This study was designed to identify the relationship between perceived self-efficacy and self care behavioral compliance in type II diabetic patient. The subjects for this study were the 113 adults with type II diabetes that received hospital treatment or attended as outpatients in 2 general hospitals at Inchon City. The data were collected during the period from August 15 to semtember 15, 2000 by means of an interview. Collected data were analyzed by means of descriptive statistics, t-test, ANOVA, Pearson's correlation using the SPSS/PC+ program. The results of this study were as follows : 1. The mean score of self care behavioral compliance was 3.06. 2. There were statistically significant difference in self care behavioral compliance according to sex(p<0.05), age (p<0.001), BMI(p<0.05), education(p<0.001), occupation(p<0.001), experience of diabetic education(p<0.05) and complication(p<0.05). 3. The mean score of perceived self-efficacy was 3.45. Self care behavioral compliance and perceived self-efficacy had a positive correlation which was statistically significant (r=0.3879 p<0.001). 4. Stepwise multiple regression analysis was performed to identify the influencing factors for self care behavioral compliance. Education, experience of diabetic education and self-efficacy accounted for 41% of the variance in self care behavioral compliance. The results suggest that education, experience of diabetic education and self-efficacy are important variables in the compliance of self-care behavior with typeII diabetes.
This study evaluated the effect of diabetic group teaching programs in one university hospital in Seoul to predict when re-education would be needed. This study examined the patients’ knowledge at four points (before, directly after, three months and six months after the teaching program) and self-care performance related to diabetes twice (three months and six months after the teaching program). The subjects of the study were 24 admitted diabetic patients who participated in four-day teaching programs. Data were gathered from January to October, 1992 by means of an instrument developed from two diabetic knowledge tests which were equivalent in item differentiation and item discrimination coefficients. Collected data were analyzed by paired t-test, Pearson correlation, t and F tests. The results of study were as follows. 1. The analysis of the effect of the diabetic group teaching program and the duration of the effect of teaching. 1) The first hypothesis, that the diabetes knowledge score directly after the teaching program would be higher than before, was rejected (t=-1.40 ; p=.172). 2) The second hypothesis, that the diabetes knowledge score directly after teaching would be higher than three months later, was rejected(t= -4.27 ; p=.000). 3) The third hypothesis, that the diabetes knowledge score three months after teaching would be higher than six months later, was supported(t=2.43 : p=.020). 2. The relation of knowledge and self-care performance 1) The forth hypothesis, that the level of self-care performance related to diabetes three months later would be higher than six months later, was rejected( t=1.49 ; p=.146). 2) The fifth hypothesis, that the higher the diabetes knowledge, the higher the level of self-care performance, was rejected(r=.2086 ; p=.118). 3. The relation of diabetes knowledge and self-care performance according to demographic variables and structural variables of diabetes. 1) Diabetic knowledge scores varied according to the educational levels of the clients directly after the teaching. Three months after the teaching program higher educational levels and higher economic status were related to higher diabetic knowledge scores and men had higher knowledge scores than women. 2) Self-care performance scores of men were higher than those of women at three months and six months after the teaching program. 3) Before the diabetes teaching, the diabetic knowledge scores of subjects who had a diabetic patient in the family were higher than those who did not have patient in their family. Six months after the teaching, the diabetic knowledge scores of subjects who read the distributed books about diabetes were higher than those who did not read them. 4) No significance differences were found be-ween self-care performance and structural variables of dialetes. The results of this study indicated that the levels of diabetes knowledge and self-care performance incense of three months after the teaching program but decrease of six months. Reeducation would be needed between three and sir months. The investigator thinks that a study of the content and teaching methodology is needed to increase the education effect. The subjects want to hear patient histories of diabetic management. Group discussion would be helped after the teaching sessions.
Diabetes, a comprehensive genetic disease, is principally due to the deregulation of glucose levels in the blood. In addition to contemporary epidemiological studies, systematic substantiation suggests that long-term diabetes leads to cancers due to a variety of reasons. In this study, blood samples were collected with informed consent from confirmed type I diabetic (T1DM, n=25) and type II Diabetic patients (T2DM, n=25) with equal numbers of controls. Further depending on the lifestyle habits they were subdivided into smokers/non-smokers and alcoholics/non-alcoholics. Chromosomal assays were performed for these cases and it was found that there was a significant increase in chromosomal aberration frequency in diabetic patient groups who are exposed to smoking and alcohol than that of normal diabetic groups (T1DM and T2DM). On the other hand, patient groups who were non-smoking and non-alcoholics also showed higher chromosomal aberrations when compared to that of controls. While the mechanisms for these increased chromosomal aberrations in diabetic groups are not clear, they may be due to increased oxidative stress leading to oxidative damage and resulting in genomic instability, which in turn may contribute to an increased risk for cancer.
Objectives : This study it designed to evaluate the effects of an oriental medicine therapy, namely Binsosan-gamibang, on diabetic peripheral polyneuropathy. Methods : The clinical data was analyzed on a patient with diabetic peripheral polyneuropathy due to subyeolongsung(濕熱壅盛), gihyeoloeche(氣血瘀滯) whose main symptoms were pain and numbness in both legs. The patient was admitted at the internal medicine department of Dae-Gu Hanny University Dae-Gu Oriental Medicine Hospital on December 22, 2003, and was treated with herbal medicine(Binsosan-gamibang), acupuncture and physical therapy. Results : After treatment, improvement in pain and numbness in both legs was seen in the subsection of the pain rating score(PRS) and the visual analogue scale(VAS). Conclusions : This study suggests that Binsosan-gamibang is significantly effective in treatment of diabetic peripheral polyneuropathy.
