• Korean Journal of Community Nutrition
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• v.27 no.5
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• pp.406-421
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• 2022

Objectives: The purpose of this study was to investigate the blood biochemical characteristics, comorbidities, dietary intake, and other risk factors leading to poor glycated hemoglobin (HbA1c) control in elderly Korean diabetes patients over 65 years of age. Methods: Data from the 4^th (2007-2009) and the 7^th (2016-2018) Korea National Health and Nutrition Examination Surveys (KNHANES) were used. Socio-demographic characteristics (age, gender, region, household income, education level, marital status, nutrition education, diabetes duration and diabetes treatment), lifestyle characteristics (drinking, smoking, regular walking, and subjective health perception), anthropometric characteristics (height, weight, and waist circumference), blood biochemical characteristics (HbA1c, high- density lipoprotein cholesterol, triglycerides, total cholesterol, blood urea nitrogen, and blood creatinine), co-morbidities (obesity, hypertension, hypercholesterolemia, hypertriglyceridemia, and anemia), energy and nutrients intake, food group intake, and HbA1c control-related risk factors were compared. Results: Compared to the 4^th survey, the 7^th survey showed an increase in diabetes prevalence among men, an increase in the prevalence of diabetes in the older patients, and an increase in the duration of diabetes. The energy ratio from carbohydrate consumption in the 7^th survey was lower than in the 4^th. Compared to the 4^th survey, thiamine and riboflavin intake had improved, and the intakes of vitamin A, vitamin C, and niacin had worsened in the 7^th. A comparison of food group intakes showed that there was a decrease in the consumption of whole grains, potatoes, and milk and an increase in the intake of beverages and alcoholic beverages. The risk factors for poor control of HbA1c were the duration of diabetes and co-morbid hypertriglyceridemia in the 4^th survey, whereas subjective health perception, obesity, and hypercholesterolemia as co-morbidities were found to be risk factors in the 7^th in addition to the risk factors highlighted in the 4^th survey. Conclusions: For the future management of elderly Korean diabetes patients, greater care is indicated for men over 75 years, and those with low levels of education. It is necessary to increase the intake of milk and vegetables, and reduce the intake of beverages and alcoholic beverages. In addition, it is necessary to reduce the incidence of obesity, hypercholesterolemia, and hypertriglyceridemia for proper control of blood sugar.

• Journal of Korean Foot and Ankle Society
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• v.23 no.1
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• pp.18-23
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• 2019

Purpose: This study compared and analyzed the risk factors that affect a wound healing group and healing failure group. Materials and Methods: From 2010 to 2018, 39 patients who had suffered a single toe amputation were evaluated retrospectively. The patients were divided into two groups (wound healing group and healing failure group - within at least 3 months following the amputation). Regarding the possible risk factors, age, gender, Wagner and Brodsky classifications, duration of diabetes mellitus, whether the patient had peripheral arterial occlusive disease (PAOD) or cardiovascular disease, body mass index, HbA1c, total cholesterol, estimated glomerular filtration rate (eGFR), blood urea nitrogen (BUN), smoking, and alcohol were investigated. Results: The mean duration of diabetes mellitus was 140 months in the healing group and 227 months in the healing failure group, and the duration of diabetes was significantly longer in the failure group (p=0.009). A significant difference in eGFR was observed between the two groups ($59.17mL/min/1.73m^2$ in the healing group and $31.1mL/min/1.73m^2$ in the failure group) (p=0.022). Sixteen patients with PAOD were found, all 10 patients in the healing failure group were PAOD patients. Conclusion: To reduce the additional complications in single toe amputation patients, the underlying disease and appropriate treatment are the most important factors. In addition, a more proximal level of amputation also should be considered in cases of patients with PAOD, high BUN and low eGFR, and patients with long-term diabetes.

