• Asian Pacific Journal of Cancer Prevention
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• v.16 no.10
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• pp.4401-4408
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• 2015

Background: Cancer is a primary source of concern in Thailand and other countries around the world, including the Asian-Pacific region. Evidence supports that an important contributing cause of cancer and other chronic illnesses such as stroke, diabetes, and hypertension is excessive alcohol consumption. Studies conducted in Thailand reveal a worrisome rise in the number of new and regular drinkers in communities. Therefore, actions for primary, secondary and tertiary prevention of problem drinking are necessary. In recent years nurses in North East Thailand have been developing and implementing the Khon Kaen Family Health Nursing model to embed disease prevention in communities through the actions of family health nurses and local family health leaders. Aim: The aim of this qualitative research was to better understand the experiences of the local family health leaders using this model and to synthesize lessons learned. Materials and Methods: As part of a participatory action research approach involving analysis of focus group discussions and individual interviews, the experiences of 45 family health leaders were synthesized. Results: Four main themes were identified, namely: i) Family first: role modeling beginning at the personal and family level. ii) Local leverage: using village community forums to reduce alcohol drinking. iii) Gentle growth: making the first step and treading gently; and iv) Respect, Redemption, Rehabilitation: valuing the person to re-integrate them in the village society. Conclusions: As alcohol consumption in the village declined significantly following the prevention program, these findings illuminate how low-tech integrated prevention approaches may be very useful, particularly in rural communities. The lessons learned may have relevance not only in Thailand but in other countries seeking to prevent and mitigate behavior that conduces to diseases such as cancer.

• Asian Pacific Journal of Cancer Prevention
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• v.16 no.5
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• pp.1789-1794
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• 2015

Background: Non-alcoholic fatty liver disease (NAFLD), the most common liver problem in diabetes, is a risk factor for liver cancer. Diabetes, high body mass index (BMI) and old age can all contribute to NAFLD progression. Transient elastography (TE) is used for non-invasive fibrosis assessment. Objectives: To identify the prevalence of NAFLD and significant hepatic fibrosis in diabetic patients and to assess associated factors. Materials and Methods: One hundred and forty-one diabetic and 60 normal subjects were screened. Fatty liver was diagnosed when increased hepatic echogenicity and vascular blunting were detected by ultrasonography. Liver stiffness measurement (LSM) representing hepatic fibrosis was assessed by TE. LSM ${\geq}7$ kPa was used to define significant hepatic fibrosis. Results: Four cases were excluded due to positive hepatitis B viral markers and failed TE. Diabetic patients had higher BMI, systolic blood pressure, waist circumference and fasting glucose levels than normal subjects. Fatty liver was diagnosed in 82 (60.7%) diabetic patients but in none of the normal group. BMI (OR: 1.31; 95%CI: 1.02-1.69; p=0.038) and alanine aminotransferase (ALT)(OR: 1.14; 95%CI: 1.05-1.23; p=0.002) were associated with NAFLD. Diabetic patients with NAFLD had higher LSM than those without [5.99 (2.4) vs 4.76 (2.7) kPa, p=0.005)]. Significant hepatic fibrosis was more common in diabetic patients than in normal subjects [22 (16.1%) vs 1 (1.7%), p=0.002]. Aspartate aminotransferase (AST)(OR: 1.24; 95%CI: 1.07-1.42; p=0.003) was associated with significant hepatic fibrosis. Conclusions: Sixty and sixteen percent of diabetic patients were found to have NAFLD and significant hepatic fibrosis. High BMI and ALT levels are the predictors of NAFLD, and elevated AST level is associated with significant hepatic fibrosis.

