• 보건교육건강증진학회지
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• 제24권4호
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• pp.149-159
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• 2007

This study was intended to provide basic data for developing an oral health management program for diabetic patients by understanding their oral health condition and defining the influence of diabetes on oral health. The following results were obtained through intraoral examination and questionnaire surveys done on one hundred and twenty two diabetic outpatients who visited endocrine department at Yeungnam University in Daegu and internal medicine department at Chungmu hospital in Cheonahn for 4 months from November, 2005 to February, 2006. DMF index according to the gender was significantly higher in females only in Filling index (p <0.05). Missing index increased as the age increased (p <0.001). Papillary bleeding index was significantly higher in females (p <0.05). Several indices which show oral status significantly higher as the duration of diabetes increased and as the blood sugar level before meal was higher (p <0.01, p <0.05). In a group that received oral hygiene education, several indices which show periodontal status were significantly lower than those in a group that didn't have it (p <0.001). According to the results, not only diabetic control but also general oral care should be included in self-management education for diabetic patients and this should be accomplished by appropriate oral health education program and staffs.

• Journal of Korean Biological Nursing Science
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• 제18권2호
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• pp.78-86
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• 2016

Purpose: Diabetic foot ulcers are significant problems in diabetes mellitus and often result in lower extremity amputation. This study was conducted to evaluate the effects of a self-care management program on Korean patient's self-efficacy, self-care behavior, size of the wound, and wound related pain. Methods: This study was a quasi-experimental study of pre-test and post-test design in a non-equivalent control group. The intervention strategies of the self-care management program consisted of individual intervention (education, practice and demonstration), computer animation, and face-to-face counseling. There were thirty seven patients, and 20 were assigned to the experimental group while the other 17 were assigned to the control group. The experimental group was given a self-care management program. The control group received information on diabetic mellitus care by means of a leaflet. The data was analyzed using descriptive statistics, a chi-square test, an independent t-test, and a Mann-Whitney test. Results: There were significant differences in self-care behavior and wound related pain. Conclusion: A Self-care program is an effective way to increase patient's self-care ability. This program is highly applicable to diabetic foot ulcer patients in various settings.

• 대한족부족관절학회지
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• 제18권1호
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• pp.1-7
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• 2014

In patients with diabetic foot, ulceration and amputation are the most serious consequences and can lead to morbidity and disability. Peripheral arterial sclerosis, peripheral neuropathy, and foot deformities are major causes of foot problems. Foot deformities, following autonomic and motor neuropathy, lead to development of over-pressured focal lesions causing the diabetic foot to be easily injured within the shoe while walking. Wound healing in these patients can be difficult due to impaired phagocytic activity, malnutrition, and ischemia. Correction of deformity or shoe modification to relieve the pressure of over-pressured points is necessary for ulcer management. Application of selective dressings that allow a moist environment following complete debridement of the necrotic tissue is mandatory. In the case of a large soft tissue defect, performance of a wound coverage procedure by either a distant flap operation or a skin graft is necessary. Patients with a Charcot joint should be stabilized and consolidated into a plantigrade foot. The bony prominence of a Charcot foot can be corrected by a bumpectomy in order to prevent ulceration. The most effective management of the diabetic foot is ulcer prevention: controlling blood sugar levels and neuropathic pain, smoking cessation, stretching exercises, frequent examination of the foot, and appropriate education regarding footwear.

• Archives of Plastic Surgery
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• 제36권6호
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• pp.679-684
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• 2009

