Journal of the Korean Society of Food Science and Nutrition (한국식품영양과학회지)

The Korean Society of Food Science and Nutrition (한국식품영양과학회)
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Effects of Web-Based Nutrition Counseling on Nutrient Intake and Blood Glucose in Type II Diabetic Patients

제 2형 당뇨병 환자의 영양섭취 및 혈당에 웹기반 영양상담이 미치는 영향

  • Park, Sun-Young (Dept. of Food Science and Nutrition, Pusan National University) ;
  • Han, Ji-Sook (Dept. of Food Science and Nutrition, Pusan National University)
  • 박선영 (부산대학교 식품영양학과) ;
  • 한지숙 (부산대학교 식품영양학과)
  • Published : 2005.11.01
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Abstract

The purpose of this study was to investigate effects of web-based nutrition counseling on nutrient intake and blood glucose in type ll diabetic Patients. Forty type II diabetic patients, twenty one of them were diabetic patients without complication (Ncx-DM) and nineteen of them were diabetic patients with complication (Cx-DM), participated in a web-based nutrition counseling program. At the first nutrition counseling, the patients were counselled through interview and then follow up nutrition counseling was accomplished four times during eight weeks through tile web-based internet program. Various markers of disease risk including anthropometric indices, nutrient intake and blood glucose were measured before and after the nutrition counseling. After the nutrition counseling, body mass index and waist circumference decreased in both group but did not change significantly. Fasting blood glucose significantly decreased from 153.9 mg/dL to 139.0 mg/dL (p<0.05) in NCX-DM and from 178.2 mg/dL to 128.5 mg/dL (p<0.01) in Cx-DM after the nutrition counseling. Glycosylated hemoglobin level decreased from $9.3\%$ to $8,7\%$ in Ncx-DM and significantly decreased from $9.7\%$ to $7.8\%$ (p<0.01) in Cx-DM after the nutrition counseling. In addition, total cholesterol and LDL-cholesterol level significantly decreased in both group (P<0,05) after the nutrition counseling. Energy intake decreased significantly in Ncx-DM (P<0.05) and Cx-DM (p<0.01). Although the nutrient intake did not change significantly, the nutrient intake was improved after the nutrition counseling. Therefore, this study shows that the web-based nutrition counseling is effective in improving energy and nutrient intake and influences positively in blood glucose and serum lipids of the patients. In addition, these results indicate that the internet presents us with potential as a new medium for nutrition counseling in informationized society.

웹기반 영양상담 프로그램은 당뇨병 환자를 위한 영양상담 프로그램에 환자들의 추후관리를 위해 추후관리 프로그램을 개발하여 삽입하였다. 개발된 추후관리 프로그램은 혈당수첩, 식품섭취빈도 조사, 식습관 평가 및 대화방으로 구성되었다. 8주간의 인터넷을 이용한 영양상담 후 체질량지수는 비합병증군과 합병증군 모두에서 약간은 감소하였으나 유의한 차이가 없었다. 허리/엉덩이 둘레비 역시 두 군 모두에서 조금씩 감소하였으나 유의한 차이가 없었다. 영양상담 후 공복혈당은 비합병증군(p<0.05)과 합병증군(p<0.01) 모두에서 유의하게 감소하였고, 당화혈색소는 비합병증군에서는 감소하였으나 유의한 차이가 없는데 반하여 합병증군(p<0.01)에서는 유의하게 감소하였다. 혈청 지질은 비 합병증군에서는 총콜레스테롤과 LDL-콜레스테롤은 영양상담후 감소하여 유의(p<0.05)한 차이를 보인 반면에 HDL-콜레스테롤은 약간 증가하고, 중성지방은 감소하였으나 유의한 변화는 없었다. 합병증군에서는 총콜레스테롤, LDL-콜레스테롤, 중성 지방은 영양상담 후 각각 유의 (p<0.05)하게 감소하였고, HDL-콜레스테롤은 증가하였다. 영양소 섭취의 변화는 두 군 모두에서 영양상담 후 열량 섭취량이 감소하였으며, 당질 및 지방의 섭취수준은 감소한 반면에 단백질의 섭취는 증가하여 환자들의 열량영양소의 섭취비가 권장되는 비율로 변하고 있음을 알 수 있었다. 또한 1,000 kcal 당 영양소 섭취량을 비교하여 보면 비타민 $B_2$, 비타민 $B_6$, 비타민C, 엽산, 칼슘, 아연의 섭취량은 영양상담 후 오히려 높아져 영양상담 후 두 군 모두에서 환자들은 열량은 낮으면서 영양소 밀도가 높은 식품을 선택하였다. 본 연구의 결과로 웹기반을 이용한 영양상담이 당뇨병 환자의 열량 및 영양소 섭취상태를 개선하고 혈당 및 혈청지질에 긍정적인 효과를 나타냄으로서 정보화 시대에 맞는 새로운 상담매체로서의 인터넷의 가능성과 영양상담의 추후관리를 위한 대안이 제시되었다고 할 수 있다. 그러나 대상자의 연령이나 학력 등에 따라 웹기반 영양상담 프로그램에 대한 반응이 다르게 나타났기에, 이러한 개인별 차이점을 고려한 맞춤형 영양상담 프로그램의 형태로 좀 더 다양화된 상담 프로그램 이 개발될 필요성이 있었다. 또한 본 연구는 영양상담 기간이 8주간의 단기였기에 그 효과를 나타내는데 미흡한 점이 있었으므로 추후 장기간의 영양상담에 따른 추가 연구도 필요할 것 같다.

Keywords

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