• Asian Pacific Journal of Cancer Prevention
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• v.17 no.10
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• pp.4681-4688
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• 2016

Objective: Our aim was to estimate whether diabetes mellitus (DM) may be associated with an increased risk of colorectal cancer (CRC) mortality in Japan. Methods: The Japan Collaborative Cohort (JACC) Study is a nationwide prospective study, initiated in 1988, which involves 110,585 subjects (age range: from 40 to 79 years; 46,395 males and 64,190 females). Our present analysis population comprised 96,081 (40,510 men and 55,571 women) who provided details on DM history. The questionnaire also included age, sex, weight, height, family history of CRC, smoking, drinking and exercise habits, and education. Cox proportional-hazard regression was used to estimate the hazard ratio (HR). We used SPSS 21 software to analyze all data. Results: Among the participants with DM, we followed up for 71,174 person-years and 640. deaths from CRC were confirmed; and, among the non-diabetic participants, 785 CRC deaths were identified during 1,499,324 person-years. After adjusting for multivariate confounding factors, such as age, sex, body mass index (BMI), family history of colorectal cancer, smoking habit, drinking habit, physical activity (sports and walking) and education, DM was associated with an increased risk of CRC death (HR 1.4, 95% confidence interval [CI] 1.0-2.0). Diabetic women, but not diabetic men, experienced increased mortality from CRC (HR 1.7, 95% CI 1.0-3.0). Conclusion: The risk of CRC mortality is significantly increased in both sexes and women with diabetes, but no significant increase was seen for diabetic men among Japanese.

• Nutrition Research and Practice
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• v.9 no.1
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• pp.22-29
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• 2015

BACKGROUND/OBJECTIVES: Recently, anthocyanins have been reported to have various biological activities. Furthermore, anthocyanin-rich purple corn extract (PCE) ameliorated insulin resistance and reduced diabetes-associated mesanginal fibrosis and inflammation, suggesting that it may have benefits for the prevention of diabetes and diabetes complications. In this study, we determined the anthocyanins and non-anthocyanin component of PCE by HPLC-ESI-MS and investigated its anti-diabetic activity and mechanisms using C57BL/KsJ db/db mice. MATERIALS/METHODS: The db/db mice were divided into four groups: diabetic control group (DC), 10 or 50 mg/kg PCE (PCE 10 or PCE 50), or 10 mg/kg pinitol (pinitol 10) and treated with drugs once per day for 8 weeks. During the experiment, body weight and blood glucose levels were measured every week. At the end of treatment, we measured several diabetic parameters. RESULTS: Compared to the DC group, Fasting blood glucose levels were 68% lower in PCE 50 group and 51% lower in the pinitol 10 group. Furthermore, the PCE 50 group showed 2-fold increased C-peptide and adiponectin levels and 20% decreased HbA1c levels, than in the DC group. In pancreatic islets morphology, the PCE- or pinitol-treated mice showed significant prevention of pancreatic ${\beta}$-cell damage and higher insulin content. Microarray analyses results indicating that gene and protein expressions associated with glycolysis and fatty acid metabolism in liver and fat tissues. In addition, purple corn extract increased the phosphorylation of AMP-activated protein kinase (AMPK) and decreased phosphoenolpyruvate carboxykinase (PEPCK), glucose 6-phosphatase (G6pase) genes in liver, and also increased glucose transporter 4 (GLUT4) expressions in skeletal muscle. CONCLUSIONS: Our results suggested that PCE exerted anti-diabetic effects through protection of pancreatic ${\beta}$-cells, increase of insulin secretion and AMPK activation in the liver of C57BL/KsJ db/db mice.

• The Journal of Korean Physical Therapy
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• v.18 no.2
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• pp.17-24
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• 2006

Purpose: This study was aimed for service to clinical data of physical therapy necessity of bone complication through analysis method of BMD (bone mineral density) used DEXA (dual energy X-ray absorptiometry) to their skeletal system for physical therapy assesement and intervention program in type II diabetic patients. Methods: Experimental group of 75 subjects and comparison group of 62 subjects were participated in type II diabetic patients(40-80 ages). BMD was measured by DEXA. BMD change of BMI score and BMD comparison of age and sex would be known. Results: This study was found that decreased BMD and increased osteopenea in type II diabetes. In particular, women were lower BMD and higher incidence of osteopenea than men. Men showed significant difference in normal group. Influence of type II diabetes was great on change of BMD in men. however, it showed no significant difference from normal group. Conclusion: it was found that skeletal system complication by type II diabetes had some relations. Because reduction of BMD had a great danger to induce trauma by fall or degenerative disease of system, evaluation of proper physical therapy for its prevention and improvement and intervention program are needed. In addition, it would be important to divide type II diabetic patients into osteopenea and osteoporosis changes of skeletal system at comprehensive aspect of physical therapy.

