• Journal of Korean Biological Nursing Science
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• 제24권4호
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• pp.219-226
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• 2022

Purpose: This study aimed to investigate the status and factors associated with self-management behavior (SMB) of patients with type 2 diabetes (T2DM) in a border area of southwest China. Methods: A cross-sectional study was conducted with T2DM patients in Dali, China. The participants filled in the questionnaires including demographic and disease-related characteristics, psychosocial status, resources of DM knowledge, knowledge of DM care, competency in DM care skills, the Chinese Diabetes Management Self-Efficacy Scale (C-DMSES), and the Chinese Summary of Diabetes Self-Care Activities (C-SDSCA). All the data were analyzed with SPSS version 26. Multiple linear regression analysis examined associations between predictors and SMB. Results: A total of 470 valid questionnaires have been collected. The score for overall SMB was 50.71± 11.99; 19.6% of patients were at a good level, 48.3% were moderate, and 32.1% were poor. The significant factors that influenced SMB included self-efficacy (β= 0.37; p< .001), competency in DM care skills (β= 0.22; p< .001) and lacked in the treatment confidence (β= -0.09; p= .023). Conclusion: The level of self-management among T2DM patients in this area was medium-low state. For future studies, our findings suggest that self-efficacy, competency in DM care skills, and treatment confidence should be considered essential factors in improving the self-management behavior of T2DM patients in the border area of southwest China.

• Nutrition Research and Practice
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• 제9권6호
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• pp.658-666
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• 2015

BACKGROUND/OBJECTIVES: The current study examined trends in adherence to dietary recommendations and compared the levels of adherence between diagnosed and undiagnosed subjects with type 2 diabetes mellitus (T2DM) in Korea over the past 14 years. SUBJECTS/METHODS: Data were collected from the 1998-2012 Korea National Health and Nutrition Examination Surveys (KNHANES). Diagnosed diabetes was defined as giving a positive response to questions about awareness of the disease, a physician's diagnosis of diabetes, or medical treatment for diabetes, whereas undiagnosed diabetes was defined as having a fasting glucose level ${\geq}126mg/dl$. Assessment of adherence level was based on 6 components of dietary guidelines, considering meal patterns and intake levels of calories, carbohydrates, vegetable/seaweed, sodium, and alcohol. The participants received 1 point if they met the criteria for each of the 6 components, and the total possible score ranged from 0 to 6 points. Multivariate generalized linear regression was performed, taking into account the complex survey design. RESULTS: Among all diabetic patients aged 30 years or older, the proportion of diagnosed diabetes increased dramatically, from 40.9% in 1998 to 75.9% in 2012 (P for trend < 0.001). The overall adherence levels to dietary recommendations were low and did not significantly differ between diagnosed and undiagnosed subjects with T2DM for all survey years. Several improvements were observed, including increased adherence to maintaining sufficient vegetable/seaweed consumption (increased from 0.12 to 0.16 points) and limiting sodium intake (increased from 0.12-0.13 points to 0.19-0.24 points; P for trend < 0.001), while adherence to maintaining moderate alcohol consumption decreased. CONCLUSIONS: Analysis of data collected by the KNHANES indicates that Korean T2DM patients have poor adherence to dietary recommendations and maintenance of a healthy lifestyle, regardless of disease awareness. This finding suggests that development of practical, evidence-based guidelines is necessary and that provision and expansion of educational programs for T2DM patients is critical after diagnosis.

• 기본간호학회지
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• 제16권2호
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• pp.144-152
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• 2009

Purpose: The purpose of this study was to predict the risk factors for vascular complications among patients with type 2 diabetes. Method: The data were collected from August to September, 2007 using clinical examination and questionnaires. Patients (N=101) were recruited from the endocrinology department of P University hospital in D city. Descriptive statistics, Pearson correlation coefficients and multiple linear regression were used to analyze the data. Results: The cardiovascular risk of patients with diabetes was significantly related to self care behavior, family history, and smoking status. The risk of peripheral vascular complications was not related to predictors included in the study. With multivariate analyses, significant predictors of cardiovascular risk for these patients were self care behavior, family history, and smoking status ($R^2=.40$, p<.0001). Conclusion: The findings of this study indicate that smoking cessation and improving self-care behavior are essential to reduce the risk of cardiovascular complications among patients with diabetes. To enhance self-care practices for the patients with diabetes, nursing interventions, such as telephone counseling, problem focused nursing counseling, and peer group activities should be considered.

