• 대한영양사협회학술지
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• 제11권2호
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• pp.137-146
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• 2005

This study was carried out to investigate the relationship between diabetic control and related factors of the practice of diet therapy which affects mostly diabetic patients’ dietary compliance. A questionnaire survey was conducted on 128 diabetic patients who had visited Internal medicine endocrinology clinic at University Medical Center of Daegu area. The questionnaires including clinical characteristics, meal regularity and food intake which shows dietary compliance, intrinsic barriers to the practice of diet therapy and knowledge of diet therapy were asked and analyzed. The factor which affects HbA1c was intrinsic barriers and HbA1c became higher as the level of intrinsic barriers was increasing. The education on diet therapy had no influence on the intrinsic barriers, but the level of knowledge on diet therapy was shown higher in the educated patients. The above results suggest that the practice of diet therapy should be leaded to develop behavioral aspects through resonable motivation on dietary compliance along with removing intrinsic barriers rather than simply providing information.

• 대한지역사회영양학회지
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• 제20권5호
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• pp.351-361
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• 2015

Objectives: The purpose of this study was to investigate the relations between diabetic dietary compliance and dietary intake, physical activity and prevalence of metabolic syndrome (MS) in type 2 diabetic patients. Methods: Seventy five subjects diagnosed with type 2 diabetes visiting the D hospital in Dongducheon from May 2014 to Dec 2014 were included in this study. The subjects were divided into two groups according to their diabetic dietary compliance score (median 39); low diabetic dietary compliance (LDDC) group (n=44) and high diabetic dietary compliance (HDDC) group (n=31). Survey data collection was carried out by direct interview method. The nutrient intake, food intake and KDDS (Korean's dietary diversity score), DVS (dietary variety score) and GMVDF (grain, meat, vegetable, dairy and fruit) were analyzed using data from the 24-recall method. Metabolic parameters were obtained from the hospital records. Data was analyzed using Chi-square test and general linear model adjusted for sex. Results: The prevalence of MS was 59.7% in the participating diabetic patients. The prevalence of MS of the HDDC (39.3%) was significantly lower than that of the LDDC (72.7%). The distribution of physical activity showed a significant difference between the groups (p=0.006). The intakes of seeds and nuts of the HDDC were significantly lower than those of the LDDC. Fat and vegetable fat intakes and % fat of energy in the HDDC were significantly lower than those in the LDDC. But, carbohydrate (CHO) and potassium intake and %CHO of energy in the HDDC were significantly higher than those in the LDDC. KDDS and GMVDF showed significant differences between groups (p=0.033; p=0.012). Conclusions: Continuous intervention by specialized nutritionists for long-term self-regulation is needed for diabetic patients, and the high compliance to diabetic diet and increasing physical activity may be effective in the prevention of metabolic syndrome.

• 대한전기학회:학술대회논문집
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• 대한전기학회 2007년도 심포지엄 논문집 정보 및 제어부문
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• pp.67-69
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• 2007

Recently, the prevalence rate of diabetes in Korea has been increasing rapidly due to high growth of economy and changes in dietary lifestyle. Vascular complication is one of diabetic complications which have frequently occurred by obesity, hyperglycemia and impaired glucose metabolism. Photoplethysmogram(PPG) measured from finger and toe is very useful for evaluation of vascular aging and sclerosis level since the PPG signal represents characteristics of peripheral vascular. Several researchers have reported that second derivative of the finger PPG waveform was useful to evaluate vascular compliance and developed various analysis methods for vascular compliance. However, peripheral vascular compliance study for diabetic patient was never evaluated by using second derivative of PPG. Therefore, we aimed to objectively compare and to assess normal and diabetic group vascular compliance using the second derivative of PPG waveform in this study. The evaluated factors of second derivative of PPG are 'a', 'b', 'c', 'd', 'e' and b/a represents vascular compliance. Study found out that when vascular compliance is decreased, b/a is increased, the absolute value of b/a is decreased. The average vascular compliance of 50 diabetic patients with neuropathy is statistically lower than the normal group(p<0.05). We suggest an objective evaluation of peripheral vascular compliance for diabetic patients and prevention of vascular complication.

