• Nutrition Research and Practice
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• v.2 no.4
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• pp.283-288
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• 2008

This study was carried out to determine whether a short-tenn zinc supplementation contributes to beneficial changes in glycemic control among type 2 diabetic patients. Seventy-six diabetic subjects and 72 normal adults participated in this study. Subjects were divided into supplemented and control groups. Forty-four diabetic patients and 34 normal subjects were supplemented with 50 mg zinc daily as zinc gluconate for 4 weeks. Zinc status was assessed from fasting plasma levels and urinary excretion. The effects of zinc supplementation on fasting blood glucose, $HbA_{1c}$, insulin, and C-peptide were measured at the beginning of the study and after 4 weeks of supplementation. The changes in glycemic control indicators were compared between diabetic groups, classified by baseline $HbA_{1c}$ levels, and by diabetic duration. At baseline, the incidence of marginal zinc deficiency in the diabetic group, as determined by plasma zinc level, was approximately twice as high as in the normal adult group. The changes of $HbA_{1c}$ concentration, and fasting blood glucose following supplementation were not statistically significant in diabetic subjects. In normal subjects, a significant decrease of $HbA_{1c}$ occurred only in the zinc supplemented group. No significant changes were observed for serum insulin and C-peptide in diabetic as well as normal subjects. However, when the changes were compared by baseline $HbA_{1c}$ level, we found that diabetic subjects with $HbA_{1c}\;{\geq}\;7.5%$ showed significantly improved levels of $HbA_{1c}$ and fasting glucose after Zn supplementation. While such improvement in fasting blood glucose was significant among diabetics with shorter diabetic duration, significant levels of increase in serum insulin and C-peptide were observed in zinc supplemented subjects with longer diabetic duration. Fasting blood glucose was significantly decreased, whereas serum insulin and C-peptide were increased in diabetics with marginal zinc status. Therefore, we suggest that Zn supplementation for a short-term period may improve glycemic control in diabetic patients with higher $HbA_{1c}$ levels and marginal zinc status.

• Journal of the Korean Society for Precision Engineering
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• v.24 no.1 s.190
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• pp.118-125
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• 2007

In this study, we analyzed the plantar shear stress and normal pressure in lateral heel diabetic foot patients during walking by using in-shoe local shear stress and plantar pressure measurement systems. The shear force transducer based on the magnetic-resistive principle, was a rigid 3-layer circular disc. Shear transducers were mounted on the locations of four metatarsal heads and heel in the insole. Twelve normal subjects and three diabetic foot patients with diabetic neuropathy in the lateral heel participated in this study. The center of pressure in lateral heel diabetic foot patients moved more medially and directed toward the first, medial to the second metatarsal heads, and the hallux during late stance, making pressure at the medial heel and the second metatarsal head significantly larger than in the normal. Shear stress at the heel changed significantly in early stance and the magnitude of shear stresses in each metatarsal head also changed. Further studies would be very helpful to design foot orthoses in patients with diabetic neuropathy or other diseases.

• Journal of Korean Foot and Ankle Society
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• v.9 no.1
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• pp.26-30
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• 2005

Purpose: To evaluate the precipitating factors of amputation as initial treatment in diabetic foot patients. Materials and Methods: Between March, 1994 and February 2003, 41 cases (37 patients) diabetic foot patients who had diabetic ulcer, pyogenic inflammation and gangrene and followed up over 1 year were collected. Among them, We evaluate the precipitating factors of amputation for average 39.6months (12-118months). Results: Among many factors, Wagner classification, pulse volume recording of toes, Ankle-Brachial Index and Albumin level are statistically significant in amputation patients. Conclusion: In determining the amputation of diabetic foot as initial treatment, the trauma history, circulation of foot and serum albumin level are important precipitating factors. So the education about preventing even minor trauma and maintaining good nutrition state decrease the amputation rate in diabetic foot patients.

