• 제목/요약/키워드: diabetics

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Relationship of Glucose Control and Wound Infection in Diabetics after Lumbar Spine Surgery

  • Kim, Byung-Ook;Kim, Seok-Won;Lee, Seung-Myung;Shin, Ho
    • Journal of Korean Neurosurgical Society
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    • 제37권1호
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    • pp.44-47
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    • 2005
  • Objective: The purpose of this study is to investigate the elevated blood glucose levels in the postoperative period are associated with an increased risk of deep wound infection in diabetic individuals undergoing lumbar spine surgery. Methods: Of 2896 patients who underwent lumbar spine operations by one surgeon between 1993 and 2002, 329(11.4%) were diabetics. The rate of deep wound infections in diabetic patients was 6.4%, versus 3.2% for nondiabetics. 152 patients had their operation before implementation of the protocol and 177 after implementation. Charts of the diabetic patients were reviewed. Mean blood glucose levels were calculated from documented results of finger-stick glucometer testing. Results: Twenty-one diabetic patients suffered deep wound infection. Infected diabetic patients had a higher mean blood glucose level through the first 2 postoperative days than noninfected patients($230{\pm}6.9$ versus $175{\pm}3.8mg/dL$; p<0.003) and had a long operation time($216{\pm}57.9$ versus $167.5{\pm}42.2$ minute; p<0.05). Multivariable logistic regression showed that mean blood glucose level for the first 2 postoperative days, long operation time, and use of the instrumentation(p<0.02) were all related predictiors of deep wound infection. Institution of a protocol of postoperative continuous intravenous insulin to maintain blood glucose level less than 200mg/dL was began in september 1997. This protocol resulted in a decrease in blood glucose levels for the first 2 postoperative days and a concomitant decrease in the proportion of patients with deep wound infection, from 8.3%(11/132) to 5.1%(10/195) (p<0.02). Conclusion: The incidence of deep wound infection in diabetic patients is reduced after implementation of a protocol to maintain mean blood glucose level less than 200mg/dL in the immediate postoperative period.

우리나라 외래서비스 이용 당뇨환자의 특성에 따른 당화혈색소(HbA1c)검사 시행률 변이 분석 (The Variation of HbA1c Examination Performance Rates among Diabetic Patients Using Ambulatory Care in South Korea)

  • 홍재석;강희정;김재용
    • 보건행정학회지
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    • 제19권1호
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    • pp.49-61
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    • 2009
  • Background: The appropriate management of diabetes mellitus(DM) can help reduce its relapse and economic burden, but the level of management of DM in Korea is reported to be insufficient. This study aims to identify the management level of DM by figuring out the HbA1c examination performance rate of the diabetics and analyzing the variation according to the characteristic of a diabetic. Methods: This study used the Korean National Health Insurance Database which includes E10-14(ICD-10 code) as a primary or secondary disease as of 2006. Study population is 1,892,062 diabetics excluding 393,784 patients with the first attack of DM in 2006, 33,440 diabetics who died in 2006, and 21,299 patients with DM having no record of ambulatory care among the 2,340,585 DM patients in total. Results: The HbA1c examination performance rate of all DM patients in our country is estimated to be 41.5% as of 2006 and shows variation according to the characteristic of individual DM patients. The highest performance odds was shown by the patients who were below 19 of age, insured for health insurance, attended more than 3 ambulatory care providers, made ambulatory care visits more than 10 times annually, attended a specialized general hospital as their main attending medical institution, had a record of hospitalization or had co-morbidity. Conclusion: This study propose that is necessary to make politic preparations for the appropriate management of diabetes at a national level, and particularly, the patients with advanced age, the ones dependent on Medical Aid, and the ones using hospitals or clinics, whose appropriate management seems vulnerable, demand a careful management.

당뇨병 환자의 비타민 D 수준이 혈당조절에 미치는 영향: 2010-2012년 국민건강영양조사 결과를 바탕으로 (The Effect of Vitamin D on the Glycemic Control in Patients with Diabetes: From the Fifth (2010- 2012) Korea National Health and Nutrition Examination Survey)

