• Quality Improvement in Health Care
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• v.7 no.1
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• pp.60-70
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• 2000

Background : The aim of this study was to examine the effectiveness of the critical pathway to diabetic patients who were admitted in the hospital. Methods : For establishment of critical pathway for diabetic patients, we organized the multidisciplinary care team. During 5 months, 31 diabetic inpatients were applied the critical pathway and the results were compared with 11 diabetic inpatients who were treated with conventional way. We assessed the patients satisfaction, knowledge on the disease, compliance of medical regimen, length of stay(LOS) and hospital cost. We used the computer program SAS for statistical analysis. Data were summarized with mean, and analyzed using t-test repeated measures ANOVA and Wilcoxon rank sum test. Results : Length of stay(LOS) was remarkably shortened in critical pathway group compared with the conventional treatment group($7.6{\pm}1.23$ vs $12.0{\pm}4.73$, p<0.000). Although LOS was significantly shortened in critical pathway group, patients satisfaction was much higher than conventional treatment group. There were no significant difference of knowledge on the disease, compliance of medical regimen and blood glucose level between two groups at discharge. Hospital cost of each patients also significantly decreased in critical pathway group(890,000 won vs 1,280,000 won, p<0.05). Conclusion : These results showed that establishment of critical pathway for diabetic inpatients with team approach is the one of the way to improve the quality of diabetic patients management and to enhance the efficiency of hospital management.

• Biomolecules & Therapeutics
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• v.17 no.3
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• pp.256-262
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• 2009

Smallanthus sonchifolius (Yacon, Asteraceae) was originally cultivated in South America and used in food and traditional medicine by Andean inhabitants. Yacon is potentially beneficial for the management of diabetes and is composed of fructooligosaccharides, proteins, minerals and phenolic compounds. The aim of this study was to investigate the hypoglycemic effect of Yacon tuber extract (YTE) and its constituent, chlorogenic acid (CGA), in streptozotocin (STZ)-induced diabetic rats. In this study, a HPLC method was developed for simultaneous determination of major active phenolic components, CGA and caffeic acid in YTE. We investigated the hypoglycemic effect of YTE and CGA in STZ-induced diabetic rats and studied glucose tolerance test (GTT). The effect of orally administered multiple doses of YTE and CGA on plasma biochemical parameters was examined using diabetic rats. We also measured free radical scavenging activity by the 2,2-diphenyl-1-picrylhydrazyl (DPPH) assay. Oral administration of YTE (200 mg/kg) and CGA (10 mg/kg) for 6 weeks produced a significant hypoglycemic effect in STZ-induced diabetic rats. YTE and CGA-treated groups exhibited significantly decreased plasma glucose surge during the GTT. Total cholesterol (TC) and triglyceride (TG) concentrations were significantly decreased by 33% and 49%, respectively, in YTE-treated rats. TC and TG concentrations were also significantly decreased by 26 % and 41%, respectively, in CGA-treated rats. In the DPPH assay, free radical scavenging activity of CGA was similar to that of vitamin E, a positive control. This study suggests that YTE and its constituent, CGA, may be a useful option for management of hyperglycemia and diabetic nephropathy.

• Health Policy and Management
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• v.29 no.3
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• pp.262-276
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• 2019

Background: The most important thing to strengthen primary care is to prove that the continuity of primary care is an essential area for good health outcomes. The purpose of this study is to analyze the effect of outpatient continuity of primary care on the hospitalization experience of diabetes mellitus in new diabetic patients. Methods: Using the Korean National Health Insurance Service national sample cohort (NHIS-NSC 2011-2015) data, 3,391 new diabetic patients in 2012 were selected for the study. Multiple logistic regression was performed to investigate the effect of outpatient continuity of primary care on hospitalization in new diabetic patients. Results: The outpatient continuity of primary care in new diabetic patients was measured by the continuity of care index, which showed that 69.4% (n=2,352) were high level and 30.6% (n=1,039) were low level. Patients who had high continuity of primary care at the early stage of diabetes diagnosis showed 3.49 times more likely to maintain high continuity of primary care in the second year (95% confidence interval [CI], 2.72-4.49). Patients with low continuity of primary care for 2 years from the initial diagnosis of diabetes were 2.56 times more likely to be hospitalized due to diabetes than those who did not (95% CI, 1.55-4.25). Conclusion: This study identified the need for policies to increase the continuity of primary care for new diabetic patients and could contribute to lowering the admission rate of diabetic patients if the policy for this would work effectively.

