• 제목/요약/키워드: type 1 diabetes mellitus

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소아연령에서의 2형 당뇨병의 임상적 고찰 (Type 2 Diabetes Mellitus in Children)

  • 박지민;유은경;김덕희
    • Clinical and Experimental Pediatrics
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    • 제45권5호
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    • pp.646-653
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    • 2002
  • 목 적 : 최근에 비만증의 증가와 함께 소아에서 2형 당뇨병의 발생 빈도가 증가하는 경향이 있어 우리나라 소아 연령에서 2형 당뇨병의 발생빈도 및 그 특성을 규명하고자 본 연구를 시행하였으며 자궁내 성장지연과의 관계도 분석하였다. 방 법 : 1990년 3월에서 2000년 12월까지 연세의료원 소아과에서 2형 당뇨병으로 진단받은 소아 25명을 대상으로 분석하였다. 결 과 : 소아에서 1형 당뇨병과 2형 당뇨병은 1990년 이후에 모두 증가하였으며 소아에서 발병한 당뇨병 중 2형이 차지하는 비율은 연도별로 볼 때 1990년에 5.3%(1/19)였던 것이 2000년에 21.0%(8/38)로 급격히 증가하였다. 총 25명 중 비만군이 68%(17/25)였고 비비만군이 32%(8/25)였다. 진단 당시의 주증상은 다음, 다뇨, 다식 증상이 48%(12/25), 학교 신체 검사에서 무증상 당뇨로 발견된 경우가 40%(10/25)였고 그외 체중 감소, 비만으로 우연히 발견된 경우였다. 진단당시 평균 연령은 $12.9{\pm}1.8$세였다. 25명 중 64%(16/25)에서 당뇨병의 가족력이 있었다. 자가항체 검사는 18.1%(4/22)에서 양성이었다. 총 7례에서 동반 질환이 있었으며 비만과 관련하여 지방간 등이 있었다. 치료는 모두 진단 후 경구용 혈당 강하제를 사용하였고 혈당 조절이 잘 되지 않았던 3명에서 인슐린을 추가하였다. 장기 합병증은 4명에서 발생하였다. 자궁내 성장지연은 9명에서 있었고 이들 중 8명은 비 비만군 당뇨병이었다. 결 론 : 최근 비만증과 관련되어 소아에서 2형 당뇨병이 증가하는 추세이고 비비만군 당뇨병 환아에서는 자궁내 성장 지연이 상관관계가 있으리라고 생각되며 소아에서 2형 당뇨병은 국가적인 차원에서 예방 및 치료책이 제시되어야 할 것이다.

비조절성 제2형 당뇨 환자의 치아 탈구 손상에 따른 치수 괴사: 증례 보고 (Pulp necrosis following luxated injury to teeth in a patient with uncontrolled type II diabetes mellitus: a case report)

  • 신한얼;이승종;정일영;이찬영
    • Restorative Dentistry and Endodontics
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    • 제37권1호
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    • pp.61-65
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    • 2012
  • Patients with diabetes mellitus show delayed wound healing and increased susceptibility to infection. Therefore, the effects of diabetes on pulpal and periodontal healing should be taken into consideration when treating diabetic dental traumatized patients. This case presents the treatment for dental traumatized 20 yr old female with uncontrolled type II diabetes. The traumatized upper central incisors had showed pulpal healing in early days. However, 7 mon after the trauma, the teeth had been diagnosed with pulp necrosis with apical abscess. Eventually, non surgical root canal treatment on the teeth had been performed.

제2형 당뇨병 환자에게 인크레틴 기반 약물치료요법 (Incretin-based Treatment for Type 2 Diabetes Mellitus)

  • 김현아;김헌성
    • 한국임상약학회지
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    • 제21권2호
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    • pp.57-65
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    • 2011
  • Incretin hormones such as glucagon-like peptide-1 (GLP-1) and glucose-dependent insulinotropic polypeptide delay gastric emptying, increasing satiety, and enhance insulin secretion. Two new classes of treatments related to incretin hormones for the management of type 2 diabetes mellitus have emerged: GLP-1 receptor agonists (e.g., exenatide, liraglutide) and the dipeptidyl peptidase-4 (DPP-4) inhibitors (e.g., sitagliptin, saxagliptin, vildagliptin, alogliptin), which prevent the degradation of GLP-1. A MEDLINE search was conducted in order to evaluate the efficacy and safety of incretin-based therapies and publications were reviewed. Data from clinical trials indicated incretin-based treatment showed clinically significant reductions in hemoglobin A1c with low risk of hypoglycemia. Weight reductions were observed with GLP-1 receptor agonists where as DPP-4 inhibitors are weight neutral.

The Effect of a Balance Training Program to Improve the Balance of Aged Patients with Diabetes Mellitus

  • Lee, Yong-Woo;Choi, Se-Jong;Song, Chang-Ho
    • The Journal of Korean Physical Therapy
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    • 제22권3호
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    • pp.23-30
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    • 2010
  • Purpose: The purpose of this study was to determine whether a balance training program could improve the balancing ability of elderly patients with type II diabetes mellitus. If yes, the results could lead to development of a method to prevent falls in elderly patients with type II diabetes mellitus (DM). Methods: Subjects were 28 elderly patients with type II DM. Subjects were divided into a control and an experimental group with 14 patients in each group. The experimental group had a balance training program consisting of balance training and lower extremity muscle strengthening exercises. The exercise group met twice a week for 8 weeks. All subjects were evaluated using a force plate for the amount of postural sway. To determine the degree of diabetes, we measured Hemoglobin A1c. Results: Balance in the experimental group (p<0.05) increased significantly compared to the control group. Conclusion: The results suggest that a balance training program should be recommended for improving balance and preventing falls in elderly type II DM patients.

