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Lower serum extracellular superoxide dismutase levels are associated with polyneuropathy in recent-onset diabetes

  • Strom, Alexander;Kaul, Kirti;Bruggemann, Jutta;Ziegler, Iris;Rokitta, Ilka;Puttgen, Sonja;Szendroedi, Julia;Mussig, Karsten;Roden, Michael;Ziegler, Dan;GDS Group
    • Experimental and Molecular Medicine
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    • v.49 no.11
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    • pp.1.1-1.6
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    • 2017
  • Increased oxidative stress is implicated in the pathogenesis of experimental diabetic neuropathy, but translational evidence in recent-onset diabetes is scarce. We aimed to determine whether markers of systemic oxidative stress are associated with diabetic sensorimotor polyneuropathy (DSPN) in recent-onset diabetes. In this cross-sectional study, we measured serum concentrations of extracellular superoxide dismutase (SOD3), thiobarbituric acid reactive substances (TBARS), and reduced glutathione (GSH) in 107 type 1 and 215 type 2 diabetes patients from the German Diabetes Study baseline cohort and 37 glucose-tolerant individuals (controls). DSPN was defined by electrophysiological and clinical criteria (Toronto Consensus, 2011). SOD3 and GSH concentrations were lower in individuals with type 1 and type 2 diabetes compared with concentrations in controls (P<0.0001). In contrast, the TBARS concentration was higher in participants with type 1 diabetes and type 2 diabetes compared with levels in controls (P<0.0001). In addition, the SOD3 concentration was higher in participants with type 1 diabetes compared to concentrations in those with type 2 diabetes (P<0.0001). A low SOD3 concentration was associated with DSPN in individuals with type 1 diabetes (${\beta}=-0.306$, P = 0.002), type 2 diabetes (${\beta}=-0.164$, P = 0.017), and in both groups combined (${\beta}=-0.206$, P = 0.0003). Lower SOD3 concentrations were associated with decreased motor nerve conduction velocity (NCV) in men and, to a lesser degree, with reduced sensory NCV in women with diabetes. In conclusion, several biomarkers of oxidative stress are altered in recent-onset diabetes, with only a lower SOD3 concentration being linked to the presence of DSPN, suggesting a role for reduced extracellular antioxidative defense against superoxide in the early development of DSPN.

The Influence of Health Literacy and Diabetes Knowledge on Diabetes Self-care Activities in Korean Low-income Elders with Diabetes

  • Jeong, Jihye;Park, Namhee;Shin, So Young
    • Journal of Korean Academy of Community Health Nursing
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    • v.25 no.3
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    • pp.217-224
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    • 2014
  • Purpose: This study aimed to assess the levels of and relationships among health literacy, knowledge about diabetes, and self-care activities in the Korean low-income elderly with diabetes and to identify factors influencing the self-care activities of this vulnerable population. Methods: This study surveyed a total of 151 low-income elderly patients with diabetes registered at 16 Visiting Health Care Services in B City, Korea. Health literacy was measured with the Newest Vital Sign. Diabetes knowledge was measured with the Diabetes Knowledge Test. The Summary of Diabetes Self-care Activities Questionnaire was used to assess diabetes self-care activities. A stepwise multiple regression analysis was conducted to identify significant factors influencing diabetes self-care activities in these patients. Results: In the regression model, diabetes knowledge (${\beta}=.322$, p<.001), exercise (${\beta}=.337$, p<.001), and experiences of diabetes education (${\beta}=.241$, p=.001) were significantly associated with increased diabetes self-care activities in low-income elderly patients with diabetes when gender, education, health literacy, and subjective health state were controlled. Conclusion: To improve diabetes self-care activities in the low-income elderly with diabetes, it is important to develop a customized program considering their knowledge, exercise, and diabetes education experience.

