• Journal of the Korea Convergence Society
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• v.10 no.11
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• pp.501-510
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• 2019

This study aimed to find health related lifestyle factors that influence glycemic control for diabetes mellitus (DM) management strategies. This study used nested case-control design with matching variables that were not controlled by individuals such as age, sex, insulin or oral hypoglycemic agent (OHA) use, disease duration, education level and household income. This study analyzed 983 subjects with type 2 DM who enrolled in the $7^{th}$ (2016-2017) Korean National Health and Nutrition Examination Survey (KNHANES). The target HbA1c level of controlled glucose was defined as less than 6.5%, and 289 (30%) were achieved. Conditional multivariable logistic regression analysis was performed to find self-control factors associated with HbA1c levels. The results statistically significant for variables such as duration of diabetes, insulin or OHA use in overall cohort and body mass index (BMI), smoking and fundus Examination in matched cohort. These results are expected to provide as evidence for the intensive care criteria(disease duration, drug use) and lifestyle management strategy(BMI, smoking, fundus examination).

• Health Policy and Management
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• v.26 no.2
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• pp.125-134
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• 2016

Background: Glycemic control is an effective way to reduce the cardiovascular complications of diabetes, but more than half of the adults with diabetes in Korea are improperly controlling their glycemic levels. The purpose of this study is to identify the factors associated with poor glycemic control in type 2 diabetes patients. Methods: This study analyzed 1,261 subjects ${\geq}30years$ old diagnosed with type 2 diabetes who participated in the fifth Korean National Health and Nutrition Examination Survey (2010-2012). Poor glycemic control rates were defined as hemoglobin A1c (HbA1c) level ${\geq}7%$. To shed light on the causes of poor glycemic control, socio-demographics, diabetes severity, health status, and health behavior factors were adjusted and logistic regression was done. Results: Of the total 1,261 patients, 53.0% of patients with type 2 diabetes had HbA1c ${\geq}7%$. After running a logistic regression model, the odds ratio of poor glycemic control was higher in high school graduates than elementary school graduates; in people living in Chungcheong and Jeolla/Jeju than those living in Seoul; in the group with diabetes for over 5 years had diabetes less than 5 years; in a group with insulin and oral hypoglycemic agent treatment than non-treatment; in a group with hypertriglyceridemia than without hypertriglyceridemia; and in the group with slept less than 6 hours slept 7-8 hours. Conclusion: We need a comprehensive public health policy to reduce the poor glycemic control rates in type 2 diabetes patients. We should recognize the education levels, duration of diabetes, diabetes treatment, hypertriglyceridemia, and sleep duration were associated with poor glycemic control.

• Childhood Kidney Diseases
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• v.13 no.1
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• pp.1-13
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• 2009

Type 1 diabetes mellitus commonly occurs in childhood and adolescence, although the prevalence of type 2 diabetes mellitus in these age groups is now being increased in the western world and Korea. Diabetic nephropathy developing in 15-25% of subjects with type 1 diabetes mellitus and in similar or higher percentage of type 2 diabetes mellitus patients is the leading cause of end-stage renal disease worldwide. Although prepubertal diabetic duration may contribute less to the development of microvascular complications than pubertal and postpubertal duration, diabetic nephropathy in susceptible patients almost certainly begins soon after disease onset and may accelerate during adolescence, leading to microalbuminuria or incipient DN. Type 1 diabetes is commonly associated with a period of hyperfiltration followed by the development of persistent microalbuminuria after as little as 7-10 years of type 1 diabetes. Microalbuminuria is associated with pathologic lesions that are so advanced as to overlap with those seen in patients with overt proteinuria and declining kidney function, therefore, microalbuminuria currently considered the best clinical indicator of overt diabetic nephropathy risk. This review covers the natural history and renal manifestations of diabetic nephropathy in children and adolescents.