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.
Ludwig's angina has been defined as a potentially lethal, rapidly spreading cellulitis, involving the sublingual and submandibular spaces, and is manifesed by a brawny, suprahyoid induration, tender swelling in the floor of mouth, elevation and posterior displacement of tongue. This paper is of interest not only because of severity of infection but also because of associated diabetic mellitus. Diabetes mellitus is a complex syndrome of disordered metabolism and elevated blood glucose, it results from deficiency of insulin secretion of combination of insulin resistance and inadequate insulin secretion. The effects of diabetic mellitus include neuropathy, vascular insufficiency, decreased leukocytic function, hematologic change etc. Clinically this may be refelected by the increased severity of infections seen in diabetics. The treatment of infections in diabetics are reduction of number of microbes through the use of appropriated antimicrobial agents and proper surgical drainage and improvement of the host factors by tight control of insulin replacement and immediate intervention to correct abnormalities of the local factors by drainage, debriment, and removal of avoidance of foreign bodies. The authors present the report of the Ludwig's angina in patient with diabetic mellitus, with literature review and good clinical result.
Diabetic neuropathy is one of the most common diabetic complications. In clinical practices, nerve conduction velocity (NCV) has been used as a standard method for diagnosing diabetic neuropathy. However, it applies maximum of 100mA electric stimulus to nerves causing stress and pain to patients. In this study. as a non-invasive method, $TcpO_2$ was utilized to investigate the difference and relationship between $TcpO_2$ and $SpO_2$ of normal and diabetic neuropathy subjects. In addition, a new method of diagnosing diabetic neuropathy using $TcpO_2$ is suggested. 50 normal subjects and 50 diabetic patients with neuropathy diagnosed by NCV participated in this study. Parameters used in this study were $TcpO_2,\;TcpCo_2$, and $SpO_2$. As a result of the $TcpO_2$ measurements, statistical significances were found from $TcpO_2$ of hands and feet from normal and patients group (p<0.01). $SpO_2$ measured from index finger of normal and patient groups showed no statistical significance (p>0.05). On the other hand, $SpO_2$ measured from great toes of normal and patient group showed statistical significance (p<0.01). Correlation coefficient between $SpO_2$ of finger and $TcpO_2$ of hand was 0.400 (p<0.01) and $SpO_2$ of toe and $TcpO_2$ of foot was 0.471 (p<0.01). Both correlation values were statistically significant. Sensitivities and specificities of the $TcpO_2$ method were found to be 66 % and 92 %, respectively. If suggested $TcpO_2$ method is used periodically. prevention and early diagnosis of diabetic neuropathy is possible.
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.
Purpose: $^{18}F$-FDG PET is to evaluate the tumor using glucose metabolism. Blood Glucose Level (BGL) is important factor that affects on a result of examination. But it often appears the distort result on diabetic patient due to a failure of BGL control. The aim of this study is to make a effective guideline for diabetic patient prescribed $^{18}F$-FDG PET and improve accuracy and reliability of examination. Materials and methods: A subject of study is 69 diabetic patients and divided them into 3 groups; 1) BGL is less than 120 mg/dl & performed PET, 2) BGL is over than 120 mg/dl & performed PET, 3) BGL is over than 120 mg/dl & not performed PET. And we investigated the type of diabetic medications and the time of dosage, whether they have meal or not. And we analyzed SUV of liver and mediastinum to recognize the effect of BGL on PET images. Results: As a methods to diabetic control, Amalyl showed high percentage of 27.5% in oral medication and Humulin R showed 14.5% in insulin. Their peak time was 2-3 hrs, 2-4 hrs and duration time was 24 hrs, 5-7 hrs. The number of that had a breakfast was 16, 7 mens (43.8%) couldn't perform PET as over 120 mg/dl and 5 mens (31.3%) performed PET as less than 120 mg/dl after they took a medication. When we set the SUV of normal for 1.5-2.0, 1.0-1.5 on liver and mediastinum, the percentage out of the range was 31.8%, 52.9%, 62.5% in 120-139 mg/dl, 140-159 mg/dl, 160-200 mg/dl respectively. Conclusions: We completed standardized guideline for diabetic patients. As a result of this study, improved customer satisfaction and increased economic benefits. It is expect to be a effective model in other PET centers.
■ Objectives This case is to report the effect of Oryeong-san and acupuncture therapy on serum creatinine level of a cerebral infarction patient with diabetic nephropathy. ■ Methods A female Korean patient was treated with Oryeong-san, acupuncture for total 32 days. We observed renal function test, input/output balance, body weight, hand and foot circumferences, and other symptoms like edema, urination, and any adverse event. ■ Results After treatment, serum creatinine level was improved to 2.48mg/dL from 3.45mg/dL at admission, and foot circumference was decreased to 18.5~18.9cm from 22.0~22.5cm without any adverse event. However, we couldn't find any significant differences on input/output balance, body weight, or symptoms of urination. ■ Conclusion This case suggests that Oryeong-san and acupuncture therapy could be effective in improving serum creatinine clearance of cerebral infarction patient with diabetic nephropathy.
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