Childhood diabetes in India

  • Kalra, Sanjay;Dhingra, Mudita
    • Annals of Pediatric Endocrinology and Metabolism
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    • v.23 no.3
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    • pp.126-130
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    • 2018
  • This review describes the epidemiology of childhood diabetes in India. It focuses on the incidence and prevalence of type 1 diabetes and its complications and comorbid conditions. The review also covers data related to type 2 diabetes, glucose intolerance, and monogenic diabetes from India. A brief discussion regarding unique contributions from India to the world literature is included. The topics discussed include use of camel milk as adjuvant therapy in type 1 diabetes, relevance of the A1/A2 hypothesis, and comprehensive clinico-etiopathological classification of type 1 diabetes.

Diabetes and depression

  • Jeon, Eon-Ju
    • Yeungnam University Journal of Medicine
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    • v.35 no.1
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    • pp.27-35
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    • 2018
  • Diabetes and depression are serious chronic conditions. As a result of their increasing prevalence, diabetes and depression, together with population growth and aging, are public health issues. The rate of depression in adults with either type 1 diabetes or type 2 diabetes is high relative to the general population. The coexistence of diabetes and depression has attracted much interest. Although it is unclear whether diabetes and depression are causally linked, most studies have shown that the association between diabetes and depression might be bidirectional. Currently, emotional well-being is becoming an increasingly important aspect of diabetes care and self-management. Psychiatric disorders and diabetic distress among people with diabetes may increase the risk of diabetes complication and mortality. Thus, assessment and appropriate management of depression in people with diabetes should be considered to achieve psychological well-being and optimize medical outcomes.

Factors Related to Self Management in Middle Aged and Elderly with Diabetes Mellitus (중년기와 노년기 당뇨병 환자의 자가관리 관련요인)

  • Moon, Mi-Young;Kim, Myung-Ae
    • 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.

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Prevalences and Management of Diabetes and Pre-diabetes among Korean Teenagers and Young Adults: Results from the Korea National Health and Nutrition Examination Survey 2005-2014

  • Cho, Eun-Hee;Shin, Dayeon;Cho, Keun-Hyok;Hur, Junguk
    • Journal of Korean Medical Science
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    • v.32 no.12
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    • pp.1984-1990
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    • 2017
  • The rapid increases in childhood obesity and physical inactivity are linked to the incidence of diabetes among young individuals. However, few studies have evaluated the prevalence of diabetes among this population. Therefore, we used Korea National Health and Nutrition Examination Survey (KNHANES) data to evaluate the prevalence and management of diabetes and pre-diabetes among young Koreans. We evaluated KNHANES data (2005-2014) from 10-29-year-old individuals. Individuals were considered eligible if they had completed the health examination and the health interview survey, and we excluded individuals with missing data regarding fasting glucose or glycated haemoglobin levels. Among the 100,101 potentially eligible individuals who participated in KNHANES (2005-2014), we included 83,577 (37,677 male and 45,900 female) individuals. The overall prevalences of diabetes and pre-diabetes among 10-19-year-old individuals were 0.2% and 11.9%, respectively. Among 20-29-year-old individuals, the prevalences of diabetes and pre-diabetes were 0.9% and 9.6%, respectively. The overall rates of diabetes awareness during the study period were 36.6% for 10-19-year-old individuals and 50.8% for 20-29-year-old individuals. However, the prevalence of diabetes and pre-diabetes had noticeably increased at the 2013-2014 KNHANES: 0.6% and 25.9% among 10-19-year-old individuals, and 0.8% and 19.2% among 20-29-year-old individuals. The prevalence of diabetes and pre-diabetes is rapidly increasing among Korean teenagers and young adults. Pre-emptive interventions to diagnose and treat diabetes and pre-diabetes are needed to improve glycaemic control among this population.

