• Journal of Nutrition and Health
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• v.32 no.1
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• pp.17-23
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• 1999

The purpose of this study was to determine the extent of oxidative stress in NIDDM patients with diabetic complications and to determine the relationship between oxidative stress and diabetic complications. For this study, 139 NIDDM patients were recruited, 85 with diabetic complications and 54 without complications were recruited. The concentration of malondialdehyde(MDA) and the activities of antioxidant enzymes including catalase, superoxide dismutase(SOD), gluthatione peroxidase(GSH-Px)were determined. The daily intakes and plasma concentrations of beta-carotene, lycopene, lutein nd alpha-tocopherol were determined by food frequency questionnaire and by high performance liquid chromatography(HPLC), respectively. Among the antioxidant enzymes studied, only GSH-Px activity was lower in NIDDM patient, with diabetic complications than in those without complications(2.91$\pm$0.80 vs 3.54$\pm$0.44 U/mgHb, p<0.05). Those NIDDM patients with diabetic complications had higher MDA concentrations than those without diabetic complications(1.40$\pm$0.25 vs 1.25$\pm$0.11 nmol/ml, p<0.05). There were no significant differences in the dietary intakes of total carotenoids(2854 vs 2824ug/day)or vitamin E (9.5$\pm$3.2 vs 9.5$\pm$2.0mg/day)between NIDDA patients with and without complications. However, the plasma concentrations of beta-carotene and lycopene were significantly lower in NIDDM patients with complications than in NIDDM patients without complications (Beta-carotene : 24.2$\pm$12.5 vs 33.1$\pm$16.2(ug/dl), lycopene : 2.8$\pm$2.1 vs 4.3$\pm$2.8(ug/dl)). This study showed that in NIDDM patients with complications, the lipid peroxidation of erythrocytes was higher increased and the antioxidant reserves were significantly dipleted, compared with NIDDM patients without complications. The lower plasma concentrations of beta-carotene and lycopene in NIDDM patients may be due to the presence of diabetic complication, not due to the lower dietary intakes of antioxidant vitamins. To define the role of carotenoids in diabetes, more experimental and clinical studies are needed.

• Journal of Korean Foot and Ankle Society
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• v.26 no.1
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• pp.30-39
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• 2022

Purpose: This study aimed to report the current trends in the management of diabetic foot over the last few decades through a survey of the Korean Foot and Ankle Society (KFAS) members. Materials and Methods: A web-based questionnaire containing 40 questions was sent to all KFAS members in September 2021. The questions were mainly related to the demographics of patients with diabetic foot, diagnostic tools, and multidisciplinary treatment. Answers with a prevalence of ≥50% of respondents were considered a tendency. Results: Seventy-eight of the 550 members (14.2%) responded to the survey. The most common demographic factors of diabetic foot patients were male dominance with a high percentage in the 60- to 70-year-old. Although the need for multidisciplinary treatment is highly recognized in the treatment of diabetic foot patients, the actual implementation rate is about 39%. The contrast-enhanced magnetic resonance imaging (88.5%) was reported to be the most used tool for the diagnosis of osteomyelitis of the diabetic foot. It was reported that the use of antibiotics was started empirically and then changed based on bacterial culture tests in 82.1% of patients. Simple wound dressing and antibiotic treatment were most frequently reported for mild ulcers. Conclusion: This study provides updated information on the current trends in the management of a diabetic foot in Korea. Both consensus and variations in the approach to patients with diabetic foot were identified by this survey study. Further efforts are required for better access to a multidisciplinary approach, such as appropriate insurance payment policies and patient education.

• The Journal of the Korean life insurance medical association
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• v.30 no.2
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• pp.16-19
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• 2011

In patents with diabetes, the higher the serum glucose level was, the more cardiovascular events and death were observed. But with a certain kind of group, to control glucose level tightly does not decrease the incidence of these events. Several studies show that intensive glucose control does not gain benefit in patient with long standing, uncontrolled diabetes, especially having previous cardiovascular events, while definitely preventing progression of newly onset of diabetic nephropathy. Whether intensive glucose control increases mortality in high risk group is obscure and needs more studies with longer observation time.

