• 동서간호학연구지
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• 제29권2호
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• pp.106-116
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• 2023

Purpose: The purpose of this study was to identify the impact of obesity on the incidence of diabetes mellitus in adults with pre-diabetes. Methods: This study employed a longitudinal study design and utilized secondary data drawn from the Korean Genome and Epidemiology Study. This study used data from a sample of 3,693 adults with prediabetes who were followed every two years from 2001 to 2018. Statistical data analysis for frequency, number of cases per 1,000 person-years, log-rank test, Kaplan-Meier curve, and Cox's proportional hazards regression analysis was performed using IBM SPSS statistics version 26. Results: During the observation period, there were 1,309 (35.4%) patients with diabetes, and the total number of person-years was 35,342. The incidence of diabetes was higher in the obese group compared to the normal weight group (body mass index [BMI]: hazard ratio=1.57, 95% confidence interval [CI]=1.40~1.77, waist: hazard ratio=1.55, 95% CI=1.38~1.76, waist to hip ratio [WHR]: hazard ratio=1.53, 95% CI=1.24~1.89, body fat [BF] (%): hazard ratio=1.42, 95% CI=1.27~1.61). Conclusion: An increase in BMI, waist circumference, and WHR, which are indicators of obesity, can exacerbate the risk factors for diabetes. Thus, a decrease in BMI, waist circumference, and WHR is necessary to prevent pre-diabetes. In particular, health care professionals should provide individualized weight management program interventions, including adult obesity programs and obesity counseling in partnership with local health departments, to reduce BMI and waist circumference in people at high risk for diabetes.

• Journal of Nutrition and Health
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• 제37권4호
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• pp.302-309
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• 2004

This study was carried out to investigate the effect of nutrition education program for diabetic patients on the glycemic control at the public health center. The study subjects, aged 61.7 $\pm$ 9.4 years, were 93 sex-and age-matched patients with type 2 diabetes mellitus. They were divided into three groups: nutrition education ＆ diet practice group (EDG), nutrition education-only group (EG), and the control group (CG). Height, weight, and the postprandial 2 hour blood glucose (PP2) were measured at baseline, and 4, 6 and 8 week after the diabetic nutrition education program. At baseline there were no differences in height, weight, and blood glucose levels among the three groups. Nutrition education programs, especially that with group lunch practice sessions were found to be effective in lowering the blood glucose levels in patients with NIDDM patients. At 4 week blood glucose levels were decreased by 40.6% and 19.6% in EDG and EG, respectively, which was further dropped by 50.2% and 35.1% at 8 week, as compared to the CG group. For the EDG group, the total energy intake, which was 162.3% of the prescription before the diet counselling session, was decreased to 113.6% of the prescription after the lunch visit, with most decrease coming from the reduction in carbohydrate and fat intake. Multiple stepwise regression analysis revealed that the total energy intake explained 47.9% and 57% of blood glucose changes for men and women, respectively, and that percent energy intake from protein explained 15.8% for women. These results demonstrate that the public health center nutrition education programs for diabetic patients, especially that with group lunch practice sessions are very effective for the glycemic control in patients with diabetes mellitus.

• 보건교육건강증진학회지
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• 제32권4호
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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.

• 한국보건간호학회지
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• 제31권1호
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• pp.71-83
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• 2017

Purpose: It is thought to be crucial to guide diabetic children and adolescents through their adolescent period psychologically and emotionally. Therefore, we investigated what positive roles a type 1 diabetic camp program would play on subjects in terms of depression, anxiety, self-esteem and self-efficacy. Methods: This study evaluated 38 diabetic children and adolescents with type 1 diabetes who attended summer camp. Subjects were analyzed using a one-group pretest-posttest quasi-experimental research design. Results: There was a significant decrease in depression (t=3.55, p=.001) and anxiety (t=3.09, p=.004) after attending camp, as well as a significant improvement in self-efficacy (t=-3.64, p=.001). However, there was no significant change in self-esteem (t=0.14, p=.891). Conclusion: The results of this study indicate that type 1 diabetic camps are an effective intervention program to promote psychological and emotional stability among diabetic children; therefore, it is recommended that various diabetes programs related to camps be developed.