Purpose: Human lipoaspirate cells are relatively easy to obtain in large quantities without cell culture. The aim of this in vitro pilot study was to determine the effect of cell therapy using uncultured lipoaspirate cells on cell proliferation and collagen synthesis of diabetic fibroblasts, which are the major contributing factors in wound healing. Methods: In order to get diabetic fibroblasts, dermis tissues were obtained from foot skin of diabetic patients who underwent debridements or toe amputations(n = 4). In order to isolate lipoaspirate cells, the same diabetic patients' abdominal adipose tissues were obtained by liposuction. The diabetic fibroblasts were co - cultured with or without autogenous lipoaspirate cells using porous culture plate insert. Initial numbers of the lipoaspirate cells and diabetic fibroblasts seeded were 15,000 cells/well, respectively. For cell proliferation assay, two treatment groups were included. In group I, diabetic fibroblasts were cultured with the insert having no cells, which serves as a control. In group II, the lipoaspirate cells were added in the culture plate insert. For collagen synthesis assay, one additional group(group III), in which diabetic fibroblasts were not seeded in the well and only lipoaspirate cells inside the insert were incubated without diabetic fibroblasts, was included for a reference. Results: One hundred to one hundred sixty thousand lipoaspirate cells were isolated per ml of aspirated adipose tissue. After 3 - day incubation, the mean cell numbers in group I and II were 17,294/well and 22,163/well. The mean collagen level in group I, II, and III were 29, 41, and 2 ng/ml, respectively. These results imply that both cell proliferation and collagen synthesis in the lipoaspirate cell treatment group were 28 and 44 percents higher than in the control group, respectively(p < 0.05). Conclusion: Uncultured lipoaspirate cell autografts may stimulate the wound healing activity of diabetic fibroblasts.

• 월간당뇨
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• 통권288호
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• pp.12-20
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• 2013

• Journal of Acupuncture Research
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• 제25권3호
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• pp.115-125
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• 2008

Diabetes mellitus is a worldwide epidemic. Global projections suggest that most nations will have a doubling of the incidence of Diabetes mellitus(DM) within 20years. The Herb-Combined Remedy(HCR) of DM was known as one of anti-hyperglycaemic agents. But it is unclear whether HCR can be used to treat patients with Diabetic nephropathy or not. The present study was designed to investigate the anti-hyperglycaemic and preventive effects from diabetic nephropathy of HCR in STZ-induced diabetic rats. Treatment with HCR regulated blood glucose levels, but did not affect body weights. In addition, HCR was able to decrease blood glucose levels after 120min. Serum BUN levels were not effective but, serum Creatinine levels were lowered by treatment with HCR or MF. In histopathological observation of renal tissue, both HCR and MF groups showed decreased tendency of inflammation and renal injury. In conclusion, these results demonstrate that HCR is effective to treat patients with DM and also has preventive activity on diabetic nephropathy.

• 가정∙방문간호학회지
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• 제15권2호
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• pp.106-114
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• 2008

Purpose: We analyzed the self-care behavior and metabolic control rates in diabetic patients based on the National Health and Nutrition Examination Survey in Korea (2005). Methods: The study group included 311 patients who were over 126 mg/dL on the FBS test. Data were analyzed using SPSS PC WIN 12.0. Results: The average score of self-care behavior was $12.08{\pm}1.05$ points, and significantly different according to DM treatment status, disease duration (years), admission experiences (within 1 year) and education about DM. Glucose, total cholesterol, triglycerides were decreased in self care subjects, but not significantly. Conclusion: An educational program for diabetic patients would help maintain metabolic control rates to improve self-care behavior.

• 대한한의진단학회지
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• 제22권1호
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• pp.57-67
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• 2018

Objectives The objective of this study is to examine the interpretability of the questionnaire-based pattern identification in terms of biosignals. For this purpose, we investigate the relationship between electrochemical skin conductance (ESC) and Qi-Blood-Yin-Yang Deficiency Questionnaire (QBYY-Q) in diabetic patients. Methods A total of 40 patients with diabetes mellitus answered the QBYY-Q and their ESC were measured by SUDOSCAN device (a diabetes screening device, France). To analyze the relationship between QBYY-Q and ESC, ANOVA analysis and Scheffe test were performed and Pearson correlation coefficients were obtained. Results Of the 40 diabetic patients, 23 (57.5%) were males and 17 (42.5%) were females. According to the QBYY-Q, 9 patients were classified into Qi deficiency pattern (QD), 9 patients were Blood deficiency pattern (BD), 10 patients were Yin deficiency pattern (YiD) and 12 patients were Yang deficiency pattern (YaD). Demographic information (age, body mass index, duration of illness, etc.), signs of vitality (blood pressure, body temperature, etc.), fasting plasma glucose and glycated hemoglobin were not significantly different in each deficiency pattern. The ESC of the right leg was significantly lower in the BD group compared to the YiD group (p<0.022). Pearson's correlation coefficient was negatively correlated with the BD questionnaire score (r=-0.343, p <0.05). Finally, ESC showed a positive correlation with hemoglobin and erythrocyte levels in all limbs (r=0.483, p<0.01). Conclusions We showed that ESC could be used to classify the Deficiency pattern identifications in diabetic patients. Especially, the ESC was significantly lower in the BD group and was negatively correlated with the BD scores. It implies the potential utility of the ESC to understand the BD in terms of modern biosignals.