• Korean Journal of Community Nutrition
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• v.19 no.4
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• pp.372-385
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• 2014

Objectives: The purpose of this study was to develop web-based self-nutrition management u-Health program for diabetic patients (DMDMG: Diabetes Mellitus Dietary Management Guide) for achieving systematic self-management of diet. Methods: The program consisted of five parts with different contents according to the results of needs assessment. Five major parts were 1) meal management part which contains calorie prescription, meals recording and dietary assessment, 2) prevention of disease part with information of diabetes and assessment of dietary behavior, 3) dietary behavior modification part with an education on dietary behavior modification plan and dietary behavior plan, 4) meal plan containing a training section for meal plan and self constructing part for meal planning by making tables, and 5) information about myself which composed with general and physical information. The system proposed in this study provides nutrients intake results right after input of diet intake, which is possible with simultaneous calculation of input data in the server with 3,495 food and 1,821 meal data base. The nutrients analysis program was evaluated with 26 diabetic patients with two-day 24 hr recall. Results: The differences of nutrients intakes between DMDMG and CANPRO 3.0 ranged from 13.5-16.5%, which was caused by the differences of databases of the two programs. The characteristics of DMDMG were; 1) it can provide an interactive tailored nutrition management, 2) it is a practical tool of diabetes nutritional management, 3) the program gives motivation for the dietary behavior modification. Conclusions: The effectiveness of whole program needs to be conducted, but the program was an innovative tool for self-management of nutrient intakes, diet behaviors, meal management and tailored nutrition education.

• The Korean Journal of Health Service Management
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• v.7 no.4
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• pp.221-232
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• 2013

This study aims to analyze the effect of hypertense, diabetic patients, managerial characteristics on their depression and suicidal thinking. Thus, this study selected 6,217 adults over the age of 19 from the 5th first-year data of Korean National Health and Nutrition Examination Survey conducted by KCDC(Korea Centers for Disease Control and Prevention) in 2010. As factors having effect on their suicidal thinking, unmarried patients(p=.000), middle school(p=.045), high school(p=.015), college and higher(p=.018), medicare(p=.045), hypertense(p=.042), exercise walking irregularly(p=.021), sense of depression(p=.035) showed a higher rate of suicidal thinking which were found to be statistically significant variables. Hypertense show a higher rate of suicidal thinking than normal people. Accordingly, it is necessary not only to pay attention to establishing plans to provide Hypertense and Diabetic patients with medical treatments, but to have more concern about their mental health so that they may be provided with a political support future.

• Korean Journal of Clinical Laboratory Science
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• v.42 no.3
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• pp.125-128
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• 2010

HbA1c test measures the amount of glycated hemoglobin in blood. HbA1c shows the average of blood glucose levels for the past three months, this is a better indicator of how overall diabetes is doing. HbA1c gives a much better idea of how the body is breaking down the glucose. Therefore, this HbA1c is very important tool for maintaining normal glucose levels for pre-and diabetic patients. Total 408 participants were tested HbA1c voluntarily from Chosunilbo Health Expo (8th~11th, July 2010). Through this small-scaled direct HbA1c, about 54.7% (207 out of 408) was shown glucose tolerance and diabetes. However, 61 from 157 participants who were shown under 6.9% HbA1c (normal and pre-diabetic stage) are taking only antidiabetic drugs to maintain a normal blood glucose. Regular HbA1c test can bring an important management and awareness about controlling blood sugar level and prevention of diabetic complications.

• Journal of agricultural medicine and community health
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• v.43 no.2
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• pp.85-96
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• 2018

Purpose: This study was to compare health behaviors, DM management and HRQoL among Diabetic patients according to education experience. Methods: Data were obtained from Community health Survey(CHS) of 2015. The participants were 22,937 diabetic patients who had education experience or not. Data were analyzed on complex sample anaysis using SPSS 24 program. Results: The education experience group showed higher percentages of health behaviors and DM Management and higher HRQoL. The significant negative factors influencing HRQoL were Bed ridden experience, higher subjective stress, depression expereince, age, low education and positive factors were good subjective health status, walking, mod-exercise, drinking, employment, spouse, good subjective happiness. Conclusion: These results show that education experience is a way to help diabetic patients' health behavior, DM management, HRQoL.