• 대한지역사회영양학회지
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• 제8권1호
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• pp.91-101
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• 2003

The purpose of this study was to investigate the compliance and need for diet therapy among diabetics and their caregivers. A total of 625 respondents participated in this survey. Appropriate management for long-term blood glucose control and difficult-to-manage cases appeared to be diet therapy, physical activity, medical treatment and folk remedies, in that order. The most important educational avenues for diet therapy were books, magazines and TV, Most respondents were educated in diet therapy within a year after diagnosis and had practiced diet therapy for over four years. The most common diet therapy Practices were food selection and Quantity control. Of the specific problems in practicing diet therapy, time and labor, taste, and meal planning appeared to be equally difficult factors. The prevailing diet therapy skills were controlling food amounts at breakfast and supper, and selecting food for lunch and refreshments. Respondents practicing both skills were about 20% of the participants; this shows the need to improve the current situation. The nutrients most frequently considered in diet therapy practice were simple sugars (sugar and sweet goods) , total fats and cholesterol. Since the perception of the role of dietary fiber among respondents was very low, nutrition education about the importance of dietary fiber and food sources of dietary fiber was needed. Diabetics seemed to be concerned about diabetic menus. Three difficult problems in planning diabetic menus were daily menu planning, patient's preferences, and the calculation of calories. As a means of nutrition counseling, they preferred interviews. The higher the educational status and the lower the age, the higher the preference was for internet or PC counseling. Therefore, it is necessary to develop nutrition educational programs so that diabetics can obtain practical knowledge of diet therapy. Furthermore, it is also necessary to develop additional means of informing diabetics about menu planning, while still considering Korean dietary behavior.

• 전자공학회논문지SC
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• 제44권4호통권316호
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• pp.15-20
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• 2007

현재, 우리나라 당뇨병의 유병률은 빠른 속도로 증가하고 있으며 당뇨병의 유병기간이 길수록 각종 합병증이 발생하여 더욱 심각한 증상을 나타내는데, 그 중 비만 및 고혈당, 당대사장애로 인한 당뇨병성 혈관합병증과 말초 혈관 경화증이 많이 발병하고 있는 실정이다. 따라서 본 연구에서는 광혈류량 측정법(Photoplethysmography)으로 손가락 및 발가락에서 얻어진 맥파의 2차 미분분석을 통해 연령이 비슷한 정상인 50명과 당뇨병으로 확진된 50명의 말초 혈관 탄성도를 객관적으로 비교하고자 하였다. PPG 파형의 2차 미분 분석에 사용되는 평가 인자는 a, b, c, d, e 이고, b/a는 혈관의 탄성도를 의미하며 탄성도가 떨어질수록 b/a의 절대 값은 감소하게 된다. 정상인 50명의 PPG 2차 미분 b/a값은 $-1.09{\pm}0.14$, 당뇨병 환자 50명의 PPG 2차 미분 b/a값은 $-0.81{\pm}0.09$로 정상인에 비해 당뇨병 환장의 말초혈관 탄성도가 감소하였으며, Independent t-test 검정 결과 통계적으로 유의한 차이를 보였다(p<0.05). 본 연구에서는 PPG 파형의 2차 미분 분석을 통하여 정상인과 혈관합병증 발병율이 높은 당뇨병 환자의 말초혈관 탄성도를 비교하였으며, 향후 비침습적이고 간단한 방법으로 당뇨병 환자의 말초혈관 탄성도와 혈관 경화정도를 객관적으로 평가하고 진단함으로써 당뇨병 환자들의 심혈관계질환 사전예방과 치료효과 판정에 도움을 줄 것으로 기대한다.

• Archives of Reconstructive Microsurgery
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• 제26권1호
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• pp.18-22
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• 2017

Inevitable immobilization after surgery on lower extremities can induce chronic constipation. Elderly diabetic women usually express ambiguous gastrointestinal symptoms and signs. We present here a case of panperitonitis developed from severe fecal impaction in an elderly diabetic woman after hand reconstruction using material harvested from the lower extremities. A 68-year-old diabetic female underwent anterolateral thigh free flap and wound revision twice on the left thumb. Three weeks after surgery, she complained about mild abdominal pain though she had daily defecation. Despite encouraging ambulation, her compliance was low. Resection of the sigmoid colon and colostomy were performed after diagnosis with bowel perforation. However, the patient went into septic shock and died with multiorgan failure after the guardians issued a DNR (do not resuscitate) order. For preventing bowel perforation, increased uptake of dietary fiber and early ambulation postoperatively should be encouraged, after even hand surgeries.

• 동아시아식생활학회지
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• 제5권1호
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• pp.7-19
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• 1995