• Health Policy and Management
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• v.20 no.1
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• pp.125-136
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• 2010

Objectives: The purpose of this study is to analyze the proportion of fundus examination of DM patients for preventing microvascular complication and to examine the factors related to fundus examination in DM patients. Methods: This study used 2005 Korean national health and nutrition survey data. We selected all 1,129 diabetes mellitus patients from the data. And we choose 8 factors related to diabetes mellitus patients. These are sex, age group, type of residential area(rural or urban), education level, income level, comorbidity with hypertension, current insulin use, and duration of suffering from DM. We have analysed these factors by whether he had been examined fundus or no through Chi-square and logistic regression analysis. Results: Female DM patients have tendency to get more fundus examination than Male DM patients. And Young patients, patients who live in urban area, well educated patients, high income patients, comorbidity with hypertension, patients have got the insulin injection, patients have long duration of suffering from DM are to get more fundus examination. According to multivariate logistic regression analysis, sex and education level, income level, and duration of suffering from DM, comorbidity with hypertension, patients have got the insulin injection are significant factors on fundus examination for prevent microvascular diabetes mellitus complications. Conclusions and Discussion: We have concluded that physicians and policy makers should consider to fundus examination especially of man and DM patients who have more shorter disease period and low educated patients and low incomed patients and patients who have taken insulin therapy.

• Nutrition Research and Practice
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• v.1 no.2
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• pp.79-83
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• 2007

The present study was conducted to document the association between plasma homocysteine levels and the presence of macrovascular angiopathy with food and nutrient intake patterns among patients with Type II diabetes mellitus in Korea. Plasma total homocysteine concentration was analyzed by HPLC-fluorescence detector method in 127 patients with non-insulin dependent diabetes mellitus. Logistic regression analyses were performed respectively to study the association of plasma homocysteine levels with clinical and dietary characteristics and macroangiopathy (MA). The average plasma homocysteine level of patients with MA was $14.2{\mu}mol/l$, which was significantly higher than that of patients without MA ($11.4{\mu}mol/l$). The proportions of patients with MA showed a significant difference, being 32.3% in hyperhomocysteinemic ($>14.0{\mu}mol/l$) patients and 13.5% in others with homocysteine levels lower than $14.0{\mu}mol/l$. Odds ratios for macroangiopathy by tertile increase of plasma homocysteine concentration were 1.633 ($Q_2$) and 4.831 ($Q_3$), when adjusted for age, sex, and cigarette smoking. Patients with MA consumed reduced amounts of vitamin $B_1,\;B_2$, and folate. The results indicate that the plasma homocysteine levels are significantly increased in NIDDM patients who have macroangiopathy. Dietary management such as increased fruits and vegetables and decreased potatoes and starches might be beneficial for the prevention of macroangiopathy in diabetic patients.

• Korean Journal of Health Education and Promotion
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• v.32 no.4
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• pp.37-46
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• 2015

Objectives: This study was conducted to expand evidence-base for the effectiveness of lifestyle intervention programs to prevent the onset of diabetes and cardiovascular diseases. Methods: Seven intervention studies between 2006 and 2014 at Korea Association of Health Promotion were analyzed. All the studies were randomized controlled trials(RCTs) and included multi-component behavioral interventions. The participants of the programs were 2,172 adults with risk factors regarding metabolic syndrome criteria. The proportions of normalized participants were compared within and across the studies using odds ratio effect sizes. Results: The reductions in the prevalence of metabolic syndrome were from 49.6% to 65.1% in intervention groups, and from 38.7% to 52.3% in comparison groups. Significant differences in effectiveness between groups were found in two studies, one in 2006 with odds ratio of 1.69(p<0.01) and another in 2009 with odds ratio of 2.36(p<0.001). Proportions of normalized participants were higher in blood pressure(31.9% to 52.5% in the intervention groups and 23.0% to 43.3% in comparison groups) than other risk factors. Abdominal obesity showed weakest improvement after the intervention in both groups. Conclusions: Lifestyle modification program is an effective method to reduce diabetes and cardiovascular risks in adults by decreasing the prevalence of metabolic syndrome and its components.