• Journal of Nutrition and Health
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• v.30 no.10
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• pp.1203-1210
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• 1997

This study was performed from March to June 1994 in ANsung Medical Center. We investigated serum components of 78 diabetics in the center, in addition to the nutrient intake status and anthrophometric status of 60 diabetics among them. We separated the latter into 2 groups(ⅰ) less tan 5 years of diabetic duration and ⅱ) more than 6 years of diabetic duration) and analyzed the clinical characteristics of each group. The results are as follows : \circled1 The average ages of male and female subjects were 57.1 and 58.9 years, respectively. The average diabetic duration of male subjects was 4.8 years and that of female subjects was 5.9 . The major occupational field of both male and female subjects was agriculture(33.3%, 36.1%). 50% of male and 75% of female subject's monthly incomes were less than 600, 000 won and 75% of male and 94.4% of female subjects had weekly food expense less than 40, 000 won. The nutrient intake status of the subjects was lower than RDA on the whole. There was no big differences between 2 the male groups of different diabetic duration , but calorie, protein , fat carbohydrate, phosphorus, iron and Vit B$_1$intakes of the above 6 year female group were appearently higher than those of the under 5 year female group (p<0.05). There were different intake tendencies between male and female subjects . For females. the longer the diabetic duration, the less intakes of calorie, protein , fat carbohydrate, phosphorus, iron Vit B$_1$, Vit B$_2$, and niacin were observed. Furthermore, the longer the diabetic duration in females , the more intakes of energy and nutrients, except Vit C were observed. Fasting blood glucose levels were 155mg/dl and 164mg/dl and Postprandial glucose levels were 242mg/dl and 247mg/dl for males and females respectively. Hb of both males and females , and Ht of males met the lower limit of normal status, The serum TG level was higher than normal , so that they seemed to suffer from hyperlipidemia ; their high HbAIC status indicated that the management of diabetes mellitus was poor. The total protein level of female subject was higher when compared with that of males(p<0.05). All subjects blood pressure were higher than normal , and the longer the diabetic duration, the higher was the blood pressure. The serum HDL-cholesterol levels of the above 6 year group male subjects were lower(p<0.05) than those of the under 5 year male group subjects, and the former group's systolic and diastolic blood pressures were higher than those of the latter(p<0.05). Levels of serum total protein, albumin and TG of the above 6 year female group were lower than those of the under 5 year female group(p<0.05). As the diabetic duration was extended, HDL-cholesterol and LDL-cholesterol levels showed a tendency to increase, while Hb, Ht, total protein, albumin, and A/G, which represent the nutrients state of iron and protein, were inclined to decrease. This result showed that serum lipid components went bad. To summarize the results, the longer the diabetic duration, the worse were the male subjects nutrient intake status, but those of the female subjects were good. With respect to serum components and serum lipid subjects Fe, protein, nutrition status and serum lipid component got worse as the diabetic duration was extended , implying the possibility of diabetes mellitus complication grows.

• Health Policy and Management
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• v.29 no.1
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• pp.68-76
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• 2019

Background: This study investigates the association between sleep duration and diabetes mellitus (DM) in a large representative population-based survey in South Korea. Methods: The fourth (2007-2009), fifth (2010-2012), and sixth (2013) Korea National Health and Nutrition Examination Survey data sets were used. A total of 37,989 individuals were selected for the study. Chi-square tests and multivariate logistic regression analyses were used to analyze whether general characteristics, health status, and health risk behaviors were associated with DM. Results: After adjusting for confounders, the odds of DM in short sleepers (${\leq}5hr/day$) and long sleepers (${\geq}9hr/day$) were 1.033-times higher (95% confidence interval [CI], 0.913-1.169) and 1.334-times higher (95% CI, 1.140-1.562), respectively, compared with individuals who slept 7 hr/day. Subgroup analysis according to gender showed a U-shaped association for both genders, although it appeared stronger in men. Conclusion: This study identified a U-shaped association between sleep duration and the risk for DM. Additional studies should help clarify the important information in this study.