• Vascular Specialist International
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• 제34권4호
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• pp.109-116
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• 2018

Purpose: Diabetic foot wound (DFW) is known as a major contributor of nontraumatic lower extremity amputation. We aimed to evaluate overall amputation rates and risk factors for amputation in patients with DFW. Materials and Methods: From January 2014 to December 2017, 141 patients with DFW were enrolled. We determined rates and risk factors of major amputation in DFW and in DFW with peripheral arterial occlusive disease (PAOD). In addition, we investigated rates and predictors for amputation in diabetic foot ulcer (DFU). Results: The overall rate of major amputation was 26.2% in patients with DFW. Among 141 DFWs, 76 patients (53.9%) had PAOD and 29 patients (38.2%) of 76 DFWs with PAOD underwent major amputation. Wound state according to Wagner classification, congestive heart failure, leukocytosis, dementia, and PAOD were the significant risk factors for major amputation. In DFW with PAOD, Wagner classification grades and leukocytosis were the predictors for major amputation. In addition, amputation was performed for 28 patients (38.4%) while major amputation was performed for 5 patients (6.8%) of 73 DFUs. Only the presence of osteomyelitis (OM) showed significant difference for amputation in DFU. Conclusion: This study represented that approximately a quarter of DFWs underwent major amputation. Moreover, over half of DFW patients had PAOD and about 38.2% of them underwent major amputation. Wound state and PAOD was major predictors for major amputation in DFW. Systemic factors, such as CHF, leukocytosis, and dementia were identified as risk factors for major amputation. In terms of DFU, 38.4% underwent amputation and the presence of OM was a determinant for amputation.

• Annals of Clinical Neurophysiology
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• 제12권1호
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• pp.21-26
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• 2010

Background: Although quantitative sensory test (QST) is being used with increasing frequency for measuring sensory thresholds in clinical practice and epidemiologic studies, there has been no age-matched normative data in Korean adults. The objective of this study is to evaluate the value of QST in diabetic polyneuropathy with normal range in Korean adults. Methods: The Computer Aided Sensory Examination IV 4,2 (WR Medical Electronics Co., Stillwater, Minnesota, U.S.A.), with 4,2,1 stepping algorithm was used to determine vibration and cold perception threshold in 70 normal controls and 19 patients with diabetic polyneuropathy aged from 21 to 79 years. The data were used to define age-matched upper and lower normal limits and normal range of side to side difference. We also evaluated the duration of diabetes, serum HbA1C level, and findings of nerve conduction study (NCS) and QST in patients with diabetic polyneuropathy. Results: In normal adults, sensory thresholds slightly increased with age, and a slight side-to-side difference was observed. The diagnostic sensitivity of QST was not higher than NCS in patients with diabetic polyneuropathy (36.8% vs. 42.1%, p=0.716), especially among elderly patients. Conclusions: QST might be used as a complementary test for NCS in the diagnosis of diabetic polyneuropathy. Although the QST is a simple method for the evaluation of peripheral nerve function, there are some limitations. Most of all, because the QST measuring is dependent on the subjective response of patients, the degree of concentration and cooperation of the patients can significantly affect the result. And thus, attention should be paid during the interpretation of QST results in patients with peripheral neuropathy.