• Perspectives in Nursing Science
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• 제14권1호
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• pp.21-31
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• 2017

Purpose: This study was conducted to identify the disease adaptation and related factors for the pediatric patients with diabetes mellitus. Methods: Participants in this study were 75 diabetic children or adolescent whose age were 10 to 18 years old visited the out-patient clinic in one general hospital located in Seoul. Data were collected using self-report questionnaires. Research tools measuring resilience, family support, psychological adaptation, Hemoglobin A1c (HbA1c) protein were used. Results: Resilience showed significant differences according to the age, gender, academic achievement, and hospitalization experience of the children. Family support was significantly different according to the age, religion, academic achievement, fathers' education level, and hospitalization experience of the children. Psychological adaptation to diabetes showed significant differences according to academic achievement. HbA1c was shown to be significant difference according to fathers' education level and hospitalization experience of the children. Positive correlations were identified among resilience, family support, and psychosocial adaptation, while negative correlations were found between HbA1c and all others including resilience, family support, and psychosocial adaptation. Conclusion: This study suggests that the educational programs as nursing intervention needs to be developed to enhance the resilience and family support for the pediatric diabetic patients.

• 지역사회간호학회지
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• 제28권2호
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• pp.216-225
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• 2017

Purpose: The purpose of the study was to analyze the effects of self-care behavior, empowerment, and social support on glycosylated hemoglobin in patients with type 2 diabetes. Methods: The data were collected during the period of July 1 to July 31, 2016. In total, 172 participants were recruited from outpatients who had been diagnosed with type 2 diabetes at a health care center, a health promotion center at National Health Insurance Corporation, and a tertiary hospital. Statistical data were analyzed with SPSS 20.0 using frequency analysis, t-test, ANOVA, $Scheff{\acute{e}}$ test, Pearson's correlation coefficients, and hierarchical regression analysis. Results: The study results showed that self-care behavior (${\beta}=-.34$, p<.001), empowerment (${\beta}=-.34$, p<.001), and social support (${\beta}=-.20$, p=.018) were found to be influential factors affecting glycosylated hemoglobin, with an overall descriptive power of 69%. Conclusion: Self-care behavior, empowerment, and social support are considered to be important factors in blood glucose management for the patients with type 2 diabetes. Therefore, self-caring blood glucose programs and internal synchronizing education through social support and empowerment need to be improved.

• 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.

• 산업융합연구
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• 제21권6호
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• pp.91-97
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• 2023

본 연구는 제8기 국민건강영양조사 자료를 이차 분석한 서술적 조사연구이다. 한국의 30~49세 성인 중 당뇨병 유병자 총 300명의 당뇨병 유병률과 인지율을 분석하고 이에 영향을 미치는 요인을 확인하고자 시도되었다. 자료 분석은 SPSS 25.0 program을 이용하여 복합표본 빈도와 백분율, χ²-test, 로지스틱 회귀분석을 실시하였다. 당뇨병 유병자 중 당뇨병임을 인지한 자는 171명(57.0%)이었으며 인지에 영향을 미치는 요인은 성별, 교육수준, BMI, 주관적 건강상태, 심혈관질환, 부계 및 모계 가족력이었다. 본 연구의 결과를 토대로 비교적 젊은 30~49세 당뇨 유병률을 감소시키고 유병자들의 인지율을 높이는 정책 및 중재 프로그램을 수립하는데 기초자료로 활용될 수 있을 것이다.

