• 문화기술의 융합
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• 제10권1호
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• pp.105-110
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• 2024

국민건강영양조사 제8기 1차년도(2019)에 참여한 대상자 중 당뇨병 유병자를 4개의 유형별로 구분하여 당뇨병 유병률과 진단율을 연령대별로 조사하였다. 또한 이미 당뇨병 진단을 받은 환자들의 당화혈색소 수치와 체중, 허리둘레, 콜레스테롤, 중성지방 수치 및 체중보정 허리둘레, 체질량지수와의 상관관계를 분석하였다, 연구 결과 2019년도 당뇨병 유병률은 16.03 %이었으며, 남성의 유병률은 30대 이후 지속적으로 증가하였고, 여성의 유병률은 40대까지 남성보다 낮았으나 50대 이후 급격히 증가하여 70 대 이후에는 남성과 비슷해졌다. 당뇨병 진단그룹에서 당화혈색소 수치는 체중, 허리 둘레, BMI, WWI 수치와 상관계수도 낮고 상관관계도 유의하지 않았으나 중성지방 수치와는 0.178의 상관계수를 보이며 p value는 0.001 이하로 통계적으로 매우 유의하였다.

• Journal of Preventive Medicine and Public Health
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• 제49권2호
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• pp.108-117
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• 2016

Objectives: Smoking is known to be associated with nephropathy in patients with diabetes. The distinct effects of smoking before and after diabetes has been diagnosed, however, are not well characterized. We evaluated the association of cigarette smoking before and after a diagnosis of diabetes with the presence of diabetic nephropathy. Methods: We analyzed data from the 2011-2013 editions of the Korea National Health and Nutrition Examination Survey. A total of 629 male patients diagnosed with diabetes were classified as non-smokers (90 patients), former smokers (225 patients), or continuing smokers (314 patients). A "former smoker" was a patient who smoked only before receiving his diagnosis of diabetes. A "continuing smoker" was a patient who smoked at any time after his diabetes had been diagnosed. Diabetic nephropathy was defined as the presence of albuminuria (spot urine albumin/creatinine ratio ${\geq}30mg/g$) or low estimated glomerular filtration rate ($<60mL/min/1.73m^2$). Multiple logistic regression models were used to assess the independent association after adjusting for age, duration of diabetes, hemoglobin A1c, body mass index, systolic blood pressure, medication for hypertension, and medication for dyslipidemia. Female patients were excluded from the study due to the small proportion of females in the survey who smoked. Results: Compared to non-smokers, continuing smokers had significantly higher odds ratio ([OR], 2.17; 95% confidence interval [CI], 1.23 to 3.83) of suffering from diabetic nephropathy. The corresponding OR (95% CI) for former smokers was 1.26 (0.70 to 2.29). Conclusions: Smoking after diagnosis of diabetes is significantly associated with the presence of diabetic nephropathy in the Korean male population.

• 대한지역사회영양학회지
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• 제27권2호
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• pp.132-145
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• 2022

Objectives: This study examined trends in the health status and dietary behavior changes by region using the raw data from the 2008 ~ 2019 Community Health Survey. Methods: This study analyzed the data of 2,738,572 people among the raw data of the Community Health Survey from 2008 to 2019. The regional differences in health status and dietary behavior were examined by classifying the regions into capital and non-capital regions, and the non-capital regions were classified into metropolitan cities and provinces. A chi-square test was conducted on the body mass index (BMI), diagnosis of diabetes and hypertension, frequency of eating breakfast, salty taste in usual diet, recognition of nutrition labeling, reading of nutrition labeling, and utilization of nutrition labeling. Results: In determining obesity using the BMI, the normal weight by year decreased, and the obesity rate by year was 34.6% in 2019, which increased by 13% compared to 2008. In addition, the diabetes diagnosis rate and hypertension diagnosis rate continued to increase with the year. Both diabetes and hypertension diagnosis rates were higher in the non-capital regions than in the capital region. Eating breakfast five to seven times per week was most common and showed a significant decreasing trend by year (P < 0.001). The percentage of respondents who said they eat slightly bland foods increased from 19.5% in 2008 to 19.9% in 2010 and then to 22.1% in 2013. The percentage then decreased to 19.9% in 2019, but showed an overall increasing trend (P < 0.001). According to the region, the capital region had a higher percentage than the non-capital region. The nutrition labeling's recognition rate and utilization rate increased yearly, whereas the reading rate decreased. Conclusions: The study results presented the primary data necessary to develop nutrition education programs and establish strategies for local nutrition management projects to improve disease prevention and dietary problems.