• Journal of Korean Public Health Nursing
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• v.19 no.2
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• pp.261-273
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• 2005

Purpose: The purpose of this study was to explore the self management and related factors that affect the self management of diabetes between the middle aged and elderly groups. Method: This study was based by the conceptual framework of Cox's interaction model of client health behavior. The subjects were two groups; the middle aged group, 80 and the elderly group, 85 who were diabetes mellitus patients. Result: In the middle aged group, gender, education and social support were significantly correlated with self-management of diabetes mellitus. In the elderly group, gender, education, social support and the duration of diagnosis were significantly correlated with self-management of diabetes mellitus. In too middle aged group, the intrinsic motivation of diabetes mellitus patients and their understanding of diabetes were significantly correlated with self-management of diabetes mellitus. Understanding of diabetes and self perception were significantly correlated with self-management in middle aged group. In the elderly group, intrinsic motivation, understanding of diabetes and the attitude of the patients were significantly correlated with self-management Conclusion: In the middle aged group, maintaining a positive attitude of diabetes, reducing stress and continuous social support were important for improving self-management of diabetes mellitus. In the elderly group, enhancing their knowledge of diabetes, and maintaining continuous social support were important to improve self-management of diabetes mellitus.

• The Journal of the Korea Contents Association
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• v.18 no.12
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• pp.208-217
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• 2018

The purpose of this study was to provide information on the treatment and management of diabetic patients using all the available data of the Korea National Health and Nutrition Examination Survey (KNHANES, 2013-2015) on the serological and complication patterns of cardiovascular disease (CVD) according to the duration of diabetes mellitus (DM). KNHANES consists of health questionnaires, screenings, and nutrition surveys. The study subjects were 1,316 persons who were aged between 18 and 80 years and who answered the duration of DM. DM was classified as 0-5, 6-10, 11-15, 16-20, and over 20 years according to duration of DM. The longer the duration of DM, the older the BMI, the lower the smoker, the higher the HbA1c and the lower the glomerular filtration rate. Total cholesterol, LDL-C and triglyceride levels were low and HDL-C levels were similar. The proportion of patients receiving insulin and oral hypoglycemic agents increased. The longer the duration of DM, the worse blood glucose control and the increased risk of microvascular and macrovascular complications. To prevent these complications, intensive care and monitoring should be used to control the risk factors.

• Nutrition Research and Practice
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• v.12 no.1
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• pp.69-77
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• 2018

BACKGROUND/OBJECTIVES: Metabolic risk factors should be managed effectively in patients with type 2 diabetes mellitus (T2DM) to prevent or delay diabetic complications. This study aimed to compare the self-management levels of diet and metabolic risk factors in patients with T2DM, according to the duration of illness, and to examine the trends in self-management levels during the recent decades. SUBJECTS/METHODS: Data were collected from the Korea National Health and Nutrition Examination Surveys (KNHANES, 1998-2014). In our analysis, 4,148 patients with T2DM, aged ${\geq}30years$, were categorized according to the duration of their illness (< 5 years, 5-9 years, and ${\geq}10years$). Demographic and lifestyle information was assessed through self-administered questionnaires, and biomarker levels (e.g., fasting glucose level, blood pressure, or lipid level) were obtained from a health examination. Dietary intake was assessed by a 24-recall, and adherence level to dietary guidelines (meal patterns and intake levels of calories, carbohydrates, vegetable/seaweed, sodium, and alcohol) were assessed. Multivariable generalized linear regression and unconditional logistic regression models were used to compare the prevalence rates of hyperglycemia, dyslipidemia, and hypertension according to the duration of patients' illness, accounting for the complex survey design of the KNHANES. RESULTS: In the multivariable adjusted models, patients with a longer duration (${\geq}10years$) of T2DM had a higher prevalence of hyperglycemia than those with a shorter duration of T2DM (< 5 years) (odds ratio 2.20, 95% confidence interval 1.61-3.01, P for trend < 0.001). We did not observe any associations of disease duration with the prevalence of hypertension and dyslipidemia. In addition, the adherence levels to dietary recommendations did not significantly differ according to disease duration, except adherence to moderate alcohol consumption. There were significant decreasing trends in the prevalence of hyperglycemia in patients with a duration of illness ${\geq}10years$ (P for trend = 0.004). CONCLUSION: Although the proportion of patients with adequate control of glucose levels has improved in recent decades, poorer self-management has been found in those with a longer disease duration. These findings suggest the need for well-planned and individualized patient education programs to improve self-management levels and quality of life by preventing or delaying diabetic complications.