• 임상간호연구
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• 제15권3호
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• pp.61-74
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• 2009

Purpose: In order to increase the quality of nursing care for patients with diabetes mellitus, it is important for clinical nurses to accept changes in diabetes knowledge and correct their approach immediately. This approach will also contribute to effective nursing practice. Methods: The study was designed to investigate the level of knowledge and diffusion of knowledge for nursing care of patients with diabetes mellitus among clinical nurses. It was conducted with nurses from 29 general hospitals in Korea from November 3 to December 5, 2008. The questionnaire consisted of 129 items and it was sent to the participants by mail. Of the 1,060 questionnaires returned, only 930 were valid for use in the statistical analysis. Results: 1) The average score for clinical nurses' knowledge of diabetes mellitus was 0.67 out of 1.0. 2) The level of persuasion of knowledge for nursing care of patients with diabetes mellitus averaged 0.64 out of 1.0 3) The level of practical application of knowledge for nursing care of patients with diabetes mellitus averaged 1.05 out of 2.0, indicating that they applied their knowledge 'sometimes'. 4) The level of diffusion of knowledge for nursing care of patients with diabetes mellitus was 2.37 out of 4.0 and level was estimated as the stage of 'persuasion'. 5) There were significant differences in nursing knowledge of diabetes mellitus, according to experience in practical education for diabetes mellitus. Conclusion: The results indicate that nurses with a lower level of knowledge of diabetes mellitus have a lower level of persuasion of knowledge for nursing care of patients with diabetes mellitus and lower practical application. To improve the level of nurses' knowledge of diabetes mellitus, practical training programs are needed for areas in which knowledge level is low, such as 'diagnosis and management of diabetes mellitus', 'oral diabetes medication', and 'glucose control in special conditions'.

• Journal of health informatics and statistics
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• 제43권4호
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• pp.307-317
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• 2018

목적: 본 연구의 목적은 메타분석을 이용하여 2000년 이후 국내외 당뇨병을 가진 성인을 대상으로 수행된 인터넷 기반 중재 프로그램의 효과를 검증하고 실무 적용의 타당성을 확인하기 위함이다. 방법: 2000년 1월부터 2015년 12월까지 시행된 연구 중 국내외 학술지에 게재된 연구 논문을 대상으로 체계적 검토를 시행하였으며, 이중 분석 대상 기준에 적합한 최종 9편의 논문을 선정하였다. 자료 분석은 Internet-based Intervention의 실험군과 대조군에 따른 효과성을 파악하기 위하여 오픈 소스 통계 소프트웨어인 R 3.5.0을 사용하여 분석하였다. 결과: 분석 결과 성인 당뇨 환자의 HbA1c 조절을 위한 인터넷 기반 중재 프로그램의 효과 크기에 관한 연구는 국외 8편, 국내 1편이었다. 연구에 사용된 중재는 Internet-based Management가 7편(77.8%)으로 가장 많았고, Internet-based Education이 2편(22.2%)이었으며, 중재 프로그램 적용기간은 6개월이 4편(33.4%)으로 가장 많았다. 선행연구와의 중재 효과 비교에서는 모바일 전용 중재에서의 HbA1c 조절에 대한 가중평균 차이(WMD -0.20%, 95% CI: -0.43-0.03; p = 0.09)의 효과는 통계적으로 유의하지 않았으며, 모바일과 인터넷을 기반으로 한 중재를 통합했을 경우 가중평균 차이(WMD 0.54%, 95% CI: 0.72-0.37; p< 0.001)의 효과를 나타냈다. 본 연구의 메타분석 결과에서도 인터넷을 기반으로 한 중재활동에서 통계적으로 유의한 효과를 보였다. 중재기간에 따른 효과 크기 분석 결과에서는 약 89%인 8편에서 3개월, 6개월, 12개월 모두 인터넷을 기반으로 한 중재활동 시행 시, 실험군에서 높은 효과를 보였으나, 중재 지속 기간의 증가에 따라 중재 효과는 감소하는 경향을 나타내었다. 결론: 본 연구의 결과에서는 인터넷 기반 중재 프로그램의 효과를 확인할 수 있었으며, 이는 인터넷을 기반으로 한 중재활동이 성인의 대표적 만성질환인 당뇨관리를 위한 HbA1c 및 혈당조절에 효과적임을 의미한다. 이와 함께 만성질환인 당뇨의 꾸준한 관리를 위한 인터넷 중재 프로그램의 활용 방안에 대한 연구와 중재활동의 구체적인 지침, 프로토콜 수립의 필요성이 제기된다.