• The Korean Journal of Pain
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• v.9 no.1
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• pp.275-278
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• 1996

The placement of epidural catheter may cause complications such as epidural hematoma, epidural abscess and neural damage. Among the above complications, epidural abscess is a rare but serious complication. This report pertains to a diabetic metlitus patient who developed spinal epidural and subdural abscess after continuous epidural catheterization for management of pain caused by reflex sympathetic dystrophy. The patient experienced urinary incontinence, as a neurologic sign, 8 days after epidural catherization. In was considered that the poor prognosis was due to a combination effects of a delayed visit to the hospital for treatment, rapid progression of abscess and uncontrolled blood sugar level. We therefore recommend aseptic technique and proper control of blood sugar level to prevent infection during and after epidural catheterization for diabetic patients. Early diagnosis of epidural abscess following surgical procedure must be required to avoid sequelae.

• Journal of Korean Academy of Nursing
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• v.33 no.5
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• pp.633-642
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• 2003

Purpose: This study was conducted to evaluate the effects of foot care education program using foot-reflexo-massage in diabetic patients. Method: A convenience sample of non-equivalent control group time series design was used. It provided foot care education to diabetic patients through small book for both group. For the experimental group, foot-reflexo-massage was taught by a researcher and research assistants. Analysis was done by Repeated Measured ANOVA. Result: There was significant increase in foot care knowledge, self care behavior, between the experimental group and the control group over three different times. There was significant in skin temperature and pulse of foot over three different times and interaction by groups or over time, but there was no significant difference between groups. There was no significant difference in blood flow volume and capillary filling time over three different times, between groups, but there was interaction by groups or over time. But there was significant difference in discrimination in change of dosalis pedis artery blood flow. Conclusion: Findings indicate that this study may contribute to develop nursing intervention for foot care of diabetic patients.

• Journal of Korea Association of Health Promotion
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• v.4 no.1
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• pp.39-48
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• 2006

Background : Diabetes mellitus is chronic condition which needs patients' understanding of disease status and effort for disease control. We investigated whether the patients' estimation for blood glucose control was reliable or not comparing with their HbA1C value, Method: Among people who visited one health promotion center in Seoul from 1995 to 2003,those who answered as having diabetes mellitus on self reported questionnaire were identified. Subsequent question was whether his or her diabetes was well controlled or not. We compared these replies with their HbA1C values. When their HbA1C values were below7% with answering not well controlled, we analyzed if there was any variable which can predict the discrepancy. And the same analyze we did for the opposite situation. Result: A total of 1193 patients were eligible. Those who answered as well controlled formed32.9% of the group with HbA1C values above 7%. In the cases with well controlled though significantly associated with this discrepancy, Conclusion: Considerable proportion of diabetic patients' estimation for diabetic control status was not matched with glycemic control guideline. For successful management of diabetes mellitus, more efforts for patient education and communication skills are essential.

• Journal of Korean Foot and Ankle Society
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• v.10 no.1
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• pp.1-6
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• 2006

Purpose: To evaluate the clinical manifestations, the patterns and the functional outcome of the amputations due to the diabetic foot complications. Materials and Methods: Fifty patients (50 feet) of diabetic foot amputations were followed for more than 1 year. The mean age was 62.5 years, and the mean follow-up period was 46 months. Retrospective analysis was performed using chart review and interview with the patients. The outcome was assessed with modified AOFAS scale. Results: The diabetic foot lesions were infection in 45 feet, gangrene in 35 feet and ulcer in 15 feet. Toe amputation was most commonly performed procedure (23 cases) followed by below knee and ray amputation. Postoperative modified AOFAS score was average 51.5 points, and 94% were satisfied with outcome. Minor amputations showed better outcome than the major amputations. Conclusion: Overall postoperative functional outcome was encouraging with high patient satisfaction rate (94%). Better outcome was obtained with the minor amputations.