• 치위생과학회지
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• 제18권3호
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• pp.137-146
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• 2018

This systematic review aimed to investigate the effects of periodontal treatment on glycated hemoglobin A (HbA1c) levels in patients with type 2 diabetes who develop periodontal disease. The search of the MEDLINE, Embase, CINAHL, and Cochrane Library databases was completed on April 8, 2018. The study design was based on randomized clinical trials. Scaling and root planing was performed for the test group, whereas no periodontal treatment or simple oral training was performed for the control group. The main outcome variable was the change in HbA1c levels. We used the Review Manager statistical analysis software for the quantitative analysis of selected documents. Meta-analysis was performed using the inverse variance estimation method of the fixed-effect model to estimate the effects of periodontal treatment on HbA1c levels in patients with type 2 diabetes. A total of 1,011 documents were searched using search strategies, and 10 documents were included in the meta-analysis. The meta-analysis of the selected literature showed that periodontal treatment significantly reduced the HbA1c levels in patients with type 2 diabetes who develop periodontal disease (mean difference, -0.34; 95% confidence interval, -0.43 to -0.26; p<0.001). This study aimed to investigate the effects of periodontal treatment on HbA1c levels, which can be used as a basis for the increasing management of diabetic complications. To improve the quality of life and reduce the burden of medical expenses for patients with diabetes, periodontal disease management through nonsurgical periodontal treatment, such as scaling and root planing, is necessary.

• 약학회지
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• 제57권1호
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• pp.37-42
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• 2013

In this present study, we determined the immunoregulatory activity of ginsenoside Rd extract from Panax ginseng. To determine the activity, we tested Rd against $CD4^+$ Th cells in a murine model of type 1 diabetes, which involves Th1-dominant immunity. The type 1 diabetes was caused by streptozotocin (STZ) and the severity of the diabetes was evaluated by measuring the degree of hyperglycemia, a major symptom of diabetes. The data resulting from experiments showed that ginsenoside Rd induced a greater level of Th1 type cytokines [IFN-${\gamma}$ & IL-2] than Th2 type [IL-4 & IL-10] (P<0.05), which was determined by cytokine profile analysis. In the animal model of diabetes, the depletion of $CD4^+$ Th cells by a treatment of anti-CD4 mAb resulted in considerably lower values of blood-glucose levels than those of the mAb-untreated mice, which indicates that the Th1 immune response from $CD4^+$ Th cells are responsible for diabetes. Based on these observations, the effect of Rd on diabetes was examined in the same animal model. Results showed that Rd-treated mice groups had increased levels of blood glucose compared to Rd-untreated mice groups that were used as a negative control (P<0.05). In other words, Rd aggravated the diabetes via the Th1 immune response. In conclusion, ginsenoside Rd had an immunoregulatory activity of Th1-dominant immunity.

• Biomolecules & Therapeutics
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• 제28권1호
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• pp.110-118
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• 2020

Migration presents a substantial social and public health issue. However, it is unclear whether diabetes is worse among Asian migrants than natives of South Korea over time. This longitudinal study investigated the nationwide population, including 2,680,495 adults aged 20 years and older (987,214 Asian migrants and 1,693,281 natives), who received health check-ups, using the Korean National Health Insurance Service data (2009-2015). Joinpoint regression was used to estimate the annual percentage change of diabetes, and multivariable logistic regression was used to examine differences in incident type 2 diabetes between Asian migrants and natives adjusting for age, sex, economic status, body mass index, smoking status, any alcohol use, and physical activity. The age-adjusted prevalence of diabetes increased among native men (from 8.8% in 2009 to 9.7% in 2015, APC=1.64, p<0.05) compared to Asian migrant men, and the age-adjusted prevalence of diabetes increased among native women (from 6.0% in 2009 to 6.7% in 2015, APC=1.88, p<0.05) compared to Asian migrant women. In the multivariate analyses, Asian migrants were less likely to get type 2 diabetes than natives (odds ratio, 0.82; 95% CI, 0.78 to 0.86) between the first and last health check-ups. However, the odds ratio for developing type 2 diabetes was 1.15 (95% CI, 1.10 to 1.20) among low-income levels compared to high-income levels, regardless of whether they were Asian migrants or natives. The results could help to establish a new strategy for prevention, treatment, and management of diabetes among the Asian population.

• 대한약침학회지
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• 제20권4호
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• pp.235-242
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• 2017

Irisin is a novel hormone like polypeptide that is cleaved and secreted by an unknown protease from fibronectin type III domain-containing protein 5 (FNDC5), a membrane-spanning protein and which is highly expressed in skeletal muscle, heart, adipose tissue, and liver. Since its discovery in 2012, it has been the subject of many researches due to its potent physiological role. It is believed that understanding irisin's function may be the key to comprehend many diseases and their development. Irisin is a myokine that leads to increased energy expenditure by stimulating the 'browning' of white adipose tissue. In the first description of this hormone, increased levels of circulating irisin, which is cleaved from its precursor fibronectin type III domain-containing protein 5, were associated with improved glucose homeostasis by reducing insulin resistance. Irisin is a powerful messenger, sending the signal to determine the function of specific cells, like skeletal muscle, liver, pancreas, heart, fat and the brain. The action of irisin on different targeted tissues or organs in human being has revealed its physiological functions for promoting health or executing the regulation of variety of metabolic diseases. Numerous studies focus on the association of irisin with metabolic diseases which has gained great interest as a potential new target to combat type 2 diabetes mellitus and insulin resistance. Irisin is found to improve insulin resistance and type 2 diabetes by increasing sensitization of the insulin receptor in skeletal muscle and heart by improving hepatic glucose and lipid metabolism, promoting pancreatic ${\beta}$ cell functions, and transforming white adipose tissue to brown adipose tissue. This review is a thoughtful attempt to summarize the current knowledge of irisin and its effective role in mediating metabolic dysfunctions in insulin resistance and type 2 diabetes mellitus.