• Korean Journal of Health Education and Promotion
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• v.17 no.1
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• pp.81-93
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• 2000

This study is intended to investigate medication compliance and polypharmacy of the diabetic patients by age group in order to determine the major factors that influence their compliance. 198 ambulatory diabetic patients were interviewed, and the sample was divided into three groups based on the age: Young age group under 55, Borderline age group between 55 - 65, Old age group over 65. According to the study results, medication compliance for the old age group was 72.6% whereas 85.1% for the young age group. Medication compliance significantly decreased as the age of the patients increased. Also the degree of polypharmacy, the rate which patients take more than 6 prescription drugs, was 45.9% for the old group, whereas 31.2% for the young group. As the most important factor of polypharmacy, the number of doctors was statistically significant. With regard to prescription factors related to medication compliance, the amount of prescribed medication is statistically significant between the compliance group and non-compliance group. In addition, the amount of information provided to patients by pharmacists was determined to be a very significant factor. Also the level of ease in understanding the medication instructions varied significantly between the compliance group and the non-compliance group. In light of the empirical data and results for the diabetic patients, it is necessary to develop and implement various programs to improve medication compliance and to decrease the level of polypharmacy among the elderly, or "old", diabetic patients. patients.

• Journal of Korean Foot and Ankle Society
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• v.11 no.2
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• pp.149-153
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• 2007

Purpose: To evaluate the possible risk factors of lower extremity amputations in diabetic foot patients. Materials and Methods: The study is based on 37 patients who received lower extremity amputations from April, 1997 to February 2005 due to diabetic foot complications with at least 1 year follow up. As for the control group, 49 diabetes patients who had been treated at the endocrinology department for at least 1 year without any diabetic foot complication were evaluated. As for the possible risk factors, age, gender, duration of diabetes mellitus, body mass index, Hb A1c, blood glucose level, total cholesterol, s-creatinine, C-peptide, smoking, alcohol, hypertension, cardiovascular disease, CVA, retinopathy and neuropathy were investigated. Results: Among the possible risk factors evaluated, age, Hb A1c, smoking, neuropathy and blood glucose level factors showed statistically significant difference between the diabetic amputation and the control group. Conclusion: In reducing the risk of the lower extremity amputations in the diabetic patients due to diabetic foot complications, strict control of blood glucose level and cessation of smoking were found to be utmost important.

• Journal of Korean Foot and Ankle Society
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• v.18 no.4
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• pp.159-164
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• 2014

Purpose: The purpose of this study is to confirm the effect of antiplatelet drugs in diabetic peripheral vasculopathy in diabetic foot patients. Materials and Methods: We designed a retrospective study in diabetic foot patients with diabetic peripheral vasculopathy. From October 2007 to December 2013, 278 cases in 139 patients who took antiplatelet drugs over at least a six-month period were included in this study. We categorized these patients according to the type of drug used. The efficacy of antiplatelet drugs was evaluated using anklebrachial index (ABI) and pulse wave velocity (PWV). Results: Only the aspirin group showed a statistically significant increase of ABI after antiplatelet therapy ($1.10{\pm}0.12$ to $1.12{\pm}0.11$). In addition, only the cilostazol group showed a statistically significant decrease of PWV after antiplatelet therapy ($1,701.20{\pm}396.56$ to $1,627.42{\pm}324.98$). Conclusion: Aspirin and cilostazol may be used in treatment of diabetic peripheral vasculopathy, whereas dual antiplatelet therapy with aspirin and clopidogrel has no specific benefits in diabetic peripheral vasculopathy.

• Archives of Plastic Surgery
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• v.35 no.5
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• pp.491-494
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• 2008

Purpose: When deciding a treatment plan in diabetic foot ulcer patients, predicting a possibility of healing wounds is important since not a few patients have poor general condition to get successful wound healing. This study was planned to find out if a serum collagen level can be used as a predictor for healing wounds in diabetic foot patients. Methods: Fifty-seven patients, who visited our clinic from January to June, 2007 for treatment of diabetic foot ulcers, were included in this study. Serum levels of type I collagen were checked using carboxy terminal type I propeptide kits. Simultaneously serum levels of vitamin C and iron, cofactors of collagen synthesis, were checked. The patients were divided into two groups; a group of successfully healed wounds and the other of unhealed wounds. Serum levels of the parameters were compared between the 2 groups. Results: The serum level of collagen was $197.65{\pm}86.26ng/ml$ in a healed group and $87.91{\pm}28.76ng/ml$ in the unhealed group(p<0.05). The serum iron and vitamin C levels were did not show significant differences. Conclusion: The serum collagen level may predict healing or nonhealing wounds in diabetic foot ulcers.