• Journal of Korean Medicine for Obesity Research
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• v.4 no.1
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• pp.139-160
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• 2004

The obesity is detrimental to the health of people living in affluent societies. Individual differences in energy metabolism are caused primarily by single nucleotide polymorphisms(SNPs), some of which promote the development of obesity-related type 2 diabetes mellitus. Type 2 diabetes mellitus is a common multifactorial genetic syndrome, which is determined by several different genes and environmental factors. In this review, five major conclusions are reached: (1)To be clinically significant, SNPs must be relevant, prevalent, modifiable, and measurable. (2)Differences in SNPs may have been caused by famine, ultraviolet light, alcohol, climate, agricultural revolution. livestock, lactase persistence, and westernized lifestyle. (3)Candidate obesity genes of calorie intake restriction are SIM 1, MC3R, MC4R, AGRP, CART, CCK, CNTFR, DRD2, Ghrelin, 5-HT receptor, NPY, PON and those of energy metabolism are LEP, LEPR, UCP1, UCP2, UCP3, B2AR, B3AR, PGC-1, Androgen receptor and those of fat mobilization are AGT, ACE, ADA, APM1, Apolipoproteins, PPAR, FABP, FOXC2, GCGR, $11-{\beta}HSDI$, LDLR, Hormonal sensitive lipase, Perilipin, $TNF-{\alpha}$, $TNF-{\beta}$ (4)Candidate obesity genes in the eastern are NPY, LEP, LEPR, UCP1, UCP2, UCP3, B2AR, B3AR, ACE, APM1, PPAR, and FABP. (5)Candidate obesity genes in type 2 diabetes mellitus are MC3R, MC4R, B2AR, B3AR, ADA, APM1, PPAR, FABP, FOXC2, PC1, PC2, ABCC8, CAPN10, CYP19, CYP7, ENPP1, GCK, GYS1, IGF, IL-6, Insulin receptor, IRS, and LPL. The discovery of SNPs will lead to a greater understanding of the pathogenesis of obesity and to better diagnostics, treatment, and eventually prevention.

• Journal of Sasang Constitutional Medicine
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• v.21 no.1
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• pp.197-216
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• 2009

1. Objectives This study is to investigate the relationship between type A behavior pattern(TABP) and diabetes according to Sasang Constitution. 2. Methods 162 persons(81 IGM persons vs 81 normal persons) out of 666 persons, more than 40 years old, who participated the community based cohort in Wonju City of South Korea from July 2nd to August 30th in 2006, were randomly selected and analyzed. Framingham Type A score, Social Support index, glucose related laboratory results were measured and analyzed according to Sasang Constitution. 3. Results Soeumin in IGM group had significantly high scores in FTA scales compared with Soyangin and Taeeumin, bur in female IGM group and normal group there was no significant difference in FTA scales and TABP frequency by Sasang Constitution. There was no significant difference in social support index in IGM and normal group by Sasang Constitution. There was no significant difference in glucose-related values between TABP/TBBP in IGM group and normal group. Soyangin in female IGM group had significantly high values in insulin(fasting) and HOMA-IR in TABP group, Soeumin group had significantly high values in FBS in TABP group. According to binary logistic regression analysis for IGM, Sasang Constitution was a significant risk factor and the ORs of Taeeumin and Soyangin were significantly higher than that of Soeumin. Social Support index was significantly higher only in female group. 4. Conclusions Adequate questionnaire of TABP for our country or a research of another subjects are needed. And Sasang Constitution is thought to be the reasonable intervention to control diabetes in terms of prevention, treatment and regimen.