This study was conducted to evaluate the nutritional status and diabetes management of diabetic patients in the Health Center. General characteristics, food habits, food intakes and the knowledge about diet therapy were investigated from ninety one diabetes subjects. Anthropometric assessment such as weight, hight, triceps skinfold thickness, and biochemical measurement of fasting blood glucose(FBG), post prandial 2 hours blood glucose(PP2), and hemoglobin A1c(HbA1c) were obtained form the subjects. The results were summarized as following : 1. The average of age was 60.9 years old and 83.5% of subjects was illiterate and primary school graduated. 2. Relative Body Weight(RBW) and % body muscle were 96.18${\pm}$13.6 and 33.56${\pm}$7.01%, respectively. Obese subjects whose body weight exceeded 120% of the ideal values were 3.3%. 3. The 86.8% of subjects were managed by oral hyperglycemic agents. 4. The mean of FBG, PP2, HbA1c were 140.75${\pm}$44.43mg/㎗, 7.60${\pm}$1.88%, respectively. 5. The mean daily intake of calorie was 1407㎉, and 73.6% of subjects lower caloric intake than prescribed calorie. when the degree of dietary compliance was expressed as Tunbridge score, 18.7% of total subjects was grouped as satisfactory, where as 20.9% and 60.4% could be considered as tolerable and hopeless, respectively. The nutrients intake were lower than RDA except for Vitamin A and Vitamin C and the ratio of carbohydrate : protein : fat was 72 : 14 : 14. 6. The mean score of knowledge test about diet therapy was 3.52${\pm}$2.19 out of possible 14.00 points. The above results suggested that the most of diabetic patient showed the poor nutritional status and they faced the lack of knowledge about diabetes management.

• 한국산학기술학회논문지
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• 제10권5호
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• pp.1141-1147
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• 2009

본 연구는 대전시 보건소에서 당뇨병치료를 받고 있는 환자 577명을 대상으로 치료순응도 및 혈당 조절 실태를 2007년 7월 30일부터 2008년 2월 24일까지 조사하였다. 조사결과 식후 혈당수준이 200mg/dl 미만인 경우가 58.5%, HbA1C가 7% 미만인 경우가 67.9%로 많은 당뇨병환자에게서 혈당조절이 제대로 되고 있지 않았다. 또한 식후 혈당수준과 HbA1C 조절정도는 보건소마다 차이가 있었다. 당뇨병 치료약을 규칙적으로 복용하는 경우는 88.0%로 높게 나타났고 당뇨병을 관리하기 위해 식이, 운동요법이 필요하다고 인지하는 환자가 많았다. 결론적으로 환자들은 약의 규칙적인 복용과 식이 및 운동요법이 당뇨병관리에 매우 도움이 된다는 사실을 잘 인지하고 있지만 실제로 HbA1C와 식후 혈당수준으로 평가한 혈당조절은 제대로 되고 있지 못했다. 이와 같은 결과는 보건소마다 차이가 크므로 이에 대한 대책이 시급하다고 본다.

• 대한지역사회영양학회지
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• 제25권3호
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• pp.214-225
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• 2020

Objectives: This study examined the effects of nutrition counseling by the nutrition care process (NCP) on diet therapy practice and glycemic control in patients with type 2 diabetes mellitus. Methods: The survey was conducted on 49 patients whose hemoglobin A1c (HbA1c) level ranged from 6.5% to below 10% among patients aged 30~60s with type 2 diabetes mellitus. Nutrition counseling by the NCP process was carried out twice: first nutrition counseling and follow up counseling. The questionnaires were composed of 54 questions in five fields (general characteristics, health-related behaviors, diet therapy-related items, dietary life, diet therapy-related knowledge, diet therapy-related barriers). Nutrition intervention in nutrition counseling was performed based on the individualized diagnosis of NCP. Results: All the subjects practiced self-monitoring of their blood glucose levels, regular exercise, and diet therapy after NCP-based nutrition counseling. Diet therapy-related knowledge and practice by the subjects were improved after nutrition counseling. While the intake of boiled white rice decreased, the intake of boiled brown rice and barley rice in the subjects increased significantly. After nutrition counseling, the weight and HbA1c of the subjects decreased. Conclusions: These results suggest that personalized nutrition counseling by NCP process is effective for diet therapy compliance and glycemic control of type 2 diabetic patients.

• Journal of Nutrition and Health
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• 제28권10호
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• pp.1015-1021
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• 1995

This study was conducted to evaluate changes in nutritional knowledge, attitudes, behavior intention and behavior in a sample of 27 insulin dependent diabetic students participating in diabetics' camp. Nutritional knowledge related to diabetes, attitudes toward diabetes treatment and behavior intention about dietary changes were tested before and after nutrition education. Six months after nutrition education, an open ended questionnaire about their actual behavior changes was mailed to all participants and 17 of them responded. Pre-and post-testing showed that nutrition education was effective in significant changes in knowledge and in promoting positive attitudes and behavior intention. Increases of knowledge were consistently the same regardless of sex, level of education, regularity of diet, and duration of disease. Compared to male students, female students showed more positive change in knowledge, attitudes and behavior intention. It also appeared that middle school students showed more positive improvement in knowledge, attitudes and behavior than elementary and high school students. A follow-up test showed that their actual behavior changes were not squared with their behavior intention. They pointed out difficulties in having proper amount of meals and snack and the conflict with school time schedule as the major reason for discordance. These findings suggest that nutrition education for diabetics can be effective to improve their knowledge, attitudes and behavior intention and understanding about barriers to behavior change is important for better compliance to the disease.