• Preventive Nutrition and Food Science
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• 제12권3호
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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.

• Diabetes and Metabolism Journal
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• 제42권6호
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• pp.496-512
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• 2018

Background: This study aimed to investigate the association between the presence and severity of cardiovascular autonomic neuropathy (CAN) and development of long-term glucose fluctuation in subjects with type 2 diabetes mellitus. Methods: In this retrospective cohort study, subjects with type 2 diabetes mellitus who received cardiovascular autonomic reflex tests (CARTs) at baseline and at least 4-year of follow-up with ${\geq}6$ measures of glycosylated hemoglobin (HbA1c) were included. The severity of CAN was categorized as normal, early, or severe CAN according to the CARTs score. HbA1c variability was measured as the standard deviation (SD), coefficient of variation, and adjusted SD of serial HbA1c measurements. Results: A total of 681 subjects were analyzed (294 normal, 318 early, and 69 severe CAN). The HbA1c variability index values showed a positive relationship with the severity of CAN. Multivariable logistic regression analysis showed that CAN was significantly associated with the risk of developing higher HbA1c variability (SD) after adjusting for age, sex, body mass index, diabetes duration, mean HbA1c, heart rate, glomerular filtration rate, diabetic retinopathy, coronary artery disease, insulin use, and anti-hypertensive medication (early CAN: odds ratio [OR], 1.65; 95% confidence interval [CI], 1.12 to 2.43) (severe CAN: OR, 2.86; 95% CI, 1.47 to 5.56). This association was more prominent in subjects who had a longer duration of diabetes (>10 years) and lower mean HbA1c (<7%). Conclusion: CAN is an independent risk factor for future higher HbA1c variability in subjects with type 2 diabetes mellitus. Tailored therapy for stabilizing glucose fluctuation should be emphasized in subjects with CAN.

• 가정∙방문간호학회지
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• 제22권2호
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• pp.206-215
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• 2015

Purpose: This study aimed to provide basic data to enhance self-nursing ability by investigating the symptoms of autonomic neuropathy and self-management activities in patients with diabetes accompanying hypertension. Methods: Subjects were 113 type-2 diabetic patients who were diagnosed as hypertensive in two primary medical institutions and taking anti-hypertensive treatments. The existence of postural hypotension was evaluated by blood pressure and pulse rate, and the subjective symptoms of autonomic neuropathy and self-management activities were checked by structured questionnaires. The collected data were analyzed by chi-square test, Fisher's exact test, t-test, Wilcoxon rank sum test and analysis of covariance. Results: Postural hypotension occurred in 4.4% of the subjects. Urinary frequency and dizziness during postural changes were the most frequent symptoms of autonomic neuropathy, and 57.5% of the subjects complained of symptoms in two or more domains. The group with autonomic neuropathy symptoms showed higher age, higher living stress, and fewer self-management activities in the diet and foot management domains as compared to the group without autonomic neuropathy symptoms. Conclusion: From these results, we learned that strengthening education on self-management for diet and foot management and customized interventions considering age and living stress are required through early identification of the symptoms of autonomic neuropathy in patients with diabetes accompanying hypertension.

• Osong Public Health and Research Perspectives
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• 제9권6호
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• pp.289-298
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• 2018

Objectives: To describe the distribution of social factors, lifestyle habits and anthropometric measurements according to hypertension and Type-2 diabetes. Methods: A cross-sectional study was conducted in Gaza City, Palestine that included 379 patients (20-60 years) who had hypertension and/or diabetes. Three groups of patients were involved; 106 hypertensive (HT), 109 diabetic (T2DM) and 164 hypertensive diabetics (HT + T2DM). Results: The HT + T2DM group were older and had a higher body mass index compared to HT and T2DM groups. There were 62.3% patients who were female, 49.2% were highly educated HT patients, and 49.3% patients had a low level of education and were HT + T2DM. There were 55.8% patients who lived in large families. Patients who were passive smokers or never smoked before were mostly HT + T2DM, while active smokers and past smokers had T2DM. There were 48.2% patients who were highly physically active who had HT, 40.9% whom were moderately active had T2DM, and 53.8% of patients who had a low level of activity were HT + T2DM. Multivariate linear regression showed that having a diseased mother, living in a large family, being a past or passive smoker, or never having smoked, having a low or moderate level of activity, and having HT or HT + T2DM, were significantly associated with an increased body mass index. Conclusion: Parental health/disease conditions and environmental factors (social network and lifestyle habits) played the greatest role in the development of obesity and disease.

• Clinical and Experimental Pediatrics
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• 제52권2호
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• pp.220-226
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• 2009

목 적 : 대혈관 합병증은 1형 당뇨병에서 주된 사망 원인으로 합병증을 예방하고 조기에 발견하는 것은 중요하므로, 저자들은 소아-청소년기에 1형 당뇨병으로 진단된 젊은 성인에서 대혈관 합병증의 발생 여부를 알아보고자 혈관초음파 검사를 통해 동맥경화의 초기 변화를 측정하였고, 이 변화와 관련된 위험인자를 분석하기 위해 본 연구를 시행하였다. 방 법 : 서울대학교병원에서 18세 이전에 1형 당뇨병으로 진단받고 추적 관찰 중인 20대의 72명의 환자들과 건강한 20명의 대조군을 대상으로 하였다. 환자들에서 고혈압과 고지혈증의 빈도 및 관련 인자를 알아보았으며, 환자군과 대조군 간에 혈관 초음파 검사를 통해 측정한 FMD, mean IMT를 비교하였고, 위험인자와의 상관성을 분석하였다. 결 과 : 72명의 대상 환자 중 32명(44.4%)에서 고혈압이 있었고, 고혈압군은 정상 혈압군 보다 남자의 빈도(P=0.03)와 평균 체질량지수(P=0.04)가 더 높았다. LDLc이 100 mg/dL 이상으로 측정된 환자는 31명(N=69, 44.9%)이었고, 전체 환자군의 LDLc은 평균 당화혈색소(r=0.32, P=0.008), 하루 총 인슐린 사용량(r=0.27, P=0.02)과 양의 상관관계를 보였다. Mean IMT는 환자군이 대조군 보다 유의하게 더 두꺼웠고($0.43{\pm}0.06$ mm vs $0.39{\pm}0.06$ mm, P=0.03), FMD는 두 군 사이의 통계적 유의성은 없었으나, 환자군 내에서 사춘기발현 이후의 유병기간이 길수록 FMD는 감소하는 경향을 보였다(r=-0.34, P=0.01). 결 론 : 20대의 1형 당뇨병 환자에서도 동맥경화가 진행되고 있으므로 대혈관 합병증의 위험인자에 대한 선별검사 및 이의 조절이 필요하며, 1형 당뇨병이 있는 젊은 성인뿐만 아니라 청소년기의 환자에서도 대혈관 합병증의 위험인자에 대한 주기적인 평가가 필요할 것으로 생각된다.