• Child Health Nursing Research
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• v.3 no.1
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• pp.19-29
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• 1997

The purpose of this study was to explore the effect of diabetic camp program on depression, self-efficacy and self-esteem of the juvenile diabetic patient who had participated with diabetic camp program at Seoul and Kyung In area from August 5 to August 9, 1995. Nursing staffs explained them how to respond to the questionnaire of depression, self-efficacy and self-esteem prior to beginning the program and following the program. The questionnaire of depression, self-efficacy and self-esteem was developed by both diabetes mellitus nurse specialist and pediatric nursing professors in reference with the previous research. Response items of the questions were structured as yes or no for the elementary school students and that of the questions were structured as 5 likert scale for the both middle and high school students. Paired t-test was used for the significance of the difference between values before and after the dia betic camp program. Depression decreased following the program, while self-esteem increased significantly following the program in elementary school students. There was no change in self-esteem, while self-efficacy increased significantly following the program in noddle and high school students. Self-efficacy following the program was high as the frequency of exercise increased In the elementary school students. Self-efficacy prior to the program was high as the experience of diabetic education increased in the middle and high school students. Self-efficacy and self-esteem prior to the camp was highly correlated with that following the camp in middle and high school students. The result suggests that diabetic camp program could be one of ways to decrease depression and to increase self-efficacy of the diabetic children.

• The Journal of Korean Academic Society of Nursing Education
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• v.4 no.1
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• pp.53-65
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• 1998

This study was designed and undertaken to analyse the factors associated with sexual satisfaction in diabetic patients. The data were collected from September to November, 1997. The subjects in this study were 77 diabetic patients who visited to check their blood glucose level to the outpatient department of internal medicine in one of hospitals located in Taejon city, The questionnaires developed by Derogatis L. R. were used. Data were analysed using percentages, means, 1-test, ANOVA and Peason-correlation coefficients, done with the SAS program. The results of this study were as follows ; 1. The mean score of sexual satisfaction in diabetic patients was higher than the mid level as 3.14 points in the 5 points scale and male patients' score was a little higher than female's. 2. The mean score of factors associated with sexual life was 3.54 points in spouses' support, 3.44 points in sexual attitude and 2.60 points in body image in the 5 points scale, and 2.76 points in the sexual act in the 6 points scale. The score of above all factors were higher in male patients than female patients. 3. The significant factors associated with sexual satisfaction were spouses' support, body image and sexual act. That is, the higher spouses' support, the more positive body image and the more frequent sexual act, the higher patients' sexual satisfaction. 4. In the relationships between the sexual satisfaction and the general characteristics of the diabetic patients, only religion and the period of disease were statistically significant differents, but the relationships between the sexual satisfaction and the period of disease showed a significant inverse correlation. This results showed that the degree of sexual satisfaction in diabetic patients was relatively high. The major factors associated with sexual satisfaction were spouses' support, body image and sexual act, religion and the period of disease. So, the above factors have to be considered during the nursing intervention on diabetic patients' sexual life.

• Journal of Korean Foot and Ankle Society
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• v.26 no.2
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• pp.78-83
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• 2022

Purpose: The purpose of this study was to evaluate the surgical outcome of split-thickness skin graft (STSG) for chronic diabetic wounds of the foot and ankle. Materials and Methods: The medical records of 20 patients who underwent surgery for chronic diabetic wounds of the foot and ankle between October 2013 and May 2018 were reviewed. Surgical management consisted of consecutive debridement, followed by negative-pressure wound therapy and STSG. We used an acellular dermal matrix between the wound and the overlying STSG in some patients with wide or uneven wounds. Patient satisfaction, comorbidities, wound size and location, length of hospital stay, wound healing time, and complications were investigated. Results: Of 20 patients, 17 (85.0%) were satisfied with the surgical outcome. Eight patients had diabetic wounds associated with peripheral vascular disease (PVD), 7 patients had diabetic wounds without PVD, and 5 patients had acute infection superimposed with necrotizing abscesses. The mean size of the wound was 49.6 cm². The mean length of hospital stay was 33.3 days. The mean time to wound healing was 7.9 weeks. The mean follow-up period was 25.9 months. Complications included delayed wound healing (4 cases) and recurrence of the diabetic wounds (2 cases), which were resolved by meticulous wound dressing. Conclusion: STSG remains a good treatment strategy for chronic diabetic wounds of the foot and ankle.