• Journal of the Korea Convergence Society
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• v.8 no.3
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• pp.79-89
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• 2017

The purpose of this study was to identify convergence factors related to DSMK, social support, and educational needs on the diabetes in rural elderly. The subjects were 115 elderly patients who were registered in diabetes control center, taking medication more than 6 months in U city. The survey period was from August 24 to October 31, 2016. The results showed that DSMK showed significant differences in gender, education level, duration of diabetes, experience of diabetes education, experience of family participation in diabetes education, and perceived health status(p<.05). The degree of social support was found to be significant differences in marital status, diabetes education experience, diabetes education needs, gender, duration of diabetes, and perception of diabetes self-management difficulty(p<.05). There were significant positive correlations between DSMK and social support, social support and educational needs(p<.05). Based on these results, we hope to develop a convergent self - management program based on the needs of the elderly patients.

• Journal of Korean Academy of Fundamentals of Nursing
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• v.18 no.2
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• pp.152-159
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• 2011

Purpose: This study was done to identify factors related to glycemic control in men with diabetes. Methods: Data from the Korean National Health and Nutrition Examination Survey 2007 2008 collected by the Korean Center for Disease Control were analyzed using chi-square test and t-test. Results: There was a difference in glycemic control according to the individual factor of economic status. Differences in glycemic control according to health related factors were as follows: fasting blood sugar, cholesterol, triglyceride, sleep duration, experience of depression and suicidal thoughts. Conclusion: The results of this study will contribute to improvements in management for men with diabetes through comprehensive identification of factors related to glycemic control.

• Preventive Nutrition and Food Science
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• v.12 no.3
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• pp.154-159
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• 2007

This study was conducted to find obesity, biochemical indices and nutrient intakes in type Ⅱ diabetes mellitus with hypertension in Gwangju area. Subjects were divided into two groups based on the status of hypertension. Duration of 139 normotensive type Ⅱ diabetes mellitus was $49.8{\pm}80.2$ months while that of hypertensive type Ⅱ diabetes was $79.7{\pm}95.5$ months. Anthropometric measurement revealed that subjects in both groups were in overweight determined by BMI, though there was no significant difference between two groups. Contrastingly, obesity rate and subscapular fat distribution were a good predictor to identify hypertensive group due to the significant differences between two groups, regardless of sex. Hypertensive type Ⅱ diabetes mellitus is significantly associated with more elevated cholesterol and fasting blood glucose level. Triglyceride level in the hypertensive female was prominent. Significant gender differences were shown in energy, carbohydrate, protein, Ca, Zn, vitamin $B_{6}$ and cholesterol intakes. Nutrient intakes of female normotensive group were higher than those of female hypertensive group except for riboflavin. However, different pattern on nutrient intakes in male was noted. Thus, sex is a great determinant to influence nutrient intakes in subject. Effective nutrition education program targeting type Ⅱ diabetes mellitus, especially hypertensive type Ⅱ diabetes mellitus should be developed and implemented to control blood glucose and lipidemia. It might be suggested to consider the importance different approaches of nutrition education program to both genders.

• Journal of Obesity & Metabolic Syndrome
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• v.27 no.4
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• pp.213-222
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• 2018

Bariatric surgery has evolved from a surgical measure for treating morbid obesity to an epochal remedy for treating metabolic syndrome as a whole, which is represented by type 2 diabetes mellitus. Numerous clinical trials have advocated bariatric or metabolic surgery over nonsurgical interventions because of markedly superior metabolic outcomes in morbidly obese patients who satisfy traditional criteria for bariatric surgery (body mass index [BMI] >$35kg/m^2$) and in less obese or simply overweight patients. Nevertheless, not all diabetes patients achieve the most desirable outcomes; i.e., diabetes remission after metabolic surgery. Thus, candidates for metabolic surgery should be carefully selected based on comprehensive preoperative assessments of the risk-benefit ratio. Predictors for diabetes remission after metabolic surgery may be classified into two groups based on mechanism of action. The first is indices for preserved pancreatic beta-cell function, including younger age, shorter duration of diabetes, and higher C-peptide level. The second is the potential for an insulin resistance reduction, including higher baseline BMI and visceral fat area. Several prediction models for diabetes remission have been suggested by merging these two to guide the joint decision-making process between clinicians and patients. Three such models, DiaRem, ABCD, and individualized metabolic surgery scores, provide an intuitive scoring system and have been validated in an independent external cohort and can be utilized in routine clinical practice. These prediction models need further validation in various ethnicities to ensure universal applicability.