• Advances in Traditional Medicine
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• v.9 no.1
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• pp.39-48
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• 2009

We have evaluated the effect of long term treatment of Enicostemma littorale (E. littorale) in type 2 diabetic patients taking pills of aqueous extract of E. littorale regularly as a complimentary medicine for at least 9 months. The effects of E. littorale on glycemic control, lipid profile, cardiac function and DNA damage in these patients were compared with those who had not been regular in taking E. littorale but regular in taking other conventional anti-diabetics. Our data suggest that, E. littorale can maintain normal blood glucose, serum insulin, serum triglycerides levels of type 2 diabetic patients if taken regularly. E. littorale also improves insulin sensitivity, and normalize disturbed lipogram and elevated creatinine levels, thereby produces beneficial effect in preventing cardiovascular complications and may preserve the kidney function. The finding that E. littorale also prevents DNA damage suggest a long term effect in diabetic patients. E. littorale thus can be considered as safe supplementary therapy for a long term and effective management of type 2 diabetic patients.

• Journal of Korean Foot and Ankle Society
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• v.19 no.3
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• pp.107-113
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• 2015

Purpose: The question of surgical versus non-surgical treatment for diabetic foot osteomyelitis remains subject to debate. The aims of this study were to analyse the outcome of conservative treatment (antibiotic treatment and conservative surgery) for diabetic foot osteomyelitis and identify the predictive factors of remission in conservative treatment of diabetic foot osteomyelitis. Materials and Methods: Seventy-seven patients with diabetic foot osteomyelitis who initially received conservative treatment from January 2004 to July 2013 were identified, and their medical records were reviewed. Diabetic foot osteomyelitis was defined by imaging studies or histological evidence. Remission was defined as the absence of any sign of infection at the initial or contiguous site assessed at least 12 months after the end of treatment. The demographic, clinical, and therapeutic factors were analysed. Results: The mean age of the patients was $62.7{\pm}12.2$ years, and 47 patients (61.0%) were male. The median diabetes duration was $15.7{\pm}11.2$ years and mean HbA1c was $8.7%{\pm}2.4%$. Forty-eight patients (62.3%) healed with conservative treatment (antibiotic treatment and conservative surgery). Twenty-five patients (32.5%) underwent amputation. In the multivariate analysis, concomitant peripheral artery disease and inadequate antibiotic therapy were associated with failure of conservative treatment. Conclusion: Antibiotics alone, or with conservative surgery, were successful in treatment of diabetic foot osteomyelitis in 62.3% of the patients. Concomitant peripheral artery disease and inadequate antimicrobial therapy were risk factors for remission in conservatively treated diabetic foot osteomyelitis.

• Korean Journal of Community Nutrition
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• v.14 no.2
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• pp.229-235
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• 2009

This study was carried out to determine whether a short-term zinc supplementation could improve the zinc status without adverse changes in copper status among type 2 diabetic patients. Seventy-six diabetic subjects and 72 normal adults participated in this study. Subjects were randomly divided into supplemented and control groups. Forty-four diabetic patients and 34 normal subjects were supplemented with 50 mg zinc gluconate daily for 4 weeks. Dietary intakes of participants were measured for two non-consecutive days by 24-hour recall method. Nutritional status of zinc and copper were also evaluated by biochemical measurement of fasting plasma samples and spot urinary collection. At baseline, diabetic patients showed significantly lower levels of dietary zinc intake and higher urinary zinc excretion than the normal adult group(p<0.05, p<0.0001). Plasma level of zinc was not significantly different between diabetic and normal adults at baseline. However, plasma zinc level increased significantly in both diabetic patients and normal adults after zinc supplementation. The changes in plasma copper levels following zinc supplementation were not statistically significant in diabetic subjects as well as in normal adults. These results indicated that four weeks of zinc supplementation did not influence Cu status and that it may contribute to improving the zinc status. Therefore, we suggest that Zn supplementation for a short-term period may improve marginal zinc status of diabetic patients without interfering with their copper status