• Journal of Korean Academy of Rural Health Nursing
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• v.8 no.1
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• pp.13-24
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• 2013

Purpose: The purpose of this study was to examine the knowledge of diabetes and self-care behavior of patients with diabetes mellitus living in rural area. Methods: Participants in this study were 94 patients with type 2 diabetes mellitus. Data were collected from July 13 to September 14, 2012. The instruments were the knowledge of diabetes measurement developed by Park Oh Jang and the measurement of self-care behavior for patients with diabetes developed by Kim Young Ok. Data were analyzed using the SPSSWIN 18.0 program for t-test, one-way ANOVA and Scheffe test. Results: There were significant differences in knowledge of diabetes according to education level (p=.011), alcohol use (p=.010), regular exercise (p=.046), and duration of illness (p=.045). There were significant differences in self-care behavior of patients with diabetes according to satisfaction with income (p=.031), regular exercise (p<.001), experience with diabetes education (p=.001), number of diabetes education sessions (p<0.001), and complications (p=.001). Conclusion: Based on the result of this study, there is a need to develop and confirm the efficacy of education programs by examining their fit to characteristics of patients with diabetes mellitus living in rural areas.

• Health Policy and Management
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• v.20 no.1
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• pp.125-136
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• 2010

Objectives: The purpose of this study is to analyze the proportion of fundus examination of DM patients for preventing microvascular complication and to examine the factors related to fundus examination in DM patients. Methods: This study used 2005 Korean national health and nutrition survey data. We selected all 1,129 diabetes mellitus patients from the data. And we choose 8 factors related to diabetes mellitus patients. These are sex, age group, type of residential area(rural or urban), education level, income level, comorbidity with hypertension, current insulin use, and duration of suffering from DM. We have analysed these factors by whether he had been examined fundus or no through Chi-square and logistic regression analysis. Results: Female DM patients have tendency to get more fundus examination than Male DM patients. And Young patients, patients who live in urban area, well educated patients, high income patients, comorbidity with hypertension, patients have got the insulin injection, patients have long duration of suffering from DM are to get more fundus examination. According to multivariate logistic regression analysis, sex and education level, income level, and duration of suffering from DM, comorbidity with hypertension, patients have got the insulin injection are significant factors on fundus examination for prevent microvascular diabetes mellitus complications. Conclusions and Discussion: We have concluded that physicians and policy makers should consider to fundus examination especially of man and DM patients who have more shorter disease period and low educated patients and low incomed patients and patients who have taken insulin therapy.

• Perspectives in Nursing Science
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• v.13 no.1
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• pp.17-28
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• 2016

Purpose: This study aimed to identify patterns of diagnosis and to explore risk factors for type 2 diabetes beyond the postpartum period in women with a previous history of gestational diabetes, and to identify differences in such risk factors between early and late-onset (aged <45 and ${\geq}45$). Methods: Using epidemiological data from the Korean Genome and Epidemiology Study, a retrospective analysis of 175 women with various timings of type 2 diabetes diagnosis was performed. Results: The average age ($42.6{\pm}10.6$) at type 2 diabetes diagnosis was earlier than the general population, and obesity was prevalent with marked weight gains around 35 years old. Longer duration of breastfeeding was observed in women with late-onset of type 2 diabetes. Conclusion: For prevention of type 2 diabetes, early intervention is required, and modifiable factors such as weight control and breastfeeding should be taken into consideration for intervention strategies.