  • 이아리;김혜진
    • Journal of Korean Biological Nursing Science
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    • 제22권1호
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    • pp.53-60
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    • 2020
  • Purpose: This study used raw data from the fifth (2010-2012) Korea National Health and Nutrition Examination Survey (KNHANES) to assess the relationship between vitamin D level and glycemic control of diabetes, and to provide basic data about the use of vitamin D for preparation of a treatment plan for diabetes in South Korea. Methods: For this study, data of 1,713 diabetes from KNHANES (2010-2012) were used. The collected data were analyzed using SPSS 18.0 program, and complex sample frequency analysis, descriptive statistics, complex sample cross analysis, complex sample general linear regression, and complex sample logistic regression analysis were performed. Results: It was found that the poor glycemic control group among the diabetes subjects had significantly lower level of blood vitamin D than the good glycemic control group. Factors affecting glycemic control included drinking, vitamin D levels, hypertriglyceridemia, duration of diabetes, and treatment of diabetes. Also, diabetics with vitamin D deficiency or shortage showed 3.55- and 2.61-times higher odds ratios, respectively, to be diagnosed as the poor glycemic control group than diabetics without vitamin D deficiency or shortage. Conclusion: This study is significant because it provides rationale and basic data about the use of vitamin D for preparation of a treatment plan for diabetes in South Korea by assessing the dependence of glycemic control on the vitamin D level of diabetics. Additionally, future studies are necessary to determine the appropriate concentration of vitamin D for diabetes prevention and treatment to prevent the side effects of excessive supplementation.

당뇨병 환자의 치주건강 상태에 대한 임상적 연구 (A CLINICAL STUDY ON THE PERIODONTAL STATUS OF THE PATIENT WITH DIABETES MELLITUS)

  • 김현섭;김병옥;한경윤
    • Journal of Periodontal and Implant Science
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    • 제23권1호
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    • pp.27-36
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    • 1993
  • The purpose of the this study was to research the interrelationship of periodontal status and patient's age between diabetic group and non-diabetic group and compare that of periodontal status according to the blood sugar level and duration of diabetics. The participants of this study were 52 diabetic patients and 51 non-diabetic patients. The diabetic group and non-diabetic group were further divided into four subgroups according to the age(under 35 years old, 36 - 45 years old, 46 - 55 years old, over 56 years old) and the diabetic group was further divided into three subgroups according to the duration of diabetics (under 5 years, 6 - 10 years, over 11 years) and blood sugar level(under 140mg/100ml, 140-200mg/100ml, over 200mg /100ml), respectively. Author evaluated such periodontal status as plaque index and calculus index, gingival lndex, loss of attachment, papillary bleeding index, tooth mobility and missing teeth, and then data was statistically analyzed by SPSS/PC+ using ANOVA, respectively. The results were as follows: 1. The mean value of plaque index, gingival index, loss of attachment, papillary bleeding index, tooth mobility and missing teeth of diabetic patients were significantly higher than that of non-diabetic patients, respectively(p <0.01, p<0.01, p<0.01, p<0.01, p<0.001, p<0.001), but there was no significant difference between diabetic group and non-diabetic group in calculus index(P>0.05). 2. According to the increase of age, loss of attachment and missing teeth were increased in both group, and correlation of each subgroup was statistically significant, respectively(p<0.05, p<0.001). 3. According to the elevation of blood sugar level of diabetics, plaque index, gingival index, loss of attachment, papillary bleeding index, tooth mobility and missing teeth were increased in diabetic group, and correlation of each subgroup was statistically significant, respectively (p<0.05, p<0.05, p<0.05, p<0.05, p<0.001, p<0.001). 4. According to the duration of diabetics, plaque index, gingival index, loss of attachment, papillary bleeding index, tooth mobility and missing teeth were increased in diabetic group, and correlation of each subgroup was statistically significant, respectively(p<0.05, p<0.05, p<0.05, p<0.05, p<0.001, p<0.001).

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Warfarin, Dansylsarcosine의 알부민결합에 미치는 유리지방산의 영향 (Influences of Free Fatty Acid on the Albumin Binding of Warfarin and Dansylsarcosine)

  • 배진우
    • 대한약리학회지
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    • 제30권2호
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    • pp.255-260
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    • 1994
  • There are some reports about the influences of free fatty acids on the albumin binding of drugs. But they were concerned to the limited free fatty acids, mostly of azapropazone-warfarin bidning site bound drugs and determination of dissociation and association constants by stopped flow technique. These data were not enough to make conculsions for the general tendency of free fatty acid to albumin binding. Therefore the influence of various saturated fatty acids of $C_{10{\sim}20}$, oleic acid and linoleic acid as unsaturated fatty acids to albumin binding of warfarin and dansylsarcosine were studied by equilibrium dialysis. The concentration of free drug was determined by spectrophotometer according to the molar ratios of 0, 0.5, 1, 2 and 4 between free fatty acid and albumin. There were significant increasing in the free durg concentration of warfarin and dansylsarcosine when the molar ratio for capric acid, lauric acid and palmitic acid was 4. The free warfarin concentration was increased significantly at a molar ratio of 4 between oleic acid and albumin. Therefore the albumin binding of durgs can be variated significantly by increased free fatty acid of diabetics and cause to the pharmacokinetic variation between healthy and diabetics.

