• Journal of Nutrition and Health
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• 제26권7호
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• pp.851-857
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• 1993

Atherosclerotic vascular disease is a major cause of the increased morbidity and mortality assciated with diabetes mellitus. The prominent role of nutrition in hypercholesteolemia and atherosclerosis is generally accepted. Diet is a key element in the management of diabetes (type I-IDDM), yet the appropriate diet for patient with diabetes mellitus is not well known. Dietary protein has been shown to have a significant effect on plasma cholesterol levels in both experimental animals and humans. The present experiment was designed to determine the effect of the dietary protein level(20% vs 60%) on plasma glucose concentration, lipids profile, insulin and glucagon levels from non-diabetic and streptozotocin-induced diabetic rats. Results showed that a high protein diet decreased triglyceride concentration in diabetic rats. Also diabetic rats fed a high protein diet were hypocholesterolemic than rats fed a control diet. There were no effects by level of protein on fasting blood glucose concentration and insulin/glucagon ratio. Results from the present study suggest that a high protein diet may be beneficial to control pasma lipids in chemically-induced diabetic rats.

• The Korean Journal of Physiology and Pharmacology
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• 제27권3호
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• pp.221-230
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• 2023

Diabetic kidney disease is one of the most serious complications of diabetes. Although diabetic kidney disease can be effectively controlled through strict blood glucose management and corresponding symptomatic treatment, these therapies cannot reduce its incidence in diabetic patients. The sodium-glucose cotransporter 2 (SGLT2) inhibitors and the traditional Chinese herb "Gegen" have been widely used in diabetes-related therapy. However, it remains unclear whether the combined use of these two kinds of medicines contributes to an increased curative effect on diabetic kidney disease. In this study, we examined this issue by evaluating the efficacy of the combination of puerarin, an active ingredient of Gegen, and canagliflozin, an SGLT2 inhibitor for a 12-week intervention using a mouse model of diabetes. The results indicated that the combination of puerarin and canagliflozin was superior to canagliflozin alone in improving the metabolic and renal function parameters of diabetic mice. Our findings suggested that the renoprotective effect of combined puerarin and canagliflozin in diabetic mice was achieved by reducing renal lipid accumulation. This study provides a new strategy for the clinical prevention and treatment of diabetic kidney disease. The puerarin and SGLT2 inhibitor combination therapy at the initial stage of diabetes may effectively delay the occurrence of diabetic kidney injury, and significantly alleviate the burden of renal lipotoxicity.

• Research in Community and Public Health Nursing
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• 제14권4호
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• pp.559-567
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• 2003

Background: We first launched the case management program for diabetic patients who were registered in NHIC (National Health Insurance Corporation) in Korea and conducted this study to assess the effectiveness of the program. Methods: During the period from October in 2002 to March in 2003, 30 case managers performed the program for 71 diabetic patients. We evaluated the effectiveness of the program based on the results of fasting blood sugar level, two hour post-prandial blood sugar level, knowledge for diabetes, difficulty index in diabetes management, and the health risk factor changes of them. We analyzed results related to these factors through $x^2$ test and paired t-test. Results: The ave rage age of the subjects was 58.9. and the numbers of women and men were 43 and 28 respectively. The fasting blood sugar level and two hour post-prandial blood sugar level decreased from 164.3mg/dl to 146.5mg/dl and from 224.0mg/dl to 203.0mg/dl respectively. The knowledge for diabetes and difficulty index in diabetes management changed from 8.13 to 9.10 and from 3.52 to 2.91 respectively, and these changes were the positive. We observed improvement in self-test of sugar level, foot management, oral hygiene and proper medication but not in self-test of nutritional management. Conclusions: This study revealed that the case management program for diabetic patients who were registered in NHIC is significantly effective. However, the program need to study further to understand its long-term effects.

