• The Journal of Internal Korean Medicine
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• v.42 no.2
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• pp.175-183
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• 2021

Diabetes mellitus, commonly known as diabetes, comprises a group of metabolic disorders characterized by a high blood sugar level over a prolonged period of time. Diabetes is classified into type 1 diabetes and type 2 diabetes, and the incidence and prevalence of diabetes, mostly type 2, have increased remarkably in recent decades. A diagnosis of type 2 diabetes is greatly influenced by heredity, and it is important to prevent diabetes in people with a family history by improving lifestyle and environmental factors. Controlling overeating, obesity, lack of exercise, and stress is effective to prevent diabetes. The patient in this case report had impaired fasting glucose and mild hyperlipidemia. The patient experienced improvements in these sequelae after the administration of herbal medicine (Yangkyuksanwha-tang) for 12 weeks and the implementation of a plant-based diet. The complete blood count, XXXX, fasting blood sugar, HbA1c, insulin, and C-peptide levels were measured, and the Homeostatic Model Assessment for Insulin Resistance (HOMA-IR) and HOMA-β were calculated according to the FBS and fasting insulin levels. Total cholesterol, triglyceride, FBS, and HbA1c levels all decreased after 12 weeks compared with baseline measures. There was no change in the insulin secretory ability; the C-peptide level did not change as a result of β-cell function; and the HOMA-β level reflected an improved insulin secretory ability.

• Journal of Korean Academy of Nursing
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• v.53 no.2
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• pp.167-176
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• 2023

Purpose: Despite the high prevalence of visual impairment caused by diabetic retinopathy and nutritional problems among older adults with diabetes, evidence regarding factors related to nutritional risk in this population is limited. Therefore, this study aimed to identify the correlates of nutritional risk among older adults with diabetes, focusing on visual impairment. Methods: This study was a secondary data analysis of the 2020 National Survey of Older Koreans aged 65 years and above. The sample comprised 2,376 older adults with diabetes, and complex sample ANOVA and Rao-Scott chi-square tests were used to compare the groups according to visual impairment. Complex-sample logistic regression analyses were conducted to verify the association between visual impairment and nutritional risk. Results: Older adults with diabetes, who also have severe visual impairment, are more likely to have nutritional risk status than those without impairment after controlling for covariates (odds ratio [OR] = 2.44, 95% confidence interval [CI] 1.16~5.13). Among the covariates, depression (OR = 3.58, 95% CI 2.60~4.94), dependent activities of daily living status (OR = 2.79, 95% CI 1.60~4.86), and experience of hospitalization during the past year (OR = 2.51, 95% CI 1.57~4.03) were strongly associated with nutritional risk. Conclusion: Severe visual impairment increases the nutritional risk among older adults with diabetes. Therefore, it is essential to prevent visual impairment due to exacerbation of diabetes through appropriate management. Additionally, tailored nutritional interventions for visually impaired older adults with diabetes that consider visual characteristics are required.

• Journal of Yeungnam Medical Science
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• v.40 no.2
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• pp.146-155
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• 2023

Background: Despite the recent increasing trend in the prevalence of type 2 diabetes among older individuals, the relationship between diabetic retinopathy (DR) and chronic kidney disease (CKD) in these patients remains unclear. This study investigated the severity of renal dysfunction according to the degree of DR in older patients with type 2 diabetes. Methods: A total of 116 patients with diabetes and CKD stage ≥3 who visited both the nephrology and ophthalmology outpatient departments between July 2021 and January 2022 were screened. There were 53 patients in the no DR group, 20 in the nonproliferative DR (NPDR) group, and 43 in the proliferative DR (PDR) group. Results: DR severity was related to the deterioration of renal function. The proportion of patients with advanced CKD significantly increased with DR severity (p for trend <0.001). In the multivariate regression model adjusted for age of ≥80 years, male sex, poorly controlled diabetes, macroalbuminuria, insulin use, diabetes duration of ≥10 years, cerebrovascular accident, hypertension, hyperlipidemia, and cardiovascular disease history, the odds ratio compared with the no DR group was approximately 4.6 for the NPDR group and approximately 11.8 for the PDR group, which were both statistically significant (p=0.025 and p<0.001, respectively). Conclusion: DR severity in older patients with diabetes may be associated with deterioration of renal function and high prevalence of advanced CKD. Therefore, periodic examination for DR in older patients with diabetes is important for predicting renal function deterioration and CKD progression.