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인슐린 의존성 당뇨병 학생을 대상으로 실시한 영양교육의 효과 (Evaluation of Nutrition Education for Insulin Dependent Diabetic Students)

  • 이정희;박동연;윤진숙
    • Journal of Nutrition and Health
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    • 제28권10호
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    • pp.1015-1021
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    • 1995
  • This study was conducted to evaluate changes in nutritional knowledge, attitudes, behavior intention and behavior in a sample of 27 insulin dependent diabetic students participating in diabetics' camp. Nutritional knowledge related to diabetes, attitudes toward diabetes treatment and behavior intention about dietary changes were tested before and after nutrition education. Six months after nutrition education, an open ended questionnaire about their actual behavior changes was mailed to all participants and 17 of them responded. Pre-and post-testing showed that nutrition education was effective in significant changes in knowledge and in promoting positive attitudes and behavior intention. Increases of knowledge were consistently the same regardless of sex, level of education, regularity of diet, and duration of disease. Compared to male students, female students showed more positive change in knowledge, attitudes and behavior intention. It also appeared that middle school students showed more positive improvement in knowledge, attitudes and behavior than elementary and high school students. A follow-up test showed that their actual behavior changes were not squared with their behavior intention. They pointed out difficulties in having proper amount of meals and snack and the conflict with school time schedule as the major reason for discordance. These findings suggest that nutrition education for diabetics can be effective to improve their knowledge, attitudes and behavior intention and understanding about barriers to behavior change is important for better compliance to the disease.

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50세 이상 당뇨병 환자의 스트레스인지, 우울, 자살생각이 건강관련 삶의 질에 미치는 영향 (The Influence on Health-related Quality of Life in Diabetes Mellitus Patients over 50 Years Old by Stress Recognition, Depression, and Suicidal Thinking)

  • 배상숙
    • 보건의료산업학회지
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    • 제9권2호
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    • pp.57-68
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    • 2015
  • This study investigated factors that affect stress recognition, depression, suicidal thoughts and health-related quality of life for diabetics over 50 years of age. Five hundred one diabetics were surveyed who participated in the 4th Korea National Health and Nutrition Examination Survey 2009. The data were analyzed with multiple regression analysis and Structural Equation Model to determine the factors. The results are as follows. Men, older and lower income groups, those not involved in economic activities, smokers, and drinkers showed a lower quality of life (p<0.001). There was no correlation with moderate-intensity exercise. Stress recognition (t=-4.229, p<0.001), depression (t=-2.156, p<0.05), and suicidal thoughts (t=-3.274, p<0.001) had significant effects on the quality of life (p <0.001, $R^2=0.25$). The most important of these factors is stress. Being diagnosed as a diabetic changes the lives of patients, who come under stress from controlling their blood sugar level. Societal support should be developed to help patients cope with the challenges of diabetes.

사회적지지가 당뇨환자의 식사요법 실천에 미치는 영향 (The Effect of Social Support on Compliance to Dietary Regimen in Noninsulin-Dependent Diabetes Mellitus)

  • 박동연
    • 한국가정과학회지
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    • 제4권1호
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    • pp.108-120
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    • 2001
  • The purpose of this study was to examine the effect of social support on compliance to dietary regimen in noninsulin-dependent diabetes mellitus. Two hundred eighty six adult non-insulin dependent diabetics from Seoul, Kyonggido, Kyongsangbukdo participated in the study. Researchers, dieticians, graduate students majoring in nutrition interviewed patients with a pre-structured questionnaire during June in 1998. The questionnaire included items about demographic factors, general characteristics about diabetes. social support, and compliance to dietary regimen. Descriptive statistics, t-test, ANOVA and Pearson's Correlation were used to analyze the data. The mean scores of support from family was 27.0(0∼44). support from relatives, friends, and colleagues was 14.7(0∼32). Mean score of intangible support from family was 19.9(0∼32) and 12.0(0∼24) from relatives, friends, and colleagues. Mean score of tangible support from family was 7.1 (0∼12) and 2.6(0∼8) from relatives, friends, and colleagues. The mean scores for compliance to dietary regimen was 31.6(0∼42). Regardless of type and source, there was significant(p<0.01) correlation between social support and dietary compliance. Therefore, inclusion of family members in nutrition education for diabetics is essential. It is necessary to find ways to increase social support from relatives, friends, and colleagues.

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