95% confidence interval [CI], 0.66-0.83; p < 0.0001), compared with sulfonylurea. Additionally, the HRs for risks of lung, liver, and stomach cancer were respectively 0.46 (95% CI, 0.31-0.66; p < 0.0001), 0.41 (95% CI, 0.31-0.54; p < 0.0001), and 0.51 (95% CI, 0.35-0.73; p = 0.0003). Conclusion: Antidiabetic therapy with metformin reduces cancer risk by 26%, specifically for lung, liver, and stomach cancer.

• Journal of Periodontal and Implant Science
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• 제52권6호
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• pp.455-465
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• 2022

Purpose: Periodontal diseases are inflammatory conditions that alter the host's response to microbial pathogens. Type 2 diabetes mellitus (T2DM) is a complex disease that affects the incidence and severity of periodontal diseases. This study investigated the gingival crevicular fluid (GCF) levels of colony-stimulating factor-1 (CSF-1) and interleukin-34 (IL-34) in patients with stage III grade C periodontitis (SIII-GC-P) and stage III grade C periodontitis with uncontrolled type 2 diabetes (SIII-GC-PD). Methods: In total, 72 individuals, including 24 periodontally healthy (PH), 24 SIII-GC-P, and 24 SIII-GC-PD patients, were recruited for this study. Periodontitis patients (stage III) had interdental attachment loss (AL) of 5 mm or more, probing depth (PD) of 6 mm or more, radiographic bone loss advancing to the middle or apical part of the root, and tooth loss (<5) due to periodontal disease. Radiographic bone loss in the teeth was also evaluated; grade C periodontitis was defined as a ratio of the percentage of root bone loss to age greater than 1.0. The plaque index (PI), gingival index (GI), presence of bleeding on probing (BOP), PD, and clinical AL were used for clinical periodontal assessments. GCF samples were obtained and analyzed using an enzyme-linked immunosorbent assay. Results: All clinical parameters-PD, AL, GI, BOP, and PI-were significantly higher in the SIII-GC-PD group than in the PH and SIII-GC-P groups for both the full mouth and each sampling site (P<0.05). The total IL-34 and CSF-1 levels were significantly higher in the SIII-GC-PD group than in the PH and SIII-GC-P groups (P<0.05), and there were significant differences between the periodontitis groups (P<0.05). Conclusions: These findings suggest that IL-34 and CSF-1 expression increases in patients with SIII-GC-PD. CSF-1 was associated with the inflammatory status of periodontal tissues and T2DM, while IL-34 was associated only with T2DM.

• Journal of Nutrition and Health
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• 제35권3호
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• pp.394-401
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• 2002

The purpose of this study was to : (a) examine diabetic patients' sensory evaluation and food preferences, (b) analyze the portion sizes & plate wastes, (c) investigate the factors affecting plate wastes, and (d) determine the nutritional & mometary values of the plate wastes. A questionnaire for determining food preference and sensory evaluation was developed. Thirty-three diabetic patients who were hospitalized in Sanggye Paik hospital in Seoul were studied. Serving sizes and plate wastes were weighed by using an electric scale, and the CAN-Pro program was used to evaluate the nutritional value or the food consumed. The data were analyzed using the SAS package program for descriptive analysis, t-test, ANOVA, and the Pearson correlation. Using a five-point Likeu-type scale, the temperature s[ore ranged from 3.1 to 3.3 (1 : very poor, 5 : excellent), the preference store was 3.0-3.2 (1 : very dislike, 5:very like), the taste score was 2.9-3.2 (1 : very poor, 5 : excellent), and the amount of food served score was 2.8-3.0 (1 : too little, 5 : too much). Serving sizes were considered insufficient by patients because most of the DM diet was low in calories. Average plate waste for the DM diet was 26.2% of the total served, by weight, and was lower than that for patients consuming a normal diet, which was 30.3%, found in previous research. Those subjects who had been previously hospitalized and who wished to participate in a campaign for food waste reduction produced less plate waste than other groups (p<.05). Plate wastes of the DM diet were negatively correlated with taste, temperature, and preference, and were positively correlated with the amount served: however, these results were not statistically significant. It was found that diabetic patients consumed adequate levels of energy, protein, Ca, Fe, Vitamin B$_1$, Vitamin B$_2$, and niacin, but inadequate levels of Phosphorus, Vitamin A and Vitamin C. The plate wastes were calculated to be 26.2% of the total cost (￦ 3,489), which is ￦9l5. This represents a significant wastage of resources from the hospital. The results of this study could assist foodservice managers in both controlling food wastage, and improving the quality of hospital food services.

• Journal of Periodontal and Implant Science
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• 제43권2호
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• pp.87-95
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• 2013

Purpose: The purpose of this study was to analyze the expression of inducible nitric oxide synthases (iNOS), tissue inhibitors of metalloproteinase $(TIMP)_{-3}$, and $TIMP_{-4}$ in the gingival tissues of periodontal patients with or without type 2 diabetes mellitus (DM). Methods: Depending on the patient's systemic condition and clinical criteria of the gingiva, each gingival sample was classified into one of three groups. Sixteen clinically, systemically healthy patients (group 1), 16 periodontal patients (group 2), and 16 periodontal patients with DM (group 3) were included. Tissue samples in each group were collected, prepared, and analyzed by western blotting. Quantification of the relative amount of $TIMP_{-3}$, $TIMP_{-4}$, and iNOS was performed. Results: The expression levels of iNOS and $TIMP_{-3}$ both increased in group 1, group 2, and group 3 in increasing order, and were significantly higher in both group 2 and group 3 as compared to group 1 (P<0.05). The expression levels of $TIMP_{-4}$ increased in the same order, but significantly increased in group 2 as compared to group 1, in group 3 as compared to group 1, and group 3 as compared to group 2 (P<0.05). Conclusions: This study demonstrated that iNOS, $TIMP_{-3}$, and $TIMP_{-4}$ might be involved in the progression of periodontal inflammation associated with type 2 DM. It is thought that further study of these factors can be applied practically for the diagnosis and control of periodontitis in diabetics.

• 생명과학회지
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• 제19권1호
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• pp.81-86
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• 2009

12주 유산소 트레이닝 결과, 제 2형 당뇨 대상자의 신체적 특성 및 심혈관계 기능은 향상되었고, 심근허혈을 판단하는 ST-level과 ST-slope가 트레이닝 후 감소함을 나타냈다. 또한, 당뇨에서 자주 나타나는 대표적인 자율신경계 이상 마커인 QTc interval을 감소시켰다. 따라서, 12주 유산소 트레이닝은 심혈관계 기능과 당뇨로 인한 심장허혈, 자율신경계 기능을 증진시킨 것으로 나타냈다.