• Journal of Korean Academy of Fundamentals of Nursing
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• 제23권3호
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• pp.300-309
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• 2016

Purpose: This study was a descriptive survey research to identify whether characteristics of patients with type 2 diabetes mellitus, their knowledge about diabetes, and self-care behavior impacted on the level of diabetic retinopathy. Methods: Participants were 133 patients who had type 2 diabetes mellitus and were being seen at a hospital in Korea. The scale for knowledge about diabetes had 24 items, the scale for self-care behavior, 20 items, and the level of diabetic retinopathy was classified according to the international clinical diabetic retinopathy severity measurement standards. Results: The influence of the independent variables on the level of diabetic retinopathy showed that age, job, time since onset of Diabetes Mellitus, regular ophthalmologic examinations, and systolic blood pressure were identified as factors affecting the level of diabetic retinopathy. The explanation power of this regression model was 23.0% and it was statistically significant (F=5.42, p<.001). Conclusion: Early education about occurrence of diabetes related diseases, specifically diabetic retinopathy should be provided for patients from younger ages. Moreover, for disease management, social support is needed from co-workers and friends. Efforts to encouraged prevention and delay of diabetic retinopathy should include control of blood sugar and blood pressure.

• Journal of Yeungnam Medical Science
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• 제40권4호
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• pp.335-342
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• 2023

Diabetic foot ulcers (DFUs) are among the most serious complications of diabetes and are a source of reduced quality of life and financial burden for the people involved. For effective DFU management, an evidence-based treatment strategy that considers the patient's clinical context and wound condition is required. This treatment strategy should include conventional practices (surgical debridement, antibiotics, vascular assessment, offloading, and amputation) coordinated by interdisciplinary DFU experts. In addition, several adjuvant therapies can be considered for nonhealing wounds. In this narrative review, we aim to highlight the current trends in DFU management and review the up-to-date guidelines.

• Journal of the Korean Dietetic Association
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• 제5권1호
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• pp.64-73
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• 1999

Carbohydrate(CHO) counting is a meal planning approach used with diabetic patients that focuses on carbohydrate as the primary nutrient affecting post-prandial glycemic response. However, it has not been used in meal management of diabetic patients in Korea. CHO counting can be used by clients with type 1 and 2 diabetes. The purpose of the study was to determine the barriers to utilize the CHO counting when three levels of CHO counting were educated to type 2 diabetic patients who started continuous subcutaneous insulin infusion (CSⅡ) therapy by nutrition lectures and counseling. And the CHO-to-insulin ratios were determined for the individual patients who followed the carbohydrate counting as a meal management, and the factors to influence the CHO-to-insulin ratios were selected through the stepwise regression analysis. Twenty- four subjects were received three lectures, and one or two nutritional counseling for a month. The average age of the subjects was 50.7 years, and the duration of diabetes was 9.4 years. Their body mass index (BMI) was 21.5 kg/$m^2$. The difficulties of using CHO counting were 1) confusing the CHO exchange system to diabetic food exchange system, 2) lack of basic nutrition and not distinguishing nutrients such as CHO, fat and calorie, and 3) lack of motivation to make effort to count and record the amount of carbohydrates eaten. Nutritional counseling replenished the nutrition education and made patients practice CHO counting. Average CHO-to-insulin ratios at breakfast, lunch and dinner were 4.1$\pm$3.3, 2.9$\pm$2.6 and 2.9$\pm$3.0units/23g of CHO, respectively. CHO-to-insulin ratios were influenced by gender, age, BMI, post-prandial blood glucose levels and post-prandial c-peptide levels. The effective education and nutritional counseling of CHO counting can make CHO counting applicable to type 2 diabetic patients as meal management for improving glycemic control with less hypoglycemic episode.

• Korean Journal of Health Education and Promotion
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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.

• Archives of Plastic Surgery
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• 제49권6호
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• pp.782-784
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• 2022

Diabetic foot ulcers are a severe complication of diabetes, and their management requires a multidisciplinary approach for optimal management. When treating these ulcers, limb salvage remains the ultimate goal. In this article, we present the "hanging" free flap for the reconstruction of chronic lower extremity diabetic ulcers. This two-staged approach involves standard free flap harvest and inset; however, following inset the "hanging" pedicle is covered within a skin graft instead of making extraneous incisions within the undisturbed soft tissues or tunnels that can compress the vessels. After incorporation, a second-stage surgery is performed in 4 to 6 weeks which entails pedicle division, flap inset revision, and end-to-end reconstruction of the recipient vessel. Besides decreasing the number of incisions on diabetic patients, our novel technique utilizing the "hanging" pedicle simplifies flap monitoring and inset and allows reconstruction of recipient vessels to reestablish distal blood flow.