• Nutrition Research and Practice
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• v.2 no.4
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• pp.301-307
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• 2008

This study was aimed to investigate the nutritional status and the role of diabetes mellitus in hemodialysis (HD) patients. Anthropometric, biochemical, and dietary assessments for HD 110 patients (46 males and 64 females) were conducted. Mean body mass index (BMI) was $22.1\;kg/m^2$ and prevalence of underweight (BMI<$18.5\;kg/m^2$) was 12%. The hypoalbuminemia (<3.5 g/dl) was found in 15.5% of the subject, and hypocholesterolemia (<150 mg/dl) in 46.4%. About half (50.9%) patients had anemia (hemoglobin: <11.0 g/dL). High prevalence of hyperphosphatemia (66.4%) and hyperkalemia (43.5%) was also observed. More than 60 percent of subjects were below the recommended intake levels of energy (30-35 kcal/kg IBW) and protein (1.2 g/kg IBW). The proportions of subjects taking less than estimated average requirements for calcium, vitamin $B_1$, vitamin $B_2$, vitamin C, and folate were more than 50%, whereas, about 20% of the subjects were above the recommended intake of phosphorus and potassium. Diabetes mellitus was the main cause of ESRD (45.5%). The diabetic ESRD patients showed higher HMI and less HD adequacy than nondiabetic patients. Diabetic patients also showed lower HDL-cholesterol levels. Diabetic ESRD patients had less energy from fat and a greater percentage of calories from carbohydrates. In conclusion, active nutrition monitoring is needed to improve the nutritional status of HD patients. A follow-up study is needed to document a causal relation between diabetes and its impact on morbidity and mortality in ESRD patients.

• Journal of the Korea Society of Computer and Information
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• v.26 no.4
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• pp.169-179
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• 2021

The purpose of this study is to examine types and characteristics of self-regulation which explain how individual diabetic patients determine their behavior in terms of diabetes management. Based on the results, we proposed the management method of the diabetic patients. As a method of analyzing the subjectivity of each item, a Q method study was used. There were 38 subjects who were treated with oral drugs or insulin injections, but not currently hospitalized. And 40 statements in Q samples were classified in the form of a normal distribution using a 9-point scale. Research results regarding self-regulation in diabetic patients, type 1 is evidence-based compliance, type 2 is crisis responding denial reaction, type 3 is information-based orientation to relationship, type 4 is independent practice, and type 5 is willingness deficit impulse reaction. Therefore, for effective management of diabetic patients, it is necessary to understand the characteristics of each type of self-regulation and develop a program that reflects motivation for diabetes management, improvement of confidence, and countermeasures for negative emotions related to disease.

• Journal of Nutrition and Health
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• v.30 no.7
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• pp.743-750
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• 1997

The hypoglycemic effects of 2 mushrooms, Pleurotus ostreatus and Lentinus edodes, on streptozotocin(STZ) induced diabetic rats were investigated in this study . Diabets mellitus was induced in male Sprague-Dawley rats by the injection of STZinto the tail vein at a dose of 45mg/kg. Sprague-Dawley male rats(200-250g) were assigned to one control and three STZ-diabetic groups. Diabetic groups were assigned to STZ-control, pleurotus ostreatus and Lenitinus edodes groups. All groups were fed a AIN 76 diet. The two experimental groups were fed with each protein-bound polysaccharide(150mg/kg BW) for 14 days and with carboxymethyl cellulose for STZ-control group. The body weight gain was monitored and the blood levels of glucose and cholesterol were measured . Levels of protein triglyceride, and free fatty acid in plasma were analysed. Serum aminotransferase activity as also measured. The body weight gain was lower in the all diabetic groups than in the of normal group. The weight of spleen was reduced by adminstration of the Lentinus edodes protein-bound polysaccharides. The result suggest that orally administered Lentinus edodes protein-bound polysaccharides exhibited hypoglycemic effect in STZ -induced diabetic rats and that these protein-bound polysaccharides may be useful for the management of diabetes mellitus.