• Journal of the Korean Society of Food Science and Nutrition
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• v.27 no.1
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• pp.149-156
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• 1998

The purpose of this study was to investigate the effects of vitamin E supplementation on the activities of antioxidative enzymes in liver of KK mice of various ages and various duration of diabetes. Diabetes was induced by feeding high fat diet containing 20% corn oil(wt/wt). Weaned KK mice were fed high fat diet containing 51 IU or 2080 IU vitamin E per kg diet. Animals were sacrificed at 4, 6, and 9 months of age. In nondiabetic group, we found the decrease of antionxidative enzyme activities with aging. In diabetic group, antioxidative enzyme activities were decreased, and the change of hepatic vitamin E was related to glutathione peroxidase activity (r=0.71, p<0.001). Treatment with vitamin E did not modify the level of fasting blood glucose. However, it was observered that glutathione reductase and glutathione peroxidase activities as well as hepatic glutathione levels were increased by vitamie E supplementation, whereas catalase activity did not changed. The present result suggest that high vitamin E supplementation protects against lipid peroxidative damage in diabetic KK mice.

• Childhood Kidney Diseases
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• v.13 no.2
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• pp.242-247
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• 2009

Type 1 diabetes mellitus (T1DM) commonly occurs in childhood and adolescence and diabetic nephropathy is a serious metabolic complication of T1DM that leads to serious morbidity. With poor glycemic control prepubertal diabetes duration contributes to the risk of long-term microvascular complications, however, the younger age at onset or longer prepubertal diabetes duration seems to prolong the time to development of microalbuminuria or later end-stage renal disease (ESRD). Therefore, there have been a few cases of diabetic nephropathy in prepubertal patients and therefore the ESRD cases developed during adolescence in T1DM children were very rare. Here we report an adolescent with T1DM who had poor glycemic control and was diagnosed as diabetic nephropathy in a prepubertal period and leading to end-stage renal disease during adolescence.

• Annals of Clinical Neurophysiology
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• v.16 no.1
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• pp.8-14
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• 2014

Background: Early detection of neuropathy may prevent further progression of this complication in the diabetic patients. The purpose of this study was to evaluate the prevalence of early neuropathic complication in patients with newly diagnosed type 1 and type 2 diabetes. Methods: Nerve conduction studies (median, ulnar, posterior tibial, peroneal, and sural nerves) were performed for 49 type 1 (27 males, mean $14.1{\pm}7.5$ years) and 40 type 2 (27 males, $42.0{\pm}14.1$ years) diabetic patients at onset of diabetes. Children with age at onset under 4 years and adults over 55 years were excluded to eliminate the aging effect and the influence of obstructive arteriosclerosis. Neuropathy was defined as abnormal nerve conduction findings in two or more nerves including the sural nerve. Results: Mean HbA1c level was $12.6{\pm}3.3%$ for type 1 and $10.5{\pm}2.9%$ for type 2 diabetes. The prevalence of neuropathy was 12.2% for type 1, and 35.0% for type 2 diabetes, respectively. There were significant trends in the prevalence of neuropathy with increasing age (p<0.05). The effect of the mean level of glycosylated hemoglobin on the prevalence of polyneuropathy at onset of diabetes was borderline (p=0.0532). Neither sex of the patients nor the type of diabetes affected the neurophysiologic abnormalities at the diagnosis. Conclusions: Even in a population with diabetes at the diagnosis, the prevalence of subclinical neuropathy was not low. Neuropathy has been significantly associated with increasing age indicating the possibility of longer duration of undetected diabetes among them, especially in type 2 diabetes.