The Relation between Glucose Control, Self-care and Depression in Community Dwelling Older Adults with Diabetes (지역사회 당뇨노인의 혈당조절, 자기관리 정도와 우울)

  • Kim, Se An;Song, Misoon
    • Perspectives in Nursing Science
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    • v.9 no.2
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    • pp.94-101
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    • 2012
  • Purpose: The purpose of this study was to examine the relationship between glucose control, diabetes self-care and depression in community dwelling older adults with type 2 diabetes mellitus. Methods: The cross-sectional survey data of 148 older adults at a senior center were analyzed in this study. We collected data on diabetes self-care, depression, and demographics by face-to-face interviews. Blood samples for HbA1C were obtained from the participants. Results: The average duration of diabetes for the participants was $10.6{\pm}9.31$ years. Fifty percent of the participants had HbA1c higher than 7.0% (mean 7.179%). The level of diabetes self-care was related to depression (r=-.225, p<.01). HbA1c was positively related with the duration of diabetes diagnosis (r=.224, p<.01). The only sub-dimension of diabetes self-care that was related to depression was exercise (r=-.307, p<.01). Conclusion: Only half of the community dwelling older adults with type 2 diabetes had an optimal level of diabetes control. Supported by the evidence, the longer the duration of diabetes since the initial diagnosis, the poorer the glucose control was. Identification and intervention for depression in people with diabetes should be considered to improve diabetes self-care, especially to perform more exercise.

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Need for Diabetes Prevention Study (당뇨병 예방연구의 필요성)

  • Jeon, Ja Young;Kim, Dae Jung
    • The Journal of Korean Diabetes
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    • v.16 no.3
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    • pp.161-167
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    • 2015
  • In Korea, diabetes mellitus, which causes micro and macrovascular complications, has been rapidly increasing during recent decades and has become a leading cause of disability-adjusted life years. The prevalence of diabetes mellitus was 12.4% in 2011 and that of prediabetes, a condition of high risk for developing diabetes mellitus, is 1.5- to 3-fold greater than that of diabetes. The diabetes prevention programs in other countries were shown to reduce or delay progression from prediabetes to diabetes mellitus. However, these results are not applicable to Korean people because of genetic and environmental differences. Therefore, we need to plan and perform a diabetes prevention study in Korean. Based on these results, we should design intervention tools for a Korean diabetes prevention program. We can consider several preventive interventions with lifestyle modification suitable for Korean people and pharmacologic treatments such as metformin or alpha-glucosidase inhibitor.

Thirst for Information and Needs Reflections of Type 2 Diabetes Patients Receiving Insulin Treatment in North-East Ethiopia: A Qualitative Exploration

  • Bayked, Ewunetie Mekashaw;Workneh, Birhanu Demeke;Kahissay, Mesfin Haile
    • Journal of Preventive Medicine and Public Health
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    • v.54 no.2
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    • pp.119-128
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    • 2021
  • Objectives: Ongoing, proactive, planned, and patient-centered diabetes education is the cornerstone of care for all persons with diabetes. Thus, the aim of this study was to explore the information needs of type 2 diabetes mellitus patients receiving insulin treatment in North-East Ethiopia. Methods: The study was conducted from July 2019 to January 2020 using a qualitative enquiry (phenomenological approach) with purposive sampling. Face-to-face in-depth interviews were used to collect data until reaching theoretical saturation. The participants were type 2 diabetes patients receiving insulin treatment. They were identified from the diabetes patients' registration book at the diabetes clinic and interviewed at their appointment time, and were selected to include wide variations in terms of socio-demographic characteristics. Twenty-four participants (11 men and 13 women), with a median age of 57 years, were interviewed. The data were organized using QDA Miner Lite version 2.0.7 and analyzed thematically using narrative strategies. Results: Most participants had not heard of diabetes before their diagnosis. They had limited knowledge of diabetes, but ascribed different connotations for it in the local language (Amharic). The needs reflections of patients were categorized into diabetes education and participants' recommendations. Diabetes education was totally absent at hospitals, and patients received education primarily from the Ethiopian Diabetes Association and broadcast and digital media. Thus, the major concern of patients was the availability of diabetes education programs at health institutions. Conclusions: Patients' main concern was the absence of routine diabetes education, which necessitates urgent action to implement diabetes education programs, especially at health institutions.

A Survey on Knowledge of Diabetes and Self-care Behavior of Rural Patients with Diabetes Mellitus (농촌지역 당뇨병 환자의 당뇨지식 및 자가관리에 대한 연구)

  • Lee, Hye-Ran
    • 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.