• Nutrition Research and Practice
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• 제13권3호
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• pp.240-246
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• 2019

BACKGROUND/OBJECTIVES: Diabetes is diagnosed after an average of 10-12 years of diabetic development. Strict glycemic control in diabetic patients promotes the normalization of blood glucose and reduces cardiovascular diseases (CVDs) and diabetic complications. Therefore, early diagnosis in non-aware individuals is very important. SUBJECTS/METHODS: Clinical indices and nutrient intakes in Korean diabetic adults aged 19-64 years were examined according to the awareness of diabetes, using 2012 and 2013 Korea National Health and Nutrition Examination Survey (KNHANES) data. The aware group was defined as individuals who were aware of having diabetes from diagnosis by physician before the survey and the non-aware group as individuals who were not aware of having diabetes. RESULTS: The average age was higher in the aware group compared to the non-aware group in both men (P = 0.002) and women (P = 0.004). The prevalences of hypertension and dyslipidemia were not different between the two groups, but the diagnosis rate was significantly lower in the non-aware group. In the non-aware group, total and LDL-cholesterol were significantly higher (P < 0.001), the risk for total cholesterol over 240 mg/dL was 3.4 times (95% CI: 1.58-7.52) higher (P = 0.002) and the risk for LDL-cholesterol over 160 mg/dL was 4.59 times (95% CI: 2.07-10.17) higher (P < 0.001). The calorie intake of the female non-aware group was significantly higher compared to the female aware group (P = 0.033). CONCLUSION: The results suggested that the recommendation of screening test is necessary even for young adults. Studies on the methodology for early diagnosis of diabetes are also needed.

• Diabetes and Metabolism Journal
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• 제42권6호
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• pp.451-464
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• 2018

Latent autoimmune diabetes in adults (LADA) is a heterogeneous disease characterized by a less intensive autoimmune process and a broad clinical phenotype compared to classical type 1 diabetes mellitus (T1DM), sharing features with both type 2 diabetes mellitus (T2DM) and T1DM. Since patients affected by LADA are initially insulin independent and recognizable only by testing for islet-cell autoantibodies, it could be difficult to identify LADA in clinical setting and a high misdiagnosis rate still remains among patients with T2DM. Ideally, islet-cell autoantibodies screening should be performed in subjects with newly diagnosed T2DM, ensuring a closer monitoring of those resulted positive and avoiding treatment of hyperglycaemia which might increase the rate of ${\beta}-cells$ loss. Thus, since the autoimmune process in LADA seems to be slower than in classical T1DM, there is a wider window for new therapeutic interventions that may slow down ${\beta}-cell$ failure. This review summarizes the current understanding of LADA, by evaluating data from most recent studies, the actual gaps in diagnosis and management. Finally, we critically highlight and discuss novel findings and future perspectives on the therapeutic approach in LADA.

• 보건행정학회지
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• 제32권3호
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• pp.323-329
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• 2022

Background: This study aimed to identify the characteristics of the referral and return of patients to clinics in the endocrinology and cardiology departments at the National Health Insurance Service Ilsan Hospital to evaluate the "referral and return of patients to clinics" program and reduce the rate of returning patients. Methods: From May 2018 to December 2020, we identified the number of visits to referral hospitals and hospital usage status at Ilsan Hospital after returning to clinics. We also identified the patients who returned to Ilsan Hospital within 6 months, defined as "failure to transport," among those recommended to be transported to clinics of the Medical Cooperation Center. Additionally, we evaluated the characteristics of the "failure to transport" patients. Results: Among the returning patients, the rate of visiting Ilsan Hospital within 6 months was higher in cardiology than in endocrinology (25.1% vs. 16.7%). Older age, more severe disease, and more number of visits to the department were associated with a high rate of failure to transport. The rate of failure to return was low in cases diagnosed with hyperlipidemia/lipoprotein metabolism disorder. With respect to diabetes, the rate of failure to transport differed according to each type of diagnosis of diabetes. Conclusion: The success rate of the "referral and return of patient to clinics" program differed based on each patient's characteristics, department of visit, and diagnosis. Individualizing according to the visit department and diagnosis is required to ensure successful transfers, and infrastructure expansion and institutional arrangements must be facilitated.

• 보건행정학회지
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• 제29권3호
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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.