• 한국임상약학회지
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• 제20권3호
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• pp.183-192
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• 2010

While Self-monitoring of blood glucose (SMBG) has been recommended in some diabetes mellitus (DM) patients population according to the 2010 American Diabetes Association (ADA), 2007 Korean Diabetes Association (KDA), 2005 International Diabetes Federation guideline, it is excluded from a routine insurance coverage for outpatients in Korea. The objective of this study is to meta-analyze the impact of SMBG on HbA1c in non insulin-treated diabetes mellitus (NIT) DM patients. Published clinical literatures were identified through electronic database searches from inception and until May 2010. Studies were selected if they met the following inclusion criteria: 1) randomized controlled trials (RCTs), 2) comparing SMBG with non-SMBG in NIT type 2 diabetes, 3) measuring HbA1c as an outcome. Literature qualities were assessed by the Scottish Intercollegiate Guidelines Network Checklist. The mean difference of HbA1c between the 2 groups was pooled from non-heterogeneous 6 RCTs by meta-analysis using Review Manger (RevMan) Version 5.0 program. Pooled results demonstrated that SMBG is associated with a statistically significant improvement in glycemic control (mean HbA1c difference -0.23, 95%CI -0.32, -0.13). Sensitivity analysis showed that glycemic controls were significantly improved in patients with shorter study duration, more frequent self-monitoring, higher baseline HbA1c value, and without prior SMBG experiences. Conclusively SMBG is effective in improving glycemic control in NIT DM patients, but additional evidences from further researches in Korean patients and cost-effectiveness analysis would be necessary to make a suggestion for coverage expansion.

• Nutrition Research and Practice
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• 제9권5호
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• pp.496-502
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• 2015

BACKGROUND/OBJECTIVES: This study was performed to investigate the association between the dietary intake of fish and shellfish, and omega-3 polyunsaturated fatty acids (PUFAs) and cardiovascular disease (CVD) risk factors in the middle-aged Korean female patients with Type 2 diabetes (T2D). SUBJECTS/METHODS: A cross-sectional analysis was performed with 356 female patients (means age: 55.5 years), who were recruited from the Huh's Diabetes Clinic in Seoul, Korea between 2005 and 2011. The dietary intake was assessed by a validated semi-quantitative food frequency questionnaire and analyzed using the Computer Aided Nutritional Analysis program (CAN-Pro) version 4.0 software. RESULTS: In a multiple regression analysis after the adjustment for confounding factors such as age, BMI, duration of diagnosed T2D, alcohol consumption, fiber intake, sodium intake, and total energy intake, fish and shellfish intake of the subjects was negatively associated with triglyceride and pulse wave velocity (PWV). Omega-3 PUFAs intake was negatively associated with triglyceride, systolic blood pressures, diastolic blood pressures, and PWV. The multiple logistic regression analysis with the covariates showed a significant inverse relationship between the omega-3 PUFAs consumption and prevalence of hypertriglyceridemia [OR (95% CI) for greater than the median compared to less than the median: 0.395 (0.207-0.753)]. CONCLUSIONS: These results suggest that the consumption of fish and shellfish, good sources of omega-3 PUFAs, may reduce the risk factors for CVD in the middle-aged female patients with T2D.

• Journal of Obesity & Metabolic Syndrome
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• 제27권4호
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• pp.213-222
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• 2018

Bariatric surgery has evolved from a surgical measure for treating morbid obesity to an epochal remedy for treating metabolic syndrome as a whole, which is represented by type 2 diabetes mellitus. Numerous clinical trials have advocated bariatric or metabolic surgery over nonsurgical interventions because of markedly superior metabolic outcomes in morbidly obese patients who satisfy traditional criteria for bariatric surgery (body mass index [BMI] >$35kg/m^2$) and in less obese or simply overweight patients. Nevertheless, not all diabetes patients achieve the most desirable outcomes; i.e., diabetes remission after metabolic surgery. Thus, candidates for metabolic surgery should be carefully selected based on comprehensive preoperative assessments of the risk-benefit ratio. Predictors for diabetes remission after metabolic surgery may be classified into two groups based on mechanism of action. The first is indices for preserved pancreatic beta-cell function, including younger age, shorter duration of diabetes, and higher C-peptide level. The second is the potential for an insulin resistance reduction, including higher baseline BMI and visceral fat area. Several prediction models for diabetes remission have been suggested by merging these two to guide the joint decision-making process between clinicians and patients. Three such models, DiaRem, ABCD, and individualized metabolic surgery scores, provide an intuitive scoring system and have been validated in an independent external cohort and can be utilized in routine clinical practice. These prediction models need further validation in various ethnicities to ensure universal applicability.