• Journal of East-West Nursing Research
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• v.29 no.2
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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 agricultural medicine and community health
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• v.49 no.3
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• pp.179-193
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• 2024

Objectives: This study aimed to determine the time-series changes in provincial diabetes management indices using by results of the 2008-2022 Korea Community Health Survey. Methods: We collected diabetes diagnosis experience rate, treatment rate for people diagnosed with diabetes, annual screening rate for diabetic eye disease complications, and annual screening rate for diabetic kidney disease complications with age-standardized rates from the Regional Health Statistics. The unit of analysis was the nation and 17 provinces and the time-series trend analysis was performed by joinpoint regression using the Joinpoint Regression Program, and the annual percent change (APC) and average APC (AAPC) were estimated, and statistical significance was tested using 95% confidence interval (CI). Results: From 2008-2022, the national AAPC (95% CI) for diabetes diagnosis experience rate steadily increased to 2.77 (2.25-3.27), increasing in all regions, excluding Sejong. The national AAPC for treatment rate for people diagnosed with diabetes was 0.75 (0.47-1.04), with a slight but steady trend toward improvement, excluding Daejeon, Sejong, and Jeonbuk, which showed significant improvement. The national AAPCs for annual screening rates for diabetic eye disease and kidney disease complications were 1.82 (0.99-2.66) and 1.95 (0.60-3. 41), respectively, and the area with the largest change was Sejong. Conclusions: In Korea, the diabetes management indices tended to increase and improve, but the trends among provinces varied. Therefore, efforts are needed to address regional disparities in diabetes management.

• Perspectives in Nursing Science
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• v.7 no.1
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• pp.1-9
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• 2010

Purpose: The purpose of this study was to review behavior change theories in terms of important variables, concept definitions, and applicability to diabetes self-management behavior. Methods: Six behavior change theories (the Transtheoretical Model, the Health Belief Model, the Theory of Reasoned Action, the Theory of Planned Behavior, Social cognitive theory, and Information-Motivation-Behavioral skills Model) were reviewed which were applied in diabetes self-management interventions. Results: The five key concepts from the five non-stage behavior change theories were delineated. Based on the key concepts, a theoretical framework was formulated as the explanatory model of diabetes self-management behaviors. The four major concepts in Information-Motivation- Behavioral skills Model were included. The cognitive arm of the proposed theoretical framework included constructs related to diabetes knowledge, motivation (beliefs, attitude, social norm), self-efficacy, and intention. Conclusion: The theoretical framework described here includes the key factors of successful diabetes self- management intervention. However, the concept of motivation needs further exploration and clarification for operationalization.

• Journal of Microbiology and Biotechnology
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• v.19 no.10
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• pp.1109-1121
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• 2009

In an attempt to discover novel biomarker proteins in type 2 diabetes prognosis, we investigated the influence of hypoglycemic extracellular polysaccharides (EPS) obtained from the macrofungus Tremella fuciformis on the differential levels of plasma proteins in ob/ob mice using two-dimensional gel electrophoresis (2-DE). The 2-DE analysis demonstrated that 92 spots from about 900 visualized spots were differentially regulated, of which 40 spots were identified as principal diabetes-associated proteins. By comparing control with EPS-fed mice, we found that at least six proteins were significantly altered in ob/ob mice, including Apo A-I, IV, C-III, E, retinol-binding protein 4, and transferrin, and their levels were interestingly normalized after EPS treatment. Western blot analysis revealed that the altered levels of the two regulatory molecules highlighted in diabetes and obesity (e.g., resistin and adiponectin) were also normalized in response to EPS. The Mouse Diabetes PCR Array profiles showed that the expression of 84 genes related to the onset, development, and progression of diabetes were significantly downregulated in liver, adipocyte, and muscle of ob/ob mice. EPS might act as a potent regulator of gene expression for a wide variety of genes in ob/ob mice, particularly in obesity, insulin resistance, and complications from diabetes mellitus.

• Journal of Korean Academy of Fundamentals of Nursing
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• v.16 no.2
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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.

• Molecules and Cells
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• v.37 no.2
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• pp.188-188
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• 2014

• International journal of advanced smart convergence
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• v.9 no.1
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• pp.37-46
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• 2020

Cerebral vascular surgery can damage patients' motor and sensory nerves; therefore, neuromonitoring is performed intraoperatively. Patients with diabetes often have peripheral neuropathy and may be prone to nerve damage during surgery. This study aimed to identify factors that should be considered when diabetic patients undergo intraoperative neuromonitoring during brain vascular surgery and to present new criteria. Methods: In patients with and without diabetes who underwent cerebrovascular surgery (n = 30/group), we compared the intraoperative stimulation intensity, postoperative motor power and sensory, glycated hemoglobin (HbA1c) and glucose levels, and imaging findings. Results: Fasting glucose, blood glucose, and HbA1c levels were 10%, 12.1%, and 9.7%, respectively; they were higher in patients with than in patients without diabetes. Two patients with diabetes had weakness, and 10 required increased Somato sensory evoked potential (SSEP) stimulation, while in 16, motor power recovered over time rather than immediately. The non-diabetic group had no weakness after surgery, but 10 patients required more increased SSEP stimulation. The diabetic group showed significantly more abnormal test results than the non-diabetic group. Conclusion: For patients with diabetes undergoing surgery with intraoperative neuromonitoring, whether diabetic peripheral neuropathy is present, their blood glucose level and the anesthetic used should be considered.