• Nutrition Research and Practice
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• 제10권1호
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• pp.11-18
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• 2016

BACKGROUND/OBJECTIVES: Type 2 diabetes (T2D) is more frequently diagnosed and is characterized by hyperglycemia and insulin resistance. $\small{D}$-xylose, a sucrase inhibitor, may be useful as a functional sugar complement to inhibit increases in blood glucose levels. The objective of this study was to investigate the anti-diabetic effects of $\small{D}$-xylose both in vitro and stretpozotocin (STZ)-nicotinamide (NA)-induced models in vivo. MATERIALS/METHODS: Wistar rats were divided into the following groups: (i) normal control; (ii) diabetic control; (iii) diabetic rats supplemented with a diet where 5% of the total sucrose content in the diet was replaced with $\small{D}$-xylose; and (iv) diabetic rats supplemented with a diet where 10% of the total sucrose content in the diet was replaced with $\small{D}$-xylose. These groups were maintained for two weeks. The effects of $\small{D}$-xylose on blood glucose levels were examined using oral glucose tolerance test, insulin secretion assays, histology of liver and pancreas tissues, and analysis of phosphoenolpyruvate carboxylase (PEPCK) expression in liver tissues of a STZ-NA-induced experimental rat model. Levels of glucose uptake and insulin secretion by differentiated C2C12 muscle cells and INS-1 pancreatic ${\beta}$-cells were analyzed. RESULTS: In vivo, $\small{D}$-xylose supplementation significantly reduced fasting serum glucose levels (P < 0.05), it slightly reduced the area under the glucose curve, and increased insulin levels compared to the diabetic controls. $\small{D}$-xylose supplementation enhanced the regeneration of pancreas tissue and improved the arrangement of hepatocytes compared to the diabetic controls. Lower levels of PEPCK were detected in the liver tissues of $\small{D}$-xylose-supplemented rats (P < 0.05). In vitro, both 2-NBDG uptake by C2C12 cells and insulin secretion by INS-1 cells were increased with $\small{D}$-xylose supplementation in a dose-dependent manner compared to treatment with glucose alone. CONCLUSIONS: In this study, $\small{D}$-xylose exerted anti-diabetic effects in vivo by regulating blood glucose levels via regeneration of damaged pancreas and liver tissues and regulation of PEPCK, a key rate-limiting enzyme in the process of gluconeogenesis. In vitro, $\small{D}$-xylose induced the uptake of glucose by muscle cells and the secretion of insulin cells by ${\beta}$-cells. These mechanistic insights will facilitate the development of highly effective strategy for T2D.

• Archives of Plastic Surgery
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• 제33권3호
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• pp.330-334
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• 2006

Polymicrobial nature of diabetic foot infection has been well documented in the literature. Initial antibiotic therapy of diabetic foot infection is usually empiric until reliable culture data is shown. This study was carried out to determine the common bacteriological flora of diabetic foot infection and antimicrobial sensitivity pattern in order to enhance possible empiric treatment. The specimens were obtained from wounds of 207 cases of diabetic foot ulcer, and the bacteriological isolation, and antimicrobial susceptibility tests of the isolates were carried out by standard microbiological methods. Staphylococcus aureus was the most common isolate, with 46.2% of recover rate among total bacterial isolated cases. Among gram-negative organisms, Pseudomonas aeruginosa was most common. Gram-positive organisms showed significant susceptibility to clindamycin, trimethoprim/sulfamethoxazole, and levofloxacin, besides vancomycin. Cefoperazone, piperacillin/tazobactam, and amikacin in addition to imipenem were most effective agents compared to gram-negative organisms. Diabetic foot infection requires use of combined antimicrobial therapy for initial management. Our results indicate that the most effective antibiotic combination for diabetic foot infection of Korean patients is clindamycin plus cefoperazone.