• 한국치위생학회지
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• 제15권5호
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• pp.925-932
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• 2015

Objectives: The aim of this study is to investigate the relationship between diabetes mellitus and oral disease in the Korea adults by using the representative data of Korea National Health and Nutrition Examination Survey (KNHANES) V. Methods: Using data from a cross-sectional survey of Korea National Health and Nutrition Examination Survey V. The subjects were 5,602 adults over 19 years old. The survey data and the examination data are used for the independent variables. KNHANES included health status, nutrition survey, and oral examination. The health status was obtained by a self-reported questionnaire of the study subjects and direct interview was carried out on economic status, prevalence rate, and use of medical services. Results: The regular dental checkup of diabetes patients was significantly lower than the general population. Regular dental visits allow adults to receive early diagnosis and obtain restorative care at the first visit. The regular annual oral examination is very important to prevent and manage the chronic diseases including diabetes mellitus. Conclusions: Diabetes mellitus can be fully prevented and managed by the regular annual dental checkup. The establishment of the regular dental checkup system can prevent and manage the complication due to diabetes mellitus and other chronic diseases.

• 한국치위생학회지
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• 제14권6호
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• pp.805-812
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• 2014

Objectives: The purpose of the study was to examine the association between diabetes mellitus and community periodontal index in Korean adults. Methods: The study populations were recruited by the Fifth Korea National Health and Nutrition Examination Survey. Study subjects were 10,411 who were examined oral examination, blood test, and aged over 19 years. Using multiple logistic regression analyses, the variables were adjusted for gender, age, household income, family history of diabetes, body mess index, smoking habit, and frequency of tooth brushing. Periodontal tissue examination of the subjects was performed and scored by Community periodontal index(CPI). Using probe, six teeth were examined for hemorrhage, plaque, and pocket depth and classified into $CPI_0$, $CPI_1$, $CPI_2$, $CPI_3$ and $CPI_4$. Healthy periodontal groups($CPI_{0-2}$) and periodontal disease groups($CPI_{3-4}$) were divided by the periodontal disease status. The definition of diabetes mellitus(DM) was decided by the diagnosis by the doctors and fasting blood sugar level. Those who were diagnosed as DM were included in DM group. The DM variables included normal blood sugar level, increased fasting blood sugar level, and DM blood sugar level. The DM variables were compared to periodontal disease blood sugar level and analyzed. Results: The periodontitis prevalence rate was 23.2%. Those who had diabetes mellitus accounted for 5.5% of the subjects. Those who had impaired fasting glucose accounted for 17.7% and 7.9% of subjects were diabetes mellitus by blood test. In the confirmed diabetes group by doctor, the periodontitis prevalence rate was significantly higher than the non-diabetic group. Diabetic group by blood test had the highest prevalence rate of periodontitis than those who had impaired fasting glucose group or normal group. After adjusting for gender, age, household income, family history of diabetes, body mass index, smoking habit, and frequency of tooth brushing, the risk of periodontitis in diagnosed diabetes mellitus was 1.57 times(95% CI; 1.27-1.94) higher than the normal group. In impaired fasting glucose group and diabetes mellitus group by blood test, the risk of periodontitis was 1.11 times(95% CI; 0.95-1.30) and 1.45 times(95% CI; 1.45-2.12) higher, respectively. Conclusions: There was a significant relationship between diabetes mellitus and periodontitis in Korean adults. These results suggest that diabetes mellitus is a risk factor for periodontitis.

• 대한예방한의학회지
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• 제27권3호
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• pp.47-67
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• 2023

Objectives : The objective of this study is to examine the findings of a survey assessing the treatment and management status of individuals with diabetes and pre-diabetes, along with their inclination to participate in the Korean Medicine Chronic Disease Management Program. Methods : The survey focused on individuals with diabetes and pre-diabetes, gathering information on respondents' demographic details, diabetes diagnosis, duration of diabetes, attitudes and experiences regarding Korean medicine diabetes treatment, and their willingness to participate in the 'Korean Medicine Chronic Disease Management Program'. Results : 33.1% of participants reported prior experience with Korean medicine treatment for diabetes. The intention to actively utilize Korean medicine treatment was positively observed, with a response rate of 61.1% expressing a favorable inclination and 8.9% indicating a negative stance. Furthermore, 75.3% of patients expressed their intention to participate in the 'Korean Medicine Chronic Disease Management Program' in the future. Among those expressing this intention, 81.4% stated a preference for the 'Korean-Western medicine combined management' in the chronic disease management Program. Conclusions : Patients' willingness to participate in 'Korean Medicine Diabetes Management Program' is high, but lack of information about Korean medicine is a factor that deprives people of the opportunity to experience Korean medicine treatment, and non-medical factors such as difficulty in visiting and administrative complexity are factors that impede participation in the 'Korean Medicine Chronic Disease Management Program'. It should be considered for improvement when formulating policies.