제 2형 당뇨환자의 우울, 자가간호 이행과 당화혈색소와의 관계 (The Relationship between Depression, Self-Care Activity and $HbA_1c$ in Clients with Type-2 Diabetes Mellitus)

  • 김선향;강희선
    • 기본간호학회지
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    • 제15권2호
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    • pp.178-185
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    • 2008
  • Purpose: This study was done to investigate the relationship between depression, self-care activity and $HbA_1c$ in clients with type-2 diabetes mellitus (DM) clients. Method: This was a cross sectional descriptive study and data were collected between October 4 and 27, 2006 using a questionnaire. The participants were inpatients and outpatients with type-2 diabetes being seen in one of two hospitals. The questionnaire included general as well as disease related characteristics, a depression scale (CES-D), and the self-care activity scale developed by Kim (1996). $HbA_1c$ was obtained from medical records. Results: There were 50 men (41.7%) and 70 women (58.3%). The mean scores for depression and self-care activity were $18.22{\pm}10.03$ and 3.51, respectively. Almost half of the Participants (46.7%) had an $HbA_1c$ greater than 7%. Self-care activity was negatively correlated with depression (r=-.436, p=0.00) and $HbA_1c$ (r=-.269, p=0.03). Depression was positively correlated with $HbA_1c$ (r=-.325, p=0.00). Participants who had diabetes education showed a significantly lower level of $HbA_1c$ than the group who had never had diabetes education. Conclusions: It is Important to make ensure that patients with diabetes have education on diabetes mellitus and to screen and manage depression as part of the care for these patients.

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새로 진단된 제1형 및 제2형 당뇨병 환자에서 말초신경이상 (Peripheral Nerve Abnormalities in Patients with Newly Diagnosed Type I and II Diabetes Mellitus)

  • 이상수;한헌석;김헌
    • Annals of Clinical Neurophysiology
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    • 제16권1호
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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.

임신성 당뇨 과거력을 가진 여성의 2형 당뇨진단 양상과 관련요인 (Patterns of Diagnosis and Risk Factors for Type 2 Diabetes in Women with a History of Gestational Diabetes Mellitus)

  • 최미진;정재원
    • Perspectives in Nursing Science
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    • 제13권1호
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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.

인지행동기반 스트레스관리 프로그램이 제2형 당뇨병 환자의 스트레스, 대처 및 스트레스 반응에 미치는 효과 (Effects of a Cognitive Behavioral Stress Management Program on Perceived Stress, Coping Strategies, and Stress Response in People with Diabetes Mellitus Type 2)

  • 박형숙;박경연
    • 기본간호학회지
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    • 제15권3호
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    • pp.291-300
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    • 2008
  • Purpose: The purpose of this study was to identify the effects of a cognitive behavioral stress management program on perceived stress, coping strategies, and cortisol in people with Diabetes Mellitus Type 2. Method: Patients with type 2 diabetes were recruited from of a public health center in an urban area. Thirty-five participants (experimental group=17, and control group=18) enrolled. The experimental group received small group-based cognitive behavioral stress management training for eighty minutes per session, once a week for eight weeks. Data were collected at baseline and ninth week for perceived stress, affect-oriented coping, problem-oriented coping, and cortisol. The data were analyzed using SPSS 12.0. Results: The experimental group had significantly less perceived stress (t=-9.82, P<.001) and cortisol (t=-2.14, p=.040) than the control group. No significant group differences were found in affect-oriented coping (t=-.43, p=.673) or problem-oriented coping (t=1.40, P<.170). Conclusion: These results suggest that a cognitive behavioral stress management program can have positive effects on perceived stress and cortisol in patients with diabetes mellitus type 2. Further research with a larger sample and for a longer period is needed to expand our understanding of the effects of the program for patients with diabetes mellitus type 2.

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Cardiovascular Autonomic Neuropathy Predicts Higher HbA1c Variability in Subjects with Type 2 Diabetes Mellitus

  • Yang, Yeoree;Lee, Eun-Young;Cho, Jae-Hyoung;Park, Yong-Moon;Ko, Seung-Hyun;Yoon, Kun-Ho;Kang, Moo-Il;Cha, Bong-Yun;Lee, Seung-Hwan
    • 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.

혈당 조절이 되지 않는 1형 당뇨병 환자에 대한 한방 치험 1례 (Case Report of Type-1 Diabetes Mellitus with Uncontrolled Blood Sugar Improved by Complex Korean Medicine Treatment)

  • 김수덕;서민조;심현아;정우진;조혜리;공건식;최요섭
    • 대한한방내과학회지
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    • 제44권2호
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    • pp.269-276
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    • 2023
  • Objective: This study reported the effectiveness of Korean medicine for a patient with Type-1 diabetes mellitus after pancreatectomy with a compression fracture of the thoracic spine. Methods: A patient diagnosed with Type-1 diabetes mellitus after a pancreatectomy was treated with acupuncture, pharmacopuncture, Gami-hwanggigyejiomul-tang (modified Huangqi Guizhi Wuwu decotion), Jindang-won, etc. The conventional treatment was maintained using an insulin pump and insulin injection. Results: Blood glucose (FBS/PP2hrs), ESR and CRP decreased after one month of treatment. Conclusion: Gami-hwanggigyejiomul-tang and Jindang-won may be effective treatments for Type-1 diabetes mellitus. Further studies are needed to confirm the findings of this case.